Counseling Skills Training

Counseling skills training originated in 1966 and resulted in the microcounseling training approach to teaching interviewing skills and the publication in 1968 of the first monograph separate in the Journal of Counseling Psychology. Since that time the microcounseling approach to teaching single skills of counseling, interviewing, and psychotherapy has become the standard and more than 450 data-based studies have examined its efficacy. Meta-analyses have concluded that microcounseling is effective for teaching a wide variety of helping skills to a variety of populations.

Forty years of research and theorizing has demonstrated microcounseling’s merit as an educational paradigm for counselor and therapist education. Microcounseling has since evolved into a comprehensive generic framework that describes not only the training process but the skills, dimensions, and processes of therapy and effective communication in general. Microcounseling sees the training process and therapy not necessarily as separate entities, but as part of a larger whole, the goal of which is to help people lead intentional, effective, and positive lives.

Origins and Development of Skills

The identification of the first microskill of attending behavior is illustrative of the theory and practice orientation of the counseling skills approach. In 1966, video was new to the helping profession and few had ideas on how to use this new medium. Allen Ivey and Weston Morrill asked a volunteer “counselor trainee” to conduct a videotaped interview. Fortunately, the trainee was ineffective and the team review of the video revealed that the beginning counselor (1) failed to maintain eye contact, (2) moved her hands and legs nervously, (3) had a tense vocal tone, and (4) awkwardly changed topics and ended up talking about herself. The opposite of these four behaviors were named attending behavior, now a generic part of the language of the helping field. The trainee was returned to the interviewing room with feedback and then conducted a vastly improved session with another client. Furthermore, 2 days later the trainee commented joyously that she had attended to her husband and that they had enjoyed a “beautiful weekend.”

The next skill to be identified was the skill of reflection of feeling (“You feel . . . because . . .”), and other listening and influencing skills soon followed. These first identified counseling skills became the basis of social skills training. Skills training in communication is often the basis for management training, nutrition counseling, AIDS peer counseling, medical interviewing, and many other types of counseling. From 1968 to 1970 Ivey demonstrated the effectiveness of teaching hospitalized patients basic communication skills. Patients who had been in a Veteran’s Administration (VA) hospital for years were successfully trained and released to the community without further therapy.

Microcounseling instruction in each skill is followed by practice sessions with feedback and a focus on generalization of each to the “real world” of interviewing practice.

Critical to this entire process is the identification of observable, countable behavioral skills that are verifiable and that produce predictable results in client verbal and nonverbal behavior. B. F. Skinner lauded the microcounseling approach as indicative of how reinforcement patterns could affect the counseling and therapy process, while humanistically-oriented counselors decried the scientific orientation of the system.

During the next decade many contributors added skills, and by the mid-1970s a comprehensive Microskills Hierarchy of skills and dimensions was formulated. Conceptually, the Hierarchy rests on a foundation of ethics, multicultural issues, and wellness. Built on this foundation, in successive layers, are attending behavior skills, the basic listening sequence, five-stages of interviewing, and influencing skills. The Hierarchy (see Figure 1) represents the cumulative impact of years of clinical teaching experience and research.

Predicting Results From Intentional Use of Interviewing Skills

Experienced counselors who use questioning skills can reliably predict the kind of response their clients will next make. However, trainees are encouraged to intentionally flex and be prepared with a new skill when the skill they are using does not produce the expected results in the client. Two example skills are presented below that exemplify intentional prediction.

Open and Closed Questions

Open questions often begin with who, what, when, where, and why. Closed questions may start with do, is, or are. Questions beginning with could, can, or would are open, but they are somewhat closed in that they permit the client to more easily say that they don’t want to respond.

The predicted result is that clients will give more detail and talk more in response to open questions. Closed questions elicit specific information, but they also discourage extended client responses. Effective questions encourage more focused client conversations with more pertinent detail and less wandering. A danger of questions, of course, is that the counselor may take too much direction and control in the session.

Reflection of Feeling

This involves identification by the interviewer of the key emotions of a client and a restatement of them back to the client to clarify and focus attention on the client’s affective experience. With less verbal or reluctant clients and children, the brief acknowledgment of feeling may be more appropriate than detailed exploration of complex feelings, as exploration of emotions may be uncomfortable.

The predicted result is that clients will understand their emotional states more clearly and will correct the interviewer with a more accurate description of their emotional state if the counselor’s reflection is not accurate.

Stages of Interview

The microskills hierarchy proposes a five-stage organization of the interview that focuses on goals and results. The stages require that the practitioner

  1. Initiate the Session. Establish rapport and structure the session so that clients know what to expect from the counseling or therapy process.
  2. Gather Data. Define the problem and identify client strengths by drawing out stories, concerns, problems, or issues.
  3. Set Mutual Goals. Determine what the client wants to happen.
  4. Explore and Create. Generate alternatives, confront the client’s conflict and incongruities, generate alternative resolutions for conflict, and help the client create a new way of thinking, feeling, or behaving.
  5. Plan for the generalization of the learning that has occurred in the counseling interviews to “real life” and for the eventual termination of the counseling relationship.

The five stages may occur sequentially, particularly in decisional and career counseling, but different theories give varying attention to the skills. Brief counseling, for example, sets goals early and spends considerable time focusing on generalization throughout the session. By way of contrast, a traditional psychoanalytic interview spends virtually the entire session focusing on the third phase of exploration of issues and concerns and gives little attention to goal setting.

Different theoretical approaches to the interview also have vastly different patterns of skill usage. For instance, practitioners of brief counseling often focus on questions, while client-centered practitioners avoid questions as much as possible and prefer reflection of feeling, paraphrasing, and summarization.

The Multicultural Connection

In 1972, Ivey observed that Alaskan Natives had a unique pattern of eye contact and body language. Many Alaskan Natives consider direct eye contact to be rude and intrusive and, at times, consider it to be an invitation to a direct confrontation. In 1974 Ivey and Norma Gluckstern advocated the need to adopt different counseling approaches and styles with clients from different cultures.

Awareness of multicultural differences was soon expanded with awareness of the culturally unique patterns of Aboriginal Australians, African Americans, Asian Americans, Latinas and Latinos, First Nation and Native Americans, and other groups. The definition of multiculturalism was extended to include issues of gender, sexual orientation, social class, and other factors. As awareness of multicultural differences has increased over the years, the use of microskill training and theories in multicultural courses has increased to better teach students about the important individual and cultural differences that require careful attention in counseling.

Adaptations of the Microskills Model

Multiple adaptations of the original approach to microcounseling skills are now available. For example, Gerard Egan combined the listening microskills with Carkhuff’s popular model of helping. Clara Hill generated the Hill Taxonomy, a variant of the original Ivey Taxonomy of microskills, based on her extensive research coupled with her adaptation of the Egan interview structure.

The language and teaching style of the micro-counseling model has become generic to the profession. Unfortunately, the culture-centered emphasis of microcounseling has not yet been generalized to the field nor to textbooks discussing counseling skills. However, guidelines for multicultural psychology have now been approved by the American Psychological Association, and the American Counseling Association has now adopted multicultural competencies, and it can be expected that counseling skills training will eventually become more culturally sensitive.

References:

  1. Daniels, T. G., & Ivey, A. E. (2007). Microcounseling: Making skills training work in a multicultural world. Springfield, IL: Charles C Thomas.
  2. Egan, G. (2006). The skilled helper: A problem-management and opportunity-development approach to helping (8th ed.). Belmont, CA: Wadsworth.
  3. Hill, C. E. (1992). Research on therapist techniques in brief individual therapy: Implications for practitioners. The Counseling Psychologist, 20, 689-711.
  4. Ivey, A. E. (1971). Microcounseling: Innovations in interviewing training. Springfield, IL: Charles C Thomas.
  5. Ivey, A. E., & Bradford, M. B. (2007). Intentional interviewing and counseling: Facilitating client development in a multicultural world (6th ed.). Belmont, CA: Thomson/Brooks/Cole.
  6. Ivey, A. E., & Bradford, M. B. (2008). Essentials of intentional interviewing: Counseling in a multicultural world. Belmont, CA: Thomson/Brooks/Cole.
  7. Ivey, A. E., D’Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2007). Theories of counseling and therapy. Boston: Thomson/Allyn & Bacon.
  8. Ivey, A. E., & Gluckstern, N. (1974). Basic attending skills. North Amherst, MA: Microtraining Associates.
  9. Ivey, A. E., Normington, C., Miller, C., Morrill, W., & Hasse, R. (1968). Microcounseling and attending behavior: an approach to prepracticum counselor training. Journal of Counseling Psychology, 15, 1-12.

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