Chapter 35: Stress Inoculation Training

How is the technique implemented?

Stress inoculation training (SIT) is based on the principle that exposure to mild stressors will eventually build tolerance for more severe issues that a client may face.  This technique is tailored for each individual and does not necessarily entail the same thing for all clients and often times collaborates with other techniques for a comprehensive treatment.  In addition the technique takes a lot of time (8-15 sessions). SIT general follows the following three steps: 1) Conceptualization 2) Skill acquisition and rehearsal and lastly 3) Application and Follow-Through.  Essentially, this means that the client will frame the issue, reveal triggers, learn how to handle them, spend time with the counselor practicing the technique and then apply it to real life and follow up with the counselor.

What type of situation can the technique be applied to?

The wonderful thing about SIT is that it can used for almost any problem that involves a trigger.  The technique would be most beneficial for dealing with things such a drug addiction but it can also be used for relationship issues or really anything that has an identifiable stressor.

What is your opinion of the technique?

I like the SIT technique because it helps a client learn how to deal with their issue slowly rather than evoking heavy amounts of the stressor like most exposure and response techniques.  Another factor about this technique that I find to be beneficial is that, while it is a CBT approach, there are plenty of opportunities for the client to express how these stressors make them feel.

Chapter 34: Systematic Desensitization

How is the technique implemented?

Systematic desensitization is a form of exposure and response therapy that can be used to help a clients build a response to negative thoughts.  By evoking negative past cognitions, this technique sets the stage for a client to react appropriately.  Repeated exposure to a stressful event or thought gives the client a chance to develop an appropriate response while minimizing the damages of those thought since they are occurring so frequently.  The process of desensitization generally occurs in three stages.  The first stage requires that the client becomes proficient in some sort of relaxation (see aforementioned deep breathing technique).  Second, the client and counselor work together to create and anxiety hierarchy.  And lastly, provoking negative stimuli and working towards developing a positive coping mechanism.

What type of situation can the technique be applied to?

Desensitization is primarily used with trauma victims such as rape victims or soldiers coming back from war.  The technique can be used for lighter issues such as phobias as well to help minimize the fears of particular situations.

What is your opinion of the technique?

This technique when employed correctly can help eliminate many of the unpleasant traumas of PTSD and related issues.  For this, I think that this technique can be incredibly beneficial (especially for things like phobias that are generally of a lower magnitude).  That being said, I think it can be incredibly dangerous to continuously expose an individual to a traumatic or difficult occasion as it may just worsen the situation.

Chapter 32: Deep Breathing

How is the technique implemented?

Deep breathing is a technique that has proven to be very beneficial in relaxation.  Deep breathing exercises are typically conducted in five steps processes.  The counselor should have the client do the following five things:

1) Breathe through the nose and out the mouth

2) In between deep breaths, breathe normally.

3) This exercise should be done while laying on one's back unless the client is more comfortable sitting.

4) If yawning is necessary the client should do so as it puts the body at equilibrium

5) Note differences in breathing.

The purpose of this technique is for the client to use their breathing as a strategy for relaxation to escape from their issues.

What type of situation can the technique be applied to?

The main use for deep breathing is to relieve or release stress.  However, deep breathing can be used in a multitude of situations to help the individual change their cognitions.  For example, deep breathing can be used when a client begins to have negative thoughts or is placed in a position that they feel uncomfortable.  Deep breathing can also be used before a client knows they are entering a stressful situation (tests, public speaking, public performance, etc.)

What is your opinion of the technique?

I think deep breathing is a good way to minimize the stress of an individual who comes the counselor in extreme panic.  That being said, I think that deep breathing is simply a complementary skill because it does not provide any education or coping strategies for future issues.  

Chapter 31: Bibliotherapy

How is the technique implemented?

Bibliotherapy is essentially the implementation of books and readings as therapy for a student.  The intent of this practice is to educate the client on a condition so that they can understand it throughout therapy.  There are four stages to implementing this technique.  First it is important to identify the needs of the client.  Second, finding literature that is appropriate and will be beneficial to helping the client with their issue.  In addition, literature needs to be appropriate with the clients reading abilities. Next, the client reads the material.  And lastly, the client and the counselor review the literature together so that they can confirm the value and meaning of the literature as it pertains to the clients struggles.

What type of situation can the technique be applied to?

This type of therapy has a wide array of uses and can be used to help any client who is unaware of what may be causing their issues.  Bibliotherapy can either educate the client on the counseling theory they will be participating in or it could be simply education on a condition or status the client assumes (mental illnesses, LGBQTA, physical illness, etc.).

What is your opinion of the technique?

Personally I find this therapy to be beneficial as a complement to other therapy.  Using bibliotherapy allows the reader/client to gain insight or education on their situation which will help them in therapy and may even make them a more willing participant in therapy.

Chapter 29: Overcorrection

How is the technique implemented?

Overcorrection is a technique that is used to eliminate maladaptive behavior and then provide the client with education.  Just like many techniques in the behavioral realm, the first step is to identify the target behavior.  Once the behavior is witnessed the counselor should tell the client to stop.  Then the counselor should guide the client through restitution and have the client undergo positive practice for a set number of repetitions. The purpose of this is so that the student can immediately recognize the behaviors that are inappropriate and is faced with consequences that will ultimately alter their decisions in the future.  For instance if the client misbehaves, the counselor will make them correct their action and then undo it and redo it a set number of times to overcorrect the action.

What type of situation can the technique be applied to?

Overcorrection can be used most effectively to eliminate bad habits.  In addition, it can be used to help a client recognize the consequences of their actions and the effort it may take someone else to correct them.  Once the student recognizes the extra effort they are forcing someone else to make, they realize why it may be important for them to behave appropriately.

What is your opinion of the technique?

Just as many behavioral techniques I find this one to be limited in scope.  It seems like a practice that would be most effective in an elementary school setting where students may do things carelessly and this technique would prevent and educate them on why that behavior is unacceptable.

Chapter 26: Extinction

How is the technique implemented?

Extinction is a technique that relies on the punishment or removal of a reinforcement for a behavior.  This technique is generally used to provide consequences for engaging in a behavior seen as inappropriate.  The first step of extinction is to make sure that extinction is appropriate considering the behavior.  If an increase in the behavior would be intolerable, this is not an appropriate technique.  Next, identify the reinforcers of the behavior.  Third, develop a method of removing those reinforcers, if this cannot be done this technique will not work.  Lastly, it is important to identify a new target behavior.

What type of situation can the technique be applied to?

One of the biggest issues with this technique that it has a limited scope of usability.  The technique can really only be implemented in a situation where the behavior requires a response and that response is eliminated.  An example of this would be tantrum behaviors.  If you eliminate the environmental and personal responses to a tantrum, the client is less likely to engage in that behavior.

What is your opinion of the technique?

I do not like this technique.  I feel as thought it is limited in applicability and there are better ways to handle a situation.  The dangerous part of the technique is that it may initially create an increase in behavior as the client will try to receive the reinforcers it previously received by increasing the behavior.

Chapter 25: Behavioral Contract

How is the technique implemented?

Behavioral contracts provide an opportunity for two or more individuals to create a contract of what behaviors they find beneficial in an attempt to eliminate the negative behaviors.  These contracts can seek to achieve a target behavior for one or both parties involved in the contract in order to ensure that progress is being made and noticed.  The first step in implementing a contract is to identify the target behavior.  These contracts typically also include how the client will feel when they have achieved a successful performance at participating in the target behavior.

What type of situation can the technique be applied to?

This technique can be applied to a widespread group of issues but the one that stands out the most is a scenario where there are incongruent beliefs regarding a behavior between two parties.  A contract can be formed to create a target behavior that both parties feel is appropriate.  Using this technique in this manner is a terrific way of developing compromise and the expectations of one another.

What is your opinion of the technique?

I see this technique as a very good way for a counselor to help individuals involved in a relationship to see the other side of an argument and try to develop a middle ground.  Overall, the technique is something that could help a client modify their behavior so that they appease others.  On that note, there is danger in using this technique because sometimes the presentation of a contract could be seen as an ultimatum or pressure one end of the contract forcing resistance or client behavior that is forced or not genuine.

Chapter 23: Behavior Chart

How is the technique implemented?

The behavior chart is a technique that allows the client to note their behaviors throughout the day and then evaluate them to see there progress in dealing with an issue.  The chart can monitor interventions or serves as one itself.  The first step in creating a behavior chart is to define the target behaviors to reform.  Next, develop a rating system that allows the client to identify either magnitude or frequency of behavior.  Then create the chart by developing a monitoring strategy and the goals for using the chart.  Lastly, create consequences for positive or behavior behaviors.  This includes things such as small rewards or punishments for the progress or lack thereof that is being made.

What type of situation can the technique be applied to?

The best situation to use something like a behavior chart would when a dealing with strong compulsions or issues with self-control.  By creating a chart the client is responsible for giving consequences to themselves for their behaviors which serves as a great motivator.  A behavior chart however, is not limited to just this type of use.  A behavior chart can be used any time a client strives to seek change in their behaviors.

What is your opinion of the technique?

The behavior chart is a great idea for anyone and almost any behavioral situation.  It's usefulness is not limited to just certain behaviors, it can be utilized to modify any behavior.  That being said, one weakness of this technique is that it is only useful when dealing with a client who seeks behavioral reform and offers little help cognitively. 

Chapter 20: Thought Stopping

How is the technique implemented?

Thought stopping technique is a classic example of cognitive-behavioral therapy.  The counselor helps the client to develop mechanisms to prevent or interrupt unwanted thoughts that may be inhibiting the client.  Thought stopping is generally implemented in a four step process.  The first step is to identify the thoughts that the client wants to eliminate or interrupt.  Second, the client is asked to imagine a scenario where the thought may occur.  Next, the client and counselor both attempt to identify situations where the thought is occurring and call "Stop" to interrupt the thought.  And the final step is to substitute in a new thought for the old thought.

What type of situation can the technique be applied to?

The thought stopping technique can be (but not optimally) for a variety of situations.  However, it specializes in dealing with things like obsessions and addictions.  The entire premise of the technique is to prevent cognition of certain aspects of an individuals life which would be inhibiting to getting to real issues in other situations.

What is your opinion of the technique?

Personally I see this technique as only having one purpose and that is to aid with the elimination of obsessions and addictions.  Otherwise, I believe that this technique prevents insight which is the opposite of what a counselor should aim to do in session.

Chapter 19: Reframing

How is the technique implemented?

Reframing is a technique that is implemented by taking a problematic situation and presenting it in a new way so that the client can gain a new perspective on the situation.  The most well known method of implementing this technique is to use three a step model.  First the counselor must effectively listen to the client to gain an understand of the problematic situation.  Second, after the counselor understands the issue they must begin to formulate a bridge between the client's point of view to a new way of handling the problem.  Finally, the counselor must reinforce the bridge that they have created by assuring themselves that this new way of looking at a problem has stuck with the client.  This may occur through a homework assignment that forces the client to view the issue in the new way.

What type of situation can the technique be applied to?

This technique can be applied most appropriately to a client who is suffering from self-defeating behavior or irrational beliefs.  In addition, if the issue is a persistent issue that the client may have given up on due to their inability to overcome it, this technique can be used to help the client seek new solutions to the problematic situation.

What is your opinion of the technique?

I like this technique in situations where the client is struggling to overcome issues that are clearly only problematic because of the manner in which the client is approaching them.  The counselor can use this technique most effectively when helping dispel negativity about a situation.  Overall, its an excellent technique because in most cases a problem can either be solved or at least understood to the fullest by approaching it from different perspectives.

Technique 17: Self-Talk

How is the technique implemented?

 The technique of self-talk requires that the counselor has already applied a humanistic approach of some type to assure that the client will use this approach in a positive regard.  Countering is the name of the method used to reduce negative self-talk.  Counter consists of four steps: 1) Identify and explore 2) What is the purpose of negativity? 3) Develop counters and lastly 4) Practice and review counters.  Once the client has developed positive self thoughts they can become a focal point for further counseling sessions. 

What type of situation can the technique be applied to?

 Situations warranting positive self-talk are situations involving clients with low self-esteem.  If an individual is expressing self-defeating thoughts and concerns, the counselor can use this technique to help cheer on that student about the positives.  In contrast, this technique can be used to help individuals of usually high self-esteem that have fallen into a rut or are dealing with some sort of block to their feelings of value.  This technique could help someone discover how to defeat those thoughts and begin feeling themselves again. 

What is your opinion of the technique?

 I see the self-talk method as a mechanism most useful when dealing with a client with either mood disorders or issues of incongruence.  While I think it is critical for individuals suffering from these issues, I find it of minimal use outside of that scope.

Technique 16: Role Play

How is the technique implemented?

 Role-playing is very similar to aforementioned techniques in this blog.  It also follows a six stage process that involves: Warm-up, scene setting, selecting roles, enactment, feedback, and reenactment.  Essentially, the client is brought in and tells the counselor their issue.  They set up a similar scene and the client picks a role.  That role can either be of them self or of the person they are having conflict with.  The client and the counselor then act that out, give feedback, and possibly reenact using that feedback to see how an effective interaction would go.

What type of situation can the technique be applied to?

 Role playing can be used in similar fashion as the previous blog entry, behavior rehearsal.  This gives the opportunity for the client to prepare a reaction for a situation that they know they may eventually have to deal with.  In addition to that use of role play, this technique can be used to simulate a conversation with someone who the client wants to express an opinion to.

What is your opinion of the technique?

 I see role play as an effective technique that should be a part of every guidance counselors arsenal.  Giving your student or client the opportunity to see how their feeling are being conveyed and the potential responses they can be facing for that belief or feeling helps them to become better adapted individuals.

Technique 15: Behavioral Rehearsal

How is the technique implemented?

 The technique of behavioral rehearsal is carried out by having the client participate in what would be consider typical daily functions in an attempt to decrease the anxiety surrounding these actions.  The counselor in this situation plays the role of the person who the client is anxious about interacting with.  The counselor's goal is to get the client to speak in a strong voice and emphasize the importance of their feelings.  The four major steps of the process are as follows: 1) Prompt client practice of modeled behavior 2) Enhance client motivation 3) Provide feedback 4) Shape behavioral approximations to desire behavior.

What type of situation can the technique be applied to?

 This technique can be used in helping a client deal with an abusive or bullying individual.  When the client is confronted by a situation where they will need to be around an abusive person they can rehearse how they will behave ahead of time in order to be prepared for that interaction.  Another example of application of this technique is when the client must tell someone news and they are afraid of how they will respond. Ex. A teenage girl telling her parents she is pregnant.

What is your opinion of the technique?

I find this technique to be incredibly useful and something I use internally on a consistent basis.  By preparing an individual for a student they feel uncomfortable, you help to ease their nerves going into that situation.  While this technique is not an end-all, cure-all it does limit the anxiety when the client feels confident and is prepared to behave a certain way.

Technique 14: Modeling

How is the technique implemented?

 Perhaps the most important part of implementing a modeling technique is to explain the client what the benefit of modeling this behavior is.  If client does not know why the behavior will help then they are far less likely to to take the method serious.  For example, deep breathing is a well-known strategy to relieve stress and anxiety.  However, if you are dealing with a younger client and they are unaware of that, they may not see why this technique is beneficial.  The most common method of modeling is deep, slow-breathing.

What type of situation can the technique be applied to?

 This techniques usefulness expands to nearly any situation that causes stress.  Anytime the client needs to slow down and aim to think more clearly, deep breathing can be beneficial.  Perhaps the biggest situation that deep breathing is sought in is the realm of test taking.  Other examples include almost any negative emotion: anger, frustration, disgust, sadness, etc..

What is your opinion of the technique?

 Personally, I'm not a huge fan of this technique.  My opinion may be biased, but from my background in psychiatric services, older individuals mock this process and younger individuals don't understand it.

Technique 11: The Empty Chair

How is the technique implemented?

 The empty chair is another technique that requires the establishment of rapport before being used.  There is a general six step process how this process works.  First, let the client know why you are using this technique.  Second, deepen the experience.  That is, find out the strongest feeling the client has.  Third, express that feeling.  Next, reverse or counter express the two sides of the conflict.  Fifth, switch roles. Sixth, create an action plan. 

What type of situation can the technique be applied to?

 The empty chair technique can be especially useful whenever a client is struggling to see the side of the person they are having a conflict with.  This technique is probably more beneficial to adolescent clients than any other because they are more willing to express their emotions and perhaps see the other side quickly.

What is your opinion of the technique?

 I think the empty chair technique is only as effective as the counselor-client relationship.  If the client is unwilling to share and does not respect the counselor, this technique will be mocked.  However, if there is established rapport the counselor may get down to the real substance of the conflict by hearing the client express emotion.

Technique 8: Spitting in the Soup

How is the technique implemented?

 Spitting in the soup requires that the counselor and client have already established strong rapport.  The basic use of this technique is to scan a student's relatively successful performance for one flaw that may be major or minor.  Once that flaw is indicated, it is the counselor's job to point it out and show the client that perhaps altering that behavior would be beneficial.  It is important when using this technique that the counselor is non-confrontational and accepts the students decision whether to alter behavior or not.

What type of situation can the technique be applied to?

 This technique is limited in the scope of how it can be applied.  Two situations that I've found it particularly useful are when you are dealing with academically successful students with bad habits, or when someone has a condition that they are mismanaging.  For example, gifted students succeed academically in the classroom.  However, often times they will develop maladaptive behaviors socially because of their lack of social awareness.  As a counselor, spitting in the soup can help the student realize that perhaps their maladaptive behavior is unnecessary.

What is your opinion of the technique?

While this technique lacks a large range of uses, I like it in the few situations its applicable.  As a guidance counselor, you want the respect of your students.  But at times it is also important to give them reality checks to make sure they understand how negative behaviors may result in negative outcomes.

Technique 7: Acting As If

How is the technique implemented?

 The acting as if strategy is used whenever a guidance counselor seeks to lead a student to their own resolution.  The counselor simply asks the client to act as if they had the skills necessary to handle their conflict.  After the client replies, the counselor can take their feedback and gear that towards manageable steps the client can make in the process of resolving conflict. 

What type of situation can the technique be applied to?

 This technique can be used when the client has low self-esteem or self-limiting thoughts.  By presenting the client with the opportunity to act how they want to act, you may encourage them that they are capable of these things but they just lacked the confidence.  This is where the counselor intervenes and tell the client that they must be willing to change in order to do something about their problems.  This technique can be used to help the student with a previously mentioned technique called flagging the minefield.  By acting as if, the client can see their strengths and weaknesses and mark potential future issue and work towards improvement in those categories.

What is your opinion of the technique?

I like this technique to help the student gain a sense of self-confidence.  If a student is shy or clearly is unwilling to confront an issue because they are timid, this strategy can help them to see that they can handle these issues as long as they can envision them.

Technique 6: I-Messages

How is the technique implemented?

 I-messages are a unique technique that gives the client the opportunity to apply a pronoun, typically I, to their statements in order to assume responsibility.  They are commonly used to express or discover feelings.  By changing a statement to be read with the word I in it the client is then put in a situation where they can control either their emotions or actions.  These messages can help to begin a more complex dialogue as well.  This technique is typically implemented in a manner that the client gives a feeling, a related behavior, and the consequence of that behavior.

What type of situation can the technique be applied to?

 This technique is especially useful when a client feels stuck and needs directed towards a proactive role in becoming unstuck.  A variation of I-messages are we-statements  which gives a group connotation to the exercise.  The we-statements are an effective exercise in not placing blame onto another person.

What is your opinion of the technique?
 I like this technique as a way to gain insight on the client's emotion.  Once an understanding is built regarding how the client feels, this step serves as an essential step into the action stage of counseling.

Technique 5: Flagging the Minefield

How is the technique implemented?

This technique is generally used as an end of the counseling process.  The technique is meant to be used as a method to mark potential future setbacks.  Once these setbacks are flagged the counselor and client can work together in order to mold a strategy to handle these situations in the future.  This technique relies on the fact that the counselor has provided the student with the tools necessary to prevent future setbacks.  The primary reason for this is so that clients can transfer their in session counseling to the external world.

What type of situation can the technique be applied to?

The noticeable issue with this technique is that it is only useful at the end of the counseling relationship.  On the positive note, it allows the client to see the progress they've made and the skills that they have learned through the process of flagging potential dangers.  This method is exceptionally useful at empowering the student.

What is your opinion of the technique?

I like this technique because it allows both the client and counselor to reflect on the work done in their relationship.  This allows the counselor to see where he/she can improve in their implementation of coping techniques to their students.

Technique 4: Miracle Question

How is the technique implemented?

This technique is most effectively implemented when a client needs to gain perspective on the presence of something rather than absence.  The miracle question is typically presented in a fashion where the student is given the opportunity to create the "ideal" situation for one day.  After being asking what that situation would be, the counselor must look for realistic ways to make all or part of that solution possible.  The goal is to help the client see what they could do rather than what others could do since the only person they can change is their self.  

What type of situation can the technique be applied to?

The miracle question can be used in almost any situation where there is conflict.  In order to solve that conflict, the miracle question gives the client control.  This can be done in a variety of ways.  The counselor can ask the client in several ways: For instance, if the problem vanished, what would you be doing tomorrow?  While this technique is most effective when trying to resolve an issue, it can also be used to allow a reluctant client to uncover their issues.

What is your opinion of the technique?

I believe the miracle question is one of the best techniques of helping a client see the problem in a perspective necessary to resolve the issue.  By placing the student in an ideal situation, you give them the power to control the situation and be responsible for their role in their issue.

Technique 3: Problem-Free Talk

How is the technique implemented?

The beauty of this technique is that it can be used throughout an entire session.  Problem free talk is more than simple small talk, as it requires the counselor to listen actively for a chance to intervene on the student's issue.  This intervention should occur as an opportunity to reveal the student's potential and competencies.  If problem-free talk does not come naturally the counselor can strive for it by just asking to know more about the client.

What type of situation can the technique be applied to?

This technique is to be implemented either before the conflict is brought to attention or at a respectful time after the conflict has been uncovered.  Also this technique is meant to be a small part of counseling not the primary technique.  Problem-free talk is important in welcoming new stakeholders to the counseling relationships.

What is your opinion of the technique?

I find this technique to be useful but in a minimal capacity.  To be able to break the ice is an important part of establishing and maintaining rapport.  However, beyond that it is of very little assistance.

Technique 1: Scaling

How is the technique implemented?

This technique is pretty simplistic and essentially just asks the client how they feel about a particular situation on a scale from either 1-5 or 1-10.  10 generally being the highest score and 1 the lowest.  Scaling is useful for measuring the progress made towards a clients goal.

What type of situation can the technique be applied to?

The most effective situation to use the scaling technique is whenever the client is having a conflict with meeting a goal.  The scaling technique can show progress towards that goal.  Another situation that would benefit from the scaling technique is using it pictorially with a child to depict emotions.  And a final method of scaling would be in relationships to get a measure of how individuals feel about each other.

What is your opinion of the technique?

The scaling technique is a very good beginning and ending of counseling technique because it gauges progress made or needed.  It is important to use techniques of this nature to be aware of the clients status.  Scaling however, does not provide us much of an interim for counseling and the client would benefit from more free associated related activities.