Authors: Carolyn Dillon
ISBN-13: 9780534524012, ISBN-10: 053452401X
Format: Paperback
Publisher: Cengage Learning
Date Published: February 2002
Edition: 1st Edition
Carolyn Dillon, LICSW, is a Clinical Professor at Boston University School of Social Work and a longtime clinician, supervisor, and consultant to practice agencies. She has received awards for teaching excellence from Boston University, from the School of Social Work's Alumni Association, and from the Massachusetts Chapter of the National Association of Social Workers. Carolyn has 35 years of practice experience with adults coping with mental illness, family breakdown, and health challenges. She is the author of LEARNING FROM MISTAKES IN CLINICAL PRACTICE and also volunteers as a teacher of English to speakers of other languages.
This text is a virtual handbook of classic mistakes to anticipate, work through, and grow from. It identifies, discusses and re-frames classic mistakes that beginning interviewers and clinicians are likely to make in practice by illuminating a myriad of mistakes through the use of first-hand vignettes, in-text exercises, and a systems framework. This book uses a strengths-perspective, and can serve as a companion text or as a stand-alone primer because of its elaboration of the phases, principles, strategies and methods used in the helping process.
This guide for students, beginning clinicians, and allied health professionals employs multicultural vignettes in a variety of settings to describe some of the mistakes commonly made by therapists. Coverage includes how to avoid or repair the damage from mistakes such as breaches of confidentiality, steering around difficult topics, and minimizing signs of risk. Dillon teaches at the Boston University School of Social Work. Annotation c. Book News, Inc., Portland, OR (booknews.com)
Preface | x | |
1 | Becoming a Professional | 1 |
The Dawning of a New Awareness | 1 | |
Additional Complications in Clinical Roles | 2 | |
The Professional Learning Curve | 3 | |
At One with Clients, Yet Different from Clients | 5 | |
Crises Around Learning to Be Deliberate | 6 | |
Tending, Not Just Having, Relationships | 7 | |
You, Too? | 8 | |
Noting and Making Use of Parallels | 8 | |
Reconciling with Strengths and Limitations | 8 | |
Moving from Smart to Wise | 10 | |
Will Anything Rule Me Out? | 11 | |
2 | Early Successes and Derailments | 14 |
Defining and Identifying Mistakes | 14 | |
How Can We Tell When Clinical Work Is On Track? | 15 | |
Usefulness of Recordings | 15 | |
General Characteristics of Effective Work | 16 | |
Discerning Our Mistakes | 20 | |
Common Worker Signals of Mistakes in Progress | 23 | |
Frequent Sources of Derailment | 26 | |
3 | Engaging With Clients and Getting Started | 39 |
True Engagement Is Hard Work | 40 | |
Initial Challenges and Pitfalls | 41 | |
Startup Conversation and Exploration | 44 | |
Other Orientation Topics | 47 | |
Hesitating to Discuss Worker--Client Differences | 48 | |
Overlooking Fundamental Human Resources | 48 | |
Problems with Technique in Engaging and Starting Up | 49 | |
Asking Questions Closely Aligned with Where the Client Is | 49 | |
Avoiding Rapid-Fire Questions | 50 | |
Using Open-Ended Questions | 51 | |
Asking Rather Than Assuming | 51 | |
Leaving Time to Reflect After Each Segment of Discussion | 52 | |
Purposeful Focusing | 52 | |
Appropriate Timing and Dosage | 53 | |
Carefully Working from the Outside In | 53 | |
Overprotecting Clients | 54 | |
Prejudice and Ignorance in Action | 54 | |
Class Differences and Classist Behaviors Can Affect Engagement | 55 | |
Attitude Taints Engagement | 56 | |
Shifting Meeting Times Creates Bad Feelings | 57 | |
Emergency Interruptions Can Derail Bonding and Work | 57 | |
Emotional Overbooking Is Visible | 58 | |
Missteps Around Confidentiality and Privacy | 58 | |
Breaches of Confidentiality | 58 | |
Inflexibility Regarding Confidentiality | 59 | |
4 | Professional Relationships: Steps and Missteps | 67 |
Unique Features of the Worker--Client Relationship | 68 | |
Worker Self-Disclosure as a Form of Relational Tending | 69 | |
Empathy: Being Where the Client Is | 70 | |
Conditions Conducive to Accurate Empathy | 71 | |
Missteps in Trying to Empathize | 76 | |
Trivializing via Excessive Universalizing | 78 | |
Restoring Empathic Alignment | 81 | |
Worker Concerns About Relating with Clients | 83 | |
Shared Concerns About Relating with Other Agencies and Helpers | 84 | |
Common Mistakes in Relating with Clients | 84 | |
5 | Assessment and Contracting | 90 |
Assessment | 90 | |
Observation Changes the Observer and the Observed | 91 | |
Elements of Good Assessment | 92 | |
Frequent Mistakes in Assessment | 96 | |
Implications for Contracting with Involuntary Clients | 108 | |
Mistakes in Contracting | 109 | |
Larger Systems Issues | 116 | |
6 | The Middle Phase of Work | 119 |
Common Foci for Work | 119 | |
Techniques for Updating Unhelpful Thoughts | 128 | |
Integrative Techniques for Working on Feelings and Behaviors | 138 | |
Connecting the Past, the Present, and Hopes for the Future | 143 | |
Going Home Again | 144 | |
7 | When the Work Doesn't Work | 149 |
Not Resolving Important Conflicts over Plan or Methodology | 149 | |
Not Helping Clients Obtain Needed Resources | 150 | |
Getting Too Far Ahead of the Client | 150 | |
Overestimating the Ease of Change | 150 | |
Skipping the Middle Part | 151 | |
Steering Around Topics or Feelings | 152 | |
Not Challenging or Confronting the Client When Process Is Stuck | 153 | |
Giving Up Too Soon | 153 | |
Pushing the Client | 154 | |
Using Inappropriate or Meaningless Strategies | 154 | |
Showing Favoritism | 155 | |
Taking Sides | 155 | |
Defending Our Own Points of View | 156 | |
Using Strategies That Embarrass the Client | 156 | |
Skewing the Work | 157 | |
Providing Inadequate Support and Reinforcement | 158 | |
Scoutmaster Behavior | 158 | |
Expressing Upsets with Clients | 159 | |
Not Dealing in Supervision with Feelings About a Client | 160 | |
"Should" and "Ought" Statements | 160 | |
Misspeaking | 160 | |
Ending Sessions Early Because the Client Is Silent | 161 | |
The Client Is Testing and the Worker Doesn't See | 161 | |
Blaming Clients for Failures in the Work | 162 | |
Serious Mistakes, Serious Consequences | 162 | |
Boundary Violations | 163 | |
Funny Money: Improper Financial Dealings | 164 | |
Working While Impaired | 165 | |
Untruthful or Devious Behaviors | 165 | |
Sexual Harassment in the Workplace | 166 | |
Responding to Egregious Behaviors | 167 | |
8 | Common Mistakes in Ending | 171 |
Factors Influencing Ending Process | 171 | |
Steps in Ending | 178 | |
Other Common Mistakes in Ending | 182 | |
9 | Epilogue | 190 |
Questions That Haunt Us All from Time to Time | 190 | |
Developing Important Capacities | 191 | |
Where to from Here? | 193 | |
References | 195 | |
Index | 203 |