10  Starting and Running Individual and Group Sessions | Addiction Counselor Exam Review Podcast

10 Starting and Running Individual and Group Sessions | Addiction Counselor Exam Review Podcast


Hey everybody and welcome to the
Addiction Counselor Exam Review. This one isn’t technically one of those topics
that’s in your addiction counselor exam review booklet so it’s probably not
going to be on the exam, but I did have a request from somebody who is getting
ready to start working as an addiction counselor and getting ready to get
certified who wanted to know a little bit more about how to start individual
counseling sessions and group counseling sessions and maybe kind of some tips on
how to facilitate them so that’s what I’m gonna do this week is just kind of
share with you some tips that I do. Now there are a lot of different ways to
facilitate individual and group counseling sessions so the way I tell
you isn’t necessarily the be-all end-all way it’s just what works for me and
you’ll find your own rhythm and your own method as you get into it so let’s get
started we’re going to talk about techniques to start and facilitate
individual sessions first and then we’re gonna move on to ways to facilitate
process groups random and planned psycho-educational groups so remember
process groups are those groups where we really talk about feelings and work
through the process hence the name and psycho-educational groups are what
teaches skills and tools and that’ll become a little bit more clear as we go
through the presentation so in general how you start and manage individual and
group sessions depends largely on your own counselor theoretical approach a
psychoanalytic therapist is going to approach it differently than than a
cognitive behavioral than a humanistic therapist so your approach is really
going to have a great effect on the way you choose to facilitate things the
other major impact that’s going to affect how you do individuals and groups
are the personal characteristics of the client such as age you’re not going to
do as long or in depth of a session with someone who is maybe a young adolescent
or with someone who is advanced in age and may be experiencing some cognitive
decline you’re going to be looking at cognitive functioning people who are
impaired in some way are going to need a different approach than people who
aren’t so anybody who’s recently out of detox or in detox anybody who is
experiencing any sort of cognitive malfunction whether it be due to
traumatic brain injury or organic issues or whatever or just age I mean children
function cognitively differently than we do and that is true for adolescents too
we don’t want to just think that high school kids are little adults we do need
to pay attention to their cognitive functioning needs other things that are
going to impact how you facilitate the session include distracting factors and
that can be anything for from something that’s going on with the client maybe
they have a cold that day or chronic pain i I’ve worked with clients who have
maybe chronic back issues or other things and they can’t sit down for an
entire hour so the way I facilitate the sessions differs with those people
because we take frequent breaks we get up we move around we do other things in
order to maintain their comfort so they can funk focus cognitively on what we’re
talking about and then the presenting issue you’re probably going to do a much
different group or individual session if you’re talking about PTSD then if you’re
talking about relationship skills or self esteem development so all of these
things are going to impact the way you really carry out the entire session but
there are some general tenants that we can look at in terms of structure so for
individual sessions regardless of your theoretical approach in the first
session you’re developing rapport and empowering the client you want the
client to feel like they have a say in what happens they have a say in their
treatment and that you are taking what they have to say seriously it’s not this
expert and and client role they’re the expert on themselves they’ve lived in
their body for you know 15 30 45 years so they are the experts on themselves
we’re the expert son book-learning so both of us if you
want to think about it that way our experts and we bring different
information to the table so we want to ask the client from from jump what is it
that you want to accomplish you’re here you know that tells me there’s something
that you want to accomplish and it doesn’t matter what kind of program
you’re in if you’re in a substance abuse program you can pretty well guess that
the person may be struggling with some substance abuse issues but that may not
be where where they’re focused right now maybe what they want to accomplish is to
avoid divorce or avoid going to jail or avoid getting violated on their
probation that’s what they want to accomplish they’re not really ready to
address some of the other stuff so let’s start with a strengths-based brief
approach and figure out what do they want to accomplish because even if
you’re you know we’ll take keeps with substance abuse right now
even if they’re coming to you and they’re on probation and they have to
come to counseling as a condition of their probation their goal may be just
to get off probation and not get violated they may have no intention
right now of ever stop being using okay that’s fine you know I’m not going to
look that far in advance what I’m gonna say is all right well in order for you
to not get violated you have to stay clean while you’re on papers so let me
help you figure out how to stay clean while you’re on papers what you do after
that that’s your decision and you can decide from there but what we’re going
to do is work on mutually agreeable goals share your understanding of the
person’s situation to make sure you’re on the same page so if you’re going
through it and you’re saying okay you’ve got three duis and you’ve been fired
from your job for being drunk at work and yeah de yada yada so I’m what I’m
seeing is you’re here for treatment for alcoholism and the client may say no I’m
here because I have to be they’re not ready maybe to work on their alcoholism
or they may say you know what I’ve got really bad depression and that’s the
reason I drank because I’m depressed all the time
and you know I think I really need to work on my depression and then I
wouldn’t drink as much okay well you know again mutually agreeable goals but
I want to understand what is the client motivated to work on ask the client to
prioritize which problems he or she wants to address first that is you know
what’s most important to you some of them maybe want to work on relationship
each issues some mood issues some chronic pain you know clients come in in
various stages of readiness for change for every single problem so I want to
know what are you motivated to work on right now ask the client what he or she
thinks might be helpful to approach the issue they’ve probably tried things so
they know sort of what doesn’t work or they have a pretty good idea what
doesn’t work so I don’t want to rehash things that don’t work let’s start out
with what do you think might work and if they don’t know okay you know that gives
us a place to start from but if they’ve tried before to deal with this issue
they’ve probably had at least limited success with some strategies so we want
to build on those that’s that strengths-based approach help the client
think back and figure out when you’ve gone half a day or a whole day without
having this problem or even two hours you know some clients that’s as far as
we’re gonna get what were you doing differently and you know obviously sleep
is one of them so people aren’t drinking if they’re sleeping people aren’t
sometimes using if they’re playing with their kids you know we want to find out
what are the exceptions to when this problem occurs and start making a list
of this because that will empower the person to start feeling like hey you
know I’ve been doing some things right you know maybe this isn’t a lost cause
and finally during this first session you want to share your theoretical
approach if your cognitive behavioral like I am we’re going to explain what
that means to the client and figure out you know if they think that that makes
sense or not if they don’t agree with that theoretical approach or they you
know want something else you’ve got to figure out if you’re
the right fit a lot of times you can adjust and they can adjust and you can
find a workable compromise based on the clients responses and your theoretical
approach you want outline a proposal for the next steps
I always hedge this when I propose to the client you know so what I’m thinking
here is you know over the next few weeks we might look at this this and this how
does that sound to you and that gives the client an opportunity to go yeah you
know that makes sense or no I think you’re totally on the wrong path here
that I don’t think that’s going to work and we can have a dialogue at that point
so the first session really doesn’t accomplish a lot except for to develop
rapport and connection and get a direction this is where you’re kind of
doing that initial treatment plan to working with the client so in subsequent
sessions we’re going to talk about two basic approaches humanistic and
cognitive behavioral there are many many others but these are kind of the two
prevailing approaches so humanistic approach acknowledges that people have
within themselves the answers to improving their own lives if you
remember back to psych 101 the human humanistic approach says that people
will solve their own problems and move towards self-actualization if we help
them remove the blocks in their way we naturally move towards
self-actualization humanistic approaches recognize and respect the ability of
people to use reason science intuition and creativity as tools for achievement
of goals so this is one of the reasons in humanistic approaches we don’t do a
lot of directive stuff with clients we use a lot more Socratic questioning so
we ask them you know what do you think would help in this situation
in similar times before what has worked what hasn’t helped you know thinking
about people that you know who’ve had this similar problem what what’s worked
for them to help them start thinking and learning how to solve their problems on
their own learning how to clear their own roadblocks one key thing with
humanistic approaches is to not get unnecessarily sidetracked you
want to let the client talk you want to let the client do the majority of the
talking in the session but you want to stay on this path so there’s an issue at
hand whatever issue you’ve decided you’ve worked on you want to make sure
what you’re talking about is on point because it’s really easy
when the client gets to a place that’s uncomfortable for him or her to kind of
sidetrack and start telling you about something else or going down to oh let
me tell you what happened last week and you want to bring them back gently and
say let’s stay focused on this issue right now you know we need to clear this
roadway and then we can go over there I’ll make a note of it and we can talk
about it in a few minutes assert that wellness and health is best
achieved through personal growth you know a lot of the things that people are
struggling with when they come to see us indicate that maybe their coping skills
aren’t strong enough or maybe this is a unique situation and they’ve never been
exposed to coping skills to deal with it or maybe there’s something physically
going on with them that they need to address in order to help their mind and
body be as healthy and operational as
possible so for an individual session begin by summarizing what was covered in
the last session so if the last session was your initial session you know you’ll
start by saying okay so last time when we talked you said this was the problem
that was most pressing and we identified that these might be the next logical
steps does that still sound like a good plan they’ll say yes or no and then you
move on to asking the client to share what’s happened in the last week
pointing out and emphasizing positive changes and then when they talk about
problems or what I call stuck points or challenges I try to avoid the word
problems well we’ll stop for a second and I’ll say okay that sounds like it
was really frustrating in retrospect yeah what do you think
brought that on what do you think might have been a better way to handle it etc
so I’m going to start asking them questions you know there was this
challenge back here and you don’t feel like you solved it very well
or caused you a lot of upsetness okay so let’s look at that and let’s see if we
can figure out how to prevent that from happening again or how to deal with it
in a way that can help you but I want the client to really be the one that’s
doing most of the heavy lifting the root the way we do this is using Socratic
questioning to draw connections between last week’s events and current
presenting issues and current skills so if the client is working with you on
depression for example and they start telling you about how the week went and
then they tell you about five or six unfortunate events that happened that
kind of stressed them out and they’re feeling pretty depressed today we want
to help them draw the connection between what can you see how the high level of
stress last week may have impacted your mood what do you think are some options
that you might be able to do to reduce stress in the future and and explore it
from that perspective cognitive approaches assert that issues
are caused by unhelpful thoughts and or unhelpful behaviors when you look at the
cognitive triangle you have thoughts behaviors and feelings in cognitive
approaches we seek to identify those thoughts and behaviors that are
unhelpful and help the client become more mindful about how things nice
things impact their mood so they’re in a negative frame of mind how does that
affect how they feel and their urges their behavioral actions if they are in
pain or they’re tired how does that affect their thought processes and their
mood and their attitude and likewise how do both of those things affect their
feelings so we want them to really constantly look at this triad and
understand how all these things interact cognitive approaches tend to be more
structured and I like structure so I tend to go with cognitive more than
anything else begin by summarizing what was covered in
last week’s session this is always a great great way to get people you know
started get them up to speed again kind of like when you watch a television show
at the beginning they say you know in in previous episodes and they catch you up
on what happened that’s what we’re doing here we’re kind of catching people up
now yeah they were there but we may need to refresh their memory because a lot of
time is elapsed in a week we’ll review their homework cognitive behavioral
therapy is really heavy on homework so we want to review these if you don’t
review them it tells the client there’s no point to do them so we want to make
sure we review them because we’re going to be referring to them throughout the
session so I want to make sure that clients are really starting to learn how
to use these tools ask the client to share what’s happened in the past week
just like with humanistic we want to find out you know okay so how did last
week go what happened emphasize positive changes and explore stuck points and
challenges so same basic principle of what we’re doing in cognitive versus
humanistic but the way we do it is different
when they start talking about those stuck points or challenges in
cognitive-behavioral we’ll stop and we’ll say okay let’s look at any
unhelpful thoughts you’re having cognitive distortions irrational
thoughts and/or any unhelpful behaviors that you were doing that were keeping
you feeling stuck and miserable so we’ll go back and we’ll analyze each situation
and help people identify habits and behaviors they have that may be keeping
them stuck and then we wrap it up from there in profit so those are two
different ways that you want to look at doing individuals and like I said there
are lots of different ways but those are two ways that I found that are really
pretty easy for new counselors to start off with they can choose one or the
other and kind of go from there depending on whether they prefer
Socratic questioning and going with the flow a little bit more or they prefer
more structure and worksheets and tangible things again you also want to
consider your client some clients are not going to be as structured and
they’re gonna want a little bit more latitude so you may have to move more
towards the humanistic approach so it’s good to be a little bit flexible in the
application of techniques so let’s move on to groups process groups process
things psycho-educational groups can be structured and that means they follow a
syllabus or what I call unstructured and that means we’re gonna do a topic but
what we do what topic we do today you know is pretty much undetermined until
the clients get there so let’s talk about how those work process groups
central to the group process is the opportunity for members to talk as
openly as they possibly can about their interactions and experiences of each
other as well as any aspects of the group experience that may come to mind
so for example if we’re in a process group and we’re talking about
abandonment and the clients are going to share their experiences of a bay
what that means to them they’re going to find connections with other people
who’ve had similar experiences so they feel less isolated but they also may
have some transference reactions or feel abandoned or rejected by other people
that are in the room and they are going to usually bring the way they interact
in the outside world into the group room so we can help them identify patterns
and habits and communication styles that may be helping or hindering them so
they’re really recreating and a microcosm of their life in this session
so we can help them begin to become more effective personally and interpersonally
process groups can also be excellent adjuncts to psycho-educational groups
when we teach clients things there are three aspects if you will to teaching
knowledge the book learning skills that means taking the book learning and being
able to do something with it and abilities so let’s talk about cooking
for example knowledge is knowing how to read a cookbook and knowing that you
know what sauteing is in theory you know that’s just knowing it from the book
never having done it or anything skills means being able to look at a
recipe and go okay I need to saute so I’m going to practice and figure out how
to do this now you’re following a recipe you’re following a very narrow set of
instructions so there’s not a whole lot of room for error abilities is when you
take those skills and you generalize and you start creating your own recipes and
go hey let me try to saute this or you know I think this would be really
awesome braised or whatever the case may be so process groups take skills that we
teach knowledge that we teach in psycho-educational groups and helps
people really make it their own you can ask clients for example if they
were in a psycho-educational group about assertiveness skills
in the process group you can talk about interpersonal communication and ask them
how did it feel last week when you practiced being assertive or what came
up for you when you practice being assertive last week and what was that
like how did it feel you know some people will feel apprehensive some
people will feel terrified a lot of times in psycho-educational groups the
next week after people have learned this skill and practiced it a little bit we
don’t have time to process it which is why process groups are really
awesome and if you’re doing the process group sort of as part of the
psycho-educational group then for example on on Monday they may meet with
you at 9:00 a.m. for psycho ed and then they may have a process group at 11:00
a.m. that processes what they did last week so they’re always going to be a
week out of sync but it’s a way to help clients really drive home what we talked
about so techniques for process groups fame
your modules you know whenever you have a process
group you don’t want to just go in and sit down and go all right what do y’all
want to talk about probably not going to be nearly as productive as if you say
all right today we’re going to talk about abandonment or grief and loss or
shame and guilt mothers fathers empowerment whatever topic and it’s you
want to choose something that’s pretty broad you can even consider choosing a
book to help give you structure seeking safety toxic parents growing up with a
borderline parent and journey to recovery are all books that I’ve used in
process groups and we talk about a general topic like abandonment and then
I have clients share how that they’ve had those experiences how have they
experienced grief and loss what does that mean to them how is it impacting
their current presenting issues and then again have members draw connections
between experiences so they can say oh yeah I felt that way or I had that same
experience they can bring hope to one another and support to another one
another sometimes in the process groups they’ll even say
you know when I experienced that situation what worked for me was you
know and then they share what that is and the person who’s receiving the
information can hear it and if it’s useful for them they take it and if not
they leave it but it allows people to open a dialogue and support one another now psychoeducation
is just what it sounds like is education but it’s not just lecture if all you do
in psychoeducation is lecture people are going to hate coming to your groups so
let’s talk about some broad concepts first in terms of adult and adolescent
education this is different for children but we’re going to talk about what a lot
of us work with the first thing you want to consider is some people learn in
terms of details and some people learn in terms of broad concepts think about
doing a puzzle if you can open a puzzle dump it out and then you start putting
pieces together just randomly you’re probably more of a detail-oriented
person broad concept people are the ones who dump the puzzle pieces out we want
the frame and then we’re probably going to look at the picture while we’re
trying to put it together so we’re seeing how all these little pieces fit
into the big scheme of things whereas the other people are seeing how all
these little things grow to become something what does that mean it turns
in terms of teaching it means that you’re probably going to have both types
of people in your group which is why it’s important to provide an overview at
the beginning of group today we’re going to talk about self esteem and how it
impacts our relationships and our mood or whatever something real general one
or two sentences also provide for those detailed people provide an outline about
the specific bullet points you’re going to talk about it doesn’t have to be
super detailed but if you’re in a 90-minute group you know give them four
or six bullet points so they can anticipate what’s coming up overview and
line after you do that you need to communicate effectively in groups you’re
going to have different types of learners some people learn well by
hearing so lecture works well for them but also the discussion does as well
anything they hear they tends to stick better visual people really struggle in
groups because they tune out they zone out they don’t remember as much of what
they hear they remember what they see and what they read so provide handouts
for those people books for them to look at and if you can’t do that because a
budget they don’t want make it you’re making that many copies at least try to
write as much as possible on the whiteboard and encourage them to bring a
notebook to take notes so they can see what’s going on the third type of
learning is called kinesthetic and that means manipulating the information some
people do better when they try to apply the information they may not really
remember it until they’ve made it theirs in some way so kinesthetic learners do
better if you’re asking them questions you know what do you think about this
give me an example of that what would you do in this situation
kinesthetic learners can also do really well when they teach so if you break
your therapy group up into you know let’s see if there’s nine people three
group groups of three and each group of three teaches a concept you give them
the information and they figure out how they’re going to present that concept to
their group members kinesthetic learners do really well with that because they’ve
had to manipulate it and figure out you know how to best communicate that
information so you want to make sure that everything you present you present
so people can hear it people can see it and people can work with it we’ll talk
about different ways to make that happen respect the process I know you’re going
oh my gosh there’s more yep there’s more this slide is probably the most
information dense so just kind of bear with me active and reflective learners
so some people learn as they go and this tends to be your extroverts
we learn as we talk and we think as we talk and we have these aha moments as we
talk reflective learners tend to be more introverted and they’re the ones who
take in all the information put it together and then they have that light
bulb moment so you may have some people in your group that don’t seem overly
participatory it could be that they’re reflective learners so it’s good if you
give them especially if you give them handouts to have them write things down
so every you know ten minutes or so take a break
have them write something down either notes or answer a question on on a
worksheet or something so they have some quiet time when nobody’s talking that
they can process all the information they’ve gotten over the last ten minutes
and have that aha moment so overview when you start the group provide
everybody an outline provide information so people can hear it see it and work
with it and make sure to take frequent breaks so reflective learners have a
chance to solidify chunks of information and and have that aha moment the next
part you know once they get that information in there and have that aha
moment it’s great it’s in short-term memory but for them to really learn it
and remember it they need to know why it’s important to them it has to be
relevant to them and if you’ve got nine fifteen people in a group what’s
relevant is going to be different for different people now there are two broad
groups some people what’s relevant is what’s right what’s just what’s factual
other people what’s relevant is what’s going to make everybody feel good so or
what’s going to help them best get along with other people or improve their
relationship with their kids so people are feeling better so you want to
present information to both both camps so to speak this is why it’s important
this is the data behind it don’t go too far into data because you’ll lose people
not because they can’t understand but because they get bored and then this is
why it’s important sometimes making it relevant you don’t
to do all the heavy lifting you can ask clients after you’ve presented the topic
you can ask them you know why do you think this topic is important to your
recovery so they can make it relevant for themselves one tip when you’re
teaching psycho educational groups or any kind of educational situation if you
ask for volunteers you may only get about 20% if that of the people
volunteering so the best way to get people to actually really work with the
information and stay with you is to call on people or have everybody go around
the circle and everybody has to say something and finally make it engaging
and this is where the kinesthetic learners really shine gamify it you know
make it into Trivial Pursuit taboo Jenga is another game that I use sometimes
where clients I have questions or facts written on a particular Jenga block and
when they pull out that Jenga block they have to answer the question that’s on
there that’s a little bit harder to do for
psychoeducation but you can what’s that other show with Alex Trebek I can’t
think of it right now jeopardy jeopardy is always an easy one to do in order to
teach a particular concept and it doesn’t require a lot of props and
supplies you can have clients do skits if they are and this can also be
scenario based things if they’re modeling or doing a skit showing
assertive versus passive versus aggressive behavior those things can be
fun and encourage clients to have fun with it and like I said earlier group
teaching is another option breaking or your group up into smaller groups and
having each sub group teach a particular aspect now structured psychoeducation is
the first type of psycho ed groups we’re going to talk about these follow a
syllabus or a work when I first started doing group
counseling we had a manual that we went by and each week we knew what group we
were going to do because that’s what was in the manual and it was pretty plug and
chug but it made sure we covered everything
so structure groups are great for beginners and what I do when I do these
groups and because again you want to keep people engaged begin by reviewing
what was discussed last week and any homework so maybe last week we talked
about the ABCs activity and cognitive behavioral or we talked about cognitive
distortions and you asked if there are any questions spend about ten minutes on
that then present the topic for the week give them that overview and that handout
talk about the topic make sure they have you know a talk something with bullet
points on it from the main points that you want them to get and they can take
notes if they want to then have the clients practice the new skill you can
use scenarios you can do anything creative to practice this new skill and
then the last 30 minutes of group obviously this is a 90 minute group the
last 30 minutes of group go around the room three times the first time you say
how would skill how would this skill have been useful to you last week think
about a situation where you could have used it and what would you have done
differently what would the outcome of been then go back around the room and
ask them how do you think this can benefit you next week you know what
types of things do you think might be coming up that you might use this skill
with and finally ask clients how they’re going to remember to use it or integrate
it if you’ve ever been to a conference which I think all of us have you know
that you’re when you’re in there you’re learning these tools and you think of
this really great stuff and it’s awesome and you can’t wait to use it with your
clients and then you get into session with your clients and it’s back to
everything as normal cuz you completely forget about that
you’re focused on the client and not on the technique okay
well the same thing is true in real life we want to help people
remember okay this is tool is new you’ve got to remember to use it how are you
going to do that homework is a great way to do it if you encourage people to keep
a log to do a worksheet you know once a day or more then it can help them start
developing the habit of using that particular tool then the other type of
psycho-educational group is what i call random and this is when we begin with a
check-in and I would have everybody come in and sit down generally this was the
first group in the morning we check in ask people how they were doing and I
would listen to everybody’s status and I would listen for a common theme that
might tie all these presenting issues together and I call it the rumba
philosophy because the Roomba vacuum the one that goes around kind of
automatically the theory is that it’s gonna bunch bump off walls and stuff but
eventually it will cover all the areas of the floor even though it just kind of
goes through the room randomly that’s kind of how random psychoeducation is
what I like to do is I have a list of I think I’m up to 73 topics now that I
think are important for people to have and I listen to my group and if they
indicate that you know maybe they have great skills self-esteem skills already
because for whatever reason then all mark that went off that’s probably not
one that we need to focus on and then when I listen to their check-in I will
identify a theme like assertiveness or grief or or whatever it is stress
management and then after a brief little break I will come back and I will
present them an outline an overview some information and then we’ll talk about it
well start I start by identifying the topic that people are gonna be just
discussing so we do our check-in take a little break then I come back and I say
all right so when I listen to everybody one of the things that I heard was
sounds like a lot of you are struggling with issues of setting boundaries and
relationships okay so then I’ll talk for 15 or 20 minutes
about setting boundaries and then again the last part of the group is going
around the circle and having clients share how the skill would have been
useful last week to prevent whatever problem they talked about at check-in
how they think they can use it next week and forevermore and how they will
remember to use it or integrate it so those are two very different ways of
doing group psycho-educational groups but they can be very effective and it
kind of depends on your facility as well as your own personal style which
approach fits better for you my suggestion is that you want to pick one
way and stick with it so if you’ve got a group on at 9 o’clock every Monday
morning and you decide to do random psychoeducation then you want to stick
with that format until that group is gone if you decide you want to change
and use something more structured you know pick that up after the current
group graduates a couple more notes because after we do group or individual
we have to do progress notes so at the beginning when you’re doing individual
sessions have the client identify what goals he or she achieved and the
progress made over the prior week you’re probably gonna do that anyway write that
down when the client is telling you and then
you can put your notepad down and you can talk to them let them know ahead of
time what you’re doing you know I want to keep track of all the great progress
that you make and set that aside and you’re gonna fill that in at the end of
session because remember our therapy hours tend to be 50 minutes so we have
10 minutes to do our paperwork towards the end of the hour 45 minutes 50
minutes you know we start wrapping up and I have the clients summarized and I
pick my pad up again have the client summarized what he or she thinks the
most salient points were in the session and how they will help the person me
they’re individualized goals so we talked about XY and Z and the client
thinks this will help him address his relationship issues or whatever then
have the client identify any tasks or goals for next week so the old way of
doing it is me saying okay so in this session we talked about all of these
things and you agreed that you would do this that in the other when you work
with a client and this is more of the Socratic questioning you want to ask
them okay so what is it that what tasks and things are you going to be working
on remind me what tasks you’re going to be
working on over the week and you write that down and then remind the client of
any referrals that were made during the session so you know I generally say and
you know you remember we talked about you know going to get food stamps
getting your annual physical and whatever else by the time you’re
finished with that you have your entire progress note written for the most part
you still have to do the mini mental status but you have the brunt of your
paperwork done the nice thing is you can take that make a copy and give it to the
client so then the client can have a record of what they talked about what
their achievements were and what their goals and tasks tasks are for the next
week so it’s a win win win win all the way
around in groups that’s not really practical to sit down and do this for
every single client so one thing you can do is have clients fill out a worksheet
what I do on mine is I have a check sheet or a check block area at the
beginning where they can identify their mood depressed anxious angry whatever it
was most of the time last week and there’s a little section for them to
explain if they want and then I have area under that for the client to
summarize the three most important points for that client in this session
and how those points will help them meet their identified goals this is
encouraging clients again to make it relevant to them and it’s also helping
me make sure that I’ve got relevant documentation have the client identified
tasks or goals for the next week with regard to the topic
remember we said have clients identify how is it you’re gonna remember to use
this particular tool well that’s what they put here and then have the client
identify any necessary resources or problems he or she is having so that way
when you get the sheet you know if referrals need to be made if they need
an individual if you’re not that person’s primary counselor you can pass
off information to the primary and say well John said that he’s having
difficulty getting his medication filled you know just wanted to let you know so
facilitates discussion it gets the notes done auditors like to see things in
client’s handwriting is again a win all the way around it takes five minutes it
doesn’t take very long at the end of group but that if clients come to expect
that that’s what they’re going to do and you explain to them it’s so they can see
their progress and so we can make sure that you know we’re keeping in
communication because sometimes when clients are in group based programs they
feel forgotten about or feel just kind of like a number so I want to make sure
that clients feel special I want to make sure that we have a really good finger
on the pulse so to speak of every client so translating everything that we
learned in class in graduate school to into working with clients can be a
really daunting task so be good to yourself one of the things that I found
out during my first couple of practicums as clients are really resilient if
you’re there and you care and you’re trying even if you flub usually no harm
no foul I remember one group I did I had a client come up to me afterwards and
said that was really boring and went way over most of our heads
I felt bad but you know I recognized that that was good constructive feedback
because I was doing group like I taught at the University instead of doing group
like we just talked about so it’s important to get feedback from your
clients pay attention during group if you see they’re starting to not offer
get antsy switch gears always have some sort of activity or something sort of in
your back pocket that you can do to rally the troops so to speak so those
are some suggestions for working in individuals and groups and kind of
getting started opening the session and feeling like you’ve got a rhythm and a
direction all of us at all CEUs wish your great success on your exam once
you’re certified or licensed please remember to visit all CEUs for all of
your continuing education needs we offer unlimited CEUs for $59 for addiction and
mental health counselors social workers and marriage and family therapists if
you’re still thinking about becoming an addiction counselor all CEUs offers the
training you need in three different formats you can choose online multimedia
self-study self-study + live webinars or even face to face weekend intensives
which meet one weekend per month for 12 months we can even present a training
series at your facility just email support at all CEUs calm to schedule it
to learn more you can also visit all CEUs com /a sir
that’s all CEUs comm /a c e are thank you

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