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					Chapter 9 Gaining New Perspectives: Helping Clients Feel and See Things

Chapter Outline
Chapter 9 Gaining New Perspectives: Helping Clients Feel and See Things Differently

I. Working with Feelings
        A. Direct Exploration of Feelings
                 1. Open-ended questions
                 2. Universalize hesitation about expressing feelings
                 3. Appreciate
                 4. Normalize and validate their feelings
                 5. Checking-in after feeling intensive exploration
                 6. Careful about timing and dosage
                 7. Culture affects feeling expression
        B. Indirect Exploration of Feelings
                 1. Tell stories in which others are having feelings
                 2. May elicit emotional identification
        C. Discrimination of One Feeling from Another
                 1. Review range of feelings
                 2. Homework in which clients monitor, name, and comment on daily feelings
                 3. Recognize feelings whether client chooses to express them or not
                 4. Avoid telling them what they are feeling
        D. Managing and Containing Feelings
                 1. Identify emotional triggers
                 2. Use scaling questions
                 3. Develop a personal “stop” strategy
                 4. Walk away
                 5. Changing the channel
                 6. Self-calming strategies
                 7. Medication
                                Exercise 9.1 Handling Strong Feelings
        E. Clinician Reactions to Feelings
                 1. Clinicians can be deeply moved
                 2. Can be important for client to know
                 3. Useful information for supervision and consultation
                 4. Be aware of individual and cultural differences between clinician’s and client’s expressions
        F. Cautions When Working with Feelings
                 1. Don’t explore too much too soon
                 2. Notice whether client story flows or deepens
                 3. Provide support and empathy when clients are upset
                 4. Acknowledge small growth steps in identifying and expressing feelings
                 5. Note your own reactions to client feelings and reflect on their various sources
                 6. Discuss lingering discomforts in supervision

II. Gaining New Perspectives
         A. Accentuating the Positive
                1. Highlight client efficacy
                         a. exception questions
                         b. coping questions
                2.   Teach transferability of skills
                3.   Construct positive future visions
                         a. miracle questions
                4.   Act as a positive mirror
         5.   Use appropriately timed helpfulness
         6.   Build on here-and-now connections
                  a. islands of possibility
B.   Creating Alternative Perspectives
         1. Questioning and brainstorming
         2. Using role-plays to expand perspective
                  a. play out the other side
                  b. take the role of the other
                  c. play the outside observer
         3. Using video to expand perspective
         4. Contact with others
         5. Developing new metaphors
                  a. cultural metaphors
         6. Using spiritual practice
C.   Developing Working Hypotheses or Hunches
         1. Hunches and advanced accurate empathy
         2. Sources of clinical intuition and hunches
                  a. clinical theory or research
                  b. clinical experience in general
                  c. experience with the specific client
                  d. knowledge about larger social issues
                  e. personal experience and beliefs
                  f. reading between the lines
                                  Exercise 9.2 Hunches
         3. Improve hypothesis-building capacity
                  a. value your intuition
                  b. supervision and consultation
                  c. test out your thinking
D.    Sharing Hunches
         1. Offer hunches in a tentative way
         2. Avoid the pitfall of assumed brilliance
         3. Know when to let go
         4. Share it so that the client feels as though it came from him or her
         5. Sharing an inaccurate hunch is okay
         6. Know when to hold your smarts
                             Exercise 9.3 Sharing Hunches
                           CLIP 9.2 SHARING HUNCHES
E.   Encouraging Client Hypothesizing
         1. Reinforce constructive introspection
         2. Silence for pondering
         3. Holding our smarts
F.   Making Observations about Stuck Patterns
         1. Client may be unaware
         2. Share as hunch
G.   Reflecting Discrepancies
         1. Reflection of discrepancy
         2. The “on the one hand…on the other hand” technique
         3. The “help me understand” technique
                    Exercise 9.4 Helping Clients See Discrepancies
H.   Education and Information Sharing
         1. Helping clients identify sources of information
         2. Providing materials
                  a. bibliotherapy
         3. Directly imparting information
                 4.   Accompanying clients in seeking information
                 5.   Sharing information through self-disclosure
                            Exercise 9.5 Sharing Information with Clients
                                 CLIP 9.4 SHARING INFORMATION
        I.   Introducing New Topics
                  1. Enlarge perspective on self or context
                  2. Wait for appropriate opening

III. Working for Social Change
        A. Clients Are Not “the” Problem
        B. Work to Change Institutions and Systems
        C. Broadening Our Own Perspective
                             Exercise 9.6 Broadening the Views of Others

IV. Conclusion

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