International Centre for Certification and Education of Addiction Professionals (ICCE)

The Universal Treatment Curriculum for Substance Use Disorders (UTC)

Curriculum 4

Basic Counseling Skills

for Addiction Professionals

MODULE 3 CORE COUNSELING SKILLS

Module 3 - Goals
To provide an overview of the helping relationship
concept; and
To provide an overview of Motivational Interviewing
To provide an opportunity for participants to consider
the complexity of balancing a helping relationship as
a counselor while protecting the boundaries with
clients
To provide an understanding of self-disclosure and
other issues inherent to the helping relationship.

3.2

Module 3 Learning Objectives

Define helping relationship;

Define aspects of Motivational Interviewing
Discuss the potential benefits and problems of
counselor self-disclosure;
Define and provide at least three examples of dual
relationships;
Discuss the importance of self-awareness in
counseling, and
Discuss at least three elements of non-verbal
communication and its impact on the counseling
relationship
3.3

Ambivalence and Change

We know that persons with SUDs are usually aware of the
dangers of their using behaviors but continue to use
substances anyway. They may want to stop, but at the same
time, they do not want to.
These mixed feelings or ambivalence are both natural
and the central problem in helping clients change.
More importantly, they provide the opportunity to help your
clients explore and resolve their opposing attitudes and find
their own motivation to actually change.

3.4

The effective counselor helps clients

to change by:
Examining

discrepancies between what is going

on in their current life and their values and future
goals.
Examining their behaviors in light of negative
personal, familial, and community consequences,
and
Presenting their own arguments for change.

3.5

Change and Me
You will be asked to think and experience the
difficulties of change not just for your clients but
even for yourself as a way to better understand
how to effectively work with clients facing the
demands of changing their attitudes, their
behaviors, their lives.

3.6

My Three-Day Abstinence Challenge

Please

refer to Resource Page 2.1 in your

Participant Manuals, and take a moment to review
your Challenge Chart for Day 1.
Please fill out the Challenge Chart for Day 2 is
you havent already. If done, please review it and
reflect on your responses.

3.7

My Three-Day Abstinence Challenge

(continued)
Did

I experience any urges? If so, what do I think

are my three top triggers?
On a scale of 1 (not at all important) to 10
(extremely important), how important is it to you to
change your target behavior? I you choose 2 or
above, why are you not at a lower number?
If you decided not to partake in this challenge,
how confident are you that you could make the
change if you decided to?
3.8

RULE: The four guiding principles of

motivational interviewing technique:

Resist
Understand
Listen
Empower

3.9

RULE (continued)

Principle

1: Resist the righting reflex

3.10

RULE (continued)

Principle

2: Understand your clients motivations

3.11

RULE (continued)

Principle

3: Listen to your client

3.12

RULE (continued)

Principle

4: Empower your client

3.13

Break
15 minutes

3.14

Large group Exercise: Using the

RULES
Roles:

Client and Counselor

Client will inform Counselor of an item from the
Abstinence Challenge exercise and why that
choice for behavior change.
Counselor will listen carefully, being aware of
his/her impulse to persuade, fix the problem or
offer advise.
Counselor not to respond but just listen
Partners will report back: How client felt about
counselors engagement and counselor about
his/her inability to respond
3.15

Large Group Exercise: The RULES

Contd
Counseling questions:
1. Why would you want to make this change?
2. If you decide to make this change (or make this
change permanently), how might you go about it
in order to succeed?
3. What are the three best reasons for you to do it?
4. How important would you say it is to make this
change on a scale or 0 10 (0= not important at
all and 10 = extremely important). Why are you
not at a lower number?
3.16

Large Group Discussion: Definition

Of Counseling
Define

the word Counseling

What are some of the responsibilities of a
counselor?
Explain how you see your role as a counselor?

3.17

Definition Of Counseling
A supportive

and empathic professional

relationship that provides a framework for the
exploration of emotions, behaviors, and thinking
patterns, and the facilitation of healthy changes.
Counseling is directed towards people
experiencing difficulties as they live through the
normal stages of life-span development.

3.18

Characteristics Of an Effective
Helper
Self-awareness

and understanding
Good psychological health
Sensitivity
Open-mindedness

3.19

Characteristics Of Effective Helpers

Contd
Objectivity
Competence
Trustworthiness
Interpersonal

Attractiveness

3.20

Setting the Stage

Although your ultimate approach to helping will

be influenced by what the client needs, what the
client will respond to best, and what stage the
client is in, ultimately you need to create an
environment that promotes feelings of safety,
respect, and understanding.
The bulk of this relationship building occurs in the
beginning stage of counseling and there are skills
that are more effective for use during this time.
3.21

Things to remember as a
COUNSELOR

Voice have a soothing, comforting tone

Eye contact - be natural with eye contact, be as
animated with facial expression (but be careful
showing shock are surprise..)
Language - keep in mind education level,
experiences of those with whom you are working but
be genuine in your own vocabulary
Confidence - Demonstrate confidence in process and
directives
EMPATHY when appropriate
Source: Basic Counseling Skills, MCFC/MHC/CC Residency 1 Walden University May 2010

22

3.22

The Counseling Setting

Consider your office setting:

Arrangement of furniture - no big objects between

you and client,
Credentials hang degree, licenses,
certifications, registrations on wall
Consider your comfort level as well

3.23

Core Counselor Skills

Creates

an atmosphere of trust and safety

Provides
Model

a vehicle for intense affect

a healthy interpersonal relationship

Provide

motivation for change

3.24

Core Counselor Skills Associated

With Facilitative Conditions
Nonverbal

and verbal attending behaviors

Paraphrasing content of client communications
Reflecting client feelings and implicit messages
Openness and self-disclosure

3.25

Core Counselor Skills Associated

With Facilitative Conditions Contd
Immediacy
Attending

to Client's Theory of Change

Interactive vs. Didactic Approach
Promoting Hopefulness

3.26

Conditions Of An Effective
Therapeutic Relationship
Accurate

Empathy

Genuineness
Positive

Regard/Respect

Clients perception of relationship is what counts!

3.27

Understanding the client

Consider:

The person of the client

How the client acts in session will elicit responses
from you (if client is withdrawn, you may use skills
that help bring him/her out; if client gregarious, you
may use skills to tone down the use of humor)
Sensitivity to diversity

3.28

Lunch
60 minutes

3.29

The Client-Counselor Relationship

Assess

clients behavior during session

Engagement
social modeling
be directive and challenging
react appropriately to what is said
deal with immediate issues
Attending to unfinished business

3.30

The Client-Counselor Relationship

Counselor

Personal support system

Major factor in relationship
Counselor Cheerleader
Support communicates:
someone

is here for you

you can count on someone
I might not approve of what you are doing, but I approve of you
there is a person in your life who is reliable and dependable
you will not be taken advantage of
my job is to help you get what you want

3.31

The Client-Counselor Relationship

Authentic

engagement

You will like some clients and dislike others, but you
must be genuine and can use this as immediacy
If you have strong reactions to liking or disliking a
client it is imperative that you discuss this in
supervision/ consultation

3.32

Basic Attending Skills

Purpose:

To help client tell story

Draw out appropriate background and contextual
information
Communicate understanding
Facilitate deeper level of exploration make
connections
Demonstrate empathy
Provide emotional support to the cli
3.33

Skill: Minimal Encourages

Prompts

Verbal (uh huh, go on, yes, hmmm,)

Nonverbal (bodily movements, gestures, nods

3.34

Small Group exercise: Attending

Skills
Form

groups of 4
Select a counselor, client, recorder and reporter
Client will give own story of use/ abuse of substances
Counselor will use attending skills, non-verbal and
verbal communications
Recorder will record client history and verbal/nonverbal actions of counselor
Reporter will report back to large group
Remember to welcome client to first session
3.35

Skill: Probes
Probes

help keep clients:

engage in dialogue
achieve concreteness and clarity
get a balanced view of problem situations and
opportunities.
get deeper into issues, move forward, and help in
exploration of issues.
challenge clients

3.36

Skill: Probes

Statements
Tell me. I wonder. Its still not clear to me Im not
sure I understand..

Phrases that are actually questions or requests

Share with me what you are thinking

Restating key words with question tone of voice

Example
Cl: I am tired of it all.
Co: Tired?
3.37

Skill: Questions
When

to ask questions:

To initiate the conversation

To clarify
To get things back on track
To make a point or connection
To define goals
To motivate

3.38

Skill: Questions
Problems with Questions
Bombarding

client
Too many questions in a row (particular text reads: then
you have just asked 2 stupid questions!!)

Using questions effectively

If

you can make it a statement its better!

Tell me.
Explain that
I wonder.
Talk more about that.

Good

idea to mix probes, statements, reflections

3.39

Skill: Questions

Good and Bad questions

Avoid why.
sounds judgmental (think of when you got
into trouble as a kid)
Why questions can be restated, sound
less accusatory and elicit the same
information.
Instead of why did you do that? you may
consider Can you tell me how you made
that decision? How did that work for you?
3.40

Skill: Interactive Presentation

Questions
Good

and Bad Questions:

Open and Closed

Open questions:

help elaborate and enrich the client story

help bring out the concrete specifics of the clients

world

Closed Questions:

gives basically a yes/no response

Fluff Questions:
If you are trying to fill space, its probably not a useful
question
If you can reflect or use another skill, its always better
3.41

Skill: Clarifying and Summarizing

What is important?
Listen to what your heard
Ask yourself what is underlying message?
Mini-summarization:
A sentence stem: I hear you say or In your point of
view or Looks like
Use key words of clients
Stay true to clients ideas.. they will correct if you are
wrong (and thats okay!)

3.42

Skill: Clarifying and Summarizing

Summarize themes of long dialogue

Summarize at beginning of new session
Summarize at end of session
Clarify/Summarize when situation seems to not be
going anywhere or client is rambling
Clarify/Summarize when client gets stuck or when
clients needs new perspective

3.43

Large Group Activity: Summarizing

Once upon a time there
was a poor fisherman. He
lived with his wife in an old
hut by the sea.
A poor fisherman and his
wife lived in a hut by the
sea.

3.44

Large Group Activity: Summarizing

contd
Everyday

he went fishing. One day the

fisherman felt something on the end of his line.
He pulled and he pulled. And up came a big
fish.

3.45

Skill: Nonverbals
Can

communicate volumes
can give context to the information the client is sharing
can support or discredit the validity of what the client is
expressing
can serve to provide additional understanding to words
the client is using.
Counselor nonverbals give clients clues about counselor
confidence, counselor listening skills
trustworthiness
3.46

Skill: Non-verbals

Facial expressions
Eye Contact (*consider cultural differences)
Appearance (clothing, grooming)
Gestures/Body movements (i.e., fidgety)
Spatial behavior (how did client position him/herself)
Posture

3.47

Skill: Non-Verbal Attending

Assessment of general mood

Clues to inner states
Mental status
Verbal and nonverbal congruency
Signals of distress
Unconscious reactions

3.48

Small Group Exercise: Skill: Nonverbals

List/

discuss nonverbal behaviors associated with

these feelings:
Anger
Fear
Happiness
Sadness

3.49

Skill: Counselor Non-verbals

SOLER
S - sit squarely
O - open posture
L - lean in
E - eye contact
R - relax
Note: Your facial expression will show appropriate
response
Minimal encouragers: head nods, uh huhs
3.50

Break
15 minutes

3.51

Large Group Activity: Telephone

game
Play Telephone Game:
One person taps the next person on the
shoulder and tells a 1-2 sentence story.
That person will then tap the next person
on the shoulder and share the same story.
The story can only be told once per person.
The last person to hear the story tells it to
the group.

3.52

Large Group Activity Continued

Now,

play the game with these instructions:

One person chooses a feeling,

Everyone closes eyes and starter taps person to right
who then opens eyes
Starter conveys emotion through facial expression
This goes round the room
The last person verbally identifies feeling

3.53

Large Group Continued

Was

the correct feeling conveyed?

How did you feel not being able to talk?
How did you feel being to closely observed?
How did you feel having to so closely observe
someone else?
Any feedback or comments?

3.54

Journaling
Write your thoughts from todays session
What is the most important take away that you
learned?
What do you think needs to be improved in
your agency?
What have you learned about yourself that will
help you engage your clients more effectively?

3.55

Wrap-up and
Day 2 Review
15 minutes

3.56