David and Lynn – Lynn is a 59-year-old woman who decided to seek counselling to work through a longstanding concern about what she describes as a lack of courage in relation to various challenges, especially physical challenges. Lynn describes an incident snow-shoeing with friends when she reached an impasse: they wanted to proceed over a dangerous icy slope and she became overwhelmed with anxiety and needed help getting down from the mountain. She jokingly refers to a “cowardly gene” to capture the sense that the anxiety that overwhelms her in these situations is an expression of her fundamental nature. At the same time she is curious to challenge this notion and wants to change the way she responds in similar situations.

Maria and Alex – Maria is a 24-year-old, second-generation Argentinian woman living in Canada who came out as a lesbian last year. Her parents are devout Catholics and opposed to homosexuality, and she feels they have not fully absorbed her sexual orientation—they see it as a “phase”. She feels they are very gradually adjusting, but is concerned that announcing the plan to move in with her partner Lisa would disturb the current peaceful equilibrium in their relationship. Maria is getting pressure from Lisa, but is concerned that moving in would be extremely upsetting to her parents, and she is stuck as to how to go forward.

David and Christy – Christy is the 26-year-old mother of a 2-year-old daughter, Cristelle. She returned to her work as an employee assistance plan counselor 4 months ago after being off on a maternity leave. One month after returning to work she separated from her husband John. She has recently moved in with her parents, who she says are caring grandparents but have many opinions about parenting that sometimes cause stresses. Christy says she is not feeling much empathy for clients at work and not getting along with workmates.

Anita and Lee – Lee is a 22-year-old college student who moved to North America from rural China with his parents when he was 13 years old. He is feeling isolated and stressed by his studies. Lee is living in residence, but characterizes himself as introverted and is not engaged in the party scene there. He enrolled in engineering and is struggling with the course load. As the first member of his family to enrol in university, Lee is feeling pressure from his parents to succeed.

Marc and Peter – Peter is a 35-year-old man who is currently unemployed. His partner is very busy with her career and Peter feels she barely notices that he is struggling. Normally very active physically, Peter has given up on exercising. He is saying no to social invitations and has also stopped engaging in one of his favorite hobbies, watching films. He describes a sort of numbness: he says he “doesn't think” about any of these things. While he can identify a degree of “anxiety”, he has difficulty articulating his emotional experience.

Gaya and Sophie – Sophie is 27 years old, married with two young children. A year ago, her husband had a routine surgery that went wrong and he has been unable to work since that time. Sophie has had to step into the primary breadwinner role. She is feeling overwhelmed, worried about finances, taking care of the children and her husband, and is sleeping poorly.

Lynn has said she wants to address a long-standing fear that she says has hampered her in taking on physical challenges. In this exchange, she provides the example of an incident that illustrates the issue. David is primarily concerned with making sure he “gets it”—in other words, coordinating meanings with Lynn. Watch the exchange carefully and identify concrete examples of:

1. Re-stating
    
2. Paraphrasing
    
3. Confirming the counselor’s understanding (verbally and nonverbally).
    
4. Recapping
    

Can you identify further questions from David that contribute to clarifying Lynn's experience? What aspects of the counselor’s practice might you have done similarly/differently?

Analysis

Recapping serves multiple purposes. It doesn’t only provide an opportunity to confirm the counselor’s understanding; it also provides a breather which allows both parties to let the conversation to this point “sink in”. And more than that, because it is based on re-stating and paraphrasing, it typically generates additional descriptions because as a person hears their experience handed back to them, they often tap into additional aspects not yet articulated. This happens here, helping David and Lynn to consolidate a thicker description prior to moving forward.

Alex explores Maria’s experience of “guilt” here without assuming he understands what “guilt” means to Maria. He has the notion that the guilt may apply to Maria’s relationship with her partner, so throws this hunch into the conversation. How does Alex bring in his observations into the conversation (“My house”) without merely presenting Maria with his one-sided interpretation of what this is like for Maria? What is the outcome of his tentative posture? What aspects of this practice might you have done similarly/differently?

Analysis

Although Maria has not explicitly referred to guilt in relation to her partner, Alex has been holding onto the notion that she may be experiencing this. He decides to throw this into the conversation, and does so in a manner that suggests a wondering rather than a certainty. This invites Maria to explore the topic further and to give Alex a more nuanced picture of what she is experiencing. Alex contributes further to how Maria makes sense of her experience by presenting the image of striving to balance between guilt that is weighed in two directions. 

In this exchange, Alex offers his interpretation of Maria’s experience, stated definitively. Watch Maria’s body language: how is she responding? What are the risks of sharing interpretations in this manner? What aspects of this practice might you have done similarly/differently?

Analysis

Here Alex, Alex announces what “he can tell” about what is going on for Maria and doesn’t seem to invite Maria’s response. However she does respond, and helps to clarify. “Getting it wrong” is not always a problem: if the client feels comfortable correcting the counselor, then the outcome of the exchange can be a furthering of mutual understanding. That is what happens here, despite Alex’s very forthright offering of his view at the outset. Maria clearly disagrees with his interpretation, but offers further clarification which eventually leads to a coordination of understanding.

In this example of recapping, Christie has just spent a few minutes laying out her situation and David takes the chance to recap both to ensure his understanding fits for her and to give her a breather before they move on. What do you see in Christie’s response to the recapping and what do you think it suggests about its impact on her? What aspects of this practice might you have done similarly/differently?

Analysis

For many people struggling with life’s challenges, much of their distress comes from not having shared their concerns with anyone. One of the most significant aspects of counselling is simply the experience of having one’s story told and heard. Here David’s brief recap signals to Christie that she has been heard. The sense of relief that she has “got it out there” to someone is palpable in her response to the recap.

After their first conversation, Anita summarizes the exchange with Lee and checks in with him on his experience of the session. She cannot assume this will not be their last session; how does Anita deal with the question of whether or not Lee will come back? How does she solicit his experience of their conversation? How might she have expanded this inquiry? What aspects of this practice might you have done similarly/differently?

Analysis

There are always many choices as to how to start a therapeutic conversation. One option is to simply ask the client what they would like to share this week. This has the advantage of giving space for the client to speak about what is in the foreground for them at the moment. However, there is also the risk that there might be too much discontinuity with previous conversations. Here, Marc is aware he needs to know more about Peter’s experience of feeling sad and anxious, so he prepares Peter to pick up where he left off by recapping highlights of what Peter shared the previous week. A recap acts as a scaffold (see glossary or Chapter 10) which helps prepare Peter to share richly on the topic at hand.

In this exchange featured in Chapter One as Exploring cultural meaning, Anita makes adjustments to her understanding about Lee’s experience with help from him. Is there anything she does to invite Lee’s correction of her interpretation of things, or does he seem to do it on his own without invitation? How does Anita’s understanding of Lee’s experience shift as a result of Lee’s interjection? What aspects of this practice might you have done similarly/differently?

Analysis

Will the client correct misreadings by the counselor or not? A lot depends on the therapeutic relationship. If counselors position themselves as experts who are there to impart arcane knowledge beyond the grasp of clients, clients will naturally defer to their counselor’s interpretations, and let go of their own. Given that people invariably have significant expertise in their own lives, a critical resource is squandered. It is important to foster a relationship in which there is an implicit (and sometimes explicit) invitation to clients to challenge counselors’ perceptions when they seem out of step with their own.

In this exchange, Gaya does her best to offer a recap of Sophie’s experience. To what degree does she invite Sophie—either verbally or nonverbally—to comment on how well the description “fits” for her? What do you notice in Sophie’s verbals and nonverbals that indicates how she is receiving this paraphrase/recap? What aspects of the counselor’s practice might you have done similarly/differently?

Analysis

Recapping involves remembering some key highlights of what a client has shared and handing it back, both through the client’s exact words (restating) and the counselor’s language (paraphrasing). A recap will never be a “perfect fit”, but when it is close enough, the client will typically signal this through nonverbals or verbals…provided there is a relationship in which there is permission (explicit or implicit) to do this. Here, there is not an atmosphere conducive to critical evaluation of the counselor’s input, and so Sophie seems to indicate Gaya is missing the main point but is hesitant to indicate that in direct terms.

Christy has just talked about some helpful shifts she’s made in her attitude towards her work and towards the task of being a parent. David summarizes some of what she has just said as well as drawing on previous descriptions she has shared. What new phrases does he seem to add to the description? What, if anything, does he do to ensure these fit for Christy?

Analysis

Summarizing is more than repeating words spoken by the client. There is a selective task at hand as the counselor weaves a story of what has been discussed to this point, highlighting thematic threads and foregrounding client values, skills, intentions, and so on. There is always a choice involved in what to summarize and how to summarize it, and the decision is always ethical—in other words, it should be informed by a consideration of what will be helpful to the client.