Intentional Interviewing and
Counseling:
Facilitating Client Development in a
Multicultural Society
7th Edition
Allen E. Ivey
University of Massachusetts
Mary Bradford Ivey
Microtraining Associates
Carlos P. Zalaquett
University of South Florida
Copyright © 2009
Chapter 13
Skill Integration:
Putting It All Together
Not to decide is to decide.
Harvey Cox
Chapter goal
▲
Help you integrate the microskills smoothly into a
naturally flowing interview and treatment plan.
Competency objectives
▲ Conduct a well-organized career interview based on a
decisional model derived from trait-and-factor theory
▲ Develop long-term treatment plans for your work with a
client and keep systematic interview records
▲ Utilize the concepts of this chapter to further your skills
and understanding of other theoretical models of the
helping process
The Case of Mary
Mary, the client, is a 36 years old divorced woman, with
two children. She has worked as a physical education
teacher for a number of years. Currently she is bored
and stymied with her job as a PE teacher and wants help
searching for a new career. She is thinking about doing
something related to business but says that she is
somewhat depressed by her situation and wants help.
The Case of Mary
Reflection Questions
▲ What do you think about Mary’s situation?
▲ How might you help Mary?
INTRODUCTION: ANALYZING THE
INTERVIEW
▲ Integrate skills, strategies and concepts of intentional
interviewing and counseling into a naturally flowing interview
and treatment plan.
▲ Conduct well-organized vocational interviews based on a
decisional model from trait-and-factor theory.
▲ Develop long-term treatment plans for your clients and keep
systematic interview records.
▲ Facilitate an examination of your own style.
INTRODUCTION: ANALYZING THE
INTERVIEW
▲ The analysis of Allen and Mary’s interview provides a
model to examine your own work and style.
 Systematically apply the skills and concepts learned so far to
analyze the full interview.
 Think ahead to how you will conduct your interviews.
 Develop a plan.
 Keep notes and integrate your own ideas into a long-term
treatment plan.
 Audio- or video record an interview to do comprehensive
analysis of your own style and its impact on clients.
INSTRUCTIONAL READING 1:
DECISIONAL COUNSELING
▲ Also called problem-solving counseling.
▲ Basic framework useful in many settings for counseling
or interviewing.
▲ Recognizes decision-making as vital part of most
systems of counseling.
▲ Facilitates client decision-making.
▲ How can we help clients work through issues and come
up with new answers?
Systematic Decision Making Model
Ben Franklin originated the systematic decision making
model.
a)
Identify the problem clearly;
b)
Generate alternative answers;
c)
Decide what to do.
The Trait-and-Factor Legacy
Frank Parsons developed the Boston Vocational Bureau in
1908. In vocational counseling, client needs to:
a)
Consider personal traits, abilities, skills, and interests.
b)
Examine the environmental factors -- opportunities, job
availability, location.
c)
Develop “true reasoning” on the relations of these two
groups of facts.
Emotional aspects of decisions
▲ Emotions play a critical role in decision making for it is
how we feel about the alternative answers/solutions that
leads us to a decision
▲ Insufficient attention to emotional aspects is a common
problem observed in decisional models.
 Few of us would be satisfied if our decisions reflected only
executive left brain activity and cognitive processes.
 Decisions require emotional energy and agreement with our
long-term memory if they are to be meaningful and lasting.
▲ Bring feeling and emotion to the interview/session when
you work with clients and decisions.
The Balance Sheet and Future Diary:
Bringing Emotions Into Decisional Practice
Leon Mann developed the Balance Sheet and Future Diary
to help people “take decisions” Decision making
involves:
1.
Facts of the problem.
2.
Option chosen to solve it.
3.
Factual outcome to the solution.
4.
Emotional outcome of the solution.
The Balance Sheet and Future Diary:
Bringing Emotions Into Decisional Practice
▲ Developing a balance sheet and future diary:
 List all possible solutions
 Rate each outcome with + or –
 Anticipate and rate emotional impact
▲ Remember, decisions need to be emotionally satisfying
for client.
Decisions, Problem Solving, and the Five
Stages/Dimensions of the Interview
▲ Decisional counseling concepts are basic to the fivestage/dimensions model of the interview.
 Decisional issues and problem-solving theory are
parallel.
 Neuropsychology research reveals similar learning
model, with special emphasis on emotion.
▲ How do these five elements fit with the traditional
problem-solving models?
Example: Should we move to a new town?
(This maps out plus and minus of decision)
+Plus
-Minus
+ New job is exciting
- Like coworkers& boss
+ Pays more
- Spouse doesn’t want to
leave
+ Better weather than here
++ Can learn new ideas that
will enhance career long
term
- Schools better here
- House difficult to sell
- Moving is agony
Comparing the five stages/dimensions of
Decisional Counseling with traditional problemsolving models
The Five Stages/ Dimensions of
Intentional Interviewing and
Counseling
Problem-Solving Models and the
Trait-and-Factor Legacy
1. Relationship—Initiating the
session—Rapport and
structuring (“Hello; this is what
might happen in this session.”)
This step has often not been
stressed as a separate
element, but it is obviously an
important part of any
problem-solving attempt.
Comparing the five stages/dimensions of
Decisional Counseling with traditional problemsolving models
The Five Stages/ Dimensions of
Intentional Interviewing and
Counseling
Problem-Solving Models and the
Trait-and-Factor Legacy
2. Story and strengths—
Gathering data—Drawing-out
stories, concerns, problems, or
issues (“What’s your concern?
What are your strengths or
wellness resources?”)
Benjamin Franklin talked of
defining the problem whereas
trait-and-factor theorists
speak of the need to consider
personal traits, abilities, skills,
and interests; with
environmental emphasis.
Comparing the five stages/dimensions of
Decisional Counseling with traditional problemsolving models
The Five Stages/ Dimensions of
Intentional Interviewing and
Counseling
Problem-Solving Models and the
Trait-and-Factor Legacy
3. Goals —Mutual goal setting— Part of defining the problem in
Establishing outcomes (“What
problem-solving approaches.
do you want to happen?”)
Goal setting is often the first
issue addressed in brief
solution-oriented interviewing
and counseling.
Comparing the five stages/dimensions of
Decisional Counseling with traditional problemsolving models
The Five Stages/ Dimensions of
Intentional Interviewing and
Counseling
Problem-Solving Models and the
Trait-and-Factor Legacy
4. Restory—Working—Exploring These models often use
alternatives, confronting client
brainstorming to find
incongruities and conflict,
alternatives and employ “true
restorying (“What are we going
reasoning” to discover the
to do about it?”)
relationship of the person to
the environment.
Comparing the five stages/dimensions of
Decisional Counseling with traditional problemsolving models
The Five Stages/ Dimensions of
Intentional Interviewing and
Counseling
Problem-Solving Models and the
Trait-and-Factor Legacy
5. Action— Terminating—
Generalizing and acting on new
stories (“Will you do it?”)
Generalization is not always
stressed but it is implicit in
brainstorming and true
reasoning.
Applications to Counseling Theories
and Multiple Settings
▲ Decisional issues and the microskills model underlie
many theoretical approaches to helping.
▲ If you have intentional competence in the microskills and
the relationship— story and strengths—goals —
restory—action model, you are well prepared to work
with many different approaches to the helping process.
Time spent in stages/dimensions by
different theoretical orientations
Stage/Dimension
Decisional
Counseling
PersonCentered
Theory
Cognitive
Behavioral
Therapy
Brief
Counseling
Motivational
Interviewing
1. Relationship
Medium
Some,
emphasis in
rapport
Some
Medium, goal
setting done
early
Medium
2. Story and
Strengths
Medium
Great
Medium
Medium
Medium
3. Goals
Medium
Little
emphasis
Medium
Great, central
issue
Medium
4. Restory
Medium
Great
Medium
Medium—
Dimensions 4
and 5
combined
Medium
5. Action
Great
Little
Great
See above
Great
INTERVIEW PLANNING AND CASE
CONCEPTUALIZATION
First Interview Plan and Objectives
▲ Before the first interview
 Study the client file and anticipate what issues you think are
important.
 Think how you want to help the client.
 What issues will be important in the session.
 How you might handle them
 Prepare a tentative plan as a guide.
 Be flexible and modify plan if needed.
INTERVIEW PLANNING AND CASE
CONCEPTUALIZATION
Develop an interview plan
▲ Interview plan characteristics:
 is tentative.
 based in intake records and other information (e.g.,
questionnaires, diagnosis, case conceptualizations).
 oriented toward helping with client’s concerns and discussion of
personal issues.
 remind us about what we need to consider as we start.
 provides a useful checklist to help ensure that you cover key
issues in the session.
INTERVIEW PLANNING AND CASE
CONCEPTUALIZATION
▲ Interview plan:
 It is not rigid.
 it changes as interview progresses and new issues are brought
up.
 it is not imposed on the client.
▲ Use cultural intentionality and flex with what actually
does happen in the session.
First Interview Plan and Objectives
Before the first interview
▲ Relationship
 Do you anticipate any special issues in regard to rapport
development?
 What structure do you have for this session?
 Do you plan to sue a specific theory?
First Interview Plan and Objectives
Before the first interview
▲ Story and strengths
 What are the anticipated problems?
 Strengths?
 How do you plan to define the issues with the client?
 Will you emphasize behavior, thoughts, feelings, meaning?
First Interview Plan and Objectives
Before the first interview
▲ Goals
 What is the ideal outcome?
 How will you elicit the idealized self?
 Idealized world?
First Interview Plan and Objectives
Before the first interview
▲ Restory
 What types of alternatives should be generated?
 What theories would you probably use here?
 What specific incongruities have you noted or do you anticipate
in the client?
First Interview Plan and Objectives
Before the first interview
▲ Action
 What specific plans, if any, do you have for transfer of training?
 What will enable you personally to feel that the interview was
worthwhile?
INTERVIEW PLANNING AND
CASE CONCEPTUALIZATION
How are you going to develop a working alliance with a
new and unique client?
▲ Allen and Mary Ivey’s transcript provides a good model.
 They transcribed the interview, then Allen analyzed his behavior
in the session, and Mary reviewed his comments and analysis.
 Not all responses were equally effective.
 Our ability to learn from these and change makes us more
effective interviewers and counselors.
▲ Develop a Plan
DEMONSTRATION INTERVIEW AND ANALYSIS:
ALLEN AND MARY’S DECISIONAL SESSION
▲ Developing a relationship is basic to case conception,
case planning, and treatment plans.
▲ Basic attitudes such as warmth and smiling help but
what else can you do to make the client comfortable and
ready to talk?
DEMONSTRATION INTERVIEW AND ANALYSIS:
ALLEN AND MARY’S DECISIONAL SESSION
Reflection Questions
▲ What do you think about Allen and Mary Ivey interview?
▲ What do you think about Allen’s responses?
▲ What responses make more sense to you?
▲ Which responses could be phrased more effectively?
▲ What would you do differently?
INSTRUCTIONAL READING 2: INTERVIEW
TRANSCRIPT ANALYSIS AND PLANNING
Following up, analyzing, and planning for the future are
critical for case management and treatment
▲ Skills and their influence on the relationship.
 What skills did you use and what was their effect on the client?
▲ Referral and consultation.
 When shall you refer and how can you obtain feedback on your
interviews?
▲ Case management and case conceptualization.
 Planning for future interviews.
First Interview Plan and Objectives
Analysis after first interview
Allen’s tentative plan demonstrates that it is possible to
plan a session before it happens.
▲ Were Allen’s objectives achieved in the session?
▲ How appropriate each of his interventions was?
▲ What would you have done differently?
First Interview Plan and Objectives
Analysis after first interview
Analyzing a Session
▲ Observe interviewer style -- maybe yourself on video.
▲ Consider appropriateness of interventions.
▲ What would you do differently?
▲ Assess your own style for strengths and improvement
opportunities.
Analyzing a Session
Skill Classifications
Listening &
Influencing
Focus
C*
Counselor and Client
Conversation
Process Comments
See Table in chapter 13
(List Skill)
(See
Chapter 9)
* Record “C” for confrontations.
Skills and Their Influence on the Client
Text example session, Allen and Mary
▲ Identifies some of the impact of his skills on the client.
▲ Fulfilled the functions suggested for each stage.
▲ Achieved predictable results with intentional use of each
skill.
Skills and Their Influence on the Client
Text example session, Allen and Mary
▲ Used about 2 attending skills for every influencing skill.
▲ Combined dual focus on Mary and the issue.
▲ Identifies and classifies several skills and stages of the
interview.
Skills and Their Impact on the Client
▲ Rapport-building: More comfortable interview
▲ Open questions: Encouraged client talk
▲ Definition stage: Client identifies specific issue
▲ Basic listening: Brought out concrete goals
▲ Summarizing: Revealed Mary’s key thoughts
▲ Confrontation: Explore deeper issues
Skills and Their Impact on the Client
▲ Mary appears ready and willing to take action.
▲ The next session will “tell” whether she acted on the
generalization plan.
▲ The work that clients do after interview is as important as
what they do in the session.
▲ Use the Client Change Scale to assess your
effectiveness as an interviewer.
Client Change Scale (CCS)
The Creation of the New
Denial
1
Full
Examination Decides to
Live With
But No
Partial
Incongruity
Change
Examination
2
Denies or
Discusses
fails to hear part, but not
incongruity.
all of
incongruity.
3
Discusses
incongruity
completely,
but will not
change.
4
Discusses
and is fully
aware of
decision
impact.
Decides to
Change From
Incongruity
5
Discusses
and alters
choices
when faced
with
incongruity.
Referral
▲ No interviewer has all the answers.
▲ Helps clients find community resources for their
continued growth.
▲ Helps when counselor skills are insufficient to aid client.
▲ Maintain contact with the client as referral process
evolves.
▲ Sometimes you continue to work with the client while
additional help is acquired from specialized
professionals.
Note Taking
▲ Helps when the interviewer forgets what happened last.
▲ Facilitates planning for subsequent sessions.
▲ Required for legal and professional accountability.
▲ Can be structured using the five stages.
▲ Structured notes provide data to interviewer supervisor,
as needed.
Case Management, Case Conception,
and Planning for Future Interviews
Treatment Plan
▲ Interview plan IS the treatment plan for short-term
counseling.
▲ Treatment plan is more detailed for long-term
counseling.
▲ Outline all issues raised by the client.
▲ List problems, issues, priorities and desired outcomes at
greater length.
▲ Many alternative plans and methods may be used longterm.
Treatment Plan
▲ Treatment plans are often required by agencies and insurance
companies.
▲ Plans with specific goals are becoming more standard.
▲ May be structured using the five-stages.
▲ Notes highlights from each stage.
▲ Summarizes issues.
▲ Notes decisions, interventions, and shifts in topic direction.
▲ Captures generalization/homework plans.
Developing a Long-Term Treatment
Plan
1. Relationship
▲ How does this client develop rapport?
▲ What issues are of most comfort/ discomfort?
▲ How does the client respond to structuring?
▲ At what place will structuring be most helpful?
Developing a Long-Term Treatment
Plan
2. Story and strengths
▲ List, in order of importance, the several areas of
concern.
▲ Include a list of the client’s strengths and assets for
coping with these issues.
Developing a Long-Term Treatment
Plan
3. Goals
▲ What are your and the client’s ideal outcomes for these
and other issues?
Developing a Long-Term Treatment
Plan
4. Restory
▲ What are the client’s main alternatives?
▲ What are your treatment alternatives?
▲ How might they best be confronted?
Developing a Long-Term Treatment
Plan
5. Action
▲ What are the specific thoughts, feelings, and behaviors
that you and the client would like to generalize to real
life?
▲ Wherever possible, work with the client to set up specific
goals of generalization.
SUMMARY
▲ This chapter is designed to serve as a model for you
transcribing and generating your own analysis of the
interview.
▲ No interview is perfect.
▲ Ability to be intentional is what counts.
▲ “Its not the mistakes make, but what you do to correct
them that counts.”
▲ All interviewing and counseling are decisional processes.
Key Points
Decisional counseling
▲ Decisional counseling, a modern reformulation of traitand-factor theory, assumes that most, perhaps all,
clients are involved in making decisions. By considering
the many traits of the person and factors in the
environment, it is possible to arrive at a more rational
and emotionally satisfying decision.
Key Points
Decisional structure and alternative theories
▲ The restorying model of the interview can be considered
a basic decisional model underlying other theories of
counseling and therapy.
▲ Once you have mastered the skills and strategies of
intentional interviewing and the five-stage model, you will
find that you can more easily master other theories of
helping.
Key Points
Interview analysis
▲ Using the constructs of this book, it is possible to
examine your own interviewing style and that of others
for microskill usage, focus, structure of the interview, and
the resultant effect on a client’s cognitive and emotional
developmental style.
Key Points
Interview plan and note taking
▲ It is possible to use the restorying model structure to
plan your interview before you actually meet with a client.
This same five-stage structure can be used as an outline
for note taking after the interview is completed.
Key Points
Treatment plan, case conceptualization, and case
management
▲ A treatment plan is a long-term plan for conducting a
course of interviews or counseling sessions. Case
conceptualization is your integration of client, issues,
challenges, and goals for the future. Case management
often leads to alternative change strategies beyond the
original interview and may involve efforts with the family,
community, and other agencies.
COMPETENCY PRACTICE EXERCISE AND
SELF-ASSESSMENT
Chapter 13
Individual Practice
Self-assessment
Individual Practice -- Practice Exercise in
Case Conceptualization and Interview Analysis
IIC
Scope of Assignment
Prepare a transcript from a taped session of a practice
interview.
Complete or partial interview, minimum 20 minutes.
Prepare a treatment plan; outline the interview before
the session.
Suggested topics can include:
•Career counseling, Interpersonal conflict, Feelings/ meanings specific
to the client, Controversial topic—abortion, divorce, death
Individual Practice -- Practice Exercise in
Case Conceptualization and Interview Analysis
IIC
Scope of Assignment
Acquire client’s permission to participate and be taped.
Only use volunteer client who understands your
assignment and is willing to participate.
Client is free to withdraw at any time.
Include written permission in the final transcript.
Complete the checklist and answer discussion questions.
Individual Practice -- Practice Exercise in
Case Conceptualization and Interview Analysis
IIC
Checklist
Describe the client.
Do NOT use the client’s real name.
Follow the model in Chapter 13.
Number each interviewer/client interaction.
Score each focus/attending/influencing skill.
Double scoring may be required for some comments.
Rate confrontations on the CCS.
Comment on interactions when appropriate.
Individual Practice -- Practice Exercise in
Case Conceptualization and Interview Analysis
IIC
Checklist
Develop interview notes on your session using the fivestage structure of the interview.
Develop a Second Interview Plan and Case
Conceptualization for the next session (Ch. 13).
Develop a Long-term Case Conceptualization and
Treatment Plan (Ch 13).
Analyzing a Session
Final Transcript Format
Skill Classifications
Listening &
Influencing
Focus
C*
Counselor and Client
Conversation
Process Comments
See Table in chapter 13
(List Skill)
(See
Chapter 9)
* Record “C” for confrontations.
Client Change Scale (CCS)
Final Transcript Evaluation
Denial
1
Full
Examination Decides to
Live With
But No
Partial
Incongruity
Change
Examination
2
Denies or
Discusses
fails to hear part, but not
incongruity.
all of
incongruity.
3
Discusses
incongruity
completely,
but will not
change.
4
Discusses
and is fully
aware of
decision
impact.
Decides to
Change From
Incongruity
5
Discusses
and alters
choices
when faced
with
incongruity.
FORM
IIC
Interview Plan and Objectives Form (in this Ch.)
As you practice, we
encourage you to use the
forms provided. Study your
client after the preceding
session. Complete this form
indicating issues you
anticipate being important in
the next session and how
you plan to handle them.
We provide specific forms
for each specific skill.
FORM
IIC
Creating a Long-Term Treatment Plan (in this Ch.)
As you practice, we
encourage you to use the
forms provided. Use this
form to develop a long-term
treatment plan.
We provide specific forms
for each specific skill.
Individual Practice -- Practice Exercise in
Case Conceptualization and Interview Analysis
IIC
Discussion Questions
What did you do well, poorly, and why?
Where would more appropriate skills have been better?
Note what worked and what you feel good about.
From observation, note how you influenced the direction
of the interview.
Be aware of the stages of the interview. Indicate when
you feel each stage ended.
Individual Practice -- Practice Exercise in
Case Conceptualization and Interview Analysis
IIC
Discussion Questions
Summarize use of skills with skill count.
Include a summary commentary of the interview.
Assess your competence level.
What have you mastered?
Where do you have room for growth?
What are your plans for further development?
PORTFOLIO OF COMPETENCE
What Is Your Level of Mastery of this Skill?
IIC
 After completing the practice exercise please go back to
the interview you completed as you started this book.
 Note how your style has changed and evolved since then.
 What particular strengths do you note in your own work?
 Are you meeting your client’s needs as described in this
chapter?
 How much do you understand and use cultural/
environmental/ contextual issues.
 How would a person from a different cultural group and
gender evaluate your work?
SELF-ASSESSMENT
Exercise: Self-Evaluation of Skill Integration
IIC
 A checklist for your portfolio has not been developed for
this chapter.
 At this point, developing and evaluating your own
interviewing style becomes the major exercise for your
portfolio.
DETERMINING YOUR OWN
STYLE AND THEORY:
CRITICAL SELF-REFLECTION
ON SKILL INTEGRATION
CRITICAL SELF-REFLECTION
ON SKILL INTEGRATION
The decisional counseling model can be very
beneficial to understand how you integrate the
skills learned.
 What single idea stood out for you among all those
presented in this chapter, in class, or through
informal learning?
 What have you learned and observed about yourself?
 How could you use the decisional counseling model
to further your development?
 What is your plan to continue developing your own
style?
Write your ideas in your journal.