Hypothetical dialogue occurring during an initial session with a client: Helping students a client with anger

Hypothetical dialogue occurring during an initial session with a client: Helping students a client with anger

Abstract

Anger is an emotion addressed by counselors with their clients. Fernandez and Beck (1998) stated that, in the field of mental health, there is great attention on anger as a key concern in relations among individuals. Hamrin and Blake (2007) states that anger together with its resulting issues like oppositional defiant disorder is among the commonest reason adolescents together with children are taken to mental health services. Typically, anger can be characterized as either trait or state in nature. People experience anger in scale from little or no anger, to mild or moderate levels of irritability, frustration, to high levels of rage and fury (Deffenbacher, et al., 1996). Irrespective of the determined nature of the anger, counselors should have a theoretical conceptualization together with a system of delivery that will make the client to mirror on their anger. This paper gives a hypothetical dialogue with a client demonstrating basic skills of counseling of empathy, reflective listening and summarizing.


Introduction

There has been an increase in the concurrence and value in using of non-conventional techniques in the relationship of counseling. Using of creative counseling techniques fulfills the counselors need for a multi-faceted approach to assist clients Jacobs (1992) Creative approaches of counseling and particularly the use of creative techniques enable counselors to approach an issue from a multisensory viewpoint. These creative techniques, tap into the client’s visual, auditory, and experimental style of learning. According to O’Laughlin & Nickerson (1982), use of a single approach when counseling, entailing talking alone confines what helpers can accomplish. Therapists should get past word and enlist more of the senses of a client (Beaulieu, 2003). Using creative techniques of counseling make concepts such as anger be extra concrete in the enhancement of the process of learning. They also give the session a focus at times when they start to get out of track. In addition, they quicken the process for counselors with limited time. The preceding section gives the application of the counseling techniques in a hypothetical counseling section for a client with anger problem.


Counselor: So after getting angry you just burst out?

Client: True; last time after my husband messed with my checkbook; I just screamed and yelled at him until he finally left the house since I was out of control and was yelling at him continuously.

Counselor: Does that happen to you often, so much that it is troublesome at the workplace?

Client: Well, that is why I had to come here; I explode at work on issues which others are able to let go with ease, but are impossible for me.

Counselor: It appears that something needs to be done about your short fuse. When something fails to go in the way it is expected to go, or someone behaves in a manner that you demand that they do not behave, it appears as if this light this fuse and you blow up. For instance, when your spouse messed up with your checkbook,


Client: True, that is what happens.

Counselor: But what would happen if we did something to get longer fuse like this one? (Counselor holding up a piece of string about 12 inches). What will be the case if you had a fuse that is long?

Client: Well, I guess I would not be blowing up as quickly as I do, true?

Counselor: Yes, you would have time for thinking and reacting to a certain situation and avoid reacting and blowing up.

Client: I wonder how I can get a longer fuse.

Counselor: Excellent question; that is something I can teach you. Would you like to know means of getting a longer fuse?

Client: Absolutely, I want to know is sooner than later.


Counselor: It appears like you feel attacked by your boss often and after feeling this way, you get angry and explode. Is this the true meaning of what you say?

Client: Exactly; I have the feeling that he is always on me and speaks things that am unable to withstand. For instance, recently he was on me because he never was not amused with the way I had started the meeting for supervisors. It is he always has issues with me.

Counselor: It appears as if you want to use your boss as a shield

Client: A shield?


Counselor: Yea what is the work of shield?

Client: A shield is used for protection, correct?

Counselor: True; that is the work of a shield! They protect someone. At this moment, you do not shield yourself in the event that your boss comes to you with such things, you get the feeling of been attacked and then explode. Let me demonstrate to you how this appears with and without a shield. I am going to be your boss and will say something, and as I do this I will tap your shoulder if that is okay, (client nods).

Counselor: (Counselor standing in front of the client and poking at the client). You should put extra energy when opening the meeting for supervisors, and you should be standing and use voice that more forceful. Does it mean you cannot get anything correct?


Client: Exactly, that is what happens.

Counselor: (Counselor takes an 8 ½ × 11 piece of Plexiglas resembling the shield and holds up to the client.) Grasp this. On coming to you, I want you to protect yourself with this. (Counselor plays the role of the boss poking at the client, the shield blocking in advance as he pokes at the client) You should put much more energy into the opening of the meeting for supervisors, and you should stand and use a voice that is more forceful.

Client: Still I am not comfortable with the yelling; however, it felt better as he did not get at me like before.

Counselor: Well; you do not like his yelling, but if we work together to determine how the shield can be used, you can get protected and avert the remarks so as to explode a lot less or avoid it altogether.


Client: If I could learn to do this, then it would be marvelous. What should I learn?

Counselor: Your shield can be a concept in your own mind; this implies that you can say to yourself something such as, ‘I have to get my expectations to align with real life situations. (The counselor explains this in greater detail to help the client change herself talk. The counselor proceeds to explain the way the shield is useful to deal with the negative rhetoric of the other person).

Counselor: Therefore, normally a fight with your parents start when they try to get to you regarding something, and you become angered and start fighting. Is that true?

Client: Exactly that is precisely what takes place.

Counselor: Therefore, which things make you parents get on to you?


Client: It starts with things like, how many times have we told you to wear a seatbelt or you need to work harder in school. Other times they insist on pressing me to be extra conscientious with my things.

Counselor: Can I know this, do you see any benefit with the things they keep on shouting for you to do and do you feel as if they are yelling?

Client: What do you imply?

Counselor: When they yell at you about working hard at school, I hear something such as we want you to perform well in school, but you hear as if they mean you are not sufficiently excellent at school.


Client:  I guess something like that.

Counselor: Take this. (Counselor, gives the client a small furnace, filter). I have the perception that if I can teach you about filtering the message, then probably you would avoid been angry and exploding at your parents. You hear that you are always messing up, or you are not doing enough, but I doubt whether this is the message the parents are sending to you. If you could let their voices’ loudness, the tone of their approach gets filtered, and then you could get the clear messages coming on the other side. On my view, the messages mean learn responsibility, stay safe, and do well in school. These are not appalling things to want for your son. Do you think so?


Client: I guess they are not. It just feels awful to hear the tone in which they are said.

Counselor: This happens because you are not filtering it out hence your feelings are hurt which leads to lashing back. Using your filter will reduce the fighting between your parents and you. Do what want to do this?

Client: Sure.

(The counselor explains how, how after the client filters the comments, she will not be angered by people who say comments that are hurting as well as essential. They get angered when they feel that someone is attempting to hurt them)

Counselor: Let me see is I understand this well. You get crazy about something at school, and the first thing you do is blowing up. You punch the locker or hit someone, which gets you into trouble or you cuss at the teacher, which also results to mess. Is that true?

Client: Exactly that is what takes place.


Counselor: Then you are pulled to the office of the principal where you get some time of thinking about what you did, and when you feel awful and have second thoughts regarding the way you handled the situation, is that true?

Client: Yes, I get an awful feeling after calming down and start wishing if I had done something differently.

Counselor: Therefore, this is what you do: You react, cuss, hit, punch, then retreat, get pulled to the office and then rethink by taking the time to reflect things you could have done instead rather than what you did.

Client: Exactly, that is what I usually do.


Counselor: And that does not work well for you since, by the time of rethinking, you have already caused trouble to yourself. I think it is essential that we rearrange reacting, retreating and rethinking.

Client: What do you imply here?

Counselor: What if we had you avoid reacting first. I suggest that you retreated first, then rethink and react. Don’t you think that life will be different?

Client: Probably I would not get into such troubles. However, that is not easy to do!

Counselor: It is difficult considering that you have not been practicing it and learning to retreat at first may be challenging.

Client: I do not want to have people see me as a person who is a coward.

Counselor: From my view, retreating does not imply cowardice. It may imply finding somewhere in your mind to think of the next course of action. One retreats in his mind, think on the way you would like a situation to go, and then how you can respond rather than reacting which usually results to trouble.


Client: It appears hard to follow.

Counselor: I can assist you to know how it can be done if are willing to learn.

Client: I am eager to stop entering into trouble. I am willing to give it trial.

Counselor: We will work on having the older be like it on the right rather than on the left (Counselor writes on the board).

The counselor then works with the client regarding retreating and rethinking first. A client can reduce his tendency towards spontaneous anger eruptions after learning this tool.


(There are other incidences, which happened long ago but also cause anger. Use of a rearview mirror prop can have an immense impact.

Counselor: This occurrence between you and your brother took place about ten years ago and you are still crazy about it today?

Client: Exactly, I just cannot give the impression of letting it go.

Counselor: May I as you a question? (Client nodes) What is this? (Counselor holding a rearview mirror of a car)

Client: A rearview mirror.

Counselor: True; how is the rearview mirror used? Do people always drive focusing on the rearview mirror, or do they simply glance up at it often an again for checking what is coming up behind them?


Client: It is used for just glancing into; focusing much on it may result to an accident.

Counselor: True, this is the same with the situation between you and your brother. Driving your life while focusing on what took place ten years ago, will make you keep on crushing things. It is allowed that you recall the occurrence to know that you should not go back there, and by this it will not come back. However, staying focused on your anger; probably you will stay with fury and keep on running into problems with your anger.

Client: This technique will help clients prevail over unfinished or unresolved anger. Aiding the client to see the present and future and avoid focusing on the past will help clients with anger resulting from past behaviors of persons in their lives.

(Pop bottle to water bottle)


Counselor: After getting crazy, you just blow up all over anyone and everyone crossing your way. Is that the case?

Client: Sure; I explode at my husband, and we have a mess for several days, we stay without talking, or hanging out.

Counselor: Therefore, it is something of this nature. (Counselor picks pop bottle, shakes it and gives the client the bottle). Open this here.

Client: Oh no; I will open that! I fear it will cause a mess.

Counselor: That is true. It will cause a mess. However, that resembles what you do at home and work after getting angry, right? You become all shaken up about something, and you let it build up, and then you just explode all over the place and whoever gets on your path is messed up.

Client: True.


Counselor: What is the distinction between this (counselor holding up a pop bottle) and this (Counselor holding up a water bottle) can you shake this one and then open? (Counselor holding to water bottle).

Client: Yea; because it cannot explode.

Counselor: Exactly; this one is clear and not cloudy. (Counselor points at the water bottle). Your thinking should be done this to prevent the mad outbursts. We should get you have clear thinking and not cloudy. Doing such will make things happen that will shake you, but you will not explode. Are you willing to work on that?

Client: Yea that sounds reasonable to me.

The counselor goes ahead to teach the client to get to know of his behavior in relation to self talk, from a cognitive, behavioral framework.


(Deck of cards)

Client: I understand that you should assist me with my anger. However, this would not happen because I inherited this from my father. He was always becoming angry, and the chain runs to grandparents. I do not believe I can change.

Counselor: Probably you are right. However, since we have some time here and since you are not certain I can assist, can we play some cards?

Client: Yea, we may play.

Counselor: (Counselor dealing the client five cards and then deals herself also five cards. Counselor looks over her cards and adds two from the deck). It appears as if I have won. (Counselor reveals her hand to the client. The counselor had fixed the deck thinking that the client would deal an extremely distressing poker hand.

Client: Truly, that is unfair; you did not allow me to draw.

Counselor: That is right; you did not draw. You should play the hand that you were dealt.

Client: But that is unfair.


Counselor: I am only playing by your rules. Initially, you indicated to me that you cannot change; you should play the card of anger since that is what you were dealt in life. You are not able to change.

Client: Exactly, now I get you. So do you believe I can transform?

Counselor: I believe you could go to the deck and get some cards which will make a better hand; however, you should show willingness of getting the assistance you need. I am willing to assist you, but you ought to be open to be the perception that you can transform; you must not play the hand that you were dealt.

Client: True, I get your point now.


Summary of justification of strategies used in counseling a client with anger concerns

Varied strategies and skills for management of anger have been tried. Some of the most empirically maintained interventions comprise of cognitive-behavioral interventions, which include problem solving skills training, social skills training, behavioral coping, cognitive interventions and relaxation coping skills (Deffenbacher, and Dahlen, 2001).Problem solving skills training are helpful when there are no behavioral skill deficits like poor social skills, but there is a lack of the general problems solving which can be used for assessing situations and for choosing various skills of coping. A basic methodology of a solving problem is identifying the problem, generating alternative solutions and identifying the consequences of the different solutions.


An effective and appropriate response should be selected, and the outcome of implementing the certain responses should be evaluated.Social skills and behavioral coping skills training are targeted at the actual anger expressions versus reduction of arousal of anger. Skills training that have empirically been supported comprises direct coping skills like feedback, negotiation, and interpersonal communication. Related coping skills like assertive communication, financial planning and parenting) and inductive social skills training like clients identifying and exploring effective behaviors to cope with anger (Deffenbacher & Dahlen, 2001).According to Deffenbacher and Dahlen (2001), relaxation coping skills target both the psychological and emotional arousal associated with anger with the intention of lowering the arousal of anger. Contrastingly to the targeting arousal, cognitive interventions target biases in processing of information and cognitive appraisals.


They help in identifying distorted patterns of thinking, developing cognitions that are reality based and anger-engendering and also freeing up coping resources and problem solving.Extra strategies that have been found to be of use in effective management of anger comprise of avoiding situations that make one angry, focusing on positive things, and changing environments. Others include improving communication and social bases skills and engaging in substitute positive activities (Hamrin, and Blake, 2007).Clients who indicate to be easily angered can be shown string pieces, cut at various lengths, from short to long ones. These implies that an individual with fuses that are extremely short have the tendency of getting angry and exploding by screaming, yelling or getting into trouble as compared to people with longer fuse. In this scenario, the counselor teaches the client how their self talk results to increase in response to anger and how changing their self talk may help to have rational response to stimuli that would have previously ended into a furious explosion.


The counselor should emphasize that the more rational and different self-talk of a client results to a longer fuse (Gladding, 2005).Many times, clients dealing with anger indicate to others for the onset of their anger. For instance, counselors frequently may hear that supervisor at work or a family member made them mad. When the anger of a client is a response to feeling attacked by a different person, it may be helpful to edify them about their mental shield. The shield is useful to deal with the negative rhetoric of other people. The clients can deflect the comments rather than absorbing them and feeling furious and hurt (Jacobs, 1994).Filters are useful in solving anger problems.


The distinction between a filter and shield is that filters allow some materials to penetrate. Adolescents together with children, mostly say that reasonable stuff passes through while unwelcome stuff gets wedged in the filter. Filters help anger clients to sort out any useful communication pieces and can trap or filter pieces of communication that typically triggers furious explosions. The counselor gives a justification that is the client filters the said comments, and then she will not show anger to the person saying both useful and hurting comments. Anger takes places when one has the feeling that someone is trying to cause harm to them. Use of the filter helps the client to learn to avoid feeling hurt by the other individual (Hamrin, and Blake, 2007).Clients struggling with issues of anger typically act out before contemplating on the cost of their measures. If this is the case, the clients should be taught of the three R’s regarding how dealing with the situations may be useful.


Clients should avoid reacting, retreating and rethinking as a way of dealing with anger and instead use retreating, rethinking and responding, which implies a thoughtful action.For clients with anger that results from events taking place long time ago, a rearview mirror example would work best for them. The technique is useful in helping clients to overcome unresolved and unfinished anger. Clients should be helped to see the present and future and avoid focusing on the past (Deffenbacher, et al, 1996).In some occasions, clients suffering from furious explosions may relate to the buildup of anger inside them like pressure coming out from a shaken bottle.


Counselors using this analogy find that when assisting clients to understand this phenomenon, showing them a bottle of pop that is almost exploding gives a visual reference point to the client with anger. In this case, the counselor teaches the client from a cognitive, behavioral framework to understand his behavior in relation to his self-talk. The counselor teaches that mad explosions result from the self-talk of a client rather than the events of the other individual (Jacobs, 1994).Clients with difficulty in control of their anger often indicate that they are not able to transform their approach to complex circumstances, due to a family history of resentment or in some cases aggression. When faced with such a situation, counselors may use deck of cards to dispute that loss of control is generic and cannot be transformed. This tool is essential for helping clients in dealing with unresolved anger. Clients thinking that they can do nothing to transform their anger can be assisted by use of this method (Gladding, 2005).


Conclusion

All people experiences and expresses anger. Some individuals manage their anger in ways which are healthy while others manage it in unhealthy ways. There are various strategies, skills and structured programs that can help individuals to improve their dealing with anger. However, there are factors to be considered in the selection of efficient interventions. In addition, the counselors should know the source, function, expression, and resulting problems of the anger of a client. Often counselors, find that clients are troubled by giving up by giving up their anger and often clients oppose conventional interventions. Engaging a multi-sensory, creative approach when working with clients struggling with anger, is an efficient way of getting concepts for sticking with clients. Using creative techniques of counseling can help counselors clearly see their issues with anger, and this assist in the process of process of assisting them (Rotter,  & Murray, 2002; and Beaulieu, 2003).


References

Beaulieu, D. (2003). Beyond just words:  Multisensory interventions can heighten therapy’s          impact. Psychotherapy Networker, Vol. 27 Is. 4, p.69-77

Besley, K. R. (1999). Anger management: Immediate intervention by counselor coach.      Professional School Counseling, Vol. 3 Is. 2 pp. 81-90

Deffenbacher, J. L. and Dahlen, E. R. (2001). Anger management. In W. J. Lyddon. & J. V.        Jones, Jr. (Eds.), Empirically supported cognitive therapies: Current and future          applications (pp. 163-181). New York: Springer Publishing Company.

Deffenbacher, J. L., et al (1996). The utility of the trait anger scale and the state-trait anger           theory. Counseling Psychology Journal, Vol. 43 Is. 2 p.131-148.

Fernandez, E. and Beck, R., (1998). Behavioral Cognitive therapy in anger treatment: A meta-     analysis. Cognitive Therapy and Research, Vol. 22 Is. 1 p.63-74.

Gladding, S. T. (2005). The art of counseling: The counseling creative arts (3rd ed.).                                  American Counseling Association: Alexandria

Hamrin, V. and Blake, C. S., (2007). Contemporary approaches in anger evaluation and    management in youth: A review.  Journal of Child & Adolescent Psychiatric Nursing,            Vol. 20 Is. 4, p.209-221.

Jacobs, E. (1994). Impact therapy. Odessa, FL: PAR.

O’Laughlin, K. S. and Nickerson, E. T., (1982). Action oriented therapies: Helping through          action:  The Human Resource Development Press, Amherst

Rotter, J. C. & Murray, P. E. (2002) Creative counseling techniques for family therapists, Family Journal, Vol. 10 Is. 2 p.203-206.





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