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Title: Brian Van Brunt, Ed.D. MJ Raleigh, Ph.D.

1
Brian Van Brunt, Ed.D. MJ Raleigh,
Ph.D. Western Kentucky University St. Marys
University of Maryland
brian.vanbrunt_at_wku.edu
mraleigh_at_smcm.edu
2

We will be discussing an approach to helping
which focuses on strength-based models of
therapeutic intervention.
These approaches are useful in working with
difficult students on college campuses. By
difficult, we mean frustrated, unmotivated, angry
and outright hostile.
These approaches are described in a way primarily
useful for therapists but may also be useful
for student affairs staff, faculty and others in
higher education with student helping roles.

The focus here is not on pathology, instead on
the potential we each have to learn, grow and
change.
This is a parallel process form of helping, a
term first defined by Searles6 to describe the
reflection between the therapist-supervisor
relationship and the client-therapist
relationship. (group home staff)
These approaches are not only for our clients,
but useful for all of us. As Rogers explains it
A Way of Being

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In Greek mythology, the muses were a sisterhood
of nine goddesses, the daughters of Zeus. They
inspired mere mortals in the areas of poetry,
history, tragedy, song, comedy and astronomy.

The metaphor here therapist as muse to client,
implies that the therapist inspires and aids the
client towards greater development or becoming.
Progressing towards a more aware or, as Maslow7
puts it, actualized self.
Clearly (hopefully?) we dont adopt flowing robes
or whisper in clients ears but nonetheless we
inspire them, offer ideas and new ways of
thinking.

We were at a training in Keene, NH where a
therapist who worked with at-risk, adolescent
girls was sharing from her 20 years of experience
shared
It is imperative that someone in the therapy
room has hope. Sometimes it is the patient,
sometimes it is the therapist. But someone must
always have hope that things will improve.

Clients often come to therapy at a low point in
their life. As such, it would make sense that the
therapist has an enormous opportunity to provide
the client with the potential for growth and the
excitement that comes with exploring the self and
branching out in new directions.
Parents know this concept wellcreating
environments that foster growth and discovery.

The candle graphic is used to represent this
area. The fire of inspiration is spread to our
clients and, when done well, does not diminish
the original source.
There is a protective nature in being the muse or
inspiration to others nurturing growth and
inspiring movement.
Weve all seen Stand and Deliver and Mr.
Hollands Opus. Teachers have long understood the
power in being the muse and inspiring others
towards their personal excellence.

The challenge for the therapist is inspiring
those who do not want to be inspired serving as
the muse for those who do not wish to grow and
create.
The therapist must believe in their heart, in
the core humanistic concepts. That those who we
seek to help have the ability to be wonderful
yet the environmental obstacles have blocked
their way.
Our goal is to inspire their individual
greatness, their own sense of Brilliance 8.

Frankls 5 work on meaning and suffering
applies here. Frankl argues meaning is found in
every moment of living life never ceases to have
meaning. Humans become lost when separated form
their greater meaning.
Those we try to help often lose track of their
meaning in life, why they continue to wake up, go
to school, go to work it is here we need to
help them find their meaning, their greater
purpose.

Stephen Covey 4 wrote the book The Seven
Habits of Highly Effective People. One of the
tenets is to begin with the end in mind.
We need to hold firm the vision of the clients
positive end amidst their struggle. Holding
onto the goal and the hope of change, which they
so often lose connection to when feeling
overwhelmed.

Brian has a client who often says at the end of
the session, Tell me something good. This
request for a positive stroke (referring to Eric
Bernes Transactional Analysis 15 model) is
related to her inability to keep these positive,
self-affirming thoughts in her head.
She becomes so overwhelmed with her day to day
depression, difficult relationships, academic
struggles and financial problems that she forgets
there is something good she is headed towards
becoming.

Hearing something good, something hopeful is
at the heart of why she returns to therapy.
We too often lose sight of the power of
relationship and connection trained to rely on
techniques, behavioral interventions and
normalization.
Yalom 17 , in his book Every Day Gets a Little
Closer, offers a patient (Ginny) a chance to
write down her experience of each therapy session
in lieu of payment.

Yalom writes down his impressions of each therapy
session as well and the two co-author the book.
There is one exchange where Yaloms experience of
the session is grand and cathartic, he recalls
making powerful analytic connections and offers
insightful therapeutic comments.
Ginny finds the session helpful because he asks
about her weekend and a movie she had seen. It is
the caring questions, not always the bold
therapeutic insights that our clients find
helpful.

17
Equanimity Balance

What we are talking about here is one of our
favorite words developing a sense of
equanimity the art and quality of being calm and
even-tempered in the face of adversity.
John Byrnes 9 talks about developing this
mindset when working with aggressive individuals.
Gene Deisinger 10 suggests this approach when
developing threat assessment team interventions
on college campuses. Retaining a sense of
balance, calmness and poise.

18
Equanimity Balance

Gavin de Becker 11 in his work in executive
protection talks about this in terms of being
like water. He refers to this as Zen and the Art
of Protection (ZAP).
The mind like water is ready to the respond to
what the situation demands without pretext or
attitude it is our most peaceful state, ready to
offer our best. It is when we bring our A game.
The challenge is keeping a mind in this neutral
state given the demands of multiple clients,
paperwork, crisis appointments and insurance
billing.

19
Equanimity Balance

We become overwhelmed with our daily duties and
struggle with our ability to achieve a mind like
water state.
Yet it is those distractions that keep us
available to our client. Irving Yalom 17
cautions therapists from being distracted from
the here and now.
When we watch the clock in session, when we think
about running errands later in the day or what we
are having for lunch we are outside the moment.

20
Equanimity Balance

William Glasser 2 offers that we each have five
separate needs in our lives. A healthy individual
keeps these needs filled, fulfilling each in
balance with the others.

21
Equanimity Balance

Too often, our clients lose sight of their sense
of balance. Work and achievement push hard and
suddenly family and friends suffer. Or
vice/versa.
They seek power in their study and career and end
up losing a sense of freedom and fun in their
lives. Balance is illusive and students find
themselves shifting chaotically between juggling
their various needs in the end, often leaving
them all unfulfilled.
When they watch TV, they think about studying.
When they are studying, they rush to go out with
friends.

22
Equanimity Balance

Fredrick Perls 16 and Erving Miriam Polster
16 talk about this in Gestalt therapys
figure/ground theory.

23
Equanimity Balance

Balance and harmony fall away as the figure
overwhelms the individual and everything else
(the background) fades.
The therapists role is to return balance and
perspective, reminding them there is more to life
than the current problem in front of them.

Empathy is the art of putting oneself into the
psychological frame of reference of another.
Seeing from their eyes and actually experiencing
the feelings of the other.
Carl Rogers1 was instrumental in pushing the
ideas of empathy, genuineness and unconditional
positive regard when working with clients. The
approach helps by creating a strong rapport
between client and therapist leading to the
client being free to achieve their goals, now
free of their obstacles.

Clients in distress often need someone who is not
in distress to aid in their recovery. A
therapist is able to make a determination of what
is the clients best interest a difficult feat,
though made easier as they gain a better
understand the patient.
The therapists assists with the healing in much
the same way a new tomato plant needs a stick
tied to it to keep it straight or the way a
lifeguard who helps the swimmer who struggling.

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First, the therapist develops a basic,
foundational rapport with the client a
beginning sense of trust, understanding and
insight.
Second, the therapist seeks to deepen their
understanding and experience the feelings,
thoughts and actions from the perspective of the
client.
Third, the therapist uses the new found
connection to assist the client in moving towards
a goal.

Byrnes 9 would refer to this process as
persuasion, or motivating an individual away from
their aggression or potential violence.
Rogers 1 saw empathy (and the clients
appreciation of this empathy) as necessary and
sufficient for change.
We suggest taking this a step further.

Goal Focused Empathy is a step beyond what Rogers
suggests. Moving away from the strictly
humanistic venue of the client always having the
ability within themselves to choose the right
path. Sometimes a client needs help.
There is a directedness to GFE that requires the
therapist to guide the client towards more
positive choices, using their previously
established empathetic connection as an aid to
the process.

Stage One
People enjoy being cared for and understood.
Questions which convey interest and which attempt
to understand their individual perspective are
ways to establish initial rapport.
Carl Rogers 1 , in his person-centered therapy
approach, focuses on the importance of making
this connection, establishing rapport and
ensuring that the client is aware of the
therapists empathy.

It is not enough for the therapist to empathize
with the client but also to convey this empathy
to the client. The therapist must have the
empathy and ensure the client knows they are
understood.
John Byrnes 9, in his book Before Conflict,
argues the importance of building a connection
and establishing trust as a way to deescalate a
potential aggressor. This trust building has been
proven useful to establishing connection with
others as a precursor to moving them to a common
goal.

Stage Two
Developing a deeper connection with clients
increases the likelihood of developing trust.
Kopp 12 suggests we attend to the specific
metaphors and examples a client uses as they
offer keys to the clients inner thoughts and
dialogues. By attending to and repeating these
examples, therapists gain a deeper understanding
into their inner language.

33
Overview of Michael Whites Narrative Therapy
13

People organize and give meaning to their
experiences through their stories.
Narrative therapists help people by reworking the
telling of their stories in a manner that gives
the patient more ownership and ability to gain
dominion over negative past experiences.

People are encouraged to separate from their
stories in order to explore unique outcomes and
obtain some freedom from the stories that
previously restricted their options.
This process of storying their experiences
adding description, sensation and detail to their
creations gives clues to the meaning they
ascribe to their own life problems and
experiences.

Imagine a patient has learned over time that she
is unattractive, common and has little in the way
of anything special to offer anyone in a
relationship.
Stories are collected as she develops that
support these ideas, Im someone who cannot do
anything right. No one would like to marry me. I
have nothing to offer anyone.
These stories become stifling and overwhelming.

The stories must be set aside, relieved of their
power, before the process of reconstruction can
begin.
The therapist helps the client set aside her
negative stories through confrontation, charisma
and enlisting her in the creation of metaphors
and imagery.
Perhaps the therapist and client create an
imaginary box where the negative stories can be
temporarily laid down for the length of their
sessions together.

This joint creation of a metaphor should use
descriptive terms and attempt to create a
memorable, realistic image.

With the negative stories safely locked away for
a time, the therapist and client are free to
dream of other stories that put the client in a
more positive, advantageous light.
It is this process of imagination,
freedom and creation which

creates the tapestry of
narrative therapy.

Stage Three

With rapport established and the connection
deepened, the therapist can then move the client
towards their goals.
One approach which is useful are the techniques
of Motivational Enhancement Therapy and
Motivational Interviewing 3.

40
Overview of Motivational Interviewing 3
1. Express Empathy 2. Develop Discrepancy 3.
Avoid Argumentation 4. Roll with Resistance 5.
Support Self-Efficacy
41
Express Empathy

Communications that imply a superior/inferior
relationship are avoided.
The clients freedom of choice and self-direction
are respected. While the therapist is in a
position of power, encouraging change happens
through listening rather than talking.
Attitude change attempts are gentle, subtle,
always with the assumption that change is up to
the subject.

42
Develop Discrepancy

Change occurs when clients perceive a
discrepancy between where they are
and where they want to be.
In certain cases such as the "precontemplators"
in Prochaska and DiClemente's stages of change
model, it may be necessary first to develop such
discrepancy by raising the client's awareness of
the adverse personal consequences of their
negative behavior choices.

43
Avoid Argumentation

Avoid direct argumentation, which
tends to evoke resistance.
The therapist does not seek to prove or convince
by force of argument.
Instead, the therapist employs other strategies
to assist the client to see accurately the
consequences of their negative behavior, and to
begin devaluing the perceived positive aspects of
their negative choices.

44
Roll with Resistance

Do not meet resistance head-on, but rather
"roll with" the momentum with a goal
of shifting client perceptions in
the process.
New ways of thinking about problems are invited
but not imposed.
Ambivalence is viewed as normal, not
pathological, and is explored openly. Solutions
are usually evoked from the client rather than
provided by the therapist.

45
Support Self-Efficacy

According to Bandura, self-efficacy is the
belief that one can perform a
particular behavior or accomplish a
particular task.
In this case, the client must be persuaded that
it is possible to change his or her own behavior
and thereby reduce their overall problems.

46
A bit about Prochaska and DiClemente
47
A bit about Prochaska and DiClemente

They suggest that the reason people fail to
achieve the change they are seeking is because
helpers focus their efforts on the action stage
too quickly (skipping pre-contemplation,
contemplation and preparation).
Many of the frustrations we face when working
with difficult, hostile or unmotivated clients
can be explained by this process.

48
A bit about Prochaska and DiClemente

When working with someone who is trying your
patience, being hostile or being unmotivated,
what is your goal?
Your goal should be to assist the person in
moving toward a higher stage of change,
maintaining positive momentum or gaining a better
understanding of their current situation and
their decision to make a change.

There are times when we all need help. We need
support and encouragement to reach our goals.
Someone who believes in us and who pushes use
forward, even though we struggle to do this on
our own.
For some, this is a significant other, our
parents, teachers or friends. They listen to us
and offer support. They believe in us when no one
else will.

For others, this encouragement comes from their
therapist.
The dogged here a word we love refers to
an act of not giving in readily. Being persistent
to the point of stubbornness.

Tolkien wrote Gandalf as the voice of dogged
encouragement for Bilbo and later, Frodo.
In Tolkiens life CS Lewis was his Gandalf.
Gandalf was quick to point
out foolish behavior and

equally as quick to point out
the positive
lessons learned.

As therapists, we strive to be the wise wizards
who share knowledge and encouragement.
Sevic and Ward 19 describe college is a time of
self discovery where positive encouragement from
a therapist can make the difference.
Rath and Clifton 18 suggest that even brief
positive encounters increase healthy attitudes,
enhancing productivity, health and happiness.

Rath and Clifton 18 suggest the smallest
interactions can play a vital role in increasing
the desire to change ones life.
Encouragement is a sound approach, even in the
face of a resistant client or a client struggling
with low self-esteem.
The therapist is the voice of esteem, the sound
of unconditional belief that the client has the
ability to learn the skills necessary to be happy.

Broaden and build theory
Broaden the clients thought action repertoire
Frederickson and Joiner 12 suggest the
importance of building new ways of thinking

The challenge for the therapist is balancing
direction and encouragement in the face of
negative behavior and cognitions.
The therapist must be creative and reinforce all,
even small, positive movement forward. Find
something positive in the behavior and thoughts,
encourage repetition.

Students come into counseling for numerous
reasons, the common denominator is feeling unable
to continue to cope.
The therapist must encourage resilience even in
the face of discouragement. We must exude a
confidence that they are good, kind and capable
people.
We are the example of resilience with our
continual encouragement, even when the client has
limited resilience.

William Glasser 2, founder of reality therapy,
talks about the importance of creating plans and
goals with a client in a manner that ensures
success.
He offers a system based on
the Wants, Direction and
Doing, Evaluation,
Planning (WDEP).

W exploring the clients wants and needs. Here
we are looking for the desires and direction the
client want to head in.
Where do they want to go? What do they want to do?

D direction and doing The therapist assesses
what the client is doing and the direction these
behaviors are taking them.

Are they studying and attending class if their
want is to do better in school?
Are they eating candy and junk food if their
want is to lose weight?

E evaluation The therapist makes an evaluation
of the clients total behavior. Is the behavior
taking them closer to their wants and needs?

P Planning and commitment assisting clients in
formulating realistic plans and making a
commitment to carry them out.
Plans should be Simple, Attainable, Measurable,
Immediate, Controlled by the planner,
Consistently practiced, and Committed to.

Simple plans are broken into small, easy pieces
Attainable plans are realistic and can be
accomplished
Measurable plans can be assessed and evaluated
Immediate short term goals that occur soon
Controlled by the planner ensuring adjustments
Consistently practiced repeat until habits form
Committed to buy-in and investment

Too often, treatment plans created by therapists
are too far reaching and miss many of these core
tenets.
Students plan to improve their grades but we
dont always identify the exact problem. Are they
missing class, not studying for tests, studying
the wrong things or not motivated to be in
school?
We can create goals that are too distant, or they
are great ideas but the client isnt on board
with them. They may be too vague difficult to
determine if they are progressing or not.

Albert Ellis 14 founded the Rationale Emotive
Behavioral Therapy (REBT) approach.
This approach can be useful for client and
therapist alike. Clients become focused on their
perception of a stressful event and these
beliefs, in turn, lead to negative consequences.
In the same manner, therapists can begin to
perceive their difficult clients as activating
events a late arrival to an appointment, rude
behavior in the office, answering a cell phone in
session. All can lead to negative beliefs and
poor outcomes in therapy.

65
A
B
C
EMOTIONAL AND BEHAVIORAL CONSEQUENCES
ACTIVATING EVENTS
RATIONAL AND IRRATIONAL BELIEFS
A cause of stress, activating event B belief,
your interpretation C consequence, your reaction
66

A Your client is late again to an appointment.
B You have talked to them repeatedly about the
importance of showing up for appointments on
time.
C You are frustrated and upset throughout the
appointment and are not very effective with them.

A Your boss gives you more clients.
B You feel overwhelmed with the clients you have
and dont think you can handle any more.
C You yell at your boss and get a negative
performance evaluation.

A You wake up late and dont have enough time
to drive to work on time.
B You have to rush to work and feel pressure to
make it on time.
C You race through a yellow light and are pulled
over by the police and given a ticket.

Our reactions become so familiar we dont think
about them.
But these automatic reactions are simply bad
habits.

If you magnify an activating event such as
A client struggling to show up on time
Lack of funding or budget to do the job the way
you feel it needs to be done
A boss who sets unrealistic expectations
You also magnify your stress. You become
Worried, upset and uncomfortable
Your thinking becomes cloudy and muddled
It will increase your frustration and stress

Instead, if you minimize an activating event
You are calmer and at ease
You think more rationally and clearly
You are better able to solve problem
You eliminate the source of your stress

How do you remain calm when experiencing an
activating event?
Recognize the old habit taking over.
Stop, take a deep breath, remain calm.
Try an alternate interpretation.

Step 1 Find the good in a bad situation
Not enough money in a budget
A client not working hard towards goals
A boss who sets high expectations
A crisis situation at work

Step 2 Control your inner dialogue
This person is out to get me. No matter what I
do, they will see me as incompetent.
They arent happy with my performance, how can I
improve my work in a way they will notice.

Step 3 Avoid the blame game
Its natural to want to blame other people for
the bad things that happen to us.
But what we really are saying to ourselves is we
arent in control of our work.
Instead, accept responsibility for things that
are in our control to fix.

Step 4 Shift your focus forward
Shifting from what was, and cant be changed.
To what is, and what can be done.
Dont wallow in self pity, think about solutions.

Step 5 Keep your problems in perspective
Changing our perspective changes the way we see
our current difficulties we see them as
temporary set-backs rather then year long events.
Try putting problems aside at the end of the day
and tackle them fresh at the start of tomorrow.
Try to see the humor in a situation.
Dont expect your interactions to always be
wonderful, expect both the ups and the downs.

78
a Cohesive Model of Helping
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Approach to Psychiatry. Colophon Books. 3
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Associate Director Addictive Behaviors Research
Center Department of Psychology / BOX 351629
University of Washington Seattle, WA 98195-1629
/ geoaparks_at_earthlink.net
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a Cohesive Model of Helping
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