Deck 10: Empathic Confrontation and the Creative New: Identifying and Challenging Client Conflict

Question 1

Careful listening is one of the most powerful influencing skills.Which one of the following statements about influencing is NOT true?

A)Paraphrasing is particularly useful when decisions need to be made.
B)Reflection of feeling is useful to feedback of mixed emotions.
C)Direct and firm confrontation helps clients identify their errors.
D)A good summary brings together many thoughts, feelings and behaviors.

Answer 1

C

Question 2

"Mobility" is to "immobility" as cultural intentionality is to ____.

A)stuckness
B)impasse
C)blocked
D)all of the above

Answer 2

D

Question 3

"On the one hand..., and on the other hand..." This is typically used in _________.

A)reframing
B)empathic confrontation
C)psychoeducation
D)interpretation

Answer 3

B

Question 4

The first step in confrontation is:

A)establishing rapport.
B)asking the client why he or she did it.
C)identifying a contradiction or discrepancy.
D)confronting the client.

Question 5

As a result of effective and empathic confrontation, a counselor or interviewer can anticipate that the client will ________.

A)resolve his or her issues
B)move to a more productive topic
C)come up with new ideas, thoughts, and feelings
D)become angry

Question 6

According to the authors, direct confrontation may be inappropriate for:

A)European-American clients.
B)African-American clients.
C)European-Canadian clients.
D)Native American clients.

Question 7

A nonjudgmental attitude is expressed through which of the following?

A)Body language
B)Vocal qualities
C)Statements that indicate neither approval nor disapproval
D)All of the above

Question 8

Discrepancies internal to the client include:

A)mixed messages observed in nonverbal client behavior.
B)incongruities between two verbal statements.
C)differences between what the client says and what the client does.
D)all of the above.

Question 9

Empathic confrontation is best described as _____________.

A)direct eye contact and a clear voice
B)identifying mixed messages
C)a gentle, but firm, challenge
D)all of the above

Question 10

Empathic confrontation is:

A)a direct, harsh challenge guiding clients to face hard issues.
B)a gentle skill that includes listening.
C)seeking clarification by "going against" client ideas.
D)the primary skill used by interviewers.

Question 11

According to the authors, an important goal of interviewing is to move clients from

A)ideas to feelings.
B)problem focus to person focus.
C)closed questions to open questions.
D)stuckness to intentionality.

Question 12

What are the three major steps of confrontation?

A)Step 1: Identifying conflict; Step 2: Pointing out conflicts and issues; and Step 3: Evaluating effectiveness
B)Step 1: Building rapport; Step 2: Identifying discrepancies; and Step 3: Confronting client's thinking
C)Step 1: Identifying conflict; Step 2: Countering client talk; and Step 3: Closing with a directive
D)Step 1: Building rapport; Step 2: Pointing out conflicts and issues; and Step 3: Evaluating client response

Question 13

Uncontrollable conflict and discrepancy bring stress to the client resulting in ____.

A)active inhibition of neurons and damaging glucocorticoids and cortisol are released
B)gradual strengthening of an individual through development of protective neural structures
C)an ultimate challenge to the counselor
D)the need to refer the client to the emergency room for medication

Question 14

Empathic confrontation is:

A)a direct, harsh challenge guiding clients to face hard issues.
B)a complex of skills requiring observation and listening.
C)seeking clarification by "going against" client idea.
D)the primary skill used by interviewers to cause clients to see their errors.

Question 15

Incongruities and discrepancies of the interviewee to be identified include all EXCEPT which of the following?

A)Between two statements
B)Between statements and nonverbal behavior
C)Between the influencing skill used by the interviewer and the interviewee response
D)Between what one says and what one does

Question 16

_______________ is essential if you are to challenge the client with a confrontation.

A)An empathic relationship
B)An assertive personality
C)A strong affirmation
D)All of the above

Question 17

Which one of the following is NOT a technique to supportively challenge or confront a client?

A)Observe and note discrepancies and conflict.
B)Feed back internal and external discrepancies to the client.
C)Match tonal quality with the client during the feedback of discrepancies.
D)Evaluate the client response and whether there is client change.

Question 18

A nonjudgmental attitude requires that you assume:

A)an evaluative listening to detect client deception.
B)a value neutrality in relation to your client.
C)an active and assertive communication with your client.
D)all of the above.

Question 19

Which word is NOT interchangeable with all the others?

A)Discrepancy
B)Incongruity
C)Conflict
D)Observation

Question 20

A nonjudgmental attitude requires that you:

A)assert your opinions with a positive attitude.
B)stop your listening skills and let client speak.
C)suspend your own opinions and attitudes.
D)all of the above.

Question 21

Achieving a major more lasting transformation in client thinking and behavior may require:

A)several interviews.
B)time to internalize new solutions.
C)moving from denial or partial acceptance.
D)all of the above.

Question 22

An interviewer may hear, "Yes, I hurt and perhaps I should be angry," in which level of the Client Change Scale (CCS)?

A)Level 1: Denial
B)Level 2: Partial examination
C)Level 3: Acceptance and recognition, but no change
D)Level 5: Development of new constructs, patterns, or behaviors

Question 23

Instructions: Imagine that you are talking with a client about emotional child abuse.You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark.How do you put that together?"
Classify the following client's response using the CCS scale.
Client response: "I don't understand what you are saying.There's no need to put it together.There's no problem.That's the way I do it." This client is where on the CCS?

A)Denial
B)Partial examination
C)Decision to live with incongruity
D)Development of new constructs, patterns, or behaviors

Question 24

Instructions: Imagine that you are talking with a client about emotional child abuse.You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark.How do you put that together?"
Classify the following client's response using the CCS scale.
Client response: "I understand what you are saying, it just doesn't make sense what I'm doing.I seem to be saying one thing, but doing another." This client is where on the CCS?

A)Denial
B)Partial examination
C)Full examination, no change
D)Development of new constructs, patterns, or behaviors

Question 25

After four interviews, Dominic comments, "Wow, it's really working.Things are great at home.Sara and I are doing well.Working together works!" Dominic is in what level of the CCS scale?

A)Denial
B)Partial examination
C)Acceptance and recognition, but no change
D)Development of new, larger, and more inclusive constructs, patterns, or behaviors-transcendence

Question 26

"On the one hand..., and on the other hand..." In which step of empathic confrontation would an interviewer most likely make this statement?

A)Step 1: Identify conflict
B)Step 2: Summarize
C)Step 3: Evaluate
D)This is not included in supportive confrontation.

Question 27

Instructions: Imagine that you are talking with a client about emotional child abuse.You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark.How do you put that together?"
Classify the following client's response using the CCS scale.
Client response: "I heard what you are saying.I want to change, but right at the moment I just can't do what I want.I tried last week, it didn't work.The divorce is getting to me.I'll do the best I can to change, but it is so hard." This client is where on the CCS?

A)Partial examination
B)Full examination, no change
C)Decision to live with incongruity
D)Development of new larger and more inclusive constructs, patterns, behaviors

Question 28

The reality of the story is acknowledged during __________________ of the Client Change Scale (CCS).

A)Level 1: Denial
B)Level 2: Partial examination
C)Level 3: Acceptance and recognition, but no change
D)Level 4: Generation of a new solution

Question 29

Instructions: Imagine that you are talking with a client about emotional child abuse.You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark.How do you put that together?"
Classify the following client's response using the CCS scale.
Client response: "Yes, I do love her.I care for her very much.She is extremely important to me.We do everything together.We really do so many things that work out OK." This client is where on the CCS?

A)Denial
B)Partial examination
C)Full examination, no change
D)Decision to live with incongruity

Question 30

Instructions: Imagine that you are talking with a client about emotional child abuse.You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark.How do you put that together?"
Classify the following client's response using the CCS scale.

-Client response: "I think I see what you're saying.There is a big incongruity there.I want to stop, but I was abused and hit by my parents.I think I'm doing better than they did -<-font>at least I don't strike Amie.But perhaps I can do something different next week.I'll try your new idea about disciplining her." This client is where on the CCS?

A)Partial examination
B)Full examination, no change
C)Decision to live with incongruity
D)Development of new constructs, patterns, or behaviors

Question 31

Confrontation during a single session and over a series of interviews may be measured on a 5-point scale called the Client Change Scale.Which of the following represents this scale?

A)Denial, Identification, Recognition, Generating Solutions, and Development
B)Denial, Partial Examination, Acceptance But No Change, Generation of New Solution, and Transcendence
C)Identification, Examination, Acceptance, Forgiveness, and Evaluation
D)Identification, Partial Examination, Acceptance, Forgiveness, and Transcendence

Question 32

Discrepancies between the client and the external world include:

A)conflict between the client and another person.
B)conflict between the client and a challenging situation.
C)conflict between the client and a nurse at a hospital.
D)all of the above.

Question 33

Which of the following is TRUE?

A)Confrontations exist in the form of both listening and influencing skills.
B)Confrontation only exists as listening skills.
C)Confrontation only exists as influencing skills.
D)None of the above.

Question 34

Which of the following statements about the Client Change Scale (CCS) is NOT true?

A)CCS measures the effectiveness of confronting clients about mixed messages.
B)CCS assesses the client's position relative to how he/she copes with life changes.
C)CCS measures the intensity of counselor statements during direct confrontation.
D)The way a client deals with a variety of life change issues can all be considered using the CCS.

Question 35

"You really want to meet him, but you're a little bit anxious." In which step of supportive confrontation would an interviewer most likely make this statement?

A)Step 1: Identify conflict
B)Step 2: Point out issues of incongruity
C)Step 3: Evaluating change
D)This is not included in supportive confrontation.

Question 36

An interviewer may hear, "You helped me see my mixed feelings; I need to express my feelings more," in which level of the Client Change Scale (CCS)?

A)Level 1: Denial
B)Level 2: Partial examination
C)Level 3: Acceptance and recognition, but no change
D)Level 5: Development of new constructs, patterns, or behaviors

Question 37

Regarding discrepancies between you and your client, which of the following is NOT true?

A)Never hide differences you may have with your client.
B)If you sense differences, support the client by listening.
C)Note your own or the client's discomfort with possible differences.
D)If you listen carefully, most discrepancies with your client will disappear.

Question 38

A client who is dying comments, "It won't happen: not to me." This is an example of:

A)denial.
B)partial acceptance of reality.
C)acceptance and recognition.
D)generation of a new solution.

Question 39

"I've been avoiding my anger, and it is getting in my way.I'm going to start dealing with it." An interviewer may hear this statement in which level of the Client Change Scale (CCS)?

A)Level 1: Denial
B)Level 4: Generation of a new solution
C)Level 5: Development of new constructs, patterns, or behaviors
D)Level 3: Acceptance and recognition, but no change

Question 40

The client may distort his or her story and blame others unfairly in which level of the Client Change Scale (CCS)?

A)Level 1: Denial
B)Level 2: Partial examination
C)Level 3: Acceptance and recognition, but no change
D)Level 5: Development of new constructs, patterns, or behaviors

Question 41

If your client starts with you at denial or partial acceptance (Level 1 or 2) and then moves with your help to acceptance and generating new solutions (Level 3 or 4), you have clear evidence of:

A)the effectiveness of your therapy process.
B)the capacity of your client to achieve progress without your help.
C)the strong need for leadership and direction your client has.
D)the powerful impact of the environment on our clients.

Question 42

Which of the following is NOT part of the Racial-Identity Development Model?

A)Disillusionment Stage
B)Resistance and Immersion Stage
C)Introspection Stage
D)Integrative Awareness Stage

Question 43

If you practice assessing client responses with the CCS model, eventually you will be able to make decisions automatically "on the spot" as you see how the client is responding to you.

Question 44

Which of the following contextual factors may lead to clients' low self-worth and self-esteem?

A)Self-talk and internal dialogue
B)Cognitive distortions and negative schemas
C)Oppression and racism
D)All of the above

Question 45

____________ developed the Racial-Cultural Identity Development (R-CID) model.

A)Ivey and Ivey
B)Sue and Sue
C)William Cross
D)Zalaquett and Montenegro

Question 46

Nelida and Allen's two sessions highlight the importance of helping clients address conflicts related to racial-cultural identity.

Question 47

Judgments should never be implicated in the counseling session.

Question 48

The CCS can be used be used to:

A)determine the creative effect of your confrontation.
B)assess success of your interventions.
C)determine client progress over a series of sessions.
D)all of the above.

Question 49

Confrontations are frequently observed in session conversations.

Question 50

Which of the following statements regarding empathic confrontation and mediation is NOT true?

A)There is a need for actual contact and communication between combatants.
B)Power needs to be equal between the two individuals or groups.
C)There is need to search for common goals and areas of agreement.
D)A win-win resolution is most achievable when two individuals or groups meet to address issues.

Question 51

The most common empathic confrontation uses:

A)paraphrasing.
B)reflection of feelings.
C)summarizations.
D)all of the above.

Question 52

According to the authors, empathic confrontation is a distinct skill that relies heavily in influencing skills and strategies to client change.

Question 53

Confrontation is relevant to all clients, but it must be worded to meet individual and cultural needs if real creativity is to occur.

Question 54

If you observe closely in the here and now of the session, you can rate how effective your interventions have been.

Question 55

Clients complete each developmental task in fairly quick succession, and their progress can be quickly assessed on the Client Change Scale (CCS).

Question 56

Counseling helped Nelida:

A)appreciate her culture and feel "proud" of her grandparents.
B)appreciate herself and feel "proud" of her achievements.
C)appreciate her mainstream culture and feel "proud" of her classmates.
D)appreciate and "proudly" adopt the counselor's worldviews.

Question 57

According to Ivey, Ivey, and Zalaquett, empathic confrontation is a not a distinct skill; it is a set of skills that may be used in different ways.The most common confrontation uses the paraphrase, reflection of feeling, and summarization of discrepancies observed in the client, or between the client and her or his situation.However, questions and influencing skills and strategies can also lead to client change.

Question 58

You can assess the direct impact of confrontation, as well as any other microskill, in the here and now with the Client Change Scale (CCS).

Question 59

Empathic confrontation serves as a solid base for mediation.

Question 60

The counselor's or interviewer's task is to move clients beyond their issues and problems to realize their potential as human beings.

Question 61

Discuss some of the key multicultural issues in the use of confrontation.

Question 62

Explain and illustrate with clear examples the different stages of the Racial-Cultural Identity Developmental (R-CID) model.

Question 63

Describe the integrated steps of empathic confrontation and provide examples of each.

Question 64

Present the Client Change Scale and explain how it is used in counseling and therapy.Illustrate each of the levels and uses.

Question 65

Define empathic confrontation and its place in the session and the counseling process.

Question 66

A client comes to you saying the following: "I have no problems in stopping smoking, I've stopped ten times in the last year."
a.Identify the incongruity in the statement.
b.Write a confrontation you might say to the client including the important check-out.
c.Follow this by writing client statements that would represent denial, partial examination, full examination, decision to live with the incongruity, and the development of new patterns, constructs, or behaviors.