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Chapter 4. Stage 1: Building Relationships and Establishing
Goals
CHAPTER REVIEW
This chapter focuses on Stage 1 of the human relations counseling model, Building Relationships
and Establishing Goals. The inherent conditions affecting the relationship stage are presented.
These conditions include: initial contact; duration of the helping relationship; applications and
forms; record keeping; physical facilities; timing of appointments; and other people. A
is determined not only by the nature of the relationship and the issues addressed, but also by the
setting and context. In some settings, number of contact hours between helper and helpee are
pre-determined; other settings are more flexible.
The chapter also discusses the issues involved with working with reluctant and resistant
clients. Ambivalence about and resistance to the helping process are part of the change and
MAJOR TEACHING OBJECTIVES
1. To provide an understanding of the conditions and five steps of the relationship stage of
counseling.
1. In order to receive insurance payments, a helper must assess a client’s issues using DSM-5
Diagnostic and Statistical Manual of Mental Disorders, 5th edition, or ICD-10-CM,
2. Suppose the client complains of anxiety about the video recording device in the room. How
3. If you have two students that speak a second language fluently, have one take the role of
client and the other the interpreter. Ask a student who does not know the language to be the
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helper. Role-play a beginning session. What was it like for the helper and the class members
to use an interpreter? Where did they look?
4. Role-play a reluctant client and have different students role-play a helper. Use these role-
plays to segue into discussion of resistance, reluctance, and helper frustration. How might a
5. Ask students to give examples of times they have resisted change. When have they been
6. As helpees change, it is not unusual for others around them to be displeased with the
COMMENTS ON EXERCISES IN THE BOOK
The exercises in this chapter aid students in gaining proficiency in enhancing helping
relationships so that Stage 2, the strategy stage, can be undertaken. These exercises include
practice with creating a safe environment, offering facilitative responses, clarifying problems,
INTERNET ACTIVITIES
1. Ask students to search the Internet using the term “HIPAA”. What did they find?
2. Have students interview a classmate on e-mail. Have them pay attention to the information
for teaching about resistance in therapy, Secrets and Resistance in Psychotherapy,
www.rider.edu/%7Esuler/resist.html. He asks students to write down a secret on a piece of
paper and promises not to reveal it. Students react to various requests to expose the secret.
BOOKS AND FILMS THAT MIGHT BE USEFUL FOR THIS CHAPTER
1. Use popular films or television series suggested in Chapter 2 of this instructor’s manual and
2. Video 2: Challenges for the Counselor, Art of Integrative Counseling and Psychotherapy, by
Gerald Corey and Robert Haynes includes a segment on resistance.
3. This topic can also be found on Corey and Haynes’ student videotape, The Art of Integrative
MULTIPLE CHOICE QUESTIONS
1. Which of the following are important points when arranging an initial appointment?
2. Record-keeping involves all of the following except:
3. Duration of the counseling relationship is dependent upon:
4. Key features in establishing trust and support in a helping relationship include:
5. What is the best response for the helper when a helpee comes late?
6. Talking about the weather and other chit-chat:
7. An appropriate amount of reassurance:
8. Which of the following is likely to help clients establish an effective helping relationship and
9. Referral may be appropriate when:
10. Helpers can handle client resistance by all of the following except:
11. During step 2, Clarification of Presenting Problem, a helper must do all of the following
except:
12. A key factor in the helping contract is:
13. The term interview is used to describe:
14. Establishment of goals:
15. Examples of resistance include:
16. Client’s resistance may be a response to all of the following except:
17. Which is in the right order?
18. Resistance can be shown by:
19. Struggling against the resistance:
ESSAY QUESTIONS
2. Why might clients want to pay “out of pocket” to see a counselor even if they have
3. Under what circumstances might you want to gather information about your client from other
professionals/agencies? When would you want the helpee to sign an informed consent form?
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4. Discuss the pros and cons of using an interpreter in a session. (pages 95-96)
5. How would you deal with a reluctant client? Give three suggestions. (pages 98-104)
6. How would you decide whether to make a referral to another helper? (page 108)
7. According to this model, what is the difference between an interview and a session?
8. Why is it important to understand the individual from an ecological perspective? Be sure to
10. A client states, “My son is flunking out of high school. I’ve done everything I can to help
him. I don’t know what to do any more. How can I make him go to college?” What is this
