The Five Stages of the Microskills SessionStage Function and Purpose Commonly Used Skills Anticipated Client Response
1.Empathic relationship. Initiate the session. Develop rapport and structuring. "Hello, what would you like to talk about?" "What might you like to see as a result of our talking today?"Build a working alliance and enable the client to feel comfortable with the counseling process. Explain what is likely to happen in the session or series of sessions, including informed consent and ethical issues. Discover client reasons for coming to you.Attending, observation skills, BLS, information giving to help structure the session. If the client asks you questions, you may use self-disclosure.The client feels at ease with an understanding of the key ethical issues and the purpose of the session. The client may also know you more completely as a person and a professional—and has a sense that you are interested in his or her concerns.
2.Story and strengths. Gather data. Use the BLS to draw out client stories, concerns, problems, or issues. "I'd like to hear your story." "What are your strengths and resources?"Discover and clarify why the client has come to the session and listen to the client's stories and issues. Identify strengths and resources as part of a strengthbased positive psychology approach.Attending and observation skills, especially the basic listening sequence and the positive asset search.The client shares thoughts, feelings, and behaviors; tells the story in detail; presents strengths and resources.
3.Goals. Set goals mutually. The BLS will help define goals. "What do you want to happen?" "How would you feel emotionally if you achieved this goal?" One possible goal is exploration of possibilities, rather than focusing immediately.If you don't know where you are going, you may end up somewhere else. In brief counseling (later in this chapter), goal setting is fundamental, and this stage may be part of the first phase of the session. All the same, openness to change and exploration are good places to start.Attending skills, especially the basic listening sequence; certain influencing skills, especially confrontation (Chapter 10), may be useful.The client will discuss directions in which he or she might want to go, new ways of thinking, desired feeling states, and behaviors that might be changed. The client might also seek to learn how to live more effectively with stressful situations or events that cannot be changed at this point (rape, death, an accident, an illness). A more ideal story might be defined.
4.Restory. Explore alternatives via the BLS. Confront client incongruities and conflict. "What are we going to do about it?" "Can we generate new ways of thinking, feeling, and behaving?"Generate at least three alternatives that might resolve the client's issues. Creativity is useful here. Seek to find at least three alternatives so that the client has a choice. One choice at times may be to do nothing and accept things as they are. The system of restorying will vary extensively with different theories and approaches.Summary of major discrepancies with a supportive confrontation. More extensive use of influencing skills, depending on theoretical orientation (e.g., psychoeducation, interpretation, reflection of meaning, feedback). But this is also possible using only listening skills. Use creativity to solve problems.The client may reexamine individual goals in new ways, solve problems from at least those alternatives, and start the move toward new stories and actions.
5.Action. Plan for generalizing session learning to "real life." "Will you use what you decided to do today, tomorrow, or this coming week?"Generalize new learning and facilitate client changes in thoughts, feelings, and behaviors in daily life. Commit the client to homework and an action plan. As appropriate, plan for termination of sessions.Influencing skills, such as directives and information/explanation, plus attending and observation skills and the basic listening sequence to check out client understanding.The client demonstrates changes in behavior, thoughts, and feelings in daily life outside of the interview conversation. Or the client explores new alternatives and reports back discoveries.
