Cognitive Distortions
"If I have one drink, I might as well have 20". Name this cognitive distortion.
All-or-nothing thinking
What does the acronym OARS stand for?
Open-ended questions, Affirmations, Reflective listening, Summarize
This group facilitation technique encourages members to communicate directly with one another rather than directing everything to the counselor.
What is horizontal processing?
A counselor spends most of the group talking about their own experiences rather than encouraging clients to share. This is a common counselor mistake.
What is talking too much?
What does CBT stand for?
Cognitive Behavioral Therapy
"My counselor didn't smile at me. They must be really not like me." Name this cognitive distortion.
Mind reading.
A counselor asks, "What would you like to be different about your life?" - What OARS skill is being demonstrated?
Open-ended questioning
This facilitation approach redirects group members away from discussing the distant past, or outside distractions & toward what is happening in the group right now.
What is here-and-now processing?
A counselor tells a client exactly what they should do without first exploring the client's perspective or asking permission. This is an example of this counselor mistake.
What is giving unsolicited advice?
A counselor says, "It sounds like you're feeling disappointed and overwhelmed." What counseling technique is this?
Reflective listening
"I feel like a bad person, so I must be one." Name this cognitive distortion.
Emotional reasoning
A client says, "I know I should stop drinking, but alcohol helps me relax." What MI concept does this demonstrate?
Ambivalence
When a group member begins to cry while sharing a difficult experience, the facilitator allows a pause without rushing to speak or fix the emotion. What facilitator skill is being demonstrated?
What is using silence and holding space?
A counselor shares personal contact information with a client and begins communicating outside of professional expectations. This violates an important counseling principle.
What are professional boundaries?
A client says, "I don't think I need treatment." What approach can help explore readiness to change without confrontation?
Motivational Interviewing
A client says, "I relapsed once, so I'll never recover." Identify the distortion and provide a healthier thought.
Overgeneralization or all-or-nothing thinking. "One setback doesn't determine my future or erase my progress."
This MI principle involves acknowledging a client's reluctance to change, avoiding conflict and responding with empathy and curiosity rather than arguing or persuading.
What is rolling with resistance?
This communication technique encourages group members to express their own feelings, thoughts, and experiences rather than giving unsolicited advice, making assumptions, or telling others what they "should" do.
What are "I" statements?
A counselor discusses a client's personal struggles with another client outside of group. This violates one of the most important ethical responsibilities in counseling.
What is confidentiality?
A client refuses to participate in group and repeatedly uses their phone after being politely asked to put it away. Rather than confronting the client or engaging in a power struggle, the counselor responds with empathy, explores the client's reluctance. What Motivational Interviewing strategy is being demonstrated?
Rolling with resistance
A client says, "If I relapse, I'll lose everything I've worked for, everyone will hate me, abandon me, and my entire life will be ruined." Name the cognitive distortion and give a balanced response.
Catastrophizing. Balanced Response: Relapsing could have serious consequences, but it doesn't automatically mean I'll lose everything. I can reach out for support, learn from what happened, and take steps to get back on track with my recovery
Engaging, Focusing, Evoking are 3 of the 4 MI principles. What is the 4th?
What is Planning?
Two group members are talking only to the facilitator, while several others remain silent. Demonstrate how you would encourage horizontal processing? (hint: practice reflective listening first)
Example: "I'm hearing some important experiences being shared. I'm curious how others are connecting with what was said. Would anyone like to respond directly to that?"
A counselor experiences strong emotional reactions toward a client because the client's experiences remind the counselor of unresolved issues in their own life. This clinical phenomenon can interfere with objectivity.
What is countertransference?
Draw and label the three components of the CBT triangle on the whiteboard. Then provide a real-life example and demonstrate how changing one component can lead to a healthier outcome.
Thoughts, Emotion/Feeling, Behavior/Action. Situation: A person relapses. Thought: I can't do anything right. Emotion: Ashamed & embarrassed. Behavior: Keep drinking and using. Solution: Ask for help, go to a meeting, mindfulness/redirect thinking - "I'm resilient, I can do this."