by Sandra Collins, Gina Ko, Yevgen Yasynskyy, Mateo Huezo, Janelle Baker, Simon Nuttgens, and Michael Hart

In this chapter we add another layer of understanding to client challenges and preferences by inviting consideration of the broader contexts of their lived experiences. This contextual or systemic perspective provides an opportunity for clients to consider sociocultural influences on their health and well-being. It opens the door to recognizing when the challenge they are encountering arises from oppressive or health-limiting narratives, norms, or institutional structures, rather than from within their thinking, emotions, competencies, or internal resources. As you move through the chapter, keep in mind both the influence of these external factors on the ways in which the challenge is conceptualized as well as the possibilities open to the client for envisioning their preferred lived experiences. We begin by exploring the ways in which identities and experiences of gender, gender identity, and sexual orientation are contextualized by sociocultural discourses and norms, attending to both the intersections of client identities and the intersectionality of cultural oppression.

Figure 1

Chapter 9 Overview

RESPONSIVE RELATIONSHIPS

A. Intersectionality

We have argued throughout this ebook that both counsellor and client are complex cultural beings, defined in part by the intersections of their cultural identities (i.e., age, ability, gender identity, sexual orientation, social class, religion, spirituality, ethnicity, Indigeneity) (Collins, 2018d). If you are not familiar with the concept of intersectionality, you may find this short video useful.

As noted in Chapter 1, Norcross and Wampold’s (2018) research on evidence-based relationships and responsiveness identified client ethnicity as well as religion and spirituality as two of the factors for which there is demonstrable evidence of the need to adapt counselling relationships and practices to be responsive to each client. They also identified gender identity and sexual orientation as important factors that have not yet been adequately investigated, based on there not existing sufficient number of empirical, randomized control studies to meet their criteria for meta-analyses (Norcross & Wampold, 2018). Two articles in this special edition of the journal highlighted the available research on the importance of attending to gender, gender identity, and sexual orientation (Budge & Moradi, 2018; Moradi & Budge, 2018). It is noteworthy that the impact of social class, age, and ability were not explored at all. However, there are many other sources of support in the multicultural counselling and social justice literature for responsive relationship-building across multiple dimensions of client identities and social locations (Collins, 2018c, Paré, 2013; Audet & Paré, 2018; Ratts et al., 2015; 2016).

1. Gender, Gender Identity, and Sexual Orientation

Our intent is not to provide a review of the literature on working with 2SLGBTQIA+ people. We encourage you to refer to our suggested list of multicultural and social justice resources in Chapter 1 for more detailed exploration of those principles with which you are less familiar. Rather, we will highlight some of the relational principles and practices identified by Budge and Moradi (2018) and Moradi and Budge (2018) that have particular importance for counselling women and clients from gender and sexual minority populations. We adapt the principles below to the conceptual frameworks and language choices in this resource, drawing also on Collins (2018c).

1. Create a welcoming environment that is explicitly inclusive of 2SLGBTQIA+ people.
2. Adopt an antipathologizing lens, which includes a critical examination of your own assumptions and biases.
3. Stay up-to-date on gender inclusive and antipathologizing language, actively choosing to honour client choices about personal pronouns and descriptors of identities and relationships.
4. Engage in collaborative exploration of client lived experiences with a stance of cultural curiosity and not-knowing that privileges clients’ knowledge, values, and worldviews.
5. Support clients to deconstruct power inequities that result in sociocultural marginalization, including explicitly addressing power dynamics within the client–counsellor relationship.
6. Assess the salience of culture to ensure that you do not inappropriately position gender identity or sexual orientation as the cause of client challenges.
7. Assume an affirmative and strengths-based approach that foregrounds client strengths, competencies, responses, and resiliency.
8. Apply the lens of intersectionality to invite consideration of the unique and fluid interplay of various dimensions of client cultural identities and social locations.
9. Apply a contextualized, systemic lens to attend to the socio–cultural–political contexts of clients’ lives, foregrounding experiences of oppression and stigma.
10. Engage in affirmative practices to acknowledge power inequities and to foreground client resistance.
11. Integrate analysis of sociocultural, institutional, and systemic influences on client lived experiences (e.g., gender analysis, power analysis) to externalize and position the locus of control and responsibility for client challenges in the broader contexts of their lives.
12. Apply a social justice framework that opens the door to systems-level change processes, including advocacy and activism in exploring client preferred outcomes.

These principles are clearly transferable to working with all clients, whether or not they identify as a member of 2SLGBTQIA+ communities. They suggest a convergence of practices related to responsive relationships and responsive conceptualization of client lived experiences that support our arguments in this ebook. In this chapter we pick up on principles 8 through 12 to apply a contextualized, systemic lens to client challenges. We attend specifically how clients’ intersectional identities and social locations necessitate understanding of the influences of organizations, communities, institutions, and broader social, cultural, and political systems on the challenges they face and the possibilities they envision for preferred futures.

B. Applying a Contextualized, Systemic Lens

One of the emergent themes in the multicultural and social justice literature is the importance of applying a contextualized, systemic lens to understanding client presenting concerns, to developing shared meaning-making about the challenges they face, and to envisioning their preferred futures (Audet & Paré, 2018; Collins, 2018a; Ratts & Pedersen, 2014). In this section we invite your consideration of a couple of ways in which client challenges may be located (in terms of both etiology and possibilities for change) in the contexts of their lives.

1. Deconstructing Socio–Cultural–Political Influences

In Chapter 8 we invited consideration of client views of health and healing as an important element of clients’ worldviews. When working with Indigenous clients, applying a systemic lens can involve looking beyond the sphere of human interactions and systems to consider the connections of clients to land and place (Dupuis-Rossi, 2018; Fellner et al., 2016; Truth and Reconciliation Commission of Canada [TRCC], 2015). Land displacement for Indigenous peoples on Turtle Island began with, and continues through, colonization and is now complicated by climate change. In 2019 24.9 million people from 140 countries were displaced because of ecological or climate disasters (United Nations High Commissioner for Refugees, 2020). It is important to be conscious of these environmental systems as you consider client-centred views of health and healing when you work together to co-construct a shared understanding of the challenges they face and the ways in which they would like their lived experiences to be different.

As we reflect specifically on building care-filled and client-centred with 2SLGBTQIA+ peoples in this chapter, it is important to step back to consider the ways in which socio–cultural–political factors often impact their lived experiences. One area where client intersectionalities and social locations play out is the complex interplay of gender identity, sexual orientation, ethnicity, and religion. Regardless of their own spiritual beliefs or religious affiliation, counsellors engaging in responsive relationships with clients must be willing to hold the space for clients to express the ways in which they have experienced discrimination or cultural oppression that stemmed from religious views and organizations, including the involvement of religious organizations in colonization (TRCC, 2015), the use of conversion therapy with 2SLGBTQIA+ peoples (Canadian Psychological Association, 2015), or other forms of persecution based in religion (Saleem, 2018).

For those counsellors who hold religious privilege (i.e., a dominant Christian faith), it may be emotionally challenging to bear witness to client experiences of oppression without being triggered into cultural countertransference (i.e., anger, defensiveness, judgment) stemming from personal values and beliefs. Counsellors demonstrate professionalism, respect, and compassion by actively supporting clients to talk openly about, and express their anger toward, white and settler privilege, the role of the Christian church in colonization, discrimination toward 2SLGBTQIA+ persons by various religious institutions, and so on. These are not easy conversations, but without them building effective and responsive relationships can be impossible. The most powerful tool for avoiding countertransference is foregrounding the ethical mandate that all your engagement within the client–counsellor relationship is in service of the client’s health and healing. We will talk more about transference and countertransference in Chapter 11.

The practice principles adapted from Budge and Moradi (2018) and Moradi and Budge (2018) in the first section of this chapter reinforce the importance of the counsellor in creating a culturally safe and responsive environment for all clients. Applying a contextualized, systemic lens to client lived experiences necessitates counsellor consciousness of the social, economic, environmental, institutional, and political inequities of society (Hargons et al., 2017; Roysircar et al., 2018). It also requires a depth of self-understanding and self-reflection that goes beyond surface acknowledgement of social inequities and injustices. Through this next video we invite you, once again, to reflect on what you may need to examine within yourself to clear a space to be fully present to your clients.

COUNSELLING PROCESSES

A. Conceptualizing Client Lived Experiences

In this chapter we return to our focus on the second question in Figure 2 (How do the client and counsellor make sense of the client’s challenges and the contexts in which they arise?) by applying the contextualized, systemic lens introduced above. Our intent is to ensure that the various contexts of clients’ lives are fully examined, particularly as potential sources or reinforcements of the challenge. This examination of socio–cultural–political influences on client lived experiences also extends to the possibilities they envision for preferred futures, the third question (How would the client like their lived experiences to be different?).

Figure 2

Culturally Responsive and Social Just Conceptualization of Client Lived Experiences

1. Contextualizing Challenges and Preferences

The process of contextualizing challenges and preferences begins with disrupting the assumptions that the source of client distress is intrapsychic or even immediately interpersonal. Instead, opportunities are generated by the counsellor to consider the potential influence of the broader contexts of clients lives. In particular, this involves examination of experiences of cultural oppression as well as potentially more subtle encounters with, or internalization of, sociocultural narratives that are health- and life-limiting. These oppressive narratives may also influence the possibilities clients are able to generate in terms of their preferred presents or futures.

Next consider the various responses to these questions provided in Figure 3. Although the presenting concern remains the same, the shared understanding of the challenge and the client’s preferred outcomes differ in each column. Imagine the conversations between counsellor and client that may have resulted in each of these conceptualizations. Notice how the locus of control and responsibility for the challenge (i.e., the client factors versus the contexts of their lived experience) shifts across the three versions in Figure 3.

Figure 3

Pathways Through the Process of Conceptualization Client Lived Experiences

Finally, consider other alternatives for the second and third step in the process of conceptualizing client lived experiences, drawing on the sociocultural narratives or discourses you identified in response to the video. The point of this activity is to reinforce that (a) there is no single, predetermined, or right pathway from client presenting concern, to their challenge, and to their preferred outcomes. One of the factors that can substantively influence the shared conceptualization between counsellor and client is purposeful attention to sociocultural narratives and contexts.

Contextualized, systemic lens

As you explore the techniques introduced in this chapter, we invite you to keep in mind the context of clients’ lives and the influences of that context on both challenges and preferred outcomes. We have provided a couple of short clips below to demonstrate what it looks like to ignore the various ecosystems that relate to client perceptions or experiences of their challenges and what it looks like to attend intentionally to those contexts.

MICROSKILLS AND TECHNIQUES

The Responsive Microskills and Techniques summary provides a quick reference to each of the techniques introduced in this chapter.

A. Responsive Techniques

Each of the techniques in this chapter invites consideration of a broader lens on client challenges by attending directly to the contexts of their lives. Together they also build a foundation for continuing to envision preferred futures, as introduced in Chapter 8. As you reflect on these techniques, consider how client views of health and healing, relationship to time and place, intersectional identities, and social locations might influence the implementation or adaption of each technique to client context.

1. Exploring Sociocultural Contexts

As you work with clients from diverse cultural backgrounds, you will inevitably encounter client presenting concerns that appear to be embedded in, or influenced by, the sociocultural contexts of their lives. This is a fundamental principle of multicultural counselling (Collins, 2018a; Ratts et al., 2015, 2016), feminist counselling (Brown, 2010; Enns et al., 2013; Worell & Remer, 2003), narrative therapy (Freeman & Combs, 1996; Nyland & Temple, 2018; White & Epston, 1990), relational-cultural theory (Jean Baker Miller Therapy Institute, 2017; Jordan, 2010; Lenz, 2016; Singh & Moss, 2016), and other approaches to practice that attend to social injustices and other social determinants of health. Paré (2013) highlighted the continuous back-and-forth movement in counselling conversations between the client and the contexts of their lived experiences. This interface and interplay of client and context influences not only how they view health and healing, more generally, but also how they make meaning of the particular challenges they confront within and across the various contexts of their lives. The technique of exploring sociocultural contexts involves examining the various layers of interpersonal, contextual, and systemic environments in which client challenges emerge and play out.

To demonstrate the ways in which the four techniques in this chapter can be used together to accomplish the overall goal of contextualizing client challenges and preferred futures, we created the story of Bennu which is presented in four parts. Part I demonstrates the technique of exploring sociocultural contexts.

2. Deconstructing Sociocultural Narratives

The importance of deconstructing sociocultural narratives was noted in the list of practice principles adapted from Budge and Moradi (2018) and Moradi and Budge (2018) earlier in the chapter. Deconstruction is a common process in feminist therapy, narrative therapy, and many models of multicultural counselling (Collins, 2018d; Ratts et al., 2015, 2016). Deconstruction is also an important foundation of decolonization (Dupuis-Rossi, 2018; Dupuis-Rossi & Reynolds, 2018). It involves positioning client experiences and perspectives within the broader context of dominant and nondominant sociocultural discourses and narratives. The steps/processes below are adapted from Paré (2013) and Worell and Remer (2003). In this case, we do not provided specific examples of counsellor verbalizations, because the technique has a number of distinct steps or processes, and you will already have a solid grasp on the various microskills at this point.

We have positioned deconstruction as a conversational tool for both (a) refining shared understanding of client challenges and the contexts in which they arise and (b) developing a picture of client preferred futures by identifying how they would like their internalized messages and engagement with external discourses to be different. The five steps or processes (Column 3) above provide a foundation for moving into what is often a sixth step in the process of deconstruction: Co-constructing change processes to facilitate these preferred outcomes (Collins, 2018b). This final step is beyond the scope of this ebook.

3. Reframing

Human beings are all susceptible to holding narrow or compartmentalized views of their lived experiences. They naturally default to interpreting their experiences in light of what they see around them on a daily basis, their socialization, and their particular worldview. Reframing is about expanding the parameters of client perceptions or inviting them to try on new lenses that might enable them to shift perspectives and to open up to new possibilities. Reframing may also allow them to position their experiences within broader contexts that they may not have considered. Reframing is a common practice in feminist therapy, where the emphasis is often on shifting from a victim-blaming position to a consideration of the sociocultural factors that are at root of the challenge (Brown, 2010). Reframing is sometimes referred to as influencing; however, we choose not to use terminology that is a counsellor-centric. The language of reframing has a more invitational tone and invites the client to explore, reflect on, and critically analyze the fit of alternative perspectives.

Notice from the examples below how the client is invited to engage actively in the reframing process rather than being handed an already-formulated lens by the counsellor. This does not mean that the counsellor is not an active participant in the co-construction of alternative perspectives; instead, it means that the client is always given the final say on what fits or does not fit for them.

4. Externalizing

Externalizing is the process of separating the person from the challenge they are facing (Nyland & Temple, 2018): I am not a perfectionist—perfectionism sometimes ambushes me! The technique of externalizing evolved within narrative therapy (White, 2007; White and Epson, 1990); however, it supports responsive relationships and socially just conceptualizations of client lived experiences regardless of your theoretical orientation (Paré, 2013). Notice how this perspective-taking is very much about a relational stance, an expression of an ethic of care, in which the interplay between person and environment is acknowledged. Externalizing often involves naming the challenge in some way (e.g., “the box” in Bennu’s story) to allow the client to progressively position themselves as separate from, and in relational to, the challenge they face. By separating the client from their challenge, a door opens to uncovering new possibilities that are not available when the client sees themselves as the problem. From this one-step-removed position, it is easier to examine the negative repercussions of challenge in the client’s life.

Most of us have an opportunity to provide a listening ear to others on an almost daily basis. The next time someone talks with you about a challenge in their lives, listen carefully for opportunities in the language they use or the way they frame their experiences to open the door for externalizing. If the person is agreeable, practice this technique. [We don’t recommend you do this in a counselling environment yet!]

Like all counselling skills, employing the technique of externalizing skilfully requires practice, and then more practice, to develop the fluidity required to be responsive in-the-moment to the client before you. Consider the reflections below by Simon Nuttgens on some of the potential challenges of embarking on externalizing conversations with clients.

We refer you to Dupuis-Rossi (2020), who offers a detailed description of how Indigenous practitioners, in particular, can apply some of the techniques in this chapter in their work with Indigenous clients to support the process of decolonization. Dupuis-Rossi offered an example of reframing a client’s internalized sense of failure as a failure of capitalism and colonialism. They noted that this reframe “resists mainstream psychology’s individualisation and privatisation of child sexual abuse [and other manifestations of colonial violence] and connects it to the systems of colonial oppression that cause this suffering for Indigenous people” (p. 8). Dupuis-Rossi supported the client to name and externalize these oppressive forces, which “opened up internal space for the next layer of healing” (p. 8). You may find the other examples in this article on the use of these techniques with Indigenous clients helpful.

REFLECTIVE PRACTICE

A. Practising mindfulness

We invite you to open yourself to a mindfulness practice that follows from Mateo Huezo’s presentation on spirituality earlier in the chapter. In this activity Mateo extends the meaning of context by inviting the past into the present through connection with ancestors.

B. Enlisting Your Own Story

As you continue to evolve your own story, reflect on the influence of the broader contexts of your lived experiences.

• How might considering these contexts, dominant or nondominant sociocultural discourses, or other systemic factors alter your current understanding of the challenge you are facing or your sense of preferred futures.
• How might you draw on the techniques of exploring sociocultural contexts, deconstructing sociocultural narratives, or reframing to deepen your understanding of your challenge and preferences?
• Take a moment to give the challenge you are facing a name or to characterize it by a personally or culturally meaningful metaphor.
• Imagine using the technique of externalizing to separate yourself from the challenge called “. . . “: How might you actively distance yourself from, negotiate with, navigate around, minimize the influence of, or otherwise approach, the externalized challenge?

C. Engaging with Macey’s Story

APPLIED PRACTICE ACTIVITIES

A. Responsive Techniques

Preparation

For each technique you will employ a variety of microskills in a way that is responsive to the client–counsellor relationship and client-centred conversation in-the-moment. Please extend your skills practice to 14 to 15 minutes each to increase your comfort with sustaining the counselling conversation over time.

Identify a challenge with which you are currently struggling, ensuring that it offers opportunities for your partner to engage in inquiry into the sociocultural contexts of your lived experience and the dominant or nondominant discourses that may influence the challenge. If you drew on the story you have been working on through each chapter of the ebook for the applied practice activities in Chapter 8, feel free to continue to explore that challenge or whichever new challenge you introduced. Alternatively you can choose to focus on a different issue. You will use the same challenge for each of the applied practice activities below so you can build upon and deepen your contextualization of client challenges and preferences as you try out each of the techniques introduced in this chapter.

You may find it useful as a beginning counsellor to thinking about your counselling sessions in these smaller 15-minute chunks. In the early stages of counselling when you are building responsive relationships with clients, you might manage each 15-minute segment of a counselling session by asking yourself some of the following questions. You will have a chance to practise this process in the activities below.

Start-up self-reflection questions (prior to each chunk of conversation)

• • What shared understanding of the client’s challenges has emerged in the previous session or previous chunk of conversation?
  • What are my current hypotheses about the challenge and, if appropriate in-the-moment, the client’s preferred futures?
  • What more can we flesh out to come to a shared, multidimensional, culturally responsive, and contextualized understanding of client challenges and preferences?
  • Which technique can best support your continued co-conceptualization of the client lived experiences?

Wrap-up self-reflection questions (toward the end of this chunk of conversation)

• • How has the use of this technique and the continued client–counsellor dialogue altered your current hypotheses about client challenges and preferences?
  • How can you make transparent your hypotheses and check your perceptions with the client to support constructive collaboration in conceptualizing their challenges and preferences?

Ongoing self-reflection questions (as client challenges and preferences become clearer)

• • How will you know when you have reached a comprehensive understanding of client challenges and preferences?
  • What can indicate that you are ready to move on together to setting therapeutic directions? (Chapter 10)

Before you start into these applied practice activities, please review these relational practices from previous chapters so that you can attend to them in your feedback to each other. Some of the earlier criteria that applied to microskills more specifically have not been included.

• strengths-focused (versus challenge-focused) responses (Chapter 4)
• client-centred (versus counsellor-centred) responses (Chapter 7)
• thick (versus thin) description (Chapter 7)
• variety of microskills (Chapter 8)
• culturally responsive (versus ethnocentric) lens (Chapter 8)
• contextualized and systemic (versus decontextualized and individualist) lens (this chapter)

We provided an example through the four parts of Bennu’s story of how to move through each of the techniques in this chapter sequentially, deepening your shared understanding of the client’s contextualized challenges and preferences with each new technique. We are not suggesting you would do this with all clients or that there is anything special about this particular sequencing; instead, we want to give you an opportunity in the practice activities below to experience what it might be like to move from one technique to another.

1. Exploring Sociocultural Contexts

(45 minutes)

Preparation

If you are introducing a new challenge this week, take 3–4 minutes prior to the skills practice to provide your partner with a sense of the challenge as a starting place for them to explore sociocultural contexts with you.

In your roles as counsellors, take a moment to consider the start-up self-reflection questions (above) prior to engaging in the skills practice.

• What shared understanding of the client’s challenges has emerged in the previous session or previous chunk of conversation?
• What are my current hypotheses about the challenge and, if appropriate in-the-moment, the client’s preferred futures?
• What more can we flesh out to come to a shared, multidimensional, culturally responsive, and contextualized understanding of client challenges and preferences?
• Which technique can best support your continued co-conceptualization of the client lived experiences?

Skills practice (14–15 minutes each)

• Client: Describe the challenging you are facing, offering a hint about one of the contexts of your life that may be relevant to understanding the nature of the challenge.
• Counsellor:
  • Draw on a variety of microskills to engage the client in a conversation about the ways in which the contexts of their life influence their understanding of the challenge they face.
• Client: Respond as naturally as possible to the counsellor’s use of each of the microskills they choose.
• Counsellor:
  • As you near the end of your practice session, consider the Wrap-up self-reflection questions:
    • How has the use of this technique and the continued client–counsellor dialogue altered your current hypotheses about client challenges and preferences?
    • How can you make transparent your hypotheses and check your perceptions with the client to support constructive collaboration in conceptualizing their challenges and preferences?
  • Synthesize your shared understanding of the clients challenge and the contexts in which it arises as well as any emergent hypotheses about their preferred futures.

Reflective practice and feedback

• How did breaking the counselling session down into chunks and applying the self-reflection questions provide meaningful structure to this part of your conversation.
• How successful were you in sharing your initial hypotheses about the client’s challenges and preferences?
• Provide each other with specific feedback on the following relational practices from earlier chapters:
  • thick (versus thin) description (Chapter 7)
  • variety of microskills (Chapter 8)

2. Deconstructing sociocultural narratives

(45 minutes)

Skills practice (14–15 minutes each)

At this point, you will have a sense of some of the contextual, systemic influences on the client’s lived experiences, and you will begin to explore the messages they have received, and potentially internalized, through past and present interactions within those contexts or systems.

• Counsellor:
  • Draw on whatever microskills are appropriate to move into deconstructing sociocultural narratives with the client.
  • Continue to ask yourself: What more might we need to flesh out to come to a shared multidimensional, culturally responsive, and contextualized understanding of client challenges and preferences?
• Client: Respond as naturally as possible.
• Counsellor:
  • As you near the end of your practice session, revisit the Wrap-up self-reflection questions:
    • How has the use of this technique and the continued client–counsellor dialogue altered your current hypotheses about client challenges and preferences?
    • How can you make transparent your hypotheses and check your perceptions with the client to support constructive collaboration in conceptualizing their challenges and preferences?
  • Pay attention to your current understanding the locus of control or responsibility for the challenge and how this might influence preferred outcomes?
  • Synthesize, noting any shifts in, your shared understanding of the client’s challenge and the contexts in which it arises as well as any emergent hypotheses about their preferred futures.

Reflective practice and feedback

• How did the process of deconstructing sociocultural narratives shape your shared understanding of client challenges and preferences? What barriers did you encounter in identifying and assessing the influences of dominant or nondominant discourses?
• Provide each other with specific feedback on the relational practices:
  • culturally responsive (versus ethnocentric) lens (Chapter 8)
  • contextualized and systemic (versus decontextualized and individualist) lens (this chapter)

3. Reframing

(45 minutes)

Preparation

In your roles as counsellors, take a moment to reflect silently on the ongoing self-reflections questions prior to engaging in the skills practice.

• How will you know when you have reached a comprehensive understanding of client challenges and preferences?
• What might indicate that you are ready to move on together to setting therapeutic directions? (Chapter 10)

Skills practice (14–15 minutes each)

The technique of reframing can follow logically deconstructing sociocultural narratives, because it invites consideration of alternative, more health-enhancing lenses or discourses.

• Counsellor:
  • You may want to practise reintroducing the current shared hypothesis about client challenges and preferred futures as if there was a pause between this conversation and the previous two activities (i.e., the client is returning for another session).
  • Draw on the start-up, wrap-up, and on-going self-reflection questions to help you provide structure to the continued conversation.
  • Introduce and apply the technique of reframing to flesh out more fully how the client would like things to be different.
  • Toward the end of the video synthesize your current shared understanding of the client’s challenge and preferences.

Reflective practice and feedback

• How effective were the alternative lenses or discourses introduced in helping to shape your shared understanding of client preferences?
• Provide each other with specific feedback on the following relational practices as they related to the process of reframing:
  • strengths-focused (versus challenge-focused) responses (Chapter 4)
  • client-centred (versus counsellor-centred) responses (Chapter 7)

4. Externalizing

(45 minutes)

Preparation

A name or cultural metaphor for the challenge may have emerged as you implemented the previous three techniques. This process of naming is part of the technique of externalizing. If nothing has emerged at this point, you may want to think ahead to potential ways to name the challenge, both as the client and as the counsellor, to facilitate your skills practice.

Skills practice (14–15 minutes each)

• Counsellor:
  • Continue to draw on the start-up, wrap-up, and on-going self-reflection questions to provide structure to the continued conversation.
  • Find a way to shift naturally from the endpoint of your previous conversation into the technique of externalizing.
  • Toward the end of the video synthesize your current shared understanding of the client’s challenge and preferences, paying particular attention to the ways in which the client has begun to act upon the externalized challenge.

Reflective practice and feedback

• Choose 2–3 of these relational practices as your focus of feedback related to the process of externalizing:
  • strengths-focused (versus challenge-focused) responses (Chapter 4)
  • client-centred (versus counsellor-centred) responses (Chapter 7)
  • thick (versus thin) description (Chapter 7)
  • variety of microskills (Chapter 8)
  • culturally responsive (versus ethnocentric) lens (Chapter 8)
  • contextualized and systemic (versus decontextualized and individualist) lens (this chapter)
• Together consider the two ongoing self-reflection questions below as a lead-in to moving into setting therapeutic directions in Chapter 10.
  • How will you know when you have reached a comprehensive understanding of client challenges and preferences?
  • What can indicate that you are ready to move on together to setting therapeutic directions? (Chapter 10)

REFERENCES

United Nations High Commissioner for Refugees. (2020, December 2). How climate change is multiplying risks for displacement. https://www.unhcr.org/news/stories/2020/12/5fc74f754/climate-change-multiplying-risks-displacement.html

White, M. (1984). Pseudo-encopresis: From avalanche to victory, from vicious to virtuous cycles. Family Systems Medicine, 2(2), 150–160. https://doi.org/10.1037/h0091651

White, M. (2007). Maps of narrative practice. W. W. Norton.

White, M., & Epston, D. (1990). Narrative means to therapeutic ends. W. W. Norton.

Worell, J., & Remer, P. (2003). Feminist perspectives in therapy: Empowering diverse women (2^nd ed.). Wiley.