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hello I'm dr. Nathan Gellert in this
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video I'll be talking about the process
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of focusing which is the process of
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establishing a strategic direction with
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a client engaging provides a foundation
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for focusing they are interrelated yet
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different processes it is possible to be
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well engaged with someone enjoying an
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energetic conversation but without any
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clear direction focus in counseling is
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formed through a purposeful conversation
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that has changed
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at its heart when we think about
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focusing it's important to consider the
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possible sources of focus the first
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source of focus is the client it is not
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uncommon for a client to come to
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counseling with a particular goal in
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mind for instance anger management
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feeling blue or relationship counseling
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when a client can easily and clearly
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articulate a concern or goal then that's
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where the counselor and client will
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begin to focus their work the second
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source of focus is the setting for
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instance a clinic that treats clients
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with eating disorders will focus on that
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presenting concern and likely refer
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clients with other diagnoses to other
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providers the third source of focus is
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the counselor sometimes a client will
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present with a certain stated concern
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and the counselor perceives another
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issue that the client is not aware of
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for instance a client seeking help for a
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broken relationship may only become
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aware of the seriousness of a
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pornography addiction when the need to
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focus on it is raised by the counselor
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there are also three potential styles of
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focus that a counselor can adopt in the
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directing style the counsellor sets the
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agenda and determines the focus of
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counseling this agenda can stem from the
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counselors own agenda that is deciding
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what's important or the agenda of the
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agency the opposite of the directing
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style is the following style
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this involves the counselor simply
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following the clients lead in
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determining the focus of counseling the
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third style of focusing and the one we
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embrace in motivational interviewing is
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the guiding style in this style the
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client and counselor work together to
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set an agenda for their work the client
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brings to counseling the expertise of
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their life and experiences which is
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matched by the counselors professional
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expertise and experience it's helpful to
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remember that these Styles exist on a
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continuum with a guiding style in the
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middle as a natural balance between
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directing and following in thinking
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about focusing it's helpful to consider
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the three possible focusing scenarios
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which are when there's clear direction
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choice and direction or unclear
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direction let's discuss each of these in
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greater depth a clear direction for
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focus of treatment can occur for three
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different reasons first the client may
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present for treatment with a clear
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concern or set of goals if this is the
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case then you don't need to spend much
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time on focusing instead you might just
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confirm with the client that you are
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both on the same page and then move
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forward to either of voguing or planning
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second the agency where you work may
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have a particular scope of treatment for
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instance if someone is seeking treatment
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at an alcohol rehabilitation center then
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they're presenting concerns will be
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issues with alcohol use third the focus
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of counseling may become clearer as the
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counselor is engaging with a client this
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occurs when the counselor identifies
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goals that the client may not realize or
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currently have for example if a woman
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suffering from obesity is seeking
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treatment to change her eating habits
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the counselor might also think that she
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should address the eating habits of her
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children the counselor would need to
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approach this respectfully and
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appropriately so as not to offend
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to the client I'll discuss how to do
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this in the next scenario in the second
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scenario there are multiple concerns and
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goals that could become the focus of
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treatment this can be challenging for
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both the counsellor and client the
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counselor may feel pressured to use his
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or her judgment to decide which concern
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to focus on the client on the other hand
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may feel overwhelmed by choices this is
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why it is important to work together to
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determine where to focus this is where
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agenda mapping comes into play agenda
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mapping involves exploring different
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options with the client and deciding
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which would be the best direction to
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take at that time this can give the
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client a sense of relief by narrowing
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down the focus onto one single problem
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I'll next share some tips for successful
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agenda mapping first consider the
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structure of how you ask the clients
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permission to consider different options
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for example you could say would you mind
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if we consider some topics we could
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discuss notice the use of the word could
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in this example this hypothetical
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language is the essence of agenda
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mapping in that it does not say we will
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discuss this but rather gently suggests
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it to the client which encourages
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collaboration and engagement second work
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together to consider options for focus
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during this process remember to allow
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the client the space to reflect and
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express their preferences and concerns
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your job as the counselor is to affirm
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and support as appropriate continually
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ask the client to raise new ideas that
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might not have come up yet and do
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include your own opinion let's look at
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an example of what it can sound like for
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a counselor to express their own opinion
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one idea that I'd like to share is that
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we could start by focusing on how your
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lack of ex
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sighs might be contributing to your low
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energy levels would that be something
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you'd like to discuss in this example
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notice how the counselor does not impose
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his or her opinion onto the client but
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rather engages the client in the
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decision-making process the final step
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of agenda mapping involves zooming in up
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to this point the counselor and client
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have brainstormed about many possible
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pathways forward much like you might do
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when planning a route on a map the next
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step is for you to decide together on
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which path to start down first a final
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point I'll make about agenda mapping is
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that it doesn't have to only occur at
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the beginning of treatment it's often a
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good idea to periodically revisit the
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broader agenda and when one task is
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complete agenda mapping can be used to
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determine where to journey next the
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third scenario occurs when there is no
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clear direction when the client has no
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clear concerns or goals you'll often
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recognize you're in this scenario when
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you feel like it's difficult to
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understand the clients story keeping
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with the simile of the map the client
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may seem like they're all over the map
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you may be just as confused as the
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client is about what's going on in their
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life this is an important
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phenomenological recognition on your
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part as to what the client is expressing
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in their life the primary task for the
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counselor in this scenario is to listen
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to the client and help put together
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seemingly diffuse pieces of the clients
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story over time
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the important pieces concerns and goals
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will become clear once this begins to
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happen then the counselor can move with
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the client into the process of agenda
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mapping focusing is a process that
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requires collaboration between the
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counselor and the client there are
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several issues related to focusing that
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are important to consider first both the
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counselor and client will be challenged
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with needing to tolerate uncertainty and
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ambiguity the direction of treatment
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won't always be clear this can be the
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case at both the onset of treatment and
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throughout the course of treatment just
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like being stuck in the woods it's not
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always best to try to rush out it's
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often better to work intentionally
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together to figure out the best path
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forward during this process you the
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counselor must resist the righting
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reflex the desire to quickly make things
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better second control over the focus of
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treatment must be shared both the
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counselor and client may have their own
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ideas about what to focus on first or
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next it's important to openly discuss
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different ideas and possibilities and
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work together to set treatment goals
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third it can be easy to focus on
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problems challenges what's not working
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well for the client doing this gets in
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the way of building on existing clients
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strengths remember to keep your eyes
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open for even small examples of
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strengths and movements towards change
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when you witness these successes affirm
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them and explore them more so they can
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be further developed thanks for joining
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me for this video in the next video I'll
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be talking about how to proceed when the
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counselor and client have conflicting
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goals for treatment please click the
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