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Learning from Mistakes in Clinical Practice

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ISBN-10: 053452401X

ISBN-13: 9780534524012

Edition: 2003

Authors: Carolyn Dillon

List price: $111.95
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This text is a virtual handbook of classic mistakes to anticipate, work through, and grow from. It identifies, discusses and re-frames classic mistakes that beginning interviewers and clinicians are likely to make in practice by illuminating a myriad of mistakes through the use of first-hand vignettes, in-text exercises, and a systems framework. This book uses a strengths-perspective, and can serve as a companion text or as a stand-alone primer because of its elaboration of the phases, principles, strategies and methods used in the helping process.
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Book details

List price: $111.95
Copyright year: 2003
Publisher: Wadsworth
Publication date: 2/14/2002
Binding: Paperback
Pages: 240
Size: 6.25" wide x 9.00" long x 0.75" tall
Weight: 0.748
Language: English

Carolyn Dillon is Clinical Professor Emerita, Boston University School of Social Work, where she has won teaching excellence awards from both the Alumni Association and the student body. She received the Metcalf Award for teaching excellence and was the recipient of the "Greatest Contribution to Social Work Education" award from the Massachusetts Chapter of the National Association of Social Workers. She has published and spoken widely about the need for professional self-care and stress management and has consulted with social workers in health and mental health settings.

Preface
Becoming a Professional
The Dawning of a New Awareness
Additional Complications in Clinical Roles
The Professional Learning Curve
At One with Clients, Yet Different from Clients
Crises Around Learning to Be Deliberate
Tending, Not Just Having, Relationships
You, Too?
Noting and Making Use of Parallels
Reconciling with Strengths and Limitations
Moving from Smart to Wise
Will Anything Rule Me Out?
Early Successes and Derailments
Defining and Identifying Mistakes
How Can We Tell When Clinical Work Is On Track?
Usefulness of Recordings
General Characteristics of Effective Work
Discerning Our Mistakes
Common Worker Signals of Mistakes in Progress
Frequent Sources of Derailment
Engaging With Clients and Getting Started
True Engagement Is Hard Work
Initial Challenges and Pitfalls
Startup Conversation and Exploration
Other Orientation Topics
Hesitating to Discuss Worker--Client Differences
Overlooking Fundamental Human Resources
Problems with Technique in Engaging and Starting Up
Asking Questions Closely Aligned with Where the Client Is
Avoiding Rapid-Fire Questions
Using Open-Ended Questions
Asking Rather Than Assuming
Leaving Time to Reflect After Each Segment of Discussion
Purposeful Focusing
Appropriate Timing and Dosage
Carefully Working from the Outside In
Overprotecting Clients
Prejudice and Ignorance in Action
Class Differences and Classist Behaviors Can Affect Engagement
Attitude Taints Engagement
Shifting Meeting Times Creates Bad Feelings
Emergency Interruptions Can Derail Bonding and Work
Emotional Overbooking Is Visible
Missteps Around Confidentiality and Privacy
Breaches of Confidentiality
Inflexibility Regarding Confidentiality
Professional Relationships: Steps and Missteps
Unique Features of the Worker--Client Relationship
Worker Self-Disclosure as a Form of Relational Tending
Empathy: Being Where the Client Is
Conditions Conducive to Accurate Empathy
Missteps in Trying to Empathize
Trivializing via Excessive Universalizing
Restoring Empathic Alignment
Worker Concerns About Relating with Clients
Shared Concerns About Relating with Other Agencies and Helpers
Common Mistakes in Relating with Clients
Assessment and Contracting
Assessment
Observation Changes the Observer and the Observed
Elements of Good Assessment
Frequent Mistakes in Assessment
Implications for Contracting with Involuntary Clients
Mistakes in Contracting
Larger Systems Issues
The Middle Phase of Work
Common Foci for Work
Techniques for Updating Unhelpful Thoughts
Integrative Techniques for Working on Feelings and Behaviors
Connecting the Past, the Present, and Hopes for the Future
Going Home Again
When the Work Doesn't Work
Not Resolving Important Conflicts over Plan or Methodology
Not Helping Clients Obtain Needed Resources
Getting Too Far Ahead of the Client
Overestimating the Ease of Change
Skipping the Middle Part
Steering Around Topics or Feelings
Not Challenging or Confronting the Client When Process Is Stuck
Giving Up Too Soon
Pushing the Client
Using Inappropriate or Meaningless Strategies
Showing Favoritism
Taking Sides
Defending Our Own Points of View
Using Strategies That Embarrass the Client
Skewing the Work
Providing Inadequate Support and Reinforcement
Scoutmaster Behavior
Expressing Upsets with Clients
Not Dealing in Supervision with Feelings About a Client
"Should" and "Ought" Statements
Misspeaking
Ending Sessions Early Because the Client Is Silent
The Client Is Testing and the Worker Doesn't See
Blaming Clients for Failures in the Work
Serious Mistakes, Serious Consequences
Boundary Violations
Funny Money: Improper Financial Dealings
Working While Impaired
Untruthful or Devious Behaviors
Sexual Harassment in the Workplace
Responding to Egregious Behaviors
Common Mistakes in Ending
Factors Influencing Ending Process
Steps in Ending
Other Common Mistakes in Ending
Epilogue
Questions That Haunt Us All from Time to Time
Developing Important Capacities
Where to from Here?
References
Index