We return to the text “Escape from Babel” by Miller, Duncan, and Hubble. The book is getting better and better, although chapter three felt like it would never end…it had a large number of case study examples in it (which is great for vicariously applicable knowledge); however, in trying to pace/read a manageable amount of pages per day it was a little on the frustrating side:) I felt like I’d read 4 or 5 chapters after reading only two. And, no…I’m not complaining about length. I just want to be able to describe and absorb all the information crammed into those pages. (And there is a LOT of great information in this book!!!)
The most important element I took away from Ch2 & 3 was the role of extratherapeutic factors in the counseling process. Extratherapeutic factors are those events that occur separate and external from the counseling session, and which cause reported client progress.
…client’s preexisting strengths, resources, and abilities in combination with fortuitous extratherapeutic events are the largest contributors to psychotherapy outcome. (Miller, Duncan, & Hubble, 1997, p. 39)
Furthermore, client report of pre-initial session progress is also an indicator of potential improvement. In other words, clients that report some improvement prior to the first counseling session but post making the decision to enter counseling are more likely to experience change quicker and with more lasting effect. This is in part because the most important part of the therapeutic process is the client’s decision to enact change. As therapists, the goal is to encourage change.
Becoming more ‘change focused’ literally means that the therapist makes a concerted effort to listen for and validate client change whenever and for whatever reason it initially occurs during the treatment process. (Miller, Duncan, & Hubble, 1997, p. 40)
In other words, when a counselor asks if anything is different or explores changes in client behavior/event patterns external to sessions, that counselor must be willing to encourage behaviors that are progressing the client toward therapeutic goals. There is a misconception that immediately labels the client as “resistant” or engaging in defensive mechanisms as if the client could not possibly improve without the mysteries of therapeutic intervention. However, the truth is that the majority of improvement occurs due to client action rather than counselor action. Miller, Duncan, and Hubble identify 3 ways that client contributions to change can be recognized and promoted:
- recognize the areas of client competence
- work within the clients worldview and goals
- utilize/emphasize client strengths
We all have our strengths and weaknesses. Rather than approaching each situation as if there is something inherently “wrong” about the client that we the “glorified therapist” must “fix,” instead we should look toward the individual capacity for change. We facilitate change, not create it.
Miller, S.D., Duncan, B., Hubble, M. (1997) Escape from Babel: Toward a unifying language for psychotherapy practice. New York, itd: Norton