B. Build another example of hierarchy construction for another type of phobia

Task 13. Another way of implementing systematic desensitization is hierarchy construction.

Task 12. One of the ways of implementing systematic desensitization is progressive relaxation. Narrate the procedure of progressive muscle relaxation in the name of a client in the past tense. The verbs which may be helpful are provided. One sentence is done for you.

The psychologist asked/invited me to make myself in a comfortable position.

I. Patients make themselves in a comfortable position.	To ask/to invite
II. Light or soft music/pleasant visual cues are provided.	To suggest
III. A brief explanation about the progressive muscle relaxation (patients relax major muscle group in a fixed order, beginning with the small muscle group of the feet towards head)	To give/to offer, to explain
IV. Clients tense each muscle group for approximately 10 seconds.	To instruct
V. Clients feel the tension of the muscle and uncomfortable sensations in the body parts.	To warn
VI. Clients relax each muscle	To offer
VII. Clients feel the difference between both the situations.	To ask

A. Narrate the example of hierarchy construction in the name of a client. Use the following patterns:

The psychologist suggested that I should…/The psychologist suggested doing …

The psychologist made me do…

The psychologist asked me to do…

An example of a hierarchy of events associated with a fear of elevators:

A. Discuss riding an elevator with the therapist.

B. Look at the picture of an elevator.

C. Walk into the elevator.

D. Push the button for the elevator.

E. Walk into the elevator with a trusted person, disembark before the door closes.

F. Walk into the elevator with a trusted person; allow the door to close; then open the door and walk out.

G. Rise the elevator one floor with a trusted person, then walk down the stairts.

H. Ride the elevator one floor with a trusted person and ride the elevator back.

I. Ride the elevator alone.

Task 14. Provide feedback to what your client is saying to become an active listener. Use the following patterns:

Encouraging	Can you tell me more about…
Clarifying	What I am hearing is…; Sounds like you are saying that… What do you mean when you say…? Is this what you mean? Are you saying …? What does that look like?
Restating	I thought I heard you say… We may need to check this out further
Reflecting	You seem quite passionate about the idea…
Summarizing	These seem to be the key ideas you have expressed… What I hear you saying is… Is it about…? Let me make sure that I understand you…
Validating	I think I understand why you are so confused.

Client 1. My parents are always away and no one seems to care about me.

Client 2. My children are very busy so I am going to be a heavy burden to them.

Client 3. I have tried all possible means to overcome the addiction so there’s no other way than giving up.

Client 4. I don’t have any friends. I know so few people. I try not to care. People just aren’t dependable, everyone is out for himself/herself.

Client 5. The test results will be ready tomorrow. I am afraid I can’t face it if something goes wrong again.

Client 6. If my brother had done it, my dad wouldn’t have asked a question. It’s always been like that.

Client 7. My maths teacher is always trying to find fault with me no matter how hard I try to be diligent and obedient.

Client 8. I am the most experienced worker but I was fired after all those years. I have no idea what to do.

Client 9. I find my present job boring. I think I will quit it.

Client 10. If my parents are divorced I will have to stay with one of them and I am afraid it is their interests only what will count.

Task 15. One of the most effective humanistic techniques is asking open-ended questions which help the client to find their own solution. Remember, that open-ended questions typically begin with words such as "Why" and "How", or phrases such as "Tell me about...".

A. Translate each of the following “yes-no” questions into an “open-ended” one. Some examples are provided for you.

E. g. How does that make you feel?" or "What do you think you need to do to resolve the situation?"

1. (A doctor to a patient…) “ Have you been taking your medication?

Your open-ended version:

2. (On talking with a person who looks disappointed…) “So you didn’t like that, huh?”

Your open-ended version:

3. (A psychotherapist to a client…) “Don’t you think it would be better if you receive the drug therapy first?

Your open-ended version:

4. (A psychotherapist to a client…) “Do you know how to cope with this problem?”

Your open-ended version:

5. (A psychotherapist to a client…) “Is it OK with you if we discuss the feelings you had at that time?)

Your open-ended version:

6. (A psychotherapist to a client…) “Did you have a good relationship with your parents”

Your open-ended version:

7. (A psychotherapist to a client…) “Did you like your pervious counselor?”

Your open-ended version:

8. (A psychotherapist to a client…) “Do you care about your health?””

Your open-ended version:

Key: 4. 5. What do you think about discussing the feelings…; 6. Tell me about your relationship with you parents.

B. Respond to the client’s words using open-ended questions:

1. Client: I had already sought therapy before.

Psychotherapist:

2. Client: I was a neglected child.

Psychotherapist:

3. Client: I feel very lonely.

Psychotherapist:

4. Client: I was divorced the same year.

Psychotherapist:

5. Client: My 16-year old daughter is pregnant.

Psychotherapist:

6. Client: My previous therapist couldn’t find a way with me.

Psychotherapist:

7. Client: I feel guilty for what has happened.

Psychotherapist:

8. Client: I was overwhelmed with fear when they announced the diagnosis to me.

Psychotherapist:

9. Client: My husband hasn’t shown me any love lately.

Psychotherapist:

10. Client: All my friends seem to avoid my company.

Psychotherapist:

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