1. Provide a brief paraphrasing response to Emmanuel. Make sure t.docx

1. Provide a brief paraphrasing response to Emmanuel. Make
sure to use present-tense.
“Your parents are responsible for ruining your life, because
they made the decision to move from Costa Rica to St. Louis,
where you have faced challenges like making new friends, going
to a new school, and learning a new language."
2. Provide a brief empathy response to Emmanuel. This must
be in the form of an “I” statement.
“I hear you saying how angry you feel that your parents have
decided to live here instead of Costa Rica, and that their
decision to live here has had a negative impact on your
relationship with them.”
3. Provide a brief confrontational response to
Emmanuel. Consult slide 8 in the power point for help.
“So on the one hand, you used to be close with your parents, but
now since they have made the decision to move your family
here, you feel like you hate them.”
4. Briefly (1-2 paragraphs) summarize the Client Change
Scale (CCS) and discuss how you could use it when working
with Emmanuel.
The Client Change Scale (CCS) is a method for evaluating
whether the counselor’s employment of empathic confrontation
has led to a change in how clients think and feel about their
situation (Ivey, Ivey, & Zalaquett, 2018). How effective the
confrontation is can be measured by how the client responds
(Ivey, Ivey, & Zalaquett, 2018). The CCS is separated into five
levels: 1. Denial (the client denies or doesn’t recognize
incongruity); 2. Partial examination (the client discusses part,
but not all of the incongruity); 3. Acceptance and recognition
but no change (the client embraces the entirety of the
incongruity, but does not concede to change); 4. Decides to live
with incongruity (the client discusses and is completely aware
of the impact of their decision not to act); and
5. Transcendence (the client acknowledges the incongruity and

alters choices) (Ivey, Ivey, & Zalaquett, 2018).
In working with Emmanuel, I might begin by asking him to tell
me more about his relationship with his parents before they
moved, and what ways they were close before and why. Before
that I might start by first asking more general questions about
life in Costa Rica, and would include questions about family
relationships and personalities, so it wasn’t obvious that I was
trying to get him to look at the reality of who his parents are
and that he could have a positive relationship with them again,
even if they continue to live here. Then I would utilize my
confrontation response: “So on the one hand, you used to be
close with your parents, but now since they have made the
decision to move your family here, you feel like you hate
them.” Depending on if and to what degree Emmanuel
acknowledged that his parents are good people and it is possible
to enjoy a relationship with them, even though he’s unhappy
with the choice that they made, I would know where he fell on
the CCS.
Reference
Ivey, A. E., Ivey, M. B, & Zalaquett, C. P. (2018). Intentional
Interviewing and Counseling: Facilitating Client Development
in a Multicultural Society. Boston, MA: Cengage Learning.
Cardiovascular System Case Study
Shani's third patient is 44-year-old banker Ronaldo Luna. His
chart shows recent chest pain and difficulty breathing. Today,
he is scheduled for a Holter monitor that will be followed up
tomorrow with a cardiac exercise stress test. His physician has
also sent him to an outside laboratory for serum lipid testing.
As Shani attaches the leads for the Holter monitor and explains
the importance of recording his daily activities, Ronaldo
mentions that CAD runs in his family and that his father died in
his late 40s of a heart attack.

1. What is chest pain called?
2. What does the abbreviation CAD stand for?
3. What is the medical term that means heart attack?
4. Measurements of cholesterol and triglyceride levels are part
what test? Define and explain
5. What is a portable electrocardiographic device that is worn to
provide an extended recording of the electrical activity of the
heart?
Chapter 11
Cardiovascular System
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier
Inc. All rights reserved.
*
Learning ObjectivesName the parts of the heart and associated
blood vessels and their functions in the circulation of
blood.Trace the pathway of blood through the heart.Identify and
describe major pathologic conditions affecting the heart and
blood vessels.

*
Learning Objectives (cont’d.)Define combining forms that
relate to the cardiovascular system.Describe important
laboratory tests and clinical procedures pertaining to the
cardiovascular system, and recognize relevant
abbreviations.Apply your new knowledge to understand medical
terms in their proper context, such as in medical reports and
records.
*
Chapter 11
Lesson 11.1
*

IntroductionCardiovascular System: delivers oxygen and
nutrients to cells of body tissueHeart (muscular pump)Blood
vessels (fuel line and transportation network)
*What are three types of blood vessels in the body? What are
the primary differences between them? (See next slide.)
BLOOD VESSELS AND THE CIRCULATION OF
BLOODArteries are the vessels that lead oxygenated blood
away from the heart.Veins are thinner walled vessels compared
to arteries. They move deoxygenated blood toward the heart
from the tissues.Capillaries are the smallest vessels. They form
the point of exchange for oxygen and nutrients into body cells
and waste products coming from body cells.
*What are smaller branches of arteries called? (arterioles)What
are small veins that carry waste-filled blood back to the heart
called? (venules)

BLOOD VESSELS
*Point out the discrete layers of each vessel. Compare and
contrast the substructures of each type of vessel.Why is the
muscle layer in an artery thicker than that of a vein?
systemic circulation
*Make sure students understand this basic flow in order to fully
understand the pathology.The anatomic terminology here is
often associated with any pathology.
Major vessels
*The major pulse points should be considered. For example, the
brachial artery is important because blood pressure is routinely
measured at this junction. What symptoms are associated with
potential blockage in these vessels?

Anatomy of the heart
*Fill in the identified structures and mention their specific
functions. Identify the major valves of the heart and important
blood vessels. Which of the four chambers has the thickest
walls and why? (The left ventricle walls have three times the
thickness of the right ventricle walls; it requires great force to
pump blood throughout the body.)
Anatomy of the heart
*Fill in the identified structures and mention their specific
functions. Identify the major valves of the heart and important
blood vessels. Which of the four chambers has the thickest
walls and why? (The left ventricle walls have three times the
thickness of the right ventricle walls; it requires great force to
pump blood throughout the body.)

Major valves of the hearttricuspid valve (cusps are flaps of the
valves): between right atrium and right ventriclepulmonary
valve: between right ventricle and pulmonary arterymitral
valve: between left atrium and the left ventricleaortic valve:
between left ventricle and aorta
*Point these out on the diagram from the previous slide to
reinforce.
Pathway of blood through the heart
*Go through each step of how the blood travels through the
heart.
HEARTBEAT AND HEART SOUNDSTwo phases of the
heartbeat:diastole: relaxationsystole: contractionThe diastole-
systole cardiac cycle occurs between 70-80 times per minute
(100,000 times per day).The heart pumps 3 ounces of blood with
each contraction. This means that about 5 quarts are pumped per
minute (75 gallons an hour and about 2000 gallons a day).

*Which valves open and which valves close during diastole?
(The tricuspid and mitral valves open as blood passes from the
right and left atria into the ventricles. The pulmonary and aortic
valves close.)
Heart sounds
Closure of valves associated with sounds “lubb-dubb, lubb-
dubb”lubb: closure of the tricuspid and mitral valves at the
beginning of systoledubb: closure of the aortic and pulmonary
valves at the end of systolemurmur: abnormal heart sound
caused by improper valve closure
*Borrow a stethoscope to demonstrate. Audio recordings are
also available online. Many also contain pathological sounds.
PHASES OF THE HEARTBEAT
*

PHASES OF THE HEARTBEAT
*
Have students fill in the labels using this slide.
CONDUCTION SYSTEM OF THE HEART
sinoatrial node (SA node): pacemaker of the heart
pacemaker: origin of electrical impulse causing walls of the
atria to contract and force blood into the ventricles (ending
diastole)
*Where in the heart is the SA node located? (in a small region
of specialized muscle tissue in the posterior portion of the right
atrium.)
Conduction system of the heart (cont’d.)atrioventricular node
(AV node): This sends the excitation wave to a bundle of
specialized fibers called atrioventricular bundle or Bundle of

His. Bundle of His (pronounced “hiss”): Helps form conduction
myofibers that extend to ventricle walls and stimulate them to
contract, beginning systole. A short rest period follows.The
pacemaker begins wave of excitation again.ECG or EKG
(electrocardiogram): The record used to detect electrical
changes in heart muscle as the heart beats.
*Where is the AV node? (in the posterior portion of the
interatrial septum)The normal ECG shows five waves
(deflections) that represent the electrical changes as a wave of
excitation spreads through the heart. What are the deflections
called? (P, QRS, and T waves.)
*

*
ElectrocardiogramP wave = spread of excitation wave over the
atria just before contraction; QRS wave = spread of excitation
wave over the ventricles as the ventricles contract; T wave =
electrical recovery and relaxation of ventricles. A heart attack
(myocardial infarction or MI) can be recognized by an elevation
in the S-T segment of the ECG. Thus, one type of MI is an S-T
elevation MI or STEMI.
*The EKG diagnoses electrical problems in the heart, such as
arrhythmias.Identify deflections on the EKG. What is happening
in the heart with each wave complex?
Electrocardiogram

Electrocardiogram
BLOOD PRESSUREBlood pressure: The force that blood exerts
on arterial walls.Measured using sphygmomanometerExpressed
as a fraction:
systolic pressure/
diastolic pressure example: 120/80 mm Hg
*How does the sphygmomanometer work?Compare this device
to over-the-counter electronic monitors. What effect does
exercise have on blood pressure measurements? What causes
increases and decreases in blood pressure?

COMBINING FORMS
AND TERMINOLOGY
angi/ovesselaort/oaortaarter/oarteryarteri/oarteryather/oyellowis
h plaqueatri/oatrium
Combining FormMeaning
*
COMBINING FORMS
AND TERMINOLOGY
brachi/oarmcardi/o
heartcholesterol/ocholesterolcoron/oheartcyan/obluemyx/omucu
s
*

COMBINING FORMS
AND TERMINOLOGY
ox/ooxygenpericardi/opericardiumphleb/oveinsphygm/opulsestet
h/ochestthromb/oclot
*
valvul/ovalvevalv/ovalvevas/ovesselvascul/ovesselven/o,
ven/iveinventricul/oventricle
COMBINING FORMS
AND TERMINOLOGY
*
QUICK QUIZ:
The double-layered membrane surrounding the heart is the

___________
pericardium
arteriole
endocardium
endothelium
*
CORRECT Answer is A, pericardium
QUICK QUIZ:
2. The contraction phase of the heartbeat is called _________
diastole
vena cava
systole
septum
*
CORRECT Answer is C, systole.
Chapter 11

Cardiovascular System
Lesson 11.2
*
PATHOLOGY:
THE HEART AND BLOOD VESSELS
HEART
arrhythmias
Bradycardia and heart block (atrioventricular block)
Flutter
Fibrillation:
Atrial AF
Ventricular VF
*What device establishes normal heart rhythm?What term
describes the action of applying a defibrillator to give an
electric shock to the heart?On the list, which terms are
associated with “palpitations”?

*
PATHOLOGY:
HEART
congenital heart disease
coarctation of the aorta (CoA)
patent ductus arteriosus (PDA)
septal defects (ASD and VSD)
tetralogy of Fallot
*What is a “blue baby”?In terms of septal defects, what are two
recent procedures that serve as alternatives to traditional
surgery? (trans-catheter closure and minimally invasive heart
surgery)

*
*
PATHOLOGY:
HEART
Congestive heart failure (CHF): The heart is unable to pump the
required amount of blood.
In U.S., primarily the result of high blood pressure and coronary
artery disease (see next slide)
Results in pulmonary edema
Fatal if untreated

*What drugs improve the performance of the heart and its
pumping activity? (angiotensin-converting enzyme (ACE)
inhibitors and beta-blockers)What device do patients awaiting a
transplant use to help assist the heart’s pumping? (a left
ventricular assist device or LVAD)
PATHOLOGY:
HEART
coronary artery disease (CAD) Atherosclerosis
thrombotic occlusion
ischemia
necrosis
myocardial infarctionAcute Coronary Syndrome (ACS)
unstable angina (chest pain)
myocardial infarction (MI)
*What is atherosclerosis? (the deposition of fatty compounds on
the inner lining of the coronary arteries)What is ACS? (It
describes the consequences after plaque rupture in coronary
arteries.)What is unstable angina? (chest pain at rest or chest
pain of increasing frequency)

*
*
PATHOLOGY:
HEART
Coronary artery disease
Drug therapies for CAD
nitrates –nitroglycerin (vasodilator)
Aspirin (Anticoagulant)
calcium channel blockers (muscle relaxant)
Statins ( lower cholesterol levels)
*What drug is given for acute attacks of angina? (Nitroglycerin

is given sublingually.)This drug is one of several nitrates that is
a powerful vasodilator that increases coronary blood flow and
lowers blood pressure.What do statins do?
PATHOLOGY:
HEART
Coronary artery disease
Surgical therapies for CAD percutaneous coronary intervention
(PCI) – Catheterization with balloons and stents open clogged
arteriescoronary artery bypass grafting (CABG) – open heart
surgery replacing clogged vessels.
*What is CABG? (an open heart operation to treat coronary
artery disease by replacing clogged vessels)What is PTCA?
(catheterization with balloons and stents opens clogged
coronary arteries)What is TMLR? (a laser makes holes in the
heart muscle to induce angiogenesis or growth of new blood
vessels)
PATHOLOGY:

HEART
Other Pathologic conditionsendocarditis
(vegetations)hypertensive heart diseasemitral valve prolapse
(MVP)murmurpericarditisrheumatic heart disease
*What is endocarditis? (inflammation of the inner lining of the
heart caused by bacteria)What is MVP? (improper closure of the
mitral valve)What is rheumatic heart disease? (heart disease
caused by rheumatic fever)
PATHOLOGY:
BLOOD VESSELSaneurysmdeep vein thrombosis
(DVT)hypertension (HTN)peripheral vascular disease
(PVD)Raynaud diseasevaricose veins
*What is PVD? (blockage of blood vessels outside the heart)A
sign of PVD in the lower extremities is intermittent
claudication, an absence of pain or discomfort in a leg at rest,
but a recurrence of pain, tension, and weakness after walking
has begun.What are the signs of Raynaud disease?

*
*
QUICK QUIZ:
3. Which arrhythmia refers to rapid, random, inefficient and
irregular contractions of the atria and ventricles (350 beats or
more per minute)?
fibrillation
flutter
bradycardia
*

CORRECT Answer is A, fibrillation
Chapter 11
Lesson 11.3
*
LABORATORY TESTSBNP testCardiac biomarkerslipid test
profilelipoprotein electrophoresis
*What are lipid tests? What is lipoprotein electrophoresis? Why
is this test ordered?What are serum enzyme tests? Why is this
test ordered?
CLINICAL PROCEDURES: DIAGNOSTIC
X-Rayangiography and arteriographycomputerized tomography
angiographydigital subtraction angiography (DSA)Electron
beam computed tomography (EBCT or EBT)
Ultrasound TestsDoppler ultrasoundechocardiography (ECHO)

*What determines when each of these tests should be used?
Differentiate between invasive and noninvasive diagnostic tests.
Nuclear Cardiologypositron emission tomography (PET)
scantechnetium (Tc) 99m Sestamibi scan (Cardiolite)Thallium-
201 scan
Magnetic Resonance Imaging (MRI)cardiac MRI
*Are there any risks or side effects from having these tests
performed?
Other diagnostic procedures:cardiac
catheterizationelectrocardiography (ECG, EKG)Holter
monitoringstress test (ETT)

*What is the anticipated or theorized cardiac problem that leads
a person to get a test? Be as specific as possible when
describing the procedures. Find one unique thing about each test
that makes it memorable. Have the students help you do this.
CLINICAL PROCEDURES: DIAGNOSTICIdentify the normal
sinus rhythm and arrhythmias
*
A Normal sinus rhythm. Notice the regularity of the P, QRS,
and T waves.
B Atrial flutter. Notice the rapid atrial rate (P wave) compared
to the slower ventricular rate (ARS).
C Atrial fibrillation. P waves are replaced by irregular and rapid
fluctuations. There are no effective atrial contractions.
D Ventricular tachycardia. Ventricular rate may be as high as
250 beats per minute. The rhythm is regular, but the atria are
not contributing to ventricular filling and blood output is poor.

*
CLINICAL PROCEDURES:
TREATMENTDefibrillationendarterectomyextracorporeal
circulationheart transplantationthrombolytic therapy
*Use photographs or online images to show some of the
equipment used routinely to diagnose and treat the heart during
acute abnormalities.
CLINICAL PROCEDURES
TreatmentCoronary artery bypass graft (CABG) surgery. A,
Section of a vein is removed from the leg and anastomosed to a
coronary artery to bypass an area of arteriosclerotic blockage.
B, An internal mammary artery is grafted to a coronary artery to
bypass blockage.
*

Treatment procedures (cont’d.)percutaneous coronary
intervention (PCI)includes: percutaneous transluminal coronary
angioplasty (PTCA), stent placement, laser angioplasty, and
atherectomy
*
Abbreviations
MIPCIHTNLDLECHO
CADBPVFAFECG
CABGMVPETTHDL
*Ask students to identify the terms associated with these
abbreviations.
QUICK QUIZ:

4. Which procedure involves insertion of a balloon-tipped
catheter into a coronary artery?
thrombolytic therapy
coronary artery bypass grafting
percutaneous coronary intervention
endarterectomy
*
CORRECT Answer is C, percutaneous coronary intervention
(also known as PCI) see page 415 for more information.
COMBINING FORMS
angi/o______________
aort/o______________
arter/o______________
arteri/o______________
ather/o______________
atri/o______________
REVIEW SHEET
*

COMBINING FORMS
angi/ovesselaort/oaortaarter/oarteryarteri/oarteryather/oyellowis
h plaqueatri/oatrium
REVIEW SHEET
*
COMBINING FORMS
brachi/o______________
cardi/o ______________
cholesterol/o______________
coron/o______________
cyan/o______________
myx/o______________
Combining Form Meaning
REVIEW SHEET

*
COMBINING FORMS
brachi/oarmcardi/o
heartcholesterol/ocholesterolcoron/oheartcyan/obluemyx/omucu
s
REVIEW SHEET
*
COMBINING FORMS
ox/o______________
pericardi/o______________
phleb/o______________
sphygm/o______________
steth/o______________
thromb/o______________

REVIEW SHEET
*
COMBINING FORMS
ox/ooxygenpericardi/opericardiumphleb/oveinsphygm/opulsestet
h/ochestthromb/oclot
REVIEW SHEET
*
COMBINING FORMS
valvul/o______________
valv/o______________
vas/o______________
vascul/o______________

ven/o, ven/i______________
ventricul/o______________
REVIEW SHEET
*
COMBINING FORMS
valvul/ovalvevalv/ovalvevas/ovesselvascul/ovesselven/o,
ven/iveinventricul/oventricle
REVIEW SHEET
*
SUFFIXES
-constriction______________

-dilation______________
-emia______________
-graphy______________
-lysis______________
-megaly______________
SuffixMeaning
REVIEW SHEET
Copyright © 2008, 2005 …
Copyright 2018 Cengage Learning. All Rights Reserved. May
not be copied, scanned, or duplicated, in whole or in part.
WCN 02-200-203
Intentional
Interviewing
and Counseling
Interviewing
and Counseling
Interviewing
Facilitating Client Development
in a Multicultural Society
Allen E. Ivey, Ed.D., ABPP
Distinguished University Professor (Emeritus)
University of Massachusetts, Amherst
Consultant: Microtraining/Alexander Street Press
Mary Bradford Ivey, Ed.D., NBCC

Amherst, Massachusetts Schools
Consultant: Microtraining/Alexander Street Press
Carlos P. Zalaquett, Ph.D., M.A., Lic., LMHC
Professor, �e Pennsylvania State University
Australia Brazil Mexico Singapore United Kingdom United
States
NINTH EDITION
WCN 02-200-203
© 2018, 2014 Cengage Learning
ALL RIGHTS RESERVED. No part of this work covered by the
copyright
herein may be reproduced or distributed in any form or by any
means,
except as permitted by U.S. copyright law, without the prior
written
permission of the copyright owner.
Library of Congress Control Number: 2016936348
Student Edition:
ISBN: 978-1-305-86578-5
Loose-leaf Edition:

ISBN: 978-1-337-27776-1
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Intentional Interviewing and Counseling:
Facilitating Client Development in a
Multicultural Society, 9th Edition
Allen E. Ivey, Mary Bradford Ivey,
Carlos P. Zalaquett
Product Director: Marta Lee-Perriard
Product Manager: Julie Martinez
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WCN 02-200-203
Love is listening.
Paul Tillick, Ph.D., Licentiate of �eology

University Professor, Harvard University
Most influential theologian of the last century
WCN 02-200-203
iv
Derald Wing Sue, Ph.D. Professor, Columbia University,
originator of the Multicultural
Competencies, nationally and internationally known for writing
on microaggressions,
past president of the Society for Counseling Psychology
President’s Committee on Race
Patricia Arredondo, Ed.D. President, Arredondo Advisory
Group, author of the Multicultural
Competencies and Guidelines, past president of the American
Counseling Association,
National Latina/o Psychological Association, APA Society for
Counseling Psychology

Co
ur
te
sy
o
f P
at
ric
ia
A
rre
do
nd
o
Eduardo Duran, Ph.D. Private practice, consultant, author of
Native American Postcolonial
Psychology and Psychology and Psychology �e Soul Wound
describing historical trauma of Native Americans, �e Soul

Wound describing historical trauma of Native Americans, �e
Soul Wound
professor of psychology in several graduate settings, continues
to teach and lecture in
community settings all over the world
Co
ur
te
sy
o
f E
du
ar
do
D
ur
an
�omas Parham, Ph.D. Vice chancellor, University of California,

Irvine, past president of
the Association for Multicultural Counseling and Development
and the Association of
Black Psychologists (Distinguished Psychologist), 100 Black
Men of America Wimberly
Award
Co
ur
te
sy
o
f T
ho
m
as
P
ar
ha

m
Paul Pedersen, Ph.D. Professor emeritus Syracuse University,
first White scholar to introduce
multicultural issues to the helping fields, author of 40 books,
American Psychological
Association Award for Distinguished Contributions to the
International Advancement of
Psychology
Co
ur
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f P
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se
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Co
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W
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Su
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To the multicultural scholars who have changed the nature and

practice
of counseling and psychotherapy
WCN 02-200-203
v
ABOUT THE AUTHORS
Allen E. Ivey is Distinguished University Professor (Emeritus),
University of Massachusetts,
Amherst. He is the founder of Microtraining Associates, an
educational publishing firm,
and now serves with Microtraining/Alexander Street Press as a
consultant. Allen is a Diplo-
mate in Counseling Psychology and a Fellow of the American
Counseling Association. He
is past president and Fellow of the Society for Counseling
Psychology. He is also a Fellow of
the American Counseling Association (where he made the first
presentation on neuros-

cience and counseling), Society for the Psychological Study of
Culture, Ethnicity, and Race,
and the Asian American Psychological Association. He has
keynoted conferences in
25 countries, but is most proud of being named a Multicultural
Elder at the National
Multicultural Conference and Summit. Allen is author or
coauthor of more than 40 books
and 200 articles and chapters, translated into 25 languages. He
is the originator of the
microskills approach, which is fundamental to this book.
Carlos P. Zalaquett is a professor in the Department of
Educational Psychology, CounCarlos P. Zalaquett is a professor
in the Department of Educational Psychology, CounCarlos P.
Zalaquett -
seling, and Special Education at the Pennsylvania State
University, and a licensed men-
tal health counselor in the State of Florida. He is also vice
president for the United
States and Canada of the Society of Interamerican Psychology,
president of the
Pennsylvania Mental Health Counselors Association, and past
president of the Florida
Mental Health Counseling Association, the Suncoast Mental

Health Counselors Asso-
ciation (SMHCA), and the Florida Behavioral Health Alliance.
Carlos is the author or
coauthor of more than 50 scholarly publications and five books,
including the Spanish
version of Basic Attending Skills. He has received many
awards, including the University
of South Florida’s Latinos Association’s Faculty of the Year,
the Tampa Hispanic
Heritage’s Man of Education Award, and the SMHCA Emeritus
Award. His current
research uses a neuroscience-based framework to compare brain
activity and self-reported
decision making. �is cutting-edge research integrates mind,
brain, and body in the
exploration of human responses central to counseling and
psychotherapy. He is an
internationally recognized expert on mental health, counseling,
psychotherapy,
diversity, and education and has conducted workshops and
lectures in 11 countries.
Co
ur

te
sy
o
f A
lle
n
E.
Iv
ey
Mary Bradford Ivey is a consultant with
Microtraining/Alexander Street Press and a Mary Bradford Ivey
is a consultant with Microtraining/Alexander Street Press and a
Mary Bradford Ivey
former school counselor. She has served as a visiting professor
at the University of
Massachusetts, Amherst; Keene State College University of
Hawai‘i; and Flinders
University, South Australia. Mary is the author or coauthor of
many articles and of
16 books, translated into multiple languages. She is a Nationally

Certified Counselor
(NCC) and has held a certificate in school counseling. She is
also known for her work
in promoting and explaining developmental counseling in the
United States and inter-
nationally, with a special background to the prevention of
bullying. Her elementary
counseling program was named one of the 10 best in the nation
at the Christa McAuliffe
Conference. She is one of the first 15 honored Fellows of the
American Counseling
Association for her extensive contributions to the multicultural
and social justice field,
as well as her well-known video demonstrations and writing. Co
ur
te
sy
o
f M
ar
y

Br
ad
fo
rd
Iv
ey
Co
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o
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s
Za
la

qu
et
t
WCN 02-200-203
vi
CONTENTS
List of Boxes xi
Preface xiii
SECTION I
The Foundations of Counseling and Psychotherapy 1
CHAPTER 1 Intentional Interviewing, Counseling, and
Psychotherapy 3
Introduction: Interviewing, Counseling, and Psychotherapy 4
Cultural Intentionality: �e Flexible, Aware, and Skilled

Counselor 8
Resilience and Self-Actualization 10
�e Microskills Hierarchy: �e Listening and Action Skills of the
Helping Process 11
Neuroscience and Neurobiology: Implications of Cutting-Edge
Science for the Future
of Counseling and Psychotherapy 16
Office, Community, Phone, and Internet: Where Do We Meet
Clients? 19
Your Natural Helping Style: Establishing Your Baseline 20
Key Points: �e Art of Applying and Taking Action As You
Work �rough �is Book 23
Portfolio of Competencies and Personal Reflection 25
CHAPTER 2 Ethics, Multicultural Competence, Neuroscience,
and Positive
Psychology/Resilience 27
Introduction: Ethics and the Counseling and Psychotherapy
Process 28
Awareness, Knowledge, and Skills of Ethics, Multicultural
Competence, Positive Psychology,
and �erapeutic Lifestyle Changes 30
Awareness, Knowledge, Skills, and Action for Multicultural

Competence 38
Positive Psychology and �erapeutic Lifestyle Changes:
Building Client Resilience 43
Action: Key Points and Practice of Ethics, Multicultural
Competence, Positive Psychology,
and �erapeutic Lifestyle Changes 51
Practice and Feedback: Individual, Group, and Microsupervision
53
CHAPTER 3 Attending and Empathy Skills 56
Introduction: Attending Behavior: �e Foundational Skill of
Listening 57
Awareness, Knowledge, and Skills of Attending Behavior and
Empathy Skills 58
Empathy: Awareness, Knowledge, and Skills 66
Neuroscience and Empathy 68
Observe: Attending Behavior and Empathy in Action 70
Attending and Empathy in Challenging Situations 73
�e Samurai Effect, Magic, and the Importance of Practice to
Mastery 74
Action: Key Points and Practice of Attending Behavior and
Empathy Skills 76

77
WCN 02-200-203
Contents vii
CHAPTER 4 Observation Skills 83
Introduction: Are You a Good Observer? 84
Awareness, Knowledge, and Skills: Principles for
ObservationAwareness, Knowledge, and Skills: Principles for
ObservationA 85
Nonverbal Behavior 85
Verbal BehaviorVerbal BehaviorV 90
Observe: Is �is Interview About Studying or Racial
Harassment? 94
Discrepancies, Mixed Messages, and Conflict 97
Action: Key Points and Practice of Observation Skills 99
100

SECTION II
The Basic Listening Sequence: Organizing a Session to Be More
Fully
Empathic and to Promote Creative

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