Flashcards on Professional Identity and Confidentiality PDF

**Flashcard Set: professional identity and limits of confidentiality** **Flashcard 1:**\ **Q: What is the definition of Ethics in professional practice?**\ **A:** Ethics refers to the principles and rules of acceptable conduct, such as \"do no harm,\" maintain professional relationships, and protec...

**Flashcard Set: professional identity and limits of confidentiality** **Flashcard 1:**\ **Q: What is the definition of Ethics in professional practice?**\ **A:** Ethics refers to the principles and rules of acceptable conduct, such as \"do no harm,\" maintain professional relationships, and protect confidentiality. **Flashcard 2:**\ **Q: What are Values in professional practice?**\ **A:** Values are beliefs about what is important or desirable, such as dignity, self-determination, social justice, and valuing diversity. **Flashcard 3:**\ **Q: How do Ethics and Values relate to each other in counselling?**\ **A:** Ethics protect both clients and counsellors, while values guide the counsellor's beliefs and actions in a professional context. **Flashcard 4:**\ **Q: What is the Johari Window model?**\ **A:** The Johari Window model is a psychological tool used to help individuals understand and improve self-awareness and interpersonal relationships. It involves the concepts of open, blind, hidden, and unknown areas of the self. **Flashcard 5:**\ **Q: What is a Dual Relationship?**\ **A:** A dual relationship occurs when a counsellor has more than one type of relationship with a client, such as a business, friendship, or sexual relationship in addition to the counselling relationship. **Flashcard 6:**\ **Q: What are Professional Boundaries in counselling?**\ **A:** Professional boundaries include limits on personal information sharing, physical contact, favours, public events, time manipulation, and gifts to maintain a clear, professional relationship. **Flashcard 7:**\ **Q: What is the Ontario Association of Child and Youth Counsellors' stance on confidentiality?**\ **A:** The association advocates respecting client confidentiality, safeguarding clients' rights, and prohibits corporal punishment and sexual involvement with clients. **Flashcard 8:**\ **Q: What are some ethical considerations before taking action with a client?**\ **A:** Consider questions like: Whose needs are being met? Are boundaries set? Is the client informed to make a decision? Would another professional make the same decision? **Flashcard 9:**\ **Q: What is Confidentiality in counselling?**\ **Q: What is Confidentiality in counselling?** **Flashcard 10:**\ **Q: What are the two types of Confidentiality?**\ **A:** 1. **Absolute Confidentiality** -- Complete protection of all client information. 2. **Relative Confidentiality** -- Limits on confidentiality, such as in cases of harm or legal requirements. **Flashcard 11:**\ **Q: What are Parameters of Confidentiality?**\ **A:** Confidentiality can be broken in cases of harm to self, harm to others, child abuse/neglect, subpoena, or supervision within the agency. **Flashcard 12:**\ **Q: How would you protect Confidentiality in these scenarios?** - A client asks you to call back, but you reach an answering machine or someone else answers. - You meet a client at Tim Hortons. - You see a youth from work in public. - You carry case notes in public. - A neighbour asks about a client's progress. **Flashcard 13:**\ **Q: What is meant by Working Within Competence?**\ **A:** It means ensuring that you are capable, qualified, and properly trained to counsel in a specific area. If not, referral to another professional is necessary. **Flashcard 14:**\ **Q: What questions should you ask to ensure you are working within your competence?**\ **A:** - Am I qualified to counsel in this area? - Do I need to refer this client? - Am I misrepresenting my qualifications or training? **Flashcard 15:**\ **Q: What are the General Guidelines of Practice in counselling?**\ **A:** - Work within the limits of your competence. - Pursue ongoing professional training and development. - Be aware of personal reactions and unresolved issues. **Flashcard 16:**\ **Q: What are the Parameters of Confidentiality in counselling?**\ **A:** Confidentiality may be broken in the following situations: 1. **Harm to Self** -- If a client is at risk of harm to themselves. 2. **Harm to Others** -- If a client poses a risk to others\' safety. 3. **Child Abuse/Neglect** -- When there is suspicion or knowledge of abuse or neglect. 4. **Subpoena** -- If required by law through a subpoena. 5. **Supervision/Within Agency** -- When discussing cases for supervision or within the agency setting, following confidentiality guidelines. **Flashcard Set: Vicarious Trauma: It Costs to Care** **Flashcard 1:** **Q:** What is **Traumatic Stress**?\ **A:** Traumatic stress is the stress response to a traumatic event(s) in which one is the victim or witness. Repeated traumatic events can elevate the body\'s stress response. **Flashcard 2:** **Q:** What are the three main responses in the **stress response**?\ **A:** The stress response includes **Fight**, **Flight**, and **Freeze**. It is the body's defence against danger, activating the brain and body to protect against threats. **Flashcard 3:** **Q:** What makes an event **traumatic**?\ **A:** An event is traumatic if it involves a **real or perceived threat** to one\'s physical or emotional well-being, is **overwhelming**, creates **intense fear and lack of control**, and results in feelings of **helplessness**. **Flashcard 4:** **Q:** How does **Vicarious Trauma** occur?\ **A:** Vicarious trauma occurs when individuals are secondary witnesses to trauma (e.g., listening to clients' traumatic stories), absorbing emotional pain through empathy, and taking on parts of the trauma themselves. **Flashcard 5:** **Q:** How is **Vicarious Trauma** defined?\ **A:** Vicarious trauma is when a person who was not directly involved in a traumatic event experiences symptoms similar to those of trauma survivors, through secondary exposure to others\' trauma (Richardson, 2001). **Flashcard 6:** **Q:** What is **Compassion Fatigue**?\ **A:** Compassion fatigue is the **cost of caring** for others in emotional pain. It builds up over time, affecting empathic helpers (e.g., nurses, counselors) as they absorb others\' trauma. **Flashcard 7:** **Q:** What is **Post-Traumatic Stress Disorder (PTSD)**?\ **A:** PTSD is a diagnostic label for emotional, behavioral, and cognitive symptoms that result from direct involvement in a traumatic event, as outlined in the DSM-IV. **Flashcard 8:** **Q:** What is the **impact of empathy** in the helping professions?\ **A:** Empathy involves relating to others\' experiences, taking on their grief, fear, anger, and despair. It can affect the helper's emotional state and well-being by deeply connecting to the pain of others. **Flashcard 9:** **Q:** How can a **strong commitment** to work lead to burnout?\ **A:** A sense of commitment can lead to high expectations, resulting in feelings of **overwhelm**, **burden**, and eventually **hopelessness** if those expectations are not met. **HFlashcard 10:** **Q:** What is **Burnout**?\ **A:** Burnout is a syndrome of physical and emotional exhaustion involving **negative self-concept**, **negative job attitudes**, and **loss of concern for clients**. **Flashcard 11:** **Q:** What are the **3 stages of burnout**?\ **A:** 1. **Stage 1**: Physical and emotional exhaustion (e.g., headaches, sleep disturbances). 2. **Stage 2**: Loss of care and concern for clients. 3. **Stage 3**: Deep cynicism about clients and work, leading to total disengagement. **Flashcard 12:** **Q:** What is **Compassion Satisfaction**?\ **A:** Compassion satisfaction refers to the **positive rewards** of helping others, such as **joy, fulfillment**, and a sense of **contribution** to society. It promotes **career longevity** and **personal wellness**. **Flashcard 13:** **Q:** What factors increase vulnerability to **Vicarious Trauma**?\ **A:** Increased vulnerability to VT can be due to **personal history of trauma**, **lack of social support**, **unsustainable work-life boundaries**, and **lack of meaning or purpose** in one's work. **Flashcard 14:** **Q:** What is a **Vicarious Trauma Action Plan**?\ **A:** An action plan involves **coping strategies** such as **escape** (getting away physically or mentally), **rest** (relaxation without goals), and **play** (engaging in light-hearted activities) to protect oneself from VT. **Flashcard 15:** **Q:** What is the key characteristic of **secondary stress**?\ **A:** Secondary stress refers to the emotional burden experienced by someone who **witnesses** or is **indirectly exposed** to traumatic events, such as those in helping professions. **Flashcard Set: Counselling & CYC Relational Practice** **Flashcard 1:**\ **Q:** How is **Counselling** defined?\ **A:** Counselling is a **time-limited relationship** where counsellors help clients **increase their ability to manage life's challenges**. The immediate goal is to help clients gain control over problems, while the long-term goal is to restore or develop **coping abilities**. **Flashcard 2:**\ **Q:** What are the **three variables** that define counselling?\ **A:** 1. **Needs and wants of clients** 2. **Mandate of the counselling setting** 3. **Competence of the counsellor** **Flashcard 3:**\ **Q:** What does **versatility** in counselling mean?\ **A:** Counsellors must be able to **adapt their approach** to meet the unique needs of each client, based on individual circumstances, challenges, and available resources. **Flashcard 4:**\ **Q:** What are the **four phases** of counselling?\ **A:** 1. **Preliminary** 2. **Beginning** 3. **Action** 4. **Ending** **Flashcard 5:**\ **Q:** What happens during the **Preliminary Phase** of counselling?\ **A:** The Preliminary phase is for **planning**, including understanding the **agency setting**, and conducting the **initial interview** to gather background information. **Flashcard 6:**\ **Q:** What is the main goal during the **Beginning Phase** of counselling?\ **A:** The Beginning phase focuses on **developing the relationship** and gaining a **deeper understanding** of the **presenting problem** to build a foundation for intervention. **Flashcard 7:**\ **Q:** What occurs during the **Action Phase** of counselling?\ **A:** The Action phase involves **goal setting**, **action planning**, and helping the client **change behaviors**, manage **emotions**, and shift **perceptions** to improve their situation. **Flashcard 8:**\ **Q:** What is involved in the **Ending Phase** of counselling?\ **A:** The Ending phase focuses on **closing the relationship**, **evaluating progress**, and potentially **referring the client to other resources** if needed for continued support. **Flashcard 9:**\ **Q:** How is **CYC relational practice** similar to traditional counselling?\ **A:** CYC relational practice shares similar **core counselling skills**, communication techniques, and processes. Both focus on an **anti-oppressive**, **rights-based**, and **strengths-focused** approach. **Flashcard 10:**\ **Q:** How does **CYC relational practice** differ from traditional counselling?\ **A:** CYC practitioners are **proactively involved** in the **daily life** of clients, intervening immediately to assist in real-time situations. It also involves **present-moment life-space counselling** and engaging in **activities** that help clients directly. **Flashcard 11:**\ **Q:** What is meant by **\"Doing\"** and **\"Being\"** in CYC relational practice?\ **A:** - **\"Doing\"**: Engaging clients through **activities** and purposeful interventions. - **\"Being\"**: Being present in the moment with clients, **living alongside** them and **participating in their daily lives**. **Flashcard 12:**\ **Q:** What is **pseudo-counselling**?\ **A:** Pseudo-counselling involves offering **unsolicited advice**, **rescuing** the client, or using ineffective techniques that do not address the client's core issues, leading to poor outcomes. **Flashcard 13:**\ **Q:** What are **communication stoppers** in counselling?\ **A:** Examples of communication stoppers include: - **Interrupting** the client - **Judging** or **minimizing** their feelings - **Giving advice** without listening - Offering **solutions** prematurely **Flashcard 14:**\ **Q:** What are the **key skills of active listening** in counselling?\ **A:** 1. **Active listening** 2. **Silence** 3. **Asking questions** 4. **Paraphrasing** 5. **Empathy** 6. **Summarizing** **Flashcard 15:**\ **Q:** What are the steps to **prepare to attend** to clients?\ **A:** - **Identify patterns** and **prioritize** issues - **Screen out irrelevant details** - **Listen** attentively to what is **said** and **unsaid** - **Avoid negative verbal/non-verbal reactions** - **Follow through** on promises made during sessions **Flashcard 16:**\ **Q:** How should a counsellor **attend** to clients effectively?\ **A:** - **Open posture**: Turn towards the client with arms uncrossed - **Eye contact**: Maintain appropriate eye contact - **Facial expressions**: Use responsive and supportive expressions - **Encouraging comments**: Short affirmations like "I understand" or "Go on" - **Leaning forward**: Show engagement and focus when appropriate - **Tone of voice**: Speak in a warm, pleasant tone **Flashcard 17:**\ **Q:** What are some **common mistakes** in counselling?\ **A:** 1. **Pseudo-counselling** 2. **Inappropriate advice giving** 3. **Rescuing the client** 4. **Communication stoppers** 5. **Using faulty techniques** 6. **Failure to control uncontrollable variables** **Flashcard Set: Carl Rogers\' Client-Centred Therapy & Types of Questions** **Flashcard 1:**\ **Q:** What is the main focus of **Client-Centred Therapy** (also known as **Person-Centred Therapy**)?\ **A:** **Client-Centred Therapy** emphasizes that people have the capacity to **change** and are not bound by their past. The therapy focuses on seeing individuals as **becoming**, highlighting their **potential**, **strength**, **inner power**, and **capacity for growth**. **Flashcard 2:**\ **Q:** What is the importance of **seeing clients for their potential** in Client-Centred Therapy?\ **A:** Clients should be viewed for their **potential**, **strength**, **inner power**, and **capacity to change**. This perspective helps avoid reducing them to their past problems or diagnoses, creating a space for **growth and transformation**. **Flashcard 3:**\ **Q:** What are the **core conditions** for successful therapy according to Carl Rogers?\ **A:** The **core conditions** for effective therapy are: 1. **Unconditional Positive Regard** 2. **Genuineness** 3. **Empathy** These conditions must be present for change to occur in the therapeutic relationship. **Flashcard 4:**\ **Q:** What does **Unconditional Positive Regard** mean in therapy?\ **A:** **Unconditional Positive Regard** involves accepting a client **without judgment** or conditions, recognizing their inherent worth and dignity. This acceptance fosters a safe environment where clients feel valued and understood. **Flashcard 5:**\ **Q:** What are the **essential components** of **Unconditional Positive Regard**?\ **A:** - **Compassion** - **Warmth** - **Respect** - **Caring**\ These components help build a trusting, non-judgmental relationship that supports the client\'s growth. **Flashcard 6:**\ **Q:** What role does **Empathy** play in Client-Centred Therapy?\ **A:** **Empathy** is the ability to deeply understand the client\'s **feelings and experiences** from their perspective. It helps build a **strong bond** and conveys **acceptance** and **understanding**, facilitating emotional healing and growth. **Flashcard 7:**\ **Q:** What is the definition of **Genuineness** in therapy?\ **A:** **Genuineness** refers to being **authentic and real** with the client, meaning the therapist is **honest** and **open** without any false fronts. This openness builds trust and helps the client feel safe to be vulnerable. **Flashcard 8:**\ **Q:** What are the **goals of questioning** in counselling?\ **A:** The goals of questioning in therapy are to: - **Gather information** (less assumption) - **Provide focus** (keep the conversation on track) - **Promote insight** (encourage self-analysis and problem-solving) - **Encourage catharsis** (allow clients to tell their story and express emotions) **Flashcard 9:**\ **Q:** What is the difference between **Structured** and **Unstructured** interviews in counselling?\ **A:** - **Structured interviews** have a fixed set of questions, ensuring consistency. - **Unstructured interviews** are more flexible and allow the client to lead the conversation based on their needs. **Flashcard 10:**\ **Q:** What are **Closed Questions** in therapy?\ **A:** **Closed questions** can be answered with a simple **\"yes\" or \"no\"**. They are often used to confirm facts, gather specific information, or bring closure to a conversation. **Flashcard 11:**\ **Q:** What are **Open Questions** in therapy?\ **A:** **Open questions** require more in-depth responses, encouraging the client to explore and express their thoughts and feelings in greater detail. These questions are harder to answer with just \"yes\" or \"no.\" **Flashcard 12:**\ **Q:** What are **Indirect (Embedded) Questions** in therapy?\ **A:** **Indirect questions** are statements that act as questions, often used as a softer way to seek information. They help ease the client into a conversation without direct pressure. **Flashcard 13:**\ **Q:** What is the **danger of asking \"Why\" questions** in therapy?\ **A:** - \"Why\" questions can lead to **defensiveness**. For example, \"Why are you upset?\" might make the client feel they need to justify their emotions. - They can also make the client feel **judged** or that their feelings are being questioned. - \"Why\" questions tend to focus on **intellectual explanations** rather than emotional understanding, which can keep the client stuck in **intellectualizing** their problems. **Flashcard 14:**\ **Q:** What type of question is recommended instead of a \"Why\" question?\ **A:** Instead of \"Why\" questions, use **\"What\" questions** (e.g., \"What led you to feel this way?\"). This approach invites more exploration without creating defensiveness and helps the client delve into their emotional experience. **Flashcard 15:**\ **Q:** How do **active listening** skills contribute to effective counselling?\ **A:** **Active listening** includes: - **Empathy** - **Attending** (paying full attention to the client's verbal and non-verbal cues) - **Paraphrasing** (restating what the client has said for clarification) - **Asking open, closed, or indirect questions** - **Summarizing** (reviewing key points)\ These skills help the counsellor to engage deeply with the client, ensuring understanding and fostering a strong, trusting relationship. **Flashcard 16:** **Q: What are the three types of questions used in therapy?**\ **A:** 1. **Closed Questions** -- Yes/no answers. Used for confirming facts. 2. **Open Questions** -- Encourage in-depth responses. 3. **Indirect Questions** -- Statements that subtly invite responses. **Flashcard Set: Contracting and Self-Disclosure** **Flashcard 1:**\ **Q: What is the purpose of Contracting in Counselling?**\ **A:** Contracting ensures both the client and CYC are aware of the goals, methods, roles, rights, and responsibilities. It also clarifies when the counselling relationship should end. **Flashcard 2:**\ **Q: What does Contracting help to address?**\ **A:** It addresses the reality of differences in how the problem may be viewed by the client, agency, and CYC. It also helps in establishing the purpose of the work. **Flashcard 3:**\ **Q: What are the three types of Contracting?**\ **A:** 1. **Relationship Contract** 2. **Anticipatory Contract** 3. **Work Contract** **Flashcard 4:**\ **Q: What is a Relationship Contract?**\ **A:** A contract that defines the roles, rights, and responsibilities of both the client and the CYC, and establishes the boundaries and expectations in the relationship. **Flashcard 5:**\ **Q: What is an Anticipatory Contract?**\ **A:** A contract that focuses on expectations about future work or events in the counselling process, helping prepare the client for potential challenges. **Flashcard 6:**\ **Q: What is a Work Contract?**\ **A:** A contract that outlines specific goals, tasks, and methods of working together to achieve the client's objectives in therapy. **Flashcard 7:**\ **Q: How does Maslow's Hierarchy of Needs relate to counselling?**\ **A:** In counselling, it's used to understand the client's needs in the context of their current situation, with **Self-Transcendence** added to the hierarchy as a way to access well-being, peace, and harmony, especially relevant for Indigenous peoples. **Flashcard 8:**\ **Q: What is Self-Disclosure in counselling?**\ **A:** Self-disclosure is the act of revealing personal rather than professional information about the CYC to the client, beyond basic professional details like name, credentials, and office policies. **Flashcard 9:**\ **Q: What are the Types of Self-Disclosure?**\ **A:** 1. **Deliberate Self-Disclosure** -- Intentionally sharing personal information. 2. **Accidental Self-Disclosure** -- Unintended sharing of personal details. 3. **Client Deliberate Actions** -- Client shares personal information with the CYC. 4. **Unavoidable Self-Disclosure** -- Personal details are revealed unintentionally in the course of the relationship. **Flashcard 10:**\ **Q: What are some Guidelines for Self-Disclosure?**\ **A:** - It can model appropriate ways of sharing feelings and experiences. - Helps normalize the client's feelings. - Used as an exploration tool. - Must always serve the client's best interests. - Self-disclosure should not burden the client or become excessive, nor should the client need to care for the CYC. **Flashcard 1** **Q: What is Deep Listening?**\ **A:** Deep Listening is an Indigenous concept that emphasizes a holistic approach to communication, informed by community and reciprocity. It involves engaging all senses and parts of one\'s being to foster connection and understanding. **Flashcard 2** **Q: What are the key elements of Deep Listening?**\ **A:** 1. **Building Relationships**: Taking the time to develop trust and rapport. 2. **Respectful Engagement**: Listening with an open mind and heart. 3. **Self-Awareness**: Being conscious of one\'s own biases and emotional state to enhance the listening experience. **Flashcard 3** **Q: Name three skills that enhance listening.**\ **A:** 1. **Clarifying Questions**: Asking for clarification or examples to deepen understanding. 2. **Use of Silence**: Employing silence strategically to allow reflection and emotional processing. 3. **Paraphrasing and Summarizing**: Validating and checking for accuracy in what has been communicated. **Flashcard 4** **Q: Why is silence important in the listening process?**\ **A:** Silence allows space for thought, reflection, and emotional processing. It can communicate respect and encourages clients to explore their thoughts and feelings more deeply. **Flashcard 5** **Q: What are the multiple meanings of silence in communication?**\ **A:** - **Thinking**: Time to formulate thoughts. - **Confusion**: Uncertainty or hesitation in conversation. - **Painful Feelings**: Difficulty in expressing emotions. - **Trust Issues**: Reluctance to share due to lack of trust. - **Personal Style**: Individual comfort with silence. - **Closure**: A need for resolution or finishing thoughts. **Flashcard 6** **Q: How can you inquire about a client's silence? Provide an example.**\ **A:** You might say, \"I've noticed you've become very quiet. I wonder what that means for you. Are you feeling hesitant to share, or do you need some time to think?\" **Flashcard 7** **Q: What is paraphrasing and its purpose?**\ **A:** Paraphrasing involves restating a client\'s words and ideas in your own language. Its purpose is to ensure understanding, clarify communication, and encourage further discussion. **Flashcard 8** **Q: Provide examples of sentence stems for effective paraphrasing.**\ **A:** - \"To put it another way, you seem to be saying...\" - \"As I understand it, you are saying...\" - \"It sounds like you feel...\" **Flashcard 9** **Q: What is summarizing and its benefits?**\ **A:** Summarizing involves organizing and condensing complex ideas to highlight key points and relationships. It helps clients see new perspectives, prioritize issues, and understand the overall narrative. **Flashcard 10** **Q: Compare paraphrasing and summarizing in terms of their focus and structure.**\ **A:** - **Paraphrasing**: Focuses on restating simple ideas in a sentence or two, encouraging dialogue and clarification. - **Summarizing**: Focuses on connecting complex ideas into a cohesive paragraph, helping to synthesize information over a session or time frame. **Flashcard 1** **Q: What are the three domains of exploration in client interviews?**\ **A:** 1. **Affective Domain**: Focuses on how the client feels about an issue. 2. **Cognitive Domain**: Concentrates on what the client thinks about the issue. 3. **Behavioral Domain**: Examines what the client is doing or not doing regarding their problem. **Flashcard 2** **Q: What is the purpose of affective questions in client exploration?**\ **A:** Affective questions help uncover clients' emotions related to decision-making, problem-solving, and coping mechanisms, facilitating deeper understanding of their feelings. **Flashcard 3** **Q: What are some examples of affective questions?**\ **A:** - \"How do you feel about the decisions you've made?\" - \"What emotions arise when you think about this issue?\" **Flashcard 4** **Q: What does the cognitive domain focus on?**\ **A:** The cognitive domain focuses on the client\'s thoughts and beliefs about the issue, including their patterns of thinking and potential inaction. **Flashcard 5** **Q: What are \"moans\" in the cognitive context?**\ **A:** \"Moans\" are negative thought patterns that include terms like must, ought, always, never, and should, which can limit a client's perspective. **Flashcard 6** **Q: What does the behavioral domain explore?**\ **A:** The behavioral domain examines what clients are actively doing or not doing in relation to their problems, assessing both active and inactive responses. **Flashcard 7** **Q: What are some pitfalls of faulty questioning in client interviews?**\ **A:** - Keeps the interview superficial. - Antagonizes clients or makes them feel judged. - Creates demands on the client. - Biases answers and can destroy trust. **Flashcard 8** **Q: What are leading questions, and why are they problematic?**\ **A:** Leading questions suggest a \"correct\" answer or indicate what the interviewer wants to hear, which can sway client responses and hinder genuine exploration. **Flashcard 9** **Q: Provide an example of a leading question in a scenario with Kendra.**\ **A:** \"Don't you think living with your mother would be better for you?\" **Flashcard 10** **Q: What are the consequences of excessive questioning?**\ **A:** Excessive questioning can overwhelm clients, lead to resistance, and divert the focus from building trust and understanding. **Flashcard 11** **Q: What are multiple questions, and what are their challenges?**\ **A:** Multiple questions involve asking two or more questions at once, which can confuse clients or lead to incomplete answers. Example: \"How did you feel about it? Did you find any strategies that helped?\" **Flashcard 12** **Q: What are the issues with irrelevant or poorly timed questions?**\ **A:** These questions can derail conversations, as they may come too early in the process, causing resistance and shifting the focus away from the client's expressed feelings.