Fall 2025 SOWK 486w Week 12 - Effecting Change - Empathy, Confrontation, & Barriers

Fall 2025 SOWK 486w Week 12 - Effecting Change - Empathy, Confrontation, & Barriers

title: Fall 2025 SOWK 486w Week 12 - Effecting Change - Empathy, Confrontation, & Barriers date: 2025-11-10 10:31:13 location: Heritage University tags:

• Heritage University
• BASW Program
• SOWK 486w presentation_video: > “” description: >

Week twelve we look to develop strategies for how to impact change with our clients. Students will read Chapters 17 and 18 from Hepworth et al. (2023) to explore key strategies for helping clients change. In class, we will engage in interactive activities to better understand empathy, assertive confrontation and discuss what facilitates recovery. Students also will submit their Interviewing Skills Role-Play, due on Monday morning. The agenda for the class session includes:

• Engaging in empathy-building activity
• Practicing additive empathy and interpretation with client examples
• Role-playing structured confrontation techniques
• Discussing transference, countertransference, and resistance
• Reviewing the 10 principles of the SAMHSA Recovery Model

Learning Objectives for the Week

• Practice empathy through stepping into others’ perspectives.
• Identify and apply the components of additive empathy and interpretive responses in client interactions.
• Demonstrate assertive confrontation techniques using structured sentence frames and client-centered feedback.
• Analyze the principles of the SAMHSA Recovery Model.

Plan for Week 12

Agenda

• Additive empathy and interpretation
• Confrontation
• Barriers to change
• Working definition of recovery

Learning Objectives

• Practice empathy through stepping into others’ perspectives.
• Identify and apply the components of additive empathy and interpretive responses in client interactions.
• Demonstrate assertive confrontation techniques using structured sentence frames and client-centered feedback.
• Analyze the principles of the SAMHSA Recovery Model.

We Each See the World Differently (1 of 2)

I’m going to get us started today with an activity focused on raising awareness of various points of view.

Learning objective: The participant is aware that every individual has their own point of view and that their own perspective is not universal. The participant can enter the perspective of the other by focusing attention on the differences between himself and others and by temporarily putting aside their own references.

[Whole Group Activity] Consider Term with All Senses

Write the word OCEAN on the flap-over and ask the participants to close their eyes for a moment and let their senses take over as they imagine OCEAN. See it, smell it, hear it, feel it. Then ask the participants to share their thoughts and feelings when they think about the word OCEAN. Write down what you hear. How are the images different?

Discuss with the participants how earlier personal experiences filter what we imagine. All of us have slightly different filters that help us make sense of the world. This is why our perceptions are never exactly like anyone else’s

(Lieber, 1994, as cited in Kingma, 2013).

We Each See the World Differently (2 of 2)

Now we are going to move on to do a small group to explore some definitions of a couple of words.

[Small Group Activity] Developing Group Definition of Terms

Divide the participants into three groups of four. Explain that the groups may select words from the list below, and participants will write down what the word on the card means to them. Then each participant in the group will read their definitions in a go-round. Remind participants not to interrupt or ask questions during this phase, and that the purpose of this exercise is to see how perceptions vary, not to determine a correct definition. This is also an opportunity to monitor listening skills and to temporarily set aside one’s own references. Each group may choose three words to use in this exercise.

Word Selection:

• Success
• Freedom
• Morality
• Racism
• Injustice
• Community
• Democracy
• Family
• Police
• Human rights
• Love
• Sexism
• Tolerance
• Prejudice
• Friend

The process may be as follows

1. The group picks the first word they want to define—for example, Freedom.
2. Each participant in the group takes a few minutes to write down a few words or phrases that give the word meaning.
3. When every participant is finished writing, the group goes around, each participant taking turns sharing what they wrote.
4. If there is time left, participants reflect to explore further the meaning each person shared.
5. After 15 minutes, tell the participants to choose the next word.

In closing this exercise, you can check whether participants’ understanding of the words on the cards changed after they were discussed in their groups.

(Lieber, 1994 as cited in Kingma, 2013)

Types of Empathy

We can think about both cognitive and emotional empathy.

“Empathy has been defined as perceiving, understanding, experiencing, and responding to the emotional state of another person (Barker, 2003, p. 141).” (Hepworth, 2023, p. 513). Decety and Jackson (2004) describe two basic types of empathy.

Emotional empathy, specifically at the cognitive level, includes expressed feeling and an understanding that infers or reflects clients’ emotions. In addition, your cognitive empathy translates those feelings into words that ultimately help clients take problem-solving action.

• Emotional Empathy - as the ability to be affected by a client’s emotions
• Cognitive Empathy - is the translation of such feelings into words

Components of Empathy

There are three basic components of empathy laid out by the Hepworth text.

• Affective Sharing: Person sharing something to respond to
• Self-Awareness: so that the social worker recognizes himself or herself as different from the person with whom he or she has empathy
• Mental Flexibility: requiring skills in both turning on receptivity and turning it off. Such skills are essential for regulating compassion fatigue by enabling the social worker to distance themselves from the client’s experience (Adams, Boscarinao, & Figley, 2006; Harr & Moore, 2011).

(Hepworth, et al. 2017)

Additive Empathic Responses & Interpretation

“Additive empathic responses go somewhat beyond what clients have expressed and, therefore, require some degree of inference by social workers. Thus, these responses are moderately interpretive— that is, they interpret forces operating to produce feelings, cognitions, reactions, and behavioral patterns” (Hepworth, p. 513). Cormier, Nurius, and Osborn (2009) describe that

Interpretation is intended to help clients view their problems from a different perspective, thereby creating new possibilities for remedial courses of action

• Lead to Interpretation: Such additive empathic responses lead us to interpretation
• The identification of patterns, goals, and wishes that clients imply but do not directly state. Insight through interpretation is the foremost therapeutic principle basic to psychoanalysis and closely related therapies.

(Hepworth, et al. 2023)

Pitfalls of Additive Empathy

If you never played Pitfall on the Atari (or have no idea what that is, there might be a problem… )

“moderate interpretations (those that reflect feelings that lie at the margin of the client’s experiences) facilitate self-exploration and self-awareness, whereas deep interpretations engender opposition” (Hepworth, p. 514)

We need to remember that we want to make interpretive statements that are closer to the clients own understanding a self image.

• Use additive empathy sparingly until a sound working relationship has evolved
• Employ these responses only when clients are engaged in self-exploration or have shown that they are ready to do so
• Pitch these responses to the edge of clients’ self-awareness and avoid attempting to foster awareness that is remote from clients’ current awareness or experiences
• Avoid making several additive empathic responses in succession
• Phrase interpretive responses in tentative terms
• To determine the accuracy of an interpretive response, carefully note clients’ reactions after offering the interpretation
• If the client responds negatively to an interpretative response, acknowledge your probable error, respond empathically to the client’s reaction, and continue your discussion of the topic under consideration
• When providing an interpretation to a client who is culturally different from the social worker, recognize that the client may not readily understand the message the way it was intended

(Hepworth, et al. 2023)

Ways of Using Additive Empathy (1 of 2)

The following are some ways that we should consider using additive empathy.

• Deeper feelings
  • To identify feelings that are only implied or hinted at in clients’ verbal messages
  • To identify feelings that underlie surface emotions
  • To clarify the nature of feelings clients express only vaguely
  • To identify feelings manifested only nonverbally
  • Challenging beliefs stated as facts

Previous textbook also included -> To add intensity to feelings clients have minimized

(Hepworth, et al. 2023)

Ways of Using Additive Empathy (2 of 2)

• Underlying meanings of feelings, thoughts, and behavior (all behavior is communication)
• Wants and goals (helping develop and understand)
• Hidden purposes of behavior (often self-protective)
• Challenge beliefs stated as facts
• Unrealized strengths and potentialities

(Hepworth, et al. 2023)

Additive Empathy and Interpretation: Practice with Client Statements

We are going to spend some practicing with some client statements and how we might engage in additive empathy or interpretation.

[Whole Group Activity] Practice with Additive Empathy and Interpretation using Client Statements

With a partner take turns going through each example and offering potential interpretations.

1. Read the statement with your partner
2. Discuss what you would say or respond
3. Engage dialogue with your partner
4. Review the modeled response for that one

Client statements on pp. 401–402 and Modeled Responses pp. 402—403

(Hepworth et al. 2023)

Confrontation

“Social workers would more appropriately consider confrontation to exist along a continuum that ranges from fostering self-confrontation at one extreme to assertive confrontation at the other extreme” (Hepworth, p. 524) describing information based on Rooney (2009).

(Hepworth, et al. 2023)

Effective Assertive Confrontation (1 of 2)

Effective assertive confrontations embody four elements

• Expression of concern
• A description of the client’s purported goal, belief, or commitment
• The behavior (or absence of behavior) that is inconsistent or discrepant with the goal, belief, or commitment
• The probable negative outcomes of the discrepant behavior

(Hepworth, et al. 2023)

Effective Assertive Confrontation (2 of 2)

Confrontation is probably one of the most important skills that you can can develop in trying to help changes others.

The sentence frame follows this pattern:

I am concerned because you (want, believe, are striving to) (describe desired outcome) but you (describe discrepant action, behavior, or inaction) is likely to produce (describe probable negative consequences).

```markdown Potential Examples from ChatGPT Example 1: Missed Appointments

I’m concerned because you’ve said you want to work on improving your mental health and build more stability, but you’ve missed several of our recent sessions, which is likely to slow your progress and make it harder to see positive change.

Example 2: Substance Use

I’m concerned because you’ve shared that staying sober is important to you so you can regain custody of your children, but continuing to use substances is likely to interfere with your recovery and your goal of being reunited with them.

Example 3: Relationship Goals

I’m concerned because you’ve said you want to have a healthier relationship with your partner, but yelling and shutting down during arguments is likely to continue the conflict and distance between you.

Example 4: Employment Goals

I’m concerned because you’ve expressed wanting to find steady work, but not following through on job applications is likely to delay you getting hired and improving your financial situation.

```

[Small Group Activity] Practice with Confrontation Using Client Statements

Review Skill Development and Exercises for Confrontation: Situations and Dialog on pp.403–404.

• What would you say
• Role-play saying it
• Review and compare the modeled responses

Barriers to Change

• Problematic social worker behavior
• Cross-racial and cross-cultural experiences
• Difficulties establishing trust
• Transference
• Countertransference

(Hepworth, et al. 2023)

Death Therapy – Transference

[Discussion] How many of you have seen the movie “What About Bob?”

[Watch] Death Therapy off of What About Bob.

[Discussion] How could this be an example of transference or counter transference? [Not exactly an correct example… but for discussion]

• Transference
  • Psychoanalysis - the redirection to a substitute, usually a therapist, of emotions that were originally felt in childhood.
  • Client has transference to the clinician
• Counter-transference
  • You have transference to the client

[Discussion] What are some examples of transference and counter transference

Reactance Theory

Brehm (1972) talked about Reactance (well and had been writing about it since the sixties).

• Importance of the freedom
• Magnitude of threat to freedom

Creates Reactance

• Mental Effects: Perceptual or judgmental changes
• Behavioral Effects: Opposition, aggression, etc.

Share story about client and being “a F… Hawaiian.”

Recovery Model from SAMHSA (1 of 12) Overview

In thinking about what are barriers to change, the SAMSA’s working definition of recovery and the required components can help us to understand what needs to be put into place to offer effective services.

Recovery Model from SAMHSA (2 of 12) Slide Change

Next Slide

Recovery Model from SAMHSA (3 of 12) Recovery emerges from hope

The first theme SAMSA describes is hope.

• The belief that recovery is real…
• Essential and motivating message of a better future
• People can and do overcome (internal and external challenges, barriers, and obstacles that confront them).
• Hope is internalized and can be fostered by peers, families, providers, allies, and others.
• Hope is the catalyst of the recovery process.

Recovery Model from SAMHSA (4 of 12) Recovery is person-driven

The second theme regarding recovery is very in line with social work values of self determination.

• Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) towards those goals.
• Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience.
• In so doing, they are empowered and provided the resources to make informed decisions, initiate recovery, build on their strengths, and gain or regain control over their lives.

Recovery Model from SAMHSA (5 of 12) Recovery occurs via many pathways

The third understanding that must be had is that recovery occurs via many pathways.

• Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds - including trauma experience that affect and determine their pathway(s) to recovery.
• Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual.
• Recovery pathways are highly personalized.
• They may include…
  • Professional clinical treatment
  • Use of medications
  • Support from families and in schools
  • Faith-based approaches
  • Peer support
  • Other approaches
• Recovery is non-linear, characterized by continual growth and improved functioning that may involve setbacks.
• Because setbacks are a natural, though not inevitable, part of the recovery process, it is essential to foster resilience for all individuals and families.
• Abstinence from the use of alcohol, illicit drugs, and non-prescribed medications is the goal for those with addictions.
• Use of tobacco and non-prescribed or illicit drugs is not safe for anyone.
• In some cases, recovery pathways can be enabled by creating a supportive environment. This is especially true for children, who may not have the legal or developmental capacity to set their own course.

Recovery Model from SAMHSA (6 of 12) Recovery is holistic

A holistic view is the fourth acknowledgment that must be made.

• Recovery encompasses an individual’s whole life, including mind, body, spirit, and community.
• This includes addressing: self-care practices, family, housing, employment, transportation, education, clinical treatment for mental disorders and substance use disorders, services and supports, primary healthcare, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, and community participation.
• The array of services and supports available should be integrated and coordinated.

Recovery Model from SAMHSA (7 of 12) Recovery is supported by peers and allies

Having recovery supported by peers and allies is an important aspect for clinicians to understand and is the fifth area discussed.

• Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery.
• Peers encourage and engage other peers and provide each other with a vital sense of belonging, supportive relationships, valued roles, and community.
• Through helping others and giving back to the community, one helps one’s self.
• Peer operated supports and services provide important resources to assist people along their journeys of recovery and wellness.
• Professionals can also play an important role in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths.
• While peers and allies play an important role for many in recovery, their role for children and youth may be slightly different. Peer supports for families are very important for children with behavioral health problems and can also play a supportive role for youth in recovery.

Recovery Model from SAMHSA (8 of 12) Recovery is supported through relationship and social networks

The sixth factor in the recovery process is understanding that recovery is supported through relationship and social networks.

• An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change.
• Family members, peers, providers, faith groups, community members, and other allies form vital support networks. Through these relationships, people leave unhealthy and/or unfulfilling life roles behind and engage in new roles (e.g., partner, caregiver, friend, student, employee) that lead to a greater sense of belonging, personhood, empowerment, autonomy, social inclusion, and community participation.

Recovery Model from SAMHSA (9 of 12) Recovery is culturally-based and influenced

The seventh area addressed is that of culturally based services and influences.

• Culture and cultural background in all of its diverse representations including values, traditions,and beliefs are keys in determining a person’s journey and unique pathway to recovery. Services should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs.

Recovery Model from SAMHSA (10 of 12) Recovery is supported by addressing trauma

Addressing trauma is the eighth area of focus for recovery.

• The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often a precursor to or associated with alcohol and drug use, mental health problems, and related issues.
• Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.

Recovery Model from SAMHSA (11 of 12) Recovery involves individual, family, and community strengths and responsibility

The ninth area to evaluate is that of responsibility.

• Individuals, families, and communities have strengths and resources that serve as a foundation for recovery.
• Empowerment: In addition, individuals have a personal responsibility for their own self-care and journeys of recovery. Individuals should be supported in speaking for themselves. Families and significant others have responsibilities to support their loved ones, especially for children and youth in recovery.
• Communities have responsibilities to provide opportunities and resources to address discrimination and to foster social inclusion and recovery.
• Individuals in recovery also have a social responsibility and should have the ability to join with peers to speak collectively about their strengths, needs, wants, desires, and aspirations.

Recovery Model from SAMHSA (12 of 12) Recovery is based on respect

The tenth and final understanding is that of respect.

• Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems including protecting their rights and eliminating discrimination are crucial in achieving recovery.
• There is a need to acknowledge that taking steps towards recovery may require great courage.
• Self acceptance, developing a positive and meaningful sense of identity, and regaining belief in one’s self are particularly important.