Psychotherapy
*Seeks to remold aspects of personality, while counseling is seen as helping people deal more effectively with the problems of life
The Therapeutic Relationship
*IS an important component of effective counseling
*Therapist as a person is a key part of effectiveness of treatment
*Research shows both the therapy relationship and the therapy used to contribute to treatment outcome
Corey's Stand
*Strongly influenced by the EXISTENTIAL APPROACH
-believes that clients can exercise freedom to choose their future
-quality of the client/therapist relationship is key
*Uses a variety of techniques from in an INTEGRATED approach:
-likes role playing, and
James Sire-in the Universe Next Door (2009)
* "I am convinced that for any of us to be fully conscious intellectually we should not only be able to detect the worldview of others but be aware of our own- why it is ours and why, in light of so many options, we think it is true.
The POST-MODERN WORLD VIEW
*Multiple truths
*Multiple universes
*Everything (even morality) is relative
**Beware of any line of thought wherein the core definition is subjective alone
*Professors assume the "truth" of ideas perhaps as much as anyone
Most lives in a time in which we
Self-centered Standards
*Egocentrism- "it's true because I believe it"
*Self-validation- "it's true because i have always believed it"
*Sociocentrism- "it's true because we believe it"
*Selfishness- "it's true because it is my own self-interest to believe it
Psychoanalytic Therapy
*Personality development, unconscious factors, early life
Adlerian Therapies
*Growth model of responsibility, creating your own destiny
Existential Therapies
*Unstructured, building therapy on here-n-now experience
Client-centered Counseling
*Non directive empowering of client to deal with problems
Gestalt Therapy
*Experiential theory emphasizing awareness, mind/body integration
Behavior Therapies
*Learning principles to resolve behavior problems
Cognitive Behavioral Approaches
*Action oriented stressing thinking and belief
Reality Therapy
*Short-term approach, emphasis on assuming responsibility for choices
Feminist Perspectives
*Focus on oppression of women by sociopolitical structures
Post-modern Approaches
*Reality is socially constructed, narrative therapy
Family Systems Therapies
*Key to changing the individual is understanding and changing the family system
Ethics and Counseling
*Principles that guide the standards of behavior and practice
*Helping professionals
Work with people who are by definition
vulnerable* to exploitation (intentional or accidental)
*Are in powerful positions over their clients/patients
*Knowledge= I have t
Examples of Ethics Codes
1. APA Ethical Principles for Psychologists
2. Code of Ethics for the National Association of Social Workers
3. American Association of Marriage and Family Therapy Code of Ethics
4. American Counseling Association Code of Ethics
5. Code of Ethics of the A
Ethical Decision Making
*Principles:
-benefit others, do not harm, respect other's autonomy, be just, fair and faithful
Role of Ethical Codes
*Educate us about responsibilities, a basis for accountability, protect clients, basis for improving professional practice
Making Ethical Decisions
*Identify problem, review relevant codes, seek consultation, brainstorm, list consequences, decide and document the reasons for your actions
*To degree possible, include client in your decision making process
I. Informed
*Clients need enough information about the counseling process to be able to make informed choices
*Educate clients about their rights and responsibilities
*Provide informed consent
-Therapy procedures
-Risks/benefits and alternatives
-Right to withdraw fr
II. Confidentiality
*Essential but not absolute
*Exceptions:
-*Duty to Warn (Tarasoff Case)
--->Client poses a danger to self or others
-Client <age 16 is the victim of abuse
-Dependent or older adult is the victim of abuse
-Clients needs to be hospitalized
*Information is m
III. Dual Relationships
*Not deemed inherently unethical in ethics codes of APA or ACA
*Multiple relationships must be managed in an ethical way to eliminate non-professional interactions and protect client well-being
Evidence-Based Practices
*STRENGTHS
-Counselors use treatments that have been validated by empirical research
-Treatments are usually brief and standardized
-Are preferred by many insurance companies
-Calls for accountability among mental health professionals to provide effective
Assessment and Diagnosis
*Assessment is an ongoing process designed to help the help the counselor evaluate key elements of psychological functioning
-Assessment practices are influenced by the therapist's theoretical orientation
-Requires cultural sensitivity
-Can be helpful in
Post-Modern" Approaches
-No single founder
-Come in several different schools (we address solution focused and narrative branches)
-They share philosophical ideas on "social constructionism and relative truth"--> core idea of post-modernism
-There are "multiple truths", sometime
...
*In post-modern therapies the stress is on the client's reality without disputing its' accuracy
*It can be truth for them (and it is not challenged)
Postmodernists assume there are
multiple truths*
*Reality is subjective and is based on the use of languag
Narrative Therapy
*Champions are Michael White and David Epston
*Basic premise is people construct the meaning of life in personal interpretive stories, which are then treated as "truth"
*Narrative Therapy focuses on the stories people tell about themselves/others & signif
Therapy is based on a belief that people can change those stories and all that goes with it
*The functions of the Narrative Therapist
*Become active facilitators of the client
*Demonstrate care, interest, respectful curiosity, openness, empathy, and fascination
*Believe in the client's abilities, talents and positive intentions
*Adopt a not-know
Solution Focused Brief Therapy
*Chief architects- a married couple
-Insoo Kim Berg and Steve DeShazer
*Goal oriented and pragmatic approach to therapy
*Brief, just 5-10 sessions
Focus on
what works for the client* rather than what's wrong with the client
*Solution focused therapy
-No d
Key Concepts of Solution-Focused Brief Therapy
*Therapy grounded on a positive orientation- people are seen as healthy and competent
*Past is downplayed, while present and future and highlighted
*Therapy is a concerned with looking for what is working
*Therapists assist clients in finding exceptions t
Basic Assumptions Solution-Focused Therapy
*Problem itself may not be relevant to finding effective solutions
*People can create their own solutions, client expert
*Small changes lead to large changes
*Best therapy is a collaborative partnership
*Therapist's not knowing affords client an opportuni
Techniques Used in Solution-Focused Brief Therapy
*Pre-therapy change ("what have you done since you made the appointment that has made a difference in your problem?"
*Exception questions (direct clients to times in their lives when the problem did not exist
*Miracle question ("if a miracle happened and
Limitations of Postmodern Approaches
*Therapists must be skilled in inplementing brief interventions
*Therapists may employ techniques in a mechanistic fashion
*Reliance on techniques may detract from building a therapeutic relationship
*Narrative therapists must be careful approach client's
Psychoanalytic Perspective
*Freud's view of human nature
-Deterministic (in another pessimistic)
-Interactions btw life instincts (libido- concept that includes sexual energy and all instincts serving survival) and death instincts (accounting for aggressive drives)
-Irrational forc
Evidence For Understanding The Unconscious
*Dreams
*Slips of the tongue
*Posthypnotic suggestions
*Material derived from free-association and projective techniques
*Concept central to psychoanalytic and projective techniques
Anxiety
*Concept central to psychoanalytic model
*Feelings of dread from repressed feelings, memories, desires
Kinds of Anxiety
1.Reality Anxiety- external world fears often exaggerated
2.Neurotic Anxiety- fear that your instincts will get out hand and so something for which you'll be punished
3. Moral Anxiety- associated with one's conscience
(defense mechanisms used)
Defense Mechanism
*When the ego can't control anxiety by direct and rational methods, defense mechanisms are used
*Used to assist coping with anxiety and prevent the ego from being overwhelmed
*They have adaptive value if they do not become a style of life to avoid facing
Common Defense Mechanisms
*Repression- exclude painful thoughts from awareness
*Denial- actively minimizing/closing one's eyes to a threatening reality
*Projection- attributing to other one's own unacceptable desires/behavior
*Regression- going back to earlier developmental stage
Development of Personality
*Oral Stage- 1st year
-related to later mistrust and rejection issues, basic nurturing
*Anal Stage- ages 1-3
-related to later personal power issues
*Phallic Stage- ages 3-6
-related to later sexual attitudes, develop desire for parent of opposite sex-->O
Transference
*Assumption is that client reacts to therapist as they did to an earlier relationship
-Allows client to experience feelings otherwise inaccessible
-Involved the unconscious repetition of the past in the present
-ANALYSIS OF TRANSFERENCE= allows the client
Countertransference
*Reaction of therapist toward client that may interfere with objectivity because their own conflicts are triggered
*Therapists total emotional response to a client
*Emotions are activated through their professional work
-Not always detrimental; they can p
Psychoanalytic Techniques
*Free Association- client reports quickly without censoring, plays key role in the process of maintaining the analytic framework
*Interpretation- therapist points out, explains, and teaches the meanings of whatever is revealed
*Dream Analysis- therapist u
Limitations Of Classical Analysis
*Approach may not be appropriate for all cultures or socioeconomic groups
*Deterministic focus does not emphasize current maladaptive behaviors
*Minimizes role of environment
*Requires subjective interpretation
*Lengthy treatment may not be practical or a
ADLER- Socially Oriented Approach
*Alderians view world from the client's subjective frame of reference
-How life is in reality, less important than how individual believes life to be
-It is not childhood experiences that are crucial but present interpretation of those events
-Believes ge
Social Interest
*Alder's most significant concept
1. Individuals attitude toward and awareness of being a part of the human community
2. Embodies a community feeling, emphasizes client's positive feelings towards others
3. Mental health measured by degree to which we suc
Inferiority Feelings
*Are normal
*Wellspring of creativity
*Develop when we are young- characterized by early feelings of hopelessness
Superiority Feelings
*Promote mastery
*Enable us to overcome obstacles
*Related complexes
*Inferiority complex
*Superiority complex- an attitude of superiority that conceals actual feelings of inferiority & failure
*Moving from lower position to higher position
*The movement
Birth Order and Siblings
*Concept assigns probability to a set of life
*Birth order has a great deal to do wit how adults interact in the world
experiences based on birth rank in family
- Oldest child = receives most attention, spoiled
- Second of only 2= behaves as if in a race,
4 Phases of Therapy
1. Establishing Proper Therapeutic Relationship
*Supportive, collaborative, educational, encouraging
*Person-to-person contact with the client precedes identification of problem
*Help client build awareness of their strengths
*Solid therapeutic relationship during this first phase of therapy
Encouragement
*Encouragement instills self confidence by expecting clients to assume responsibility for their lives and embrace the fact that they can make changes
*Encouragement is the most powerful method available for changing a person's beliefs
*Helps build self-co
2. Exploring Individual's Psychological Dynamics
*Deeper understanding of lifestyle
-subjective interview--> must follow from a sense of wonder, fascination and interest
-objective interview--> seeks to discover info about how problems in the client's life begun, any precipitating events, a medical hist
3. Encouraging Self Understanding/Insight
*Interpret findings of assessment as an avenue for promoting self-understanding and insight--> understanding of the motivations that operate in a client's life
*Hidden goals and purpose of behavior are made conscious
Therapist offers interpretations to he
4. Reorientation and Re-education
*Action-oriented--> putting insights into practice
*Focuses on helping clients discover a new and more functional perspective
*Clients are encouraged to take risks and make changes in their life
*Clients need to be reoriented toward the useful side of lif
Aside on Adlerian Techniques
1. Family constellation
-e.x. choose 3 words that capture the essence of each of your parents and siblings, which sibling is closest to you, why?
2. Early recollections analysis
-e.x. "What was your earliest memory?" (Adler believed we consciously choose
Limits of the Adlerian Approach
*Adler spent most of his time teaching his theory as opposed to systematically documenting it
*Hence, some consider Aldlerian theory simplistic
*Many of Adler's theoretical constructs (i.e. lifestyle) are difficult to measure and require empirical testing
Existential Perspective
*More a philosophical approach than particular school of counseling, therapy or single theory
*Existentialism stresses:
-Helping clients experience their own existence in a meaningful way
-Clients are seen as searching for meaning in their world
-Capacity
Continued Existential Perspective
*The greater our awareness, the greater our possibilities for freedom
*Awareness is realizing:
-we are finite--> limited time here
-we choose to act or not
-meaning isn't automatic- it must be sought
-we can be lonely, meaningless, empty, guilty, and isol
Identity
*"Courage to be"- we trust ourselves to search within and find our own answers
-being existentially "alone" helps us to discover our authentic self
Relatedness
*Our relationships are based on a desire for fulfillment
-relationships that spring from our sense of deprivation are clinging, parasitic, and symbiotic!
-clients must distinguish between neurotic dependence and the authentic need to be with others
-We mu
Meaning Must Be Pursued
*Finding meaning is a by-product of a commitment to creating, loving, and working
*Life is not meaningful in itself; the individual must create and discover meaning
Goals of Therapists in Existential Therapy
*Their views of human nature vary from pessimistic (e.g. life is meaningless, isolating, empty) to neutral, to positive, hopeful and optimistic
*No single or fixed view of human nature- people are seen as constantly changing and becoming whomever and what
Therapy
*Journey by therapist and client
-Person to person relationship is key
-Relationship demands that therapists be in contact with their own phenomenological world
*The core of the therapeutic relationship
-Respect and faith in the clients' potential to cope
Person-Centered Therapy
*Carl Rogers
*Maintaining that the presence of certain core conditions were necessary and sufficient to facilitate client change- people have vast potential for understanding themselves and resolving their own problems w/o direct intervention on the thera
Emphasize
*Therapy as a journey shared by 2 fallible people
*Client's self-actualization
*Quality of therapeutic relationship
*Counselor's creation of "growth-promoting" climate
1. Congruence
*Genuineness or realness in therapy
*Therapist's behaviors match their words
2. Unconditional positive regard
*Acceptance/genuine caring about client as a person
*Accepting clients as they are
*Therapist need not approve of client behavior
3. Accurate empathetic understanding
*Ability to deeply grasp the client's world
*Helper attitudes are more important than knowledge
-Therapist need not experience the situation to develop an understanding of it
Conditions Necessary/Sufficient For Personality Changes
1. Two persons are in psychological contact
2. Client is experiencing incongruence
3. Therapist is congruent or integrated in the relationship
4. Therapist experiences unconditional positive regard for client
5. Therapist experiences empathy for client's
Client-Centered (Cont.)
*Some felt Roger was revolutionary
*Maintaining that the presence of certain core conditions were necessary and sufficient to facilitate client change
*These were:
-Unconditional positive regard
-Empathetic understanding
-Congruence
-Warmth
*Note- they we
Client Centered Approaches challenge:
1. Assumption "counselor knows best"
2. Validity of advice, persuasion, diagnosis, and interpretation
3. Belief clients cannot understand and resolve their own probs without direct help
Limitations of the Person-Centered Approach
*Cultural considerations
-Some clients prefer a directive, structured treatment
-Individuals accustomed to indirect communication may not be comfortable with direct expression of empathy or creativity
-Individuals from some cultures may disagree with the
The Effective Counselor
*Most important instrument you have is YOU
*Is authentic (stereotyped, professional roles can be problematic)
*CLEAR about who they are
-willing to GROW, to care, and to be involved
*Counselors are comfortable dealing with emotion
*GOOD listeners (and can
The Counselor's Values
*Be aware of value imposition
-how YOUR values influence your interventions
-how YOUR values may influence your client's experiences in therapy
*Recognize that you are not value-neutral (nor should you be) have to find a middle ground!
*Your job is to ASS
1. Pre-interaction phase
*This is the time before interview has occurred
*Self-awareness- attitude, physical & emotional state
*Early impressions you may have formed
2. Beginning Phase
*This is the greeting and introduction
*State your purpose, set expectations
*Establish trust and rapport
3. Working Phase
*This is the body of interview (Q&A)
*Most data are typically collected here
*Goal is to GUIDE people to tell what you want to know in order to assist them
4. Ending Phase
*This is where you work toward the close
*Allowing questions form the interviewee
*Make plans, give instructions, homework and recommendations
*Terminate the contact
Problems common to the new counselor
-Too much self-disclosure
-Dealing with age & genera
Practitioners who may Counsel
*Psychiatrists (M.D.)
*Psychoanalysts (M.D., Ph.D., Psy.D.)
*Clinical Psychologists (Ph.D., Psy.D)
*Counseling Psychologists (M.A, Ed.D., Ph.D)
*Social Workers (M.S.W., LCSW)
Theoretical orientation
*"A conceptual framework used by a counselor to understand client therapeutic needs"
*Things which shape one's orientation:
-Our personalities, mentors, professors, supervisors, clients, deeper world views we have, pragmatics, knowledge base
PSYCHOANALYTIC overview
*Deterministic
*We understand our present by examining our past
*Early childhood and psychosexual issues are keys to understanding psychological development
Key concepts
- defense mechanisms, psychosexual stages, id, ego, superego,
*Therapy goals- make th
ADLERIAN overview
*People motivated by social interest
*People establish goals in life, some of which are fictional
*During early childhood create styles of life, which remain quite stable
Key concepts
- inferiority and superiority complexes, birth order
*Therapy goals- he
GESTALT THERAPY overview
*Grounded in here and now
*People move toward wholeness, integration of thinking, feeling, behaving
Key concepts
- figure ground relationships, contact and contact resistances, unfinished business
*Therapy goals- help clients become aware of the moment to
REALITY THERAPY overview
*Problems develop when people don't take responsibility for their behavior
*Reality assumes that people need quality relationships
Key concepts
- choice theory, responsibility, psychological needs of belonging, power, freedom, fun
*Teach clients choice th
COGNITIVE BEHAVIORAL overview
*People's thoughts are primary causes of MI
*Therapy focuses on thought patterns, teaching new ways of thinking
Key concepts
- automatics thoughts, cognitive distortions
*Goals- eliminate irrational thoughts and replace with more adaptive ones
Most students...
*Are upon entering courses of counseling and psychotherapy calling themselves eclectic
*Even after a careful study of theories...are you?
*If you are truly eclectic- it means that you don't just change techniques to fit a situation, but actually possess d
Addressing Problems vs. Addressing People
*Counseling by it's very nature is largely designed to assist people with problems of life
-but it is not just guidance
*The continuum= guidance...counseling...psychotherapy
What Are the Cardinal Virtues?
*Prudence
*Temperance
*Forbearance
*Justice
*These 4 derive from classical Greek philosophers who considered them to be the foremost virtues of good character
*Later, the early Christian Church saw these virtues as vitally important to all people, whether
What is Personality
*Different temperaments (constitutional differences) right from the start
*What are the well recognized temperaments in newborns?
- Easy, difficult and slow to warm up
Psychotherapy
*Seeks to remold aspects of personality, while counseling is seen as helping people deal more effectively with the problems of life
The Therapeutic Relationship
*IS an important component of effective counseling
*Therapist as a person is a key part of effectiveness of treatment
*Research shows both the therapy relationship and the therapy used to contribute to treatment outcome
Corey's Stand
*Strongly influenced by the EXISTENTIAL APPROACH
-believes that clients can exercise freedom to choose their future
-quality of the client/therapist relationship is key
*Uses a variety of techniques from in an INTEGRATED approach:
-likes role playing, and
James Sire-in the Universe Next Door (2009)
* "I am convinced that for any of us to be fully conscious intellectually we should not only be able to detect the worldview of others but be aware of our own- why it is ours and why, in light of so many options, we think it is true.
The POST-MODERN WORLD VIEW
*Multiple truths
*Multiple universes
*Everything (even morality) is relative
**Beware of any line of thought wherein the core definition is subjective alone
*Professors assume the "truth" of ideas perhaps as much as anyone
Most lives in a time in which we
Self-centered Standards
*Egocentrism- "it's true because I believe it"
*Self-validation- "it's true because i have always believed it"
*Sociocentrism- "it's true because we believe it"
*Selfishness- "it's true because it is my own self-interest to believe it
Psychoanalytic Therapy
*Personality development, unconscious factors, early life
Adlerian Therapies
*Growth model of responsibility, creating your own destiny
Existential Therapies
*Unstructured, building therapy on here-n-now experience
Client-centered Counseling
*Non directive empowering of client to deal with problems
Gestalt Therapy
*Experiential theory emphasizing awareness, mind/body integration
Behavior Therapies
*Learning principles to resolve behavior problems
Cognitive Behavioral Approaches
*Action oriented stressing thinking and belief
Reality Therapy
*Short-term approach, emphasis on assuming responsibility for choices
Feminist Perspectives
*Focus on oppression of women by sociopolitical structures
Post-modern Approaches
*Reality is socially constructed, narrative therapy
Family Systems Therapies
*Key to changing the individual is understanding and changing the family system
Ethics and Counseling
*Principles that guide the standards of behavior and practice
*Helping professionals
Work with people who are by definition
vulnerable* to exploitation (intentional or accidental)
*Are in powerful positions over their clients/patients
*Knowledge= I have t
Examples of Ethics Codes
1. APA Ethical Principles for Psychologists
2. Code of Ethics for the National Association of Social Workers
3. American Association of Marriage and Family Therapy Code of Ethics
4. American Counseling Association Code of Ethics
5. Code of Ethics of the A
Ethical Decision Making
*Principles:
-benefit others, do not harm, respect other's autonomy, be just, fair and faithful
Role of Ethical Codes
*Educate us about responsibilities, a basis for accountability, protect clients, basis for improving professional practice
Making Ethical Decisions
*Identify problem, review relevant codes, seek consultation, brainstorm, list consequences, decide and document the reasons for your actions
*To degree possible, include client in your decision making process
I. Informed
*Clients need enough information about the counseling process to be able to make informed choices
*Educate clients about their rights and responsibilities
*Provide informed consent
-Therapy procedures
-Risks/benefits and alternatives
-Right to withdraw fr
II. Confidentiality
*Essential but not absolute
*Exceptions:
-*Duty to Warn (Tarasoff Case)
--->Client poses a danger to self or others
-Client <age 16 is the victim of abuse
-Dependent or older adult is the victim of abuse
-Clients needs to be hospitalized
*Information is m
III. Dual Relationships
*Not deemed inherently unethical in ethics codes of APA or ACA
*Multiple relationships must be managed in an ethical way to eliminate non-professional interactions and protect client well-being
Evidence-Based Practices
*STRENGTHS
-Counselors use treatments that have been validated by empirical research
-Treatments are usually brief and standardized
-Are preferred by many insurance companies
-Calls for accountability among mental health professionals to provide effective
Assessment and Diagnosis
*Assessment is an ongoing process designed to help the help the counselor evaluate key elements of psychological functioning
-Assessment practices are influenced by the therapist's theoretical orientation
-Requires cultural sensitivity
-Can be helpful in
Post-Modern" Approaches
-No single founder
-Come in several different schools (we address solution focused and narrative branches)
-They share philosophical ideas on "social constructionism and relative truth"--> core idea of post-modernism
-There are "multiple truths", sometime
...
*In post-modern therapies the stress is on the client's reality without disputing its' accuracy
*It can be truth for them (and it is not challenged)
Postmodernists assume there are
multiple truths*
*Reality is subjective and is based on the use of languag
Narrative Therapy
*Champions are Michael White and David Epston
*Basic premise is people construct the meaning of life in personal interpretive stories, which are then treated as "truth"
*Narrative Therapy focuses on the stories people tell about themselves/others & signif
Therapy is based on a belief that people can change those stories and all that goes with it
*The functions of the Narrative Therapist
*Become active facilitators of the client
*Demonstrate care, interest, respectful curiosity, openness, empathy, and fascination
*Believe in the client's abilities, talents and positive intentions
*Adopt a not-know
Solution Focused Brief Therapy
*Chief architects- a married couple
-Insoo Kim Berg and Steve DeShazer
*Goal oriented and pragmatic approach to therapy
*Brief, just 5-10 sessions
Focus on
what works for the client* rather than what's wrong with the client
*Solution focused therapy
-No d
Key Concepts of Solution-Focused Brief Therapy
*Therapy grounded on a positive orientation- people are seen as healthy and competent
*Past is downplayed, while present and future and highlighted
*Therapy is a concerned with looking for what is working
*Therapists assist clients in finding exceptions t
Basic Assumptions Solution-Focused Therapy
*Problem itself may not be relevant to finding effective solutions
*People can create their own solutions, client expert
*Small changes lead to large changes
*Best therapy is a collaborative partnership
*Therapist's not knowing affords client an opportuni
Techniques Used in Solution-Focused Brief Therapy
*Pre-therapy change ("what have you done since you made the appointment that has made a difference in your problem?"
*Exception questions (direct clients to times in their lives when the problem did not exist
*Miracle question ("if a miracle happened and
Limitations of Postmodern Approaches
*Therapists must be skilled in inplementing brief interventions
*Therapists may employ techniques in a mechanistic fashion
*Reliance on techniques may detract from building a therapeutic relationship
*Narrative therapists must be careful approach client's
Psychoanalytic Perspective
*Freud's view of human nature
-Deterministic (in another pessimistic)
-Interactions btw life instincts (libido- concept that includes sexual energy and all instincts serving survival) and death instincts (accounting for aggressive drives)
-Irrational forc
Evidence For Understanding The Unconscious
*Dreams
*Slips of the tongue
*Posthypnotic suggestions
*Material derived from free-association and projective techniques
*Concept central to psychoanalytic and projective techniques
Anxiety
*Concept central to psychoanalytic model
*Feelings of dread from repressed feelings, memories, desires
Kinds of Anxiety
1.Reality Anxiety- external world fears often exaggerated
2.Neurotic Anxiety- fear that your instincts will get out hand and so something for which you'll be punished
3. Moral Anxiety- associated with one's conscience
(defense mechanisms used)
Defense Mechanism
*When the ego can't control anxiety by direct and rational methods, defense mechanisms are used
*Used to assist coping with anxiety and prevent the ego from being overwhelmed
*They have adaptive value if they do not become a style of life to avoid facing
Common Defense Mechanisms
*Repression- exclude painful thoughts from awareness
*Denial- actively minimizing/closing one's eyes to a threatening reality
*Projection- attributing to other one's own unacceptable desires/behavior
*Regression- going back to earlier developmental stage
Development of Personality
*Oral Stage- 1st year
-related to later mistrust and rejection issues, basic nurturing
*Anal Stage- ages 1-3
-related to later personal power issues
*Phallic Stage- ages 3-6
-related to later sexual attitudes, develop desire for parent of opposite sex-->O
Transference
*Assumption is that client reacts to therapist as they did to an earlier relationship
-Allows client to experience feelings otherwise inaccessible
-Involved the unconscious repetition of the past in the present
-ANALYSIS OF TRANSFERENCE= allows the client
Countertransference
*Reaction of therapist toward client that may interfere with objectivity because their own conflicts are triggered
*Therapists total emotional response to a client
*Emotions are activated through their professional work
-Not always detrimental; they can p
Psychoanalytic Techniques
*Free Association- client reports quickly without censoring, plays key role in the process of maintaining the analytic framework
*Interpretation- therapist points out, explains, and teaches the meanings of whatever is revealed
*Dream Analysis- therapist u
Limitations Of Classical Analysis
*Approach may not be appropriate for all cultures or socioeconomic groups
*Deterministic focus does not emphasize current maladaptive behaviors
*Minimizes role of environment
*Requires subjective interpretation
*Lengthy treatment may not be practical or a
ADLER- Socially Oriented Approach
*Alderians view world from the client's subjective frame of reference
-How life is in reality, less important than how individual believes life to be
-It is not childhood experiences that are crucial but present interpretation of those events
-Believes ge
Social Interest
*Alder's most significant concept
1. Individuals attitude toward and awareness of being a part of the human community
2. Embodies a community feeling, emphasizes client's positive feelings towards others
3. Mental health measured by degree to which we suc
Inferiority Feelings
*Are normal
*Wellspring of creativity
*Develop when we are young- characterized by early feelings of hopelessness
Superiority Feelings
*Promote mastery
*Enable us to overcome obstacles
*Related complexes
*Inferiority complex
*Superiority complex- an attitude of superiority that conceals actual feelings of inferiority & failure
*Moving from lower position to higher position
*The movement
Birth Order and Siblings
*Concept assigns probability to a set of life
*Birth order has a great deal to do wit how adults interact in the world
experiences based on birth rank in family
- Oldest child = receives most attention, spoiled
- Second of only 2= behaves as if in a race,
4 Phases of Therapy
1. Establishing Proper Therapeutic Relationship
*Supportive, collaborative, educational, encouraging
*Person-to-person contact with the client precedes identification of problem
*Help client build awareness of their strengths
*Solid therapeutic relationship during this first phase of therapy
Encouragement
*Encouragement instills self confidence by expecting clients to assume responsibility for their lives and embrace the fact that they can make changes
*Encouragement is the most powerful method available for changing a person's beliefs
*Helps build self-co
2. Exploring Individual's Psychological Dynamics
*Deeper understanding of lifestyle
-subjective interview--> must follow from a sense of wonder, fascination and interest
-objective interview--> seeks to discover info about how problems in the client's life begun, any precipitating events, a medical hist
3. Encouraging Self Understanding/Insight
*Interpret findings of assessment as an avenue for promoting self-understanding and insight--> understanding of the motivations that operate in a client's life
*Hidden goals and purpose of behavior are made conscious
Therapist offers interpretations to he
4. Reorientation and Re-education
*Action-oriented--> putting insights into practice
*Focuses on helping clients discover a new and more functional perspective
*Clients are encouraged to take risks and make changes in their life
*Clients need to be reoriented toward the useful side of lif
Aside on Adlerian Techniques
1. Family constellation
-e.x. choose 3 words that capture the essence of each of your parents and siblings, which sibling is closest to you, why?
2. Early recollections analysis
-e.x. "What was your earliest memory?" (Adler believed we consciously choose
Limits of the Adlerian Approach
*Adler spent most of his time teaching his theory as opposed to systematically documenting it
*Hence, some consider Aldlerian theory simplistic
*Many of Adler's theoretical constructs (i.e. lifestyle) are difficult to measure and require empirical testing
Existential Perspective
*More a philosophical approach than particular school of counseling, therapy or single theory
*Existentialism stresses:
-Helping clients experience their own existence in a meaningful way
-Clients are seen as searching for meaning in their world
-Capacity
Continued Existential Perspective
*The greater our awareness, the greater our possibilities for freedom
*Awareness is realizing:
-we are finite--> limited time here
-we choose to act or not
-meaning isn't automatic- it must be sought
-we can be lonely, meaningless, empty, guilty, and isol
Identity
*"Courage to be"- we trust ourselves to search within and find our own answers
-being existentially "alone" helps us to discover our authentic self
Relatedness
*Our relationships are based on a desire for fulfillment
-relationships that spring from our sense of deprivation are clinging, parasitic, and symbiotic!
-clients must distinguish between neurotic dependence and the authentic need to be with others
-We mu
Meaning Must Be Pursued
*Finding meaning is a by-product of a commitment to creating, loving, and working
*Life is not meaningful in itself; the individual must create and discover meaning
Goals of Therapists in Existential Therapy
*Their views of human nature vary from pessimistic (e.g. life is meaningless, isolating, empty) to neutral, to positive, hopeful and optimistic
*No single or fixed view of human nature- people are seen as constantly changing and becoming whomever and what
Therapy
*Journey by therapist and client
-Person to person relationship is key
-Relationship demands that therapists be in contact with their own phenomenological world
*The core of the therapeutic relationship
-Respect and faith in the clients' potential to cope
Person-Centered Therapy
*Carl Rogers
*Maintaining that the presence of certain core conditions were necessary and sufficient to facilitate client change- people have vast potential for understanding themselves and resolving their own problems w/o direct intervention on the thera
Emphasize
*Therapy as a journey shared by 2 fallible people
*Client's self-actualization
*Quality of therapeutic relationship
*Counselor's creation of "growth-promoting" climate
1. Congruence
*Genuineness or realness in therapy
*Therapist's behaviors match their words
2. Unconditional positive regard
*Acceptance/genuine caring about client as a person
*Accepting clients as they are
*Therapist need not approve of client behavior
3. Accurate empathetic understanding
*Ability to deeply grasp the client's world
*Helper attitudes are more important than knowledge
-Therapist need not experience the situation to develop an understanding of it
Conditions Necessary/Sufficient For Personality Changes
1. Two persons are in psychological contact
2. Client is experiencing incongruence
3. Therapist is congruent or integrated in the relationship
4. Therapist experiences unconditional positive regard for client
5. Therapist experiences empathy for client's
Client-Centered (Cont.)
*Some felt Roger was revolutionary
*Maintaining that the presence of certain core conditions were necessary and sufficient to facilitate client change
*These were:
-Unconditional positive regard
-Empathetic understanding
-Congruence
-Warmth
*Note- they we
Client Centered Approaches challenge:
1. Assumption "counselor knows best"
2. Validity of advice, persuasion, diagnosis, and interpretation
3. Belief clients cannot understand and resolve their own probs without direct help
Limitations of the Person-Centered Approach
*Cultural considerations
-Some clients prefer a directive, structured treatment
-Individuals accustomed to indirect communication may not be comfortable with direct expression of empathy or creativity
-Individuals from some cultures may disagree with the
The Effective Counselor
*Most important instrument you have is YOU
*Is authentic (stereotyped, professional roles can be problematic)
*CLEAR about who they are
-willing to GROW, to care, and to be involved
*Counselors are comfortable dealing with emotion
*GOOD listeners (and can
The Counselor's Values
*Be aware of value imposition
-how YOUR values influence your interventions
-how YOUR values may influence your client's experiences in therapy
*Recognize that you are not value-neutral (nor should you be) have to find a middle ground!
*Your job is to ASS
1. Pre-interaction phase
*This is the time before interview has occurred
*Self-awareness- attitude, physical & emotional state
*Early impressions you may have formed
2. Beginning Phase
*This is the greeting and introduction
*State your purpose, set expectations
*Establish trust and rapport
3. Working Phase
*This is the body of interview (Q&A)
*Most data are typically collected here
*Goal is to GUIDE people to tell what you want to know in order to assist them
4. Ending Phase
*This is where you work toward the close
*Allowing questions form the interviewee
*Make plans, give instructions, homework and recommendations
*Terminate the contact
Problems common to the new counselor
-Too much self-disclosure
-Dealing with age & genera
Practitioners who may Counsel
*Psychiatrists (M.D.)
*Psychoanalysts (M.D., Ph.D., Psy.D.)
*Clinical Psychologists (Ph.D., Psy.D)
*Counseling Psychologists (M.A, Ed.D., Ph.D)
*Social Workers (M.S.W., LCSW)
Theoretical orientation
*"A conceptual framework used by a counselor to understand client therapeutic needs"
*Things which shape one's orientation:
-Our personalities, mentors, professors, supervisors, clients, deeper world views we have, pragmatics, knowledge base
PSYCHOANALYTIC overview
*Deterministic
*We understand our present by examining our past
*Early childhood and psychosexual issues are keys to understanding psychological development
Key concepts
- defense mechanisms, psychosexual stages, id, ego, superego,
*Therapy goals- make th
ADLERIAN overview
*People motivated by social interest
*People establish goals in life, some of which are fictional
*During early childhood create styles of life, which remain quite stable
Key concepts
- inferiority and superiority complexes, birth order
*Therapy goals- he
GESTALT THERAPY overview
*Grounded in here and now
*People move toward wholeness, integration of thinking, feeling, behaving
Key concepts
- figure ground relationships, contact and contact resistances, unfinished business
*Therapy goals- help clients become aware of the moment to
REALITY THERAPY overview
*Problems develop when people don't take responsibility for their behavior
*Reality assumes that people need quality relationships
Key concepts
- choice theory, responsibility, psychological needs of belonging, power, freedom, fun
*Teach clients choice th
COGNITIVE BEHAVIORAL overview
*People's thoughts are primary causes of MI
*Therapy focuses on thought patterns, teaching new ways of thinking
Key concepts
- automatics thoughts, cognitive distortions
*Goals- eliminate irrational thoughts and replace with more adaptive ones
Most students...
*Are upon entering courses of counseling and psychotherapy calling themselves eclectic
*Even after a careful study of theories...are you?
*If you are truly eclectic- it means that you don't just change techniques to fit a situation, but actually possess d
Addressing Problems vs. Addressing People
*Counseling by it's very nature is largely designed to assist people with problems of life
-but it is not just guidance
*The continuum= guidance...counseling...psychotherapy
What Are the Cardinal Virtues?
*Prudence
*Temperance
*Forbearance
*Justice
*These 4 derive from classical Greek philosophers who considered them to be the foremost virtues of good character
*Later, the early Christian Church saw these virtues as vitally important to all people, whether
What is Personality
*Different temperaments (constitutional differences) right from the start
*What are the well recognized temperaments in newborns?
- Easy, difficult and slow to warm up