Theory and Practice of Counseling and Psychotherapy Reviewer
The unconscious stores all experiences, memories, and repressed materials. Anxiety – feeling of dread that results from repressed feelings, memories, desires, and experience that emerge to the surface of awareness. (reality [from external world, proportionate to the threat; ego], neurotic [fear that instincts will get out of hand; id], moral [fear of one’s own conscience; superego]) Ego-defense Mechanisms – coping with anxiety and prevent the ego from being overwhelmed; either deny or distort reality; operate on an unconscious level (e.
g. repression, denial, reaction formation, projection, displacement, rationalization, sublimation, regression, introjections, identification, compensation) Ultimate goal: to increase adaptive functioning Reduction of symptoms Resolution of conflicts Freudian: to make the unconscious conscious and to strengthen the ego Oriented toward achieving insight
Theory and Practice of Counseling and Psychotherapy Reviewer Essay Example
Classical psychoanalysis: anonymous stance (blank-screen approach) Transference relationship – cornerstone of psychoanalysis, transfer of feelings originally experienced in an early relationship to other important people Engage in very little self-disclosure and maintain a sense of neutrality To help clients acquire the freedom to love, work, and play Help in achieving self-awareness, honesty, and more effective personal relationships; dealing with anxiety in a realistic way; and in gaining control over impulsive and irrational behavior Must establish a working relationship and do a great deal of listening and interpreting.
6 basic techniques: 1. Maintaining the analytic framework – whole range of procedural and stylistic factors (relative anonymity, neutrality and objectivity, etc. ) 2. Free association – clients are encouraged to say whatever comes to mind 3. Interpretation – analyst points out, explains and even teaches the client meanings of behavior manifested in dreams, free association, resistances, and the therapeutic relationship itself 4. Dream analysis –latent content, manifest content 5.
Analysis of resistance – resistance is anything that works against the progress of therapy and prevents the client from producing previously unconscious material; any idea, attitude, feeling or action that fosters the status quo and gets in the way of change 6. Analysis of transference – through the relationship with the therapist, clients express feelings, beliefs and desires they have buried in their unconscious; allows client to achieve a here-and-now insight Jungian Therapy We are not merely shaped by past events but that we are influenced by our future as well as our past.
Part of the nature of humans is to be constantly developing, growing, and moving toward a balanced and complete level of development. Achieving individuation is an innate and primary goal. Midlife: we need to let go of many of the values and behaviors that guided the first half of our life and confront our unconscious. Individuation – the harmonious integration of the conscious and unconscious aspects of personality Unconscious – source of creativity Collective unconscious – deepest level of the psyche containing the
accumulation of inherited experiences of human and prehuman species Archetypes – images of universal experiences contained in the collective unconscious Persona – mask Anima – femininity Animus – masculinity Shadow – dark side 2 functions of dreams: prospective and compensatory Increase client’s consciousness in order to move toward psychological balance and wholeness Bring relief and meaning to psychological suffering To examine the motivations in our thoughts and actions that lie beneath conscious awareness so as to achieve deeper and more long-lasting changes in the personality.
Therapist and client are seen as more or less equals Dream analysis Creative expressions Adlerian Therapy Unity of personality, the need to view people from their subjective perspective, importance of life goals People are motivated by social interest and by finding goals to give life meaning. Humans are motivated primarily by social relatedness. Behavior is purposeful and goal-directed Consciousness rather than unconsciousness is the focus of therapy. Stressed choice and responsibility, meaning in life, and the striving for success, completion and perfection.
Inferiority feelings – wellspring of creativity; motivate us to strive for mastery, success (superiority) and completion Life goal – unifies the personality and becomes the source of human motivation We have the capacity to interpret, influence and create events Subjective perception of reality – viewing the world from the client’s subjective frame of reference (phenomenological orientation) Individual psychology – unity and indivisibility of the person; stresses understanding the whole person in the context of his or her life: how all dimensions of a person are interconnected components Holistic concept – we cannot be understood in parts
Fictional finalism – an imagined life goal that guides a person’s behavior; replaced with ‘guiding self-ideal’ and ‘goal of perfection’ Striving for significance and superiority – recognition of inferiority feelings and the consequent striving for perfection or mastery are innate Lifestyle – connecting themes and rules of interaction that give meaning to our actions; perceptions regarding self, others, and the world; includes the individuals characteristic way of thinking, feeling, acting, living and striving toward long-term goals Social interest – central indicator of mental health; being as concerned about others as one is about self; includes capacity to cooperate and contribute; identification and empathy with others Community feeling – social connectedness; feeling of being connected to all of humanity (past, present and future) and to being involved in making the world a better place 3 universal life tasks: social task (friendship), love-marriage task (intimacy), occupational task (society) Birth order and sibling relationship – 5 psychological positions or vantage points from which children to view life: oldest, second of only 2, middle, youngest, and only Increase the client’s social interest Decrease a sense of inferiority Change the lifestyle Change faulty motivation Tend to look for major mistakes in thinking and valuing Assume a non-pathological perspective; do not label clients with pathological diagnoses Assist clients in better understanding, challenging, and changing their life story.
Make a comprehensive assessment of the client’s functioning thru family constellations, life tasks and early recollection The therapeutic process: 1. Forming a relationship based on mutual respect 2. Holistic psychological evaluation or lifestyle assessment 3. Disclosing mistaken goals and faulty assumptions 4. Reeducation or reorientation Phases of Adlerian Counseling: 1. Establish the proper therapeutic relationship 2. Explore the individual’s psychological dynamics (lifestyle investigation) – subjective interview – objective interview – family constellation – early recollections: stories of events that a person says occurred before he or she was 10 years of age; used as a projective technique 3.
Encourage self-understanding and insight (developing self-understanding): – insight: understanding of the motivations that operate in the client’s life – possible only when hidden purposes and goals of behavior are made conscious – disclosure and well-timed interpretations – interpretation: deals with client’s underlying motives for behaving the way they do in the here and now 4. Reorientation and Reeducation Putting insights into practice Reorientation: involves shifting rules of interaction, process and motivation facilitated thru change in awareness Encouragement – most distinctive Adlerian procedure; entails showing faith in people, expecting them to assume responsibility for their lives, and valuing them for who they are Existential Therapy
Essentially an experiential approach to counseling rather than a firm theoretical model Stresses core human conditions Interest is on the present and on what one is becoming The approach has a future orientation and stresses self-awareness before action Focuses on exploring themes such as mortality, meaning, freedom, responsibility, anxiety and aloneness Basic existential premise: we are not victims of circumstance because we are what we choose to be Existential traditions: seeks a balance between recognizing the limits and tragic dimensions of human existence on one hand and the possibilities of human life on the other Basic dimensions of human condition: 1.
The capacity for self-awareness: freedom, choice and responsibility make up the foundation 2. Freedom and responsibility: – freedom to become, capacity to reflect on the meaning of our choices, capacity to act on choices – free to choose among alternatives – freedom means we are responsible for our lives, for our actions and our failures to take action – authenticity: we are living by being true to our own evalution of what is a valuable existence for ourselves – inauthenticity: not accepting personal responsibility – existential guilt: being aware of having evaded a commitment or having chosen not to choose 3. Striving for Identity and Relationship to others:
People are concerned about preserving their uniqueness and centeredness but we also strive for connectedness: the courage to be (awareness of our finite nature); experience of aloneness (we cannot depend on anyone else for our own confirmation; that is, we alone must give a sense of meaning to life, and we alone must decide how we will live); we have to be able to stand alone before we can truly stand beside another. The experience of relatedness: when we are able to stand alone and tap into our own strength, our relationships with others are based on our fulfillment, not our deprivation. Struggling with our identity: doing mode to avoid the experience of being 4. The Search for Meaning Struggle for a sense of significance and purpose in life
Task of the therapeutic process: to help clients create a value system based on a way of living that is consistent with their way of being Meaninglessness: major existential neurosis of modern life; can lead to emptiness and hollowness or ‘existential vacuum’ 5. Anxiety as a condition of living Existential anxiety: unavoidable result of being confronted with the givens of existence (death, freedom, choice, isolation and meaninglessness) 6. Awareness of Death and Nonbeing Awareness of death as a basic human condition gives significance to living Serves as a motivation for us to take advantage of appreciating the present moment Positive force that drives us to live as fully as possible Death and life are interdependent, and though physical death destroys us, the idea of death saves us.
To assist clients in their exploration of the existential ‘givens of life’ Assist clients in moving toward authenticity and to recognize when they are deceiving themselves Help people to reclaim and reown their lives 4 essential aims: to help clients become more present to both themselves and others; to assist clients in identifying ways they block themselves from fuller presence; to challenge clients to assume responsibility for designing their present lives; to encourage clients to choose more expanded ways of being in their daily lives Central goal: increased awareness Understanding the subjective world of clients to help them come to new understandings and options.
Assist the clients in seeing the ways in which they constrict their awareness and cost of such constrictions. Encourage experimentation Phases of counseling: Initial phase: definition of the client’s view of the world, perception of existence, examination of values, beliefs and assumptions Middle phase: self-exploration Final phase: learnings are put into action Person-Centered Therapy The client has the potential to become aware of problems and the means to resolve problems. Faith is placed in the client’s capacity for self-direction. Mental health is a congruence of ideal self and real self. Maladjustment is the result of a discrepancy between what one wants to be and what one is.
In therapy, attention is given to the present moment and on experiencing and expressing feelings. People are essentially trustworthy. They have a vast potential for understanding themselves and resolving their own problems without direct intervention of the therapist’s part. Basic sense of trust in the client’s ability to move forward in a constructive manner if conditions fostering growth are present. People are trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives. Therapist attributes: Congruence (genuineness or realness) Unconditional positive regard
Accurate empathic understanding Actualizing tendency: directional process of striving toward realization, fulfillment, autonomy and self-determination Mental health: congruence of ideal self and real self Maladjustment: result of discrepancy between what wants to be and what one is Achieving a greater degree of independence and integration. Assist clients in their growth process so clients can better cope with clients as they identify them. Provide a climate conducive to helping the individual strive toward self-actualization. To increasingly actualize: Openness to experience Trust in themselves Internal source of evaluation Willingness to continue growing
Rooted in their ways of being and attitudes, not in techniques. Therapists use themselves as an instrument of change. To be present and accessible to clients and to focus on their immediate experience. Be congruent, accepting, and empathic to be a catalyst for change. Gestalt Therapy The person strives for wholeness and integration of thinking, feeling and behaving. Nondeterministic view. Person is viewed as having the capacity to recognize how earlier influences are related to present difficulties. Experiential approach: grounded on the here-and-now, emphasizes awareness, personal choice and responsibility Holism – gestalt means whole or completion or a form that cannot be separated
into parts without losing its essence Field theory – organism must be seen in its environment or in its context Figure formation – how the individual organizes experience from moment to moment; foreground and background Organismic self-regulation – process by which equilibrium is disturbed by the emergence of a need, sensation, or interest and how the individual strives to maintain balance Paradoxical theory of change: authentic change occurs more from being who we are than from trying to be who we are not Phenomenological inquiry – paying attention to what is occurring now Unfinished business – when figures emerge from the background but are not completed and resolved, manifested in unexpressed feelings Contact – made by seeing, hearing, smelling, touching and moving; interacting with nature and with other people without losing one’s sense of individuality Resistances to contact – coping processes but often end up preventing us from experiencing the present in a full and real way Introjection Projection Retroflection – turning back onto ourselves what we would like to do to someone else or doing to ourselves what we would like someone else to do or for us Deflection: distracting or veering offs Confluence: blurring the differentiation between the self and the environment Assisting the client to attain greater awareness, and with it, greater choice. Awareness: knowing the environment, knowing oneself, accepting oneself, and being able to make contact Move toward awareness of themselves (client) Gradually assume ownership of experiences
Develop skills and acquire values that will allow them to satisfy their needs without violating the rights of others Attitudes and behavior of the therapist count more than the techniques Therapist does not interpret for the clients but assists them in developing the means to make their own interpretations Experiments Internal dialogue – empty-chair technique Behavior therapy Focus is on directly observable behavior Present behavior is given attention Therapy is based on the principles of learning theory Normal behavior: reinforcement and imitation Abnormal behavior: faulty learning Person is the producer and product of the environment Current trend is on developing procedures that give control to clients and thus increase their range of freedom Goal is to overcome debilitating behaviors that restrict choices 7 Key Characteristics 1. Founded on scientific method and empirically derived principles 2.
Behavior is not limited to overt actions 3. Deals with client’s current problems and the factors influencing them; functional assessment/behavioral analysis (looking at current environmental events that maintain problem behaviors) 4. Clients are expected to have an active role by engaging in specific actions to solve their problems. 5. Change can take place without insight into underlying dynamics and without understanding the origins of a psychological problem. 6. Assessment is an ongoing process of observation and self-monitoring. 7. Behavioral treatment interventions are individually tailored to specific problems experienced by the client.
To eliminate maladaptive behaviors and learn more effective behaviors To identify factors that influence behavior and find out what can be done about problematic behavior To encourage clients to take an active and collaborative role in clearly setting treatment goals and evaluating how well these goals are being met Conduct a thorough functional assessment to identify maintaining conditions by systemically gathering information about situational antecedents (A), dimensions of the problem behavior (B) and the consequences of the problem (C) Therapist is active and directive and functions as a teacher or mentor Progressive Muscle Relaxation Systematic Desensitization Relaxation training Development of graduated anxiety hierarchy Systematic desensitization proper Exposure therapies
In Vivo Exposure: client exposure to actual anxiety-evoking events rather than simply imagining these situations Flooding: exposure to anxiety-evoking stimuli for a prolonged period of time (in vivo flooding, imaginal flooding) Cognitive Behavior Therapy Cognitions are the major determinants of behavior. Psychoeducational model: therapy is a learning process Human beings are born with potential for both rational and irrational thinking. REBT: we learn irrational beliefs from significant others during childhood WE actively reinforce our self-defeating beliefs through auto-suggestion and repetition Blame: at the core of most emotional disturbances
A-B-C framework: (A) Activating event -> (B) Belief -> (C) emotional Consequence -> (D) Disputing intervention -> (E) Effect -> (F) new Feeling Cognitive restructuring: replacing irrational beliefs with rational beliefs Major goal of REBT: to encourage clients to be less emotionally reactive To teach clients how to separate evaluation of their behaviors from the evaluation of themselves To teach clients how to accept themselves in spite of their imperfections To teach clients to analyze and to correct their distortions of reality To teach clients to distinguish their irrational and rational beliefs To reduce or eliminate undesirable emotions 2 main goals: Achieve unconditional self-acceptance Achieve unconditional other acceptance Directive function Confronting the client Persuades and debates in attacking client’s self-defeating patterns ABC-DEF Theory of Behavior Disputing Cognitive: persuasion and direct questioning Imaginal: rational emotive imagery Behavioral: behaving in different ways process: Detecting Debating Discriminating Cognitive restructuring
Countering (should be direct opposite of irrational belief, believable, concise, assertive and emotional intensity, owned by clients) Rational self-analysis: repeated investigation and disputation of irrational beliefs Other cognitive techniques and methods: Bibliotherapy: self-help books Changing language Psychoeducation Using humor Role playing Shame-attacking exercise Emotionl control cards (inappropriate or appropriate feelings) Major behavioral techniques: Heightening awareness (numerical ratings and self-recording) Action homework Case Conceptualization and Treatment Planning Step 1: Assess patient concerns and difficulties Problem lists
ABC’s of functional assessment: Antecedents, Behaviors, short-term and long-term consequences Clinical hypotheses and treatment plan Identifying possible treatment obstacles Goal-setting Goals should be SMART Broad goals -> prioritize -> break into smaller steps -> operationalize (define, steps to be taken) Reality Therapy We need quality relationships to be happy. Choice theory is the theoretical basis Unhappiness results from the way we choose to behave Psychological problems are the result of our resisting the control by others or of our attempt to control others. We are born with 5 genetically encoded needs: Survival Love and belongingness needs Power Freedom Fun Quality world – file of wants, our personal Shangri-la
Picture album of specific wants as well as precise ways to satisfy these wants Total behavior (thinking, feeling, acting, and physiology) – best attempt to get what we want and to satisfy our needs The emphasis is what clients can control in their relationships: the only person you can control is yourself To help clients get connected or reconnected with the people they have chosen to put in their quality world To help clients learn better ways of fulfilling all of their needs Assist clients in making more effective and responsible choices related to their wants and needs To serve as mentors or teachers Teach clients how to engage in self-evaluation by raising the question, “is what you are choosing to do getting you what you want and need? ” To challenge clients to examine what they are doing Assist clients in evaluating their own behavioral direction, specific actions, wants, perceptions, level of commitment, possibilities for new directions, and action plans Convey the idea that no matter how bad things are, there is hope Cycle of counseling: creating the counseling environment and implementing specific procedures that lead to changes in behavior The WDEP system: Wants (exploring wants, needs, and perceptions)
Directing and doing (learning better ways to get what they want) Self-evaluation (cornerstone of reality therapy, involves the client examining behavioral direction, specific actions, wants, perceptions, new directions, and plans) Planning and action Feminist Theory Constructs include being gender-fair, flexible, interactionist and life-span-oriented Gender and power are at the heart of feminist therapy Systems approach that recognizes that social, cultural, and political factors that contribute to an individual’s problem The personal is political Therapists have a commitment to social change Women’s voices and ways of knowing are valued and women’s experiences are honored The counseling relationship is egalitarian Therapy focuses on strength and a reformulated definition of psychological distress All types of oppression are recognized
To bring about transformation both in the individual client and in society To assist clients in recognizing, claiming, and using their personal power to free themselves from the limitations of gender-role socialization To confront all forms of institutional policies that discriminate or oppress on any basis Therapeutic relationship is based on empowerment and egalitarianism Actively breaks down the hierarchy of power and reduce artificial barriers by engaging in appropriate self-disclosure and teaching clients about the therapy process Strive to create a collaborative relationship Empowerment Self-disclosure Gender-role analysis Gender-role intervention Power analysis Bibliotherapy Assertiveness training Reframing and relabeling Social action Postmodern approaches: Solution-focused brief therapy
Future-focused, goal-oriented therapeutic approach to brief therapy Emphasizes strengths and resiliencies of people by focusing on exceptions to their problems Unique focus: what is possible Behavior change is viewed as the most effective approach to assisting people in enhancing their lives No necessary relationship between the causes of the problems and their solutions Positive orientation: people are healthy and competent and have the ability to construct solutions that can enhance their lives Changing the viewing of a situation or a frame of reference Changing the doing of the problematic situation Tapping the client’s strengths and resources Client-as-expert
To point the clients in the direction of change without dictating what to change Strive to create a climate of mutual respect, dialogue, and affirmation in which clients experience the freedom to create, explore, and coauthor their evolving stories Helping clients imagine how they would like life to be different and what it would take to make this transformation Ask questions 4 steps that characterize SFBT: Find out what clients want rather than what they do not want Do not look for pathology If what clients are doing is not working, encourage them to experiment with doing something different Keep therapy brief by approaching each session as if it were the last and only session Steps involved in solution building: Problem Goals Exceptions Feedback, encouragement, suggestion Evaluate progress Pretherapy change: what clients have already done to elicit positive change; “What have you done since you called for the appointment that has made a difference in your problem?
” Exception questions: when the problem did not exist or was not as intense The miracle question: “If a miracle happened and your problem was solved overnight, how would you know it was solved, and what would be different? ”; hypothetical solutions, rests on the assumption that changing the doing and viewing of the perceived problem changes the problem; opens up a range of future possibilities Scaling questions: enables clients to play closer attention to what they are doing now and how they can take steps to achieve desired goals Formula first session task – elicits hope that change is inevitable Therapist feedback to client: compliments, bridge, suggesting a task (homework) Terminating: ultimate goal of therapy Postmodern approaches: Narrative Therapy Individuals construct the meaning of life in interpretive stories, which are then treated as ‘truth’.
Focus: listening respectfully to client’s stories; search for a time in client’s lives when they were resourceful; to use questions as a way to engage clients and facilitate their exploration; to avoid diagnosing and labeling clients or accept a totalizing description based on a problem; to assist clients in separating themselves from the dominant stories they have internalized Role of stories: shape reality in that they construct and constitute what we say, feel, and do; the stories we live by grow out of conversations in a social and cultural context Listening with an open mind – normalizing judgment: any kind of judgment that locates a person on a normal curve and is used to assess intelligence, mental health, or normal behavior; avoid totalizing language (labels) To invite people to describe their experience in a fresh and new language This new language enables clients to develop new meanings for problematic thoughts, feelings, and behaviors Active facilitators Help clients construct a preferred storyline Understanding the client’s lived experiences and de-emphasize efforts to predict, interpret and pathologize Renaming the problem Externalizing the problem (separates the person from identification with the problem); externalizing conversation Searching for hopeful exceptions to the problem (unique outcomes) – moments of choice or success regarding the problem Alternative stories and reauthoring – constructing new stories, possibility questions Family Systems Therapy The family is viewed from an interactive and systemic perspective.
Clients are connected to a living system; change in one part of the system will result in change in other parts The family provides the context for understanding how individuals function in relationship to others and how they behave Treatment deals with family unit An individual’s dysfunctional behavior grows out of the interactional unit of the family and out of larger systems as well Focus is on communication patterns within a family, both verbal and nonverbal. Problems in relationship are passed on from generation to generation. Symptoms are often viewed as an expression of a set of habits and patterns within a family Multigenerational family therapy:
A predictable pattern of interpersonal relationships connects the functioning of family members across generations Emotional problems will be transmitted from one generation to another if not resolved or dealt with effectively Triangulation: triads that result in a two-against one experience Differentiation: psychological separation of intellect and emotion and independence of the self from others Human Validation Process Emphasis on family communication Strong, nurturing relationship Four communications stance: blaming, placating, super reasonable, irrelevance Antidote: congruence Experiential family therapy Choice, self-determination, growth, and actualization Goal was not to eliminate anxiety in the family but to maintain or enhance it so that it would serve as motivation for change Structural-strategic family therapy
An individual’s symptoms are best understood from the vantage point of interactional patterns, or sequences, within a family Structural changes must occur in a family before an individual’s symptoms can be reduced or eliminated Goals are two-fold: reduce symptoms and dysfunction; bring about structural change within the system To help family members gain awareness of patterns of relationships that are not working well To create new ways of interacting Teacher, coach, model and consultant Genograms Teaching Asking questions Joining the family Tracking sequences Issuing directives Use of countertransfernce Family mapping Reframing Restructuring Enactments Setting boundaries