Basic Concepts of Major Psychotherapy Approaches

Question 0

Key Concepts of Psychoanalytic Approach

Answer 0

Normal personality development is based on successful resolution and integration of psychosexual stages of development. Faulty personality development is the result of inadequate resolution of some specific stage. Anxiety is a result of repression of basic conflicts. Unconscious processes are centrally related to current behavior.

Question 1

Basic Philosophies of Psychoanalytic Approach

Answer 1

Human beings are basically determined by psychic energy and by early experiences. Unconscious motives and conflicts are central in present behavior. Irrational forces are strong; the person is driven by sexual and aggressive impulses. Early development is of critical importance because later personality problems have their roots in repressed childhood conflicts.

Question 2

Goals of treatment in Psychoanalytic Approach

Answer 2

To make the unconscious conscious. To reconstruct the basic personality. To assist clients in reliving earlier experiences and working through repressed conflicts. To achieve intellectual and emotional awareness.

Question 3

Therapeutic Relationship in Psychoanalytic Approach

Answer 3

The classical analyst remains anonymous, and clients develop projections toward him or her. Focus is on reducing the resistances that develop in working with transference and on establishing more rational control. Clients undergo long-term analysis, engage in free association to uncover conflicts, and gain insight by talking. The analyst makes interpretations to teach clients the meaning of current behavior as it relates to the past. In contemporary relational psychoanalytic therapy, the relationship is central and emphasis is given to here-and-now dimensions of this relationship.

Question 4

Techiques of Psychoanalytic Approach

Answer 4

The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference, and understanding countertransference. Techniques are designed to help clients gain access to their unconscious conflicts, which leads to insight and eventual assimilation of new material by the ego.

Question 5

Application of Psychoanalytic Approaches

Answer 5

Candidates for analytic therapy include professionals who want to become therapists, people who have had intensive therapy and want to go further, and those who are in psychological pain. Analytic therapy is not recommended for self-centered and impulsive individuals or for people with psychotic disorders. Techniques can be applied to individual and group therapy.

Question 6

Contributions of Psychoanalytic Approach to Multicultural Counseling

Answer 6

Its focus on family dynamics is appropriate for working with many cultural groups. The therapist’s formality appeals to clients who expect professional distance. Notion of ego defense is helpful in understanding inner dynamics and dealing with environmental stresses.

Question 7

Limitations of Psychoanalytic Approach to Multicultural Counseling

Answer 7

Its focus on insight, intrapsychic dynamics, and long-term treatment is often not valued by clients who prefer to learn coping skills for dealing with pressing daily concerns. Internal focus is often in conflict with cultural values that stress an interpersonal and environmental focus.

Question 8

Contributions of Psychoanalytic Approach

Answer 8

More than any other system, this approach has generated controversy as well as exploration and has stimulated further thinking and development of therapy. It has provided a detailed and comprehensive description of personality structure and functioning. It has brought into prominence factors such as the unconscious as a determinant of behavior and the role of trauma during the first 6 years of life. It has developed several techniques for tapping the unconscious and shed light on the dynamics of transference and countertransference, resistance, anxiety, and the mechanisms of ego defense.

Question 9

Limitations of Psychoanalytic Approach

Answer 9

Requires lengthy training for therapists and much time and expense for clients. The model stresses biological and instinctual factors to the neglect of social, cultural, and interpersonal ones. Its methods are less applicable for solving specific daily life problems of clients and may not be appropriate for some ethnic and cultural groups. Many clients lack the degree of ego strength needed for regressive and reconstructive therapy. It may be inappropriate for certain counseling settings.

Question 10

Basic of Adlerian Psychotherapy

Answer 10

Humans are motivated by social interest, by striving toward goals, by inferiority and superiority, and by dealing with the tasks of life. Emphasis is on the individual’s positive capacities to live in society cooperatively. People have the capacity to interpret, influence, and create events. Each person at an early age creates a unique style of life, which tends to remain relatively constant throughout life.

Question 11

Key Concepts of Adlerian Psychotherapy

Answer 11

Key concepts of this model include the unity of personality, the need to view people from their subjective perspective, and the importance of life goals that give direction to behavior. People are motivated by social interest and by fi nding goals to give life meaning. Other key concepts are striving for signifi cance and superiority, developing a unique lifestyle, and understanding the family constellation. Therapy is a matter of providing encouragement and assisting clients in changing their cognitive perspective and behavior.

Question 12

Treatment Goals of Adlerian Psychotherapy

Answer 12

To challenge clients’ basic premises and life goals. To offer encouragement so individuals can develop socially useful goals and increase social interest. To develop the client’s sense of belonging.

Question 13

Therapeutic Relationship in Adlerian Therapy

Answer 13

The emphasis is on joint responsibility, on mutually determining goals, on mutual trust and respect, and on equality. Focus is on identifying, exploring, and disclosing mistaken goals and faulty assumptions within the person’s lifestyle.

Question 14

Techniques in Adlerian Therapy

Answer 14

Adlerians pay more attention to the subjective experiences of clients than to using techniques. Some techniques include gathering life-history data (family constellation, early recollections, personal priorities), sharing interpretations with clients, offering encouragement, and assisting clients in searching for new possibilities.

Question 15

Applications of Adlerian Therapy

Answer 15

Because the approach is based on a growth model, it is applicable to such varied spheres of life as child guidance, parent–child counseling, marital and family therapy, individual counseling with all age groups, correctional and rehabilitation counseling, group counseling, substance abuse programs, and brief counseling. It is ideally suited to preventive care and alleviating a broad range of conditions that interfere with growth.

Question 16

Contributions of Adlerian Therapy in Multicultural Counselling

Answer 16

Its focus on social interest, helping others, collectivism, pursuing meaning in life, importance of family, goal orientation, and belonging is congruent with the values of many cultures. Focus on person-in-the-environment allows for cultural factors to be explored.

Question 17

Limitations of Adlerians Therapy to Multicultural Counselling

Answer 17

This approach’s detailed interview about one’s family background can conflict with cultures that have injunctions against disclosing family matters. Some clients may view the counselor as an authority who will provide answers to problems, which conflicts with the egalitarian person-to-person spirit as a way to reduce social distance.

Question 18

Contributions of Adlerian Therapy

Answer 18

A key contribution is the infl uence that Adlerian concepts have had on other systems and the integration of these concepts into various contemporary therapies. This is one of the fi rst approaches to therapy that was humanistic, unifi ed, holistic, and goal-oriented and that put an emphasis on social and psychological factors.

Question 19

Limitations of Adlerian Psychotherapy

Answer 19

Weak in terms of precision, testability, and empirical validity. Few attempts have been made to validate the basic concepts by scientific methods. Tends to oversimplify some complex human problems and is based heavily on common sense.

Question 20

Basic Philosophies of Person-centered Therapy

Answer 20

The view of humans is positive; we have an inclination toward becoming fully functioning. In the context of the therapeutic relationship, the client experiences feelings that were previously denied to awareness. The client moves toward increased awareness, spontaneity, trust in self, and inner-directedness.

Question 21

Key Concepts of Person-Centered

Answer 21

The client has the potential to become aware of problems and the means to resolve them. 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.

Question 22

Goals of Person-centered Therapy

Answer 22

To provide a safe climate conducive to clients’ self-exploration, so that they can recognize blocks to growth and can experience aspects of self that were formerly denied or distorted. To enable them to move toward openness, greater trust in self, willingness to be a process, and increased spontaneity and aliveness. To fi nd meaning in life and to experience life fully. To become more self-directed.

Question 23

Linitations of Person-centered Therapy

Answer 23

Possible danger from the therapist who remains passive and inactive, limiting responses to refl ection. Many clients feel a need for greater direction, more structure, and more techniques. Clients in crisis may need more directive measures. Applied to individual counseling, some cultural groups will expect more counselor activity.

Question 24

Basic Philosophies of Existential Therapy

Answer 24

The central focus is on the nature of the human condition, which includes a capacity for self-awareness, freedom of choice to decide one’s fate, responsibility, anxiety, the search for meaning, being alone and being in relation with others, striving for authenticity, and facing living and dying.

Question 25

Key Concepts of Existential Therapy

Answer 25

Essentially an experiential approach to counseling rather than a
firm theoretical model, it stresses core human conditions. Normally, personality development is based on the uniqueness of each individual. Sense of self develops from infancy. Interest is on the present and on what one is becoming. The approach has a future orientation and stresses self-awareness before action.

Question 26

Goals of Existential Therapy

Answer 26

To help people see that they are free and to become aware of their possibilities. To challenge them to recognize that they are responsible for events that they formerly thought were happening to them. To identify factors that block freedom.

Question 27

Therapeutic Relationship in Existential Therapy

Answer 27

The therapist’s main tasks are to accurately grasp clients’ being in the world and to establish a personal and authentic encounter with them. The immediacy of the client–therapist relationship and the authenticity of the here-and-now encounter are stressed. Both client and therapist can be changed by the encounter.

Question 28

Techniques in Existential Therapy

Answer 28

Few techniques flow from this approach because it stresses understanding first and technique second. The therapist can borrow techniques from other approaches and incorporate them in an existential framework. Diagnosis, testing, and external measurement are not deemed important. Issues addressed are freedom and responsibility, isolation and relationships, meaning and meaninglessness, living and dying.

Question 29

Applications of Existential Therapy

Answer 29

This approach is especially suited to people facing a developmental crisis or a transition in life and for those with existential concerns (making choices, dealing with freedom and responsibility, coping with guilt and anxiety, making sense of life, and finding values) or those seeking personal enhancement. The approach can be applied to both individual and group counseling, and to couples and family therapy, crisis intervention, and community mental health work.

Question 30

Contributions of Existential Therapy

Answer 30

Its major contribution is recognition of the need for a subjective approach based on a complete view of the human condition. It calls attention to the need for a philosophical statement on what it means to be a person. Stress on the I/Thou relationship lessens the chances of dehumanizing therapy. It provides a perspective for understanding anxiety, guilt, freedom, death, isolation, and commitment.

Question 31

Therapeutic Relationship in Person-centered Therapy

Answer 31

The relationship is of primary importance. The qualities of the therapist, including genuineness, warmth, accurate empathy, respect, and nonjudgmentalness—and communication of these attitudes to clients—are stressed. Clients use this genuine relationship with the therapist to help them transfer what they learn to other relationships.

Question 32

Limitations of Existential Therapy

Answer 32

Many basic concepts are fuzzy and ill-defined, making its general framework abstract at times. Lacks a systematic statement of principles and practices of therapy. Has limited applicability to lower functioning and nonverbal clients and to clients in extreme crisis who need direction.

Question 33

Techniques under Person-centered Therapy

Answer 33

This approach uses few techniques but stresses the attitudes of the therapist and a “way of being.” Therapists strive for active listening, reflection of feelings, clarification, and “being there” for the client. This model does not include diagnostic testing, interpretation, taking a case history, or questioning or probing for information.

Question 34

Applications of Person-centered Therapy

Answer 34

Has wide applicability to individual and group counseling. It is especially well suited for the initial phases of crisis intervention work. Its principles have been applied to couples and family therapy, community programs, administration and management, and human relations training. It is a useful approach for teaching, parent–child relations and for working with groups of people from diverse cultural backgrounds.

Question 35

Basic Philosophies of Gestalt Therapy

Answer 35

The person strives for wholeness and integration of thinking, feeling, and behaving. Some key concepts include contact with self and others, contact boundaries, and awareness. The view is nondeterministic in that the person is viewed as having the capacity to recognize how earlier influences are related to present difficulties. As an experiential approach, it is grounded in the here and now and emphasizes awareness, personal choice, and responsibility.

Question 36

Key Concepts of Gestalt Therapy

Answer 36

Emphasis is on the “what” and “how” of experiencing in the here and now to help clients accept all aspects of themselves. Key concepts include holism, figure-formation process, awareness, unfinished business and avoidance, contact, and energy.

Question 37

Contributions of Person-centered Therapy

Answer 37

Clients take an active stance and assume responsibility for the direction of therapy. This unique approach has been subjected to empirical testing, and as a result both theory and methods have been modified. It is an open system. People without advanced training can benefit by translating the therapeutic conditions to both their personal and professional lives. Basic concepts are straightforward and easy to grasp and apply. It is a foundation for building a trusting relationship, applicable to all therapies.

Question 38

Goals of Gestalt Therapy

Answer 38

To assist clients in gaining awareness of moment-to-moment experiencing and to expand the capacity to make choices. To foster integration of the self.

Question 39

Therapeutic Relationship in Gestalt Therapy

Answer 39

Central importance is given to the I/Thou relationship and the quality of the therapist’s presence. The therapist’s attitudes and behavior count more than the techniques used. The therapist does not interpret for clients but assists them in developing the means to make their own interpretations. Clients identify and work on unfinished business from the past that interferes with current functioning.

Question 40

Techniques under Gestalt Therapy

Answer 40

A wide range of experiments are designed to intensify experiencing and to integrate confl icting feelings. Experiments are co-created by therapist and client through an I/Thou dialogue. Therapists have latitude to creatively invent their own experiments. Formal diagnosis and testing are not a required part of therapy.

Question 41

Limitations of Gestalt Therapy

Answer 41

Techniques lead to intense emotional expression; if these feelings
are not explored and if cognitive work is not done, clients are likely to be left unfinished and will not have a sense of integration of their learning. Clients who have difficulty using imagination may not profit from experiments.

Question 42

Basic Philosophies of Reality Therapy

Answer 42

Based on choice theory, this approach assumes that we need quality relationships to be happy. Psychological problems are the result of our resisting the control by others or of our attempt to control others. Choice theory is an explanation of human nature and how to best achieve satisfying interpersonal relationships.

Question 42

Key Concepts of Reality Therapy

Answer 42

The basic focus is on what clients are doing and how to get them to evaluate whether their present actions are working for them. People are mainly motivated to satisfy their needs, especially the need for significant relationships. The approach rejects the medical model, the notion of transference, the unconscious, and dwelling on one’s past.

Question 44

Goals of Reality Therapy

Answer 44

To help people become more effective in meeting all of their psychological needs. To enable clients to get reconnected with the people they have chosen to put into their quality worlds and teach clients choice theory.

Question 44

Contributions of Gestalt Therapy

Answer 44

The emphasis on direct experiencing and doing rather than on merely talking about feelings provides a perspective on growth and enhancement, not merely a treatment of disorders. It uses clients’ behavior as the basis for making them aware of their inner creative potential. The approach to dreams is a unique, creative tool to help clients discover basic confl icts. Therapy is viewed as an existential encounter; it is process-oriented, not technique-oriented. It recognizes nonverbal behavior as a key to understanding.

Question 46

Therapeutic Relationship in Reality Therapy

Answer 46

A therapist’s main function is to create a good relationship
with the client. Therapists are then able to engage clients in
an evaluation of all their relationships with respect to what they want and how effective they are in getting this. Therapists find out what clients want, ask what they are choosing to do, invite them to evaluate present behavior, help them make plans for change, and get them to make a commitment. The therapist is a client’s advocate, as long as the client is willing to attempt to behave responsibly.

Question 47

Techniques under Reality Therapy

Answer 47

This is an active, directive, and didactic therapy. Various techniques may be used to get clients to evaluate what they are presently doing to see if they are willing to change. If clients decide that their present behavior is not effective, they develop a specific plan for change and make a commitment to follow through.

Question 48

Limitations of Reality Therapy

Answer 48

Discounts the therapeutic value of exploration of the client’s past, dreams, the unconscious, early childhood experiences, and transference. The approach is limited to less complex problems. It is a problem-solving therapy that tends to discourage exploration of deeper emotional issues.

Question 49

Applications of Reality Therapy

Answer 49

Geared to teaching people ways of using choice theory in everyday living to increase effective behaviors. It has been applied to individual counseling with a wide range of clients, group counseling, working with youthful law offenders, and couples and family therapy. In some instances it is well suited to brief therapy and crisis intervention.

Question 50

Basic Philosophies of Behavior Therapy

Answer 50

Behavior is the product of learning. We are both the product and the producer of the environment. No set of unifying assumptions about behavior can incorporate all the existing procedures in the behavioral field. Traditional behavior therapy is based on classical and operant principles. Contemporary behavior therapy has branched out in many directions.

Question 51

Key Concepts of Behavior Therapy

Answer 51

Focus is on overt behavior, precision in specifying goals of treatment, development of specifi c treatment plans, and objective evaluation of therapy outcomes. Present behavior is given attention. Therapy is based on the principles of learning theory. Normal behavior is learned through reinforcement and imitation. Abnormal behavior is the result of faulty learning.

Question 52

Goals of Behavior Therapy

Answer 52

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.

Question 52

Contributions of Reality Therapy

Answer 52

This is a positive approach with an action orientation that relies on simple and clear concepts that are easily grasped in many helping professions. It can be used by teachers, nurses, ministers, educators, social workers, and counselors. Due to the direct methods, it appeals to many clients who are often seen as resistant to therapy. It is a short-term approach that can be applied to a diverse population, and it has been a significant force in challenging the medical model of therapy.

Question 54

Therapeutic Relationship in Behavior Therapy

Answer 54

The therapist is active and directive and functions as a teacher or mentor in helping clients learn more effective behavior. Clients must be active in the process and experiment with new behaviors. Although a quality client–therapist relationship is not viewed as sufficient to bring about change, it is considered essential for implementing behavioral procedures.

Question 55

Techniques under Behavior Therapy

Answer 55

The main techniques are reinforcement, shaping, modeling, systematic desensitization, relaxation methods, flooding, eye movement and desensitization reprocessing, cognitive restructuring, assertion and social skills training, self-management programs, mindfulness and acceptance methods, behavioral rehearsal, coaching, and various multimodal therapy techniques. Diagnosis or assessment is done at the outset to determine a treatment plan. Questions concentrate on “what,”
“how,” and “when” (but not “why”). Contracts and homework assignments are also typically used.

Question 56

Basic Philosophies of Cognitive Therapy

Answer 56

Individuals tend to incorporate faulty thinking, which leads to emotional and behavioral disturbances. Cognitions are the major determinants of how we feel and act. Therapy is primarily oriented toward cognition and behavior, and it stresses the role of thinking, deciding, questioning, doing, and re-deciding. This is a psychoeducational model, which emphasizes therapy as a learning process, including acquiring and practicing new skills, learning new ways of thinking, and acquiring more effective ways of coping with problems.

Question 57

Applications of Behavior Therapy

Answer 57

A pragmatic approach based on empirical validation of results. Enjoys wide applicability to individual, group, couples, and family counseling. Some problems to which the approach is well suited are phobic disorders, depression, trauma, sexual disorders, children’s behavioral disorders, stuttering, and prevention of cardiovascular disease. Beyond clinical practice, its principles are applied in fields such as pediatrics, stress management, behavioral medicine, education, and geriatrics.

Question 58

Goals of Cognitive Therapy

Answer 58

To challenge clients to confront faulty beliefs with contradictory evidence that they gather and evaluate. To help clients seek out their faulty beliefs and minimize them. To become aware of automatic thoughts and to change them.

Question 59

Techniques of Behavior Therapy

Answer 59

Therapists use a variety of cognitive, emotive, and behavioral techniques; diverse methods are tailored to suit individual clients. This is an active, directive, time-limited, present-centered psychoeducational, structured therapy. Some techniques include engaging in Socratic dialogue, collaborative empiricism, debating irrational beliefs, carrying out homework assignments, gathering data on assumptions one has made, keeping a record of activities, forming alternative interpretations, learning new coping skills, changing one’s language and thinking patterns, role playing, imagery, confronting faulty
beliefs, self-instructional training, and stress inoculation training.

Question 60

Contributions of Behaviroal Therapy

Answer 60

Emphasis is on assessment and evaluation techniques, thus providing a basis for accountable practice. Specifi c problems are identified, and clients are kept informed about progress toward their goals. The approach has demonstrated effectiveness in many areas of human functioning. The roles of the therapist as reinforcer, model, teacher, and consultant are explicit. The approach has undergone extensive expansion, and research literature abounds. No longer is it a mechanistic approach, for it now makes room for cognitive factors and encourages self-directed programs for behavioral change.

Question 61

Key Concepts of Cognitive Therapy

Answer 61

Although psychological problems may be rooted in childhood, they are reinforced by present ways of thinking. A person’s belief system is the primary cause of disorders. Internal dialogue plays a central role in one’s behavior. Clients focus on examining faulty assumptions and misconceptions and on replacing these with effective beliefs.

Question 62

Therapeutic Relationship in Cognitive Therapy

Answer 62

In REBT the therapist functions as a teacher and the client as a student. The therapist is highly directive and teaches clients an A-B-C model of changing their cognitions. In CT the focus is on a collaborative relationship. Using a Socratic dialogue, the therapist assists clients in identifying dysfunctional beliefs and discovering alternative rules for living. The therapist promotes corrective experiences that lead to learning new skills. Clients gain insight into their problems and then must actively practice changing self-defeating thinking and acting.

Question 62

Limitations of Behavior Therapy

Answer 62

Major criticisms are that it may change behavior but not feelings; that it ignores the relational factors in therapy; that it does not provide insight; that it ignores historical causes of present behavior; that it involves control by the therapist; and that it is limited in its capacity to address certain aspects of the human condition.

Question 64

Applications of Cognitive Behavior Therapy

Answer 64

Has been widely applied to treatment of depression, anxiety, relationship problems, stress management, skill training, substance abuse, assertion training, eating disorders, panic attacks, performance anxiety, and social phobias. CBT is especially useful for assisting people in modifying their cognitions. Many self-help approaches utilize its principles. CBT can be applied to a wide range of client populations with a variety of specific problems.

Question 65

Limitations of Cognitive Behavior Therapy

Answer 65

Tends to play down emotions, does not focus on exploring the unconscious or underlying conflicts, de-emphasizes the value of insight, and sometimes does not give enough weight to the client’s past. REBT, being a confrontational therapy, might lead to premature termination. CBT might be too structured for some clients.

Question 66

Contributions of Cognitive Behavior Therapy

Answer 66

Major contributions include emphasis on a comprehensive and eclectic therapeutic practice; numerous cognitive, emotive, and behavioral techniques; an openness to incorporating techniques from other approaches; and a methodology for challenging and changing faulty thinking. Most forms can be integrated into other mainstream therapies. REBT makes full use of action-oriented homework, various psychoeducational methods, and keeping records of progress. CT is a structured therapy that has a good track record for treating depression and anxiety in a short time.

Question 67

Basic Philosophies of Feminist Therapy

Answer 67

Feminists criticize many traditional theories to the degree that they are based on gender-biased concepts, such as being androcentric, gendercentric, ethnocentric, heterosexist, and intrapsychic. The constructs of feminist therapy include being gender-fair, flexible, interactionist, and life-span-oriented. Gender and power are at the heart of feminist therapy. This is a systems approach that recognizes the cultural, social, and political factors that contribute to an individual’s problems.

Question 68

Key Concepts of Feminist Therapy

Answer 68

Core principles that form the foundation for practice of feminist therapy are that the personal is political, 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, a focus on strengths and a reformulated definition of psychological distress, and all types of oppression are recognized.

Question 68

Goals of Feminist Therapy

Answer 68

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.

Question 70

Therapeutic Relationship in Feminist Therapy

Answer 70

The therapeutic relationship is based on empowerment and egalitarianism. Therapists actively break down the hierarchy of power and reduce artifi cial barriers by engaging in appropriate self-disclosure and teaching clients about the therapy process. Therapists strive to create a collaborative relationship in which clients can become their own expert.

Question 70

Techniques under Feminist Therapy

Answer 70

Although techniques from traditional approaches are used, feminist practitioners tend to employ consciousness-raising techniques aimed at helping clients recognize the impact of gender-role socialization on their lives. Other techniques frequently used include gender-role analysis and intervention, power analysis and intervention, demystifying therapy, bibliotherapy, journal writing, therapist self-disclosure, assertiveness training, reframing and relabeling, cognitive restructuring, identifying and challenging untested beliefs, role playing psychodramatic methods, group work, and social action.

Question 71

Basic Philosophies of Postmodern Approaches

Answer 71

Based on the premise that there are multiple realities and multiple truths, postmodern therapies reject the idea that reality is external and can be grasped. People create meaning in their lives through conversations with others. The postmodern approaches avoid pathologizing clients, take a dim view of diagnosis, avoid searching for underlying causes of problems, and place a high value on discovering clients’ strengths and resources. Rather than talking about problems, the focus of therapy is on creating solutions in the present and the future.

Question 72

Techniques under Postmodern Approches

Answer 72

In solution-focused therapy the main technique involves change-talk, with emphasis on times in a client’s life when the problem was not a problem. Other techniques include creative use of questioning, the miracle question, and scaling questions, which assist clients in developing alternative stories. In narrative therapy, specific techniques include listening to a client’s problem-saturated story without getting
stuck, externalizing and naming the problem, externalizing conversations, and discovering clues to competence. Narrative therapists often write letters to clients and assist them in finding an audience that will support their changes and new stories.

Question 72

Limitations of Feminist Therapy

Answer 72

A possible limitation is the potential for therapists to impose a new set of values on clients—such as striving for equality, power in relationships, defining oneself, freedom to pursue a career outside the home, and the right to an education. Therapists need to keep in mind that clients are their own best experts, which means it is up to them to decide which values to live by.

Question 74

Key Concepts of Postmodern Approaches

Answer 74

Therapy tends to be brief and addresses the present and the future. The person is not the problem; the problem is the problem. The emphasis is on externalizing the problem and looking for exceptions to the problem. Therapy consists of a collaborative dialogue in which the therapist and the client co-create solutions. By identifying instances when the problem did not exist, clients can create new meanings for themselves and fashion a new life story.

Question 75

Goals of Postmodern Therapy

Answer 75

To change the way clients view problems and what they can do about these concerns. To collaboratively establish specific, clear, concrete, realistic, and observable goals leading to increased positive change. To help clients create a self-identity grounded on competence and resourcefulness so they can resolve present and future concerns. To assist clients in viewing their lives in positive ways, rather than being problem saturated.

Question 76

Applications of Feminist Therapy

Answer 76

Principles and techniques can be applied to a range of therapeutic modalities such as individual therapy, relationship counseling, family therapy, group counseling, and community intervention. The approach can be applied to both women and men with the goal of bringing about empowerment.

Question 78

Contributions of Feminist Therapy

Answer 78

The feminist perspective is responsible for encouraging increasing numbers of women to question gender stereotypes and to reject limited views of what a woman is expected to be. It is paving the way for gender-sensitive practice and bringing attention to the gendered uses of power in relationships. The unified feminist voice brought attention to the extent and implications of child abuse, incest, rape, sexual harassment, and domestic violence. Feminist principles and interventions can be incorporated in other therapy approaches.

Question 79

Limitations of Postmodern Approaches

Answer 79

There is little empirical validation of the effectiveness of therapy outcomes. Some critics contend that these approaches endorse cheerleading and an overly positive perspective. Some are critical of the stance taken by most postmodern therapists regarding assessment and diagnosis, and also react negatively to the “not-knowing” stance of the therapist. Because some of the solution-focused and narrative therapy techniques are relatively easy to learn, practitioners may use these interventions in a mechanical way or implement these techniques without a sound rationale.

Question 80

Basic Philosophies of Family Systems Therapy

Answer 80

The family is viewed from an interactive and systemic perspective. Clients are connected to a living system; a change in one part of the system will result in a 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 the family unit. An individual’s dysfunctional behavior grows out of the interactional unit of the family and out of larger systems as well.

Question 81

Therapeutic Relationship in Postmodern Approaches

Answer 81

Therapy is a collaborative partnership. Clients are viewed as the experts on their own life. Therapists use questioning dialogue to help clients free themselves from their problem-saturated stories and create new life-affirming stories. Solution-focused therapists assume an active role in guiding the client away from problem-talk and toward solution-talk. Clients are encouraged to explore their strengths and to create solutions that will lead to a richer future. Narrative therapists assist clients in externalizing problems and guide them in challenging self-limiting stories and creating new and more liberating stories.

Question 83

Key Concepts of Family Systems Therapy

Answer 83

Focus is on communication patterns within a family, both verbal and nonverbal. Problems in relationships are likely to be passed on from generation to generation. Symptoms are viewed as ways of communicating with the aim of controlling other family members. Key concepts vary depending on specifi c orientation but include differentiation, triangles, power coalitions, family-of-origin dynamics, functional versus dysfunctional interaction patterns, and dealing with here-and-now interactions. The present is more important than exploring past experiences.

Question 83

Applications of Postmodern Approaches

Answer 83

Solution-focused therapy is well suited for people with adjustment disorders and for problems of anxiety and depression. Narrative therapy is now being used for a broad range of human difficulties including eating disorders, family distress, depression, and relationship concerns. These approaches can be applied to working with children, adolescents, adults, couples, families, and the community in a wide variety of settings. Both solution-focused and narrative approaches lend themselves to group counseling.

Question 85

Goals of Family Systems Therapy

Answer 85

To help family members gain awareness of patterns of relationships that are not working well and to create new ways of interacting.

Question 86

Therapeutic Relationship in Family Systems Therapy

Answer 86

The family therapist functions as a teacher, coach, model, and consultant. The family learns ways to detect and solve problems that are keeping members stuck, and it learns about patterns that have been transmitted from generation to generation. Some approaches focus on the role of therapist as expert; others concentrate on intensifying what is going on in the here and now of the family session. All family therapists are concerned with the process of family interaction and teaching patterns of communication.

Question 87

Techniques under Family Systems Therapy

Answer 87

A variety of techniques may be used, depending on the particular theoretical orientation of the therapist. Techniques include genograms, teaching, asking questions, joining the family, tracking sequences, issuing directives, use of countertransference, family mapping, reframing, restructuring, enactments, and setting boundaries. Techniques may be experiential, cognitive, or behavioral in nature. Most are designed to bring about change in a short time.

Question 88

Contributions of Postmodern Approaches

Answer 88

The brevity of these approaches fit well with the limitations imposed by a managed care structure. The emphasis on client strengths and competence appeals to clients who want to create solutions and revise their life stories in a positive direction. Clients are not blamed for their problems but are helped to understand how they might relate in more satisfying ways to such problems. A strength of these approaches is the question format that invites clients to view themselves in new and more effective ways.

Question 89

Applications of Family Systems Therapy

Answer 89

Useful for dealing with marital distress, problems of communicating among family members, power struggles, crisis situations in the family, helping individuals attain their potential, and enhancing the overall functioning of the family.

Question 90

Contributions of Family Systems Therapy

Answer 90

From a systemic perspective, neither the individual nor the family is blamed for a particular dysfunction. The family is empowered through the process of identifying and exploring interactional patterns. Working with an entire unit provides a new perspective on understanding and working through both individual problems and relationship concerns. By exploring one’s family of origin, there are increased opportunities to
resolve other conflicts in systems outside of the family.

Question 91

Limitations of Family System Therapy

Answer 91

Limitations include problems in being able to involve all the members of a family in the therapy. Some family members may be resistant to changing the structure of the system. Therapists’ self-knowledge and willingness to work on their own family-of-origin issues are crucial, for the potential for countertransference is high. It is essential that the therapist be well trained, receive quality supervision, and be competent in assessing and treating individuals in a family context.