Chapter 13: Integrative Theories of Counseling and Psychotherapy Flashcards
Two Contraindications in Psycotherapy and Counseling
Psychotherapists have a strong commitment to a particular psychotherapy approach
Little evidence of the psychotherapy approaches is more effective than another
Societies, institutes, centers, and journals devoted to particular therapy apporaches dominate the field of psychotherapy
Mijority of practicing therapists do not identify themselves as adhering to one particular approach but refer to themselves as eclectic or integrative
Sources of Theoretical and Practical Diversity in Psychotherapy
Individuality
Cultural Specificity
Human Conflict
Individuality
Adler emphasized that every child born into the same family is at the same time born into a different family; Every perspective is unique; Integrational and eclectic approaches to therapy may allow greater latitude in addressing each client as a unique individual being
Cultural Specificity
Some individuals and groups are systematically treated differently, often discriminated against, throughout the world; Many factors distinguish individuals from one another, these factors might determine not only whether someone seeks therapy but also whether they even have access to therapy; Integrational and eclectic therapy approaches must address cultural backgrounds, values, and needs
Human Conflict
Conflict should not abe avoided because it can potentially lead to positive transformations
Conflict in the field of Counseling and Psychotherapy
Freud was ostracized for suggesting that sexual abuse was at the roots of hysteria;
Adler suggested that women’s psychopathology was at least generated and maintained by social factors, Freud sent him packing from the Vienna Psychoanalytic society
Jung and Freud finalized their theoretical divorce
Adler dismissed Frankl from his study group, Frankl emerged after WWI and championed meaning as central in psychotherapy and human development
Fritz Perls was rebuffed by Freud and became influential and productive
Carl Rogers and BF Skinner had great debates
Feminist therapists have reshaped theories and techniques
Staunch behaviorists threatened tnal Cognitive Therapy and Research
Francine Shapiro’s approach Eye Movement and Desensitization Reprocessing (EMDR) was criticized
Micheal Mahoney et al developed into leading constructivist thinkers
Options open to Ethical, Theory-Based Counseling and Psychotherapy
Ideological Purity
Theoretical Integration
Focus on Common Factors
Technical Eclecticism
Ideological Purity
Studying and learning one theoretical approach to therapy and applying it ethically and competently; allows the therapist to become a master of one approach; focusing on one approach can ease the ambiguity inherent in practicing therapy
Theoretical Integration
Involves the combining of two or more theoretical approaches to maximize therapeutic effectiveness; based on the idea that two heads are better than one
Dollard and Miller
Published Personality & Psychotherapy: An Analysis in Terms of Learning, Thinking, and Culture; early effort at integrating psychoanalytic and behavioral principles
Wachtel
Published Psychoanalysis and Behavior Therapy: Toward an Integration; his intent was to develop an open and evolving theoretical framework; goal was not designed to be a specific hybrid theory; wanted to develop a system that might change as learning theory and psychoanalytic theory continued to change and develop
Alexander and French
Articulated the concept of corrective emotional experience; in all forms of psychotherapy, the basic therapeutic principle is the same: To re-expose the patient, under more favorable circumstances, to emotional situations which he could not handle in the past; The patient, in order to be helped, must undergo a corrective emotional experience suitable to repair the traumatic influence of previous experiences
Common Therapeutic Principles
Roger’s Certain Type of Relationship, many theorists integrate Rogers’s concepts of unconditional positive regard, congruence, and accurate empaty into their therapeutic approaches, although some do it more formally and systematically than others
Jerome Frank
Developed a comprehensive common factors model of psychotherapy
Comprehensive Common Factors Model of Psychotherapy
All psychotherapeutic methods are elaborations and variations of age-old procedures of psychological healing. These incloude confession, atonement and absolutions, encouragement, positive and negative reinfocements, modeling, and promulgation of a particular set of values. These methods become embedded in theories as to the causes and cures of various conditions which often become highly elaborated
Components that continue to be relevant to practicing therapists
The Demoralization Hypothesis
Shared Therapeutic Components
The Demoralization Hypothesis
People who come for therapy are also experiencing a common form of distress; he refers to common distress as the demoralization hypothesis; Demoralization occurs when, because of lack of certain skills or confusion of goals, an individual becomes persistently unable to master situations which both the individual and others expect him or her to handle or when the individual experiences continued distress which he or she cannot adequately explain or alleviate. Demoralization may be summed up as a feeling of subjective incompetence, coupled with distress
Demoralization Symptoms
Low self-esteem, anxiety, sadness, and hopelessness; initial target of effective therapy
Shared Therapeutic Components
An emotionally charged, confiding relationship with a helping person.
A healing setting
A rationale, conceptual scheme, or myth
A ritual
Factors that Selection of Particular Therapy Technique is Based On
Relevant or empirical outcomes research
Pragmatics of the Situation
Clinical Intuition
Syncretism
Choosing what to do with a client in a whimsical, unreasoned, or even impulsive manner
Eclecticism
Selecting what appears to be best in various doctrines, methods, or styles
Behavioral Theory and Therapy
Most flexible of all theoretical orientations; behaviorists contend that they practice a form of therapy based on scientific research and observable processes; their interest is not in a static theory but in what has been tested in the laboratory and in what has been demonstrated as effective
Gordon Paul
What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about (who-how-whom question)
Primary purpose of the Diagnostic system of the DSM
To identify specific disease entities that are best ameliorated through the application of specific (often pharmacological) treatments
Main Eclectic or Integrative Forms of Therapy
Multimodal Therapy Eye Movement Desensitization Reprocessing Interpersonal Psychotherapy Process-Experiential Psychotherapy Dialectic Behavior Therapy Acceptance and Commitment Therapy Cognitive-Constructivist Psychotherapy The Transtheoretical Change Model The Last Best Therapy Dialectic
Preparing Your Client for Eclectic or Integrative Therapy
Avoid the word eclectic or define it simply.
Indicate reasons for not adhering to a certain theory or set of techniques.
Explain how you will choose the kinds of techniques you will use
Discuss your overall theory of human change and why you think your services might be of help.
Mention the theoretical origins of any techniques you might commonly use.
Indicate a willingness to discuss the reasons for choices you might make during the course of the client’s work with you
Arnold Lazarus
Coined the term Technical Eclecticism; noted the following: to attempt a theoretical rapprochement is as futile as trying to picture the edge of the universe. But to read through the vast amount of literature on psychotherapy, in search of techniques, can be clinically enriching and terapeutically rewarding.
Lazarus’ Opinion about why Techinical Eclecticism is preferable to Theoretical Purity
The most essential ingredients for an effective psychotherapist are flexibility and versatility. This implies an ability to play many roles and to use many techniques in order to fit the therapy to the needs and idiosyncrasies of each patient. By contrast, therapists with pet theories or specially favored techniques usually manage, in their own minds at least, to fit their patients’ problems within the confines of their particular brand of treatment
Mutimodal Therapy
Applies specific techniques and adopt specific interpersonal styles in an effort to help clients obtain their goals.
Primary Foci of Multimodal Therapy
Assessment
Technical Applications
Therapist Interpersonal Style
