Chapters 1,2,3 Flashcards
ACA definition of counseling
A professional relationship that empowers diverse individuals, families, and groups too accomplish health, wellness, education and career goals.
1800’s
- Medical model: stemmed from curing syphilis
- Late 1800’s Freud “talk therapy”, Psychoanalysis -> Psychiatry
- 1892: APA, American Psychological Association
- 1896: First clinic in Philadelphia for children opened
1900’s
- Counseling: Frank Parson’s started to “guide” the unemployed
- Testing Started during World War I
- The first marriage & family counseling center was formed
- The first theory: Trait-Factor Counseling OR Directive Counseling
- Carl Rogers: Client focused (non directive), Individual’s ability to make their own life choices. (Challenging Parsons, Freud, Williamson)
- 1952: 1st DSM
- Space Race -> American Education Act (funding for counseling)
- 1963: Community Health Act “Deinstitutionalization”
- 60’s pharmacological treatment + new theories, 1st licensure
Behavioral Theories
Joseph Wolpe (1958)
Systematic desensitization is a type of behavioral therapy based on the principle of classical conditioning
Rational-Emotive Theory
Albert Ellis (1962) - ABC model
Thoughts -> Feelings, Behavior: all interact together
Goal of the therapy is to change irrational beliefs to more rational ones.
Cognitive Theories
Aaron Beck (1967) - CBT
Cognitive Model: The way that individuals perceive a situation is more closely connected to their reaction than the situation itself.
Weldon v. Virginia State board of psychologists examiners
1974 Established counseling as a profession distinct from psychology
1976 - 1st LPC & AMHCA (American mental health counseling Association)
CACREP
1981 - Council for Accreditation of Counseling and Related Educational Programs
NBCC
1982 - National Board for Certified Counselors
- offers specialty certifications after receiving NCC
CSI
1985 - Chi Sigma Iota
Professional Identity
- critical for growth & health
- creates behavioral norms, values, ethics & professional pride.
- Facilitated by legal recognition (Licensure), Memberships professional organizations, Standards of behavior (code of ethics)
Psychiatry
Based on medical model
Social work
Mission to improve the quality of life, Promote social values and encourage self advocacy
Psychology
Emphasizes the scientist- practitioner
- aka “Testing and Assessment”
Counseling
- Wellness focused
- Prevention
- Human development (solve their own problems)
- Holistic approach
Ethical codes
ACA
AMHCA
- expands on the ACA
- more protective of client rights
Informed Consent
Always verbalize prior to starting session.
It is not just paperwork
Kitchner Model
5 moral principles
- Autonomy
- Nonmaleficence
- Beneficence
- Justice
- Fidelity
ABCDE Model
Beneficence Focused:
Assessment Benefit Consultation Duty Education
Privilege
a right or immunity granted as a peculiar benefit, advantage, or favor
PA has Privilege
8 CACREP
Core AREAS
- Ethics & Orientation
- Social & cultural diversity
- Human growth & development
- Career development
- Helping relationships
- Group work
- Assessment
- Research and program evaluation
- Social justice (may become a 9th)
Concurring diagnoses
Multiple diagnosis
i.e. Alcoholism & Depression
Case Conceptualization
Fills the gap between diagnosis and treatment
- Is a narrative that helps organize information
- Typically linked to theory
Case Conceptualization Helps
- Build a relationship
- Identify important issues (Hypothesis)
- Normalizes problems while collaborating
- Guide selection of interventions
- Goal to find a pattern
Intake forms
Don’t replace asking
Evaluation Techniques
Informal interview
Self report
Observations
Formal assessments (replace above)
Leverage
Working with in the pattern or theme to allow the counselor to intervene at the core and be efficient
Spot leverage points —ways to make things happen by using little effort to achieve powerful results
Solution Focused Brief Therapy
SFBT
- use past clients success
- help client identify their own strengths and resources
- change focus from “problem” to SOLUTION
Cognitive Behavioral Therapy
CBT
- Aaron Beck
- Thinking affects behavior
- Behavior is learned
- Our beliefs Impact our emotional state and behavior choices
- Thoughts -> Feelings
Cognitive mechanisms
Cognitive distortions - ways that our mind convinces us of something that isn’t really true
Negative thoughts
Schemas
Psychodynamic
- inherent motivation for relationships
- maladaptive patterns of thinking that stem from early childhood experiences
- transference and counter transference inform the conceptualization process
Humanistic
Carl Rogers - Diagnosis is Not necessary & human nature is good
- Unconditional positive regard
- focus on the present
- clients have innate potential to be healthy “self actualization”
Extensionalism
Individual, Passion, Freedom (triangle)
- problems are from lack of Individual choice
- conscious choice must align with values and believes
WE ARE FREE to CHOOSE
Family systems
- Examines multiple family generations to identify norms, communication patterns and significant life events
- Make patterns visible
- Make strengths and challenges tangible
Post Modern Theories
- Narrative: People give meaning to their existence
- Feminist, Social justice, Multicultural: work against oppression, discrimination, and inequality
- Systems theories (these): Look at the the cultural influences and how the greater group Influences individuals
Biopsychosocial
- MicroSystem: Parents
- ExoSystem: Boss at work
- MacroSystem: Cultural expectations
- ChronoSystem: Things that affect micro (ie divorce fighting)
Readiness for Change: Prochaska Model
4 Core Constructs
- process of change
- decisional balance: weighs pros vs cons
- self efficacy: confidence to sustain
- temptation
Stages of Change
Precontemplation Contemplation Preparation Action Maintenance
T/C Model - triangle
Affect - express & regulate emotions
Cognition - perceive & interpret environmental info
Behavior
T/C Model - inner circle
The boundary between the clients inner and outer worlds
- client interacts and impacts their environment
Symptomology (somatic & psychological)
Coping skills/strengths
Understanding life roll
T/C Model - outer circle
The multiple environmental & relational influences
- client also impacts
interpersonal relationships culture socioeconomic status social structures societal norms
T/C Model - timeline
Provides context of the Past, Present and Future
- counselor should focus on the present and plan for the future.
The Treatment Plan
Maps the presenting problems and the goal
- individualized
- cooperative
- begins with a preliminary plan in the beginning
- specific & measurable
Treatment Plan - Components
- Problem statements
- Goal statements (global)
- Goal statements (then per problem)
- Objectives
- Interventions
Treatment Plan - Objectives
- measurable
- attainable
- timely
- realistic
- specific
“Feedback Loop”
Case Conceptualization & Treatment plans are interconnected
- always collect data to modify the treatment plan and hypothesis
