Chapters 3 and 15

Question 1

Aspirational ethics

Answer 1

A higher level of ethical practice that addresses doing what is in the best interests of clients.

Question 2

Assessment

Answer 2

Evaluating the relevant factors in a client’s life to identify themes for further exploration in the counseling process.

Question 3

Boundary crossing

Answer 3

A departure from a commonly accepted practice that could potentially benefit a client (e.g., attending a client’s wedding).

Question 4

Boundary violation

Answer 4

A boundary crossing that takes the practitioner out of the professional role, which generally involves exploitation. It is a serious breach that harms the client and is therefore unethical.

Question 5

Confidentiality

Answer 5

This is an ethical concept, and in most states therapists also have a legal duty not to disclose information about a client

Question 6

Diagnosis

Answer 6

The analysis and explanation of a client’s problems. It may include an explanation of the causes of the client’s difficulties, an account of how these problems developed over time, a classification of any disorders, a specification of preferred treatment procedure, and an estimate of the chances for a successful resolution.

Question 7

Dual or multiple relationships

Answer 7

A counselor assumes two (or more) roles simultaneously or sequentially with a client. This may involve assuming more than one professional role or combining professional and nonprofessional roles.

Question 8

ethical decisions

Answer 8

To make ethical decisions, consult with colleagues, keep yourself informed about laws affecting your practice, keep up to date in your specialty field, stay abreast of developments in ethical practice, reflect on the impact your values have on your practice, and be willing to engage in honest self-examination.

Question 9

Evidence-based practice (EBP)

Answer 9

Psychotherapists are required to base their practice on techniques that have empirical evidence to support their efficacy.

Question 10

Informed consent

Answer 10

The right of clients to be informed about their therapy and to make autonomous decisions pertaining to it.

Question 11

Mandatory ethics

Answer 11

The view of ethical practice that deals with the minimum level of professional practice.

Question 12

Nonprofessional interactions

Answer 12

Additional relationships with clients other than sexual ones.

Question 13

Positive ethics

Answer 13

An approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble.

Question 14

Privileged communication

Answer 14

A legal concept that generally bars the disclosure of confidential communications in a legal proceeding. Clients are protected from having their confidential communications revealed in court without their permission

Question 15

Some Steps in Making Ethical Decisions

Answer 15

Identify the problem or dilemma. Gather information that will shed light on the nature of the problem. This will help you decide whether the problem is mainly ethical, legal, professional, clinical, or moral.

Identify the potential issues. Evaluate the rights, responsibilities, and welfare of all those who are involved in the situation.

Look at the relevant ethics codes for general guidance on the matter. Consider whether your own values and ethics are consistent with or in conflict with the relevant guidelines.

Consider the applicable laws and regulations, and determine how they may have a bearing on an ethical dilemma.

Seek consultation from more than one source to obtain various perspectives on the dilemma, and document in the client’s record the suggestions you received from this consultation.

Brainstorm various possible courses of action. Continue discussing options with other professionals. Include the client in this process of considering options for action. Again, document the nature of this discussion with your client.

Enumerate the consequences of various decisions, and reflect on the implications of each course of action for your client.

Decide on what appears to be the best possible course of action. Once the course of action has been implemented, follow up to evaluate the outcomes and to determine whether further action is necessary. Document the reasons for the actions you took as well as your evaluation measures.

Question 16

syncretism

Answer 16

A practitioner, lacking in knowledge and skill in selecting interventions, grabs for anything that seems to work, often making no attempt to determine whether the therapeutic procedures are indeed effective.

Question 17

Psychotherapy integration

Answer 17

Looks beyond and across the confines of single-school approaches to see what can be learned from other perspectives.

Question 18

Technical integration

Answer 18

A focus on selecting the best treatment techniques for the individual and the problem. It tends to focus on differences, chooses from many approaches, and is a collection of techniques.

Question 19

theoretical integration

Answer 19

A conceptual or theoretical creation beyond a mere blending of techniques with the goal of producing a synthesis of the best aspects of two or more theoretical approaches; assumes that the combined creation will be richer than either theory alone.

Question 20

assimilative integration

Answer 20

Selectively incorporating a variety of interventions from other therapeutic approaches, but grounded in a single coherent theoretical system.
An example of this form of integration is mindfulness-based cognitive therapy (MBCT), which integrates aspects of cognitive therapy and mindfulness-based stress reduction procedures.

Question 21

common factors approach

Answer 21

A search for common elements across different theoretical systems.

Question 22

Key Concepts: Psychoanalytic therapy

Answer 22

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 23

key concepts: Adlerian therapy

Answer 23

Key concepts 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 finding goals to give life meaning. Other key concepts are striving for significance 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 24

Key concepts: Existential therapy

Answer 24

Essentially an experiential approach to counseling rather than a firm theoretical model, it 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.

Question 25

key concepts: Person-centered therapy

Answer 25

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 26

key concepts: Gestalt therapy

Answer 26

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 27

key concepts: Behavior therapy

Answer 27

Focus is on overt behavior, precision in specifying goals of treatment, development of specific 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 28

key concepts: Cognitive behavior therapy

Answer 28

Although psychological problems may be rooted in childhood, they are reinforced by present ways of thinking. A person’s belief system and thinking 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 29

key concepts: Choice theory/Reality therapy

Answer 29

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 30

key concepts: Feminist therapy

Answer 30

Core principles of feminist therapy are that 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 strengths and a reformulated definition of psychological distress, and all types of oppression are recognized.

Question 31

key concepts: Postmodern approaches

Answer 31

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 32

key concepts: Family systems therapy

Answer 32

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. Key concepts vary depending on specific 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 33

spiritual or religious values

Answer 33

These play a major part in the lives and struggles of many people. Exploring spiritual/religious values, when deemed important by the client, can enhance the therapy process.

Question 34

Goals of Therapy
Psychoanalytic therapy

Answer 34

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 35

Goals of Therapy: Adlerian therapy

Answer 35

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 36

Goals of Therapy: Existential therapy

Answer 36

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 37

Goals of Therapy: Person-centered therapy

Answer 37

To provide a safe climate conducive to clients’ self-exploration. To help clients recognize blocks to growth and 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 find meaning in life and to experience life fully. To become more self-directed.

Question 38

Goals of TherapyL 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

Goals of Therapy: Behavior therapy

Answer 39

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 40

Goals of Therapy: Cognitive behavior therapy

Answer 40

To teach 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. To assist clients in identifying their inner strengths, and to explore the kind of life they would like to have.

Question 41

Goals of Therapy: Choice theory/Reality therapy

Answer 41

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 42

Goals of Therapy: Feminist therapy

Answer 42

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 43

Goals of therapy: Postmodern approaches

Answer 43

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 44

Goals of therapy: Family systems therapy

Answer 44

To help family members gain awareness of patterns of relationships that are not working well and to create new ways of interacting. To identify how a client’s problematic behavior may serve a function or purpose for the family. To understand how dysfunctional patterns can be handed down across generations. To recognize how family rules can affect each family member. To understand how past family of origin experiences continue to have an impact on individuals

Question 45

The Therapeutic Relationship
Psychoanalytic therapy

Answer 45

The classical analyst remains anonymous, and clients develop projections toward him or her. The 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 46

The therapeutic relationship: Adlerian therapy

Answer 46

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

Question 47

the therapeutic relationship:Existential therapy

Answer 47

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 48

the therapeutic relationship: Person-centered therapy

Answer 48

The relationship is of primary importance. The qualities of the therapist, including genuineness, warmth, accurate empathy, respect, and being nonjudgmental—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 49

the therapeutic relationship: Gestalt therapy

Answer 49

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 50

the therapeutic relationship: Behavior therapy

Answer 50

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 51

The therapeutic relationship: Cognitive behavior therapy

Answer 51

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. In strengths-based CBT, active incorporation of client strengths encourages full engagement in therapy and often provides avenues for change that otherwise would be missed.

Question 52

the therapeutic relationship: Choice theory/Reality therapy

Answer 52

A fundamental task is for the therapist to create a good relationship with the client. Therapists are then able to engage clients in an evaluation of all of 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 53

the therapeutic relationship: Postmodern approaches

Answer 53

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 examining self-limiting stories and creating new and more liberating stories.

Question 54

the therapeutic relationship: Family systems therapy

Answer 54

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 55

the therapeutic relationship: Feminist therapy

Answer 55

The therapeutic relationship is based on empowerment and egalitarianism. Therapists actively break down the hierarchy of power and reduce artificial 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 56

techniques and applications: psychoanalytic therapy

Answer 56

The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference, and 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. 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 56

techniques and applications: Alderian Therapy

Answer 56

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.

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 56

Techniques and applications: existential therapy.

Answer 56

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 measurements are not deemed important. Issues addressed are freedom and responsibility, isolation and relationships, meaning and meaninglessness, living and dying.

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 57

techniques and applications: person-centered therapy

Answer 57

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, “being there” for the client, and focusing on the moment-to-moment experiencing of the client. This model does not include diagnostic testing, interpretation, taking a case history, or questioning or probing for information.

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 58

techniques and applications: Gestalt Therapy

Answer 58

A wide range of experiments are designed to intensify experiencing and to integrate conflicting 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.

Addresses a wide range of problems and populations: crisis intervention, treatment of a range of psychosomatic disorders, couples and family therapy, awareness training of mental health professionals, behavior problems in children, and teaching and learning. It is well suited to both individual and group counseling. The methods are powerful catalysts for opening up feelings and getting clients into contact with their present-centered experience.

Question 59

techniques and applications: behaviour therapy

Answer 59

The main techniques are reinforcement, shaping, modeling, systematic desensitization, relaxation methods, flooding, eye movement and desensitization reprocessing, cognitive restructuring, social skills training, self-management programs, mindfulness and acceptance methods, behavioral rehearsal, and coaching. 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.

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 60

Techniques and applications: cognitive behavior therapy

Answer 60

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.

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 61

techniques and applications: Choice theory/Reality therapy

Answer 61

This is an active, directive, and didactic therapy. Skillful questioning is a central technique used for the duration of the therapy process. 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.

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 62

techniques and applications: Feminist Therapy

Answer 62

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

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 63

techniques and applications: Postmodern approaches

Answer 63

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.

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 and to school counseling.

Question 64

techniques and applications: family systems therapy

Answer 64

A variety of techniques may be used, depending on the particular theoretical orientation of the therapist. Some techniques include genograms, teaching, asking questions, joining the family, tracking sequences, 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.

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 65

Feedback-informed treatment (FIT)

Answer 65

Designed to evaluate and to improve the quality and effectiveness of counseling services. FIT involves consistently obtaining feedback from clients regarding the therapeutic relationship and clinical progress, which is then used to tailor therapy to the unique needs of clients.

Question 66

Outcome Rating Scale (ORS)

Answer 66

Assessment of the client’s therapeutic progress through ratings of a client’s personal experience of well-being in his or her individual, interpersonal, and social functioning.

Question 67

Session Rating Scale (SRS)

Answer 67

Measures a client’s perception of the quality of the therapeutic relationship, which includes the relational bond with the therapist, the perceived collaboration around specific tasks in therapy, and agreement on goals, methods, and on client preferences.

Question 68

Contributions and limitations: multicultural counselling. Psychoanalytic Therapy

Answer 68

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.

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 69

Contributions and limitations: multicultural counselling: Alderean Therapy

Answer 69

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.

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 70

Contributions and limitations: multicultural counselling: Existential Therapy

Answer 70

Focus is on understanding client’s phenomenological world, including cultural background. This approach leads to empowerment in an oppressive society. Existential therapy can help clients examine their options for change within the context of their cultural realities. The existential approach is particularly suited to counseling diverse clients because of the philosophical foundation that emphasizes the human condition.

Values of individuality, freedom, autonomy, and self-realization often conflict with cultural values of collectivism, respect for tradition, deference to authority, and interdependence. Some may be deterred by the absence of specific techniques. Others will expect more focus on surviving in their world.

Question 71

Contributions and limitations: multicultural counselling: person-centred therapy.

Answer 71

Focus is on breaking cultural barriers and facilitating open dialogue among diverse cultural populations. Main strengths are respect for clients’ values, active listening, welcoming of differences, nonjudgmental attitude, understanding, willingness to allow clients to determine what will be explored in sessions, and prizing cultural pluralism.

Some of the core values of this approach may not be congruent with the client’s culture. Lack of counselor direction and structure are unacceptable for clients who are seeking help and immediate answers from a knowledgeable professional.

Question 72

Contributions and limitations: multicultural counselling: Gestalt Therapy

Answer 72

Its focus on expressing oneself nonverbally is congruent with those cultures that look beyond words for messages. Provides many experiments in working with clients who have cultural injunctions against freely expressing feelings. Can help to overcome language barrier with bilingual clients. Focus on bodily expressions is a subtle way to help clients recognize their conflicts.

Clients who have been culturally conditioned to be emotionally reserved may not embrace Gestalt experiments. Some may not see how “being aware of present experiencing” will lead to solving their problems.

Question 73

Contributions and limitations: multicultural counselling: Behaviour Therapy

Answer 73

Focus on behavior, rather than on feelings, is compatible with many cultures. Strengths include a collaborative relationship between counselor and client in working toward mutually agreed-upon goals, continual assessment to determine if the techniques are suited to clients’ unique situations, assisting clients in learning practical skills, an educational focus, and stress on self-management strategies.

Family members may not value clients’ newly acquired assertive style, so clients must be taught how to cope with resistance by others. Counselors need to help clients assess the possible consequences of making behavioral changes.

Question 74

Contributions and limitations: multicultural counselling:CBT

Answer 74

Focus is on a collaborative approach that offers clients opportunities to express their areas of concern. The psychoeducational dimensions are often useful in exploring cultural conflicts and teaching new behavior. The emphasis on thinking (as opposed to identifying and expressing feelings) is likely to be acceptable to many clients. The focus on teaching and learning tends to avoid the stigma of mental illness. Clients are likely to value the active and directive stance of the therapist.

Before too quickly attempting to change the beliefs and actions of clients, it is essential for the therapist to understand and respect their world. Some clients may have serious reservations about questioning their basic cultural values and beliefs. Clients could become dependent on the therapist choosing appropriate ways to solve problems.

Question 75

Contributions and limitations: multicultural counselling: Choice theory/reality therapy

Answer 75

Focus is on clients making their own evaluation of behavior (including how they respond to their culture). Through personal assessment clients can determine the degree to which their needs and wants are being satisfied. They can find a balance between retaining their own ethnic identity and integrating some of the values and practices of the dominant society.

This approach stresses taking charge of one’s own life, yet some clients are more interested in changing their external environment. Counselors need to appreciate the role of discrimination and racism and help clients deal with social and political realities.

Question 76

Contributions and limitations: multicultural counselling: Feminist Therapy

Answer 76

Focus is on both individual change and social transformation. A key contribution is that both the women’s movement and the multicultural movement have called attention to the negative impact of discrimination and oppression for both women and men. Emphasizes the influence of expected cultural roles and explores client’s satisfaction with and knowledge of these roles.

This model has been criticized for its bias toward the values of White, middle-class, heterosexual women, which are not applicable to many other groups of women nor to men. Therapists need to assess with their clients the price of making significant personal change, which may result in isolation from extended family as clients assume new roles and make life changes.

Question 77

Contributions and limitations: multicultural counselling: Postmodern Approches

Answer 77

Focus is on the social and cultural context of behavior. Stories that are being authored in the therapy office need to be anchored in the social world in which the client lives. Therapists do not make assumptions about people and honor each client’s unique story and cultural background. Therapists take an active role in challenging social and cultural injustices that lead to oppression of certain groups. Therapy becomes a process of liberation from oppressive cultural values and enables clients to become active agents of their destinies.

Some clients come to therapy wanting to talk about their problems and may be put off by the insistence on talking about exceptions to their problems. Clients may view the therapist as an expert and be reluctant to view themselves as experts. Certain clients may doubt the helpfulness of a therapist who assumes a “not-knowing” position.

Question 78

Contributions and limitations: multicultural counselling: Family Systems Therapy

Answer 78

Focus is on the family or community system. Many ethnic and cultural groups place value on the role of the extended family. Many family therapies deal with extended family members and with support systems. Networking is a part of the process, which is congruent with the values of many clients. There is a greater chance for individual change if other family members are supportive. This approach offers ways of working toward the health of the family unit and the welfare of each member.

Family therapy rests on value assumptions that are not congruent with the values of clients from some cultures. Western concepts such as individuation, self-actualization, self-determination, independence, and self-expression may be foreign to some clients. In some cultures, admitting problems within the family is shameful. The value of “keeping problems within the family” may make it difficult to explore conflicts openly.