Counseling and Helping Relationships (1/6) Flashcards
Helping relationships
the relationship in counseling is the determining factor whether or not counseling is successful
Key elements in building this relationship
Human relations core
1
empathy, respect, genuineness
- Carl Rogers
Key elements in building this relationship
Social influence core
2
competence, power, intimacy
- expertness, attractiveness, trustworthiness were identified by Stanley Strong in his social influence model
Key elements in building this relationship
Skills core
3
Allen Ivey identified microskills - communication skill units such as attending, inquiry, reflection
Key elements in building this relationship
Theory core
4
these help the counselor understand self and interpersonal relationship and skills
- help to understand the problems of clients and help to choose interventions that are likely to be effective with the identified problems
Psychoanalytic - Freud
Overview
identified a structure of personality (id, ego, superego)
- id: unconscious motivation/energy; ruled by pleasure principle
- ego: controlled by reality principle
- superego: internalized ethics
Therapy includes: free assocation, interpretation of dreams/other client material
Psychoanalytic - Freud
Transference
projections into therapist; must be worked through
Psychoanalytic - Freud
Countertransference
projections of the therapist onto the client
Neo-Freudians
Overview
a number of psychoanalysts moved away from Freud’s emphasis on the id as the dominant psychological force and placed more emphasis on the ego, including both psychodynamic and sociodynamic forces
Neo-Freudians
Karen Horney
- security is each person’s major motivation and the person becomes anxious when it is not achieved
- irrational ways to mend disrupted human relationships may become neurotic needs
Neo-Freudians
Erich Fromm
the individual must join with others to develop self-fulfillment (social character) otherwise they may become lonely and nonproductive
- society offers opportunities to experience mutual love and respect
Neo-Freudians
Harry Stack Sullivan
- a social systems (interpersonal) approach can lead to understanding human behavior
- behavior can best be understood in terms of social interactions, not as mechanistic and linear
Neo-Freudians
Other Neo-Freudians
- Otto Rank
- Wilheim Reich
- Theodore Reik
- Carl Jung
- Alfred Adler
Objects Relations Theory
Objects Relations Theory
based on psychoanalytic concepts
Objects Relations Theory
Object relations
interpersonal relationships as represented intrapsychically
- shape an individual’s current interactions with people, both in reality and in fantasy
Objects Relations Theory
Object
a significant person or thing that is the target (object) of one’s feelings/drives
Objects Relations Theory
Four broad stages of development
identified as important in first three years of life
- progressing through these stages provides the child a secure base for later development. the child develops trust that needs will be met
- attachment, borderline, narcissistic disorders may occur when normal progression through these stages does not occur
Objects Relations Theory
Stages of development
Fusion with mother
1
first 3 - 4 weeks of life
normal infantile autism
- state of merged oneness with the mother
- period of total dependence, unable to distinguish between self and mother
Objects Relations Theory
Stages of development
Symbiosis
2
3rd to 8th month
- infant behaves and functions as though they and their mother are a single omnipotent system, a dual unity within one common boundary
Objects Relations Theory
Stages of development
Separation/Individuation
3
starts the 4th or 5th month
- begins to develop an understanding of boundaries of self, and so mother is increasingly viewed as an individual
Objects Relations Theory
Stages of development
Constancy of self and object
4
by 36th month
- the ability to maintain positive feelings for someone while you are hurt/angry/frustrated
- ability to maintain a stable and consistent perception of oneself and others
Objects Relations Theory
Margaret Mahler
Psychological Birth of the Human Infant
Objects Relations Theory
Other theorists
- Heinz Kohurt
- Otto Kernberg
Person-centered/Client-centered (Rogerian)
Carl Rogers
reacted against the directive psychoanalytic approach which put the counselor in charge of giving advice, teaching, interpreting
- focus was more on the person’s phenomenological world reflecting and clarifying their verbal/nonverbal communication
Principle books
- Counseling and Psychotherapy (1942)
- Client Centered Therapy (1951)
- On Becoming a Person (1961)
Person-centered/Client-centered (Rogerian)
Concepts
- process of becoming, moving clients to self-actualization, relationship between client and counselor are critical
- Focus of counseling went from past to present and was on feelings
Counselor should show (core conditions):
- unconditional positive regard
- genuineness (congruence)
- empathic understanding
Gestalt (Frederick “Fritz” Perls)
Concepts
Gestalt is German and roughly means a collection of shapes/pieces that make up a whole
- based on existential principles
- here-and-now focus
- holistic systems theory viewpoint
- When a need is in the forefront, it represents a figure, and other needs are ground (in the background)
- as the need is met, completes the gestalt and a new need takes its place
Goal: to become whole beings, to complete ‘gestalts’
Key concepts:
- personal responsibility
- unfinished business
- awareness of the ‘now’
Gestalt (Frederick “Fritz” Perls)
Gestalt is a type of experiential therapy
encouraging the taking of responsibility by the client
- the counselor uses confrontation and encourages the client to stay with feelings and to relive experiences and finish business
Gestalt (Frederick “Fritz” Perls)
Techniques
- role-playing
- two-chair techniques
- dream work
Interpretation is done by the client and not the counselor
Gestalt (Frederick “Fritz” Perls)
Perls wrote:
- Gestalt Therapy Verbatim
- In and Out of the Garbage Can
Individual Psychology (Alfred Adler and Rudolph Dreikurs)
Main concepts
belief in the uniqueness of each individual is influenced by social factors
- each person has a sense of inferiority and strives for superiority
- we choose a lifestyle, a unified life plan, which gives meaning to our experiencs which include habits, family, career, attitudes, etc.
- very adaptable/versatile and can be used to treat specific disorders
Limitation:
- lack of supporting research
- narrow theory
- vague
- lack of a how to use in counseling
Individual Psychology (Alfred Adler and Rudolph Dreikurs)
Counseling goals
to help the client understand lifestyle and identify appropriate social and community interests; explain clients to themselves and for them to overcome inferiority
Individual Psychology (Alfred Adler and Rudolph Dreikurs)
Techniques
those leading to insight such as life histories, homework assignments, paradoxical intentions
Transactional analysis (Eric Berne)
Main ideas
Personality has three ego states:
- Parent
- Adult
- Child
life script: develops in childhood and influences a person’s behavior
- many transactions with others can be characterized as games with the intent to avoid intimacy
Transactional analysis (Eric Berne)
Complementary transactions
Adult to adult
- lead to good communication
Transactional analysis (Eric Berne)
Crossed transactions
Adult to Child and Child to Parent
- lead to barriers to communication
Transactional analysis (Eric Berne)
Goal of therapy
to teach the client the language and ideas of TA in order to recognize ego state functioning and analyze one’s transaction
Transactional analysis (Eric Berne)
Techinques
- teaching concepts
- helping diagnose
- interpretation
- use of contracts
- confrontation
Transactional analysis (Eric Berne)
Berne wrote
Games People Play
Transactional analysis (Eric Berne)
Thomas Harris wrote
I’m OK - You’re OK
Existential (Rollo May, Victor Frankl, Irvin Yalom)
Other existentialists include
- Soren Kierkegaard
- Paul Tillich
- Martin Heidegger
- Jean Paul Satre
Existential (Rollo May, Victor Frankl, Irvin Yalom)
Phenomenology
the basis of existential therapy
- the study of our direct experiences taken at their face value. We have freedom of choice and are responsible for our fate
Existential (Rollo May, Victor Frankl, Irvin Yalom)
Concepts
- we search for meaning and struggle with being alone, unconnected from others
- anxiety and guilt are central concepts: anxiety is the threat of non-being and guilt occurs because we fail to fulfill our potential
- authentic relationship is important
- Client-centered approaches are appropriate
Existential (Rollo May, Victor Frankl, Irvin Yalom)
Main goal
the understanding of one’s being, one’s awareness of who one is and who one is becoming
Other goals:
- awareness of freedom
- choosing responsibility
Existential (Rollo May, Victor Frankl, Irvin Yalom)
Logotherapy
Victor Frankl’s counseling theory found in his book Man’s Search for Meaning which followed his concentration camp experience
- goal is to help people find meaning in life… life can have a purpose even after suffering, and people can find meaning through their attitudes, choices, and actions
Existential (Rollo May, Victor Frankl, Irvin Yalom)
Principles underlying logotherapy are individual’s
- motivation to find meaning in their life journey
- freedom to choose what they do, think, how they react
- with freedom of choice comes personal responsibility
Cognitive and Behavioral Counseling
Leading proponents
- Joseph Wolpe
- Donald Meichenbaum
- Aaron Beck
- Albert Bandura
- Albert Ellis (REBT)
- Arnold Lazarus (Multimodal Therapy)
Cognitive and Behavioral Counseling
Main concepts
- stimulus-response and stimulus-organism-response paradigm are the basis
- belief is that behavior is learned and can be unlearned/relearned
Cognitive and Behavioral Counseling
Goals of counseling
to identify antecedents of behavior and the nature of the reinforcements maintaining that behavior
the counselor helps create learning conditions and may engage in direct intervention
- Goals of therapy are likely to be behaviorally stated
Cognitive and Behavioral Counseling
Counseling techniques
- operant and classical conditioning
- social modeling
- problem-solving
- direct training
- reinforcement
- decision making
Dialectical behavior therapy (DBT)
Who developed this and to treat what?
Marsha Linehan for the treatment of borderline personality disorder
but is now used more widely with a variety of disorders including traumatic brain injury, eating disorders, mood disorders
- can be used with adolescents (and their families) and adults
- group component is usually involved with the individual sessions
Dialectical behavior therapy (DBT)
Main concepts
- uses cognitive behavioral techniques
- helping clients increase emotional and cognitive regulation by learning the triggers that lead to their undesired behaviors
- the dilectical principle of recognizing two sides to situations, such as the need for accepting change and recognizing the resistance to change, receives attention
- long-term therapeutic intervention because it requires the learning, practicing, acquiring of a number of skills by the client
Four modes: 1. skills training, 2. phone counseling, 3. therapist consultation team, 4. individual treatment
Dialectical behavior therapy (DBT)
Skills of DBT
Mindfulness
paying attention to the present moment nonjudgmentally, experiencing one’s emotions and senses fully
Dialectical behavior therapy (DBT)
Skills of DBT
Distress tolerance
accepting and tolerating oneself and the current situation, often painful and negative, in a non-evaluative way
Dialectical behavior therapy (DBT)
Skills of DBT
Interpersonal effectiveness
developing effective strategies for asking for what one needs, saying no as appropriate, and coping with interpersonal conflict
Dialectical behavior therapy (DBT)
Skills of DBT
Emotion regulation
identifying emotions and obstacles to changing them, reducing vulnerability, increasing positive emotions
Dialectical behavior therapy (DBT)
Other DBT tools
Diary cards - tracking interfering behaviors
Chain analysis - analyzing sequential events that lead to behaviors
Dynamics of the mileu or culture of client’s group
The counselor must obtain training in order to teach the required skills and facilitate the application of these skills on an individual and group basis with a variety of clients
Rational Emotive Behavior Therapy (REBT) - Albert Ellis
Main concepts
- based on idea that it is not the events we experience that influence us, but rather the interpretation of events that is important
- individuals have the potential for rational thinking
- in childhood, we learn irrational beliefs and re-indoctrinate ourselves on a continuing basis. This leads to inappropriate affect and behavior
- Belief system
- self-talk
- crooked thinking
Rational Emotive Behavior Therapy (REBT) - Albert Ellis
A-B-C-D-E system
A = external event (activity/action)
B = belief (self-verbalization)
C = consequent affect (may be (ir)rational)
D = disputing the irrational belief which is causing the affect/behavior
E = effect (cognitive = a change in the self-verbalization)
Rational Emotive Behavior Therapy (REBT) - Albert Ellis
Emotive techniques
role-playing and imagery
Rational Emotive Behavior Therapy (REBT) - Albert Ellis
Self-talk
the source of emotional disturbance
Multimodal therapy (Arnold Lazarus)
Main concepts
- a comprehensive, holistic approach (eclectic)
- has strong behavioral ties
- addresses 7 interactive yet discrete modalities (BASIC ID)
- assessment covering all 7 modalities is necessary to determine total human functioning
Multimodal therapy (Arnold Lazarus)
BASIC ID
B = behaviors (acts, habits, reactions)
A = affective responses (emotions/moods)
S = sensations (five senses - touch, hearing, taste, etc.)
I = images (how we see selves, memories, dreams)
C = cognitions (insights, philosophies, ideas)
I = interpersonal relationships (interactions with people)
D = drugs (generally, biology including nutrition)
Multimodal therapy (Arnold Lazarus)
Counseling techniques
uses a variety of theroetical perspectives
- anxiety-management training
- modeling
- positive imagery
- relaxation training
- assertiveness training
- biofeedback
- hypnosis
- bibliotherapy
- thought stopping
Reality Therapy (William Glasser)
Main concepts
- based on Choice theory
- individuals determine their own fate and are in charge of their lives
- other perceptions control our behaviors and we use behavior ((in)appropriately) to fill our needs
- we act to control the world around us and the real world is important to the extent that it helps us satisfy our needs. We may not satisfy our needs directly
- Taking responsibility is key
Reality Therapy (William Glasser)
Five genetically-based needs
- survival
- love and belonging
- power or achievement
- freedom or independence
- fun
Reality Therapy (William Glasser)
Characteristics of reality therapy
- emphasize choice and responsibility
- reject transference - by being yourself as the therapist
- present-oriented (past is not critical)
- avoid focusing on symptoms - focus on how to meet needs
- challenge traditional view of mental illness - take a more solution-focused approach
Reality Therapy (William Glasser)
WDEP
(developed by Robert Wubbolding to help learn reality therapy)
W = exploring client’s WANTS as they relate to perceived needs
D = encouraging clients to DISCUSS actions and feelings
E = refers to SELF-EVALUATION by clients concerning their behaviors
P = following self-evaluation, PLANNING in order to effect change
Feminist Therapy
Origins
can be traced back to the women’s movement in the 1960s but no specific individual is associated with its development and nurturance
Feminist Therapy
Basic perspectives
- gender is central to therapeutic practice
- awareness/understanding of the role of sociocultural influences as they manifest themselves in therapy
- need to empower women and address societal changes
Feminist Therapy
Basic principles
The person is political and critical consciousness
- the problems of client have societal and political roots which often result in marginalization, oppression, subordination, stereotyping
Commitment to social change
- therapy is for the individual and to advance a transformation in society. Therapists must also take action for social change
Women’s and girls’ voices and ways of knowing, as well as the voices of others who have experienced marginalization and oppression, are valued and their experiences are honored
- women’s perspectives are considered central rather than using the male experience as the norm against which women often appear deviant
The counseling relationship is egalitarian
- clients are experts on themselves and their oppression is recognized; therapy is a collaborative process
A focus on strengths and a reformulated definition of psychological distress
- intrapsychic factors are only a part of the explanation for the pain experienced; psychological distress is reframed as a communication about unjust systems; systems can be reframed as survival strategies
All types of oppression are recognized along with connections among them
- all clients can be best understood in the context of their sociocultural environments. In addition to helping clients make changes in their lives, feminist therapists work towards societal change
Feminist Therapy
Therapeutic techniques
- gender-role analysis and intervention
- empowering techniques
- self-nurturance activities
- power analysis and intervention
- bibliotherapy
- assertiveness training
- reframing and re-labeling
- groups
- social action
Relational-Cultural Theory
Premise
human growth (female and male) develops in connection with others rather than through separation and individuation
- addresses how people respond to relational and cultural adversity
- issues in counseling include power, privilege, marginalization, acceptance rather than pathology
Connections are central and powerful in people’s lives (brain changes through connections and relationships with others)
Relational-Cultural Theory
Judy Jordan
one of the early scholars of relational-cultural theory
- we need to move from a human growth mode of separation to a relationship one
- as social beings, cultural values and connections are paramount and individuals thrive in relationships
Solution-Focused Brief Therapy (SFBT)
Premise
does not address history or past experience of a problem
- understanding the nature of the problem is not necessary to generating solutions to a problem
Solution-Focused Brief Therapy (SFBT)
Focus
maintain a positive orientation believing that the client can construct solutions
- stress is placed on what is working for the client, the exceptions that exist to the problem pattern
Solution-Focused Brief Therapy (SFBT)
Therapeutic techniques and procedures
Exceptions question
- what were the circumstances when the problem did not exist; these circumstances represent news of difference
Miracle question
- if a miracle happened, how would you know and what would be different?
Scaling questions
- using a scale from one to ten, identify changes in the client’s affect, anxiety, etc. Focus is on any positive change and then duplicate or increase that change
Solution-Focused Brief Therapy (SFBT)
Importance
brief therapy models are becoming more important with the need to meet health maintenance and employee assistance problem needs for services
- the number of sessions may be limited to less than 6 or 8
- college counseling centers offer limited sessions
Solution-Focused Brief Therapy (SFBT)
Need for specific goals
focus will be on identifying and resolving immediate problem which led to the counseling intervention and development of coping skills to assist counselees manage current and future problems
Solution-Focused Brief Therapy (SFBT)
Related to intermittent counseling
a client sees a counselor on and off as problems arise sometimes over several years
- not all client problems will be addressed adequately using brief therapy models
- the counselor and client must identify those circumstances when additional sessions are necessary and do what is possible to meet client’s needs appropriately
- using brief therapy procedures with certain client problems may raise ethical questions of professional competence and abandonment
Narrative therapy
Premise
Post-modern approach
social constructionism: independent, objective reality exists through subjective experiences, and client’s perception of reality is valid
- this reality is based on the language and words clients use to represent their situation and circumstances in which people live
Narrative therapy
Basic concepts
- clients’ lives are stories in progress, which can be told/explored from a variety of perspectives
- stories use words and language to give meaning to experiences and help determine feelings/attitudes
- are subjective and constructed by the individual living within a context made up of family, culture, race, ethinicity, gender orientation, etc.
- client tells the problem-saturated story and therapist encourages other perspectives and interpretations
- the story might be deconstructed and new meanings and variations may be substituted
- after deconstruction, focus is on helping client rewrite the story
Narrative therapy
Therapeutic techniques and interventions
Questions and clarifications
- by the therapist to discover and construct the story of the client’s experience
Externalization and deconstruction
- with the focus that the person is not the problem, the problem is the problem
- externalizing the problem can help deconstruct it
Re-authoring
- helping the client find a more appropriate alternative story
- by finding strengths and exceptions, help the client write a new story more consistent with what they want their life to be like
Documenting the evidence through writing of letters
- therapists can consolidate gains and advance therapy by writing letters to the client between sessions
- these have been found to be powerful adjuncts to the sessions
Integrative counseling
Premise
Goes beyond eclectic counseling (which uses a variety of techniques from a variety of theories that best meet the needs of the client)
Integrative counseling implies the creation of a model by synthesizing existing theories and practice, not the mere borrowing of useful techniques
- begins with the counselor developing a personal theory based on values, worldview, education, experience
- counselor fleshes out this integrative counseling theory to include the processes and techniques that fit from other theoretical perspectives
- result is a highly individualistic theory owned by the counselor, highly congruent, yet flexible so that the counselor can address particular client problems and use counseling experiences to further develop this theory
Attribution theory by Fritz Heider
Dispositional/internal attribution
when the cause or outcome is generated by the person
ex. a grad student doing poorly on an exam because they didn’t study
Attribution theory by Fritz Heider
Situational/external attribution
when the cause is attributed to factors outside the individual
ex. the department made the exam so difficult no one could pass it so a student failed
Fundamental attribution error
occurs when a person attempts to look at someone else’s negative behavior, failure, or undesirable event and come up with an explanation
- the tendency is to put more stock in dispositional (personality/judgement/ability) explanations than situational ones
- more people attribute their own negative outcomes in life to situational/external attributes but assess other’s as dispositional/internal
Self-serving bias
a positive event occured because you are so wonderful, etc. but a negative event occurred because of the situation/external circumstances/nothing to do with you
ex. if you pass your exam it is because of dispositional issues, if you fail it, it is because of situational issues
this does not always apply to depressed people (they will probably blame themselves)
Teleological approach
focuses on future
ex. a future event is responsible for client’s current behavior
