Counseling and Helping Relationships Flashcards

Question

behavior therapy - basic philosophy and key concepts

Answer 1

basic philosophy - behavior is the product of learning. we are both the product and the producer of the environment. traditional behavior therapy is based on classical and operant principles. contemporary behavior therapy has branched our in many directions, including mindfulness and acceptance approaches. key concepts - 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.

Answer 2

basic philosophy - 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 redeciding. this is a psychoeducational model, which emphasized 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. key concepts - 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.

Answer 3

basic philosophy - 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 to best achieve satisfying relationships. key concepts - 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.

Answer 4

basic philosophy - feminists criticize many traditional theories to the degree that they are based on gender-biased concepts, such as being androcentric, gendercentric, ethnocentrist, heterosexist, and intrapsychic. the constructs of feminist therapy include being gender fair, flexible, interactionist, and lifespan 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. key concepts - 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.

Answer 5

basic philosophy - 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. key concepts - 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.

Answer 6

basic philosophy - 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. key concepts - 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 patters, and dealing with here-and-now interactions. the present is more important than exploring past experiences.

Answer 7

the brain grows and differentiates not only because of genetics but continues this process through its continuous interaction with the environment. consequently, the person's experiences with different environmental conditions and events throughout life can promote re-mapping of different regions of the brain. so, too, the experience of psychotherapy can restructure neural networks in the brain. the triune model of the brain suggests three principal locations and functions: 1. the surviving brain is the stem and response to danger and controls the automatic functions (fight or flight) 2. the feeling brain (limbic system) is the emotion center, mediating feelings and thoughts, and storing some memory 3. the cortex comprises the thinking brain including executive functions, meaning-making, and self-awareness neuroplasticity is the brain's ability to reproduce new neurons and reorganize itself as the individual experiences new situations and experiences (including psychotherapy) various counseling theoretical approaches, skills, and interventions result in the formation of new neurons and connections. the production of neurotransmitters is promoted. research suggests that CBT promotes cognitive restructuring useful in working with clients who have experienced trauma such as PTSD. CBT promotes new connections within their memory network leading to a reduction of symptoms. EMDR is believed to help clients access new, more adaptive information. biofeedback (or neurofeedback) has been found useful for a number of client problems such as sleep disorders, anxiety attacks, phobias, and migraine headaches. biofeedback procedures attempt to "re-wire" neural networks. ivey, d'andrea, and ivey argue that most counseling relationships foster the development of new neurons and neural networks whether counselors know that or not. they also write of cultural neuroscience and how counselors help generate neurons and networks to assist diverse clients to lead more satisfying and empowered lives. other ways to increase production of positive neurotransmitters besides talk therapy include involvement in integrative therapies such as art, music, physical movement and exercise, relaxation exercises, balanced nutrition, and yoga. medication can reduce or control symptoms but there are no biochemical means to change faulty interaction patterns and behaviors that have led to a disorder. in addition to the processes listed above, change will come with new and repeated emotional, verbal, and interpersonal processes of learning that over time become ingrained into brain structures. current standards of CACREP require curricular experiences for all counselors in training to promote an understanding of theories of learning and personality development to include current understanding of neurological behavior. separate courses in anatomy or neurobiology are not required. CACREP defines neurological behavior as the relationship among brain anatomy, function, and biochemistry, as well as learning and behavior.

Answer 8

the concept of mindfulness is appearing more frequently as an important aspect in many counseling approaches especially cognitively-oriented applications. there are two major aspects to mindfulness as applied to counseling. one component is a focus and attention on one's current experience including one's environment as well as internal sensations, emotions, and thoughts. the other important component of mindfulness is a nonjudgmental, accepting attitude to whatever the client is experiencing externally or internally. mindfulness is viewed as a form of mental discipline wit ha focus on the here and now rather than the past or the future. most individuals need instruction and practice in order to implement mindfulness as defined here. instruction may include, deep breathing exercises, other relaxation techniques, and meditation. mindfulness-based cognitive therapy assists the client in stopping the self-perpetuating mental habits of ruminating on negative thoughts. clients learn to pay attention to their thoughts and body sensations in a nonjudgmental way learning to accept them and let go of cycles and patterns of responding that are not useful. the purpose is not to change these thoughts and body sensations as much as change the relationship to them in a reframing sort of way. application of mindfulness counseling practices have been described with a variety of troubled clients such as those with depression, generalized anxiety disorders, as well as other clients experiencing anxiety and stress. a variety of studies suggest mindfulness may not be appropriate for individuals with schizophrenia, bipolar disorder, and posttraumatic stress disorder. many counselors might find mindfulness techniques useful no matter what counseling theory and techniques are used.

Answer 9

empathetic understanding - the ability to experience the client's subjective world including feelings and cognitions congruence - also called genuineness, this characteristic implies that the counselor is authentic and integrated in the counseling session. congruence can also mean an agreement between a client's behavior and their values and beliefs. unconditional positive regard - also called acceptance, this characteristic implies the counselor is caring without condition and is neither evaluative nor judgmental concreteness - this is the extent to which the client and the counselor deal with issues in specific terms rather than in vague generalities immediacy - this is dealing with what is going on in the counseling process at the present time interpretation - this is a therapeutic technique used to uncover and suggest meanings and relationships often underlying the apparent expression self-disclosure - appropriate self-disclosure means that the counselor shares personal affect and experiences relative to the client's issues attending - this refers to several behaviors including listening, engaging in eye contact, and being psychologically present restatement - repeating what the client has stated with emphasis on the cognitive message reflection - repeating what the client has stated with emphasis on the affective or feeling portion of the message paraphrasing - restating the message of the client to show or to gain understanding summarizing - this is a process whereby the counselor or client brings together several ideas or feelings usually following a lengthy interchange silence - silence may have many meanings such as quietly thinking, boredom, hostility, waiting for the counselor to lead, preparing the next trust, or emotional integration confrontation - confrontation occurs when the counselor identifies and presents discrepancies between a client's verbal and nonverbal behaviors or between a counselor's and client's perceptions

Answer 10

the treatment plan outlines the counseling interventions. the interventions employed are based on several factors in addition to the diagnosis. client characteristics influence the treatment plan. besides the presenting problem, factors such as cultural background, age, and personality may influence the interventions selected. for example, depression may manifest itself very differently for various cultures or age groups. not uncommonly in seniors, depression can co-occur with medical issues or losses suffered. counselor therapeutic orientation also influences the counseling interventions selected. psychodynamic theoretical approaches, look different from cognitive behavioral methods.

Answer 11

mental health counselors are encourages to know about and apply evidence-based research findings in selecting therapeutic interventions. particular issues and problems consistent with particular client characteristics may thus be dealt with most effectively. quality standards of care are the goal of consistent with ethical practices. mental health counselors are encouraged to conduct their own pre and post assessments and to use such results in selecting or modifying their interventions.

Answer 12

clinical counselors should integrate their practice with other mental health specialists including those trained in medicine. the incidence of co-occurring mental disorders and substance use issues is an example where counselors need additional professional interventions for their clients. many estimates indicate that substance use co-occurs in as many as one half of individuals seeking mental health services. integrating counseling interventions with other professionals may assure an appropriate level of care is provided.

Answer 13

structuring refers to defining the nature, limits, and goals of the counseling process. the roles of the client and counselor may be described.

Answer 14

crakhuff developed 5-point scales to measure empathy, genuineness, concreteness, and respect. counselor responses may be viewed as additive, interchangeable, or subtractive. the counselor's empathetic response may be: level 1 - does not attend to or detracts significantly from the client's affect level 2 - subtracts noticeably from the client's affect level 3 - interchangeable with the client's content and affect level 4 - adds noticeably to the client's affect level 5 - adds significantly to the client's affect and meanings for example: client (obviously distressed and anxious): "we had an argument last night and he got very angry, I was really afraid - then he stormed out and I haven't seen him since." level 1 response - where do you think he went? level 2 response - you seem a little worried about all this level 3 responses - you've very anxious about what happened last night and his whereabouts level 4 or 5 response - you're very anxious about what happened last night but also afraid for your safety and wondering where this relationship is going

Answer 15

jung believed in the collective unconscious. the collective unconscious is determined by the evolutionary development of the human species and it contains brain patterns for the most intense emotional responses that humans experience. the operant for the collective unconscious is the archetype. an archetype is a response pattern occurring universally in the human experience and is characterized by an emotional charge to the existential issues of identity, meaning, and purpose. examples of archetypes are: anima and animus (male and female traits) goals of jungian therapy include transformation of self including gaining knowledge of self, recognition and integration of self. therapy is viewed as a healing process. jung introduced the concepts of introversion and extraversion. the MBTI is based on jung's theory.

Answer 16

two important concepts are birth order and family constellation. techniques of counseling: counselor is egalitarian with client - it is a collaborative effort. adler views neuroses as a failure in learning which results in distorted perceptions. stress is on client responsibility in counseling. counseling examines family constellations, dreams, early memories. asking 'the question' - what would be different if you were well? - focuses the counseling process. birth order implications - children in the same family have different psychological environments because of the difference in birth order. oldest child - gets much attention, tends to be dependable and hardworking, achievement oriented. when another child (intruder) comes, oldest may fear losing love. second child - shares attention, sees self as if in a race to complete with first child, often succeeds where older fails. middle child - often feels left out, may see life as unfair, poor me attitude, may develop problems. youngest child - baby in family, pampered, special role to play, influenced by all others, tends to go own way, often develops in directions no one else thought of. only child - does not learn to share or cooperate, often deals with adults well, wants center stage even as adult and if they do not get it, may have difficulties. childhood experiences influence our adult interactions and family dynamics.

Answer 17

allport acknowledged that individuals with their personalities exist within systems. behavior of an individual must be viewed as fitting any system of interaction including culture, its situational context, and field theory. lewin, a field theories, believed behavior is a function of life space which is a function of the person and the environment. he challenged the linear, mechanistic view of behavior.

Answer 18

developed a system of psychotherapy called cognitive therapy. identified automatic thoughts in client. these were similar to the preconscious. there is an internal communication system. in depressed people, this internal communication was negatively focused resulting in low self-esteem, self-blame, and negative interpretations of experiences. the person experiences a negative cognitive shift. the cause of depression may be in any combination of biological, genetic, stress, or personality factors. follow-up studies suggest there is a greater stability of results and fewer relapses with cognitive therapy than anti-depressant drugs. developed assessments including beck depression inventory.

Answer 19

wolpe developed a theory of reciprocal inhibition. the underlying principle states that a person cannot be both anxious and relaxed at the same time. systematic desensitization (based on the theory of reciprocal inhibition) is a behavioral intervention of counterconditioning. the goal is to reduce anxiety by associating negative stimuli with positive events. specifically, negative images are paired with muscle relaxation.

Answer 20

meichenbaum spoke of cognitive behavior modification - a shift from self-defeating thoughts to coping ones. he introduced the concept of stress inoculation which is practicing positive or reinforcing self-statements.

Answer 21

token economy - this is the use of tokens (points, ratings, etc.) as a reinforcement in a behavioral treatment program. shaping of behavior can occur through the use of tokens. privileges and goods can be purchased with tokens. paradoxical intention - with this method, clients are urged to 'intend' that which they fear or wish to change. it may work with a variety of unwanted behaviors such as insomnia, smoking, arguing, etc. implosive therapy - this behaviorally based intervention induces anxiety around the problem by presenting vivid images or cues (flooding). the anxiety is expected to diminish (extinguish) with repeated exposure and in the absence of any threat. thought stopping - this behavioral intervention is designed to inhibit recurring thought by consciously stopping it whenever it occurs.

Answer 22

the window was named after joe luft and harry ngham. the client brings material in this window the counseling session; some is known and other information is not. known to self, known to others (maximize) known to self, not known to others not known to self, known to others not known to self, not known to others (minimize) several principles of change may be identified: a change in one quadrant affects all other quadrants it takes energy to hide, deny, or be blind to behavior threat increases awareness; mutual trust tends to increase awareness the smaller the first/upper left quadrant (known to self and others), the poorer the communication there is universal curiosity about the unknown area but customs, social training, and fears keep parts unknown the goal of counseling is to minimize the lower right quadrant and maximize the upper left

Answer 23

consultation is defined as voluntary, problem-solving process, initiated or terminated by the consultant or consultee, to help consultees develop attitudes or skills so they can function more effectively with individuals, groups, or organizations. consultation is work related. consultation may be client, consultee, or system focused, and the goal is not just to resolve the issues that cause human problems but to increase competence so future problems may be avoided. thus, consultation has a preventative function as well. you use many of the same skills as in counseling but the context, role, and function are different. consultation is not counseling or therapy. consultation may be: content oriented - transfer of knowledge or information from the consultant to the consultee process oriented - looking at the process - may use communication theory, attribution, change, or motivation theory examples of some models of consultation are: bergan - this is a behavioral model with four stages which are problem identification, problem analysis, plan implementation, and problem evaluation. part of the focus of this consultation is on problem behaviors and their antecedents and consequences. bergan's model emphasizes the verbal interaction in consultation. bandura - this is a social learning model. there is a dynamic interplay of behaviors, cognitions, and the environment and all three are assessed in problem identification. many solutions revolve around modeling, rehearsing, and changing conditions. schein - identified the 'purchase model' which involves buying the consultant expert's knowledge or service. his doctor-patient model stresses diagnosis and problem identification. the process model involves the consultee with the consultant in the diagnostic process and identification of interventions. caplan - this is a mental health consultation model. consultation occurs between two professionals and can be centered on the client, the consultee and client, the program, or the consultee and administration. a nine-state process of consultation is described by splete. these are: pre-contract contract and exploration of relationship contracting problem identification problem analysis feedback and planning implementation of the plan evaluation of the plan conclusion and termination of relationship

Answer 24

animal-assisted counseling helps clients establish a relationship with an animal that facilitates communication, builds self-confidence, and is non-judgmental. these positive interactions can be used to better understand oneself and generalize to others. dogs and horses are used most commonly although many other animals have been found effective. individuals who are mentally challenged, victims of trauma, and socially shy persons may be especially good candidates for animal-assisted counseling. adventure-based counseling is designed for children as well as younger and older adults as an experiential set of outdoor activities. these activities may range from camping to hiking to completing 'challenge' courses designed for individuals, pairs, or small groups. self-awareness, communication skills, trust, and camaraderie are possible outcomes of adventure-based activities. depending upon the makeup of the participants, diversity sensitivity and multicultural skills may be developed. a more clinically-oriented program, wilderness therapy, is an outdoor behavioral mental healthcare approach for troubled adolescents and adults. the purposes of wilderness therapy are to identify and address emotional, behavioral, and psychological problems through an outdoor, often unfamiliar environment.

Answer 25

distance counseling and telemental health are broad terms encompassing webcounseling, e-counseling, and telephone counseling. when conducted on the internet, it may occur via email messages, be chat-based, or video-based. it may consist of information-giving, be assessment-focused, psychoeducational in nature, or deal with personal, therapeutic issues. anyone may benefit from distance counseling including those who are shy, physically challenged, agoraphobic, or those who have no counseling resources nearby. some younger individuals who tend to be technologically savvy may prefer this medium for counseling. some issues surrounding distance counseling include security of communications, imposters (both counselor and client), records maintenance, trust building/transparency, and contacts for clients in case of crisis.

Answer 26

the need for mental health crisis counseling is growing as a result of various natural disasters as well as human-caused wars, tragedies, violence, and terrorism. the skills needed for counseling individuals impacted by these incidents are unique and training is required. CACREP standards require the infusion of emergency preparedness language throughout the training curriculum as well as crisis intervention and suicide prevention models. the red cross continually trains qualified mental health counselors for specific roles dealing with crises and tragedies. possible consequences for counselors working with clients impacted by trauma and violence include compassion fatigue, secondary traumatic stress, and vicarious trauma. counselors may deny they have been impacted, however, they may show some of these reactions: lack of energy, prefer isolation, be irritable, have sleeping problems, self-medicate, and cease self-care activities. compassion fatigue may be evidenced by counselors who work with difficult client issues and it may result in loss of empathy and interest in the client's concerns. it may occur even when working with clients who have not experienced trauma. secondary traumatic stress may result because of the exposure to graphic material presented by traumatized clients. the counselor may begin experiencing some of the same symptoms as the client. although some writers equate vicarious trauma to secondary traumatic stress, others believe vicarious trauma includes a change in the counselor's worldview, sense of self, and beliefs.

Answer 27

richard bandler and john grinder are the original proponents. nlp is a communications theory using the five sensory channels. it can be used to establish and maintain rapport and pace the client's verbal cues. nlp examines the structure of language and how it is used to represent reality.

Answer 28

emdr is a counseling technique used to facilitate the client's accessing of memories of painful and traumatic experiences and reprocessing these experiences through eye movements similar to those found in rem sleep cycles. emdr has generated considerable positive research.

Answer 29

over 19 million americans suffer from substance abuse addiction and for 14 million of these the abuse is alcohol related. nearly 50 percent of adults have been exposed to alcohol dependence in the family either in a blood relative or partner/spouse. teenage drinking is associated with suicide, early sexual activity, date rape, and automobile accidents. substance abuse is often viewed as the number one problem in the US. estimates of use are difficult to determine because of unknown recreational use (especially marijuana), addiction to prescription drugs, and simultaneous use of alcohol and drugs (polysubstance abuse). in addition to themselves, substance abusers adversely affect as many as four other people including family, friends, and coworkers. beginning in 2012, two states (CO and WA) approved the recreational use of marijuana. since then, many additional states have passed similar legislation. more than 30 states allow for the legal use of marijuana for medical purposes. personality traits often found in alcoholics and drug users include low self-concept, anxiety, underachievement, feeling of social isolation, sexual dysfunctions, dependence, fear of failure, and suicidal impulses. questionnaires such as SASSI (substance abuse subtle screening inventory) are useful in assessing signs of addiction. alcoholism is viewed by many as a disease in itself, not a symptom, thus requiring treatment of the disease before effective counseling can begin. twelve step programs have been found effective for many with alcohol or drug problems. individual, group, and family counseling are valuable components of treatment. residential programs, often using behavior modification and social learning theory, may be effective. treatment of the physical addiction is also necessary.

Answer 30

kinesics refers to nonlinguistic communication which occurs through body movements such as gestures and facial expressions. proxemics refers to the spatial features of the environment such as positioning of furniture, seating arrangements, etc. how we arrange space will have an impact on behavior. each of us has a personal space.

Answer 31

person-centered - the theory encourages open dialogue and breaking down of cultural barriers. these is respect for others' values and differences. some clients want more structure than this theory provides and the core values may not be congruent with the client's culture. the counselor's lack of direction may not fit the client's expectation for help with answers from a knowledgeable professional. existential - this approach may be the most useful in helping clients find meaning and harmony in their lives as well as empowerment in an oppressive society. it assists clients to examine the options for change within their cultural reality. this approach may not be effective with multicultural clients who see themselves as having little personal choice and freedom. clients may see this therapy as promoting values which conflict with collectivism and respect for tradition. some may want answers and solutions with more focus on surviving the world. psychoanalytical - the focus on family dynamics may appeal to multicultural clients. the therapist's formality may appeal to the client's expectation of professional distance. because this theory often requires long-term restructuring of personality, it may not be appropriate for many clients or counseling settings. many multicultural clients want short-term, solution-oriented counseling. gestalt - the variety of techniques allows the counselor to choose those that fit the client. different approaches allow for many different ways of working with clients who may have difficulty expressing feelings. the focus on nonverbals may be easier for some clients. many gestalt techniques with their high stress on feelings may be difficult or inappropriate for multicultural clients, at least initially. behavior - a collaborative relationship between the counselor and multicultural client aims for agreed-upon goals which suit the client's unique situation. the focus is on learning practical skills and self-management techniques. counselors must help clients incorporate their new behaviors into their cultural context, and be willing to address the consequences these new behaviors may lead to. cognitive-behavior - the psychoeducational focus of this theory works well with multicultural clients in that it gets them to examine their cultural conflicts and teach new behaviors. the emphasis is on thinking rather than on expressing feelings. clients may value the active and directive approach of the therapist. the therapist much understanding and respect the clients' world before appropriate ways of solving problems can be determined. solutions presented may not be consistent with cultural beliefs. because the counselor has solutions, clients may become dependent on the counselor. reality - using this theoretical approach, the counselor explores how satisfying the client's current situation is for themselves and others. thus, it may work well in multicultural settings helping clients find a balance between their own ethnic identity and integrating some of the values and practices of the dominant society. cultural and environmental factors, as well as social and political realities must be recognized by the counselor, clients may be more interested in changing their environment and circumstances than their own life. feminist - therapy approaches are very compatible with multicultural clients. issues of oppression and privilege are common to both and the use of power in relationships is often a concern for multicultural clients. in addition to individual empowerment, social change is often a core issue. this model may be biased toward values of white, middle-class women which may not fit many women of other cultures. the feminist therapist must be aware of the consequences of some client actions and behaviors including the potential isolation from extended family as life changes are made and new roles assumed. adlerian - focus on person-in-environment is helpful working with clients from diverse cultures. the therapy's emphasis on collectivism, importance of the family, social interest, and belonging is consistent with the values of many cultures. a detailed focus on the client's family background may conflict with cultural concerns in disclosing family matters. the counselor's interest in a joint, egalitarian process may be uncomfortable with clients who see the therapist as authority. postmodern approaches - stories told in counseling can fit into the social world of clients. therapists don't make assumptions about people and their background. they take an active role in challenging injustices leading to oppression of the client. therapists' interests in having their clients talk about exceptions to their problems may lead to resistance. clients may view therapists as experts and not see themselves as experts on their problem. family systems - therapy's focus on family and community may fit in well with the views of many clients about extended family. networking is a part of the process and fits the values of having others in their support system. some value assumptions of family therapy may not be congruent with the client's of some cultures. for example, individuation, self-actualization, and self-determination may be foreign concepts to some members of some cultures. admitting family problems may be shameful.

Answer 32

for counselors trained in individual one-on-one psychotherapy, moving into family counseling requires a paradigm shift in thinking. rather than an individual perspective, problem definition and problem resolution from a systems perspective.

Answer 33

in a social system such as a family, every member can influence and be influenced by every other member in a continuous process. linear causality suggests that one event causes another in a unidirectional fashion such as found in a stimulus-response situation. simple, straightforward language/content may explain what is occurring. circular causality suggests that there are forces moving in many directions at the same time so the influences and results impact each other resulting in a complex array of outcomes. the explanation of what is occurring in this situation focuses on the process.

Answer 34

locus of pathology - family counseling views the locus of pathology not within the individual but within the social context of the individual, ordinarily the family. focus of treatment interventions - the focus of treatment of the family counselor is on the family rather than the individual even though a particular individual may be the identified client or patient. unit of treatment - because the locus of pathology is the family, the unit of treatment in family counseling is the family, not the individual. duration of treatment - individual psychotherapy is often focused, at least in part, on problems of a long standing nature, and thus long term counseling is indicated. family counseling, in general, attempts to provide brief counseling to resolve current family problems. thus the duration of family counseling may be shorter than individual therapy.

Answer 35

family theorists express caution when reducing family development into discrete, identifiable and common stages or cycles. within the contexts of class and culture, there are many variations, and the cycles and stages of family development within a particular class or culture are dynamic. for many families of various classes and cultures, the cycles may look like this: leaving home - emerging young adults/single young adults - accepting emotional and financial responsibility for self joining of families through marriage/union - commitment to new system families with young children - accepting new members into the system families with adolescents - increasing flexibility of family boundaries to permit children's independence and grandparents' frailties launching children and moving on at midlife - accepting a multitude of exist from and entries into the family system families in late middle age - accepting the shifting generational roles families nearing the end of life - accepting the realities of limitations and death and the completion of one cycle of life

Answer 36

family is defined differently in different cultures and ethnic groups. family membership may differ (some more extended than others). child reading practices may differ. the mother may be home or there may be grandparent or extended family involvement. the nature and severity of the use of punishment varies among cultures and classes. time of adolescence or adulthood (as well as transitional rituals) may be more clearly defined in some cultures and classes than others.

Answer 37

the number of alternative families is growing and the rate of growth of these alternative family styles in the united states may be greatest among those with eurocentric backgrounds. some of the more common alternative families are: single parent families which comprise about one fourth of all families with children remarried families, because of the high divorce rate and subsequent remarriages, result in complex relationships within step families gay and lesbian families, which may or may not have children, are not immune from complex multigenerational family dynamics, and need to sort through the roles and rules which will arise

Answer 38

ludwig von bertalanffy (biologist) proposed systems theory. this is not the reductionistic view where structure was important. in this view, the organization and the interrelations of the parts are important. this is not linear thinking (a causes b) but circular (a may cause b, but b also causes a, which may affect b, etc.)

Answer 39

nathan ackerman is principal proponent. theory came out of psychoanalytic background. in a new marriage, the couple brings psychological heritage and resemblances from families of origin. they may bring introjects (imprints or memories) from parents or others. the family unit seeks homeostasis and an individual family member's symptomatic or pathological behavior disturbs the homeostasis. ackerman believed in an interactive style of therapy, moving into the family's living space, stirring things up, and acting as a catalyst for change. james framo, also psychodynamic in orientation, believed the social context of a person's life helped shape behavior. conflict stemming from one's family of origin continued to be acted out in current relationships in one's family. framo believed that human beings in childhood are object seeking, i.e., hoping to establish satisfying object relationships, especially with parents. if the child is rejected, this frustration is retained as an introject that will appear later. although framo begins therapy with the entire family, he often concludes therapy by doing conjoint (couple) therapy followed by couples group therapy and then family of origin (intergenerational) conferences.

Answer 40

carl whitaker does family counseling from an experiential perspective. less reliant on theory, he becomes highly involved in the therapeutic process. he actively joins the family paying close attention to what he himself was experiencing in the therapy. he would then use that awareness to press for changes in the family. the process of therapy is most important and the encounter in therapy is designed to challenge the old ways of thinking and heaving, on the way to new growth. whitaker uses symbolism to help explain many experiences, and these symbols are often outside of awareness or consciousness.

Answer 41

virginia satir represents a humanistic model of family counseling. human beings as well as families have the resources within themselves to flourish, grow, and develop. self-concept of the individual is important. poor communication (discrepancies) within the family is often blocking members from healthy functioning, so satir would serve as a teacher and trainer. under stress, satir believed that family members would adopt one of five different styles of communication - placater, blamer, super-reasonable, irrelevant, and congruent communicator. the last one is a healthy style. satir's counseling approach has also been characterized as one of process orientation thus her therapeutic style is also an experiential one. she believed in interacting closely with the family and stressed the need for intimacy in family relationships.

Answer 42

murray bowen is the architecht of the systems theory of family counseling and presented the most well developed family counseling theory. based on general systems theory, bowen emphasized the family as an emotional unit in the formation of dysfunctional behavior in a family member. because be believed that family history including more than one generation of the family was central to therapy, his approach has often been labeled transgenerational. eight theoretical concepts were identified by bowen: differentiation of self - the degree to which individuals can distinguish between their intellectual (thinking) processes and their emotional (feeling) processes. if there is fusion between these two processes, individuals are likely to experience involuntary emotional reactions and become dysfunctional. triangles - individuals have a need for closeness and individuation. to the extent two individuals (e.g. spouses) are fused, they may bring in a third person (e.g. child) to resolve such two-person stress. the basic building block of a family's emotional system is the triangle. the greater the fusion in the family, the greater the triangulating that will occur. nuclear family emotional system - marital partners chose mates with equal levels of differentiation. thus two undifferentiated partners will probably become highly fused and produce a family with similar characteristics. such a nuclear family emotional system will be unstable. family projection process - the fused, unstable marital partners will focus on one of the children (typically the most infantile) and this is called the family projection process. emotional cutoff - children involved in the projection process may try to escape the fusion by moving way geographically, or isolating themselves psychologically. this emotional cutoff is only a deception. multigenerational transmission process - the poorly differentiated child of poorly differentiated parents will select a similarly poorly differentiated child to marry. this process could repeat itself through several generations with the 'weak links' always marrying weaker links, etc. sibling position - roles tend to be associated with birth order. if two individuals of the same birth order or different birth order marry, these individuals could complement each other or compete with each other. societal regression - bowen extended his thinking to society's emotional functioning, and in his pessimistic view, society is regressing because it does not differentiate between emotional and intellectual decision making. bowen's therapy begins with a comprehensive assessment process. he develops a genogram for the last three generations. this is a visual picture of the family tree. in therapy, bowen's tendency is to work only with the marital couple even if children have been identified (IP - identified patient) as having the family problem. his goal is to maximize each partner's self-differentiation. his style as a therapist is to remain neutral and detriangulated unlike the experiential and humanistic family therapists.

Answer 43

salvador minuchin is the primary proponent of structural family therapy. each family has an organization or structure characterized by the evolved rules which are the transactional patterns between members. these rules dictate how, when, and with whom family members interact. rules may be generic (for all family members) or idiosyncratic (individualized). the family is composed of subsystems which are necessary to carry out family functions. these subsystems have boundaries and rules for membership. examples of subsystem are spousal, parental, and sibling. boundaries between subsystems may be permeable or diffuse. if boundaries are too diffuse, this may lead to enmeshment. rigid boundaries lead to disengagement. either extreme is likely to create problems within the family other concepts defined in structural family therapy are alignments (the way family members join together or oppose each other), power (who has authority and who has responsibility), and coalitions (alliances between specific family members). minuchin uses a map diagramming the current family structure in identifying where dysfunction may be present. this structural map shows boundaries, alliances, coalitions, conflicts, etc. in therapy, structuralists challenges the transaction patterns in the family and hope to change, reorganize, or restructure the family. one goal might be clearer boundaries. the parental subsystem must be clearly defined with executive power and responsibility. minuchin joinrs the family therapy as an active member. he may mimic (mimesis) some aspect of the family's manner, style, etc., and encourages enactments of some dysfunctional interactions. through reframing, he labels what occurs into a more positive or constructive perspective.

Answer 44

the mental health institute (MRI) focused on family communication patterns in its research in helping families with problems. metacommunication qualities or puts conditions on the communication which occurs on the surface or content level. it is called the second level of communication. several communication techniques were identified which have proven useful: therapeutic double bind - a paradoxical technique wherein the client is asked to continue some undesirable behavior or symptom when they expected to be told to stop it. the client is caught in a bind and must give up the symptom or acknowledge control over it. prescribing the symptom - the paradox here is to refuse to continue the behavior and abandoning it or acknowledging control over it. relabeling - similar to reframing wherein the meaning of a situation is changed so that the situation is perceived differently. the strategic family therapy approach advocates are jay haley and cloe madanes. power and control characterize relationships in families, and symptoms are attempts at controlling a relationship. strategic therapy techniques are often direct suggestions or assignments. assignment of paradoxical tasks often occurs.

Answer 45

this therapeutic approach came out of milan, italy, and was led by mara selvini-palazzoli. the family is viewed as a system with connections between family members with a goal of keeping the system in balance. the family is viewed as playing a 'game' to maintain the system. systemic family therapists bring hypotheses to the therapy sessions to be checked out. usually a team of therapists are also observing, and they may provide the suggestions and directives to be related to the family before it leaves. circular questioning is the process of asking several family members the same question about the same relationships. this reveals family members' connections and the differences in meaning the ascribe to an event. rituals of the family are often used therapeutically; established family patterns might be changed suggesting new ways of doing things, which may alter beliefs and attitudes. by revealing family 'games' and through new information, milan therapists hope to change family rules and relationships.

Answer 46

behavioral techniques have been used effectively for behavioral therapy, behavioral parent-skills training, functional family therapy, and conjoint sex therapy. cognitive behavior therapy, with its focus on thoughts an actions, has received increasing emphasis. robert liberman introduced operant conditioning and social learning principles to the solution of family problems. richard stuart called his approach operant interpersonal therapy. his social exchange model argues for the influence of ongoing behavioral exchanges on their long-term outcomes in relationships. marital skills training and behavioral contracting were other features of stuart's approach. behavioral parent-skills training focuses on child management. techniques such as time out and designing contingency contracts may be used. in functional family therapy, all behavior is viewed as adaptive, always serving a function. therapy helps individuals learn new skills through education. conjoint sex therapy, as practiced by masters and johnson, assumes that any sexual inadequacy exists in a system the two partners represent. consequently, conjoint therapy is necessary. a very high success rate is reported by masters and johnson.

Answer 47

some postmodern approaches to family therapy are gaining acceptance. these approaches challenge the traditional systems way of thinking about family dynamics and relationships. for example, there may be no objective 'functional' family dynamics in reality that apply to all families. individuals of various cultures, genders, races, sexual orientations, etc. determine their own level of healthy family functioning. social constructionists do not believe there is a common reality we share. we use language to share our experiences and perceptions and use language to communicate with others and construct a common reality. one therapeutic approach adopting a social constructionist philosophy is that of steve deshazer who focuses on solutions rather than problems. solution-focused therapy pays little attention to the history of the problem or underlying causes. the therapist and clients have 'discussions' about solutions they want to construct together. the language (words) that are used give meaning to the therapist-family discussions and 'stories' they bring. since word and language meanings vary for different people and from different perspectives, one task is to get agreement on the 'reality' under discussion. one assumption is that clients already know what they need to do to solve the problem but need help in constructing a new way to use that knowledge. deshazer viewed clients as facing locked doors with no keys and through the counseling process, he would help provide them ' skeleton keys' - interventions that they could use to unlock many doors. a counseling approach developed from deshazer's model was the solution-oriented therapy of william o'hanlon. again, the language used by clients and therapists is important because meanings and perceptions are embedded within. in solution-oriented therapy, the counselor collaborates with clients, acknowledges them, and suggests that the possibilities for solution and change already exist within them. some of the focus in therapy is on what is working well (rather than what is not) and increasingly doing something different.

Answer 48

another postmodern therapeutic approach involves the use of narratives, which are stories family members bring to therapy. these narratives may be negative and limiting perceptions of themselves and their lives. deconstruction is the process of examining a narrative, determining underlying assumptions, and suggesting that there may be other meanings that may be attached to the story. this provides the family an opportunity to reauthor the story and the process empowers them. the family therapist may assist in building a scaffold for a new story and assist in the co-authoring.

Answer 49

psychoeducation may be a therapeutic technique or adjunct to any number of family therapy approaches. the goal of psychoeducation is to assist a family with their daily functioning in general, and in dealing with specific issues the family may be experiencing such as with an individual with medical problems. in addition, families who have a member with mental health problems may need assistance with medication regimens and life coping skills. stress and time management, and self-care issues may be present. psychoeducation may also be valuable in such areas as marriage preparation, marital enrichment, and stepfamily blending.

Answer 50

feminist and gender-sensitive issues are important in family therapy. there must be recognition of the social, cultural, and political factors which influence the treatment of men and women. roles for men and women within a society, within a culture, and within families are well established. in many cultures, patriarchal models dominate with attendant power differentials between genders. and therapists are influenced by the same social and cultural factors and role stereotypes as anyone else. feminist and gender-sensitive family therapy challenges traditional viewpoints of gender roles and the family therapist must be sensitive to how these roles are being played out in the family in therapy. there should be an identification of strengths and needs of both men and women. family members must be empowered and enabled to move beyond traditional sex roles and be given choices such as changing established sex roles and the expectations of those roles.

Answer 51

the genogram is a pictorial representation of the relationships within a family typically extending through three generations. developed with the help of family members, the genogram may identify emotional, communication, and behavior patterns within a family. other items of information such as religion, occupations, and ethnic origin may be added.

Answer 52

in play therapy, children are encouraged to express feelings, act out dreams and ambitions, and direct their own life. play helps the child master anxieties, relieve tensions, cope with life's problems, and expend physical energy. play therapy also allows the child to relieve frustrations and helps the therapist analyze the child's conflicts. children often feel less threatened and more at lease in showing their feelings through play. providing them with a variety of media including toys, art supplies, and equipment gives them an opportunity to make decisions and the therapist an opportunity to observe how children deal with conflict (approach-approach). virginia axeline wrote play therapy and dibs: in search of self. she believes the leader or therapist attends, recognizes feelings, helps the child express them, and helps the child implement new behaviors.

Answer 53

clusters of alliances between family members within the overall family group; affiliations and splits from one another, temporary or permanent, occur in pursuit of homeostasis.

Answer 54

an abstract delineation between parts of a system or between systems, typically defined by implicit of explicit rules regarding who may participate and in what manner.

Answer 55

a self-contained system with impermeable boundaries, operating without interactions outside the system, resistant to change and thus prone to increasing disorder.

Answer 56

covert alliances of affiliations, temporary or long-term, between certain family members against others in the family.

Answer 57

involving two or more family members seen together in a therapy session.

Answer 58

the study of methods of feedback control within a system, especially the flow of information through feedback loops.

Answer 59

a family organization in which boundaries between members are blurred and members are over concerned and overinvolved in each other's lives, limiting individual autonomy.

Answer 60

a physical arrangement of the members of a family in space, with the placement of each person determined by an individual family member acting as "director"; the resulting tableau represents that person's symbolic view of family relationships.

Answer 61

a form of collaborative, egalitarian, nonsexist intervention, applicable to all genders, addressing family gender roles, patriarchal attitudes, and social and economic inequalities in relationships.

Answer 62

a schematic diagram of a family's relationship system in the form of a genetic tree and usually including at least three generations, used in particular by bowen and his followers to trace recurring behavior patterns within the family.

Answer 63

a dynamic state of balance or equilibrium in a system, or a tendency toward achieving and maintaining such as state in an effort to ensure a stable environment.

Answer 64

the family member with the presenting symptoms; thus, the person who initially seeks treatment or for whom treatment is sought.

Answer 65

the therapeutic tactic of entering a family system by engaging its separate members and subsystems, gaining access in order to explore and ultimately to help modify dysfunctional aspects of that system.

Answer 66

a form of therapy in which members of several families meet together as a group to work on individual as well as family problems.

Answer 67

a family composed of spouses and children living together as family unit.

Answer 68

a system with more or less permeable boundaries that permits interaction between the system's component parts or subsystems and outside influences.

Answer 69

the ease or flexibility with which members can cross subsystem boundaries within the family

Answer 70

a therapeutic approach in which the therapist develops a specific plan or strategy and designs interventions aimed as solving the presenting problem.

Answer 71

a therapeutic model directed at changing or realigning the family organization or structure in order to alter dysfunctional transactions and clarify subsystem boundaries.

Answer 72

a set of interacting units or component parts that together make up a whole arrangement or organization.

Answer 73

a process in which each parent demands that a child ally with them against the other parent during parental conflict.