Counseling & Helping Relationships Flashcards
Re Helping Relationships, what does research say is the determining factor of counseling success?
the counseling relationship
What are the ‘core’ elements to building a counseling relationship?
4 core elements:
- Human: Carl Rogers identified respect, empathy, genuineness (Rogers’ rrrrreg)
- Social: competence, power, intimacy. Stanley Strong identified trustworthiness, attractiveness, and expertise in his social influence model
- Skills: Allen Ivey identified attending, inquiry, reflection (“Allen Iverson in the AIR”)
- Theory: helps counselors understand self with relationship and skills; helps them identify client problems and effective interventions
Neo-Freudians
A number of psychoanalysts who moved away from Freud’s theory on the id as the driving psychological force. No id or superego, no sex driver
- Emphasized the ego instead - including psychodynamic and sociodynamic forces
(think: What the HEK? re freud’s theory)
Harry Stack Sullivan (think We stack each other on each other)
- a social systems (interpersonal) approach helps us understand human behavior. Behavior best understood via social interactions, not as mechanistic or linear.
Erich Fromm (think 2Ms joining together)
- one must join w/others to develop self-fulfillment (social character). Otherwise–>becomes lonely, nonproductive. Society offers oppty’s to practice mutual love & respect
Karen Horney
- security is major motivation and one feels anxious when not achieved.
- Irrational ways to mend disrupted reln’s–>becomes neurotic needs
Other Neo Freudians (think “3Rs in TOW”)
Theodore Reik
Otto Rank
Wilheim Reich
Gestalt
- overview
- concepts
- counselor’s role
- techniques
- books
-frederick ‘fritz’ perls
- based on EXISTENTIAL PRINCIPLES, here and now focus, holistic systems viewpoint
Premise: ppl have needs. When a need is in the forefront it represents the “figure,” while others are the ground (ie background). As the need is met, it completes the ‘gestalt’ and a new need takes its place. Goal is to become a whole person, completing the gestalt.
Key concepts: personal responsibility, unfinished business, awareness of the now
Counselor encourages client to stay w/feelings and finish business
Techniques: role playing, chair techniques, dream work
Interpretation is done by the client, not the counselor
Books by Perls:
Gestalt Therapy Verbatim
In and Out of the Garbage Can
Person-Centered
- Premise
- Critical concepts
- focus of counseling
- counselor’s role
client focused (Rogerian)
Rogers was against the therapist-as-expert model and instead emphasized the client’s phenomenological (experiential) world
Critical concepts: process of becoming, moving to self-actualization, reln’p bw client and counselor
Focus of counseling: on feelings, from past to present
Counselor’s role: showing unconditional positive regard, genuineness (congruence), empathic understanding–these are the core or facilitative conditions of effective counseling
Books
Counseling & Psychotherapy (1942)
Client Centered Therapy (1951)
On Becoming a Person (1961)
What were Carl Rogers’ main books?
Counseling & Psychotherapy (1942)
Client Centered Therapy (1951)
On Becoming a Person (1961)
Object-Relations Theory
Based on psychoanalytic concepts
- are interpersonal relnp’s as represented intraphysically
- freud used the term ‘object’ to mean a significant person or thing that’s the target of one’s feelings or drives (ie seeing a person as ‘good’ or ‘bad’)
- object relations are interpersonal reln’ps that shape one’s interactions w/ppl both in reality and fantasy
4 Stages of Development Important in first three years of life:
- autism/Fusion w/mother: normal infantile autism (3-4 weeks)
- Symbiosis: w/mother (3-8 months)
- Separation/Individual: starts at 4th or 5th month
- Constancy of self and object: by 36months
Progressing through the stages provides basis for secure development and trust that needs will be met
Attachment, borderline, and narcissistic disorders may occur w/abnormal progression through stages
Books
Margaret Mahler
- wrote ‘Psychological Birth of Human Infant
Heinz Kohut
Otto Kernberg
Authors associated with object relations theory?
Think Mho; we Mahl objects
Margaret Mahler
- wrote ‘Psychological Birth of Human Infant
Heinz Kohut
Otto Kernberg
Individual Psychology
- overview
- goals
- techniques
Alfred Adler, Rudolph Dreikurs
- belief in individual uniqueness
- influenced by social factors
- ea person has a sense of inferiority and strives for superiority
- we choose a lifestyle, a unified life plan, that gives meaning to our experience, which includes habits, family, career, attitudes
Counseling Goals
- Help client understand lifestyle and identify social and commty interests
- explain clients to themselves
- overcome inferiority
Techniques
- those leading to insight (ie, life stories, homework assignments, paradoxical intentions)
Transactional Analysis
- overview
- types of transactions
- goal of TA
- techniques
- books
Eric Berne
(BURNing yourself on the stove is a tx; when we complete a transaction we move on to the next; games are transactions)
- personality has 3 ego states that are hypothetical constructs: parent, child, adult that explain the function of the personality
- life script develops in childhood and influences one’s behavior.
- many transactions characterized as games to avoid intimacy (think “ea transaction writes a new part of one’s life script”)
Complementary transactions
- Adult: adult, leads to good communication
Crossed transactions
- adult: child or child: parent, leads to barriers to comms
Goal of TA: teach the client the language and ideas of TA to recognize ego state functioning and analyze one’s transactions
Techniques: teaching concepts, helping diagnose, interpretation, use of contracts and confrontation
Books
Games People Play (Berne)
I’m Okay, You’re Okay (Thomas Harris)
Existential Therapy
- Premise
- Concepts
- Goal
- Techniques
(Think “VIR –>VERY existential”)
Victor Frankl, Irvin Yalom, Rollo May
- based on phenomenology, which is the study of direct experience (~person centered)
Premise
- we search for meaning
- we have freedom of choice and are responsible for our fate
- we struggle with being alone, unconnected from others (we EXIST w/others)
Main Concepts
-anxiety: the threat of non-being
- guilt: occurs when we fail to fulfill our potential
Goal: to understand one’s being, one’s awareness of who one is and who one’s becoming (Very similar to Person-centered in this sense)
- awareness of freedom and choosing responsibility are other goals
Techniques
- authentic reln’p important
- client centered
Logotherapy
Type of existential therapy developed by Victor Frankl
3 principles:
- motivation to find meaning in life
- freedom to choose (what to do, think, react)
- w/freedom of choice comes personal responsibility
Book by Margaret Mahler
‘Psychological Birth of Human Infant
Cognitive and Behavioral Therapy
- pioneers
- basis of theory
- goals
- counselor role
- techniques
(think
Pioneers:
Aaron Beck
Albert Bandura
Donald Meichenbaum
Joseph Wolpe
Albert Ellis (REBT)
Arnold Lazarus (Multimodal)
Basis of theory:
- stimulus-response and stimulus-organisim-response paradigms are basis of theory
- behavior is learned and can be unlearned and relearned
Goals:
-identify antecedents of behavior and reinforcements maintaining that behavior
- goals are typically behaviorally stated
Counselor Role
- create learning conditions, direct intervention
Techniques
- operant and classical conditioning
- social modeling
- problem solving
- direct trng
- reinforcement and decision making
Dialectical Behavioral Therapy
- background
- principles
- skills
- techniques
Marsha Linehan
developed initially to treat borderline personality disorder
- now used widely to treat TBIs, eating disorders, mood disorders
- used w/adolescents (and families, if applicable) and adults
- A group component typically complements individual work
Basic Principles
- include typical cognitive behavioral principles
- helping clients increase cognitive and emotional regulation by learning their triggers
- dialectical principle of learning 2 sides of situations. Eg: need to accept change and recognizing resistance to change
- Long term intervention b/c it requires the learning, practicing, and acquiring of new skills
DBT Skills
- Mindfulness
- Distress Tolerance: accepting and tolerating oneself and the situation, despite the pain, without evaluation
- Interpersonal Effectiveness: strategies for asking for what one wants, saying no, dealing with personal conflict
- Emotion Regulation: identifying emotions and obstacles to changing them, decreasing vulnerability, increasing positive emotions
Techniques
- Diary Cards (tracking interfering emotions)
- Chain Analysis (analzying sequential events that lead to behavior)
- The dynamics of the milieu or culture of the client’s group
Rational Emotive Behavior Therapy
- basis
- major concepts
- techniques
Albert Ellis
- It’s not the events themselves but one’s interpretation of them
- Ppl have potential for rational thinking. In childhood, we learn irrational beliefs and then constantly re-indoctrinate them–>leads to inappropriate affect & behavior
- teaches that (-) self talk is the source of emotional disturbance
Major Concepts
- belief system
- self-talk
- ‘crooked thinking’
- ABCDE system
A: external event (activity/action)
B: belief (self-verbalization/self-talk)
C: consequence (may be rational or irrational)
D: dispute the irrational belief causing the affect/behavior
E: effect (cognitive)–a change in the self-talk
Techniques
- role playing
- imagery
Reality Therapy
- basis
- key concept
- characteristics
William Glasser (seeing reality through glass)
based on choice therapy but he referred to it Reality
therapist assumes a role of friend, as opposed to a detached clinician
- assumes we need quality reln’ps to be happy
- psych. problems are the result of 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 relnp’s.
- individuals choose their own fate and are in charge of their own lives (~existential)
- we act to control the world around us and the world helps us satisfy our needs. we may not satisfy our needs directly.
- perceptions control behavior and we behave to fill our needs
5 Genetically-based needs:
- survival
- love and belonging
- power or achievement
- freedom or independence
- fun
Key Concept: taking responsibility
Characteristics of choice therapy:
- choice & responsibility
- reject transference by being oneself
- keep therapy in present (past not critical)
- focus on how to meet needs, not on symptoms
- solution-focused approach; challenge traditional mental illness model
- assumes we need quality relationships to be happy
WDEP
- developed by Robert Wubbolding to help learn Reality Therapy
W= exploring the clients’ WANTS related to perceived needs
D= DISCUSS actions and feelings
E= self-EVALUATION by clients of their behavior
P= PLANNING to effect change (following E)
Multimodal Therapy
- premise
- techniques
Arnold Lazarus
- holistic, sometimes considered eclectic approach
- strong behavioral ties
- address 7 interactive modalities. Assessing all 7 determines total human functioning
7 Modalities represented through BASIC ID:
B=behaviors (acts, habits, reactions)
A=affect
S= sensations
I=images (how we see ourselves, memories, dreams)
C= cognitions ( insights, philosophies, ideas)
I= interpersonal reln’ps
D= drugs (represents biology, including nutrition)
Techniques
- uses various theoretical perspectives
- anxiety mgmt trng
- modeling
- (+) imagery
- relaxation trng
- assertiveness trng
- biofeedback
- hypnosis
- bibliotherapy
- thought stopping
Famous books on TA
Games People Play (Berne)
I’m Okay, You’re Okay (Thomas Harris)
Robert Wubbolding
developed WDEP to help therapists learn Reality Therapy
W= exploring the clients’ WANTS related to perceived needs
D= DISCUSS actions and feelings
E= self-EVALUATION by clients of their behavior
P= PLANNING to effect change (following E)
Feminist Theory
No single author
started from women’s mvmt in 60s
Basic Principles: (starts with the person, what are they committed to? how are they heard? what characterizes the reln when they are (heard)? What is the focus?)
- Person is political and critical consciousness
- roots of oppression are political and societal–>leads to marginalization, oppression, stereotyping - Commitment to social change
- therapy is for society, not just for individual - Value women’s voices, knowledge, and (oppressed) experience.
- central perspective is female (vs male) - Counseling reln’p is egalitarian
- client is expert; oppression recognized; therapy=collaborative - Focus on strengths, redefining psychological distress
- intraphysical factors only part of the pain experienced. Psychological distress=communication about unjust systems; Oppressive systems reframed as survival strategies
Techniques (GESP BARGS)
gender-role analysis
empowering techniques
self-nurturance
power analysis and intervention
bibiotherapy
assertiveness trng
reframing and relabeling
groups
social action
Relational Cultural Theory
- main person
- premise
- common issues
Judy Jordan
- believes we need to move from a human growth mode of separation to a relationship one
Premise of RCT: we grow in connection with others, not as individuals (through (separation/individuation)
Issues may include:
power, privilege, marginalization, accceptancce
Solution Focused Brief Therapy (SFBT)
Steve deShazer
focuses on what works and seeks to duplicate/add more of it
history or nature of the problem not necessary to find solution
Characteristics
- few sessions (6-8)–>may be seen as unethical or abandonment
- warrants setting specific goals early on
- not applicable for all clients
Techniques (“send an EMS to solve”)
Exception Question - “what were circumstances when the problem didn’t exist?”–>news of difference
Miracle Question - If miracle happened, how would you know/whaat would be different?
Scaling question - on scale of 1-10, rate client’s anxiety. Focus on the (+) changes and duplicate/increasing them
Narrative Therapy
post modern
strengths based
rooted in social constructionism
Premise
Independent objective reality exists through subjective experiences; client’s view is valid
- this reality based on language & words client uses–>leads to reality that is socially constructed
Clients lives are stories in progress
Techniques
- Questions and clarifications: by therapist to understand and deconstruct
- Externalization & deconstruction: the problem is the problem, not the person. externalizing the problem helps deconstruct it
- Re-authoring: helping clients find an appropriate alternative story
- Documenting evidence through writing of letters: shown to be a powerful adjunct, increases gains
Integrative Counseling
A highly individualized theory based on synthesis of theories and practices. NOT simply borrowing of a theory/practice.
This is a personalized theory based on values, worldview, education and experience
Highly congruent yet flexible
Behavior Therapy
Basic Philosophy and Key Concepts
Philosophy
- behavior is the result of learning
- we are both the product and producer of the environment
Concepts
- focus is on overt behavior
- precision in specifying treatment goals, development of specific treatment plans, objectively evaluating outcomes (METRICS!)
- based on learning theory principles
- Normal behavior is learned through reinforcement and imitation, abnormal behavior is result of faulty learning
Neurobiology & Psychotherapy
CACREP requires an understanding of the neurological behavior to underpin theories of learning and personality development.
CACREP defines neurological behavior as: the reln’p among the brain anatomy, functioning, and biochemistry, as well as learning and behavior
Premise of neurobiology & psychotherapy
- brain grows genetically but also by interacting with the environment, which means psychotherapy affords oppty to help w/brain restructuring
Triune Model of the Brain
- brain has 3 principal locations and functions:
1) Surviving brain - the stem; fight or flight
2) Feeling brain - limbic system, emotion; mediates feelings and behaviors; stores some memory
3) Thinking brain - cortex; executive functions, meaning making, self-awareness
CBT promotes neural networking, as does EMDR
Biofeedback: helpful for sleep disorders, anxiety attacks, phobias, migraines; attempts to rewire neural networks
CACREP’S defn of neurological behavior
the reln’p among the brain anatomy, functioning, and biochemistry, as well as learning and behavior
Biofeedback
helpful for sleep disorders, anxiety attacks, phobias, migraines
attempts to rewire neural networks
CACREP is acronym for what?
Council for Accreditation of Counseling and Related Education Programs
Mindfulness
2 major aspects of mindfulness for counseling:
1) focus on current experience (ie environment, thoughts, sensations, emotions)
2) nonjudgmental acceptance of experience–internal and external
Mindfulness-Based CBT
- helps client in stopping self-perpetuating mental habits of ruminating on negative thoughts
- purpose isnt to change thoughts but change the reln’p to them by reframing
May not work with schizophrenia, bipolar, or PTSD clients
Therapists may find minfulness useful no matter what theory they use
Counseling skill of: congruence
aka genuineness
counselor is authentic and integrated in the session
can also mean an agreement bw the client’s behavior and values/beliefs
Counseling skill of: Unconditional positive regard
Acceptance; counselor is caring and non-evaluative/judgmental
Counseling skill of: Concreteness
extent to which client and counselor deal with issues in specific vs vague generalities
Counseling skill of: Restatement
repeating what the client said w/emphasis on the cognitive message
Counseling skill of: Reflection
repeating what the client said w/emphasis on affective portion of message
treatment plan outlines _______, which are based on several factors, including __________
treatment plan outlines counseling interventions, and interventions are based on several factors, including the diagnosis
Client characteristics influence the treatment plan (culture, demographics like age, personality)
Counselor’s therapeutic orientation influences the intervention(s) chosen. For instance, a psychodynamic approach is different than a cogntive behavioral approach)l4
Main reason why people come to counseling?
Self disclosure
Carl Jung
founded analytic psychology
introduced concepts of intro- and extraversion
MBTI based on his work
believd in the collective unconscious, which is
- determinedd by the evolutionary development of the human species (most intense emotional responses that we experience)
- operated by archetypes
archetypes= universal response pattern in human experience, characterized by emotional charge to identity, meaning, purpose.
Ex of archetypes: anima (female) and animus
Goals of therapy
- transformation of self by gaining knowledge of self, recognition, and integration of self
Robert Carkhuff
developed a 5 pt scale to measure for empathy, genuiness, concreteness, and respect in counselor; L1=low, L5=high
Counselor responses are either additive, interchangeable, or subtractive
Eg (p. 114 of Helwig)
Structuring
refers to defining the nature, limits, and goals of counseling process, may include roles too.
Dual diagnosis intervention
counselors should integrate their practice w/other specialists (ie medical)
substance use co-occurs in ____ of ppl seeking mental health services
half
Alfred Adler
father of individual psychology
2 Main concepts
- birth order
- family constellation
Techniques
- counselor is egalitarian w/client–(cooperative effort)
- views neuroses as failures in learning–>leads to distorted perceptions
- focus is on client responsibility in counseling
- examines family constellation, dreams, early memories
Birth Order Implications:
- children in same family have different psychological environments b/c of birth order
*childhood experience influences adult interactions and family dynamics
implication of first born, per Adler
gets much attn
dependable
goal and achievement oriented
hard working
fears losing love when another child (intruder) enters
implication of 2nd born, per Adler
shares attn
competes w/1st born
succeeds where first born doesn’t
implication of middle born, per Adler
feels left out
may see life as unfair and develop a “poor me” attitude
may develop problems
implication of youngest child, per Adler
baby in family, pampered, special role to play; influenced by others but tends to go own way; dvlops in directions nobody anticipated
implication of only child, per Adler
doesn’t learn to share/cooperate
deals well w/adults
wants center stage as adult and has problems when they don’t get it
Gordon Allport
individuals and their personalities exist w/in a system (ie cultural, situational context)
Kurt Lewin
Field theorist
- believed behavior is a function of life space, which is a function of the person and the environment
- challenged the linear, mechanistic view of behavior
Aaron Beck
developed cognitive therapy, in which client experiences a cognitive shift
-identified automatic thoughts (~preconscious)
- there is an internal communication system, and in depressed ppl it’s negatively focused
- cause of depression is any combo of factors (eg., biological, genetic, personality, stress)
- there is greater stability of results and fewer relapses with CT than anti-depressants
Joseph Wolpe
theory of reciprocal inhibition
- states that anxiety and relaxation cannot coexist
Systematic desensitization (based on reciprocal inhibition theory) is a behavioral intervention of counterconditioning.
- goal is to reduce anxiety by associating (-) stimuli w/positive events. (Eg., negative images paired with muscle relaxation)
Donald Meichenbaum
- spoke of cognitive behavior modification, which is a shift from self-defeating thoughts to coping ones
- introduced concept of stress inoculation, which is practicing positive or reinforcing self-statements
Other Behavioral Techniques
token economy
paradoxical intention
implosive therapy (imagination)
thought stopping
token economy
using tokens to reinforce behavior; shaping of behavior through tokens
privileges and goods can be purchased through tokens
paradoxical intention
clients urged to “intend” that which they fear or want to change
implosive therapy
induce anxiety via images/imagination or cues (called ‘flooding’). The anxiety is then expected to diminish (extinguish) w/repeat exposure and in the absence of any threat
thought stopping
behavioral technique to consciously stop recurring thoughts
Johari Window
Jon Luft & Harry Ingham
is a psychological tool to help individual better understand relationship w/oneself and others
- Top (horizontal, left to right(: known to self/not known to self
- Left (vertical, top to bottom): known to others/not known to others
top left quadrant: known to self/known to others
top right: not known to self/known to others
bottom left: known to self/not known to others
bottom right: not known to self/not known to others
Premise
- client brings material (stuff) into session, some of which is known and other info that isn’t.
Principles of Change Identified During Session:
goal of counseling is to minimize the lower right and maximize upper left
smaller the upper left quadrant–> worse the comms
there’s universal curiosity about the lower right (unknown) but customs, socialization and fears suppress it
change in one quadrant affects them all
requires energy to hide, deny, or be blind to behavior
threat increases awareness, mutual trust increases awareness
In Groups
- helps explain group dynamics
- lower right quadrant decreases in productive groups as awareness and feedback increase
Definition of consultation
a voluntary, problem-solving process, initiated by consultant or consultee, to help consultees devp attitudes or skills to increase functioning.
Consulting is similar to counseling except for what?
context, role, function
Consultation is preventative in nature, T/F?
True
2 types of consultation
Content - knowledge transfer bw parties
Process - examines the process
Names behind some of the consultation models
Bergan, Bandura, Schein, Caplan, Splete
Bergan model of consultation
- behavioral model emphasizing verbal interaction
4 stages:
- problem identification
- problem analysis
- plan implementation
- problem evaluation
(So, identify it, plan it, implement the plan, evaluate it)
Part of the focus is on problem behaviors and the antecedents and consequences (it IS a behavioral model))
Bandura model of consultation
social learning model
- there’s a dynamic interplay of behaviors, cognitions, and environment. these are assessed in problem identification
- soln’s revolve around modeling, rehearsing, changing cognitions
Schein model of consultation
Purchase model - buying consultant’s knowledge/service (“I buy”)
Doctor-Patient Model - stresses diagnosis and problem identification (“you tell me”)
Process Model - involves both parties in the diagnosis and interventions (“we do”)
Caplan model of consultation
mental health consulting model
- occurs bw two professionals and can be centered on the client, consultee and client, program, consultee and administration
Caplan’s model of consultation in counseling is a mental health consultation model. In Caplan’s model, two professionals discuss issues specific to mental health diagnoses, such as eating disorders, and treatment. The center of discussion can be an individual client or family, the consultee and the client, treatment or a specific program, or the consultee and administration.
Splete model of consultation
9 stage process of consultation:
pre-contract
contract and exploration of rel’p
contracting
problem identification
problem analysis
feedback and planning
implementation of plan
evaluation
conclusion and termination of rel’p
Animal assisted therapy
used to better understand oneself and generalize to others
Who
- physically/mentally challenged
- trauma victims
- socially shy
Adventure-based therapy
- outdoor and experiential (ie camping, hiking, challenge courses for individuals/groups)
- developed based on paricipant makeup
Wilderness Therapy
- more clinically oriented
- identify and address behavioral, emotional, and psychological problems in adults and trouble adolescents by placing them in unfamiliar environment
What are some potential issues in distance counseling?
security
record maintenance
emergency contact info
imposters (both counselor and client)
trust bldg
signs of compassion fatigue
losing empathy and interest in the client
One cause of secondary traumatic stress
exposure to graphic material presented by clients
Neurolinguistic programming
Who and what?
- Richard Bandler and John Grinder (“band around the head, grinding into the mouth”)
- a communication theory using the 5 sensory channels
- can be used to build and maintain rapport and pace the client’s verbal cues
- examines the structure of language and how it’s used to represent reality
EMDR
Eye Movement Desensitization Reprocessing
- used to help elicit painful memories and experiences and reprocess them, similar to REM sleep
Alcohol and Substance Abuse Counseling
> 19M americans suffer from substance abuse, with ~14M of those from alcohol
~50% of americans exposed to alcohol dependency in family/extended family
Substance abuse considered #1 problem in US by many
> 30 states legalized marijuana
Teenage drinking often leads to…
early sex
date rape
car accidents
suicide
Kinesics
refers to nonlinguistic communication through body movement (ie gestures, facial expressions)
Proxemics
spatial features of the environment (ie positioning of furniture, seating arrangement)
- how we arrange space impacts our behavior
TA’s 3 ego states roughly correspond to Freud’s what?
id, ego, superego, or the hypothetical constructs that explain the function of personality
Eros vs Thanatos
Eros: the Greek god of the love of life. To the Freudians this means self-preservation.
Thanatos is the Greek word for death.
Per Freud, dreams consist of two parts. what are they?
Manifest content which is the surface meaning
Latent content, which is the hidden meaning
Psychoanalytic vs Psychodynamic styles of therapy
Psychoanalytic
- lengthy, more frequent sessions, couch (so NOT F2F)
Psychodynamic
- uses analytic principles but in fewer sessions, no couch and F2F
Topographical theory
Is Freud’s first “map” of the different systems of the mind. According to Freud, the mental apparatus can be broadly understood in terms of three mental systems: the unconscious (Ucs.), preconscious (Pcs.), and conscious (Cs.)
Most controversial aspect in Freud’s theory is_____?
The most important concept is ____?
the Oedipus complex = controversial
unconscious mind= most important
sour grapes rationalization
“I didn’t really want it anyway”
sweet lemon rationalization
trying to convince themselves that something undesirable is actually something they want or planned. Someone who’s recently been fired, for example, might insist that they’re excited to look for something new
Logos means what?
Logic
Eros refers to what?
intuition
Mandalas
Jung used drawings around a center point to analyze himself, his clients, and dreams and called them mandalas.
Rudolph Dreikurs
student of Alfred Adler
- was the first to discuss the use of group therapy in private practice.
difference bw linear and circular causality in family therapy
linear: CONTENT explains what is occurring (ie stimulus–>rsponse)
Circular: PROCESS explains what is occurring (forces moving in multiple directions and their influences and results cause an array of outcomes)
which tends to be shorter in duration, IC of FC?
family counseling
Family Life Cycles
Leaving home
joining families via marriage
families w/young children
families w/adolescents
Launching children and moving on at midlife
Families in late middle age
Families near end of life
Alternative families
- prevalence
-types
of alternative families in US is growing; may be greatest among Eurocentric backgrounds
Types of alternative families:
single parent
remarried
gay/lesbian
Adler emphasized that people wish to belong. This is known as_______
social connectedness
Why do paradoxical strategies often seem to defy logic?
Bc the client is instructed to intensify or purposely engage in the maladaptive behavior.
Who founded general systems theory?
Ludwig von Bertalanffy
circular causality
Names in Psychodynamic Theory of Family Counseling
Nathan Ackermann
James Framo
Nathan Ackermann
Psychodynamic Theory of Family Counseling
- main proponent
- says that a couple brings psychological heritage and resemblances from their original families
- they bring introjects (imprints, memories) from parents and others
- family unit seeks homeostasis and an individual member’s symptomatic or pathologicl behavior disturbs homeostasis
- believed in interactive style of therapy (ie living w/family, stirring things up, being catalyst for change)
James Framo
Think: frames of reference—> social=reln’al context; O in framo=object relations
Psychodynamic Theory of Family Counseling
- believed the social behavior of a person’s life shapes their behavior. So, conflict from one’s family of origin is acted out in one’s current reln’ps
- believed ppl in childhood are object seeking (ie hoping to establish satisfying reln’ps. So if the child is rejected, then this frustration is returned as an introject later in life)
- Would begin therapy w/entire family, then conjoint (couples), then couples group therapy, then w/family of origin (intergenerational)
Carl Whitaker
Experiential family counseling
-relied less on theory, more on experience
- would actively join the family and use his awareness/experience in therapy to advocate for change
- challenged old thinking and behavior
- used symbolism to explain experiences, and these symbols were often outside one’s consciousness or awareness
Experiential family counseling
Carl Whitaker
-relied less on theory, more on experience
- would actively join the family and use his awareness/experience in therapy to advocate for change
- challenged old thinking and behavior
- used symbolism to explain experiences, and these symbols were often outside one’s consciousness or awareness
Humanistic Family Counseling
Virginia Satir
- humans and families have the resources within them to flourish (self-concept very important)
- discrepancies (ie poor communication) w/in family blocked members from healthy functioning. So Satir became the teacher/trainer
Believed that under stress, ppl adopted 1 of 5 communiction styles:
1) placater
2) blamer
3) super-reasonable
4) irrelevant
5) congruent communicator (healthy style)
Her style was considered a process orientation, and thus experiential
- believed in interacting closely w/family and a need for intimacy in family reln’ps
Virginia Satir
Humanistic
- humans and families have the resources within them to flourish (self-concept very important)
- discrepancies (ie poor communication) w/in family blocked members from healthy functioning. So Satir became the teacher/trainer
Believed that under stress, ppl adopted 1 of 5 communiction styles:
1) placater
2) blamer
3) super-reasonable
4) irrelevant
5) congruent communicator (healthy style)
Her style was considered a process orientation, and thus experiential
- believed in interacting closely w/family and a need for intimacy in family reln’ps
Family Systems Theory
Murray Bowen
- family as an emotional unit in the formation of dysfunctional behavior
- believed >1 generation of family is central to therapy (3 generations for genogram). Thus his approach labeled transgenerational
8 Bowenian Concepts: (dtn fem ss)
Differentiation of self
Triangles
Nuclear family emotional system
Family projection process
Emotional cutoff
Multigenerational Transmission Process
Sibling Position
Societal Regression
Differentiation of self
Bowenian Concept
- degree to which individual distinguishes bw thinking and feeling
- goal is to maximize ea person’s differentiation
- if there’s fusion of thinking and feeling–>involuntary emotional reactions and dysfunction
What does “IP” refer to in Bowenian theory?
the identified patient (ie parents)
What was the style difference bw Bowen and experientialists and humanists?
- Bowen’s style was more neutral and detriangulated unlike experiential and humanistic
Bowenian concept of: Triangles
Basic bldg block of a family’s emotional system
Ppl have a need for closeness and individuation. To the extent 2 ppl are fused (ie parents) they may bring in a 3rd (ie child) to resolve the 2-person stress
- process in which ea parent demands that a child ally with hm/her against the other parent during a marital conflict
Greater the fusion, greater the triangulating
Bowenian concept of: Nuclear Family Emotional System
partners choose mates w/equal differentiation. Thus 2 undifferentiated ppl become highly fused and the nuclear family emotional system becomes unstable.
Bowenian concept of: Family Projection Process
the fused, unstable marital partners will focus on one of the children
Bowenian concept of: Emotional Cutoff
children involved in the family projection process will try to escape the fusion by isolating themselves physically (ie moving away) or psychologically
this is only a deception
Bowenian concept of: Multigenerational Transmission Process
Poorly differentiated child of similar parents will choose a similar poorly differentiated partner to marry
“Weak links marry weaker links”
Bowenian concept of: Sibing Position
individuals of same or different birth order will complement/compete with ea other
Bowenian concept of: Societal Regression
society is regressing b/c it doesn’t differentiate bw emotional and intellectual decision making
the word ‘eclectic’ is most closely associated with who?
Frederick C. Thorne
Skinner’s operant conditioning is also referred to as what type of learning?
Instrumental learning
(“i” in Skinner, “i” in instrumental learning)
Respondent behavior refers to ____
Pavlov’s reflexive
respondent is ACCREDITED to Skinner but APPLIES to the theoretical notions of Pavlov’s
The most effective time interval (temporal relation) between the CS and the US
.5 second
As the interval exceeds 0.5 seconds, more trials are needed for effective conditioning. How will you remember that the CS comes before the US? Just remember that “c” (as in CS) comes before “u” (as in UCS) in the alphabet. Nice! Or better still, common sense would dictate that the reinforcer (the meat/US) would come after the bell (the CS) to reinforce it.
When the CS is delayed until the US occurs, the procedure is known as “delay conditioning.”
If, however, the CS terminates before the occurrence of the US, it is termed “trace conditioning.”
Here’s a slick and easy-to-use memory device. Trace begins with “t” and so does termination. In trace conditioning, the CS will terminate prior to the onset of the US (or UCS as it will be abbreviated on some exams
John B. Watson’s name is associated with_____
Little Albert
The significance of the Little Albert case was that it demonstrated that fears were “learned” and not the result of some unconscious psychopathology.
behavior modification is associated with who?
skinner
higher-order conditioning
When a new stimulus is associated or “paired” with the CS and the new stimulus takes on the power of the CS
What do EMG vs EEG vs EKG measure?
EMG =Muscle tension ( M=muscle)
EEG= cognitivE/brain waves
EKG=heart
Discuss efficacy regarding schedules of reinforcement
Variable schedules are more effective than fixed schedules. Ratio schedules are more effective than interval schedules.
(Most effective) VR, VI, FR, FI (Least effective)
Structural Family Therapy
Salvadore Minuchin
Goal of therapy: to challenge the family’s transactional patterns hoping to change structure
- Believed the family is composed of organization/structure determined by social rules, which are the transactions bw members. Rules can be generalized (everybody) or idiosyncratic (individual)
- Subsystems exist (eg., parental, spousal, sibling) which carry out family functions
- These subsystems have boundaries and rules for membership.
- These boundaries can either be rigid, which leads to disengagement, or diffuse/permeable, which leads to enmeshment.
- Used a structural map to show boundaries, alliances, conflicts…
- Structural family therapy is directive and enacted in the here and now. It explicitly diagnoses and addresses maladaptive family systems through direct participatory observation and changes in the present.
Other concepts:
Alliances
coalitions
power
Minuchin would actively participate in therapy and challenge the family using mimesis (mimicking), enactments, and then reframe into (+)
Goal of Structural Family Therapy
to challenge the family’s transactional patterns hoping to change structure
Strategic Family Therapy
Jay Haley & Cloe Madanes
(think ‘strategic communication’)
- power and control characterize family reln’ps; symptoms are attempts at controlling a reln’p
- aims to rapidly change problematic behavior via targeted interventions (ie reframing, paradox, observation)
- paradoxical interventions used (Therapeutic double bind, Prescribing the symptom).
- direct. Therapy tends to be short.
Mental Health Insitute (MRI) focused on family communication patterns
Therapeutic Double Bind
Strategic family therapy technique
- paradoxical technique where client is asked to continue undesirable behavior even when expected to stop it–>caught in a BIND and must either give it up or acknowledge control over it
Prescribing the symptom
Strategic family therapy technique
- paradox here is to refuse to continue the behavior or acknowledge control over it
Milan Systemic Family Therapy
Mara Solvini-Palazzoli (Italy)
- family seen as a system and the intent is to keep the system balanced
- family seen as playing a ‘game’ to maintain the system. The therapist uses these games to invoke change in behavior and attitudes
- Systemic family therapists bring hypotheses to be checked out; sometimes a team of therapists observe
Used:
Circular questioning: asking members same Qs about reln’ps to reveal family connections and the meaning they ea ascribe
Rituals used therapeutically to change beliefs/attitudes
Family Behavioral/Cognitive Approaches
- leading figures and types of therapy
Robert Liberman
- operant conditioning & social learning principles
Richard Stuart
- operant interpersonal therapy, which is a social exchange model–>argues for the influence of ongoing behavioral exchanges on their long-term outcomes in reln’ps.
- skills trng
- behavior contracting
Behavior Parent- Skills Trng
- focuses on child mgmnt (ie time out, contingency contracts)
Functional Family Therapy
- views all behavior as adaptive; serving a function
- therapy helps ppl learn new skills via education
Conjoint Sex Therapy
- Masters and Johnson
- assumes any sexual inadequacy exists in a system the 2 partners present
Behavior Parent-Skills Trng
a type of family behavior/cognitive therapy
- focuses on child mgmnt (ie time out, contingency contracts)
Richard Stuart
behavioral/cognitive family therapy
- operant interpersonal therapy, which is a social exchange model–>argues for the influence of ongoing behavioral exchanges on their long-term outcomes in reln’ps.
- skills trng
- behavior contracting
Robert Liberman
behavioral/cognitive family therapy
- operant conditioning & social learning principles
Functional Family Therapy
Behavior/cognitive Family Therapy
- views all behavior as adaptive; serving a function
- therapy helps ppl learn new skills via education
Conjoint Sex Therapy
Behavior/cognitive Family Therapy
- Masters and Johnson
- assumes any sexual inadequacy exists in a system the 2 partners present
Social Constructionist (Family)
post modern
SC’s don’t believe ppl share a common reality. Instead, we use language to share our experiences and perceptions, and use language to communicate w/others and CONSTRUCT a common reality
Believes clients know what they need to do to solve a problem, they just need help constructing a way to use that knowledge
May use SFBT to ‘construct’ a sol’n (giving the client a “skeleton key” to unlock doors in their life)
Therapist should get agreement on the “reality” of what words mean
William O’Hanlon
developed a solution-oriented therapy based on Steve deShazer’s SFBT where language used by clients and therapists is important because meanings and perceptions are embedded within.
- possibility for change already exists within the client
Narrative Family therapy
postmodern approach
uses narratives (vice words), which are stories family members bring to therapy. They may be negative and limiting perceptions of themselves and their lives.
“Deconstruction” in narrative family therapy
the process of examining a narrative, determining underlying assumptions, and finding other potential meanings attached to the story.
This gives the family an oppty to re-author the story, which thus empower them
Psychoeducation in family therapy
may be a technique or an adjunct to family therapy.
goal is to assist the family in daily functioning
Primary theme of psychodynamic family counseling
unresolved conflicts from the past continue to attach themselves to current objects and situations
Feminist Issues and Gender-Sensitive Family Therapy recognizes….
the social, cultural, political influences on men and women
Virginia Axeline
(think: Axel foley is playful)
wrote “Play Therapy” and “Dibs: In search of self”
believed the leader or therapist attends, recognizes feelings, helps the child express them, and helps child implement new behaviors
Cybernetic
the study of methods of feedback control w/in a system; the flow of info through feedback loops
family sculpting
Psychodrama technique where there’s a physical arrangement of members of a family in space as determined by a single member as “director”
Joseph Wolpe’s systematic desensitization used the acronym SUDS. what does it stand for?
subjective units of disturbance scale
Yerkes-Dodson law
a moderate amount of arousal (anxiety) improves performance (high arousal is more appropriate for simple tasks, such as an exam) but only to a certain point.
arousal and performance is often represented as an inverted U-shaped curve
what is sensate focus?
type of behavioral sex therapy developed by Masters & Johnson that relies on counterconditioning
what word is associated with covert sensitization?
Imagination
sympathy often implies what?
pity
Existentialists speak of three worlds. what are they?
Umwelt=physical (welts leave physical marks)
Mitwelt=relationship (think “my”=relationship)
Eigenwelt=identity (Ei=identity)
Maxie Maultsby Jr
father of relational behavioral therapy (RBT)
The Parent ego state resembles Freud’s____ and is composed of what two values?
Freud’s superego;
nurturing parent and critical parent
The Adult ego state resembles Freud’s____
Adult=Freud’s ego (rational, logical, does not focus on feelings)
Structural Analysis refers to what?
How a TA therapist would describe a client using P-A-C conceptualization
Morphogenesis
Describes the ability of the family to change
Mindfulness may not work with…
schizophrenia, bipolar, or PTSD clients
Distress Tolerance of DBT
accepting and tolerating oneself and the situation, despite the pain, without evaluation
Describe the differences bw FR, FI, VR, and VI conditioning
A fixed ratio schedule reinforces a certain response after a fixed number of responses.
A fixed interval schedule reinforces the responses after a certain period of time,
A variable ratio reinforces after an average number of responses.
A variable interval reinforces after an average number of minutes
Stages of Systematic desensitization
Systematic desensitization deals with a person’s systematically reduced anxiety when exposed to a certain stimulus. It is generally seen as proceeding through 4 stages:
- Relaxation training to gain control of one’s responses
- Construction of anxiety hierarchy to gain intellectual knowledge of one’s fear
- Imaginative desensitization to explore one’s fear in safe circumstances
- In vivo sensitization to gain control over the feared stimulus
The progression is necessarily stepwise and iterative.
Under what circumstances is physician assisted suicide permitted?
Physician-assisted suicide is an ethical issue about which many health care workers disagree. As of 2015, five states (Oregon, Washington, Montana, New Mexico, and Vermont) allow physician-assisted suicide,
provided the individual has a terminal illness.
In these states (only in one county in New Mexico), physicians are legally permitted to prescribe medications to cause death.
According to research, how much therapeutic benefit is a function of the therapeutic relationship?
30%
negative vs positive feedback loops in family therapy?
Negative feedback loops preserve homeostasis and prevent change
Positive feedback loops are patterns of interaction that promote positive change
In family therapy, what are feedback loops?
In family therapy, feedback loops are the result of interlocking family systems, which are dedicated to preventing change and preserving homeostasis, even if this homeostasis enables dysfunction.
The goal of family systems therapy is to break negative feedback loops and create positive ones.
Purpose of genogram
To assess family dynamics and understand the relnp bw members
To illustrate and understand the structure of a family’s systems, which may not otherwise be apparent.
Genograms do not address genetic patterns nor are they meant to deal with communication.
Who did Super borrow his theory from?
Ginsburg
Who did Ann Roe base her theory on?
Maslow’s
Behavior therapy is associated with who?
Pavlov
Therapy=passive (Pavlov)
Modification =active (skinner)
Konrad Lorenz
- best known for his work in imprinting, an instinctual behavior in goslings and other animals in which the infant instinctively follows the first moving object it encounters, which is usually the mother
- said aggression is part of our evolution and necessary for survival, and catharsis–a means to get anger out–is the only solution.
what is imprinting and when does it occur?
Imprinting—rapid learning during a critical period of development—is an instinct in which a newborn will follow a moving object.
what is ethology and who is it associated with?
concerns field research using animals. ass’td w/konrad lorenz
According to Robert Carkhuff’s scale, what is considered the minimum level of empathic acceptance?
3
Roe spoke of 3 different parenting styles. What are they?
overprotective, avoidant, acceptant
what is Accurate empathy ?
refers to the ability of the counselor to experience the client’s point of view in terms of their actual experience in feeling and cognition. The stress is on the client’s point of view rather than the counselor’s.
Differences bw low and high-context communication, who postulated it, and where they likely occur.
postulated by Edward Hall.
In low-context communication, a direct, explicit message is expected. This way of communication, broadly speaking, is more common in the U.S., the U.K., and Canada.
In high-context communication, much of the message is implicit and depends on context, relies on nonverbal over verbal, and respects tradition. This is the communicative style more common in the Middle East, Italy, Spain, and many Asian countries.
where are psychotherapy notes to be stored?
Psychotherapy notes are considered part of the client’s record overall, but are to be stored separately with another level of security.
In advocating for clients, it’s important to remember that psychotherapy notes are not always considered part of the overall record for third-party purposes.
denial, as it pertains to grief, tends to be consciously or unconsciously chosen?
consciously
How does PDD differ from other depressive disorders?
persistent depressive disorder is less severe in intensity
Persistent depressive disorder (PDD) is a chronic depression of relatively low intensity that persists for two years or more for more days than not. It tends to be of lower intensity than other depressive disorders.
Is a counselor more or less effective when they are of the same gender and ethnicity as their client?
Research does not show a correlation in this regard
Though the research is not robust, there is no substantial evidence to suggest that counselors are more or less effective with those with whom they share ethnic or gender similarity.
Which of the following contexts is necessary for a biopsychosocial interview?
historical
cultural
treatment
agency
cultural
A biopsychosocial interview will contain many elements of assessment, aimed at establishing as full a picture as possible of the client’s situation. A biopsychosocial interview must contain the cultural context in which the client exists as a guide to culturally-informed treatment.
What is Shaping?
Shaping refers to the technique of reinforcing small behaviors that approximate the larger and more desirable behavior sets that are the eventual goal.
According to Sigmund Freud, what is the essence of dreaming?
Sigmund Freud’s belief about dreams was that they were the unconscious mind’s way of playing out either negative or positive wish fulfillment about events that took place during the day that the dream occurred.
What does ‘competence’ in counseling generally refer to?
being able to help a client
what is the purpose of a ‘safety contract?’
To prevent suicide by agreeing on a contact strategy
A “safety contract,” though it may go by other names, is a document or agreement that stipulates that a person who may be at risk for impulsive suicide will contact someone who can help them rather than go through with ending their life.
what is the main problem with dual reln’ps?
They can interfere with the helping process for a client
- Dual relationships, which in some cases cannot be avoided, are mainly a problem due to the fact that care for the client can be compromised. Objectivity can suffer if the therapeutic relationship is not the only relationship at work.
- These relationships are not always morally wrong, do not always invite legal consequences, and are not always in violation of codes of ethics or conduct.
What is the role of Rogerian factors in influencing client’s outcome–do they support or not?
Research does not support the idea that Rogerian factors support positive therapeutic outcomes
Though of definite help in establishing rapport and eliciting information from clients, the research does not support the idea that Rogerian factors support positive therapeutic outcomes per se. Therapeutic outcomes seem to be more related to what the client does, rather than what the therapist does.
Are treatment plans considered part of psychotherapy notes?
No, under no circumstances
Psychotherapy notes belong to a special class of clinical documentation. These notes are considered separate documentation in their own right, and treatment planning would not be included.
Crisis intervention is mainly concerned with what type of people?
Those who are experiencing a normal reaction to stress
Crisis intervention is mainly directed at helping those individuals who are experiencing the overwhelming stress that is definition to a state of crisis. Pathology per se is not addressed as part of crisis intervention; abnormal behavior or symptoms will require another modality to address effectively.
who is bullied more, girls or boys?
girls
what is basic empathy and who coined it?
Allen E. Ivey suggests that basic empathy is that style of empathy that neither adds nor subtracts from a client’s awareness and understanding. It demonstrates a basic level of understanding and feeling the client experiences.
When would advice-giving be most appropriate as an intervention?
When clients are in crisis
Advice-giving is controversial in counseling, with some saying it is never appropriate and others saying it has its uses. There seems to be a better use for advice-giving when clients are in crisis and there is limited time for the real exploration of feelings. In circumstances where insight therapy relying on exploration of one’s emotions is important, advice-giving would be less recommended.
Should group members change roles in a healthy group?
Yes, in a healthy therapeutic group, roles often change
In counseling groups, roles can often change. In fact, when group members can change roles—for instance, roleplaying various parts in a group member’s situational or therapeutic issue—this often leads to better therapeutic outcomes.
In general, roles are not fixed in healthy therapeutic groups.
What is a common liability of groups?
lack of therapeutic goals
In many groups, particularly those considered “unstructured,” one common potential liability is the lack of concrete, appropriate therapeutic goals for the group members. A therapeutic group should have goals, though there is flexibility in exactly how these are formulated and applied.
What is Premack’s principle?
David Premack
- behaviorist
- suggested that family members, must complete an unpleasant task (low probability behavior, or LPB) before completing a pleasant one (high probability behavior, HPB)
ex: completing your homework before going out with friends
what does the psychodynamic term splitting refer to?
refers to when the client sees an object (ie another person) as all good or all bad
what is restraining in strategic family therapy?
a therapist may warn the client about the negative consequences of change. They may tell the client to “take it slow” or “expect a relapse.”
It helps overcome resistance by suggesting that the family does not change
