Counseling Theories, Methods, & Techniques

Question 1

Core dimensions for counselors (Carkhuff, Truax, and Mitchell)

(Page 254).

Answer 1

• authenticity/genuineness
• positive regard/acceptance
• accurate empathic understanding

(Page 254).

Question 2

Global Scale for Rating Helper Responses
by George Gazda

(Page 254).

Answer 2

• A Level One Response giving no help to the client at all
• A Level Two Response being strictly superficial
• A Level Three Response facilitating growth but only minimally since the counselor’s responses are at least not distorted though only surface
• A Level Four (Gazda’s highest level) Response which entails the counselor’s going beyond reflection to underlying feelings and meanings

(Page 254).

Question 3

Communicating empathy requires

Answer 3

• Intensely concentrating on the client’s verbal and non-verbal communication.
• Responding as an interchange with the client.
• Responding with language attuned to the client.
• Responding with a tone similar to that of the client.
• Responding readily and actively.
• Moving tentatively toward expanding the client’s understanding to higher levels.
• Concentrating on what the client is not saying.
• Judging the effectiveness of the responses by the client’s behavior.

(Page 255).

Question 4

Communicating respect requires

Answer 4

• Suspending all critical judgments of the client.
• Speaking with warm and modulated tones, even if minimally so.
• Focusing on understanding the client.
• Providing the client adequate opportunities to self-disclose knowledge that would engender further positive regard from the counselor.
• Communicating spontaneously and genuinely.

(Page 255).

Question 5

Communicating concreteness requires

Answer 5

• Making concrete reflections and interpretations.
• Assigning value to the client’s communications.
• Determining the necessity and appropriateness of a client’s making concrete or nonconcrete observations.

(Page 255).

Question 6

Communicating genuineness and self-disclosure requires

Answer 6

• Minimizing the effects of the counselor’s profession, role, etc.
• Responding authentically.
• Welcoming encouraging authentic responses from the client.
• Purposefully increasing the openness and freedom within the helping relationship.
• Fully sharing experiences with the client.
• Progressively delving into difficult areas of the counselor’s own experience.
• Using the counselor’s own experience as the best guideline.

(Page 256).

Question 7

Effective confrontation requires

Answer 7

• Concentrating on the client’s verbal and non-verbal expression.
• Questioning discrepant communication.
• Questioning discrepant behavior.

(Page 256).

Question 8

Communicating immediacy requires

Answer 8

• Concentrating on the immediate experience with the client.
• Sometimes disregarding the content of the client’s communication in an attempt to discern what the client is really trying to say.
• Turning seemingly directionless moments to the question of immediacy.
• Purposefully applying the question of immediacy on a periodic basis.

(Page 256).

Question 9

Ivey and Authier’s Microcounseling Skills

(Page 257).

Answer 9

Ivey and Authier’s microcounseling skills include the following (Axelson, 1999):

1. Fundamental attending and self-expression skills (both verbal and nonverbal)
2. Qualitative dimensions that provide the foundation for attending – Concreteness, immediacy, respect, confrontation, genuineness, and positive regard
3. Microtraining skills that help lead the client
4. Attending skills – closed and open questions, paraphrasing, summarizing, reflection, encouragement, etc.
5. Influencing skills – interpretation, directives, expressing content, influencing summary, etc.
6. Focus dimensions that pinpoint the target content – Others, the client, a topic, the counselor, direct mutual communication, cultural or environmental context

(Page 257).

Question 10

Good Counselor Responses

Answer 10

1. Attending – paying attention, eye contact, sitting forward, etc.
2. Reflection – restating the emotional component of the client’s communication. Common reflection errors include:
   
   • Reading more or less into the client’s communication than is there.
   • Using inappropriate language for the client (wrong cultural reference or education level
   • Beginning every response in the same manner
   • Using poor timing (reflecting every statement or waiting too long to respond
3. Paraphrasing – restating the content of the client’s communication
4. Leading – direct or indirect encouraging to talk further
5. Summarizing – distilling and expressing the theme or topic of the client’s communication.
6. Clarification – clearing up ambiguities, inclusive terms, double meanings, etc.
7. Support – expressing that the client has been heard or understood
8. Confrontation – questioning discrepancies, conflicts, mixed messages, etc.
9. Approval – agreeing with the client’s ideas, behaviors, or feelings
10. Interpreting – positing meaning for implicit messages from the client’s communication
11. Instructing – teaching appropriate responses for specific situations
12. Information giving – providing information so the client can make decisions, consider alternatives, etc.
13. Homework – assigning tasks to be done outside of sessions
14. Contracting – formal or informal commitment

(Page 257).

Question 11

PSYCHOANALYTIC THERAPY
Key figure
(Page 258).

Answer 11

Sigmund Freud

Question 12

Overview of the Psychoanalytic Model

(Page 258).

Answer 12

A. Sigmund Freud learned the “talking cure” (his cathartic method) from Jean-Martin Charcot and Josef Breuer. He went on to theorize the personality structure of the id, ego, and superego as well as the existence of an unconscious mind which resides under or behind the conscious and preconscious minds. Thus, Freud is credited with formulating the first counseling model.
B. The psychoanalytic counselor concentrates on:
1. The client’s past history, especially early childhood events
2. The inter-relationship of the parts of the client’s personality
3. The relationship between the counselor and the client

(Page 258).

Question 13

Goals of Psychoanalytic Treatment

(Page 258).

Answer 13

A. Bring the client’s unconscious to the conscious
B. Help the client work through repressed conflicts
C. Help the client reach intellectual awareness
D. Help the client restructure his or her basic personality

(Page 258).

Question 14

Role of the Psychoanalytic Counselor

(Page 258).

Answer 14

A. The counselor is an anonymous expert and makes interpretations of the meaning of current behavior as the behavior relates to the past.
B. The client is encouraged to develop projections toward the counselor.
C. The counselor assists with reducing any resistances that develop as the client works with transferences.

(Page 258).

Question 15

Normal Development
(Psychoanalytic)
(Page 258).

Answer 15

Successfully resolving and integrating the psychosexual stages of development leads to normal personality development.

(Page 258).

Question 16

Development of Behavioral Disorders

(Page 259).

Answer 16

A. Personality flaws result from the failure to successfully resolve conflicts at an earlier stage of ego development.
B. Anxiety occurs when basic conflicts are repressed.

(Page 259).

Question 17

Freud’s Structure of Personality

(Page 260).

Answer 17

ID – is the original system of personality and the primary source of psychic energy and the seat of instincts. It is the seat of the libido and is ruled by the pleasure principle. The id has no sense of time, never matures, and is chaotic.
EGO – functions to contact the real world. It balances (similar to the fulcrum of a see-saw) between the impulses of the Id and the Superego’s controls. SUPEREGO – is the moral branch of the personality. It represents the ideal rather than the real and strives for perfection. It represents the traditional values and the ideals of society. It rewards through feelings of pride and self-love; it punishes through feelings of guilt and inferiority. Freud believed that successfully resolving the Oedipus complex gives rise to the superego.

(Page 260).

Question 18

four primary phases which all pertain to transference
(Psychoanalytical)

(Page 260).

Answer 18

1. opening 3. working through 2. developing 4. resolving

(Page 260).

Question 19

Catharsis/Abreaction
(Psychoanalytical)

(Page 260).

Answer 19

purging of emotions and feelings by giving them expression.

(Page 260).

Question 20

Parapraxis (Freudian slips)

(Page 260).

Answer 20

an action in which one’s conscious intention is not fully carried out, as in the mislaying of objects, slips of the tongue and pen, etc.

(Page 260).

Question 21

Countertransference

(Page 260).

Answer 21

The counselor substitutes the client for the original object of the counselor’s own repressed impulses (counselor’s being extremely angry with or sexually attracted to a client).

(Page 260).

Question 22

Criticisms of the Psychoanalytic Model

(Page 261).

Answer 22

• The functions of the id, ego, and superego cannot be empirically tested.
• Not suitable in the common counseling setting.
• Not suitable for many minority, ethnic, or cultural groups.
• Not suitable for solving specific problems of lower socioeconomic individuals.
• Social, cultural, and interpersonal influences are largely ignored.
• Regressive and reconstructive therapy requires ego strength that is not always present.
• The training time for counselors is lengthy, often considered impractical.
• Classic psychoanalysis positions the client on a couch performing free association with an unseen analyst. This expensive process requires several sessions a week for several years.

(Page 261).

Question 23

EGO DEFENSE MECHANISMS

(Page 263).

Answer 23

1. Displacement – means displacing or directing emotion onto a person/object other than the one that originally aroused the emotion. Example: A meek employee, who is continually ridiculed by her boss, builds up tremendous resentment but verbally attacks family members instead of her boss, who might fire her.
2. Rationalization – is justifying behavior to oneself and to others with well thought-out and socially acceptable but fictitious reasons for certain behaviors. This is not just lying; it’s a matter of habit and intensity. Example: A high school student explains away her failing of an algebra exam by saying, “I really don’t see why I have to take this course. I don’t need it to graduate and that teacher just sits there and doesn’t explain anything.”
3. Compensation – means attempting to overcome the anxiety associated with a feeling of inferiority in one area by concentrating on another where the person can excel. This may be healthy and constructive; it may be avoidance. Example: A woman who cannot bear children becoming overly attached to pets.
4. Projection – entails attributing to another person feelings and ideas that are unacceptable so the other person seems to have these feelings and ideas. Example: Feeling like a coward in handling a situation but blaming the outcome on the cowardice of the other person.
5. Reaction Formation – involves exaggerating and openly displaying a trait that is the opposite of the tendencies that we do not want to recognize (traits that have been repressed). Example: People who are zealots about smut but really have hidden desires.
6. Denial – means failing or refusing to acknowledge or to recognize and deal with reality because of strong inner needs. Example: Ignoring the symptoms of a heart attack; wearing copper bracelets.
7. Repression – is an unconscious process of blocking urges, forbidden or dangerous desires, or traumatic experiences from consciousness. The most basic defense mechanism according to Freud. (Suppression is a conscious process.) Example: A police officer who witnesses the violent death of a fellow officer may press the incident out of consciousness because it symbolizes his own mortality.
8. Identification – is the attempt to overcome feelings of inferiority by taking on the characteristics of someone important to oneself. Example: A student who takes on characteristics/attributes of his/her mother, father, favorite teacher, or coach.
9. Substitution – involves achieving alternate goals and gratifications in order to mask feelings of frustration and anxiety. Example: Young girls who miss their father shacking up with older men.
10. Fantasy – involves retreating in one’s mind to a comfortable (maybe ideal) setting. While one of the most useful defense mechanisms, it can become addictive and substitute for honest effort.
11. Regression – consists of reverting to a pattern of feeling, thinking or behavior appropriate to an earlier stage of development. Example: A competent and capable adult acting very childish when sick in an attempt to have those around them provide greater care.
12. Sublimation – is the redirecting of unacceptable impulses into socially and culturally acceptable channels. Example: Ones need for approval leading to an interest in theatre productions.
13. Introjection – is the taking in, absorbing or incorporating into oneself the standards and values of another person. Example: The abused child who becomes an abusive parent.
14. Undoing – occurs when a person acts inappropriately thus producing anxiety; then the person acts in an opposite way so as to reverse or negate the original behavior thus extinguishing the original anxiety. Example: A child yells at the dinner table and then offers to help with the dishes.
15. Emotional Insulation – is protecting oneself from hurt by withdrawing into passivity. Example: “Looking for a new job will bring rejection so I’ll just go with the flow and see what happens.”
16. Isolation – is separating the emotion from an experience so as to deal dispassionately with an otherwise emotionally overwhelming topic. Example: Making funeral arrangements instead of grieving.

(Page 264).

Question 24

ADLERIAN THERAPY OR INDIVIDUAL PSYCHOLOGY
Key figure
(Page 265).

Answer 24

Alfred Adler
Others: Rudolf Dreikurs was a student of Adler who eventually brought the child guidance center concept to the U.S. He initiated group therapy into private practice. Donald Dinkmeyer, Sr. is a current Adlerian proponent.

(Page 265).

Question 25

Overview of the Adlerian Model

(Page 265).

Answer 25

• Alfred Adler originally collaborated with Freud but broke away in 1911 as he became convinced that external, social forces play as important a role, if not a more important role, in personality development. As such, Adlerian therapy was one of the first humanistic, unified, holistic approaches that recognized social and psychological influences.
• Humans, in Adler’s view, are goal oriented and are motivated by social urges and a desire to overcome inferiority. Successful lifestyle is in terms of superiority, i.e., selfactualization. He established the first community-outreach program: child guidance centers. -
• Each person has a positive capacity to live cooperatively socially and can interpret, influence, and create events to make this happen.
• The conscious, rather than the unconscious mind, is the foundation of personality development.

(Page 265).

Question 26

Goals of Adlerian Treatment

(Page 265).

Answer 26

• To help the client develop a healthy self-esteem and lifestyle through reeducation and restructuring.
• To question and challenge clients’ perceptions of self and life beliefs and goals (target faulty logic, misdirected goals).
• To help the client cultivate healthy social interests.
• To provide encouragement toward meaningful goals.

(Page 265).

Question 27

Role of the Adlerian Counselor

(Page 265).

Answer 27

• The counselor is a cooperative partner with the client in establishing mutual respect and trust and in mutually outlining goals.
• Joint responsibility is established through a therapeutic contract.
• As a diagnostician, teacher, and model, the counselor focuses on identifying and bringing to awareness faulty assumptions and goals and then educating the client on changing resulting behavior.

(Page 265).

Question 28

Normal Development
(Adlerian)
(Page 266).

Answer 28

• Our life struggle is between achieving the goal of superiority versus the social realities that make us feel inferior to the task.
• Our life tasks are social, occupational, sexual, spiritual, and self-relationship directed.
• As an individual takes personal responsibility for his or her behavior, a positive self-esteem and purposeful, goal-directed behavior results.

(Page 266).

Question 29

Development of Behavioral Disorders
(Adlerian)
(Page 266).

Answer 29

• Discouragement is at the root of psychopathology.
• Basic mistakes are faulty perceptions, values, or goals that keep us from achieving superiority (Mosak, 1998):
  
  1. Overgeneralization
  2. Misperceptions of life and life’s demands
  3. Impossible or false goals of security
  4. Denial or minimization of one’s worth
  5. Faulty values
• Children who are discouraged will endeavor to achieve the desired social interest through one of four goal directed behaviors:
  
  1. Prove their power
  2. Display deficiencies
  3. Get attention
  4. Get revenge
• Adler authored Organ Inferiority in 1907 to articulate his assumption that the wish for power was a crucial motivating force (thus his term inferiority complex). The individual attempts to compensate for inferiority.
• This concept evolved into the “striving for superiority” or drive for perfection (not to be confused with a desire to dominate others or a superiority complex).
• Over-compensation is the reacting to a real or imagined physical or psychological defect with an exaggerated drive to compensate for it.

(Page 266).

Question 30

Applications of the Adlerian Model

(Page 266).

Answer 30

• This growth model is well suited to preventive care and is able to deal with the broad range of conditions that interfere with growth.
• Some specific target clients would include:
  1. Individuals of all ages
  2. Child guidance
  3. Parent–child counseling
  4. Family therapy
  5. Couples therapy
  6. Group counseling
  7. Rehabilitation and/or correctional counseling
  8. Substance abuse counseling
  9. Brief, solutions-oriented counseling

(Page 266).

Question 31

CARL JUNG — ANALYTICAL PSYCHOLOGY
How he differed from Freud/Overview
(Page 269).

Answer 31

• Jung broadened Freud’s concept of the unconscious and said it could be developed and tapped.
• He taught the realizing of self (living for purpose and meaning) through dealing with the levels of the unconscious, especially with dream analysis.
• Jung differentiated between the ways men and women process experiences (Jung, 1961).
• Personal or individual unconscious – What was once conscious but is now repressed experiences.
• Collective unconscious – Made up of archetypes (Buried inherited memories from the ancestral past).
• Anima and animus – Humans have both feminine and masculine characteristics. Jung believed that society encourages men to deny their feminine side and women to deny their masculine side.
• Men operate on logic or the logos principle; women operate on intuition or the eros principle.
• Jung used mandalas, concentric circular designs, to represent the relationship between himself, his clients, and his dreams. The mandala also symbolized self-unification.
• Persona – Public self
• Shadow – Repressed self
• Self
• Extroversion and introversion – Polarities within humans.
  a. Introversion is a turning in towards oneself as the main source of pleasure.
  b. Extroversion seeks pleasure and satisfaction in others.
• Personality types:
  a. Thinking
  b. Feeling
  c. Sensing
  d. Intuitive
• The bipolar personality types used in the Myers-Briggs Type Indicator are associated with the work of Jung.

(Page 269).

Question 32

ERICH FROMM
Overview/areas different from Frued
(Page 270).

Answer 32

• Humans are influenced by social and cultural forces but shape their own nature.
• Humans by nature experience isolation and alienation.
• Options for relief are learning how to love or finding security by conforming one’s will to authority (Rosenbaum & Seligman, 1989).
• Five basic needs:
  
  1. Relatedness
  2. Transcendence
  3. Rootedness (to world, nature, and others)
  4. Identity
  5. Frame of orientation (to make sense out of the world)
• Character Types:
  
  1. Receptive
  2. Exploitive
  3. Hoarding
  4. Marketing
  5. Productive

(Page 270).

Question 33

OTTO RANK
Overview/differing from Freud
(Page 271).

Answer 33

• The person’s goal is to return to the security experienced in the womb.
• The person struggles for individuality (Hunt, 1993).
• Separation anxiety
• Character types
  
  1. Average
  2. Neurotic
  3. Creative

(Page 271).

Question 34

ERIK ERIKSON
Overview/differing from Freud
(Page 272).

Answer 34

• Psychosexual and psychosocial growth occurs simultaneously.
• Erikson conceived ego identity as the polarity of what “one feels one is and what others take one to be.”
• There is continuity in development from birth through old age (Santrock & Yussen, 1987).

(Page 272).

Question 35

Erikson’s stages

Answer 35

1. Early infancy (Birth - 1 year)
   Psycho-social Crisis: Basic trust vs. mistrust
2. Later infancy (1 - 2 years)
   Psycho-social Crisis: Autonomy vs. shame & doubt
3. Early childhood (3 - 5 years)
   Psycho-social Crisis: Initiative vs. guilt
4. Middle childhood (6 - 11 years)
   Psycho-social Crisis: Industry vs. inferiority
5. Adolescence (12 - 20 years)
   Psycho-social Crisis: Identity vs. role confusion
6. Early adulthood (20 - 35 years)
   Psycho-social Crisis: Intimacy vs. isolation
   Sharing one’s life with others vs. I’m the only one I can depend on
7. Middle adulthood (35 - 65 years)
   Psycho-social Crisis: Generativity vs. stagnation
   The productive ability to create a career, family, leisure time, etc. vs. self-absorption
8. Late adulthood (65+ years)
   Psycho-social Crisis: Integrity vs. despair
   Life has been worthwhile vs. life’s precious opportunities have been wasted.

(Page 272).

Question 36

HARRY STACK SULLIVAN
Overview/differed from Freud
(Page 273).

Answer 36

• Personality manifests itself through relationships beginning with the infant’s relationship with its primary caregiver.
• Personality is malleable (influenced by relationships).
• The emphasis is on a power motive as a means to overcoming a sense of helplessness.
• The self-system is the power system formed as a reaction against the anxiety produced in relationships (Rosenbaum & Seligman, 1989).
• Modes of experience involved in ego formation:
  
  1. Protaxic – Infancy; the infant has no concept of time and place.
  2. Parataxic – Early childhood; the child accepts what is without questioning or evaluating and reacts on an unrealistic basis.
  3. Syntaxic – Later childhood; the child is able to evaluate his/her own thoughts and feelings against those of others and learns about relationship patterns in society.
• Four stage interview (learns about relationships in society):
  
  1. Inception
  2. Reconnaissance
  3. Detailed inquiry
  4. Termination

(Page 273).

Question 37

KAREN HORNEY
Overview/differing from Freud
(Page 274).

Answer 37

• Horney purported an inborn potential for self-realization.
• Character develops out of childhood experiences and basic security needs (Horney, 1967).
• Basic anxiety – the child’s feelings of being isolated and helpless in a potentially hostile world. Anything that disturbs basic security yields basic anxiety.
• Ten neurotic needs:
  
  1. affection/approval
  2. dominate partner
  3. restricting one’s life
  4. power
  5. exploitation of others
  6. prestige
  7. independence
  8. personal achievement
  9. personal admiration
  10. protection
• Character types:
  
  1. Compliant
  2. Aggressive
  3. Detached

(Page 274).

Question 38

EXISTENTIAL - HUMANISTIC THERAPY
Key figures
(Page 275).

Answer 38

Abraham Maslow Rollo May Victor Frankl

(Page 275).

Question 39

Overview of the Existential–Humanistic Model

(Page 275).

Answer 39

• Existentialism has been so identified with humanism that the terms are often used together, many times as a hyphenated term. Both existentialism and humanism emphasize existence, the present, and the meaning of existence. The literature in the field does not consistently assign theorists to either philosophical side but does point out that the need to self-actualize, to exhibit automatic positive growth, is a humanistic quality. Existentialism, on the other hand, recognizes a freedom to both grow or decay.
• Kierkegaard, a nineteenth-century Danish theologian and philosopher, asserted that each person carves his or her own destiny, and his or her essence (inner being) is the product of his or her actions.
• Seventy years later, Heidegger and Sartre expounded on existential themes by arguing that people are never isolated from or independent of the objects around them. People are engaged with the objects around them via their perceptions, moods, and feelings. Such subjectivity influences the existential nature of people’s existence.
• Concepts such as Maslow’s self-actualized person (and the framework of the hierarchy of needs) set the existential humanistic philosophies apart from both classical psychology and the behaviorists who believe that human thought and behavior are predictable consequences of identifiable training processes.
• Existential Humanistic psychology is call “third force psychology” because it was a reaction to the two initial forces at the time – psychoanalysis and behaviorism.

(Page 275).

Question 40

Goals of Existential–Humanistic Treatment

(Page 275).

Answer 40

• Guide clients to greater self-awareness through exploring possibilities and by identifying factors that block awareness and freedom.
• Increase the client’s view of his or her freedom to make choices and create meaning.
• Validate the importance of responsibility, freedom, awareness, and potential.

(Page 275).

Question 41

Role of the Existential–Humanistic Counselor

(Page 276).

Answer 41

• The existential counselor is fully committed to an authentic, deeply personal, shared relationship with the client.
• The counselor must accurately understand the client’s being-in-the-world.
• The counselor models authenticity, realizing personal potential and decision making within the context of self-awareness.
• The authentic encounter can change both the therapist and the client.

(Page 276).

Question 42

Normal Development
Existential–Humanistic
(Page 276).

Answer 42

• Each individual is unique and therefore has a unique path of personality development.
• One’s sense of self begins and develops from infancy.

(Page 276).

Question 43

Development of Behavioral Disorders
Existential–Humanistic
(Page 276).

Answer 43

• Psychopathology results from making negligent choices or failing to emphasize and reach for one’s higher potential.
• Guilt results from not acting responsibly.
• Anxiety results from an inconsistent relationship between one’s perception of meaning and purpose in life with one’s awareness of the reality of death.

(Page 276).

Question 44

Existential/humanistic therapies are useful for these types of issues/problems:

(Page 277).

Answer 44

1. Increased personal awareness and self enhancement
2. Transitions in life or developmental junctures
3. Guilt or anxiety
4. Making decisions or choices
5. Balancing freedom and responsibility
6. Determining values
7. Finding meaning or making sense of life

(Page 277).

Question 45

Being-in-the-world
Existential/humanistic
(Page 278).

Answer 45

the unique way the client experiences self and the world and gives direction to life. This being-in-the-world is accepted as real, meaningful, and legitimate.

(Page 278).

Question 46

Being-in-the-world is spoken of as having three different patterns:
Existential/humanistic
(Page 278).

Answer 46

1. Umwelt – refers to behaviors grounded in the physical: human biology (sleeping, eating, excreting, copulating) and aiming at biological survival and satisfaction.
2. Mitwelt – refers to interpersonal relationships in which there is sharing or encounter, which seeks to prevent or to alleviate feelings of loneliness or aloneness and to enrich life.
3. Eigenwelt – refers to behaviors of self-awareness, self-evaluation, and self-identity, which attempt to make one’s life meaningful.

(Page 278).

Question 47

Phenomenology
Existential/humanistic
(Page 278).

Answer 47

the study of perceptual experience in its purely subjective aspect. The basis of psychology should be the scientific study of immediate experience. The objective reality of events is not denied; rather, the emphasis is on how the events are perceived and experienced.

(Page 278).

Question 48

Ontology

(Page 278).
Existential/humanistic

Answer 48

This philosophy seeks to explain the nature of being or reality or ultimate substance (stands opposed to Phenomenology).

(Page 278).

Question 49

Techniques Specific to the Existential–Humanistic Model

(Page 280).

Answer 49

• The authentic, mutually personal counselor-client relationship is the main technique used.
• Confrontation is used to spur clients toward self-responsibility.
• Techniques from other approaches are chosen as they are deemed useful in helping the client toward self-awareness.
• Action is preceded by self-awareness.

(Page 280).

Question 50

PERSON-CENTERED THERAPY (CLIENT-CENTERED)
Key figure
(Page 281).

Answer 50

Carl Rogers

Question 51

Overview of the Person-Centered Model

(Page 281).

Answer 51

• Client-centered therapy is America’s first distinctively indigenous school of therapy. It was conceived and nurtured by Carl R. Rogers and is sometimes referred to as Rogerian therapy.
• While the histories of many other schools of therapy are strewn with schisms and rebellion against the original concepts, client-centered therapy is nonprescriptive and responsive enough to allow the expression of individual techniques and styles within the accepted framework (Belkin, 1987).
• The basic principle of “an open and accepting attitude” must be adhered to.
• The therapy is flexible because the client directs the movement of his or her own treatment.
• Note the different names all referring to the same basic theory: Initially called Nondirective Counseling Changed to Client-Centered Updated to Person-Centered Sometimes known as Self Theory

(Page 281).

Question 52

Goals of Person-Centered Treatment

(Page 281).

Answer 52

• No predetermined goals are outlined other than the understood purpose of increasing selfawareness and increasing the trust in one’s own actualizing process.
• This self-awareness includes the clients exploring their roadblocks to growth and recognizing parts of self that were previously denied or distorted.
• The real relationship with the counselor becomes a springboard to transfer learning to other relationships.

(Page 281).

Question 53

Role of the Person-Centered Counselor

(Page 282).

Answer 53

• The counselor’s primary task is to provide what Rogers called a therapeutic atmosphere which stems from the counselor core conditions. Just the presence of these core conditions or attitudes will create change in the client toward self-actualization. This environment provides the safety for a client to explore any aspect of self.
• Three core conditions of the therapist:
  
  1. Congruence (genuineness) – The counselor is aware of and accurately expresses his or her own feelings; is authentic and genuine.
  2. Unconditional positive regard – The counselor accepts the client without judgment.
  3. Accurate empathy – The counselor truly understands the thoughts and feelings of the client.

Of these, Rogers considered congruence the most important.

• This non-directive approach emphasizes reflection of emotional content which occurs when a client’s verbalizations are restated in such a way as to bring awareness of emotions to the client.
• So, if one is a Rogerian counselor, has empathy, feels what his/her client is feeling, and sees the situation as the client sees it, he/she will be non-judgmental.
• The therapist is not viewed as the traditional “expert.”
• Diagnosing, probing, and interpretation are laid aside.

(Page 282).

Question 54

Normal Development
Person-centered

(Page 282).

Answer 54

• Men and women have an inborn tendency toward self-actualization, toward growth and full functioning.
• Basic striving is to actualize, maintain, and enhance.

(Page 282).

Question 55

Development of Behavioral Disorders
Person-centered
(Page 283).

Answer 55

• Pathology results when the inborn tendency toward self-actualization is hampered. Needing love and belonging (similar to Maslow’s hierarchy) can impede growth. The frustration of basic impulses can impede growth.
• A lack of self-knowledge hampers an individual’s ability to resolve conflicts.
• Conflicts are the discrepancy between self-perception and experienced reality.
• The greater the incongruence between the real self and the ideal self, the greater the maladjustment.

(Page 283).

Question 56

Techniques Specific to the Person-Centered Model

(Page 284).

Answer 56

• The counselor’s attitude is of primary importance and colors any specific techniques used.
• Person-centered counselors would use any of the following:
  1. Reflection
  2. Active listening
  3. Confrontation
  4. Open-ended questions
  5. Summarization
  6. Clarification
  7. Support
  8. Reassurance
• No diagnosis or interpretations; only minimal probing. - No making judgments, giving advice, suggesting solutions, or moralizing.
• A strict Rogerian would generally not tell a client “how to think,” nor would a strict Rogerian give a client detailed methods to achieve behavioral change.

(Page 284).

Question 57

GESTALT THERAPY
Key figure
(Page 286).

Answer 57

Fritz Perls

(Page 286).

Question 58

Overview of the Gestalt Model

(Page 286).

Answer 58

• This experiential approach is antideterministic in that personal choice and responsibility are emphasized.
• Gestalt does not translate exactly into English but roughly means a form, figure, or configuration unified as a whole. It can also mean essence or manner. The primary focus is on the unified whole which is different from the sum of its parts.
• The term gestalt (Perls, 1969) was borrowed from Max Wertheimer and his psychology of studying perceptual phenomena (e.g., figure/ground relationships). The three most common gestalt concepts are:
  1. Insight Learning as discovered by Wolfgang Kohler
  2. Zeigarnik Effect as proposed by Bluma Zeigarnik; unfinished tasks are more readily recalled than finished tasks
  3. Phi-phenomenon as proposed by Wertheimer wherein the illusion of movement can be achieved by two or more stimuli which are not moving (neon sign with a moving arrow)

(Page 286).

Question 59

Goals of Gestalt Treatment

(Page 286).

Answer 59

• The emphasis is to help the client live a fuller life in order to be fully integrated.
• Since awareness is believed to be curative, the “here and now” should be fully experienced including confronting unfinished business and other forms of resistance and blocked energy.
• The client is taught to be self-supporting, to take responsibility for feelings, thoughts, and actions.
• Insight is prized.

(Page 286).

Question 60

Role of the Gestalt Counselor

(Page 286).

Answer 60

• To help the client explore his or her needs in order to discern life patterns, to focus on using energy to adapt positively, and to grow.

(Page 286).

Question 61

Normal Development
Gestalt

(Page 287).

Answer 61

• Humans have an innate capacity to function and to live successfully.
• People can become self-regulating and achieve a sense of unity and integration.

(Page 287).

Question 62

Development of Behavioral Disorders

(Page 287).

Answer 62

• Overemphasizing intellectual experience to the neglect of the emotions and senses leads to maladaptive behavior.
• Introjection and reduced awareness result from being taught to devalue and to distrust oneself.
• Perls outlined five layers of neuroses (likened to the layers of an onion) (Corey, 2000):
  1. Phony layer – not authentic, playing games, playing roles, following stereotypes.
  2. Phobic layer – emotional pain resulting from denying parts of self is avoided; selfacceptance is resisted; fear of rejection will be experienced if one is who he/she really is.
  3. Impasse layer – feeling stuck and not trusting inner resources; sense of deadness.
  4. Implosive layer – the deadness is fully experienced, defenses are exposed, and contact with the genuine self is begun.
  5. Explosive layer – pretenses and phony roles are abandoned; the energy previously required to maintain the pretenses is not free to be redirected.

(Page 287).

Question 63

Key Gestalt Concepts and Terminology

(Page 288).

Answer 63

• With an emphasis on the interaction of thinking, feeling, and behaving to produce wholeness, gestalt therapists consider these concepts to be significant:
  1. Awareness – focusing on the present moment
  2. Holism – how the parts of a person fit together
  3. Avoidance and unfinished business – unexpressed, avoided feelings
  4. Process of figure formation – how an aspect of the environment takes a focal role
  5. Placement, blocking, and usage of energy
  6. Contact with the environment without losing one’s sense of individuality
• Ego defense mechanisms are called channels of resistance and prevent effective contact (interacting with others and with nature without losing one’s sense of individuality):
  1. Introjection – Accepting another’s beliefs or standards without analyzing and restructuring them to make them congruent to oneself.
  2. Projection – Disowning and putting on other people’s personality characteristics of self that are inconsistent with one’s self-image; the reverse of introjection.
  3. Retroflection – Turning back to oneself what he/she would like to do to someone else or doing to oneself what he/she would like someone else to do to him/her. 4. Confluence – Blurring the line between self and the environment; blending in to the point that there is no clear line between outer reality and inner experience. 5. Deflection – Using humor, abstract generalizations, and questions rather than statements, etc. as distractions so a sustained sense of contact is avoided (Corey, 2001).

(Page 288).

Question 64

Techniques Specific to the Gestalt Model

(Page 289).

Answer 64

1. Confrontation – calls attention to discrepancies and incongruencies
2. The “Empty Chair” (also called games of dialogue) – addressing a part of the personality as if it were sitting there in a chair; underdog (weak, powerless, passive, full of excuses), top dog (authoritarian shoulds and oughts) or masculine versus feminine traits.
3. Reliving and thereby experiencing unfinished business in the here and now with its attending resentment and guilt.
4. Exaggeration – overdramatizing gestures and movements to gain insight; similar to Frankl’s paradox.
5. “Making the Rounds” – a group exercise in which the client repeats the same words to each member adding a personalized phrase.
6. Role-playing or psychodrama (introduced by Moreno).
7. Stay with the feeling – do not avoid the feeling.
8. Rehearsal exercise – sharing internalized rehearsals of situations.
9. Dream work – dreams are recounted as if they are in the here and now; every facet of the dream is considered a projection of self.
10. “I statements” – instructing the client to take personal responsibility for a thought or feeling by making an “I feel…….” or “I take responsibility for……….” statements.
11. “How” and “what” questions instead of “why.”
12. Interpretation by the client, not the counselor.
13. No formal diagnosis or testing is required.
14. “Frustration is therapeutic.”

(Page 289).

Question 65

TRANSACTIONAL ANALYSIS
Key figures
(Page 291).

Answer 65

Eric Berne; Thomas A. Harris

(Page 291).

Question 66

Overview of the TA Model

(Page 291).

Answer 66

• Berne began in the Freudian tradition but realized the limitations of the classical method in which he was trained as he conducted group therapy during World War II and afterwards. He sought a more “rational” approach that would prove less dependent on the unconscious. His ideas evolved from his experiences and from his work with Dr. Wilder Penfield, neurological researcher at McGill University. By this time, Berne was also reading Carl Rogers.
• Berne discovered his parent-adult-child equivalents in Freudian psychoanalysis. Penfield’s research provided the neurological basis for the assumption that people exist in different ego states simultaneously and that these states are connected to memories. Rogers work rejected the Freudian diagnostic model and accepted the client as a rational, capable person. Thus, the theory and practice of transactional analysis was born (Belkin, 1987).

(Page 291).

Question 67

Goals of TA Treatment

(Page 291).

Answer 67

• The goal of therapy is to assist the client in becoming a script-free, game-free, autonomous person who is capable of choosing how he/she wants to be.
• Additionally, therapy is to assist the client in examining early decisions and making new decisions based on awareness.

(Page 291).

Question 68

Role of the TA Counselor

(Page 291).

Answer 68

• The TA counselor is a joint, equal partner in the contractual counselor/client relationship.
• The counselor functions as teacher, trainer, and resource person.
• The client contracts with the therapist for the specific changes desired; when the contract is completed, therapy is terminated.
• Transference and dependence on the therapist are de-emphasized.

(Page 291).

Question 69

Normal Development
TA
(Page 292).

Answer 69

• TA asserts four life positions which replace explicit psychopathology. These positions are developmental and associated with growth:
  1. I’m not OK—You’re OK
  2. I’m not OK—You’re not OK
  3. I’m OK—You’re not OK
  4. I’m OK—You’re OK

1. I’m not OK – You’re OK The infant’s earliest response to the world is “I’m not OK—You’re OK.” The infant feels inadequate, incompetent, and, in Adlerian terms, inferior. The outside world is more competent and able to provide stroking (emotional nurturing). If this position continues into later life, the person is self-abusive, self-mutilating, and often suicidal—all masochistic characteristics.
2. I’m not OK—You’re not OK As the infant attempts to become more autonomous, he or she may evolve into the second position, “I’m not OK—You’re not OK.” Independence increases; stroking decreases. This is a difficult position. If no growth and warmth exists, the child may become stuck in this position, a most hopeless and pessimistic position. Schizoid behavior may result, and in extreme cases, the tendency to kill another and then kill oneself may surface.
3. I’m OK—You’re not OK If a child is continually brutalized by the parents he or she once felt were OK, the child will switch positions to the third position of “I’m OK—You’re not OK.” Adolescent delinquents and adult criminals are found here feeling victimized and paranoid. He or she distrusts everyone and sees this posture as survival. Extreme cases will engage in homicidal behavior as an acceptable solution to problems in life. The first three positions are based on feelings.
4. I’m OK—You’re OK The fourth position is conscious, rational, and verbal and based on “thought, faith, and the wager of action” (Harris, 1995). The “I’m OK—You’re OK” position is one of hopefulness and health marked by successful interpersonal relationships, feeling good about ourselves, feeling that we deserve the best, that we can attain the best. This position is roughly equivalent to Freud’s ideal of full psychosexual development and sublimation.

(Page 292).

Question 70

Development of Behavioral Disorders
TA
(Page 293).

Answer 70

• Maladaptive behavior results from an individual staying in one of the first three life positions.
• Misdirected early decisions can cause later problems.

(Page 293).

Question 71

Key TA Concepts and Terminology

(Page 294).

Answer 71

• The personality is made up of three ego states:
  1. Parent – made up of admonitions, values, instructions, attitudes, and behavior handed down from parents or authority figures (also called the exteropsyche; resembles Freud’s superego).
  a. Nurturing Parent – supports, cares, encourages
  b. Critical Parent – finds fault, is critical and harsh; shoulds, oughts, musts
  c. Prejudicial Parent – opinionated, biased with no factual basis
  d. Incomplete Parent – parent is absent or dies

2. Adult – objective, logical, nonemotional, thinking, rational; deals with reality; assimilates and evaluates information based on facts; keeps Parent and Child ego states in balance (also called the neopsyche; resembles Freud’s ego).
3. Child – Source of childlike (not childish) behaviors (also called the archaeopsyche; resembles Freud’s id); contains three aspects:
   a. Adapted child – controlled, cries, rebels, is a product of demands
   b. Natural child – untrained, spontaneous, impulsive, self-loving, expressive, pleasure-seeking
   c. Little Professor – intuitive wisdom

(Page 294).

Question 72

BEHAVIORAL THERAPY
Key figures
(Page 297).

Answer 72

Classical Conditioning Respondent Conditioning: Ivan Pavlov; Joseph Wolpe; William H Masters & Virginia Johnson; Andrew Salter; Hans Selye;

Operant Conditioning Instrumental Learning: B.F. Skinner; David Premack; Neal Miller; Edmund Jacobson

Vicarious Conditioning Social Learning Theory: Albert Bandura & Rochard Walters; Juliam Rotter; Jon Dollard & Neal Miller; Geiorge Kelly

Question 73

Overview of the Behavioral Therapy Model

(Page 297).

Answer 73

• Behavioral therapies comprise a body of related approaches held together by the common belief that emotional, learning, and adjustment difficulties can be treated through a variety of prescriptive, mechanical, usually nondynamic techniques and procedures.
• Through the last century, behavioral approaches have evolved in four basic directions:
  1. Classical (respondent) conditioning
  2. Operant (instrumental) conditioning
  3. Social learning
  4. Cognitive behavior therapy
• All share some basic concepts, but each brings a distinguishing focus or addition to the field.

(Page 297).

Question 74

Goals of Behavioral Therapy Treatment

(Page 298).

Answer 74

• Classical conditioning, operant conditioning, and social learning therapies all endeavor to eliminate inappropriate or maladaptive behaviors and to teach more effective ones.
• The focus is on meeting treatment goals which the client and counselor have evaluated and set.
• A baseline measurement is a requirement of behavioral therapy so that behavioral change can be objectively measured.

(Page 298).

Question 75

Role of the Behavioral Therapy Counselor

(Page 298).

Answer 75

• The counselor takes a teacher/trainer role and can model behavior.
• The counselor must establish a good working relationship with the client in order for the evaluating of old behaviors and the teaching of new behaviors to be accepted by the client.

(Page 298).

Question 76

Normal Development
Behavioral Therapy
(Page 298).

Answer 76

• Classical conditioning asserts that human responses are elicited from the pairing of stimuli.
• Operant conditioning asserts that new responses are based on the reinforcement given.
• Social learning, which is in effect a form of sensory conditioning, asserts that new responses come from observing behaviors in others.
• Note that the cognitive-behavioral approaches add the function of cognitive processes. What one thinks influences behavior.

(Page 298).

Question 77

Development of Behavioral Disorders

(Page 298).

Answer 77

• Maladaptive behavior results from faulty learning/conditioning.

(Page 298).

Question 78

Behavioral techniques

Answer 78

1. Agoraphobia – Graded exposure and flooding.
2. Alcoholism – Aversive therapy (Antabuse).
3. Phobias – Systematic desensitization for simple phobias. Social skills training for shyness and fear of other people.
4. Schizophrenic disorders – Token economy and social skills development.
5. Sexual dysfunctions – Relaxation, desensitization, and graded exposure techniques.
6. Obsessive compulsive disorder (OCD) – Flooding.

(Page 299).

Question 79

CLASSICAL CONDITIONING / RESPONDENT CONDITIONING
Key info Pavlov
(Page 300).

Answer 79

A. Ivan Pavlov
Classical Conditioning is a product of Ivan Pavlov and his study of behavior based upon dogs in the early 1900’s. Before conditioning, the dog food (UCS) produces salivation (UCR). During conditioning, the dog food (UCS) is paired with a ringing bell (neutral) so that the bell becomes the conditioned stimulus (CS) producing salivation (CR). After conditioning, the bell (CS) produces salivation (CR). Classical conditioning is mechanistic and deterministic. The client is passive.
- Important Terms associated with Classical Conditioning:
1. Acquisition – the period during which the organism learns the association between the conditioned stimulus and the conditioned response.
2. Chaining – the chaining together of a sequence of behaviors to produce a more complex behavior; the phenomenon of each response acting as the stimuli for the next response; used by behaviorists to explain complex behaviors.
3. Conditioned Response (CR) – the learned response to a conditioned stimulus.
4. Conditioned Stimulus (CS) – a stimulus that, through repeated pairings with an unconditioned stimulus (UCS), acquires the capacity to evoke a response it did not originally evoke.
5. Counter-conditioning – occurs when a negative conditioned stimulus is paired with a pleasant stimulus that elicits a response that is incompatible with the unwanted conditioned response.
6. Stimulus discrimination or differentiation – learning to make distinctions among similar stimuli.
7. Experimental neurosis – emotional disturbance that shows when two or more stimuli cannot be differentiated.
8. Extinction – the reduction in response that occurs when the conditioned stimulus is presented without the unconditioned stimulus. Often, the response will increase or worsen (called a response burst or extinction burst) before it is eliminated. (This parallels the stage in Operant Conditioning when reinforcement is no longer given.) A counselor must weigh the importance of the response burst factor when attempting extinction of self-mutilating or self-abusive behaviors.
9. Higher order conditioning – the process whereby a new stimulus is paired with the CS and takes on the associative power of the CS (dog salivates at bell; then light is paired with bell; dog salivates at light).
10. Stimulus Generalization – the showing of a given behavior toward similar stimuli once an organism has learned to associate a given behavior with a specific stimulus; Pavlov termed this irradiation (Little Albert’s fear of anything furry, including Santa Claus).
11. Spontaneous Recovery – the recurrence of the previously extinguished conditioned response following a rest period.
12. Unconditioned Response (UCR) – a response that occurs to an unconditioned stimulus automatically without requiring any learning.
13. Unconditioned Stimulus (UCS or US) – a stimulus that naturally and automatically elicits an unconditioned response.

(Page 300).

Question 80

CLASSICAL CONDITIONING / RESPONDENT CONDITIONING

(Page 301).
Key info Joseph Wolpe

Answer 80

B. Joseph Wolpe

• Systematic Desensitization. Joseph Wolpe (1969) maintained that all neurotic behavior is an expression of anxiety. By using counter-conditioning, the anxietyproducing power of the stimulus can be weakened and the symptom of anxiety controlled and eliminated through stimulus substitution of the positive incompatible response.
• This technique is useful for phobias, neurotic anxieties, generalized fears, sexual dysfunctions, and interpersonal anxiety producing situations and is excellent for group use. This technique is not helpful for free-floating anxiety (anxiety with no identifiable stimulus).
• Systematic desensitization uses relaxation training as a counter-condition to anxiety. This is known as reciprocal inhibition: two opposite responses cannot exist simultaneously.
• The subjective units of distress scale (SUDS) allows the client to rate threatening experiences in relation to the scale with higher ratings indicating a greater perceived threat. A treatment hierarchy is then developed with the first action involving the least amount of anxiety.
• These steps are sequenced in systematic desensitization:
  1. Relaxation training
  2. Construction of the anxiety hierarchy (SUDS) – best if hierarchy items are evenly spaced
  3. Desensitization in imagination - This may be called interposition - implying that one thing covers or hides another as in relaxation hiding the anxiety.
  4. In vivo desensitization - This should not start until 75 percent of the hierarchy has been subjected to desensitization.

(Page 301).

Question 81

CLASSICAL CONDITIONING / RESPONDENT CONDITIONING
Key info William H. Masters and Virginia Johnson

(Page 301).

Answer 81

Masters and Johnson (1966) developed sensate focus, a form of behavioral sex therapy relying on counterconditioning. Couples engage in lower anxiety activities (touching and caressing) and then gradually progress in future encounters to intercourse.

(Page 301).

Question 82

Eye Movement Desensitization and Reprocessing (EMDR)

(Page 301).

Answer 82

Francine Shapiro (1995) experienced traumatic memories being abated when her eye moved from side to side on a walk in the park. From this experience, she formulated the eight steps that comprise EMDR, a form of exposure therapy. EMDR has particularly been studied with posttraumatic stress disorder (PTSD) treatment and has received “probably efficacious for civilian PTSD” treatment status from the APA.

(Page 301).

Question 83

Andrew Salter – Reflex Therapy

(Page 302).

Answer 83

• Inhibition (the blocking or clogging of emotions) is the cause of all psychological problems, so the focus of treatment is the removal of inhibitions through reconditioning via verbal expression of emotions. Salter called this verbal expression excitation and meant the spontaneous expressing of both positive and negative emotions (Salter, 1949).
• Wrote The Case Against Psychoanalysis and Conditioned Reflex Therapy from which assertiveness training was formulated.
• Assertiveness training utilizes behavioral rehearsal as a technique. This is role playing based on a hierarchy of situations requiring assertiveness.

(Page 302).

Question 84

Hans Selye – Stress

(Page 302).

Answer 84

• Selye’s (1956) research indicated that stress is a part of life. How one copes leads to ease or disease. The following are the three stages of the General Adaptation Syndrome (G.A.S.) or the biological stress syndrome:
  1. Alarm Reaction – The body produces a physiological response to a stressor.
  2. Stage of Resistance – The body mobilizes to overcome or escape stress.
  3. Exhaustion – Failure to resolve stress leads to physical/psychological exhaustion, possibly even death.

(Page 302).

Question 85

Exposure therapy

(Page 303).

Answer 85

includes desensitization, in vivo desensitization, flooding, and implosive therapy.

(Page 303).

Question 86

Flooding

(Page 303).

Answer 86

based on the premise that escaping from an anxiety-provoking experience reinforces the anxiety through conditioning. Thus, by not allowing the person to escape, anxiety can be extinguished, and the conditioned avoidance behavior can be prevented. The client is deliberately confronted with the feared situation. No relaxation exercises are used. The client experiences the fear which gradually subsides after a period of time. “Deliberate exposure with response prevention” defines flooding.

(Page 303).

Question 87

Implosive Therapy

(Page 303).

Answer 87

the forming of very vivid images of specific situations that cause the fear. Implosive therapy differs from flooding because the client is not exposed to the actual stimuli. T. G. Stampfl discovered implosive therapy.

(Page 303).

Question 88

Aversive Therapy

(Page 303).

Answer 88

a form of Classical conditioning which involves the use of punishment reinforcement and is sometimes called in vivo aversive conditioning. The goal is to eliminate problem behaviors by subjecting the client to pain or nausea (Example: Some smoking cessation programs; antabuse for alcoholism; use of electric shocks). The ethics are questionable since people have died from such treatments.

(Page 303).

Question 89

Relaxation Therapy

(Page 303).

Answer 89

teaches the client how to control tension. Jacobson’s progressive relaxation techniques are popular.

(Page 303).

Question 90

Assertiveness training

(Page 303).

Answer 90

based in counter-conditioning; would be considered a classical conditioning approach.

(Page 303).

Question 91

OPERANT CONDITIONING / INSTRUMENTAL LEARNING
Key info
(Page 304).

Answer 91

• Operant Conditioning is the product of B.F. Skinner who researched using rats. Also referred to as Instrumental Learning.
• The client is an active participant. Reinforcement and proper timing are required for learning to take place.
• The term behavior modification is associated with operant or Skinnerian conditioning, as opposed to behavior therapy which is Pavlovian or classical.
• In Operant Conditioning, the behaviors increase or decrease in frequency as the result of the application of or withdrawal of rewards; this is known as reinforcement.

(Page 304).

Question 92

Operant conditioning: Types of Reinforcements

(Page 304).

Answer 92

a. Positive – a consequence that is added, thereby strengthening the response that precedes it by virtue of its presentation. (Examples: stickers on good school work; payment for work; compliments for accomplishments)
b. Negative – a consequence that is withdrawn or terminated thereby strengthening the response that precedes it by virtue of its removal or termination. In other words, when a negative event is removed, the desired behavior takes place. (Examples: 1) Being released from detention hall early for good behavior. 2) Skinner’s rats were continuously shocked until they pushed a bar that turned off the current. Turning off a shock is a negative event because it takes away a stimulus. Since removal of the shocks increases the likelihood that a rat will push the bar again, the event is reinforcing.)
c. Primary – an event with reinforcing qualities that are barely dependent, if dependent at all, on prior learning. (Example: food).
d. Secondary – an event that is not inherently pleasant or reinforcing but it becomes so through its association with other reinforcing stimuli. (Example: money – currency is not in itself reinforcing, but the products money can buy are; token economies work the same way)
e. Partial or intermittent – reinforcement that occurs only sometimes, not every time the desired response is given.
f. Punishment – an aversive stimulus used repeatedly to produce avoidance behavior. Skinner did not believe punishment was effective in that it did not cause behavior to be unlearned, merely temporarily discontinued.

(Page 304).

Question 93

Schedules of Reinforcement

(Page 305).

Answer 93

a. Fixed-interval schedule: Reinforcement is given after a certain fixed period of time. The amount of work done (the number of responses) does not affect when reinforcement is given. In other words, the reinforcement is given at a set time (or a set time period) regardless of how much work is done. EXAMPLE: Generally speaking, people who receive a salary fit this category. They receive a paycheck at a specific time each month regardless of the amount of work they do. They do not get their paycheck earlier by standing around at the payroll window or by repeatedly asking/begging to get it early. They are paid (reinforced) at a pre-determined time or at a fixed interval.
b. Variable-interval schedule: Reinforcement is given at variable (unpredictable) intervals of time. EXAMPLE: Let’s say you are attempting to call a friend and get a busy signal several times. So, you begin to place the call based on your best “guess” of when he/she will be off the line. But no matter how often or when you dial, the length of time (the variable) your friend stays on the phone (let’s say 7 minutes) determines when you will be rewarded (i.e., finally reach your friend). The next time the phone line is busy, he/she may be on the phone 3 minutes, and then you get rewarded. The following time he/she may be on the phone 13 minutes.
c. Fixed-ratio schedule: Reinforcement is given after a set number of responses are performed. EXAMPLE: Let’s say you are hired to sew short sleeve shirts and are told you will be paid after completing every twelfth shirt. Upon completion of the 12th shirt, you are paid (being reinforced). You are not paid after the 3 rd shirt, the 7 th shirt, or the 9 th shirt. You are paid only after you sew 12 shirts, 24 shirts, 36 shirts, etc.
d. Variable-ratio schedule: The number of responses required before being reinforced is unpredictable/continually changing. EXAMPLE: Let’s say you are sitting at a slot machine putting in quarters. You know that there is a chance of winning. However, you don’t know how many quarters you’ll have to put in before winning. Sometimes you win after 7 quarters. Sometimes you win after 777 quarters. Sometimes you win after 7,777 quarters.

(Page 305).

Question 94

Successive approximation

(Page 306).

Answer 94

increments of change toward a desired behavior are reinforced, thereby shaping the response into the desired behavior (Example: Language development – a baby makes a small sound, mom smiles and says words that sound like the infant’s. This continues until the infant makes a sound that is a recognized word.)

(Page 306).

Question 95

Token Economy

(Page 306).

Answer 95

a medium of exchange for the giving or withdrawing of positive reinforcers. The objects that the token “purchase” are sometimes referred to as back-up reinforcers.

(Page 306).

Question 96

Contingency Contracting

(Page 306).

Answer 96

is a behavior management technique. The consequences of using the target behavior are decided in advance and written in a contract. This technique is used primarily in school settings.

(Page 306).

Question 97

The Premack principle

(Page 307).

Answer 97

The Premack principle proposes that high-probability behavior (HPB) can be used to positively reinforce a low-probability behavior (LPB), and engaging in a low-probability behavior can function as a punishment stimulus for a high-probability behavior. Parents use this principle when they tell children they must first do their chores and then they may play (Corsini, 1984).

(Page 307).

Question 98

Neal Miller
Biofeedback-operant conditioning
(Page 307).

Answer 98

• Neal Miller was a pioneer researcher in biofeedback and learning theory. He was the first to show that autonomic (involuntary) bodily processes can be controlled.
• Biofeedback is a form of operant conditioning.
• A biofeedback device provides biological information. These devices can be sophisticated electronic devices or an object as simple as a mirror.
• Landmark research in biofeedback has been performed at the Menninger Clinic in Kansas. One of its discoveries is that raising the temperature in the right hand can prevent or stop a migraine headache. A temperature trainer (an expensive but precise thermometer) is used in this biofeedback training.
• An electromyogram (EMG) is used to measure muscle tension during biofeedback training.
• An electroencephalogram (EEG) is used to measure alpha brain waves which indicate that the client is awake but very relaxed.
• An electrocardiogram (EKG) is used to measure the heart rate and pattern.
• Galvanic skin response (GSR) measures skin resistance to a slight electrical current when certain words or topics are brought up.

(Page 307).

Question 99

The Jacobson Relaxation Method

(Page 307).

Answer 99

The Jacobson Relaxation Method (1974) involves a tensing and relaxing of groups of muscles until the whole body is relaxed. It is praised for its simplicity and effectiveness.

(Page 307).

Question 100

VICARIOUS CONDITIONING / SOCIAL LEARNING THEORY

(Page 308).

Answer 100

Also known as: Observational Learning Linear–Interactionist Social – Cognitive Theory Cognitive Social Learning Theory

(Page 308).

Question 101

Albert Bandura and Richard Walters

(Page 308).

Answer 101

• This is a Socio-behavioristic approach
• They emphasized Modeling – BoBo Doll experiment on children modeling aggression
• It is an Observational-learning theory
• They used “in vivo” exposure to confront threatening situations and personal expectations
• Four processes in observational learning:
  1. Attentional processes
  2. Retention processes
  3. Motor reproduction
  4. Incentive and motivational processes
• Modeling is enhanced by the nature of the model, the observer, and the presentation of the behavior.
• A model should be similar to the observer in age, race, sex, and attitudes. A model should appear competent and of an appropriate level of prestige, warmth, and care. The perceived rewards received by the model will also influence the observer.
• An observer must be able to process what he observes and retain that information. The observer’s level of anxiety and uncertainty regarding the behavior to be modeled must be moderate enough not to block the process and yet high enough to optimize learning.
• The presentation can take many forms: live, symbolic, multiple, covert, a coping model, a learning model, an expert at the behavior. Graduated procedures may be used; instruction may be given; rules may be made; summarizing by the observer may be required.

(Page 308).

Question 102

Julian Rotter

(Page 309).

Answer 102

• Expectancy-reinforcement theory
• Developed a system of constructs to provide maximum prediction and control of behavior.
• Three basic constructs are:
  1. Behavior Potential – Potential for specific behavior to occur in a given situation.
  2. Expectancy – Expectancy by a person that certain reinforcements will follow certain behaviors.
  3. Reinforcement Value – Degree of preference for any one of several possible reinforcements when all are equal.
• Rotter theorized that behavior problems result when a behavior is avoided because either a punishment was previously associated with that behavior or satisfaction is attained through inappropriate means.
• A maladjusted person expects his or her maladjusted behavior to lead to greater gratification than would be expected by a mentally healthy individual.
• Therapy is geared to the gratification expected: lowering the expectancy of gratification for maladjusted behavior and increasing the expectancy of gratification of alternative behavior.
• Techniques include direct reinforcement, observing models, discussing observed behaviors, dealing with prior negative reinforcements, introducing alternative behaviors, and suggesting and reinforcing expectancy that the client has the capacity to identify and test alternative behaviors, etc.

(Page 309).

Question 103

John Dollard and Neal Miller (Dollard & Miller, 1950)

(Page 310).

Answer 103

Reinforcement Theory

• Reinforcement theory is an integration of psychoanalytic principles, Hullian behaviorism (Clark Hull’s mathematically-oriented theory of motivational processes (drive), and social learning theory. Whereas Bandura considered responses to be innate, Dollard and Miller said that responses are learned.
• All learning entails these four elements:
  1. Drive (motivation) – Either internal or from the environment; can be innate or learned.
  2. Cue (a discriminative stimulus; what a person notices) – Either internal or external; sets a response in motion and guides that response; determines “when [an individual] will respond, where he will respond, and which response he will make” (Miller & Dollard, 1941).
  3. Response (the resulting behavior) – In any given situation, an individual will have a multitude of possible responses to choose from. The person’s prior learning reinforcement history will have ingrained responses with different response strengths. The dominant or strongest response is the most likely to manifest.
  4. Reinforcement (the reward for the behavior) – Since the drive is satisfied, the reinforcement is a drive-reduction factor. All reinforcers reduce drive.
• To Dollard and Miller, the personality is the system of habits that an individual develops in response to cues in the environment. Behavior is motivated by primary (survival needs) and learned drives. The habits that are reinforced tend to be repeated and thereby become part of the stable collection of habits that constitute personality.
• Four types of conflict situations:
  1. Approach-approach: Choosing between two desirable goals. (Example: Choosing between two good job offers)
  2. Approach-avoidance: Approach and avoidance of the same goal. (Example: Wanting to eat but not wanting to gain weight)
  3. Avoidance-avoidance: Conflict around two undesirable goals. (Example: Washing a load of dishes or vacuuming the house)
  4. Double Approach-avoidance: Conflict involving both the approach and the avoidance of two different goals simultaneously. (Example: One’s attraction to a larger, newer house with higher payments and an attraction to a smaller older house with smaller payments)
• Reinforcement theory is based on six conflict behavior assumptions:
  1. The inclination to approach a goal strengthens the closer a person gets to the goal.
  2. The inclination to avoid a feared goal (stimulus) strengthens the closer a person gets to the feared goal. 3. The strength of avoidance increases more quickly than the strength of approach.
  4. An increase in drive increases either/both approach and avoidance.
  5. The strength of a response (either approach or avoidance) is influenced by the history of reinforcement.
  6. Two simultaneous, conflicting responses will result either in the stronger response occurring or in a stalemate causing neurosis.
• Dollard and Miller asserted that neurosis develops when conflict from two or more strong drives results in incompatible responses.
• Therapy is viewed as a new learning arena in which both psychoanalytic and behavioral techniques assist the client in extinguishing neurotic responses and in learning better, more constructive responses. The restoration of the higher mental processes is the goal.
• Better responses will follow when the client learns to remove repression, to implement relationship transference, to label, and to discriminate.
• Common techniques include counselor permissiveness, free association, full attention and acceptance from the counselor, interpretation of silence, confronting avoidance, reframing, labeling, rehearsing responses, identifying similarities and differences in responses, etc.

(Page 311).

Question 104

George Kelly

(Page 311).

Answer 104

• Kelly’s (1955) system of personal constructs is based on Kelly’s belief that an individual’s own concepts or constructs are created by the individual in an effort to understand the individual environment.
• Constructive alternativism is an important determinant of one’s decisions and behavior.
• Kelly’s fixed role therapy comes from his psychology of personal constructs and involves giving a client an outline sketch or a fixed role. The client is to read the role at least three times a day and act, think, and talk like the role.

(Page 311).

Question 105

Yerkes-Dodson Law

(Page 312).

Answer 105

The Yerkes-Dodson Law states that there is a level of arousal or stress connected to the optimal performance of an action or task. Too high a level of arousal or stress will block performance just as too low a level of arousal or stress (i.e., a little bit of test anxiety is beneficial and produces better performance).

(Page 312).

Question 106

RATIONAL EMOTIVE BEHAVIOR THERAPY – (REBT) COGNITIVE BEHAVIORAL STYLE
Key Figures

(Page 313).

Answer 106

Albert Ellis

Question 107

Overview of the REBT Model

(Page 313).

Answer 107

Ellis (1973) wrote that people are not exclusively the products of social learning (as the theories of the psychoanalysts and the behavior psychologists emphasize) but that their so-called pathological symptoms are the result of biosocial learning. That is to say, because they are human…they tend to have several strong, irrational, empirically unvalidatible ideas; and as long as they hold on to these ideas…they will tend to be what we commonly call ‘neurotic,’ ‘disturbed,’ or ‘mentally ill’ (p. 123). Simply put, one’s feelings and actions are determined by his/her cognitions, the way one thinks.

(Page 313).

Question 108

Goals of REBT Treatment

(Page 313).

Answer 108

A. REBT is unequivocally directive and intentionally attempts to “lead” the client to a “healthier” perspective.
B. Clients learn to reperceive or rethink their life events and philosophies and thereby to change their unrealistic and illogical thought, emotion, and behavior. C. Rational-emotive “teaching” empowers the client to analyze introspectively and to correct his or her distortion of the world.
D. The client is taught to apply the scientific model to his or her own thought processes and behaviors.
E. “Automatic” thoughts must be recognized and changed.

(Page 313).

Question 109

Role of the REBT Counselor

(Page 314).

Answer 109

• The counselor/client relationship is described as teacher/student and is not necessarily a personal relationship.
• The counselor is directive and authoritarian.
• The A-B-C model of changing cognitions is taught to the client.
• The therapist works to distinguish between understanding the patient and agreeing with his or her irrational perceptions. According to Ellis (1962), the therapist is to understand the client’s behavior, no matter how immature, without getting involved in or believing in it.
• The counselor may inject his or her own values into the therapeutic process.

(Page 314).

Question 110

Normal Development

(Page 314).

Answer 110

• While growing up, a child is taught to think certain thoughts and feel certain emotions about the self and others. The thoughts that are associated with the idea of “This is good!” become positive human emotions, such as joy or love. The thoughts associated with the idea of “This is bad!” become negative emotions and result in painful, negative, depressive feelings.
• Ellis emphasized that a person is born with the potential to be rational and logical but becomes illogical and influenced inordinately by “crooked thinking” because of distortions during childhood and continued contemporary repetitions of those distortions.

(Page 314).

Question 111

Development of Behavioral Disorders

(Page 314).

Answer 111

• A faulty belief system is at the root of emotional and behavioral disorders. Ellis’s examples of faulty beliefs include the following: A stronger someone is needed to lean on. External events make a person happy or unhappy. Every important person in one’s life must show love and approval.
• Neurosis results from irrational or faulty thinking and behaving.
• Blame is the core of emotional disturbance.
• The client must learn to stop blaming and to accept him/herself in spite of imperfections.

(Page 314).

Question 112

A-B-C Theory of Emotional Disturbance

(Page 316).

Answer 112

A = ACTIVATING experience
B = BELIEF about or the interpretation of the experience
C = upsetting emotional CONSEQUENCES
D = DISPUTING of irrational ideas
E = new EMOTIONAL consequence or EFFECT
F = new FEELING

An individual’s Belief (B) about the Activating (A) experience generates the upsetting emotional Consequences (C). Disputing (D) the irrational ideas Beliefs (B) is a process of:

• detecting irrational beliefs,
• debating the beliefs by challenging them logically, and - discriminating between rational, self-helping beliefs and irrational, selfdefeating ones. (These three “D”s are known as the Scientific Method.) New, Effective (E) philosophies are created along with new Feelings (F).

(Page 316).

Question 113

REBT therapy modes

Answer 113

1. Cognitive – teaches the client “how to find his should, oughts, and must; how to separate his rational…from his irrational beliefs; how to use the logico-empirical method of science (the scientific method) in relation to himself and his own problems; and how to accept reality” (p. 196, Ellis, 1973).
   - Confrontation
   - Analyzing interpretations and forming alternate ones
   - Socratic dialogue
   - Debating or disputing irrational beliefs
   - Gathering data validating assumptions or misassumptions
   - Therapeutic cognitive restructuring: Rewording self-talk or internal verbalizations
   - Humor to point out absurd ideas
   - Homework assignments: Purposefully take risks Reading a book (bibliotherapy) such as Ellis’ A Guide to Rational Living
2. Emotive – dramatizes truths and falsehoods so that the client can clearly distinguish between the two:
   - Role playing ● Imagery
   - Modeling ● Shame attacking exercises
   - Unconditional acceptance ● Forceful and vigorous responses
   - Exhortation
3. Behavior – “helps the client change his dysfunctional symptoms and to become habituated to more effective ways of performing, and to help him radically change his cognitions about himself, about others, and about the world” (p. 197, Ellis, 1973).
   - Regular behavior therapy procedures: Operant conditioning
   Systematic desensitization
   Modeling
   Self-management techniques
   Relaxation techniques
   Assertiveness training

• Failing on purpose at something
• Keeping a diary of activities
• Changing thoughts and language
• Practice new coping skills

(Page 317).

Question 114

COGNITIVE THERAPY COGNITIVE BEHAVIORAL STYLE
Key figures
(Page 319).

Answer 114

Aaron Beck; Donald Meichenbaum

(Page 319).

Question 115

Overview of the Cognitive Therapy Model

(Page 319).

Answer 115

• Aaron Beck originally set out to validate Freud’s explanation of depression as self-directed anger. He instead ended up rejecting Freud’s motivational model and developed a cognitive theory of depression. Beck, calling himself an ex-psychoanalyst, identified “cognitive distortions” in the thinking of depressed individuals. These negative thoughts are based on underlying dysfunctional assumptions and beliefs. Beck went on to apply his concepts to other problems as well.
• Ellis and Beck arrived at their conclusions separately, but Beck gives Ellis credit for bringing forth the concept that feelings and behaviors can be changed by focusing on cognitive factors. Ellis regards Beck’s research as very beneficial to the furtherance and the success of cognitive-behavioral therapies.

(Page 319).

Question 116

Goals of Cognitive Therapy Treatment

(Page 319).

Answer 116

• Since distorted “rules” and “formulas for living” cause unhappiness in individuals, new rules must be experimented with and tested.
• “The remedy,” according to Beck (1988, page 157), “lies in modifying the cognitive set. This psychological modification then produces biochemical changes which in turn can influence cognitions further.”
• Cognitive distortions must be identified and discarded.

(Page 319).

Question 117

Role of the Cognitive Therapy Counselor

(Page 319).

Answer 117

• The core therapeutic conditions outlined by Rogers are necessary: genuine warmth, accurate empathy, nonjudgmental acceptance, the ability to establish rapport with the client, etc.
• In addition, the CT counselor must be active, creative, and able to engage the client in the therapeutic process.
• Therapy is a collaborative process between the counselor and client. Beck conceptualizes a partnership to formulate individually meaningful evaluations of the client’s “distorted” assumptions (Beck & Haaga, 1992).

(Page 319).

Question 118

Normal Development
Beck
(Page 320).

Answer 118

• As people grow up, they develop views of the connections between themselves and others, and the environment.
• These views become “rules” and “formulas for living.”
• To function appropriately, one’s perception of the world and one’s relationship with it should be consistent with the probable responses to one’s actions (Belkin, 1987).

(Page 320).

Question 119

Development of Behavioral Disorders

(Page 320).

Answer 119

• When the views people have of the connections between themselves and the environment become distorted, these distortions influence the way they feel about themselves and the way they perceive and process the world around them.
• Problems occur when an individual thinks dysfunctionally; ideas that are too broad or too absolute lead to problems like depression.

(Page 320).

Question 120

Cognitive distortions
According to Beck
(Page 321).

Answer 120

1. Magnification and minimization – judging something as greater or less than it is.
2. Selective abstraction – making assumptions based on one detail rather than the whole.
3. Arbitrary inferences – making assumptions with no evidence to support it.
4. Labeling and mislabeling – basing one’s identity on past mistakes or imperfections.
5. Polarized thinking – going to either-or extremes or dealing in all-or-nothing terms.
6. Personalization – relating an unrelated external event to oneself.
7. Overgeneralization – adopting an extreme belief based on a single incident.
8. Incorrect assessments of danger or safety – phobias or underestimating dangers.

(Page 321).

Question 121

REALITY THERAPY
Key figure
(Page 323).

Answer 121

William Glasser

(Page 323).

Question 122

Overview of the Reality Therapy Model

(Page 323).

Answer 122

• William Glasser was trained in the psychoanalytic approach but became discouraged and objected to the psychoanalytic concepts of neurosis and mental illness. Instead of being ill, the client was weak, according to Glasser, and could be strengthened to become a contributing member of society (Glasser, 1965).
• Glasser decided that it was not necessary to explore a patient’s past history in detail, and he rejected the notion of transference.
• Glasser also rejected the Freudian notion that attaining insight into the unconscious was necessary for mental health.
• Glasser arrived at his theory after working with troubled adolescents and went on to apply it to broader population groups.
• By the 1970’s, Glasser was looking for a theoretical framework to explain his findings and work. He chose Control Theory originally espoused by William Powers (1973). By the mid- 1990’s, Glasser had expanded, clarified, and revised the theory and adopted the term Choice Theory to denote the connection between behavior and choice.

(Page 323).

Question 123

Goals of Reality Therapy Treatment

(Page 323).

Answer 123

• The counselor must teach (Belkin, 1987) the client:
  1. to make appropriate choices
  2. to develop a sense of responsibility
  3. to be able to interact constructively with others
  4. to understand and accept the reality of his or her existence

(Page 323).

Question 124

The Role of the Reality Therapy Counselor

(Page 323).

Answer 124

• The counselor’s most important task is to become a “friend” to the client.
• The counselor teaches clients to apply choice theory in their day-to-day living.
• The counselor follows the eight step counseling process which employs WDEP:
  Wants and needs
  Doing and direction
  Evaluation Planning and commitment

(Page 323).

Question 125

Normal Development
Reality Therapy

(Page 324).

Answer 125

• According to Glasser’s Choice Theory
  1. We are born with five needs: survival, love and belonging, power, freedom, and fun.
  2. These needs have varying strengths and drive us for all of our lives.
• One’s identity results from the interactions of the self, others, and the environment.
• Two critical developmental periods are identified:
  1. Ages 2 to 5 as socialization skills are learned. Love, acceptance, guidance, and support from parents are critical to the child’s burgeoning success identity.
  2. Ages 5 to 10 as increasing interaction in the school environment can result in increased frustration and a resulting failure identity.

(Page 324).

Question 126

Development of Behavioral Disorders
Reality Therapy
(Page 324).

Answer 126

• Problem behavior stems from one of two avenues: neurological factors or choices.
  1. Neurological factors – Glasser uses the term “mental illness” to encompass conditions caused by brain abnormalities, brain damage, etc. e.g. Alzheimer’s disease, brain infections, head trauma, and epilepsy.
  2. Choices – Behavior choices have been made in response to either a current unsatisfying relationship or to the lack of any relationship at all. Perhaps a person is trying to control others or is resisting being controlled by others. These problem behaviors are attempts to deal with the resulting pain and frustration. The resulting frustration leads to an individual adopting a failure identity. These choices are not “mental illness.”
• Glasser does not endorse assigning a diagnosis. He feels that a diagnosis just gives the client “permission” to continue to behave in that manner. Since Glasser rejects the traditional medical model of disease, he refrains from using either the DSM or the ICD (the International Classification of Disease) as guidelines.

(Page 324).

Question 127

Choice theory
Reality Therapy
(Page 325).

Answer 127

the only behavior a person can control is one’s own. A person controls himself/herself and makes choices to satisfy his/her wants and needs. (The abbreviation BCP stands for behavior controlled by one’s perception.)

(Page 325).

Question 128

Glasser formulated an eight step counseling process

(Page 326).

Answer 128

Step 1: The counselor establishes a good working relationship with the client, a friendship.
Step 2: Present behavior is identified in a noncritical way.
Step 3: The client evaluates or judges his or her behavior.
Step 4: Alternative behaviors are examined and a plan of action is developed.
Step 5: The counselor gains a commitment to the action plan from the client.
Step 6: No excuses or noncompliance are accepted; logical consequences are employed.
Step 7: The counselor holds the client to his or her commitment without employing punishment.
Step 8: The counselor and client never give up until the action plan is fulfilled.

(Page 326).

Question 129

ECLECTIC THERAPY OR INTEGRATIVE THERAPY
Key figures
(Page 327).

Answer 129

Frederick Thorne; Robert Carkhuff; Arnold Lazarus; Gerard Egan; Gordon Allport

(Page 327).

Question 130

Overview of the Eclectic Therapy Model

(Page 327).

Answer 130

A. Roughly fifty percent of all counselors now consider themselves to be eclectic.
B. Two basic types of eclecticism are generally recognized:
1. Counselor- or therapist-centered eclecticism refers to counselors’ choosing personal counseling systems that match their personalities and are, therefore, considered to be more effective. Gerald Corey encourages beginning counselors to become familiar with the major therapeutic approaches. He cautions, however, that the synthesis of ideas which will comprise an eclectic framework will come only after years of training, study, and actual counseling experience (Corey, 2001). Arnold Lazarus emphasized the importance of choosing the appropriate technique or intervention for a particular client. Making an appropriate choice depends on the counselor’s versatility, flexibility, and comprehension of available techniques (Lazarus, 1971).
2. Process-centered eclecticism emphasizes particular underlying factors as being common to all therapeutic interchanges. What works is more important than the theoretical basis from which the technique comes. The communication skill approaches are prime examples of process-centered eclecticism.

(Page 327).

Question 131

Arnold Lazarus’ Multimodal Therapy

(Page 330).

Answer 131

B = Behavior (overt, measurable)
A = Affect (strong feelings, emotions, mood)
S = Sensation (the five senses)
I = Imagery (how one sees self)
C = Cognition (basis of values and beliefs)
I = Interpersonal relationships (interactions)
D = Drug/Biology (influences on body)

(Page 330).

Question 132

Lazarus 8 issues to address for brief therapy

Answer 132

1. Ambivalent or conflicting feelings
2. Maladaptive behaviors
3. Misinformation
4. Lack of information
5. Interpersonal demands and pressures
6. External pressures and demands (not from close interpersonal networks)
7. Severe traumatic experience
8. Biological dysfuntioning

(Page 330).

Question 133

Gerard Egan’s Skilled Helper Approach

(Page 331).

Answer 133

Stage 1: Initial problem clarification
Respect, genuineness, and what Egan calls primary-level accurate empathy are needed and evidenced. Egan’s primary-level accurate empathy is communicating the understanding of the client’s feelings and what is behind those feelings.
Step 1-A: The story – includes details to give a clear picture of what is going on.
Step 1-B: Blind spots – includes breaking through blind spots to help clients see themselves, their situations, and their opportunities clearly.
Step 1-C: Choosing the right problems/opportunities to work on – includes working on issues that will make a difference.

Stage 2: Setting goals based on dynamic understanding Challenging skills, information sharing, what Egan calls advanced accurate empathy, confrontation, and self-disclosure by the counselor are required. Egan’s advanced accurate empathy includes communicating the understanding of what the client is only partially expressing or implying.
Step 2-A: Possibilities for a better future – includes helping clients spell out the various elements of the desired future.
Step 2-B: The change agenda – includes choosing realistic and challenging goals.
Step 2-C: Commitment – includes finding the incentives that will encourage persistence.

Stage 3: Facilitating action Program development (outlining the means to reach the goals), facilitating action (preparation, challenging, supporting), and evaluation are necessary components of this stage.
Step 3-A: Possible actions – including evaluating the many ways a goal can be achieved.
Step 3-B: Choosing best-fit strategies – includes choosing the strategies that best fit the client’s temperament, style, talents, resources, etc.
Step 3-C: Crafting a plan – includes organizing the actions to be taken.

(Page 332).

Question 134

Robert Carkhuff’s (1981) Human Resource Development Model

(Page 333).

Answer 134

Level 1: Process goals
Exploration – Where is the client in relation to where he or she wants to be or needs to be?
Understanding – Where does the client want to be? How shall the goal be defined?
Action – The client moves from where he or she is to where he or she wants to be.

Level 2: Intermediate goals
Skills result from achieving process goals:
- Physical skills such as exercise or functional habits.
- Interpersonal skills such as listening, initiating, etc.
- Cognitive skills such as analyzing, interpreting, etc.

Level 3: Ultimate goals
High levels of responsiveness and initiative lead to self-actualizing.

(Page 333).

Question 135

Overview of the Feminist Therapy Model

(Page 334).

Answer 135

• Feminist therapy has its roots in the women’s movement of the 1960’s. A “sisterhood” of women arose to address the oppression of women and to advance the value of women’s perceptions and values.
• Traditional therapy models were formulated by white, Western (European or American) males and tended to view mental health in terms of that background. Feminist psychology therefore attempts to address the constraints put on both men and women through psychological oppression and the sociopolitical status afforded to each. Identity development, goals, and self-concept are all viewed as products of socialization.
• The rise of the feminist viewpoint is credited with the current attention being given to issues of rape, incest, child abuse, domestic violence, and sexual harassment.

(Page 334).

Question 136

Goals of Feminist Therapy Treatment

(Page 334).

Answer 136

• Feminist therapy seeks to transform both the individual and society (Corey, 2001).
  Individual – to empower the individual to break free from gender-role expectations; to reject societal expectations such as those of appearance, relationship to men, relationship to other women, etc.
  Society – to force replacement of gender-role expectations; to foster interdependence, cooperation, and mutual support for both women and men.
• Worell and Remer (1992) have listed these goals of feminist therapy:
  1. Gaining awareness of one’s gender-role socialization process.
  2. Identifying internalized gender-role messages and replacing them.
  3. Understanding the negative impact on sexist, oppressive beliefs and practices in society.
  4. Acquiring skills to generate change in oneself and in society.
  5. Developing freely chosen behaviors.
  6. Trusting one’s experiences and intuition.
  7. Appreciating female-related values.
  8. Assisting women in taking care of themselves.
  9. Helping women accept and like their bodies.
  10. Identify and respond to one’s sexual needs rather than the sexual needs of someone else.

(Page 334).

Question 137

Role of the Feminist Therapy Counselor

(Page 335).

Answer 137

• The feminist counselor acts much like a humanistic or a person-centered therapist. The relationship with the client is a collaborative partnership.
• The counselor believes the client has the capacity to be constructive and to make positive decisions and changes.
• The counselor strives to empower the client to transcend societal role-stereotyping; to encourage the client to live by his or her internal values, rather than external (societal) values.
• Appropriate self-disclosure and education about the therapeutic process act to tear down walls and barriers of power and control.

(Page 335).

Question 138

Normal Development
Feminist Therapy
(Page 335).

Answer 138

• Differences between the behaviors of men and women are due to gender-role socialization.
• Since development takes place over the lifespan, changes in behavior and personality patterns can take place at any time.

(Page 335).

Question 139

Development of Behavioral Disorders
Feminist Therapy
(Page 335).

Answer 139

• Accepting traditional roles hinders the true development of men and women. Gender stereotypes are so powerful that one must either acquiesce to the role for the sake of being socially acceptable or rebel and fall prey to the consequences.
• Adjusting to the status quo is not true personal development.

(Page 335).

Question 140

NEURO-LINGUISTIC PROGRAMMING (NLP)
Key figures
(Page 340).

Answer 140

Richard Bandler; John Grinder

(Page 340).

Question 141

Overview of the NLP Model

(Page 340).

Answer 141

• Richard Bandler and John Grinder (Bandler & Grinder, 1979) based their theory on linguistics and theories of personalities. The term programming was chosen to infer an organization and system of ideas similar to early computer programming.
• Bandler and Grinder observed expert counselors (most notably Virginia Satir, Milton H. Erickson, and Fritz Perls) in their sessions with clients and compared what was done with what the counselors said they had done. Subtle changes in breathing, skin tone, eye movements, etc. were noted.
• NLP is concerned with how the processes of the brain perceive, store, and recall events.

(Page 340).

Question 142

Goals of NLP Treatment

(Page 340).

Answer 142

• The goal of therapy is to discover the client’s method of perception, storage, and retrieval through observing the eye movements and listening to the client’s language.
• Once this pattern is understood, the therapist teaches the client ways to consider the problem area using the same representational system pattern, or perhaps by using another pattern that has not been used before.
• Example: A client uses mostly visual perception and not kinesthetics. The therapist may ask the client to visualize himself/herself doing a new behavior, and then have him/her look down and to the right to see how he/she “feels” about that behavior.

(Page 340).

Question 143

Role of the NLP Counselor

(Page 340).

Answer 143

• The therapist is a communicator/educator.
• Not a lot of time is spent on the therapist/client relationship as compared to other forms of therapy, though this is still considered important.
• Rapport is more quickly established through observing the client’s pattern and other nonverbal cues and then “mirroring” these back to the client thereby “telling” the client behaviorally that the therapist understands him/her.

(Page 340).

Question 144

Normal Development
NLP
(Page 341).

Answer 144

Normal development is strictly a matter of determining if a behavior pattern works or not. If a person has successfully modeled appropriate behavior, then development will be judged successful. Successful modeling of appropriate behavior requires three points of knowledge:
A. The behavior and physiology the model uses to perform the skill
B. The model’s thinking strategies in performing the skill
C. The beliefs and values of why the model performs the skill
- If any of these components is missing, the new skill cannot be acquired by the client. Additionally, taking a skill out of context changes the skill. For example, modeling the thinking processes of Albert Einstein will not automatically produce another Einstein.

(Page 341).

Question 145

Mirroring to establish rapport
NLP
(Page 342).

Answer 145

The therapist asks “how” questions and observes eye movements to determine the representational system:

a. Eyes up and to the right or up and to the left both indicate visual perception.
b. Eyes to the left center or left downward indicate inner auditory selection.
c. Eyes to the right lower corner indicate kinesthetic or feeling perception.
d. Eyes to the right central indicate auditory output, or what the client may be rehearsing to say.

(Page 342).

Question 146

Pacing and leading
NLP
(Page 342).

Answer 146

The therapist paces or matches a non-verbal behavior in the same rhythm as the client and then changes to another behavior or speed to lead the client to a new behavior. (Example: A client with a rapid breathing pattern can be paced by the therapist’s moving a finger in sync with the breathing. Once this is done, the therapist can slow the finger pace, and the client’s breathing will follow the new rhythm.)

(Page 342).

Question 147

Anchoring
NLP
(Page 342).

Answer 147

The client does an internal search for a representation of the problem to be solved. Once experienced, the client is “anchored” to a touch, a word, or a color representing that these cues are the old issue. Then a new possibility is created or an old solution with modifications is considered. When the new anchor is activated, the mind connects/applies the new solution to the problem. This is similar to classical conditioning or the concept of a posthypnotic suggestion.

(Page 342).

Question 148

Androcentric

(Page 343).

Answer 148

conclusions regarding human development are based on male-oriented constructs.

(Page 343).

Question 149

Johari’s Window

(Page 344).

Answer 149

The Johari Window (from the first names of its inventors, Joseph Luft and Harry Ingham) (Luft, 1969) is a four-paned “window” that serves as a model for human interaction and communication:

a. The “open” window represents those things that one knows about oneself and that other people know. Examples include factual information such as one’s name as well as feelings, wants, needs, etc., that are openly expressed.
b. The “blind” window represents those things that others know about oneself but that one may be unaware of. For example, a person may be unaware of a bug on their shoulder or that their tie is crooked while it is obvious to others. These blind spots also include personality and interactional traits.
c. The “hidden” window represents those things known about oneself but hidden from others. These are sometimes referred to as “hidden agendas” or as issues “under the table.”
d. The “unknown” window represents those things of oneself that are not known by oneself or others. The Johari Window demonstrates the different kinds of information we deal with when we interact with others. The underlying assumption is that moving information to the “open” window facilitates deeper relationships and clearer communication.

(Page 344).