exam 2 c6 Action Oriented Approaches Flashcards
Behavioral Counseling
Emphasis on the present rather than the past
Attention to changes to*dysfunctional behaviors
Reliance on** research**as an integral partner for developing and testing interventions
Preference for carefully measuring treatment outcomes
Matching specific treatments to particular presenting problems
Behavioral Counseling: Learning New Skills
Behavioral assessment and identification of target symptoms
*Reinforcement (both operant and classical)
*Social modeling of skills, desirable behaviors
*Skills training
*Environmental changes that will encourage identified goals
*Objective measurement of changes over time
Behavioral Technology Aid
Valuable tool for researchers and behaviorists is time-series charts
–Graphic portrayal of client change
–Helps the counselor study a single case intensively, plotting baseline data and the results of therapeutic interventions
–Aids in quantitatively and specifically describing the behaviors targeted for changes and in noting the effects of any action
Strategies:Operant-conditioning procedures
Methods in which the** frequency of behavior may be increased or decreased according to the type and timing of stimuli presented**
–In **positive reinforcement strategies, the counselor hopes to increase behavior by rewarding **the client
**–Negative reinforcement **also produces an increase in desired target behaviors such as assertiveness, but does so by **removing a stimulus the client perceives as aversive
Behavioral Counseling Strategies:Contingency Contracting
Use of a behavioral contract that defines the necessary contingencies on which a reinforcer will be presented
Strategies
*Punishment strategies
Punishment strategies are used to **reduce the frequency of a client’s behavior **by presenting an aversive stimulus
–Many parents and teachers **rely too heavily **on this strategy because of its seeming convenience
–Usually produces **negative side effects in the child **such as withdrawal, aggression, and generalized fears
Strategies:Shaping
A process in which complex terminal behaviors are reinforced in approximate successive stages
Behavioral Strategies:Classical or Pavlovian conditioning
Presented stimulus elicits automatic response
**Systematic desensitization is the most common **of these methodologies
**Clients are taught to substitute relaxation responses for anxiety **when confronted by previously frightening situations such as tests or social events
Strategies
*Flooding
An opposite strategy is employed to erode the stimulus/response sequence
–**A phobia, fear, or bad habit can be extinguished by bombarding the person with the stimulus until fatigue sets in **or until (in the case of a habit) the stimulus loses its pleasurable value
Cognitive Behavioral Therapy (CBT)
In childhood, we learn a set of assumptions and beliefs (schemas) that influence our interpretations of daily situations and incidents throughout life
–We experience these as the thoughts that instinctively flit across our conscious minds right after the event itself and when we later ruminate about the meaning of the event
Self-critical belief systems learned in childhood can be activated by certain life situations
–Can generate distorted, unrealistic, automatic thoughts, which negatively affect our mood
Teach the client the categories of cognitive distortions
CBT: Beck
–Beck developed a list of the typical kinds of unrealistic, distorted thoughts clients experience
Create a thought diary
–Clients record in a chart their irrational thoughts following a mood-affecting situation, the category the thoughts belong to, and more realistic alternative thoughts (did this in class)
Engage in a Socratic dialogue
–Counselor questions the client’s thinking processes, persistently challenges illogical ideas, and gradually leads the client to appreciate that his or her negative cognitive response to an event does not make rational sense
*Test the evidence
–Counselor assigns the client the task of testing the validity of a negative belief
CBT Distortions
All or nothing thinking
**–Life is seen in black or white terms.
Mind reading
**–Assuming you know what others are thinking about you
**should statements**
–Saying “I should,” “I must,” or “I ought to” statements that are common attempts to motivate ourselves is more likely to make us feel anxious or depressed
–Ellis’s REBT makes similar point, calling this tendency Musterbating
Catastrophizing
–Making a mistake or having a bad experience and assuming it will lead to the worst possible outcome
–REBT counselors call this Awfulizing**
**Labeling*
–Calling ourselves a derogatory name, something we all do from time to time, inevitably making us feel worse
Disqualifying the positive
–Ignoring our positive qualities and achievements and only seeing our negative characteristics or mistakes
Magnification
–Overemphasizing the importance of one negative event
*Fortune telling
–Assuming we know what’s going to happen
who wrote? Rational Emotive
Therapy Behavior (RETB)
Ellis developed an “ABC Theory” of emotions to help explain the ways irrational beliefs lead people to negative emotional outcomes
–A: Activating Emotional Experience
*Reading chapters on counseling approaches that present a dozen complex theories
–B: Belief or Interpretation of Experience
*“I feel so stupid that I can’t understand all of this stuff.”
C: Consequences
*Anxiety
*Fear
*Confusion
*Frustration
*Anger
–D: Disputing Irrational Beliefs
*“Of course I feel overwhelmed — that is what an introductory student is supposed to feel…”
Limitations of Behavioral Approach
Criticized most often because of its narrow focus on observable human behavior and lack of attention to feelings and thoughts
Counselor’s role is so verbal, active, and directive
–Client may feel overpowered, dominated, and not responsible for the outcome
–Make up significant part of a person’s functioning
*Works only with the presenting complaint
–Could be a symptom of underlying conflicts
*Many insight-oriented theorists believe symptoms thus cured will inevitably be replaced by others because the internal condition has not been altered
CBT and REBT are probably less effective with some kinds of clients
–Those who already have problems with over intellectualizing or who don’t have the capacity to reason logically
*Young children, schizophrenics, some clients with personality disorders, or clients with minimal intelligence
Many cognitive-behavioral **counselors **complain of boredom and **burnout **from continuously repeating the same arguments and processes with all clients
*CBT and REBT are difficult for some professionals to practice if they are not outgoing and assertive and don’t enjoy vigorous debate and confrontation
Rational Emotive Approach: Personal Implications
We create our own emotional misery through distorted thinking
–We can potentially change these negative feelings by changing the way we think about our situations
*Carefully monitor our language for words such as “should,” “must,” and “ought”
–Imply irrational beliefs
Solution-Focused Therapy
If it doesn’t work, do something different
–If it works, do more of it
*Clients have strength and resources to change
*Problems from not recognizing alternatives rather than from underlying pathology
–Change comes from focusing on future possibilities and solutions
–A small change in any aspect of a problem begins the process of solving it
Solution-Focused Interventions
*The miracle question
“If a miracle occurred and the problem was fixed, what would be different? How would I know?”
who said it? Solution-Focused Interventions: Pretending
Madanes preferred when working with children who have disruptive symptoms
–After the child has been deliberately directed to engage in the symptoms, they lose their controlling power
Solution-Focused Interventions: Exception finding
Counselor and client play detective, searching for times in the client’s life when the problem did not occur
Solution-Focused Interventions: Scaling questions
Throughout treatment, counselors ask clients to rate their progress in achieving their goals
Solution-Focused Interventions: Task assignments
Ultimately, the success of this theory relies on the counselor’s assigning clients to perform specific tasks between sessions
Limitations of
Solution-Focused Therapy
Real test of any theory is utility after initial feelings of hopefulness fade and the client must face the challenge of changing
–Hard to know if solution-focused counseling is more than a placebo, because it is so brief
*Clients may not grow from the experience or learn new skills
Some clients need the opportunity, at least initially, to talk about their problems and explore their meaning
Insight is unnecessarily downgraded or totally ignored as a distracting variable**
**–Self-understanding is an important goal of many clients
Focus is on solving problems**
–Could rely largely on a male-oriented, control-based methodology that is inconsistent with the values of some cultures.
**Many strategies are intuitively constructed
– in which are difficult to learn and apply reliably
*Limited empirical base
–Number of studies demonstrating efficacy is small
*Some are significantly flawed in their research design
Solution focsed therapy: Personal Applications
At some point, you have found a way to solve even the most daunting of challenges
When you try something and it doesn’t work, don’t do the same thing
–Try anything else other than what you are doing*
*When you are facing a problem that feels insurmountable,** reframe it in a way that makes it more manageable**
Assume you are a client who feels stuck
–First, you are asked to practice traveling into the past and future through the use of fantasy
–Once you can easily move forward or backward at will, you are asked to** travel into the future to a time when your problem is resolved**
*Are you there yet?
*Okay, then — what did you do to fix your problem
Multimodal Counseling
Seeks to understand and intervene at the levels of all seven modalities of the human personality
People are capable of experiencing 1.sensations, 2. feelings, 3.thoughts, 4.images, 5.observable behavior, 6.interpersonal responses, and 7. biochemical and neurophysiological reactions
*Multimodal assessment permits the practitioner to understand at a glance:
–How the client characteristically functions
–How, where, and why the presenting problem manifests itself
–How specifically to use the profile as a blueprint for promoting change
Avoids the use of formal diagnostic labels and psychological jargon in favor of more down-to-earth terms
Reality Therapy
Didactic approach that stresses problem solving, personal responsibility, and the need to cope with the demands of a person’s “reality”
*Based on the assumption that all individuals need to develop an identity, which can be either a “success identity” or a “failure identity”
Counselor’s job is to become highly involved with the client and to encourage motivation to make a plan of responsible action that will lead to constructive behavior change and a “success identity”
Expressive Therapies: Art therapy
Has long been a form of treatment for children
*Helps them express feelings actively and talk through images represented in their drawings
Expressive Therapies: Music and dance therapy
Movement bypasses intellectualization and verbal defenses to help people become more self-expressive, in touch with their bodies and minds, and inclined to explore their potential in creative ways
Expressive Therapies: Biofeedback
Gives clients accurate information about their psychophysiological responses
*Readings can be taken of bodily functions such as brain activity, heart rate, muscle movement, blood pressure, and skin responses in order to improve muscular and neurological control
Expressive Therapies
*Play therapy
Most counseling with children employs play
*Drawing, playing cards or games, building structures, dressing up in costumes, playing catch with a ball
–From age 2 until the teen years (especially during early childhood and elementary school years), play is the primary form of expression for children
–Counselor seeks to establish trust, facilitate communication and solve problems through the interactive nature of play
Expressive Therapies: Hypnotherapy, who uses it?
Requires additional training and certification
–Has been applied widely in therapeutic situations since Freud’s day
Behavioral counselors** who wish to intensify systematic desensitization techniques
**Psychoanalysts in order to access the unconscious
*Many other clinicians who use imagery, rehearsal, and fantasy techniques
Expressive Therapies: Exercise
Running, walking, bicycling, rowing, aerobic dance, swimming, weight lifting, and the martial arts have therapeutic benefits
expressive therapy: Bibliotherapy
Therapists recommend to their clients that they** read** certain books that** complement or reinforce the ideas that come up in sessions**
–Also make use of films (cinematherapy)
Mindfulness
Person strives for focused attention on whatever he or she is experiencing in the present moment
–Maintains a stance of nonjudgmental acceptance toward whatever he or she experiences in the present moment
Whether emotional or physical, the problem gets worse when we try to avoid it, ignore it, or fight it
–Pain actually reduces when we accept it by simply taking note of it with no attempt to do anything about it
–“Acceptance way of being” gives us some distance from our distress
*We are not “in our pain” but rather in a state of observing it — that is, being mindful of it
Mindfullness Approaches: Mindfulness-Based Stress Reduction (MBSR
Clients are taught a variety of mindfulness meditation techniques
Mindfulness-Based Cognitive Therapy (MBCT)
Clients asked to accept their irrational thoughts without trying to change or stop them
Dialectical Behavior Therapy (DBT)
Practitioners teach their clients mindfulness so they can achieve a state of nonjudgmental acceptance of their feelings, rather than resort to self- destructive avoidance maneuvers
Acceptance and Commitment Therapy (ACT)
Similar to other mindfulness therapies
–Emphasizes the value of accepting one’s painful thoughts and feelings rather than escaping them
