Humanistic and Constructivist Psychotherapies.

Question 1

Humanistic

Answer 1

Humanistic: Person-centered therapy, Gestalt therapy, Existential therapy and Reality therapy

• phenomenological approach assumes that to understand a person one must understand their subjective experience
• focus on current bx
• belief in the individual’s inherent potential for self-determination and self-actualization
• therapy involving authentic, collaborative, and egalitarian relationship between therapist and client
• rejection of traditional assessment techniques and diagnostic labels.

Question 2

Constructivist

Answer 2

• incorporate assumptions and characteristics of humanistic
• emphasis on the client’s perceived reality
  
  • being to some degree individually and/or socially constructed
  • focus of therapy is on the process of meaning creation rather than on the accuracy/rationality of meanings created by the client.
• Kelly’s personal construct therapy is a forerunner of this approach.

Question 3

1.0

Person-Centered Therapy

Roger’s

Answer 3

1. client-centered,
2. people have innate ‘self-actualizing tendency’ that serves as the major source of motivation and guides them to positive healthy growth
3. SELF: organized consistent conceptual gestalt composed of the I or ME, and I/ME to others, and values attached to these perceptions.
4. everyone has ability to become self-actualized (full potential), but SELF must remain unified, organized and whole.

Maladaptive Bx:

• self becomes disorganized due to incongruence
• incongruence: between self and experience that produce conditions of worth (as opposed to unconditional positive regard).
  
  • unpleasant visceral sensations that are subjectively experienced as anxiety and serve as a signal that the unified self is threatened.
  • defense mechanisms come in to counter self-actualization

GOAL: to achieve consguence between SELF and experience to become a more fully-functioning, self-actualizing person.

Techniques: Therapist provides the ‘right environment’ via three facilitative conditions:

1. Unconditional Positive Regard (RESPECT): no judgements (positve or negative) in order to not create a condition for worth
2. Genuineness (Congruence): maintain trust, and authenticity in thearpist words and behavior.
3. Accurate Empathic Understanding: to see the world as the client does and to relate this. nodding, eye contact, reflection of feeling.

Avoid Directive techniques (power differential/conditions)

Do not foster/interpret Transference.

Question 4

2.0

Gestalt Therapy

Answer 4

Gestalt Therapy: Perls; help client become a unified whole by integrating the various aspects of the self.

1. each person is capable of assuming personal responsibility for their own thoughts, feelings, actions, and living as an integrated whole.
2. focus on perceptions
3. people tend to seek closure
4. person’s gestalts (perceptions of parts of wholes) reflect current needs
5. behavior represents a whole that is greater than thesum of its parts
6. bx can be fully understood only in its context
7. person experiences the world in accord with the principle of figure/ground.

Personality Theory: Self and Self-Image

• Self: creative aspect of the personality that promotes inherent tendency for self-actualization or the ability to live as a fully integrated person.
• Self-Image: darker side of the personality and hinders growth and self-actualization
  
  • children need support to face and overcome frustration, if totally sheilded from frustration then the self is curtailed and facilitates develoopment of the self-image (dark side).

View of Maladaptive Bx:

1. growth dx, abandonmnt of the self for the self-image and lack of integration
2. FOUR Boundary Disturbances:
   
   1. Introjection: person psychologically swallows whole concepts w/o actually understanding them. Introjectors have trouble distinguishing between me and not me and are often overly compliant.
   2. Projection: disowning aspects of the self by assigning them to other people. Often results in paranoia.
   3. Retroflection: doing to oneself what one wants to do to others. Anger for other’s turned inwards.
   4. Confluence: absense of a boundary between self and the environment. intolerance of any differences between oneself and others and underlies feelings of guilt and resentment.

Therapy Techniques:

• avoid diagnostic labels and the ‘past’ unless needed
• Transferences: counterproductive and respond to help client see the difference between their transference fantasy and reality. (makes sense!)
• Awareness: primary curative factor!
  
  • full understanding of one’s thoughts, feelings, and actions in the here-and-now.
• ready-made exercises and spontaneous experiments to lead to awareness
• empty-chair, guided fantasy, dream work.

Question 5

3.0

Existential Therapy

Answer 5

Logotherapy (Frankl) and other Existential Therapies: Personal Choice and responsibility for developing a meaningful life and we are not static, but constantly evolving and becoming.

1. Maladaptive bx is inability to cope authentically with the ultimate concerns of existence (death, freedom, existential isolation and meaninglessness)
2. Neurotic anxiety (bad) vs. Existential anxiety (good and normal).

Goal:

1. Help clients live in more committed, self-aware, authentic and meaningful ways.
2. freedome to choose their own destinies and accept responsibility for changing their own lives.
3. therapist-client relationship is most important therapeutic tool
   
   1. paradoxical intention: reduce client’s feat and focus on exaggerated and humorous way on the feared situation.

Question 6

4.0

Reality Therapy

Answer 6

**Glasser’s Reality Therapy: **(see reality through Glass(er))

• Choice theory: assumes that people are responsible for the choices they make and focuses on how people make choices that affect the course of their lives.
• 5 basic innate needs are source of motivation:
  
  • survival, love/belonging, power, freedom and fun
  • Love/Belonging is most important since it fills all other needs.
  • Success Identity: person fulfills needs in a responsible way that is conscious and realistic which does not infringe on the rights of others to fulfill their needs.
  • Failure Identity: unable to satisfy needs or does so in a irresponsible way.

Maladaptive BX: mental illness is the result of one’s choices.

Thus, not one’s past, environment, or neurochemisty, but choice to depress oneself in order to gain attention or avoid activities.

**Therapy Goals/Tech: **

1. rejects medical model of mental illness
2. focus on current bx and beliefs
3. tranference is detrimental to therapy progress
4. focus on conscious processes
5. value judgments and ability to judge what is right and wrong in daily life
6. MUST HELP: client identify responsible and effective ways to satisfy their needs and thereby develop a success identity.
7. Questioning encouragement strategy, commit to realistic plan of action,
8. focus on ‘total behavior’: actions, thoughts, emotions, physiology but mostly thoughts and behavior most easily controlled byt client.

Question 7

5.0

Personal Construct Therapy

Answer 7

Kelly’s Personal Construct Therapy:

1. how client experiences the world and
2. people choose ways they deal with the world and there are always alternative ways to do so.
3. Personal constructs: how we construe the world using personal bipolar dimensions of meaning (happy/sad) to define world.
   
   1. we are scientists who continually test personal constucts by checking the accuracy of the predictions derived from them and revising constructs that lead to inaccurate predictions.

Maladaptive BX:

• rejects medical model
• pathology is result of inadequate personal constructs
  
  • experience challenges the current constructs and person is not adapting/revising constructs based on invalidating evidence.

GOALS/Techniques:

1. therapist and client as mutual experts and co-experimenters to work together to derive tasks that help identify and revise maladaptive personal constructs to make better sense of world.
2. Assessment tech: repertory grid, self-characterization sketch, fixed-role therapy…different ways to either look at self and other personal constructs differently/objectively, role plays to experiment.