RAT 1 Flashcards
3 Core Concepts
- Truth is subjective
- Primary reality exists in the therapeutic relationship
- Talmudic Insight
12 Basic Tenets of an Existential Approach (1-4)
Subjective experience
Personal attribution of meaning
Therapeutic relationship
Here and now
12 Basic Tenets of an Existential Approach (5-8)
Process centered therapy
Parallel process
Affect, cog, act realms
Enhanced personal awareness
12 Basic Tenets of an Existential Approach (9-12)
Tension between freedom and security
Meaning attribution
Anxiety as a driver of change
Initial confusion
Why is context important?
(1) Creates full understanding
(2) Explore freedom/security relationship
(3) Aware of ongoing processes to avoid impulsive decisions
Relationship between freedom and security
(1) Both are essential needs
(2) Each stage of life requires balancing these needs
Therapist Role regarding freedom and security
(1) Highlight tension between needs
(2) Encourage clients to push the boundaries of freedom without compromising their need for security.
(3) Support clients in making active choices and holding both sides of the dilemma.
Existential Anxiety v. Neurotic Anxiety
EA: Stems from the realization of life’s limits and potential meaninglessness. -> leads towards growth
NA: Represents pressure to maintain the status quo. -> does NOT lead towards growth
Here-and-Now
Focuses on the present moment as the most salient timeframe.
Recognizes the influence of past experiences while emphasizing real-time connection and aliveness.
Parallel Process
Clients replicate dynamics from their outside life within the therapeutic relationship.
Explores the meta-communication present in these interactions
Primary Goal of Existential Therapy
Help clients accept their reality and build the courage to face the unknown.
How would you describe asocial responses, and how might they function in a session?
Asocial responses: deliberate use of atypical responses to conversations that break social norms
Therapist creates a new context in which the client can be conscious and creative in the here-and-now
What is involved with working from the client’s worldview?
Therapist must accept the client’s worldview and current way of being
Afterwards, therapists can work within this worldview to focus on…
(1) defenses, (2) limiting beliefs, and (3) behaviors that are working AGAINST their goal
How might an existentially oriented practitioner view client’s memories of past events?
Better to shift from “What do you remember?” to “What’s happening now as you recall this?”
What are some tools for maximizing therapeutic effects?
(1) Be a “teammate” and practice partner for the client
(2) Instill hope
- Make the effort worthwhile
- Instill a basic belief that meaning and choices may be derived despite of circumstances
(3) Therapist expect clients to make good decisions.
- Talk about the potential consequences
(4) Therapist self-disclosure
- May minimize client’s sense of pathology by showing the client that you are a person
- Share feelings in the moment
(5) Trust in the Therapist’s Ability
- Trust builds due to demeanor, ease with difficult conversations, confidence
What is the essence of therapy from an existential perspective?
Facing the human condition and creating meaning.
Symptom frequency and strength are not a direct focus on attention
Maximizing Placebo in Psychotherapy/Counseling
(1) Faith in the healer’s ability enhances client hopefulness
(2) Creating a setting conducive to hope and expectation of help
(3) Explanations for the world
(4) Promotes hope for connection w/others
Why is resistance a useful component of the therapeutic process?
Natural outcome of the tension between security and freedom
If you’re feeling resistance, you’re approaching change (ex. GPS)
How is client resistance a client strength?
Client uses their best skills to defend against the risks of facing the unknown
How would you describe the different styles of client resistance?
Often unconscious
What are strategies for joining the different client styles of resistance?
(1) The therapist begins by reinforcing the reality that a decision is difficult
(2) Initiate examination of unconsidered options that might on the surface seem to complicate matters.
(3) The therapist enters the internal maze and only slowly allows for movement, once momentary security has been achieved.
(4) Initial interventions will be cognitive and often confusing. Movement to attribution of meaning and/or feelings is on invitation or agreement and is often generated by mounting frustration in the lack of movement in therapy.
What is meant by differentiated relatedness?
- the ability to be close to someone while still being connected to your own thoughts, feelings, and values
- Coming to terms with one’s self, within the world of family life
What are advantages to working with clients in groups, as couples, or as families?
- Economics
- Universality/more shared reality
- Multiple forms of learning
- Minimizing subjective experience of pathology, maximizing hope
- Altruism
- Opportunities for safer experimentation
- Dilution of transference
- Enhanced transfer of training
- Recapitualizing the family dynamic
What are two important foci of multi-person intervention and what makes them important?
(1) Communication and (2) structural work
What is enactment?
Creating an environment in which the clients replicate outside-the-office communications
What is The Fight?
(1) Well-practiced battle, unconsciously designed to create distance and maintain the status quo
(2) Emerges at times when one or more members of the family are feeling needy or vulnerable
(3) Shuts down communication before progress can be made.
What is the role in therapy of triangulation?
- Helping streamline communication between the people involved.
- The therapist asks as the “translator” for true feelings and emotions
What is the third stage of couple’s therapy?
- Extraction with influence
- Therapist turns it back to the clients to communicate directly.
- Direct the clients to speak to each other
What are the distinguishing characteristics of group therapy from an existential framework?
Offers clients the opportunity to pursue that goal with
fellow members of a couple, family, or group of strangers.
What are two cultural pitfalls a clinical social worker might encounter?
(1) Lack of respect and cultural sensitivity
(2) Danger of reductionism
What are the five transcultural spheres of existential clinical work and how would you explain them?
(1) Mortality
(2) Isolation
(3) The search for meaning
(4) Freedom
(5) The social animal
