Week 8 Flashcards
According to choice therapy: The only person whose behavior we can control is
our own.
According to choice therapy: All we can give another person is
information.
According to choice therapy: All long-lasting psychological problems are
relationship problems.
According to choice therapy The _______ is always part of our present life.
problem relationship
According to choice therapy: What happened in the past has everything to do with ____________, but we can only ______________ and plan to continue satisfying them in the future.
what we are today
satisfy our basic needs right now
According to choice therapy: We can only satisfy our needs by satisfying the
pictures in our Quality World.
According to choice therapy: All we do is .
behave
According to choice therapy: All behavior is _________ and is made up of four components:
Total Behavior
acting, thinking, feeling and physiology.
According to choice therapy: All Total Behavior is _________ but we only have direct control over the _____________ components. We can only control our ____________ indirectly through how we choose to act and think.
chosen
acting and thinking
feeling and physiology
According to choice therapy: All Total Behavior is designated by _____ and named by the part that is the most recognizable
verbs
Reality therapy is developed by
William Glasser and added to by William Wubbolding
Reality therapy is based on the concepts of
choice theory (also created by Glasser).
RT believed the underlying problem for most client is
involvement in present unsatisfying relationship and lack of relationships
To Glasser, unhappiness is as a result of
the way people choose to behave.
“The solution to a happier existence is fairly simple: ______________________ will lead to better relationships and overall happiness. The choice theory dictates that people, at their core, are trying to ______________ .”
people making better choice
satisfy five basic needs
Reality Therapy’s View of Human Nature
We are all born with 5 genetically encoded needs that drive us that vary in strength
According to RT, how do we satisfy our needs?
We do not satisfy needs directly, but from others around us (not necessarily something we can do for ourselves)
According to RT From birth we build/store information inside our mind of anything we want – referred to as
quality world
What is the most important component of our quality world
People we are closest to and most enjoy being with
5 Basic Needs According to RT
- Survival (food, shelter, safety, the urge to reproduce)
- Love and belonging (connectedness and relationships)
- Power (competence, achievement, and internal control)
- Freedom (autonomy, ability to make choices)
- Fun (pleasure, enjoyment, knowledge)
Total behaviour is composed of
acting, thinking, feeling, and physiology
RT focuses on_______ / avoids discussing the _______
avoids discussing _________ and ____________
ocus on what we can do __________
present - past
symptoms and complaines
directly (act and think)
Therapist Role in RT
Seven Caring Habits
- Supporting
- Encouraging
- Listening
- Accepting
- Trusting
- Respecting
- Negotiating differences
Seven Deadly Habits
- Criticizing
- Blaming
- Complaining
- Nagging
- Threatening
- Punishing
- Bribing or rewarding to control
Process of Reality Therapy (5 Steps)
- establish a supportive relationship
- explore client’s wants, needs, and perceptions
- evaluate how they are in getting what they want
- make a plan to do better
- commit to plans
What therapy uses the WDEP procedure
Choice Therapy
How are choice and reaiity therapy connected
- Choice theory is like the train track (directs where you go, underlying concepts)
- Reality Therapy is the train and the delivery system – the practicality
According to choice therapy everything we do is
chosen from within ourselves; nobody is forcing us to do anything
According to choice therapy behaviour is purposeful and designed to
close the gap between what we want and what we perceive we are getting
WDEP Procedure
Wants – Ask “What do you want?”
Doing – Ask “What are you doing?” – what behaviors are getting client towards what they want
Evaluation – Ask “Is it working?”
Plan – Ask “What do you see as your choices now?” – what can you do differently to get to that want
*Ask “What is one thing you can do differently?”
Therapist Role/Goal in RT/CT
help client connect with the people they have chosen to put in their quality world
as well as all other needs: achievement, love, power, freedom & fun
CT/RT treatment is focussed on ____ and ____ goals
short term and long term
In RT/CTTherapy is considered a _________ in which a therapist is the ________ & the client is the _______
mentoring process
teacher
student
In CT/RT clients are not expected to backtrack or get sidetracked into talking about
symptoms
The emphasis of CT/RT is on
Action
when clients change what they are doing, they often change what they are feeling and thinking
Application of RT/CT to group counselling
- Establish group guidelines ahead of time:
- “My Job Is/Is Not – Your Job Is/Is Not” - Facilitator establishes the environment by using the 7 Caring Habits
- Use the group to teach about the needs and total behavior
- Reinforce who they can control (only themselves)
Modernist description of reality
Objective reality can be accurately described and observed and can be systematically known through scientific methodology.
According to modernists reality exists ______ of any attempt to observe it
indepedent
according to modernists, Clients seeks therapy when ____________ that is caused by __________
faced with a problem
deviating from the norm.
Post modernism is based on
Social constructionism: values the client’s reality without questioning its accuracy.
According to post modernism clients are:
Experts of their lives and there is no one right or wrong way to live
Historically social constructionism is focussed on
- diversity: not one universal truth about anything
- multiple frameworks
- integration
Postmodernism seeks to provide
wider range of perspective in counselling practice.
In post modernism, change begins by
deconstructing the power of cultural narratives, specifically the dominant cultural positions that exist in society.
Examples of postmodern therapies
- Collaborative language systems approach
- Solutions-focused brief therapy
- Solution-oriented therapy
- Narrative therapy
- Motivational Interviewing
- Feminist therapy
Describe the Post Modern Collaborative Language Systems Not Knowing Approach
o Therapist retain their expert knowledge BUT enter the conversation with the client with curiosity and interest in discovery.
o Enter client’s world as fully as possible.
o No preconceived idea about what direction the conversation will take.
What is the intent of Collaborative Language Systems Approach
not to challenge or confront the client narrative, but to assist in telling and re-telling.
How does the conversation evolve in Collaborative Language Systems Approach
into a dialogue of new meaning new narrative new possibilities.
Example of therapy using Collaborative Language Systems Approach
Collaborative Couples Therapy
Who developed solution-focussed brief therapy
Initially developed by Steve de Shazer and Insoo Kim Berg in the 1980s
Focus of SOLUTION-FOCUSED BRIEF THERAPY
Future focused goal-oriented therapy approach to brief intervention
Strength and Resilience
Constructing solutions rather than problem solving
Role of therapist in SFBT
Therapists assist clients in finding exceptions to their problems; facilitator over expert
Basic Philosophy of SFBT (6)
Change is constant and inevitable
Clients are the experts & define goals
Future orientation – history is not essential
Emphasis is on what’s possible & changeable - do something differently
Short term and only small amount of change needed
Clients want change
How does SFBT state problems are maintained?
- Doing More of the Same
- Expecting no change
Describe the solution focussed nature of SFBT
- If it ain’t broke – don’t fix it
- Once you know what works, do it more
- If it doesn’t work, do something different
What is change-talk
Solution talk, not problem talk
Average length of SFBT
3-8 session
Main goal of SFBT
to help clients efficiently resolve problems and move forward as quickly as possible
Basic Assumptions of SFBT
- Clients have resources and strengths to resolve complaints; patient centred
- Since change is constant, the therapist’s job is to identify and amplify change.
- A small change in one part is all that is needed and can affect change in another.
- There is no one right way to view things and different views may be valid.
- Focus on what is possible and changeable.
SFBT has a _______ orientation
Positive
SFBT is based on the assumption
that people are healthy and competent and have the ability to construct solutions that can enhance their lives.
SFBT believes we already
have the ability to resolve the challenges life brings us, but at times we lose our sense of direction or our awareness of our competencies.
5 Steps to Therapeutic Process of SFBT
- client are given opportunity to describe problem and therapist asks how they can be useful
- develops well-formed, action oriented goals structured in the here and now
- asks clients about those times when their problems were not present or less severe – what did they do to make these events happen?
- therapist offers clients summary feedback, provided encouragement, and suggests what clients might observe or do before the next session to further solve their problem.
- The therapist and clients evaluate the progress being made in reaching satisfactory solutions by using a rating scale. Clients are asked what needs to be done before they see their problem being solved and what their next step will be.
3 Criteria for Therapeutic Goals in SFBT
- start based
- specific
- Social
Start based SFBT goal refers to
stated in positive terms as the start or presence of something the client wants
Specific SFBT goal refers to
(SMART goal) Concrete, observable, measurable, detailed, behavioral description
Social SFBT goal refers to
Description of what significant others would notice, how they might respond, how the responses might affect the client.
- explore possible responses of family members
Therapist Role in SFBT
Not knowing, client as expert
Help client imagine how they would like life to be different and what it would take to make this transformation happen
What is the main intervention of SFBT
Questions
What is the aim of questions in SFBT
Aim is not to gather information; not going in with set list of questions but going in with curiosity and desire to learn more about stor
True or false: in SFBT the therapist has a list of questions they go into the interview with
false
In SFBT, useful questions assist people in:
paying attention to what they are doing and can open possibilities for them to do something different
3 Types of therapist-client relationships that can develop in SFBT
- customer type
- complainant type
- visitor type
Customer type relationship SFBT
Client and therapist jointly identify a problem and a solution to work toward; ideal relationship type.
Complainant type relationship SFBT
A client describes a problem, but is not able or willing to take an active role in constructing a solution
Visitor type relationship SFBT
Clients come to therapy because someone else thinks they have a problem; not willing to develop self awareness
9 SFBT Techniques Utilized
- Pre-Therapy Change
- Exception Questions
- Miracle Question
- Scaling Questions
- Coping Questions
- Reframing Questions
- Formula First Session Talk
- Therapist Feedback
- Terminating
PreTherapy Change SFBT
What have you done since you made the appointment that has made a difference in your problem?
Exception Question
Direct clients to times in their lives when the problem did not exist e.g. Was there a time when you were able to respond without anger?
Reminds clients that problems are not “all-powerful!”
Miracle Question
If a miracle happened and the problem you have was solved, what would be different in your life? – One of main components of SFBT
Scaling Question
On a scale of zero to 10, where zero is the worst you have been and 10 represents the problem being solved, where are you with respect to __________? Or On a scale of 0 to 10, how committed are you to finding a solution to your relationship problems?
Coping Question
ask about how clients somehow manage to keep going in spite of the adversity they face. E.g. “How do you keep going day after day when there seems to be no hope?” – Assessment of strength
Reframing SFBT
involves building a different frame of reference around the problem to make it more solvable
Formula First Session Talk
A form of homework a therapist might give clients to complete between their first and second session. Examine what changed between sessions to assure change is occurring
Offers hope that change is inevitable
Therapist Feedback SFBT + 3 Components
A summary provided to the client, including strengths noted, signs of hope, commentary on what the client is doing well to work towards goals.
Includes 3 components
Compliments
Bridges
Suggesting tasks.
Terminating SFBT
From first session, therapist is mindful of working towards termination.
Therapists assist clients in identifying things they can do to continue the changes they have already made
Discuss perceived hurdles or barriers in the future
6 Applications of SFBT to group counselling
- solution focussed tone
- help members see themselves as less problem saturated
- create opportunities for members to see themselves as resourceful
- work with members to develop well-formed goals
- helps members to recognize personal resilience
- incorporate SFBT techniques
Who founded motivational interviewing?
Co-founded by William R. Millar and Stephen Rollnick.
True or false motivational interviewing is directive, evidence-based, brief, and stresses client responsibility
True
What 2 therapies does motivational interviewing share characteristics with?
PCT and SFBT
How is motivational interviewing similar to and different from PCT
similar: bedrock is the attitude of therapist
different: MI is deliberately directly while staying within client’s frame of reference
What is the motivational interviewing spirit?
o Clients possess abilities, strengths, resources, and competencies.
o Therapist works to evoke inner resources of clients.
o Bedrock attitude of therapist
Goal of motivational interviewing
reduce client ambivalence to change and increase client motivation.
In motivational interviewing, therapists strive to:
see the world from the clients perspective.
Motivational interviewing is designed to
evoke and explore discrepancies and ambivalence.
________ is viewed as an expected part of the process in motivational interviewing
Reluctance
In motivational interviewing, therapists support client
self efficacy
In motivational interviewing, once clients are ready for change, therapists focus on _________ and implementing a __________
strengthening commitment
change plan
5 Stages of Change in MI
- precontemplation stage
- contemplation stage
- preparation stage
- action stage
- maintenance stage
Precontemplation stage of MI
no intention of changing behavior anytime soon.
Contemplation stage of MI
Awareness of problem, consideration of change, no plans or commitment.
Preparation stage of MI
Individuals plan to take action immediately and small changes are noted.
Action stage of MI
Steps are taken to modify behavior and solve problems.
Maintenance Stage of MI
Work is done to consolidate gains and prevent relapse.
4 Techniques Used in MI
- nonpathological - avoids diagnosing/labelling issue
- reframing resistance/expecting it will occur
- strength based
- deliberate practice of skills
Who founded narrative therapy
Michael White and David Epston
Goal of narrative therapy
help clients see themselves as empowered
What is narrative therapy all about?
listening to client’s story
Basic philosophy of narrative therapy
focus on respectfully listening to client story while searching for times they were resourceful and avoiding diagnosing problems
What are dominant stories in NT
events that clients have internalized
o Stories with repeating themes that have had profound effect on self image
What do therapists seek to do in NT?
seek to assist clients to separate themselves from these stories to allow space for new stories
2 Key Concepts of NT
stories and listening
Normalizing Judgement
judging someone on what is deemed the “normal curve” (ex. Of intelligence, mental health, normal behavior).
What is totalizing language?
reducing the complexity of the individual by assigning an all-embracing, single description to the person.
What is double listening
Separating the person from the problem while listening to the story.
The therapeutic process of NT involves collaborating with the client to
name the problem
Nt involves _______ the problem and attributing ________ to it
personifying
oppressive tactics
The therapeutic process of NT involves investigating how the problem has:
disrupted, dominated, or discouraged the client.
NT involves inquiring into _____________ for events to see _________
alternative meanings
the story differently
5 therapist functions in NT
- active facilitator
- demonstrate openness, fascination, interest
- not knowing position
- create preferred story line
- avoid diagnostic language
5 therapeutic techniques utilized in NT
- questions
- externalization and deconstruction
- searching for unique outcomes
- alternative stories/reauthoring
- documenting evidence
Externalizing
a way of speaking that separates the problem from the person/
o Addresses what clients uncritically accept about themselves and examines this
Double listening
involves listening to the problem story while also listening for the counter story
o Contrast the problem story and the counter story and keeps the contrast alive to allow the client to choose which story they want to invest in
