General Counseling Information

1
General Counseling Information

• EDCE 655
• Theories Techniques II

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Estimation of Percent of Time Spent by
Counselors Psychotherapists in Professional
Activities

• Process Counseling Psychotherapy
• Listening 20 60
• Questioning 15 10
• Evaluating 05 05
• Interpreting 01 03
• Supporting 05 10
• Explaining 15 05
• Informing 20 03
• Advising 10 03
• Ordering 09 01
• Based on Counseling Psychotherapy in E.F.
  Borgatta W.W. Lambert (Eds.), Handbook of
  Personality Theory Research (Chicago, Rand
  McNally, 1968).

3
Percent of Improvement in Psychotherapy clients
as a Function of Therapeutic Factors
4
Lambert (1986) reviewed psychotherapy outcome
research with respect to eclectic psychotherapy
came to 4 basic conclusions

• A substantial number of clients improve without
  formal psychological intervention (40).
• Psychological treatments are, in general,
  beneficial (15).
• A variety of factors common across therapies
  account for a substantial amount of improvement
  found in psychotherapy clients (30). Of the
  so-called COMMON CURATIVE FACTORS, Lambert
  identifies three
• Support factors
• Learning factors
• Action factors
• Specific techniques can be selected on the basis
  of their peculiar effectiveness. (There is some
  evidence for the use of particular techniques for
  particular problems) (15).

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5 Basic Assumptions of the REPLAN

• A structure is needed to organize treatment
  planning so that the therapist can present a
  coherent concept to the client and can develop a
  reasonable defensible plan.
• Goals are negotiated between client counselor.
  These contracted goals direct the therapy help
  client counselor identify the point at which
  therapy should end.
• The therapist should devise the treatment plan
  based on the clients goals uses the 6 curative
  factors as the basic guide for selecting the
  general treatment approach.
• The choice of specific therapeutic techniques
  should be made on the basis of the clients
  unique characteristics, especially considering
  cultural factors the clients membership in a
  special population.
• Each therapy session is organized around the
  specific agreed-upon goals. While the counselor
  should be flexible able to deal with crises as
  they arise, this system is designed to keep
  client and counselor on track by making the
  agenda for each session the same until each goal
  is achieved or eliminated from the list.

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6 Curative Factors in the REPLAN System
Efficacy Self-Esteem
New Learning Experiences Changing Perceptions
Practicing New Behaviors
Relationship
Activating Expectations Motivations
Lowering or Raising Emotional Arousal
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The REPLAN System

• Relationship
• Efficacy Self-Esteem
• Practicing New Behaviors
• Lowering or Raising Emotional Arousal
• Activating Expectations Motivations
• New Learning Experiences Changing Perceptions

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REPLAN Counselors

• Counselors who have a single theoretical
  orientation but who wish to use some methods
  derived from other theories
• Counselors who identify themselves as eclectic
  wish to have a systematic way to apply a variety
  of techniques
• New counselors who for one reason or another have
  not aligned themselves with a particular school
  and want to learn a variety of techniques to
  apply them in a systematic way

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Enhancing the Client/Counselor Relationship

• Unconditional Positive Regard (Person-Centered)
• Counselor Self-Disclosure
• Joining with Families
• Intimacy-Building Exercises in Groups
• Some Hypnotic Techniques (Eriksonian)
• Empathy (Person-Centered)
• Involving Oneself with the Client (Reality
  Therapy)
• Not Giving Up on the Client (Reality Therapy)
• Resolution of Transference (Analytic)

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Increasing Efficacy (Confidence) Self-Esteem

• Self-Monitoring
• (Behavioral)
• Countering self-defeating thoughts
• (Cognitive Behavioral)
• Disputing irrational beliefs
• (Cognitive Behavioral)
• Compensatory self-improvement
• (Existential)
• Coping self-statements
• (Cognitive Behavioral)
• Shame attacks
• (Rational Emotive Therapy)
• Providing feedback to the client

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Practicing New Behaviors

• Imaginal rehearsal
• Role playing
• In-vivo rehearsal
• Cognitive rehearsal
• Participant modeling
• Hypnotic rehearsal
• Role modeling
• (Reality Therapy)

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Lowering or Raising Emotional Arousal

• Lowering Emotional Arousal Methods
• Isolation of the client
• Relaxation training
• Physical exercise
• Thought stopping
• Meditation

• Arousal Methods
• Amplification
• Free association
• Body techniques
• Emotional production
• Repetition Exaggeration
• Hot seat Empty chair
• Reflection of feelings
• Doubling

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Activating Expectations of Help Motivation

• Encouragement
• (Adlerian)
• Increasing client perceptions of counselor
  expertness
• Confrontation of resistance
• Paradoxical methods
• Self-reinforcement / self-control
• (Behavioral)
• Contracting
• (Reality Therapy Behavioral)

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Providing New Learning Experiences Changing
Perceptions

• Producing insight through interpretation
  confrontation
• Early recollections
• (Adlerian)
• Dream Analysis
• Life-style assessment
• (Adlerian)
• Spitting in the soup
• (Adlerian)
• Flooding
• (Behavioral)
• Extinction
• (Behavioral)
• Role training
• (Psychodrama)

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Psychoanalytic Psychotherapy

• Sigmund Freud
• A theory of personality development, a philosophy
  of human nature, a method of psychotherapy, if
  focuses on unconscious factors that motivate
  behavior
• Attention is given to the events of the 1st 6
  years of life as determinants of the later
  development of personality

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Adlerian Therapy

• Alfred Adler
• Following Adler, Rudolf Dreikurs brought it to
  the US
• A growth model stressing taking responsibility,
  creating ones own destiny, finding meaning
  goals to give life direction
• Key concepts are used on many other current
  therapies

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Existential Therapy

• Victor Frankl, Rolo May, Irvin Yalom
• It reacts against the tendency to view therapy as
  a system of sell-defined techniques. Instead, it
  stresses building therapy on the basic conditions
  of human existence
• Choice
• Freedom responsibility to shape ones life
• Self determination
• It focuses on the quality of the person-to-person
  therapeutic relationship

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Person-Centered Therapy

• Carl Rogers
• Developed during the 1940s
• Nondirective reaction against psychoanalysis
• Based on subjective view of human experiencing
• Places faith in gives responsibility to the
  client

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Gestalt Therapy

• Frits Perls
• Experiential therapy stressing awareness
  integration
• Grew as a reaction against analytic therapy
• Integrates the functioning of the mind body

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Behavior Therapy

• Arnold Lazarus Albert Bandura
• Applies the principles of learning to the
  resolution of specific behavioral disorders
• Results are subject to continual experimentation
• Always in the process of refinement

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Cognitive-Behavioral Therapy

• Albert Ellis Rational Emotive Behavioral
  Therapy (REBT)
• Highly didactic, cognitive, action-oriented model
• Stresses the role of thinking belief systems of
  the root of personal problems
• A.T. Beck founded Cognitive Therapy

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Family Systems Therapy

• Bases on the assumption that the key to changing
  the individual is understanding working with
  families

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10 Forms of Twisted Thinking

• Overgeneralization
• 1 single negative event all bad
• Words such as always never
• Magnification
• Exaggerate the importance of you problems
  shortcomings
• Minimize the importance of your positive
  qualities
• Mental Filter
• 1 single negative detail dwell on it
  exclusively
• Distorted outlook on life

• Discounting the Positive
• Reject positive experiences by insisting they
  dont count
• If you do a good job, you may tell yourself that
  it wasnt good enough or anyone could have done
  as well
• Results in inadequacy unrewarded feelings
• All or Nothing Thinking
• Black-or-White Thinking
• You are a total failure if things do not go
  perfectly

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10 Forms of Twisted Thinking

• Jumping to Conclusions
• Interpret things negatively when there are no
  facts to support your conclusions
• Mind Reading without checking it out, you
  arbitrarily conclude that someone is reacting
  negatively to you
• Fortune-Telling You predict that things will
  turn out badly
• Emotional Reasoning
• Assume that your negative emotions reflect
  reality
• I feel hopeless So I must be hopeless

• Should Statements
• You tell yourself you SHOULD be the way you hoped
  / expected them to be.
• Directed against yourself lead to guilt
  frustration
• Directed against others lead to anger
  frustration
• Many try to motivate themselves with shoulds
• Ellis musterbation Shouldy approach to
  life

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10 Forms of Twisted Thinking

• Labeling
• An extreme form of all-or-nothing thinking
• Instead of saying I made a mistake you add a
  negative label Im a looser
• Useless abstractions leads to anger, anxiety,
  frustration, low self-esteem
• Can also label others
• Can make you feel hostile hopeless about
  improving things
• Leaves little room for constructive communication

• Personalization Blame
• Occurs when you hold yourself personally
  responsible for things that isnt entirely under
  your control
• i.e., Kid gets bad grade Bad parents!
• The opposite is blaming others
• i.e., The reason my marriage is so lousy is
  because my spouse is totally unreasonable

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Outcomes

• Smith Glass looked at a controversial area in
  the field of psychotherapy Are behavioral
  techniques (Implosion Therpay, Systematic
  Desensitization, Behavioral Modification) more
  effective than non-behavioral techniques
  (Client-centered Therapy, Rational Emotive
  Therapy, Transactional Analysis, Psychodrama)
• Results There is no difference between
  behavioral non behavioral approaches
• Meninger (1975) Temple (1973) also indicated
  that there are no discernible differences between
  behavioral non-behavioral approaches

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Outcomes

• better off than control group
• Systematic Desensitization 82
• Rational Emotive Therapy 78
• Adlerian Therapy 76
• Client Centered Therapy 74
• Implosion Therapy 74
• Psychodrama 72
• Eclectic Approach 68
• Gestalt Therapy 60

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This exercise is designed to help you review,
compare, integrate the approaches presented in
class. For each study (1) Select an approach,
(2) Give your reasons for doing so, (3) Explain
which techniques from this approach might be most
appropriate. There is not one right approach
the purpose of these test cases is to stimulate
your thinking in applying the various techniques
which we have studied. CASE 1 The client
population is a group of drug addicts who are
part of a federally funded detoxification center.
The director of the center would like the clients
to be seen occasionally on an individual basis,
but for the most part she would like them in
small groups for the therapy. She was awarded her
grand on the basis that she had a program that
could teach the clients interpersonal skills
could enhance their self-esteem while they were
off of drugs. CASE 2 The client, Yvonne,
specifically wants to work on her dreams. She
says that they are frequent powerful, that
she wants to learn what they are telling her
about what is going on in her life. CASE 3 Joan
comes in for crisis counseling. This young woman
complains of chronic depression is frightened
by the frequency of her suicidal thoughts
impulses. She attempted suicide several years ago
was committed to a state mental hospital for a
time. She fears being sent up again, because
she does not know how to cope with her bouts of
depression. CASE 4 The setting is a state
hospital for the mentally disordered sex
offender. One ward is composed of a group of male
sex offenders (mostly rapists other violent
types), the program director wants them to be
in some form of group counseling. She says about
these men They are very verbal pretty bright
for the most part. They are diagnoses as
sociopathic personalities, which means they are
generally resistant to treatment, will con the
counselor, will learn the language play the
game all so they can get a good report get
discharged. They do not feel much remorse or
guilt for their offenses. She wants the group to
focus on getting them to look at their offenses
learn something about themselves in terms of how
poorly they dealt with their tensions impulses.
She hopes they can learn more constructive
approaches to dealing with their feelings in the
future. CASE 5 The parents bring Tim, a
7-year-old phobic child, for treatment of his
fear of riding in cars. When he was 6 he was in a
serious auto accident, he has developed phobic
reactions to even getting close to cars. His
parents are anxious to know what can be done to
help him work through his fears.
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Critical Evaluation of All Theories

• Key Concepts
• What is the theorys view of human nature, what
  are the basic assumptions underlying the
  approach?
• What are the key characteristics that distinguish
  the approach?
• What are the major areas of focus emphasis?
• What are the key concepts?

• The Therapeutic Process
• What are the therapeutic goals?
• What are the functions role of the counselor?
• What is the clients role in the therapy process?
• What is expected of the client?
• What does the client do?
• What is the nature of the relationship between
  the client the counselor?

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Critical Evaluation of All Theories

• Applications - Techniques Procedures
• What are the major techniques procedures?
• When where is the approach MOST applicable? To
  what types of client? To what types of problem?
  In what settings?
• What is YOUR EVALUATION of the approach? What are
  the limitations? Unique contributions? Aspects
  you most like leas like?
• What are some specific aspects of this approach
  (CONCEPTS TECHNIQUES) that you would MOST want
  to incorporate into your own counseling style?
  Why?
• In what ways can you apply this approach to
  yourself PERSONALLY as a basis for
  self-understanding for ideas that you might use
  in your daily life?
• What are some of the most significant
  personally meaningful questions that you would
  like to pursue further (and bring to class for
  discussion)?