COUNSELING

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• COUNSELING
• THEORIES
• CHAPTER 7

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I. INTRODUCTION

• A. Definition of and Need for Counseling
• Counseling is a helping relationship that
  involves one party who needs help, another party
  that provides help, and a setting that allows the
  process to occur.
• Frequently, we are helping people deal with the
  feelings or emotions surrounding a communication
  disorder
• We are also providing guidance

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Often, I have found that

• As the SLP, I am the key person parents turn to
  when they need to vent their emotions or talk
  over their worry, fear, and stress
• As a student, I was never ready for thisI
  thought my job ended with assessment and treatment

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B. Guidance, Counseling, and Psychotherapy
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Counseling
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Guidance
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II. THEORIES OF COUNSELING

• A. Psychodynamic Theory
• based on psychoanalytic theory
• created by Freud
• behavior is the product of conflicts between the
  id, ego, and superego
• 5 psychosexual stages

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B. Client-Centered Theory
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The counselor (you, the SLP) needs to be fully
present

• You have to be in touch with your own needs and
  experiences
• You enter into a therapeutic alliance with the
  client so as to release the clients
  self-actualizing drive
• With the right therapeutic environment, the
  clients self-actualizing drive will bubble up
  and they will actively choose to make changes

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• Step 1
• Step 2

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• Step 3
• Step 4

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DiLollo Neimeyer, 2014
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For example

• Me to Kiree Youre really bored right now,
  arent you? Im pretty boring!
• It must be make you mad when kids make fun of
  you because you talk different.
• Me to Eddie You really dont want to do this
  test, huh? Feels like the same ol same ol,
  right?

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Some multicultural clients might not like this

• They often expect advice and specific solutions,
  not just a shoulder to cry on
• The more educated the client, the more they will
  want the list of action steps

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Robinson, 2014
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C. Behavioral Theory
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• All behavior is caused by environmental stimuli
• human behavior is the product of external
  reinforcement
• behavior is shaped and maintained by immediate
  consequences
• reinforcement must be given immediately after a
  particular behavior has occurred

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• Rather than focusing on feelings, the clinician
  focuses on specific outcomes
• Goal emphasize clients identifiable behaviors
  and make positive changes
• Danger fruit loop therapy
• May be most effective after a client-centered
  approach, esp. in the beginning where clients
  have strong emotions

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• Many multicultural clients appreciate this
• Behavioral therapy does not rely on having people
  get in touch with and express their feelings
• Provides specific and practical steps for
  positive change

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DiLollo and Neimeyer 2014
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DiLollo Neimeyer 2014
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Robinson, 2014
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D. Cognitive-Behavioral Theory
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Luterman states that
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There are some irrational thoughts that can cause
pain to clinicians and clients

• I must be universally liked
• It is awful when things are not just the way I
  want them to be
• Or, as Mark McKibbin said in Europe, I dont
  believe this. In the States, the customer is
  always right.
• To be worthwhile, a person must be competent and
  high-achieving in all areas

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Mistakes are not OK, and I must be stupid to have
done thisits awful!
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• A persons past history is an all-powerful
  determinant of his present behavior because
  something once strongly affected his life, it
  should continue to do so
• A person should become very upset over other
  peoples problems and disturbances
• There is always a perfect solution to problems,
  and it is catastrophic if this solution is not
  found

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A cognitive therapist
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• 1)
• 2)
• 3)
• 4)

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For example hearing impaired client

• 1. So you dont want to wear your hearing aid
  because youre afraid people will avoid you at
  social gatherings.
• 2.When you go to the party Sat. PM, see if you
  think this is true. Observe peoples reactions to
  you.
• 3. (next session) How did people react? Oh, no
  one avoided you? You had fun?
• 4. Now that we know this, would you be willing
  to wear your hearing aid more often?

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Severe stutterer23 yrsafraid to ask a girl out
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E. Reality Therapy
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Like a breath of fresh air. ?

• This approach involves helping people take more
  effective control of their lives
• Accomplished by helping them choose effective,
  responsible behaviors
• SLP confronts inconsistencies openly and directly
• 8 steps

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8 Steps

• 1.
• 2.
• 3.

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• 4.
• 5.
• 6.

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• 7.
• 8.

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F. Eclectic Approach

• 1)
• 2)
• 3)

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Again, remember
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III. DEALING WITH CLIENTS COGNITIVE
DISTORTIONS

• 1.
• 2.
• 3.

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• 4.
• 5.

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6.
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7. Catastrophizing

• People believe the worst that can happen, and
  that it will happen to them
• If my child is retained in 4th grade, hell
  become a behavior problem and maybe eventually
  turn to a life of crime

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• Mindsets that Inspire Procrastination

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Many Americans have low frustration tolerance

• Because our society emphasizes instant
  gratification
• The LA-Z boy culture
• Everything should be easy, fast, effortless, and
  comfortable!

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Youtube
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IV. REACHING RESOLUTION

• Sometimes people cannot come to a conclusion or
  agree upon a course of action
• In these cases, I use a little Roseberry magic

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A technique I have sometimes used

• First present a solution thats really
  unpalatable
• We could not enroll Neil for stuttering therapy,
  and just let him go. Of course, the danger is,
  that when he gets to junior high, the other kids
  might really make fun of him and ostracize him.

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Next

• Present another unpalatable extreme
• I could see Neil daily for 20-30 minute
  sessions, but he would always miss social studies
  and probably fall behind.

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Lastly

• Present a middle of the road option that is
  very palatable
• A third option is that I could see Neil twice a
  week for 20 minutes, and send home brief
  assignments for you to do with him. In this way,
  he wouldnt miss too much class and we could work
  on strategies for him to be more fluent,
  especially as he goes into junior high.
• Which one of these sounds best to you?