Theories and Techniques Exam

What does it mean for a counseling approach to be phenomenological?

experiences are important but what we make of them is more important. Our perception of events is more important than event.

Common Therapeutic Factors

Client factors not specific to any theoretical orientation
Culturally appropriate explanation/myth
A healing setting
advice/education
An emotionally charged relationship bond between therapist and client
Catharsis or emotional expression
Exposure to feared stimuli
Feedback from therapist
Insight into one's problems
Positive experience (hope)
Working alliance
Therapist credibility
Trust in therapist

4 Soapbox Suggestions

Commit to a 3-year action plan to develop your own theoretical orientation
Remember eclecticism requires expertise in multiple approaches
Do not confuse the theory with the theorist
Choose an area of specialization and commit to creating a 3-year action plan to become proficient in that area

Sequence of Freud's psychosexual stages

Oral
Anal
Phallic
Latency
Genital
Operas Are Pretty Lame Generally

Transference and Countertransference

Transference - clients react to you as if you are a person from their past and puts emotions from other relationships on your relationship - client displacement
Countertransference - you to client

What theory did Freud put forth in the "Aetiology of Hysteria" and why and how did he change it?

Freud presented 18 cases of people with hysteria who had sexual abuse in their childhood - childhood sexual trauma leads to symptoms of hysteria and psychoanalysis can address it
Icy reception from the audience. Could be they were uncomfortable with sexual topics or Freud's arrogance and lack of scientific rigor
Self-exploration lead to Oedipus theory as an alternate explanation

What is the "basic rule"?

Say whatever comes to your mind"
Also called free association
Minimize external stimuli, minimize internal distractions
Encouraging spontaneous talk

Freud's three components of the personality

ID
EGO
SUPEREGO

Freud's defense mechanisms

Automatic, unconscious, ward off unacceptable impulses, and distort reality
Denial
Repression
Projection
Reaction Formation
Displacement
Rationalization
Regression
Sublimation
Introjection
Identification
Compensation

Defense mechanism: Denial

refusing to believe or even perceive painful realities usually the first defense mechanism and feeds into others

Defense Mechanism: Repression

Putting unacceptable ideas, thoughts, and emotions out of conscious awareness
if denial is just under the surface, this is at the ocean floor

Defense Mechanism: Projection

Disguising one's own threatening impulses by attributing them to others - ex: cheating partner accuses partner of cheating

Defense Mechanism: Reaction Formation

Switching unacceptable impulses into their opposites
"Protest too much" ex loudly homophobic closeted gay person

Defense Mechanism: Displacement

Shifting impulses toward a more acceptable or less threatening object or person
Ex. going home and kicking the dog because you can't confront your boss

Defense Mechanism: Rationalization

Explain away a bruised ego

Defense Mechanism: Regression

Revert to outgrown behaviors

Defense Mechanism: Sublimation

dealing with unacceptable feelings or impulses by unconsciously redirecting impulses to creative or socially acceptable channels

Defense Mechanism: Introjection

Taking in and swallowing values of others

Defense Mechanism: Identification

Identifying with successful causes or people to feel worthwhile

Defense Mechanism: Compensation

Masking perceived weaknesses

Why Psychoanalytical theory is sometimes referred to as a "museum theory"?

1 person intrapsychic model that treats clients as an artifact to be systematically & objectively examined

Primary differences between Adlerian and Psychoanalytic

Motivated by human relations vs sexual impulses
Motivated by future goals vs Freud past experiences
Conscious motivators vs Freud's unconscious
Discouraged vs mentally ill
Soft deterministic vs determinism
Holistic vs museum theory
Therapeutic relationship vs detached
Early feminism vs blaming women

Social Interest

Community feeling
Inferiority leads to destruction
Main goal to get to relationships and community
Ability to care about and connect with others - increased happiness and mental health
Father of many ideas in modern psychology

Birth Order

Adlerian
Family psychological birth order impacts personality
Oldest - bossy and responsibility
Middle - even-tempered, hard time finding niche, manipulative
Youngest - want power but follow through is lacking
Only - struggle with peer relationships and want to be taken care of

4 Goals of Misbehavior

Attention, Power/Control, Revenge, Display of Inadequacy

3 Core Competencies

Congruence (most important) - authenticity or genuineness
Empathetic understanding - understand the client's feelings and inner-world - walking within
Unconditional positive regard - acceptance of the client

Periods of Development of Person Centered Therapy

Nondirective counseling (1940's)
Client Centered Therapy (1951)
On Becoming a Person (1961)
Name changed to Person-Centered Therapy to reflect broadening application of the approach (1970's and 1980's)
More Contemporary forms of P-C Therapy developed and popularized (i.e., Motivational Interviewing) (1990's)

What is motivational interviewing and how is it different from traditional Person Centered Therapy

PCT for addressing Ambivalence about change
Substance use
Lack of confrontation and education
Collaboration, acceptance, compassion, evocation

Paths to Meaning (Existential)

Umwelt - being with nature or the physical world
Mitwelt - being with others or social world
Eigenwelt - being with oneself or the world of the self
Uberwelt - being with the spiritual or overworld

Umwelt

Being with nature or the physical world

Mitwelt

Being with others or social world

Eigenwelt

Being with oneself or the world of the self

Uberwelt

Being with the spiritual or overworld

4 Ultimate Concerns of Living

Death

Types of anxiety and guilt

Normal anxiety - appropriate for the situation
Neurotic - disproportionate and out of awareness
Normal guilt - productive - a sensor for morality and adjusting behavior
Neurotic guilt - disproportionate and destructive - usually avoided or repressed

Existentialist's view of death and anxiety

Death is a reality of life that cannot be ignored. Death is a source of anxiety. Facing death allows for self-awakening and shedding of trappings and roles to live in the now as an individual with free choice

Describe the 4 Stages of Theoretical Development

Self-focus and counselor anxiety
Taking a counselor's stance (requires intentionality and should be evidence-based)
Cognitive dissonance and confusion
Flexible and integrated

16 Common Pitfalls for Beginning and Experienced Counselor

Equating counseling with advising.
Trying to solve problems prematurely.
Asking irrelevant or curiosity questions:
Interrupting silence prematurely or inappropriately
Allowing self-focus to disrupt the listening process and prevent the counselor from being fully present.
Not recognizing the importance of non-verbal communication (both yours and theirs).
Not knowing or dealing with your own stuff (countertransference).
Assuming client/student shares your worldview
Assuming you know how client/student feels
Mistaking empathy for agreement
Not paying attention to what you pay attention to.
Failing to recognize and utilize familial or community resources.
Providing too much or too little structure.
Failing to provide both support and challenge.
Confusing people with labels.

Psychoanalytic Techniques

Free Association / The Basic Rule
Projective Tests (e.g., Rorschach Inkblot Tests)
Analysis of Transference
Listen for and help interpret unconscious derivatives
Interpretation of Dreams

Adlerian Techniques

Push-button
Future autobiography
Acting "as if"
Catching oneself
Spitting in the soup

Gestalt Techniques

Staying with the feeling
Empty chair
Exaggeration experiment
I take responsibility for
Dream reenactment
Reversal technique

Gestalt Technique: Staying with the feeling

What are you aware of right now?

Gestalt Technique: Empty Chair

Empty chair - Two sides of client to enable client to experience all parts of themselves more fully (e.g., parent inside v child, responsible v. impulsive -To bring someone else into the session (e.g., mom, significant other)

Gestalt Technique: Exaggeration Experiment

To help clients become more aware of non-verbal behaviors, they are asked to exaggerate subtle nonverbal

Gestalt Technique: I take responsibility for

If they state they are bored or angry or depressed, they might be instructed to say, I am angry and I take responsibility for my anger

Gestalt Technique: Dream Reenactment

Dreamer tells the dream story. -Dreamer "revives" dream by changing the language and tells the dream in present tense. -The dreamer becomes director and organizes the dream as a play. -Dreamer acts out dream always using personal pronoun "I".

Contributions of Psychoanalysis

Importance of Unconscious Processes
Defense Mechanisms
Stresses instincts; aggressive and sexual impulses
Personality Structure
Understanding present in context of the past
Interpretation of meaning
Transference and Countertransference
Spawned other theories / approaches

Limitations of Psychoanalysis

Limited applicability
"Museum Theory"
Catch 22 re. ego strength
De-emphasis on therapeutic relationship
Overly deterministic
Overemphasis on sexuality
Personality theory derived from the very ill.
Limited scientific evidence regarding efficacy
Feminist Criticism / Borne out of denial of women's reality

Contributions of Adlerian Therapy

Social Interest
Broad techniques

Limitations of Adlerian Therapy

Broad

Contributions of Person Centered Therapy

Over 75 years old and still prominent
Literally opened the field to research
Core conditions widely accepted
Applicable to other settings
Contemporary Approaches grounded in P-C principles (i.e., Motivational Interviewing)

Limitations of Person Centered Therapy

Tendency to support without challenging
Limited range of responses
May not be a good "fit" for some counselor's personality type
Too simplistic or naïve; Rose colored glasses
Lack of structure can lead to rambling
Role of expert can be empowering if used respectfully
May not be a good "fit" for some cultural groups and/or crisis situations

Contributions of Gestalt Therapy

de-emphasizing the intellectualizations of problems, brief therapy, working with past to recognize past, work with dreams to increase awareness of unconscious, focus on experiencing rather than just talking about the problems, can be used in group, school and classroom, workshops and indv counseling sessions

Limitations of Gestalt Therapy

Can be gimmicky or abused
May expect behaviors counter to cultural norms and expectations.
Less evidence-based so might not want to rely on GT entirely
Lack of emphasis on Cognitive Reflection - runs counter to most evidence-based approaches.

Contributions of Existential Therapy

client-counselor relationship is based on the humanity of the individual
focuses on issues important to attaining life satisfaction

Limitations of Existential Therapy

lack of systematic procedure,
concepts are difficult to comprehend,
no scientific research,
lower functioning clients, those in crisis, and others may not benefit

Important Figures: Psychoanalysis

Sigmund Freud

Important Figures: Adlerian Therapy

Alfred Adler

Important Figures: Person Centered Therapy

Carl Rodgers

Important Figures: Gestalt Therapy

Fritz and Laura Perls

Important Figures: Existential Therapy

Yolom
Frankl
If you don't recognize, probably existential

Social interest is central to?

Adlerian Therapy

Which approach uses the empty chair technique?

Gestalt

Who developed the core conditions?

Carl Rogers

Which core condition is the most important?

Congruence

Which theorist spoke about the 4 ultimate concerns of living?

Yalom

Who used the "basic rule"

Freud

Which approach uses the future autobiography?

Adlerian

"I take responsibility for" is a technique used in

Gestalt

Staying with the feeling is a technique used primarily in?

Gestalt

Freud's Psychosexual Stages in order are:

Oral, Anal, Phallic, Latency, Genital

Which component of personality is the most hedonistic?

Id

A man who has aggressive urges becomes an MMA fighter. Which defense mechanism does he exhibit?

Sublimation

An adult under stress starts using "baby talk". They might be using which defense mechanism?

Regression

A student does poorly on the Kahoot review quiz and goes home and yells at her neighbor might be using which defense mechanism?

Displacement

Jenny frequently interrupts others yet she complains that others interrupt her. Which defense mechanism does she use

Projection

Bob thinks he is unattractive so he spends five hours a day body building. What defense mechanism does he use?

Compensation

Which is NOT one of Dreikur's goals for children's misbehavior?

Attachment

William Miller develop an approach called __ to work with ambivalent substance abusers:

Motivational Interviewing

Which of the following is most associated with Adler?

The Phenomenological model

For most psychologically healthy individuals, the ____ is the most robust part of their personality?

Ego

Which approach emphasizes the "here and now" the most ?

Gestalt

For existentialists, neurotic or maladaptive behaviors is most linked to

Avoidance

Which approach uses dream re-enactment?

Gestalt

Reminder about empathy:

Empathy is most important when its hardest

1. Equating counseling with advising

-Misperception of role as counselors

2. Trying to solve problems prematurely

-Giving advice instead of support/space
-Based off of limited understanding of client's personal experience
-Listen first, understand-> can offer small pieces of advice

3.Asking irrelevant or curiosity questions

-Can take off track

4. Interrupting silence prematurely or inappropriately

Very common mistake thru all experience
-Most important stuff during counseling happens between words
-Using nonverbals, try to assess if they're done or not

5. Allowing self to disrupt the listening process and prevent counselor from being fully present

-Mindful-> being aware when you aren't
-Compartmentalize
-Intentional

6. Not recognizing importance of non-verbal communication

-Both yours and theirs
-Body language
-tone etc.

7. Not dealing with your own stuff (counter transferenece)

-Distorting objectivity (inadvertently unconscious)
-Based on your own experience

8. Assuming client shares your world view

-Don't make assumptions
-Cultural competence
-Courage to have difficult conversation

9. Assuming you know how client/student feels

NEVER say "I know exactly how you feel I went through the same thing"
-No you dont!

10. Asking "How did that make you feel"

-Inadvertently implying something else controls your feelings
-"How were you feeling when xyz"

11. Mistaking empathy for agreement

Friend vs. counselor

12. Not paying attention to what you pay attention to

-Miss the strengths by focusing on the gray and drab, have to look at the green and alive

13. Failing to recognize and utilize familial or community resources

-Use your resources!

14. Providing too much or too little structure

-Can't switch topics as needed
-Talk too much and dont get enough done

15. Failing to provide both support and challenge

-Balance
-Holding them accountable