Intro to Counseling Quiz 2

Counseling Theories

Attempts to organize information in a consistent and easily retrievable manner

Allow practitioners to repeat previously used strategies to lead to uniform outcomes

Answers how problematic behaviors arise

Counseling theories are generally grouped as:

Humanistic-existential

Psychodynamic

Cognitive-behavioral

Person-centered counseling

Unconditional positive regard

empowerment…client has the most knowledge of themselves/is the expert

Values present moment and personal knowledge

Focus on the therapeutic relationship

Focus on emotion

Existential therapy

Irvin Yalom:

the inevitability of death

the existence of freedom

the truth of our aloneness adn isolation

the inherent meaninglessness of life

In what ways do you think death might come into the counseling room?

older clients…lots of things remind them of deat

suicidal clients

client with dead family member/loved one

The death of a relationship/friendship

Freedom and Meaning making

Type of existential therapy

People have a fear of freedom because with freedom comes choice and the possibility of choosing poorly (responsibility)

No inherent meaning to life…individual must create their meaning

Key Freudian concepts

Topography of the mind…we move things inot our unconscious

Structure of psyche: Id, ego, superego

psychosexual stages

defense mechanisms…repression…need them to function in society

modern psychodynamic approaches

focus on relationship, affect, and attachment

focus on the unconscious and process rather than content…how people say things, not what they did

transference and countertransference

Modern psychodynamic techniques

interpretation

immediacy

Adlerian therapy

Alfred Adler

a holistic approach that considers how the client exists within a social context…early family life and current social embeddedness

focus on empowerment, creativity, connection

birth order

Alfred Adler

Adlerian therapy

disciple of Freud

known for birth order

Gestalt therapy

the human experience in terms of our own awareness

goal is to enable clients to pay close attention to their moment-to-moment experiences so they can recognize and integrate disowned aspects of themselves

unfinished business

Four bases/legs of gestalt therapy

phenomenological viewpoint

dialogical relationship

experimental freedom

field theory

What counseling theory did Perl use?

gestalt

Gestalt therapy in practice

process over content…focus on presence of counselor and client being genuine and honest with one another

exploration of past through unfinished business…bring past into present with immediate emotional arousal and processing

Goal is to have client process unfinished business to become more themselves

use of confrontational experiments in session…therapy as “safe emegency”

Postmodernism

multiple truths and realities that are socially constructed

everyone has a unique reality

Narrative therapy

subset of postmodernism

white and epston…challenged traditional western models

language to create meaning and explain life…explanations are socially constructed from relationships and context

only the individual can truly understand their experience…counselor is just a curious observer/supporter

Narrative therapy in practice

name and personify the problem

explore the oppressive influence of the problem…mapping the influence

search for unique moments when the problem has not dominated

use historical evidence to support client’s ability to stand up to problem

Miracle question… wonder about what a future without the problem would look like

solidify new story through re-telling

feminist therapies

group of critical theories

the personal is political…personal and social identities are interdependent

marginalized people’s experiences and the ways of knowing are honored

goal is to increase awareness of the impact of marginalization and develop power

feminist therapies in practice

emphasis on decreasing power between counselor and client

empowerment

constant re-assessment

focus on advocacy

behavior therapy

research-based…focused on principles of behaviorism

client develop and engage in behaviors based on previous responses and change via new consequences

goals and assessments to track progress

subjective concepts are operationalized

effective in treatment of phobias

criticisms of behavior therapy

impersonal and mechanistic

general disinterest in client’s thoughts or feelings

Behavior techniques

relaxation training…progressice muscle relaxation

exposure therapy…systematic desensitization (baby steps toward phobias), flooding, virtual reality

social skills training

assertiveness training

EMDR

Cognitive behavior therapies

built on behavior therapy…skinner

focus shifts from behaviors to client cognition…schemas, negative automatic thoughts

top down approach

effective in treating a range of issues

criticism of cognitive behavior therapies

overly mechanized and directive

ignoring emotion and depth

gimmicks or bandaids

Rational emotive behavior therapy

Albert Ellis…did lots of demonstrations and self-help books

highly educational process to help clients become aware and take responsibility…awareness of the “musts”

action oriented…insights dont do anything to create change

ABCs of emotion

Activating event 

You have a belief about the situation 

Consequence: how i reacted emotionally/behaviorally to the event 

Disputing the irrational beliefs 

New effect: how I would prefer to feel/behave 

Further action: what I'll do to avoid repeating the same irrational thoughts/reactions 

basics of cognitive therapy

Aaron Beck

brief treatment…10-12 sessions

founded in the relationship

recognition of distorted thinking

cognitive behavior therapy in practice

establishment of goals

psychoeducation…cognitive model and distortions

questioning to repeatedly focus on specific cognition: “what is going through your head?”

homework to empower client to recognize they can do it on their own…diaries

reflection of resistance and progress

Criticisms of cognitive approaches

emphasis on cognitions

less effective with clients who already intellectualize or struggle to logically reason

counselors can burn out due to repetition

difficult for counselors who are not outgoing

client may feel overpowered

solution focused brief therapy

steve de shazer and insoo kim berg

proposes that looking at the cause of a problem is irrelevant and wastes time

extremely short in duration

uses questions to help clients recognize their own strengths

assumptions of SFBT

if it does not work, do something different

if it works, do more

clients have the strength and resources to change

client problems result from not seeing alternatives

criticisms of SFBT

placebo effect…long term gains?

less growth or new skills

insight is ignored

male-oriented

mindfulness

focused on bringing attention to the present moment

integration

systemic integration of underlying principles and methods common to a range of therapeutic approaches

increasing integration spurred by a range of explanations

types of integration

technical eclecticism

theoretical integration

common factors

technical eclecticism

An integrative approach that advocates using multiple procedures taken from various therapeutic approaches without specific concern from which theories they come

Using the techniques from other approaches for one theory

Theoretical Integration

Elements of counseling are part of one combined approach to theory and practice

Connected on the level of theory

The hardest because not every theory will fit with another theory…they could be saying something totally different from each other

Common factors (integration)

elements common to all theoretical approaches

includes the therapeutic relationship, emotional arousal, instillation of hope, enhancement of self-efficacy…

concerns with integration

can be overwhelming

syncretism…combining of techniques randomly and without any thought for theoretical consistency…most dangerous thing that can happen

Microskills hierarchy

(things at bottom are most important)

active listening

Goals:

demonstrate to the client that you are paying close attention

help the client clarify what they are trying to say

confirm you understand/help client feel understood

encourage clients to expand on key topics

show your presence and ability to stay present

attending behaviors

shows the client that we are engaged and care about their distress and issues

open posture

leaning in

positive facial expression

eye contact

being centered, present, and coherent

encouragers

nonverbal: head nods, open occasional gestures, “mmm-hmm” or “uh-huh”

verbal/key word: repeating keywords

open questions

requires more than one or two word asnwers

Elaboration, reflection

How, could, why, what?

closed questions

Can be answered in a few words or a sentence

Focus and specific information

Is, are, do, have, what?

Why be cautious of “why” questions

They often initiate a discussion of explanations for which the client doesn't have answers

they can feel like an interrogation and may remind clients of times when they were chastised by authority figures

Best used in a safe and comfortable relationship

Problems in asking questions

common fallback for beginning counselors

overuse of questions can feel overly directive or interrogative

Double/multiple questioning

may feel marginalizing to clients from other cultures

Question goals: informal assessment

Use questions to assess any changes in client's behaviors, emotions, and thoughts

example: “How have you been feeling over the past two weeks?”, “For how long have you been struggling with this issue?”

Question goals: eliciting specifics

Client often speak in generalities, which are very hard to work with

open questions

Particularly useful with clients who tend to be vague or with clients who have a hard time talking/opening up

Question goals: enriching the story

Very open questions that allow the client to lead the session and fill in possible gaps

particularly useful:

• when you’re feeling stuck  

• for clients who tend to be very cognitive/intellectual  

• when you’re feeling disconnected 

• pretty much anytime

Question goals: searching for strengths

don't start focusing on strengths too quickly, as this can feel invalidating to clients

• “What would others say you do well?”  

• “What are some positive aspects of your family?”  

• “Who are your social supports right now?”

• “How have you gotten through tough times in the past?”

Question goals: getting more information

Counselors can use questions to fill in holes

• What else is going on in your life?”

• “Have we missed anything today?”  

• “Is there anything I didn’t ask about that feels particularly important?”