Counseling Psych- Exam #3

existential therapy

philosophy or way of thinking about therapy than a particular style of practicing psychotherapy

existential theory

rejects deterministic model of psychoanalysis/behaviorism

what does existential theory focus on

choice, acknowledging that even when deterministic forces affect us we CAN NOT control the external forces

Roots of existential therapy

born from philosophy- clients search for meaning in their world, in a transition of evolving and becoming

common questions of existential therapy

who am i

what does it all mean

how do i get where i wanna be in my life

Viktor Franki

disagree wuth psychoanalitic system- developed logotherapy

logotherapy main themes

-life has meaning

-will to meaning is central for motivation for living

-we must have freedom to find meaning

Rollo May

-brought existentialism from europe to the us

-believed that psychotherapy should be focused on problems of being, compared to problem solving

6 propositions about human condition

1. capacity for self awareness increases

2. freedom/responsibility

3. striving for identity/relationship to others

4. search for meaning

5. anxiety as a condition for living

6. awareness of death/non being

how do problems develop

-confrontation for 4 ultimate concerns

1. freedom

2. death

3. meaningless

4. isolation

-state of inauthentic/meaninglessness

-anxiety (existential/normal vs neurotic)

-individuals use defense mechanisms to cope

phases

1. identifying and clarifying assumptions about world

2. exam present value system

3. putting new knowledge about self into action

roles of therapist and client

Therapist (no uniform rules, concerned with understanding clients world, help form new understandings)

Client (assume responsibility for how the choose to be in world, active role, confront concerns)

Goals

-help clients to accept their freedom

-assisting people to terms with the crisis in their lives

-encouraging clients to recognize the ways in which they are not living authentic lives

techniques

general de-emphasis

• paradoxical intention

• dereliction

• socratic questions

Therapeutic relationship is most effect/powerful technique

Pros/cons

Pros

• humanize therapy

• provide perspectives on basic human conditions

cons

• concepts are abstract

• lack empirical backing

• limited applicability to lower functioning and clients concerned about basic needs

experiental (gasalt) therapy

founder is Fritz Perls

This therapy has an emphasis on the person as a whole

-believed that the behavior was guided by the whole person not just parts of them

-this is a reaction against reductionism and determinism

Key concepts

-unfinished business

-humanistic philosophy

-gestalt (holism)

-here and now

-self regulation

-figure ground

some examples of laws

-similarity

-continuity

-pragnanz(law of good figure)

-proximity

-common religion

major beliefs

-stresses individual responsibility and individuality

-believes in the power in the present

-promotes direct experiencing

how do problems develop

-lack of awareness of needs,desires and wishes

-inordinate focus on past and future not present (unfinished business, feelings of alienation)

-not living in the here and now

-resistances to contact

resistance to contact

defenses we develop to prevent us to experiencing the present fully

emotion focused therapy

• short (8-20 sessions)

• emotions are connected to needs

• focusing on emotions can lead to therapeutic change

types

• Primary adaptive emotions

Initial emotional response; clear beneficial value

• Primary maladaptive emotions

Initial emotional response; not beneficial

• Secondary reactive emotions

Reaction to the initial emotional response

• Instrumental motions

Emotions expressed because they have an effect on

others

How does change occur

awareness

• increasing awareness of all parts of self

contact

• Making contact with one’s

  inner and external world

  without losing sense of

  self and individuality

Greater choice

• Helping clients assume

  ownership of their internal

  coping strategies

outcome renowning

• Identification with all vital

  functions of the individual

  including ideas, emotions,

  and actions

techniques

● Internal Dialogue/ Two-chair

● Empty Chair

● Exaggeration

● Focusing

● Repetition

● Rehearsal: role play

● Reversal: role play but in

others’ role

role of therapist

● Creates an atmosphere that promotes growth

and self-actualization

● Uses immediacy skills regularly

● Identifies patterns, particularly related to

avoidance

● Uses techniques in the service of increasing

clients’ awareness

● Strives for person-to-person relationship

role of client

● Actively engage in therapy as expert of their

own experiences

● Make interpretations and make meaning out

of their experiences

strengths

● Deemphasizes abstract intellectualization of

one’s problems

● Recognizes working with the past as it related

to the here and now

● Emphasizes doing

● Heightens awareness in a novel way

● Helps individuals integrate polarities within

themselves

weaknesses

● Potential for abuse

● May not be useful for clients who have

difficulty abstracting and imagining or

focusing on emotions

● Cross-cultural relevance: heavy emphasis on

developing separateness from one’s social

circle

● Fewer studies on this approach

What is

Integrative/Eclectic

Psychotherapy?

A particular form of psychotherapy

that draws its theoretical basis and

clinical methods from two or more

theoretical orientations

Psychotherapy

Integration

● Different from integrative psychotherapy

● Developing novel and effective approaches to

psychotherapy by combining elements of two

or more therapies

○ Every appraoch to psychotherapy has

something valuable to offer

○ Psychologists should not be preoccupied

with enforcing strict boundaries between

approached

Four types of Integrative Approaches

Technical

Eclecticism

Common

Factors

Theoretical

Integration

Assimilative

Integration

• Technical Eclecticism

• Common Factors

• Theoretical Integration

• Assimilative integration

• Technical Eclecticism

Therapist selects and uses techniques from different

approaches

● Strength: can draw on a variety of appraches and

meet different client needs

● Weakness: may be atheoretical

○ Does not require an underlying theory of how

problems develop or how change occurs

○ Using techniques without understanding what is

helping the client

• Common Factors

Based on:

○ Findings that different theoretical orientations do not

show differences in effectiveness

○ Idea that all approaches to psychotherapy share

certain effective ingredients

● Maximizing use of change processes common across

theoretical orientations (i.e. common factors)

• Theoretical Integration

Bringing together theoretical concepts from different

approaches to form a new model of therapy

• Assimilative integration

Maintaining one central theoretical position while

incorporating (assimilating) techniques from other

theories

Transtheoretical

Model-Prochaska & DiClemente’s Stage of Change

Stage Description Interventions

1. Precontemplation Unaware of problem or

consequences

Increase insight

2. Contemplation Considering a change but

not ready to take action;

stuck between changing

and not changing

Increase insight

3. Preparation Making plans to take

action; can take “baby

steps”

Focus on action,

behavioral change

(smaller steps)

Stage Description Interventions

4. Action Actively making

significant changes to

behavior, experiences, and

environment

Focus on action,

behavioral change

(larger steps)

5. Maintenance Prevent relapse of

behavior; consolidate

gains

Anticipate/prepare for

challenges; celebrate

progress

6. Relapse/

Termination (of

behavior)

Change process

complete; zero

temptation; high

self-efficacy

None

Important Considerations

• People do not pass those these stages in linear

fashion

• A client’s readiness can fluctuate throughout the

change process

• Limitations

PRACTICE

CONSIDERATIONS

• Solid grounding in a theoretical orientation

  • Client understanding of treatment

  • Adapting to clients

  • What approach is most consistent with the client’s

  worldview?

  • Client preferences

  • Accepting feedback from clients

  • Drawing on clinical wisdom and experience

THERAPEUTIC RELATIONSHIP

• Across theoretical approaches, a strong

therapist-client relationship is extremely

important

• The therapeutic relationship contributes

substantially to therapy outcomes & client

improvement

• Common factors