Intro to Counseling

What is one challenge of group therapy?

• Confidentiality

• Not individualistic

What stage of group consist of introduction?

Forming

Which theory would have interventions of pretending and miracle question?

Solution Focused

Counseling that helps to find personal meaning in suffering.

Existential

Which type of therapy is circular causality used?

Family

What is a useful tool to get info on family systems?

Genogram

What is the term for treatment that has been effective in systematic researches?

Evidence based practice

Active listening involves reflection of:

Content and Emotion

Fatigue, reduced work performance:

Burnout

Discussion of fees; alternative options of treatment:

Informed consent

3 different roles (Psychopharmacology):

Referral to evaluation

Cost-effectiveness was prompted by:

Managed Care

Counseling that focuses on here and now and the central role of unfinished business from the past:

Gestalt

Over emphasize; autonomy:

Person-centered

Positive reinforcement; extinction; flooding:

Behavioral therapy

Name a treatment for addiction:

AA

What professional group is associated with standardized testing and research?

Psychologist

What process is used to determine a person's characteristics?

Assessment

What is it that provides standardization and accountability in the counseling field?

Licensing and accreditation

Who is the father of person centered counseling?

Carl Rogers

Who was it that saw power imbalances in relationships as critical in a therapeutic relationship?

Freud

The confidential nature of the client/relationship may be ethically preached when?

Tarasoff

Ethical decision making

• preparation

• Code of ethics

• Motivation

• Supervision

• Documentation

Reasons for being a counselor

1. PHILANTHROPI: -Desire to help others -"Give back" to those around you.

2. PRAGMATIC: -Comfortable in the role. -Wants to make a living while working around people. -Natural talent.

3. SELF-SERVING: -To meet unmet needs -Broader perspective on the meaning of life.

4. POWER/SAVIOR COMPLEX: -You have suffered/struggled and now have to answer. -You enjoy the power and influence.

What is countertransference?

-Loss of objectivity and clarity due to personal issues
-Personal reactions to work that interfere with work

Self-awareness

All counsellors should understand themselves and their emotions, which will help them navigate their own biases and better support their clients.

"a mind that found itself"

Cliford Beers

Carl Rogers

"therapeutic relationship"

Carkuff, Berenson, Krmbeltz

behavior therapy

Albert Ellis and Aaron Beck

cognitive therapies

FREUD AND (BREUER):

"Talking cure"
-First formal methodology of counseling
-Adapting hypnosis

PSYCHIATRISTS

A medical doctor who specializes in diagnosing and treating mental illnesses.

PSYCHOLOGISTS:

-Wihelm Wundt → 1st experimental laboratory
-Wilem James→ "Professor of psychology
-Stanley Hall → 1st doctorate
-John Watson and B.F. Skinner → experiments

Managed care

A health care delivery system that aims to reduce costs while improving quality.

Accreditation & licensure benefits

Comprehensive mental health system
Accredidation → CACREP, AAMFT, CORE, ADA
Licensure laws across states
Managed care movement

(3)Reasons for research

1. Terminology and language of the research field

2. Knowledge of the classic studies of the field and their implications for clinical work.

3. Ability to conduct systematic studies on topics that have professional meaning to you as a student and as a professional counselor

Ethical decision making (NO PERFECT ANSWERS!)

-Prepare
-Professional code of ethics
-Examine motivation
-Preventative
work with client
-Seek consultation
-Document

Informed consent

Limits of confidentiality
Fees
Limitations and dangers
Right to refuse treatment
Access to records
Alternative treatment models
Counselor qualifications and training

Client rights

-Right to informed consent
-Right to privacy
-Right to protection against harm
-Right to refuse treatment
-Right to competent treatment

Confidentiality and its limits

-Record and keeping
-Personal support system
-Child abuse/neglected
-Duty to warn (Tarasoff)
-Court order (subpoena, records, witness)

Power dynamics (3)

1.PSYCHOANALYTIC (Freud) 2. MINUCHIN 3. HUMANISTIC (Rodgers)

Relationships skills (attending)

-Restrict distractions
-Have a reason for listening
-Be non-judgemental
-Look for themes
-Wait to respond

Relationships skills (, listening)

-Non-verbal communication
-Paraphrasing and summarizing
-Reflection (content and emotion)

Relationships skills (exploration)

-Probe: open and closed questions
-Immediacy (looking for non-verbal conversation (reluctant, defensive)
-Self-disclosure
-Interpretation
-Confrontation → Curiosity goes a long way.

Evidence based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

Counselor obligations with personal faith

Obligated to inform client of personal faith

Obligated to inform client of personal faith.Reasons for:

-Personal awareness
-Organizational policy and procedure
-Supervision/ consultatn
-Informed consent
-Recommendations for change of counseling

Reflecting God's heart towards creation in counseling

Sin is the problem (Romans 8:20-21 + Daniel 5:23).

Reasons for theory

-explain, predict, control
-Blue print for action
-Working hypothesis

Person-centered counsling

• Person-centered counsling→ Carl Rogers (we think empathy)
-Humans are intrinsically good and trustworthy
-Growth-oriented→ self actualization
TECHNIQUES: active listening
CRITICISMS: Not useful for crisis clients; too much client responsibility

Existential Counseling

-Find personal meaning in suffering
CRITICISM: difficult to understand; too philosophical; not appropriate for all populations/presenting issues; nonempirical

Psychoanalytic Theory

-Layers of awareness and psyche
-Defense mechanisms
-The counselor interprets links from past/present and relationship issues, hypnosis, free association, and dreams.
CRITICISMS: complex and length; power dynamics; not useful for ciriss; Deterministic and pessimistic.

Gestalt Counseling

Gestalt Counseling → Fritz Peris
-Basic tenet: here and now
TECHNIQUES: hot seat, resentment expression, double chair

Narrative

Narrative → White epston
-Envisioning lives from new perspectives
TECHNIQUES: naming problems; collaborative relationship; problem in social context; identify unique outcomes.

Interpersonal Neurobioloy

Interpersonal Neurobioloy→ Daniel Siegel →Education!
*Neuroscience in response to "lack of science" criticisms
*Childhood trauma and the brain.

Adlerian

*Pragmatic psychoanalysis
*Responding to feelings of inferiority
*Goals represent choice
*Social context

Feminist Theory

*Gender and culture
*Marginalization
*Autonomy/self-sufficiency is a connection

Behavioral counseling

Behavioral counseling → Skinner and pavlov
*Classical conditioning
*Operant conditioning
CRITICISMS: Narrowly focused on observable behavior; no work on underlying causes; mechanistic, manipulative, impersonal.

Cognitive behavioral and Rebt

Cognitive behavioral and Rebt → Aaron Beck and Albert Ellis
*Cognitive interpretation maladaptive thinking
*Automatic thoughts = instinctive interpretations, beliefs
TECHNIQUES: ABC theory; Socratic dialogue; thought diary; cognitive ditoritions; break big problems down into smaller ones; behavioral strategies.
CRITICSIM: Burnout for counselors/boredom; excluding feelings; less effectiveness with overintellectualizing clients or lower capacity for logic.

Solution-focused (brief therapy)

TECHNIQUES: Miracle question; pretending; scaling questions; exception finding.
CRITICISM: Placebo effect; no growth/skills; need for exploration of problem/meaning.

Multimodal therapy

Multimodal therapy → Lazarus
-Can we pick and choose what we use?

Expressive therapies

*Music and dance therapy
*Play therapy
*Exercise
*Cinematherapy

Mindfulness

Acceptance and Commitment Therapy Act

STANDARDIZED measure

uniformity in administration and scoring.

NON-STANDARDIZED measure

non-uniform, subjective, general, and diverse approach.

RELIABILITY

Consistent

VALIDITY

If it's not valid, it's not accurate.

Benefits of diagnosing

*Standardized terminology
*Record keeping for insurance/credentialing agency
*Classifying clientele
*Predicting course and prognosis
*Treatment planning

Criticism of diagnosing

*Inconsistency in diagnoses
*Pathology vs. wellness focus
*Medical model
*Dehumanizing labels

Red flags

*Ethical or legal issues
*Medical assessment is indicated
*Abuse or neglect of a child, elder, or dependent
*Client is a danger to themselves or others

CHALLENGES of group therapy

*Less individualized time
*Confidentiality
*Leader experience
*Not everyone is suitable for groups

BENEFITS of group therapy

*Cost effectiveness
*Spectator effects
*Stimulation value
*Feedback
*Support
*Structured *Practice

Group stages

Forming
Storming
Norming
Performing
Adjourning

High functioning groups

*Safety
*Construct and enforce group norms
*Share resources
*Address conflict
*Address distractions, digressions, and acting out.
*Follow-up

Cues for counselor intervention

*Abusive Behavior
*Rambling and digressions
*Withdrawal and passivity
*Boredom
*Semantic errors: changes or catch phrases from I should or I can't to I can or I will.

Criteria (symptoms) for substance use disorders

IMPAIRED CONTROL
*Larger amounts and or longer-time
*Desire/attempts to cut back
*Time obtaining, using, recovering, from use.
*Intense desire/urge for substance
SOCIAL IMPAIRMENT
*Failure to fulfill role obligations
*Continued use despite interpersonal problems
*Withdrawal in order to use
RISKY USE
*Use when physically hazardous
*Use despite physical/psych problems
PHARMACOLOGICAL
*Tolerance
*Withdrawl

Addiction treatment models

MEDICAL MODEL → Addiction is viewed as a disease, such as diabetes.
AAINA MODEL → Uncontrollabel, spirutal problem.
CONTINUED
Motivational Interviewing
Relapse prevention
Psychoeducation
Behavioral interventions
Matrix model
Harm reduction

Counselor obligations with pharmacology (medication)

Referral for an evaluation

Family systems approach

Family as system = behaviors are interrelated
HOMEOSTASIS (going home for 2 weeks and falling into old habits → everything changed).

Differences between family & individual counseling

Problem = interactions
*Active and direct
*Pragmatic and flexible
*Focus: organizational structures and family development (norms, rules)
*Circular (rather than linear) causality
*Family life cycle (all different ages, how long married?)

Problem-solving versus acceptance approaches to couples counseling

PROBLEM SOLVING

• identifying and developing strategies to resolve them. ACCEPTANCE

• emphasizes understanding, validating, and adapting to differences without necessarily changing them

Goals in career counseling

*Selection of an occupation
*Adjustment to an occupation

Burnout symptoms

*Fatigue
*Reduced work performance
*Negaitve attitudes
*Disillusionment
*Apathy
*Boredom

Causes of Boredom

*Long hours
*Can't accept personal limits
*Savior complex
*Poor boundaries

Counselor obligations with diverse clients

• understanding the cultural context of clients

• actively examining their own cultural biases

• Adapting counseling techniques to fit in different cultural needs

• seeking further education to develop multicultural competence

Power dynamics in counseling

inherent imbalance of power that exists within a therapeutic relationship.