Existential, Client-Centered, REBT, and Behavior Therapy: Key Concepts and Techniques

Existential Therapy

Emphasizes freedom, choice, and responsibility.

Personality

Shaped by how individuals confront existential concerns: death, freedom, isolation, and meaninglessness.

Distress: Psychoanalytic vs. Existential

Psychoanalytic: Distress arises from unconscious conflicts and defense mechanisms. Existential: Distress stems from avoidance of existential truths and failure to live authentically.

Rollo May on "Existential" Label

May argued that labeling people as "existential" is misleading because existentialism is a philosophical stance, not a personality type.

Four Goals of Existential Psychotherapy

1. Increase self-awareness 2. Promote authentic living 3. Help clients confront existential concerns 4. Foster personal responsibility

Fellow Traveler

Therapist is not an expert but a companion on the client's journey through life's challenges.

Four Ultimate Concerns

1. Death - inevitability of mortality 2. Freedom - responsibility for choices 3. Isolation - existential aloneness 4. Meaninglessness - search for purpose

Ultimate Concern: Death

Common defenses: denial, distraction, immortality projects (e.g., legacy building).

Willing and Its Pathologies

Willing: Capacity to make choices and act. Pathologies: Impotence (inability to act), compulsivity (acting without reflection), decisional paralysis.

Living in Bad Faith

Avoiding responsibility by conforming or self-deception, thus living inauthentically.

Three Forms of Isolation

1. Interpersonal: Lack of connection with others 2. Intrapersonal: Disconnection within oneself 3. Existential: Fundamental aloneness of existence

Therapist's Role in Addressing

Freedom: Encourages choice and responsibility; Meaning: Explores values and purpose; Isolation: Builds authentic relationships; Death: Helps confront mortality and live fully.

Goal Regarding Anxiety

Not to eliminate anxiety but to help clients face it courageously and use it as a growth signal.

Cultural Considerations in Existential Therapy

Must respect diverse worldviews on meaning, death, and identity; avoid imposing Western existential ideals.

Client-Centered Therapy

People have an actualizing tendency: innate drive toward growth and fulfillment.

Actualizing Tendency

Innate drive to grow.

Reacting as a Whole

Integrated response to experience.

Internal Frame of Reference

Personal perception of reality.

Organismic Valuing Process

Natural evaluation of experiences.

Psychological Adjustment

Congruence between self and experience.

Unconditional Positive Regard

Acceptance without judgment.

Formative Tendency

Drive toward complexity and order.

Self-Concept

Perception of oneself.

Congruence

Authenticity and transparency.

Reality

Subjective experience.

Locus of Evaluation

Source of judgment (internal vs. external).

Comparison with Psychoanalytic Therapy

Client-Centered: Non-directive, growth-focused; Psychoanalytic: Directive, insight into unconscious.

Necessary and Sufficient Conditions

Empathy, unconditional positive regard, and congruence are both necessary and sufficient for therapeutic change.

Zimring's New Paradigm

Emphasizes constructive self-development over pathology.

Cultural Considerations in Client-Centered Therapy

Must adapt to collectivist values, hierarchical relationships, and non-verbal communication styles.

Evidence Base

Strong support for therapeutic alliance, but hard to isolate effects due to non-directive nature.

Therapist Responses

Avoid giving direct answers; instead, reflect and explore client's internal frame.

Moments of Movement

Sudden shifts in self-awareness or emotional insight that propel growth.

Emotional distress

Stems from irrational beliefs and self-defeating thinking.

Satisfaction of Demands

Getting what one irrationally insists on.

Distraction

Avoiding distress without resolving beliefs.

Magic and Mysticism

Seeking supernatural fixes.

Primary Goals of REBT

Reduce irrational beliefs and promote rational thinking and emotional well-being.

Therapeutic Relationship

Active, directive, and educational; therapist challenges irrational beliefs.

Unconditional Acceptance Components

Self-acceptance, Other-acceptance, Life-acceptance.

ABC Model

Activating event → Belief → Consequence.

Reindoctrination

Replacing irrational beliefs with rational alternatives.

Emotion Classification

Healthy: Sadness, annoyance, concern, disappointment, regret, frustration; Unhealthy: Rage, anxiety, jealousy, depression, guilt.

ABCD Model

Dispute irrational beliefs to change emotional outcomes.

Addressing 'Musts'

Challenge rigid demands and replace with preferences.

Want vs. Demand

Want: Flexible desire; Demand: Rigid, irrational necessity.

Experiential Exercises

Take risks: Challenge fear; Seek pleasure: Break guilt cycles; Stay in poor circumstances: Build tolerance; Take on hard tasks: Strengthen resilience.

Cultural Considerations in REBT

Must respect belief systems, communication styles, and emotional norms.

Stimulus-Response (S-R)

Behavior is a direct response to stimuli.

Stimulus-Organism-Response (S-O-R)

Includes internal processes.

Classical Conditioning

Learning via association (e.g., Pavlov's dogs).

Operant Conditioning

Learning via consequences (Skinner's theory).

Little Albert Experiment

Demonstrated fear conditioning by pairing a loud noise with a white rat.

Reinforcement

Increases behavior.

Punishment

Decreases behavior.

Positive Reinforcement

Add pleasant stimulus (e.g., Praise for good work).

Negative Reinforcement

Remove unpleasant stimulus (e.g., Stop nagging after task done).

Positive Punishment

Add unpleasant stimulus (e.g., Scolding for misbehavior).

Negative Punishment

Remove pleasant stimulus (e.g., Take away phone for bad grades).

Discrimination

Specific response to one stimulus.

Generalization

Response to similar stimuli.

Learning Types

Vicarious: Learning by observing others; Rule-Governed: Learning via instructions.

Distress Sources

Operant: Reinforced maladaptive behaviors; Classical: Conditioned fear or anxiety.

Classical Conditioning Principles

Extinction: Weakening of conditioned response; Exposure: Confronting feared stimuli; Stimulus Control: Managing cues that trigger behavior.

Operant Conditioning Principles

Extinction: Removing reinforcement; Shaping: Reinforcing successive approximations.

Therapeutic Style

Structured, goal-oriented, and empirical.

Behavioral Assessment

Excesses: Too much behavior (e.g., aggression); Deficits: Too little behavior (e.g., social skills); Functional Analysis: Identifying behavior triggers; Information Sources: Interviews, observations, self-reports.

Reinforcement Procedures

Differential Reinforcement: Reinforce desired, not undesired behavior; Token Economy: Earn tokens for good behavior; Contingency Management: Rewards tied to behavior change.

Exposure Types

In-Vivo: Real-life exposure; Imaginal: Mental visualization; Interoceptive: Exposure to bodily sensations.

Stimulus Control for Insomnia

Strengthen bed-sleep association (e.g., no TV in bed).

Cultural Considerations in Behavior Therapy

Tailor interventions to cultural norms, reinforcers, and communication styles.