Tuesday, February 21, 2012

WORRY CARTOON

YOU CAN'T CHANGE THE PAST
BUT YOU CAN RUIN THE PRESENT
BY
 WORRYING ABOUT THE FUTURE



SOME THINKING ERRORS USED IN WORRYING:

AWFULIZING/
CATASTROPHIZING
POWER AND CONTROL
PERFECTIONISM
SHOULDING


CAN YOU THINK OF ANY MORE?

COMPARISONS OF THEORETICAL COUNSELING MODELS PART 4

THE INFLUENCE OF THEORETICAL MODELS ON COUNSELING

The varying ideas and beliefs of counseling modalities greatly influence the manner and approach in which therapists help clients. Therapists need to use the theoretical approach most suited to each individual client’s issues to be most effective.

Cognitive Model

The cognitive model is one of the more popular theoretical models used by therapists. Cognitive therapy is brief, focused, time limited, and only deals with the presenting problem.

The major focus of cognitive therapy is on thinking patterns and their modifications. It also focuses on taking new ideas and acting them out. By examining the dysfunctional thinking and self-defeating thought patterns that keep clients from improving, therapists help clients create more satisfying relationships and functional lives.

Behavioral Model

The behavioral model helps clients through demonstrating accurate listening, concern, caring, acceptance, and understanding of the client as a unique person. For therapists to maximize their helping potential, they must first develop positive relationships with their clients, thereby ensuring greater understanding of clients’ issues and which intervention strategies to develop.

By involving clients in goal setting, therapists also provide them with enough motivation to succeed in acquiring adaptive and functional behaviors. Modern day therapists involve clients in the analysis, planning, process, and evaluation of their behavior management program.

Psychodynamic Model

Psychodynamics attempts to help clients by discovering how their past influences the present. Therapists using this approach often use free association as a tool as an aid to understanding past influences. Orthodox psychoanalysis gives special attention to sexual development during the Oedipal period. However, Jungians search for cultural archetypes in history that determine how we live our lives today, and family therapy explores how intergenerational family issues affect our present condition.

Existential Model

The existential model focuses on the meaning of human existence. Existentialism purports that people are responsible for their own lives. Using the existentialist approach, therapists help clients learn to drop their masks and become more open and self-trusting.

To help accomplish the aim of existential therapy, therapists demonstrate unconditional positive regard and empathetic understanding of clients’ internal frame of reference. Clients can become more mature and self-integrated through therapists’ reflecting clients’ feelings.

Family Systems Model

Family therapy has been compared by therapists as simultaneously running a circus with different acts. In the family systems model, therapists follow sequential stages in their attempt to help clients.

The first stage involves the first contact therapists have with their clients. During the first contact with family members, therapists connect with each person in a way that is intimate and meaningful. The second stage requires the therapist to become part of the family through trust and confidence-building with all family members. In this stage therapists use warmth, authority, and interpersonal skills to create connections with each family member.

Conclusion

While each theoretical approach and modality has its advantages and disadvantages, it is imperative that therapists choose the approach most suited to clients’ issues. For example, while there are some similarities, there are important differences between behavioral theory and existential theory. 

Behavioral approaches work best with clients who are more rigid in their thought patterns, are more comfortable with structure, and are very goal-oriented. Existential approaches work best with clients who are above average in intelligence, are comfortable with the more gray areas of life, and who are have good communication skills.

Behaviorism and existentialism are alike in that both theories encourage establishing a more humanistically-oriented, warm, genuine, and generally positive relationship with clients, influenced by respect and unconditional regard for clients. Rapport with clients is an essential requirement for building a solid therapeutic foundation in both approaches. However, while behaviorism strives to be structured, concrete, immediate, and focus on goal-setting, existentialism is very flexible in focusing on abstract, philosophical constructs that influence meaning in clients’ lives.

A behavioral approach is therapist-directed, whereas existentialism lets clients decide the flow of their sessions. Behaviorism’s focus on goals contrasts with existentialism’s focus on clients’ beliefs about life and relationships and letting clients’ discover themselves through dialog and introspection. Finally, behaviorism focuses on the extrinsic or outside world and behavior, while existentialism concerns itself mainly with the intrinsic or internal world of clients, their thoughts, feelings, and attitudes.

While both approaches have the goal of alleviating clients’ suffering, their methods are very different. Yet, each is a valid approach, depending on the type of client, their issues, time allowed for therapy. Therefore, all theoretical approaches can be useful if applied appropriately. It is therapists’ responsibility to be knowledgeable about the commonly used modalities so that they know how, when and with whom to apply a particular therapeutic approach, thereby maximizing their therapeutic potential.

SEE POSTS:  COMPARISONS OF THEORETICAL COUNSELING MODELS  PARTS 1, 2 AND 3

COMPARISONS OF THEORETICAL COUNSELING MODELS PART 3

AGE, GENDER, AND ETHNICITY

Age, gender and ethnicity play important characterological roles in the therapist/client relationship. The success or failure of therapeutic relationships is dependent on the interaction between the two cohorts in considering and accommodating gender, age and ethnicity factors. In establishing counseling relationships therapists must begin by building a positive foundation with their clients by skillfully eliciting information, establishing a rapport, trust, psychological comfort, and mutual purpose.

The Age Factor

How therapists approach counseling depends greatly on the age of clients. According Hackney and Cormier (2005), “Counseling seems to work better if children can control the distance between themselves and the counselor” (p. 70). Because children feel more comfortable talking with adults at eye level, it is important that seating during the session accommodates eye-to-eye contact.

The key element required in working with adolescents is trust-building. Adolescents sense if the counselors are genuine, have empathy, and if rapport is established. Adults are more concerned with therapists’ competence and open-mindedness. Adults also consider other factors such as the sensitivity, objectivity, and inter-personal attractiveness of counselors.

The Gender Factor

Gender influences therapists’ ability to judge clients’ state-of-being, past experience, and past client feedback. The main gender issue stems from clients’ male or female worldview and how past personal issues may impact counseling sessions. For example, if male clients believe that women are second-class citizens, pairing them with female therapists may not be productive.

Another example is female clients who have been emotionally, physically and/or verbally abused by a male. To foster productive therapy, therapists must be sensitive to clients’ needs and allow them to decide if their therapist’s gender feels comfortable to them.

Racial, Ethnic, and Cultural Factors

Having a strong foundation in clients’ culture and ethnicity supports counselors in laying groundwork for future sessions. Therapists have two ways to view clients in a cultural and ethnic framework. One is the “…etic or focused culture-specific approach…” which “…holds that all cultures are unique and must be understood for their uniqueness” (2005, p.70). By contrast, Hackney and Cormier (2005) cite Atkinson and Hackett (1998) who state that the universal approach is more subjective and includes “…how culture affects the counseling process by broadening the definition of minority to include all oppressed groups…” (p. 70).

SEE POSTS:  COMPARISONS OF THEORETICAL COUNSELING MODELS  PARTS 1, 2 AND 4

(References available on request.) 

Monday, February 20, 2012

B.F. SKINNER QUOTE

     "Give me a child and I'll shape him into anything."
B.F. SKINNER, PROMOTER OF BEHAVIORAL THERAPY 

 

COMPARISONS OF THEORETICAL COUNSELING MODELS PART 2

THE ROLE OF QUESTIONING IN ASSESSMENT AND INTERVENTION

Cognitive Theory

COGNITIVE AND BEHAVIORAL MODELS ARE USUALLY COMBINED

The focus of cognitive therapy is on the idea that people are born with the potential of correct thinking. Therefore, the focus of therapists using cognitive modalities is on fighting distorted thinking by asking clients questions related to rationale. Currently, the A-B-C theory is a cognitive modality commonly used. Using questions and confrontation, therapists explore (A) activating events of clients’ issues; (B) beliefs surrounding these events; (C) the consequences of clients’ A and B thoughts. The hope is that clients’ will see the errors in their thinking, change these distortions in logic, and ease or eradicate negative consequences in their lives.

Behaviorism Theory


PAVLOV, FATHER OF BEHAVIORISM
Behavior therapy is grounded on a scientific perspective of human behavior. Behaviorists believe people are producers and produce in their own environment. The questions clients face from behavioral modalities are designed to help them gain skills to help facilitate more choices and eventually gain full control over their lives. One important goal of behaviorism is to help clients to rid themselves of maladaptive behaviors. Clients are active in their therapy by learning and applying coping skills, role-playing, and completing homework assignments from their therapists.

Psychodynamic Theory

Psychodynamic theory focuses on the id, ego, super ego, unconscious motivations and libido (which refer to sexual energy. When therapists follow a psychodynamic modality the role of questioning in assessments and interventions use the following main concepts:
 
1.    Understanding and exploring client resistance such as: quitting therapy prematurely, canceling appointments, and  resisting self-exploration.

     2.    Exploring underlying issues and giving new endings to some issues.

     3.    Exploring and using transference and countertransference.

     4.    Understanding the reasons clients overuse ego defenses in both counseling and other relationships that keep clients from healthy functioning.

Therapists act as a blank slate. They engage in very little self-disclosure with clients and, as clients make projection onto them, they are more able to connect and understand how clients’ feelings are associated with their unfinished business. Therapists doing psychodynamic counseling ask probing questions to help clients gain self-awareness, healthy relationships, anxiety-reduction skills, and incorporate healthy work, love and play into their lives.

Existential Theory

While practitioners of psychodynamic theory believe freedom is restricted by unconsciousness, past experiences and libido, existential therapy views freedom as a choice implying responsibility for actions and choices. Existentialist approaches focus on helping clients explore and understand passivity in their lives and how they have accepted circumstances, thus giving up control over their lives. The goal of the existential modality is, therefore, to help clients gain control over their lives. The first step in the therapeutic journey is for clients to accept responsibility. “Once individuals recognize their role in creating their own life predicament, they also realize that they, and only they, have the power to change that situation” (Corey, 2004, citing Yalom, 2003, p. 141).

The main concepts existentialist therapists focus on are: freedom and responsibility; clients’ self-awareness; clients’ ability to establish healthy relationships with self and others; life as including anxiety and death; and clients’ personal purpose, meaning, goals and values in life.

Existential therapy focuses on life passages including the struggle for identity in adolescents, coping with disappointments in middle age, adjusting to children leaving home, coping with failures in marriage and work, and dealing with increased physical limitations as clients age. Existentialist counselors tailor questions to help guide their clients through self-discovery and realize the potential power within them.

Family Systems Theory

GENOGRAM
The family systems approach focuses on the clients’ family rather than only clients alone. The belief in family systems theory is that every event and action in families has an impact on each member of the family and displaces some of the clients’ blame externally. Therapists using a family systems approach usually try to include family members in clients’ sessions to help address issues. Questions are geared to triangulations, individualism, anxiety, and emotional disconnects.

SEE POSTS:  COMPARISONS OF THEORETICAL COUNSELING MODELS  PARTS 1, 3 AND 4

(References available on request.) 

Sunday, February 19, 2012

COMPARISONS OF THEORETICAL COUNSELING MODELS PART 1




CURRENT STRATEGIES USED BASED ON THEORETICAL ORIENTATION


Ideally, the strategy counselors use to treat clients are based on specific theoretical orientations they chose that are most appropriate for the presenting problems of clients. Five theoretical orientations commonly used are cognitive, behavioral, psychodynamic, existential, and family systems. Each of these theories purports different strategies as the best method for treating clients.

Cognitive Strategies

Cognitive therapy is used to treat common presenting issues such as substance abuse, anxiety, and depression. One of the cognitive strategies currently used is A-B-C-D analysis that is closely associated with rational-emotive therapy. In A-B-C-D strategy, A represents the activating event, B represents the clients’ belief system, C presents the consequence produced by the interaction between A and B, and D represents the disputation of such irrational beliefs and thoughts. The goals of the A-B-C-D modality, as in many of the strategies used in cognitive therapy, are designed to help “the client modify existing thought patterns, or remind the client to avoid undesirable thought, or even help the client assess events more constructively”. The main goal, therefore, is to change thoughts so that a positive change in feelings and behaviors of clients can follow, thereby alleviating clients’ distress.

Behavioral Strategies

Behavioral therapy is another commonly used approach in helping clients resolve issues. The general goal of behavioral therapy is to “help clients develop adaptive and supportive behaviors to a variety of settings”. Phobias are usually treated with behavioral therapy.

One of the most important strategies of behavioral therapy is goal-setting which allows clients to translate their concerns into specific therapeutic tasks. Goal setting also encourages the client to take small, successive steps toward resolving their issues. Therapeutic goals must be concrete, observable, and measurable and developed by both client and counselor to be specific and realistic.

In most cases, client-involvement in designing their goals is paramount, thus increasing the likelihood of their motivation and commitment in goal completion. For example, behavioral contracts are commonly used to help clients feel more committed to completing a task because contracts require clients to decide which behaviors they want and are able to attain.

Psychodynamic Strategies

Psychodynamic therapy places emphasis on clients’ unconscious processes. Therapists using a psychodynamic approach attempt “to deal with underlying characterological changes”. Therapists usually play an authoritative role and encourage clients’ transference to identify and resolve clients’ issues. In contrast, however, the free association psychodynamic modality often used requires therapists to become more like teachers/consultants rather than parental figures. Free association allows clients to freely report whatever enters their mind without bias or criticism from therapists thereby aiding unhampered reporting of clients’ unconscious mind.

Existential Strategies

Existential therapy allows clients to explore the meaning of life and their human existence. The existential approach is useful in helping clients examine issues of personal meaning in their lives and realize their ability for empowerment. Techniques of existentialism are extremely flexible.

Four steps essential in using an existentialist approach are: (1) being in the moment, (2) integrating the felt experience into primary relationships, (3) making connections to the past, and (4) integrating what was learned.

By including these steps, both therapists and clients are better facilitated in exploring the world of clients, thereby identifying presenting issues and possible solutions.

Family Systems

A systemic view “sees the family as the primary unit and holds that all the members of the family are important contributors to clients’ psychological functioning and development”. The family systems approach allows clients to separate the person from the problem, reduces guilt, and helps clients in joining with other family members to defeat the problem. Therapists using a family systems approach often use narrative therapy to help teach clients to externalize rather than internalize their problems.

 (I wrote this post for students and practitioners of psychology/therapy; however, I believe it contains much interesting information for the layperson, especially those interested in psychology and/or philosophy.)

SEE POSTS:  PARTS 2, 3 AND 4  COMPARISONS OF THEORETICAL COUNSELING MODELS

Wednesday, February 15, 2012

FRITZ PERLS QUOTE

"Our dependency makes slaves out of us, especially if this dependency is a dependency of our self-esteem. If you need encouragement, praise, pats on the back from everybody, then you make everybody your judge."


FRITZ PERLS

SEE POST:  "What to Do if Your Self-Esteem Takes a Dive?"
 

THEORY IN BRIEF: GESTALT THEORY

 I wrote this post for students and practitioners of psychology/therapy; however, I believe it contains much interesting information for the layperson, especially those interested in psychology and/or philosophy.


NAME OF THEORY:  Gestalt Theory

BASIC PREMISES AND PHILOSOPHY:  Learning occurs incrementally through successive reinforcement.  People become disconnected from their essential selves and require reintegration of them selves into a whole to heal.  Focus in on the present instead of the past.  Emphasizes whimsy and playfulness.  The goal is to heighten awareness and act on what is experienced.  Uses clients’ behaviors to bring about awareness of their creative potential to discover and facilitate their own change.

FOUNDERS OR IMPORTANT CONTRIBUTORS:  Fritz Perls, Latner, Polster, Wheeler, Kurt Lewin, Wolfgang Pohler

COUNSELING GOALS:  To have clients focus on the moment and their personal immediate experience and feelings and integrate this into appropriate action, showing ownership and responsibility.
 


FRITZ PERLS
ROLE OF COUNSELOR:  Demonstrate a high degree of authenticity, creativity, sensitivity.  Be willing to confront clients on their repression and denial. 

ROLE OF CLIENT:  Focus on the present, be open to emotions and immediate experiences, be willing to implement solutions and take personal accountability and responsibility for change and personal behaviors. 

 





USEFUL WITH WHAT POPULATIONS AND TYPES OF PROBLEMS:  Best with clients who are willing to engage in longer-term therapy.  Good with clients who are resistant to self awareness regarding their feelings.  Often used in group therapy.


 

BOOK COVER INDICATING FAMOUS EMPTY CHAIR TECHNIQUE

EXAMPLES OF TECHNIQUES:  Focus on the here and now, unfinished business (focus on resentment and other unexpressed feelings), channels of resistance (focus on defense mechanisms), choice of language indicating ownership, empty chair technique (speak to imaginary person).












CREATIVE EXPERIENTIAL GROUP THERAPY
TERMS:  experiential nature, existential encounter, client awareness, channels of resistance, person-centered, process-oriented, non-verbal behavior, eureka phenomenon/”aha” moments.




See more in "THEORY IN BRIEF" series.