The world of the Counselor An introduction to the counseling profession 5e chapter 4

 Overview Dominated early part of 20th century  Common elements ▪ Unconscious and conscious affects person’s functioning ▪ Early child-rearing has some affect on development of person

Chapter 4: Individual Approaches to Counseling

Chapter 5: Counseling Skills

Individual Approaches to Counseling

 Offers us a framework

 Knowledge builds on knowledge (Paradigm Shifts)

 See Box 4.1, p 102

 Theories are heuristic

 Based on our view of human nature

 Helps us work in an organized manner

 Today, hundreds of counseling theories, but only some have gained prominence

 Psychodynamic Approaches

 Existential-Humanistic Approaches

 Cognitive-Behavioral Approaches

 Post-Modern Approaches

 Overview

 Dominated early part of 20th century

 Common elements

▪ Unconscious and conscious affects person’s functioning

▪ Early child-rearing has some affect on development of personality

▪ Past, in interaction with conscious and unconscious, affects person’s development

▪ Have tended to be longer term

 Some approaches: psychoanalysis (Freud), analytical therapy (Jung), individual psychology (Adlerian)

Developed by Sigmund Freud

 First comprehensive approach to therapy

▪ Psychic energy (instincts) drive behavior

▪ Life instinct (Eros): love, intimacy, sex, survival

▪ Death instinct (Thanatos): fear, hate, self-destructive behavior aggression

▪ All life and death instincts = libido

 Structure of personality:

▪ Id (pleasure principle)

▪ Ego (reality principle)

▪ Superego (moral imperatives)

 Psychosexual Stages: Oral, Anal, Phallic, Latency, Genital

 Parenting affects developmental through stages

 Defense mechanisms reflect that development

 Name some defense mechanisms!

 Deterministic Approach

 See Figure 4.1, p 104

 Long term approach that relies on making a little more of the unconscious conscious

 Developed by Carl Jung

 Less pessimistic and less deterministic than Freud

 8 Psychological Types—include combinations of:

▪ Extraversion and Introversion (E or I) with

▪ Mental Functions: Thinking and Feeling (T or F); Sensing and Intuiting (S or N)

 Information that matches psychological type goes into

consciousness Information that doesn’t, goes into personal

unconscious.

 Our collective unconscious is inherited Contains archetypes —

tendency to perceive things in ways we call “human”

 Well known archetypes: persona, anima and animus, shadow

Jung believed we can make almost anything conscious

 If we understand our personal and collective unconscious, we are “whole”

 Developed by Alfred Adler

 “Teleology”—we inherently are goal directed

 We move to fulfill one drive—striving for perfection

 All other drives subsumed by this one

 Part of being human: having feelings of inferiority

 Feelings of inferiority lead us to our subjective final goal

 Our private logic leads us toward our final goal

 Drive toward our subjective goal results in development of

behaviors that compensate for feelings of inferiority

 You can tell how a person is driven toward his/her goal through

his/her style of life

Work through feelings of inferiority, and you will move toward

social interest (Gemeinschaftsgefuhl)

 Followers: Dreikrus and Dinkmeyer

 Worked with children whose typical behaviors from feelings

of inferiority yield:

▪ Attention seeking, use of power, revenge seeking, and inadequacy

 Sometimes seen as an early humanistic approach (through

education and counseling one can change)

 One of first approaches to work with families

 Exploring family constellation

 Examining early recollections

 Encouragement

 Democratically held discussion groups

 Limit setting

 Acting “as if” spitting in client’s soup

 Setting logical and natural consequences

 Loosely based on existential philosophy

 Deals with struggles of living and how we construct meaning in our lives

 Tends to be optimistic and not deterministic

 Phenomenological perspective

 Focus on consciousness and the relationship

 Help people “self-actualize”

 Three approaches: Existential Therapy, Person-Centered, Gestalt Therapy

 A number of theorists developed this approach: Frankl

(Logotherapy); May, Bugental, Yalom

 Central tenets of most existential approaches

▪ Born into a world with no inherent meaning

▪ We make our meaning

▪ Struggle throughout life to be “human”

▪ Most people live a life of limited self-reflecton

▪ We are born alone, die alone, and mostly live alone

▪ Choice about who we are

▪ Can gain awareness about choices we made

▪ See Box 4.4, p 110

Developed by Carl Rogers (“client-centered therapy”)

 We all have need to be regarded

 Conditions of worth placed on us by significant others

 Help people become more congruent and gain a more

realistic sense of ideal self

 "Necessary & sufficient conditions" (pp 110-111)

 “Techniques”:

▪ Congruence/genuineness

▪ Unconditional positive regard

▪ Empathic understanding

 Developed by Fritz Perls

 Based on Gestalt psychology, phenomenology, &

existentialism

 More directive

 Self-regulation, need identification, and need-fulfillment

 Only aware of needs in “foreground”

 “Blockages” or “impasses” yield “unfinished business”

 Now = experience = awareness = reality

 Anti-deterministic

 Techniques “push” one into awareness (pp 114-115)

 Pavlov (1848-1936): Classical Conditioning

 Skinner (1904-1990): Operant Conditioning

 Bandura: Modeling or Social Learning (1940s)

 Recent Years:

▪ Cognitive Structures

▪ illogical Ways of Thinking

 See common assumptions (p 116)

 Approaches: Modern-Day Behavior Therapy, Rational Emotive Behavior Therapy, Cognitive Therapy, Reality

 Developed by Many Different Indivdiuals

 Based on an understanding of classical condition, modeling, and operant conditioning

 Therapeutic stages

1 Building the relationship

2 Clinical Assessment

3 Focusing on Problem Areas and Setting Goals

4 Choosing Techniques and Working on Goals

5 Assessment of Goal Completion

6 Closure and follow-up

REBT: Developed by Albert Ellis

 Complex interaction between thinking, feeling, & acting

 Mostly, focus on Rational vs Irrational Thinking

 People have cognitive distortions

 People often driven by 1 or more of 3 core irrational beliefs

(see Box 4.9, p 120)

 ABCs of feeling and behaving

 Relationship important, but not critical (see Box 4.10, p 120)

 Developed by Aaron Beck

 Continuity hypothesis: older emotional responses continue into modern day world

 Diathesis-stress model: biological/genetic/environmental

model—under stress, our (unique) disorders are shown

 Rational, pragmatic, antideterministic, educative, empirical

 We all have “core beliefs” that drive us—embedded beliefs often out of our awareness

 We can have negative core beliefs (see Box 4.11)

Cognitive Therapy (cont’d)

 Core beliefs lead to intermediate beliefs (“attitudes, rules, and expectations”)

 Intermediate beliefs lead to automatic thoughts

 Automatic thoughts related to certain “cognitive distortions (see Table 4.1, p 123)

 Automatic thoughts lead to possible reactions to certain situations (see Figure 4.2, p 124)

 Treatment: focus on automatic thoughts, get to intermediate beliefs, then get to core beliefs—change core beliefs through thinking and acting differently

 Developed by Glasser—originally called Reality Therapy

 Five genetically based needs: survival, love and belonging, power, freedom, and fun

 Unique “need-strength profile”

 We can only satisfy our needs and control our behaviors in the present

 Since birth, we create a “quality world” to determine how

to satisfy our needs

 Some quality worlds lead to destructive behaviors

Reality Therapy (cont’d)

▪ Can change the pictures in our quality worlds and our behaviors

▪ Total behavior: We can only choose our actions and thoughts

▪ Use internal-control language, not external control language

▪ Techniques: see WDEP system (Figure 4.3, p 127)

▪ Anti-deterministic

 Overview

 Based on modernism, social constructionism,

post-structuralism

▪ Post-modernists: Questions modernism and many

assumptions and beliefs we take for granted

▪ Social Constructionism: Values are transmitted through

language via social milieu (family, culture, society)

▪ Post-structuralism: Questioning of “inherent truths” or

“structures” we have believed

 Two approaches: Narrative Therapy and Solution-Focused

Brief Therapy

Developed by White and Epston (and others)

 Four basic tenets:

▪ Realities are socially constructed

▪ Realities are constituted through language

▪ Realities are organized and maintained through narrative

▪ There are no essential truths

 Anti-deterministic and anti-objectivist

 Deconstruct older, negative narratives

 Construct new narratives

 Narrative Therapy (cont’d)

 We all are multistoried

 Look at “thin” and “thick” stories

 Look for exceptions to stories (see Fig 4.4, p 129)

 Be respectful, curious, show awe, ask questions

 Phases: joining, examining patterns, re-authoring, moving on

 Use journaling, retelling new stories, symbols to reinforce

new stories

SFBT: Developed by Berg and de Shazer (and others)

 Six Stages

 Stage 0: Pre-Session Change

 Stage 1: Forming a Collaborative Relationship

 Stage 2: Describing the Problem

 Stage 3: Establishing Preferred Goals

 Stage 4: Problem-to-Solution Focus

 Stage 5: Reaching Preferred Goals

Bias in Counseling Approaches

 Many theories developed by White men, European heritage

 Their values impacted their theories

 Some of these values included:

▪ Truth can be found

▪ External factors not important

 It’s time to take into account other cultures

 It’s time to become more multicultural sensitive in our

theories

 Many of the theories can be adapted to address these

issues

 Sometimes, new theories will need to be undertaken

 And, let’s not forgot our own biases and how they

interplay with bias in theories

Some common issues related to Sections A and B of ACA ethics code: Section A: The Counseling Relationship, and Section B: Confidentiality, Privileged and Privacy

 Section A

▪ Welfare of clients

▪ Informed Consent

▪ Clients being seen by other professionals

▪ Roles and relationships with clients (including sexual relationships)

Embracing a Theory but Open to Change

 Theory development is an ongoing process

 Be open to changing your approach over your career

 How do you think your approach might change?