© 2007 Thomson Brooks/Cole, a division of Thomson Learning Chapter 4: Individual Approaches to Counseling Chapter 5: Counseling Skills 1

© 2007 Thomson Brooks/Cole, a division of Thomson Learning

Chapter 4: Individual Approaches to CounselingChapter 5: Counseling Skills

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Individual Approaches to Counseling

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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

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Psychodynamic Approaches

Existential-Humanistic Approaches

Cognitive-Behavioral Approaches

Post-Modern Approaches

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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)

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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)

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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

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Techniques Free Association Dream Analysis Empathy Developing

transference relationship

Techniques Interpretation of:

▪ Resistance▪ Defense mechanisms▪ Parapraxes▪ Dreams (manifest and

latent meanings)▪ Transference

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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

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Jung believed we can make almost anything conscious

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

Techniques: Goal of techniques—to make unconscious

conscious Some techniques:

▪ Examining our dreams▪ Meaning of symbols▪ Creative Techniques (working with clay)▪ Active imagination

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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

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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

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Phase of therapy Building

relationship Assessing lifestyle Insight and

interpretation Reeducation and

reorientation

Techniques: 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

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Overview 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

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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

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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

See Box 4.5, p. 111

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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)

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Overview 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 Therapy and Choice Theory

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Developed by Many Different Indivdiuals Based on an understanding of classical

condition, modeling, and operant conditioning Therapeutic stages

1. Building the relationship 2. Clinical Assessment3. Focusing on Problem Areas and Setting Goals4. Choosing Techniques and Working on Goals5. Assessment of Goal Completion6. Closure and follow-up

Some techniques: See Box 4.8

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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)

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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)

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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

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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

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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

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Overview Based on post-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

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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

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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

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SFBT: Developed by Berg and de Shazer (and others) Developed at BFTC of Milwaukee Rejected “disease model” believed that clients

could work quickly to reach goals Pragmatic, optimistic, anti-deterministic, future-

oriented Miracle Question Questions: evaluative, coping, exception-seeking,

solution-focused Find exceptions Often, under 6 sessions

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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

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MORE POPULAR OF HUNDREDS OF THERAPIES

Erikson’s Psychosocial

Theory

Object-Relations Theory Relational and Subjectivity

Theory Dialectical Behavior Therapy

(DBT) Acceptance and

Commitment Therapy (ACT)

Constructivist Therapy

MORE POPULAR OF HUNDREDS OF THERAPIES

Eye Movement Desensitization Therapy (EMDR)

Motivational Interviewing

Gender-Aware Therapy Positive Psychology and

Well-Being Therapy Complementary,

Alternative, and Integrative approaches

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Four stages: Stage 1: Chaos Stage 2: Coalescence Stage 3: Multiplicity Stage 4: Metatheory

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Bias in Counseling Approaches Many theories developed by White men, European

heritage Their values impacted their theories Some of these values included:

▪ Individualism▪ Expression of feelings▪ Uncovering “self”▪ If you work hard, you’ll succeed▪ Mind-body dualism▪ Truth can be found▪ External factors not important

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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

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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)

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Section A (cont’d)▪ Roles and relationships at individual, group,

institutional, and societal levels▪ Multiple clients▪ End-of-life care for terminally ill clients

Section B▪ Respecting client rights (including foreseeable

harm and life-threatening diseases)▪ See “Tarasoff Case and Foreseeable Harm (Duty to Warn) Box 4.13, p. 142

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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?

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© 2007 Thomson Brooks/Cole, a division of Thomson Learning Chapter 4: Individual Approaches to Counseling Chapter 5: Counseling Skills 1