Chapter 1

Theories and Therapies

What is a theory? A group of related laws or

relationships that are used to provide explanations within a discipline (Sharf, 2004)

No one theory fits all situations or persons.

Characteristics of Sound TheoriesHansen, Stevic, & Warner (1986)

1. Clear, easily understood, and communicable

2. Comprehensive3. Explicit and heuristic4. Specific in relating means to

desired outcomes5. Useful to its intended practitioners

Pragmatic Value of Theories

Helps explain what happens in a counseling relationship

Assists the counselor in predicting, evaluating, and improving results

Provides a framework for making scientific observations about counseling

Encourages the coherence of ideas about counseling and the production of new ideas

Functions of TheoryBoy & Pine (1983)

1. Find unity and relatedness within the diversity of existence.

2. Examine relationships they would otherwise overlook.

3. Provide operational guidelines by which to work and helps them evaluate their development as professionals.

4. Focus on relevant data and tells them what to look for.

5. Assist clients in the effective modification of behavior.

6. Evaluate approaches to the process of counseling.

Antiquated Theories

Trephining Exorcism Flogging, Starving, Chains,

Immersion in Hot Water Institutions and “Lock-up”

Talk Therapies Proposed the unchaining of patients

and better treatment such as time outdoors, feeding them a more nutritious diet, and talking with them.

Two Early Examples: Paul Dubois (1848-1918) – a Swiss physician Pierre Janet (1859-1947) – a French physician

Examples of Modern Theories Psychoanalysis Behaviorism Existentialism Adlerian theory Person-Centered theory Reality therapy

Present Trend Helping professionals seem to be

pragmatically flexible in adapting techniques and interventions from different theoretical approaches into their work without actually accepting the premises of some theoretical points of view.

Can be seen in the development and use of microskills.

Eclecticism Most modern professionals consider

themselves as eclectic Combine theories or techniques from

a wide variety of therapeutic approaches.

Modern counselors use an average of 4.4 theories making up their therapeutic work with clients. (Cheston, 2000)

Style-shift counseling As needs change, counselors

depart from a theory they are using to another approach.

Strength of Eclecticism The ability to draw on various

theories, techniques, and practices to meet client needs.

Drawback of Eclecticism Can be hazardous to the

counseling process if counselors are not thoroughly familiar with all aspects of the theories involved.

Can do more harm than good because the counselor may have little or no understanding about what is helping the client.

Levels of EclecticismMcBride and Martin (1990)

Syncretism Lowest or first level Sloppy, unsystematic process of

combining clinical concepts

Levels of EclecticismMcBride and Martin (1990) (cont.)

Traditional Second level An orderly combination of compatible

features from diverse sources into a harmonious whole

More thought out and theories are examined in greater depth.

Levels of EclecticismMcBride and Martin (1990) (cont.)

Theoretical Integrationism Third level Requires that counselors master at least

two theories before trying to make any combinations.

Assumes two things: A degree of equality between theories (which may

not be true) The existence of criteria to determine what pieces

of each theory to include or exclude.

Levels of EclecticismMcBride and Martin (1990) (cont.)

Technical Eclecticism Fourth level Procedures from different theories are

selected and used “without necessarily subscribing to the theories that spawned them” (Lazarus & Beutler, 1993)

Critical variables are a mastery of theory and an acute sensitivity to knowing what approach to use when, where, and how.

Transtheoretical Model (TTM) of change Model is developmentally based

and has been empirically derived over time.

An alternative to technical eclectic approaches.

TTM Five (5) Stages Model of Change

Precontemplation Contemplation Preparation Action Maintenance

TTM’s Underlying Stages of Change

Consciousness-raising Dramatic Relief Environmental Reevaluation Self-evaluation Self-liberation Contingency Management,

Counterconditioning, and Stimulus Control

TTM’s Levels of Change Symptom/Situation problems Maladaptive Cognitions Current Interpersonal Conflicts Family System Conflicts Intrapersonal Conflicts

Drawbacks of TTM Comprehensiveness of approach Complexity of approach Has only been tested among

limited groups

The Case of Linda Linda is a recently divorced, 32-year-old Caucasian

woman. Comes seeking counseling because of “relationship

problems.” Was married for 7 years but ended her relationship

because she no longer found her husband exciting and thought he was verbally abusive.

Had an abortion in the marriage two years earlier because her husband insisted and she did not feel ready for parenting responsibilities.

Family Background Father was a construction worker with

just a 7th grade education. Drank heavily on weekends. Good work ethic and positive attitude toward

work. Definite and vocal opinions about politics,

religion, and the subservient place of women in society.

Family Background

Mother was a high school graduate. Did not work outside the home Quiet and introverted woman

Family Background

Older Brother (two years). Two younger sisters (13 months and 3

years). Linda reports she is not emotionally

close to her family at all.

Historical Context Grew up in a lower class neighborhood

in a mid-size Midwest city. As a teenager, she reports being mildly

rebellious. Dated older boys and was flirtatious,

but never engaged in more than heavy petting.

States her brother was her protector.

Educational Background Good enough grades to be admitted to

a 4-yr college but did not feel confident enough to apply since it would go against family norms.

Father discouraged her from furthering her education.

Enrolled in a local community college and completed a program in business administration.

Employment History Since graduation she has drifted

from job to job as an administrative assistant or secretary.

No job has challenged her. Admits to getting “fed up” with the

treatment she gets from her bosses, who are sexist, she thinks.

Hobbies Likes to read romance novels. Watches the home and garden TV

channel. Goes to see action movies. All make her feel better by taking

her away from her mundane existence.

Social Factors Has felt “aimless, anxious, and

depressed” since the divorce. Has not found a group of singles to

associate with and her former friends have all “married or moved away.”

Considers her family boring and sees them only once a week.

Take-In Session Reveals she has had daydreams about

ending her life by stepping out in front of a truck, though she doubts she would ever do thing.

Has recently contemplated finding a new job and has given two weeks notice.

Thinks life is passing her by and her voice is desperate as she relates this to you.