© 2007 thomson brooks/cole, a division of thomson learning chapter 4: individual approaches to...
TRANSCRIPT
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Chapter 4: Individual Approaches to CounselingChapter 5: Counseling Skills
1
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Individual Approaches to Counseling
2
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
3
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Psychodynamic Approaches
Existential-Humanistic Approaches
Cognitive-Behavioral Approaches
Post-Modern Approaches
4
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
5
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
6
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
7
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Techniques Free Association Dream Analysis Empathy Developing
transference relationship
Techniques Interpretation of:
▪ Resistance▪ Defense mechanisms▪ Parapraxes▪ Dreams (manifest and
latent meanings)▪ Transference
8
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
9
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
10
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
11
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
12
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
13
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
14
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
15
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
16
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
17
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
18
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
19
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
20
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
21
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
22
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
23
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
24
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
25
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
26
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
27
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
28
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
29
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
30
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Four stages: Stage 1: Chaos Stage 2: Coalescence Stage 3: Multiplicity Stage 4: Metatheory
31
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
32
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
33
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
34
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
35
© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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?
36