Counseling and Helping Relationships (Helwig)

Examples of some Models of Consultation

-Bergan -Bandura -Schein -Caplan -A nine-stage process of consultation described by Splete

secondary traumatic stress

-May result because of the exposure to graphic material presented by traumatized clients. -The counselor may begin experiencing some of the same symptoms as the client.

Harry Stack Sullivan

-Neo-Freudian -A social systems (interpersonal) approach can lead to understanding human behavior. -Behavior can best be understood in terms of social interactions, not as mechanistic and linear.

Karen Horney

-Neo-Freudian -Security is each person's major motivation and the person becomes anxious when it is not achieved. -Irrational ways to mend disrupted human relationships may become neurotic needs.

Distress Tolerance

-One model of skills conceptualized in DBT -Accepting and tolerating oneself and the current situation, often painful and negative, in a non-evaluative way

Interpersonal Effectiveness

-One model of skills conceptualized in DBT -Developing effective strategies for asking for what one needs, saying no as appropriate, and coping with interpersonal conflict

Emotion Regulation

-One model of skills conceptualized in DBT -Identifying emotions and obstacles to changing them, reducing vulnerability, and increasing positive emotions

Kinesics

-Refers to nonlinguistic communications which occur through body movements such as gestures and facial expressions.

Bandura

-Social learning model -There is a dynamic interplay of behaviors, cognitions, and the environment and all three are assessed in problem identification. -Many solutions revolve around modeling, rehearsing, and changing cognitions.

Splete

-A 9-stage process 1. Precontract 2. Contract and exploration of relationship 3. Contracting 4. Problem Identification 5. Problem analysis 6. Feedback and planning 7. Implementation of the plan 8. Evaluation of the plan 9. Conclusion and termination of relationship

Bergan

-A behavioral model with four (4) stages which are: 1. Problem identification 2. Problem analysis 3. Plan implementation 4. Problem evaluation -Part of the focus of this consultation is on problem behaviors and their antecedents and consequences. -Emphasizes the verbal interaction in consultation.

Eye Movement Desensitization and Reprocessing (EMDR)

-A counseling technique used to facilitate the client's accessing of memories of painful and traumatic experiences and reprocessing these experiences through eye movements similar to those found in REM sleep cycles. -Has generated considerable positive research.

Wilderness Therapy

-A more clinically-oriented program. -An outdoor behavioral mental healthcare approach for troubled adolescents and adults. -The purposes are to identify and address emotional, behavioral, and psychological problems through an outdoor, often unfamiliar environment.

Neo-Freudians

-A number of psychoanalysts moved away from Freud's emphasis on the ID as the dominant psychological force, and placed more emphasis on the EGO, including both psychodynamic and sociodynamic forces. -Karen Horney -Erich Fromm -Harry Stack Sullivan -Other Neo-Freudians include Otto Rank, Wilheim Reich, and Theodore Reik. -Carl Jung and Alfred Adler

Archetype

-A response pattern occurring universally in the human experience and is characterized by an emotional charge to the existential issues of identity, meaning, and purpose. -Examples of archetypes are: anima and animus (female and male traits).

Rational Emotive Behavior Therapy (REBT)

-Albert Ellis -REBT is based on the philosophy that it is not the events we experience that influence us, but rather it is our interpretation of those events that is important. -Individuals have the potential for rational thinking. -In childhood, we learn irrational beliefs and re-indoctrinate ourselves on a continuing basis. -This leads to inappropriate affect and behavior. -Belief system, self-talk, and 'crooked thinking' are major concepts. Therapy follows an A-B-C-D-E system as follows: A=external event (an activity or action) B=belief--in the form of a self-verbalization C=consequent affect--which may be rational or irrational D=disputing of the irrational belief which is causing the affect/behavior E=Effect (cognitive)--which is a change in the self-verbalization -Emotive techniques in therapy include role-playing and imagery. -This theory teaches that self-talk is the source of emotional disturbance

Gordon Allport and Kurt Lewin

-Allport acknowledged that individuals with their personalities exist within systems. -Behavior of an individual must be viewed as fitting any system of interaction including culture, its situational conflict, and field theory. -Lewin, a field theorist, believed behavior is a function of life space which is a function of the person and the environment. -He challenged the linear, mechanistic view of behavior.

Vicarious Trauma

-Although some writers equate vicarious trauma to secondary traumatic stress, others believe vicarious trauma includes a change in the counselor's worldview, sense of self, and beliefs

BASIC ID

-Arnold Lazarus -Multimodal Therapy B=Behaviors (acts, habits, and reactions) A=Affective responses (emotions and moods) S=Sensations (five (5) senses as touch, smell, sight, hearing, and taste. I=Images (how we see selves, memories, dreams) C=Cognitions (insights, philosophies, ideas) I=Interpersonal relationships (interactions with people) D=Drugs/biology; which is to signify, more generally, biology including nutrition

Multimodal Therapy

-Arnold Lazarus -This is a comprehensive, holistic approach sometimes classified as eclectic. -It has strong behavioral ties. -This multimodal model addresses seven (7) interactive, yet discrete modalities summarized in the acronym BASIC ID. -The seven (7) modalities are: B=Behaviors (acts, habits, and reactions) A=Affective responses (emotions and moods) S=Sensations (five (5) senses as touch, smell, sight, hearing, and taste. I=Images (how we see selves, memories, dreams) C=Cognitions (insights, philosophies, ideas) I=Interpersonal relationships (interactions with people) D=Drugs/biology; which is to signify, more generally, biology including nutrition -Assessment covering all seven (7) modalities is necessary to determine total human functioning. -Counseling techniques from a variety of theoretical perspectives are used. -These include anxiety-management training, modeling, positive imagery, relaxation training, biofeedback, hypnosis, bibliotherapy, and thought stopping.

Narrative Therapy

-As one of the strength-based therapies, narrative therapy's philosophical basis is social constructionism. -This post-modern approach believes that independent, objective reality exists through subjective experiences, and the client's perspective of reality is valid. -This reality is based on the language and words clients use to represent their situation and circumstances in which people live. -Consequently, their realities are socially constructed. -Narrative therapy believes that clients' lives are stories in progress and these stories can be told and explored from a variety of perspective. Stories use words and language to give meaning to experiences and help determine feelings and attitudes. -They are subjective and constructed by the individual living within a context made up of family, culture, race, ethnicity, gender orientation, etc. -In narrative therapy, the client tells the often 'problem-saturated' story and the therapist encourages other perspectives and interpretations. -The story might be 'deconstructed' and new meanings and variations may be substituted. -After deconstruction, the focus is on helping the client rewrite the story. -Some specific therapeutic techniques and interventions may be: 1. Questions and Clarifications--by the therapist to discover and construct the story of the client's experience. 2. Externalization and Deconstruction--with the focus that the person is not the problem, the problem is the problem. Externalizing the problem can help deconstruct it. 3. Re-authoring--helping the client find a more appropriate alternative story. By finding strengths and exceptions, help the client write a new story more consistent with what they want their life to be like. 4. Documenting the evidence through writing of letters--therapists can consolidate gains and advance therapy by writing letters to the client between sessions. These have been found to be powerful adjuncts to the sessions.

Object Relations Theory

-Based on psychoanalytic concepts. -Interpersonal relationships as represented intrapsychically. -Freud used the term object to mean a significant person or thing that is the object or target of one's feelings or drives. -Interpersonal relationships that shape an individual's current interactions with people, both in reality and in fantasy. -Four (4) broad stages of development have been identified as important in the first three (3) years of life. --These are: 1. Fusion with mother-normal infantile autism (first 3 to 4 weeks of life) 2. Symbiosis-with mother (3rd to 8th month) 3. Separation/Individuation-(starts the 4th or 5th month) 4. Constancy of Self and Object- (by the 36th month) -Progressing through these stages provides the child a secure base for later development. -The child develops trust that his or her needs will be met. -Attachment, borderline, and narcissistic disorders may occur when normal progression through these stages does not occur. -Margaret Mahler-wrote-Psychological Birth of the Human Infant -Heinz Kohut and Otto Kernberg are other writers in this area

Token Economy

-Behavioral Technique -The use of tokens (points, ratings, etc.) as a reinforcement in a behavioral treatment program. -Shaping of behavior can occur through the use of tokens. -Privileges and goods can be purchased with tokens.

Implosive Therapy

-Behavioral Technique -This behaviorally based intervention induces anxiety around the problem by presenting vivid images or cues (flooding). -The anxiety is expected to diminish (extinguish) with repeated exposure and in the absence of any threat.

Paradoxical Intention

-Behavioral Technique -With this method, clients are urged to 'intend' that which they fear or wish to change. -It may work with a variety of unwanted behaviors such as insomnia, smoking, arguing, etc.

Carl Jung

-Believed in the collective unconscious -The collective unconscious is determined by the evolutionary development of the human species and it contains brain patterns for the most intense emotional responses that humans experience. -The operant for the collective unconscious is the archetype. -An archetype is a response pattern occurring universally in the human experience and is characterized by an emotional charge to the existential issues of identity, meaning, and purpose. -Examples of archetypes are: anima and animus (female and male traits). -Goals of Jungian therapy include: transformation of self including gaining knowledge of self; recognition and integration of self. -Therapy is viewed as a healing process. -Jung introduced concepts of introversion and extraversion. -The Myers-Briggs Type Indicator is based on Jung's therory.

Helping Relationships

-Considerable research evidence suggests that the relationship in counseling is the determining factor whether or not counseling is successful. -Theories of counseling provide the underlying philosophy and strategies for building and maintaining this relationship. -Four (4) key elements in building this relationship are: 1. Human Relations Core 2. Social Influence Core 3. Skills Core 4. Theory Core

Adventure-based Counseling

-Designed for children as well as younger and older adults as an experiential set of outdoor activities. -These activities may range from camping to hiking to completing 'challenge' courses designed for individuals, pairs, or small groups. -Self-awareness, self-confidence, communication skills, trust, and camaraderie are possible outcomes of adventure-based activities. -Depending on the make-up of the participants, diversity sensitivity and multicultural skills may be developed.

Robert Carkhuff

-Developed 5-point scales to measure empathy, genuineness, concreteness, and respect. -Counselor responses may be viewed as additive, interchangeable, or subtractive. -The counselor's empathetic response may be: Level 1: Does not attend to or detracts significantly from the client's affect. Level 2: Subtracts noticeably from the client's affect. Level 3: Interchangeable with the client's content and affect. Level 4: Adds noticeably to the client's affect. Level 5: Adds significantly to the client's affect and meanings. -For example: --Client: (Obviously distressed and anxious) "We had an argument last night and he got very angry. I was really afraid - then he stormed out and I haven't seen him since." --Counselor Level 1 Response: "Where do you think he went?' --Counselor Level 2 Response: "You seem a little worried about all this." --Counselor Level 3 Response: "You're very anxious about what happened last night and about his whereabouts." --Counselor Level 4 or 5 Response: "You're very anxious about what happened but also afraid for your safety and wondering where this relationship is going."

Aaron Beck

-Developed a system of psychotherapy called cognitive therapy. -Identified automatic thoughts in clients. -These were similar to the preconscious. -There is an internal communication system. -In depressed people, this internal communication was negatively focused resulting in low self-esteem, self-blame, and negative interpretations of experiences. -The person experiences a negative cognitive shift. -The cause of depression may be in any combination of biological, genetic, stress, or personality factors. -Follow-up studies suggest there is a greater stability of results and fewer relapses with cognitive therapy than anti-depressant drugs. -Developed assessments including Beck Depression Inventory.

Joseph Wolpe

-Developed a theory of reciprocal inhibition. -The underlying principle states that a person cannot be both anxious and relaxed at the same time. -Systematic desensitization (based on the theory of reciprocal inhibition) is a behavioral intervention of counterconditioning. -The goal is to reduce anxiety by associating negative stimuli with positive events. -Specifically, negative images are paired with muscle relaxation.

Solution-Focused Brief Therapy (SFBT)

-Does not address the history or past experience of a problem. -Understanding the nature of the problem is not necessary to generating solutions to a problem. -One focus of SFBT is to maintain a positive orientation believing that the client can construct solutions. -Stress is placed on what is working for the client, the exceptions that exist to the problem. -Some principle therapeutic techniques and procedures are: 1. Exceptions Question-What are the circumstances when the problem did not exist; these circumstances represent news of difference. 2. Miracle Question-If a miracle happened, how would you know and what would be different? 3. Scaling Questions-Using a scale from one to 10, identify changes in the client's affect, anxiety, etc. Focus is on any positive change and then duplicate or increase that change. -Brief therapy models are becoming more important with the need to meet health maintenance and employee assistance program needs for services. -The number of sessions may be limited to 6 or 8 or even fewer. -Even in college counseling centers, limits to the number of counseling sessions are common. -Brief therapy dictates setting specific goals early in the counseling relationship. -The focus may be on resolving the immediate problem which led to the counseling intervention and the development of coping skills to assist counselees manage current and future problems. -A related therapeutic approach is intermittent counseling. -A client sees a counselor on and off as problems arise sometimes over several years. -Not all client problems will be addressed adequately using brief therapy models. -The counselor and client must identify those circumstances when additional sessions are necessary and do what is possible to meet the client's needs appropriately. -Using brief therapy procedures with certain client problems may raise ethical questions of professional competence and abandonment.

Feminist Therapy

-Feminist therapy origins can be traced back to the women's movement in the 1960s, but no specific individual is associated with its development and nurturance. -Basic perspectives include gender as central to therapeutic practice, awareness and understanding of the role of sociocultural influences as they manifest themselves in therapy, and the need to empower women and address societal changes. -The basic principles of feminine psychology which underlie feminist therapy are (from Corey, 2017): 1. The personal is political and critical consciousness-The problems of the client have societal and political roots which often result in marginalization, oppression, subordination, and stereotyping 2. Commitment to social change-Therapy is not only for the individual but to advance a transformation in society. Therapists must also take action for social change. 3. Women's and girl's voices and ways of knowing, as well as the voices of others who have experienced marginalization and oppression, are valued, and their experiences are honored-Women's perspectives are considered central rather than using the male experience as the norm against which women often appear deviant. 4. The counseling relationship is egalitarian-clients are experts on themselves, and their oppression is recognized; therapy is a collaborative process. 5. A focus on strengths and a reformulated definition of psychological distress-intrapsychic factors are only a part of the explanation for the pain experienced; psychological distress is reframed as a communication about unjust systems; symptoms can be reframed as survival strategies. 6. All types of oppression are recognized along with the connections among them-All clients can be best understood in the context of their sociocultural environments. In addition to helping clients make changes in their lives, feminist therapists work toward societal change. -Therapeutic processes and techniques which may be used in feminist therapy include: Gender-role analysis and intervention, Empowering techniques, Self-nurturance activities, Power analysis and intervention, Bibliotherapy, Assertiveness training, Reframing and re-labeling, Groups, and Social action

Integrative Counseling

-Goes beyond eclectic counseling which is the use of a variety of techniques from a variety of theories that best meet the needs of the client. -Integrative Counseling implies the creation of a model by synthesizing existing theories and practices, not the mere borrowing of useful techniques. -Integrative counseling begins with the counselor developing a personal theory based on values, worldview, education, and experience. -From this personal perspective, the counselor fleshes out this integrative counseling theory to include the processes and techniques that fit from other theoretical perspectives. -The result is a highly individualistic theory owned by the counselor, highly congruent, and yet flexible so that the counselor can address particular client problems and use counseling experiences to further develop this integrative theory.

Schein

-Identified the 'purchase model' which involves buying the consultant expert's knowledge or service. -His 'doctor-patient' model stresses diagnosis and problem identification. -The process model involves the consultee with the consultant in the diagnostic process and identification of interventions.

Miracle Question

-If a miracle happened, how would you know, and what would be different?

Systematic Desensitization

-Joseph Wolpe -Based on theory of reciprocal inhibition -A behavioral intervention of counterconditioning -Goal is to reduce anxiety by associating negative stimuli with positive events -Specifically, negative images are paired with muscle relaxation

Dialectical Behavior Therapy (DBT)

-Marsha Linehan developed this therapeutic approach for the treatment of Borderline Personality Disorder. -It is now used more widely with a variety of disorders including: Traumatic Brain Injury, Eating Disorders, as well as a range of Mood Disorders. -DBT has been used with adolescents as well as adults. -A group component usually complements the individual work. -Used with adolescents, family members may be involved if available and willing. -A basic principle of DBT, in addition to the usual cognitive behavioral techniques, is helping clients increase emotional and cognitive regulation by learning the triggers that lead to their undesired behaviors. -The dialectical principle of recognizing two sides to situations, such as the need for accepting change and recognizing the resistance to change, receives attention. -DBT is viewed as a long-term therapeutic intervention in part because it requires the learning, practice, and acquiring of a number of skills by the client. -The skills are conceptualized in the following four (4) modules: 1. Mindfulness 2. Distress Tolerance 3. Interpersonal Effectiveness 4. Emotion Regulation -The DBT practitioner might also use such tools as diary cards (tracking interfering behaviors), chain analysis (analyzing sequential events that lead to behaviors), and the dynamics of the milieu or culture of the client's group. -For effective use of dialectical behavior therapy (DBT), the counselor must obtain training in order to teach the required skills and facilitate the application of these skills on an individual basis with a variety of clients.

Erich Fromm

-Neo-Freudian -The individual must join with others to develop self-fulfillment - social character - otherwise she or he may become lonely and nonproductive. -Society offers opportunities to experience mutual love and respect.

Skills Core

-One key element of building and maintaining the counseling relationship. -Allen Ivey identified micro-skills---communication skill units such as attending, inquiry, and reflection.

Social Influence Core

-One key element of building and maintaining the counseling relationship. -Competence, power, and intimacy. -Expertness, attractiveness, and trustworthiness were identified by Stanley Strong in his social influence model.

Human Relations Core

-One key element of building and maintaining the counseling relationship. -Empathy, respect, and genuineness as identified by Carl Rogers

Theory Core

-One key element of building and maintaining the counseling relationship. -These help the counselor understand self and interpersonal relationships and skills. -They also help understand the problems of clients and help to choose interventions that are likely to be effective with the identified problems.

Existential (Rollo May, Victor Frankl, Irvin Yalom)

-Other existentialists include: Soren Kierkegaard, Paul Tillich, Martin Heidegger, and Jean Paul Satre -Phenomenology is the basis of existential therapy. -Phenomenology is the study of our direct experiences taken at their face value. -We have freedom of choice and are responsible for our fate. -We search for meaning and struggle with being alone, unconnected from others. -Anxiety and guilt are central concepts: ---Anxiety is the threat of non-being ---Guilt occurs because we fail to fulfill our potential -The goal of existential therapy is the understanding of one's being, one's awareness of who one is, and whom one is becoming. -Awareness of freedom and choosing responsibility are other goals. -The authentic relationship is important in existential therapy. -Client-centered counseling techniques are appropriate. -Logotherapy is the name of Victor Frankl's counseling theory found in his book Man's Search for Meaning which followed his concentration camp experience. -The principles underlying his theory are individuals': 1. Motivation to find meaning in their life journey 2. Freedom to choose what they do, think, and how they react 3. With freedom of choice comes personal choice

Alcohol and Substance Abuse Counseling

-Over 21 million Americans suffer from substance abuse addiction and for 15 million of these the abuse is alcohol related. -Nearly 50% of adults have been exposed to alcohol dependence in the family either in a blood relative or partner/spouse. -Teenage drinking is associated with suicide, early sexual activity, date rape, and automobile accidents. -Substance abuse is often viewed as the #1 problem in the U.S. -Estimates of use are difficult to determine because of unknown recreational use (especially marijuana), addiction to prescription drugs, and simultaneous use of alcohol and drugs (polysubstance abuse). -In addition to themselves, substance abusers adversely affect as many as four (4) other people including family, friends, and co-workers. -Beginning in 2012, two states (Colorado and Washington) approved the recreational use of marijuana. -Since then, many additional states have passed similar legislation. -More than 30 states allow for the legal use of marijuana for medical purposes. -Personality traits often found in alcoholics and drug users include: low self-concept, anxiety, underachievement, feeling of social isolation, sexual dysfunctions, dependence, fear of failure, and suicidal impulses. -Questionnaires such as SASSI (Substance Abuse Subtle Screening Inventory) are useful in assessing signs of addiction. -Alcoholism is viewed by many as a disease in itself, not a symptom, thus requiring treatment of the disease before effective counseling can begin. -Twelve (12) step programs have been found effective for many with alcohol or drug problems. -Individual, group, and family counseling are valuable components of treatment. -Residential programs, often using behavior modification and social learning theory may be effective. -Treatment of the physical addiction is also necessary. -See also OPIOID CRISIS

Proxemics

-Refers to the spacial features of the environment such as positioning of furniture, seating arrangements, etc. -How we arrange space will have an impact on behavior. -Each of us has a personal space.

Neurolinguistic Programming (NLP)

-Richard Bandler and John Grinder are the original proponents. -A communications theory using the five sensory channels. -Can be used to establish and maintain rapport and pace the client's verbal cues. -Examines the structure of language and how it is used to represent reality.

WDEP

-Robert Wubbolding -Reality Therapy W=exploring clients' WANTS as these apply to perceived needs D=encouraging clients to DISCUSS actions and feelings E=refers to SELF-EVALUATION by clients concerning their behaviors P=following self-evaluation, PLANNING in order to effect change

Person-Centered (client-center, Rogerian)

-Rogers reacted against the directive psychoanalytic approach which put the counselor in charge of giving advice, teaching, and interpreting. -Rogers' focus was more on the person's phenomenological world reflecting and clarifying their verbal and nonverbal communication. -The process of becoming, moving clients to self-actualization, and the relationship between the client and counselor were critical concepts. -The focus of counseling went from past to present and was on feelings. -The counselor showed: Unconditional Positive Regard, Genuineness (Congruence), and Empathetic Understanding. These are the core or facilitative conditions of effective counseling. -Rogers' principal books are: 1. Counseling and Psychotherapy (1942) 2. Client Centered Therapy (1951) 3. On Becoming a Person (1961)

Psychoanalytic Theory

-Sigmund Freud -Freud identified a structure of personality, namely, the id, ego, and superego. -Unconscious motivation or energy is the ID (shoulder devil) ruled by the pleasure principle. -The EGO (self) is controlled by the reality principle. -The SUPEREGO (shoulder angel) is internalized ethics. -Therapy techniques include: free association, interpretation of dreams and other client material. -Transference -Countertranference

Donald Meichenbaum

-Spoke of cognitive behavior modification--a shift from self-defeating thoughts to coping one. -Introduced the concept of stress inoculation which is practicing positive or reinforcing self-statements

Individual Psychology (Alfred Adler and Rudolph Dreikurs)

-The belief in uniqueness of each individual is influenced by social factors. -Each person has a sense of inferiority and strives for superiority. -We choose a lifestyle, a unified life plan, which gives meaning to our experiences which include habits, family, career, attitudes, etc. -Counseling goals are to help the client understand lifestyle and identify appropriate social and community interests. -Also, counseling strives to explain clients to themselves and for them to overcome inferiority. -Techniques used are those leading to insight such as life histories, homework assignments, and paradoxical intentions.

Relational-Cultural Theory

-The central premise of this approach is that human growth develops in connection with others rather than through separation and individuation. -This applies to the growth and development of men as well as women. -Relational-cultural theory addresses how people respond to relational and cultural adversity. -Issues in counseling may include power, privilege, marginalization, and acceptance rather than pathology. -Connections are central and powerful in peoples' lives. -Neuroscience appears to corroborate this. -The brain changes through connections and relationships with others or with a therapist. -Judy Jordan (Wellesley Center for Women) is one of the early scholars of relational-cultural theory. -She believes we need to move from a human growth mode of separation to a relationship one. -As social beings, cultural values and connections are paramount and individuals thrive in relationships.

Cognitive and Behavioral Counseling

-The leading proponents of cognitive and behavioral counseling include Joseph Wolpe, Donald Meichenbaum, Aaron Beck, and Albert Bandura. -Albert Ellis and his Rational Emotive Behavior Therapy (REBT), and Arnold Lazarus with Multimodal Therapy, are often included in this broad category but are presented here separately. -The stimulus-response and stimulus-organism-response paradigms are at the basis of this theory. -The belief is that behavior is learned and, consequently, can be unlearned and relearned. -The goals of counseling are to identify antecedents of behavior and the nature of the reinforcements maintaining that behavior. -The counselor helps create learning conditions and may engage in direct intervention. -Goals of behavior are likely to be behaviorally stated. -Counseling techniques may include any of the following: 1. Operant and Classical Conditioning 2. Social Modeling 3. Problem-Solving 4. Direct Training 5. Reinforcement 6. Decision Making -Most counselors would establish a strong, personal relationship with the client.

Trauma and Disaster Counseling

-The need for mental health crisis counseling is growing as a result of various natural disasters, as well as human-caused wars, tragedies, violence, and terrorism. -The skills needed for counseling individuals impacted by these incidents are unique and training is required. -CACREP Standards require the "infusion of emergency preparedness language" throughout the training curriculum as well as crisis intervention and suicide prevention models. -The Red Cross continually trains qualified mental health counselors for specific roles dealing with crises and tragedies. -Possible consequences for counselors working with clients impacted by trauma and violence include compassion fatigue, secondary traumatic stress, and vicarious trauma. -Counselors may deny they have been impacted; however, they may show some of these same reactions: lack of energy, prefer isolation, be irritable, have sleeping problems, self-medicate, and cease self-care activities.

Johari Window

-The window was named after Joe Luft and Harry Ingham. -The client brings material in this window to the counseling session. -Some is known and other information is not. -Several principles of change may be identified: 1. A change in one quadrant affects all other quadrants. 2. It takes energy to hide, deny, or be blind to behavior. 3. Threat increases awareness. Mutual trust tends to increase awareness. 4. The smaller the first quadrant (upper left), the poorer the communication. 5. There is universal curiosity about the unknown area but customs, social training, and fears keep parts unknown. 6. The goal of counseling is to minimize the lower right quadrant and maximize the upper left.

Gestalt (Frederick 'Fritz' Perls)

-This approach is based on existential principles, has a here-and-now focus, and a holistic systems theory approach. -Individual experience needs. -To the extent a need is in the forefront, it represents the 'figure' and other needs are 'ground,' i.e., in the background. -As the need is met, it completes the 'gestalt' and a new need takes its place. -The goal for individuals in therapy is to become whole beings, to complete the 'gestalts.' -Key concepts in the theory include: 1. Personal responsibility 2. Unfinished business 3. Awareness of the 'now' -This is an experiential therapy, encouraging the taking of responsibility by the client. -The counselor uses confrontation and encourages the client to stay with feelings and to relive experiences and finish business. -Role playing, two-chair techniques, and dream work are done. -Interpretation is done by the client NOT the counselor. -Perls wrote: Gestalt Therapy Verbatim -and- In An Out of the Garbage Can

Thought Stopping

-This behavioral intervention is designed to inhibit recurring thought by consciously stopping it whenever it occurs.

Caplan

-This is a mental health consultation model. -Consultation occurs between two professionals and can be centered on the client, the program, or the consultee and administration.

Alfred Adler

-Two important concepts are birth order and family constellation. -Techniques of counseling: counselor is egalitarian with client--it's a collaborative effort. -Views neuroses as a failure in learning which results in distorted perceptions. -Stress is on client responsibility in counseling. -Counseling examines family constellations, dreams, early memories. -Asking "The Question"--"What would be different if you were well?" focuses the counseling process. -Birth order implications: Children in the same family have different psychological environments because of the difference in birth order. --Oldest Child-Gets much attention. Tends to be dependable, hard-working, achievement oriented. When another child (intruder) comes, oldest may fear losing love. --Second Child-Shares attention. Sees self as if in a race to compete with the first child. Often succeeds where older fails. --Middle Child-Often feels left out. May see life as unfair. "Poor me" attitude. May develop problems. --Youngest Child-Baby in family. Pampered. Special role to play. Influenced by all others. Tends to go own way. Often develops in directions no one else thought of. --Only Child-Does not learn to share or cooperate. Often deals with adults well. Wants center stage even as an adult and if does not get it, may have difficulties. -Childhood experiences influence our adult interactions and family dynamics.

Scaling Questions

-Using a scale from one to ten, identify changes in the client's affect, anxiety, etc. -Focus is on any positive change and then duplicate or increase that change.

Exceptions Questions

-What were the circumstances when the problem did not exist? -These circumstances represent news of difference.

Reality Therapy

-William Glasser -Although it is based on Choice Therapy, Glasser continued to refer to the therapy as Reality. -Individuals determine their own fate and are in charge of their lives. -Our perceptions control our behavior and we behave (appropriately or inappropriately) to fill our needs. -We have five (5) genetically-based needs: 1. Survival 2. Love and Belonging 3. Power or Achievement 4. Freedom or Independence 5. Fun -Choice theory means we act to control the world around us and the real world is important to the extent it helps satisfy our needs. -We may not satisfy our needs directly. -Taking key responsibility is a key concept. -Characteristics of reality therapy include: 1. Emphasize choice and responsibility 2. Reject transference--by being yourself as the therapist 3. Keep the therapy in the present--the past is not critical 4. Avoid focusing on symptoms--focus on how to meet needs 5. Challenge traditional views of mental illness--take a more solution-focused approach -Robert Wubbolding has developed a system for helping counselors learn and use reality therapy. -The acronym, WDEP, represents: W=exploring clients' WANTS as these apply to perceived needs D=encouraging clients to DISCUSS actions and feelings E=refers to SELF-EVALUATION by clients concerning their behaviors P=following self-evaluation, PLANNING in order to effect change

Consultation

-defined as a voluntary, problem-solving process, initiate or terminated by the consultant or consultee, to help consultees develop attitudes or skills so they can function more effectively with individuals, groups, or organizations. -Consultation is work related. -May be client, consultee, or system focused. -The goal is not just to resolve the issues that cause human problems, but to increase competence so future problems may be avoided. -Has a preventive function as well. -You may use many of the same skills as in counseling but the context, role, and function are different. -Not counseling or therapy. Consultation may be: --Content oriented-transfer of knowledge or information from the consultant to the consultee. --Process oriented-looking at the process-may use communication theory, attribution, change, or motivation theory.

Compassion Fatigue

-may be evidenced by counselors who work with difficult client issues and it may result in loss of empathy and interest in the client's concerns. -It may occur even when working with clients who have not experienced trauma.

Mindfulness

-one model of skills conceptualized in DBT -Paying attention to the present moment nonjudgmentally, and experiencing one's emotions and senses fully

Animal-assisted Therapy

-this counseling helps clients establish a relationship with an animal that facilitates communication, builds self-confidence, and is nonjudgmental. -These positive interactions can be used to better understand oneself and generalize to others. -Dogs and horses are used most commonly although other animals have been found effective. -Individuals who are physically or mentally challenged, victims of trauma, and socially shy persons may be especially good candidates for animal-assisted counseling.

Countertransference

Consists of projections of the therapist onto the patient

Transference

Projections onto therapist must be worked through

Transactional Analysis (Eric Berne)

The personality has three ego statuses 1. Parent 2. Adult 3. Child -A life script develops in childhood and influences a person's behavior. -Many transactions with others can be characterized as games with the intent to avoid intimacy. -Complimentary Transactions (Adult to Adult) lead to good communication. -Cross Transactions (Adult to Child & Child to Parent) lead to barriers in communication. -The goal of therapy is to teach the client the language and ideas of TA in order to recognize ego state functioning and analyze one's transactions. -Techniques include teaching concepts, helping diagnose, interpretation, and use of contracts and confrontation. -Berne wrote: Games People Play -Thomas Harris wrote: I'm OK-You're OK

Cybercounseling

a broad term encompassing webcounseling, e-counseling, and telephone counseling. -When conducted on the internet, it may occur via e-mail messages, be chat-based, or video-based. -It may consist of information-giving, be assessment-focused, psycho-educational in nature, or deal with personal, therapeutic issues. -Anyone may benefit from cybercounseling including those who are shy, physically-challenged, agoraphobics, or those who have no counseling resources nearby. -Some younger individuals who tend to be technologically savvy may prefer this medium for counseling. -Some issues surrounding cybercounseling include security of communications, imposters (both counselor and client), records maintenance, trust-building/transparency, and contacts for clients in crisis.