Psych of Counseling Exam #2
EFT strategies focus on two major tasks:
(1) help clients with too little emotion access their emotions (2) help clients who experience too much emotion contain their emotions
Existentialism and Humanism
*A third force in therapy as an alternative to psychoanalytic and behavioural approaches: Existential therapy/ PCT/ Gestalt therapy. Similarities between existentialism/ humanism: - Both respect the client's subjective/ unique experience, perceptions. - Both trust the client to make positive and constructive choices. - Both emphasize freedom, choice, values, personal responsibility, autonomy, purpose, meaning. - Both place little value on techniques, but rather on the genuineness of the encounter (the therapeutic relationship is at the core of therapy). - Both require the therapist to be fully present, and to provide a safe, responsive, caring relation to facilitate growth and healing. Differences: - Existentialism: humans are face with the anxiety of choosing to create an identity in a world that packs intrinsic meaning. Focus on death, anxiety, meaninglessness. - Humanism: more optimistic view that everyone has natural potential that can be actualised, and that can give us meaning.
Emotion-Focused Therapy (EFT)
- "approach informed by understanding the role of emotion in human functioning and psychotherapeutic change." - Leslie Greenberg - rooted in person-centered but synthesizes aspects of Gestalt and Existential
Clinical Behavior Therapy
- A comprehensive, systematic, holistic approach to behavior therapy - developed by Arnold Lazarus. - Grounded in social-cognitive learning theory. - Applies diverse behavioral techniques to a wide range of problems; that encourages technical eclecticism.
expressive arts therapy
- All people have an innate ability to be creative - Creative process is transformative and healing. The healing aspects include meditation, art, and music. - Consciousness achieved through self-discovery, self-awareness, and insight. - Self-awareness, understanding, and insight are achieved by delving into our feelings of grief, anger, pain, fear, joy, and ecstasy - The various art modes interrelate in what Natalie Rogers called the "creative connection"
Eye Movement Desensitization and Reprocessing (EMDR)
- An exposure-based therapy - Involves imaginal flooding, cognitive restructuring, and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders - extensive research validated
ABC model of behavior
- Antecedent: influenced by events that precede it - Behavior: model of behavior - Consequence: influenced by events that follow it
Energy and Blocks to Energy (Gestalt)
- Blocked energy is a form of defensive behavior that may result in unfinished business - Clients are encouraged to recognize how their resistance is being expressed in their body and transform their blocked energy into more adaptive behaviors
Victor Frankl
- Survived a concentration camp - wrote a "Man's Search for Meaning" which emphasized each persons uniqueness and finite nature of life.
Accurate Emphatic Understanding (PCT)
- The ability to deeply grasp the subjective world of another person
Restricted existence (Existential therapy)
- Therapists with an existential orientation usually deal with people who have what could be called restricted existence. - These clients have a limited awareness of themselves and are often vague about the nature of their problems.
client-centered therapy (2nd period)
- a humanistic therapy - the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients' growth. - focus on the phenomenological world of the client
3 therapist attitudes that create a growth-promoting climate (PCT)
- congruence - unconditional positive regard - accurate empathic understanding
Mindfulness and acceptance-based approaches
- dialectical behavior therapy - mindfulness-based stress reduction - mindfulness based cognitive therapy - acceptance and commitment therapy
Contributions (Gestalt)
- direct experiencing and doing good for growth not just remediation. - Unique approach to dreams to discover conflicts. - Therapy as existential encounter. Process not technique oriented. - - Nonverbals are important.
Internal Dialogue Exercise (Gestalt)
- goal is to bring about functioning & acceptance of aspects of ones personality that's been disowned & denied.
Abraham Maslow
- humanistic psychology - self-actualization was central - Hierarchy of needs is a source of motivation, with the most basic needs being physiological needs
5 different kinds of boundary disturbances
- introjection - projection - retroflection - deflection - confluence
Application (Existentialism)
- not technique oriented - when the deepest self of the therapist meets the deepest part of the client, the counseling process is at its best
Stages of Change (PCT)
- pre-contemplation - contemplation - preparation - action - maintenance
relationship between therapist and client (Existentialism)
- the relationship demands that therapists be in contact with their own phenomenological world § Respect and faith in the clients' potential to cope § Sharing reactions with genuine concern and empathy
The Rehearsal Exercise (Gestalt)
-Encourages clients to share their mental rehearsals out loud with their therapist -This helps them 1. Become aware of the fact that they try to meet the expectations of others 2. The degree to which they want to be approved, accepted, and liked 3. The extend to which they would go for acceptance
limitations of Gestalt therapy
-The approach has the potential for the therapist to abuse power by using powerful techniques without proper training -This approach may not be useful for clients who have difficulty abstracting and imagining -The emphasis on therapist authenticity and self-disclosure may be overpowering for some clients
Therapeutic Goals (Existentialism)
1) Become more present to self and others 2) Identify ways we block ourselves from presence 3) Assume responsibility for designing your life 4) Choose more expanded ways of being /// > Recognize where we are not being authentic > Make choices to becoming what we're capable of > Realizing when we deceive ourselves > Face anxiety and engage action > Reclaim and reown our lives
Contributions of PCT
1. Extensive research supports the effectiveness of PCT and EFT with a wide range of problems/ clients of all age groups. 2. Rogers opened the field to research, had great emphasis on importance of research/ conducting extensive studies on the counselling process and outcome. 3. The philosophy/ principles permeate the practice of most therapists (great longevity). 4. Natalie Rogers' use of nonverbal methods and expressive arts to enable healing and development has expanded Carl Rogers' work. 5. Shifted focus from technique and therapist authority to the power of the therapeutic alliance. 6. Provided a powerful and radical alternative to psychoanalysis. 7. PCT has expanded into many different forms and approaches that are continuously evolving.
Limitations of PCT
1. PCT does not focus on the specific use of techniques, making the treatment difficult to standardize. 2. Beginning therapists may find it difficult to provide both support and challenges to the client. 3. Limits of the therapist as a person may interfere with developing a genuine therapeutic relationship. Because it is so reliant on the therapist being authentic and congruent; if they are not, it reduces the therapy to a bland, safe and ineffectual approach. 4. Clients may become frustrated that the therapist is not offering any direction,advice, practical guidance, intervention. 5. The six conditions for change may be necessary, but according to research they're not sufficientl (more is needed). 6. There are methodological shortcomings in PCT studies (eg: not using an untreated control group); but this can apply for research on all approaches.
Basic Dimensions of the Human Condition
1. The capacity for self-awareness 2. Freedom and responsibility 3. Creating one's identity and establishing meaningful relationships with others 4. The search for meaning, purpose, values and goals 5. Anxiety as a condition of living 6. Awareness of death and nonbeing
Social Skills Training
A behavior therapy designed to improve interpersonal skills that emphasize shaping, modeling, and behavioral rehearsal.
Search for meaning
A distinctly human characteristic is the struggle for a sense of significance and purpose in life
Acceptance and Commitment Therapy (ACT)
A mindfulness-based program that encourages clients to accept, rather than attempt to control or change, unpleasant sensations. - ACCEPTANCE & non-judgemental awareness
Existentialism
A philosophy based on the idea that people give meaning to their lives through their choices and actions - philosophical approach - we are not victims - more of a way of thinking than a particular style of practice
Progressive Muscle Relaxation (PMR)
A relaxation method that involves tensing and relaxing muscles of the body in sequence.
The Empty-Chair Technique (Gestalt)
A role-playing intervention in which clients play conflicting parts. This typically consists of clients engaging in an imaginary dialogue between different sides of themselves.
Systematic Desensitization (SD)
A type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. - Commonly used to treat phobias. - based on classical conditioning - developed by Joseph Wolpe
Functional Assessment
An assessment of the contingencies responsible for problem behaviors
Deflection (Gestalt)
Avoidance of contact/awareness by being vague, indirect, overly polite
Confluence (Gestalt)
Blurring the differentiation between the self and the environment
initial phase
Clients are assisted in identifying and clarifying their assumptions about the world
final phase
Clients are assisted in translating what they have learned about themselves into action
Awareness of death and nonbeing
Death gives significance to living; it is necessary to think about death if we are to think significantly about life - Our awareness of death is the source of zest for life and creativity - We can turn our fear of death into a positive force when we accept the reality of our mortality
Striving for identity and relationship to others (preposition 3)
Discovery of self. Takes effort and courage to discover if we are more than a collection of others' beliefs. For we fear that we have no core.
Gestalt Therapy (Fritz Perls)
Form of therapy where the therapist emphasizes the wholeness of the personality and attempts to reawaken people's emotions in the here and now. - phenomenological/existential/process-based
The Reversal Exercise (Gestalt)
Gestalt exercise that helps clients to accept certain personal attributes they have tried to deny
Social Learning (or Social-Cognitive) Approach
Gives prominence to the triadic reciprocal interaction between an individual's behavior, personal factors, and the environment
positive and negative punishment
Goal: to decrease target behavior
self-management programs
In S-M programs people make decisions concerning specific behaviors they want to control or change The process includes selecting goals, translating goals into target behaviors, self-monitoring, working out a plan for change, and evaluating an action plan S-M strategies have been successfully applied to many populations and problems
Making the Rounds (Gestalt)
In group work, members listen to the person in the hot seat say something about each member. members might give feedback in return.
flooding
In vivo or imaginal exposure to anxiety-evoking stimuli for a prolonged periods of time without the feared consequences
Phases of existential therapy
Initial phase: Clients are assisted in identifying and clarifying their assumptions about the world Middle phase: Clients are assisted in more fully examining the source and authority of their present value system Final phase: Clients are assisted in translating what they have learned about themselves into action
Contact (Gestalt)
Interacting with nature and with other people without losing one's individuality
MI Spirit
It is essential that therapists function within the spirit of MI, rather than simply applying the strategies of the approach. - The attitudes and skills in MI are based on a person-centered philosophy. - Achieving successful outcomes as the specific theoretical model
Operant Conditioning
Learning based on the consequences that follow
The Now (Gestalt)
Our "power is in the present" -Nothing exists except the "now" -The past is gone and the future has not yet arrived For many people the power of the present is lost -They may focus on their past mistakes or engage in endless resolutions and plans for the future
Anxiety as a Condition of Living (preposition 5)
Recognizing the realities of our mortality, our confrontation with pain and suffering, our need to struggle for survival, and our basic fallibility. Anxiety helps us become aware of our freedom and the consequences of accepting or rejecting that freedom.
existential tradition
Seeks a balance between recognizing the limits and the tragic dimensions of human existence and the possibilities and opportunities of human life.
Retroflection (Gestalt)
The act of turning back onto ourselves something we would like to do (or have done) to someone else.
Multimodal Therapy: BASIC ID
The complex personality of human beings can be divided into seven major areas of functioning: B = behavior A = affective responses S = sensations I = images C = cognitions I = interpersonal relationships D = drugs, biological functions, nutrition, and exercise
Boundary Disturbances/Resistance to Contact (Gestalt)
The defenses we develop to prevent us from experiencing the present fully
Freedom and Responsibility
The freedom to become within the context of natural and self-imposed limitations which shape our destiny. The capacity to reflect the meaning of our choices and to act on the choices we make. Avoided by making excuses. - avoid inauthenticity
The Capacity for Self-Awareness (Preposition 1)
The greater our awareness, the greater our possibilities for freedom
Impasse (Gestalt)
The stuck point in a situation in which individuals believe they are unable to support themselves and thus seek external support.
Holism (Gestalt)
a concept that considers the whole person - the whole person has physical, social, psychological, and spiritual parts that are woven together and cannot be separated
Motivational Interviewing (MI)
a directive, client-centered style for eliciting behavior change by helping clients explore and resolve ambivalence - humanistic, client-centered, psychosocial, directive counseling approach developed by William R. Miller and Stephen Rollnick in the early 1980s - Applied to many clinical problems but was initially designed as a brief intervention for problem drinking - Both MI and person-centered practitioners believe in the client's abilities, strengths, resources, and competencies.
dialectical behavior therapy
a form of therapy used to treat borderline personality disorder - tailored to each individual - both acceptance-oriented and change-oriented strategies
Person-Centered Therapy
a nondirective insight therapy based on the work of Carl Rogers in which the client does all the talking and the therapist listens
Cognitive Behavior Therapy (CBT)
a therapeutic approach that consciously combines behavioral and cognitive theories and practices
Unconditional Positive Regard (Rogers) (PCT)
an attitude of total acceptance toward another person
existential guilt
being aware of having evaded a commitment, or having chosen not to choose
middle phase
clients are assisted in more fully examining the source and authority of their present value system
Extinction (operant conditioning)
decreases in the frequency of a behavior when the behavior is no longer reinforced
Projection (Gestalt)
disowning the parts of ourselves and blaming them on the environment
Organism Self-Regulation (Gestalt)
emergence of a need, a sensation, or an interest disturb an individual equilibrium
Staying with the Feeling (Gestalt)
encourages the client to continue with the feeling that is being reported, instead of blocking or avoiding them.
Congruence (PCT)
genuineness or realness
Leslie Greenberg
he developed Emotion-Focused Therapy
The Exaggeration Exercise (Gestalt)
i. Helps clients become more aware of the subtle signals and cues they are sending through body language ii. Clients are asked to exaggerate the movement or gesture repeatedly, which usually intensifies the feeling attached to the behavior and makes the inner meaning clearer iii. Examples: trembling, slouched posture, clenched fist, tight frowning, facial grimacing, crossed arms, etc.
The Gestalt Approach to Dream Work
i. Intent is to bring dreams back to live and relive them as though they were happening now ii. All of the different parts of a dream are expression of the client's own contradictory and inconsistent sides iii. By engaging with opposing sides, the client gradually becomes more aware of the range of his or her own feelings
authenticity
implies that we are living by being true to our own evaluation of what is a valuable existence for ourselves; it is the courage to be who we are
freedom
implies that we are responsible for our lives, for our actions, and for our failures to take action - freedom and responsibility go hand-in-hand
Introjection
integrating the beliefs and values of another individual into one's own ego structure
Introjection (Gestalt Therapy)
integrating the beliefs and values of another individual into one's own ego structure
in vivo desensitization
involves client exposure to the actual anxiety-evoking events rather than simply imagining these situations
Field theory (Gestalt)
it emphasizes that one's experience is influenced by one's environment or context.
view of human nature (PCT)
o At their core, humans are trustworthy and positive. o Humans are capable of making changes and living productive and effective lives. o Humans innately gravitate toward self-actualization. o Given the right growth-fostering conditions, individuals strive to move forward and fulfill their creative nature o counselor's creation of a "growth-promoting" climate
Application (PCT)
o Emphasizes staying with clients as opposed to getting ahead of them with interpretations o Straightforward and easy to comprehend, and they encourage locating power in the person o Demands a great deal of the therapist o Without a person-centered way of being, mere application of skills is likely to be hollow
Therapist (Gestalt)
o Invite clients into an active partnership o Increase clients' awareness, freedom, and self-direction o Pay attention to clients' body language o Emphasis on the relationship between language patterns and personality o Clients express their feelings, thoughts, and attitudes o "it" talk o "you" talk
crisis intervention (PCT)
o Let them fully express o Genuine support; non-possessive warmth to motivate them o Illustrate a deep sense of understanding before trying to problem-solve
Mindfulness-Based Cognitive Therapy (MBCT)
o MBSR is not a form of psychotherapy per se, but it can be an adjunct to therapy. o MBSR assists people in learning to live more fully in the present. o The skills taught in MBSR include sitting meditation and mindful yoga, aimed at cultivating mindfulness. o MBSR programs are offered in hospitals, clinics, schools, workplaces, offices, law schools, prisons, and health centers
Basic Principles of Motivational Interviewing
o Therapists strive to experience the world from the client's perspective without judgement or criticism o Evoke and explore both discrepancies and ambivalence o Reluctance to change is viewed and expected part of the therapeutic process o Therapists support clients' self-efficacy o Strengthening clients' commitment to change and assist them in implementing a change plan
unfinished business (Gestalt)
people's unfinished business causes neuroses and needs to be resolved - when external support is not available, impasse occurs.
positive and negative reinforcement
positive reinforcement- give good when desired behavior performed negative reinforcement- remove bad when desired behavior performed goal: increase target behavior
Classical (or Respondent) Conditioning
refers to what happens prior to learning that creates a response through pairing
existential neurosis
the experience of meaninglessness
Behavior Therapy
therapy that applies learning principles to the elimination of unwanted behaviors - set of clinical procedures that rely on experimental findings - Behaviorists would ask: "What treatment, by whom, is the most effective for this individual with that specific problem and under which set of circumstances?
Logotherapy
therapy through meaning - Frankl
Non-directive Counseling (1st period)
to listen, support, and advise without directing a course of action
Figure Formation Process (Gestalt)
tracks how the individual organizes experience from moment to moment - some aspect of the environmental field emerges from the background and becomes the focal point of the individual's attention and interest
Fritz Perls-Gestalt Therapy
uses a variety of techniques to help patients integrate aspects of the self into coherent whole Increasing self-awareness and self-acceptance
six conditions necessary for personality change to occur (PCT)
§ 1) two persons are in psychological contact. § (2) the first, the client, is experiencing incongruence § (3) the second person, the therapist, is congruent or integrated in the relationship § (4) the therapist experiences unconditional positive regard or real caring for the client § (5) the therapist experiences empathy for the client's internal frame of reference and endeavors to communicate this to the client § (6) the communication to the client is, to a minimal degree, achieved.
EMDR - 3 pronged methodology to identify and process
§ Memories of past adverse life experiences that underlie present problems § Current situations that elicit disturbance § Needed skills that will provide positive memory templates to guide the client's future behavior
