counseling exam 3

Know Choice Theory/Reality Therapy

Basic assumptions: we do not live in reality, we live in subjective perception of reality, an antecedent to the contrusctivist post modern therapies, we develop pics in our heads to satisfy innate needs, stored in our quality world, which is where we live and satisfy our desires our quality world; like a picture album of specific wants as well as precise ways to satisfy these wants, getting into the clients quality world is the art of therapy View of human nature and human needs: motivated by basic humans needs, all internally motivated behavior is geared toward meeting one or more of our basic genetically encoded needs- love and belonging, power, fun, survival and freedom Know choice theory explanation of behavior: reality therapy is based on choice theory, symptoms are the results of the choices we have made, we can chose to think feel and behave differently, emphasis is placed on personal responsibility in our choices Characteristics of RT: we often mistakenly chose misery in our best attempt to meet our needs, we act responsibly when we meet our needs without keeping others from meeting their needs, therapist function is to keep therapy focused on the present choices and NOT on symptoms Total behavior: doing- acting behaviors walking talking moving thinking- voluntary and involuntary thoughts and self-statements feelings- anger joy pain anxiety phsyiology- bodily reactions Behavior as Choice- we choose our behavior thus our symptoms are an active choice we may chose to be miserable: to get others to help us, to gain power over others, as an excuse for not living for effectively we are actively constructing our misery. we are: depressing angering anxietying and phobicing

Gestalt therapy

Contact and resistances to contact: 5 diff kinds of contact boundary disturbances: introjection, projection, retroflection, deflection, confluence (screenshot) Contact is made by seeing, hearing, smelling, touching and moving. effective contact means interacting with nature and with other people without losing one's sense of individuality. Energy and block to energy:Gestalt therapists often focus on where energy is in the body, how it is used, and how it may be causing a blockage (Corey, 2005). Blocked energy is a form of resistance, for example, tension in a part of the body, not breathing deeply, or avoiding eye contact

Know DBT, MBCT, ACT (know therapeutic process for each, techniques and procedures, and cog b therapy from a mulicultural perspective, understand the contributions and limitations)

DBT- DBT is blend of behavioral and psychoanalytic techniques for treating borderlie personality disorder and other disorders. focus to help change patterns of behavior that are not effective, such as self harm suicidal thinking and substances abuse. goal: hekp ppl increase their emotional and cognitive regulation by learning about triggers that lead to reactive states, assesing which coping skills to apply in the sequence of events thoughts feeling and behavior that lead to undesired behavior. MBCT- 8 week group treatment program adapted from MBSR that includes components of CBT, aim is to change clients awareness of and relation to their negative thoughts, rather than on merely challenging the content of thoughts ACT- fully accepting present experience and mindfully letting go of obstacles, in ACT there is little emphasis on changing the content of a clients thoughts, instead its emphasis acceptance nonjudgemental awareness of cognitions the goal is to allow for increase psychological flexibility and there is evidence demonstrating the effectiveness of ACT limitations and contributions are screenshoted!

CBT

Elli''s rational emotive BT (REBT): underlying assumption: we are born with a potential for both rational and irrational thinking, we have the capacity to change our cognitive emotive and behavioral processes, our response is controlled by our beliefs that do not match the reality of the situation (irrational beliefs) irrational beliefs lead to self defeating behaviors ABDEF framework: goals: Antecedents Behaviors Consequences Disputation (of irrational beliefs) REBT techniques- disputing irrational beliefs doing cognitive homework, bibliotherapy, changings ones lagnuage, psychoeducational methods therapist function and role: therapist practice REBT using: Rational emotive imagery, humor, role playin, shame attacking exercises, standard behavior therapy procedures therapist-client: clients learn irrational ideas lead to self defeating behaviors. indetify the interplay of their thoughts feelings and behaviors and to identify the dispite irrational beliefs that are maintained by self-indoctrination to replace ineffective ways of thinking with effective and rational cognitions, to stop absolutistic thinking, blaming and repeating false behaviors Application of REBT to various settings and groups:

Gestalt therapy

Experiment in Gestalt Therapy: exercises- read-made techniques that are somtimes used to make something happen in a therapy session or to achieve a goal experiments: grow out of the interaction between the client and therapist, and they emerge within this dialogic process. 8 techniques: 1. the experiment thru physical or through mental enactment client experiences. 2 internal dialogue exercises: clients emerge themselves in dialgue to clarify their existing beliefs and feelings, move from chair to chair to represent each side of themselves. 3. rehearsal exercise: client practices an encounter or activity in session. 4. reversal technique: therapist has client behave in an opposite way to what they were thinking, client says she is inhibited so is asked to play the role of the most extroverted person they can think of. 5. exaggeration exercise: therapist helps the client to fully experience their emotions. 6. staying with the feeling: therapist help the client to stay w their feeling 7. making the rounds: client goes to each person in the group and either speaks to them or does and exercises with them. 8 dream work: understand dreams as happening now, dream is acted out in the present with the client acting each role in the dream. Preparing clients for gestalt experiments: important therapist experiences gestalt therapy, experiments are only means to the end of helping people become more aware and making changes they most desire. The role of confrontation: to be done in such a way that clients cooperate, especially when they are invited to examine their behaviors, attitudes and thoughts The gestalt therapy interventions: a main division is between the top dogt and the under dog and therapy often focuses on the war between the two. identified in class application to group counseling: encourages direct experience and action, here and now focus allows members to bring unfinished business to the present, members try out experiments within the group setting, leaders can use linking to include members in the exploration of a particular individuals problem, leaders actively design experiments for the group while focusin on awareness and contact, group leaders actively engage with the members to form a sense of mutuality in the group

Gestalt Therapy

Goals: 6 methodological components (screenshotted): continumum of experience, the here and now, paradoxicall theory of change, the experiment, the authentic encounter and process-oriented diagnosis. assist client to gain greater awareness. Function and role: therapist job is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life in which they try out new behaviors and notice what happens. Pay attention to clients' body language calling attention to clients' nonverbal language. The client's experience: general orientation of GT is toward diagloue. Clients make their own interpretations and meaning. 3 stage integration sequence miriam polster" discovery, accomodation, and assimilation move towards increased awareness of themselves, gradually assume ownership of their experiences, develop skills and acquire values that will allow them to satisfy their needs without violating the right of others, become more aware of all their senses,, learn to accept responsibility for what they do and accepting the consequences of their actions, be able to ask for help and get help from other and give help. Therapist to Client relationship: therapist is attentive to the client's present experience and trusts in the process, thereby assisting the client in moving toward increased awareness, contact and integration

BT

Goals: increase personal choice and to create new conditions for learning Therapist function and role: functional assessment is conducted and used to identify the maintaining conditions by systematically gathering info about situational antecedents, the dimension of the problem behavior, the consequence of the problem. AKA the ABC model b behavior a- antecedents which is what influences the behavior and consequences of certain events. Behavioral assessment interview, the therapist task is to identify the particular antecedent and consequences that influence pr are functionally related to an individuals behavior Clients experience: active role for bth client and therapist, client engages in behavioral rehearsal with feeback until skills are well learned and generally receives active hw assignments to complete between sessions, clients are encouraged to experiment for the purpose of enlarging their repertoire of adaptive behaviors. clients need to be willing to make changes and implement new behavior. Therapist-client: establishing a collaborative working relationship, flexible repertoire of relationship styles, helps clients change in the direction they wish

Meichebaum's CB modification

Know the CBM: emphasis on requiring practical coping skills Donald Meichenbaum is a psychologist noted for his contributions to cognitive behavioral therapy (CBT). 1 He developed a therapeutic technique called cognitive behavior modification (CBM), which focuses on identifying dysfunctional self-talk in order to change unwanted behaviors. cognitive structure- are the organizing aspect of thinking, which seems to monitor and direct the choice of thoughts, are the executive process for continuing itnerupting or change thoughts Know the phases and how behavior changes: 1 self observation 2 starting a new internal dialogue 3 learning a new skill Know the principles of stress incolulation training: SIT is a 3 phase coping skill program 1. the conceptual-educaional phase 2. skills acquisition and skills consolidation phase, application and follow thru phase

Gestalt therapy

Multicultural perspective: can be tailored to fit the unique wats in which clients perceive and interpret their culture, helping clients integrate the polarities within themselves, creative experiments can be designed that emphasize nonverbal behaviors. limits: clients can be emotionally reserved and experienced therapist contribution and limits of gestalt therapy: limits- contributions- it is creative and lively approach that uses experiments to move clients from talk to action and experience. clients are provided with a wide range of tools for discovering new facets of themselves and making decisions about changing their lives. holistic approach that values each aspect of the individual's experience equally, working with dreams is a unique pathway for people to increase their awareness of key themes in their lives and attempt to integrate theory, practice and research. Limitations- has potential for therapist to abuse power by sing powerful techniques without proper training, not useful for clients who have difficulty abstracting and imagining. the emphasis on therapist authenticity and self-disclosure may be overpowering for some people.

BT

Operant Cond. based therapies techniques of ABA: the basic assumption underluing assertion training is that people have the right but not the obligation to express themselves, increase people behavioral repertoire so that they can make the choice of whether to behave assertively in certain situations. self-management programs and self- directed behavior: self-management: indlude self-monitoring, self reward, self contracting and stimulus control. change can be brought by teaching people to use coping skills in problematic situations, specific behavior wanted to be controlled or changed. self management include self monitoring, self reward self contracting and stimulus control

Gestalt therapy

View of human nature: Genuine knowledge is the product of what is immediately evident in the experience of the perceiver. Perl's style/two personal agendas- moving the client from environmental support to self-support and reintegrating the disowned parts of one's personality. The more we work at becoming who or what we are not, the more we remain the same. Process of reowning parts of onself that has been disowned and the unification process proceed step by step until clients can carry on with their personal growth. Principles: here and now, phenomenological inquirt, our power is the present, nothing exists except the now, for many ppl power of the present is lost. field theory: simply put asserts that the organism must be seen in its environment or in its context as part of the constantly changing field. Boundary between the person and environment. Emphasis on a figure (aspects of individual's experience that are most salient at any moment) or the ground (those aspects of the client's presentation that are often out of his or her awareness) Figure-formation process and organismic self-regulation the now and unfinished business: when feelings about the past are unexpressed, these feelings are associated with distinct memories and fantasies, feelings not fully expressed linger and interfere w effective contact. Result: preoccupation, compulsive behavior, wariness, oppressive energy and self-defeating behavior

Becks cognitive therapy

basic principles of cognitive therapy: insight focused therapy w emphasis on changing negative thoughts and maladaptive behaviors Thereoretical assumption- peoples internal communication is accessible to introspection, clients belief have highly personal meanings, these meanings can be discovered by the client rather than being taught or interpreted by the therapist role of challenging automatic thoughts: pattersn that trigger depression- everything is hopeless- i am totally worthless, no one likes me and nothihg can change anxiety and fear- im in danger and i wont be able to cope w it anger- i am being treated unfairly and i wont stand for it becks cogntivie triad: 1. client shod negative views: i am a lousy person 2. selective abstraction: the world is a negative place where bad things are bound to happen to me 3. client holds a gloomy vision of the future: the world is bleak and isnt going to improve Therapist-client: Theory and goals of cognitive therapy: basic theory- to understtand the nature of an emotional episode or disturbance it is essential to focus on the cognitive content of a individuals reaction to the upsetting event or stream of thoughts goals: to change the way the client think by using their automatic thoughts to reach the core schemata and begin to introduce the idea of schema restructing Process and application: cogntivie distortions- personalization, labelling and mislabeling and polarized thinking aka all or nothing application:(cognitive) identifying and examining a clients beliefs and the orgins of these beliefs and modifying them if the client cannot support those beliefs application (behavioral)- used by CT include activity scheduling, behavioral experiments, skill training, role playing, behavioal rehearsal and exposure therapy

Padesky and Mooney's Strength-Based CBT:

basic principles of the Strength-Based approach: help clients build positive qualities the client-therapist relationship: Application of strength-based approach:

BT

classical cond. based therapies: progressive muscle relaxation, systematic densensitization, in vivo exposure and flooding, eye movement desensitization and reprocessing (screenshot) -controlling the association between the stimulus and the response, systematic desensitization for phobias, relaxation training: learning to relax with a feared stimuli , flooding: surviving your fears, aversion therapy: learning to avoid performing a response, and EMDR

BT

from a multicultural perspective: task orientation focus on objectivity focus on cognition and behavior action orientation brevity emphasis on the present commitment to teach coping strategies and problem solving orientation. focuses on environment social political conditions. contributions and limitations: contribution- helps clients unclear goals into concrete plans of action, BT have a wide variety of specific behavioral techniques at their disposal, more rigorous evaluation limitations- heavy focus on behavorial change not focused on clients experience of emotions, does not place emphasis on insight, therapist like a teacher, tends to focus on symptoms rather than causes of behaviors, potential for therapist to manipulate the client using this approach, some clients find direct approach to be imposing or too mechanistic.

Therapeutic process of RT

goals: help clients uncover their wants in their quality world and prioritizing their wants and their relationship to their needs therapist function and role: help clients find better ways of fulfilling their basic 4 needs, to help them assess their total behavior and if their behavior is moving them toward responsibly meeting their needs client's experience in therapy: therapist-client: therapist attitudes- do not accept excuses no punishment or criticism and do not give up therapist strategies- questioning, using humor and metaphors, being positive, confront ineffecive choices, and used paradoxical techniques.

Behavior Therapy

historical background: based on the principles of modernism: materialism, mechanism, reductionism, and positvism. all behavior is based on the assumption that both normal and abdnormal behavior is CAUSED BY the environment. four areas of development: classical conditioning- what happens prior to learning that creates a response thru pairing. Operant: type of learning in which behaviors are influenced mainly by the consequences that follow them. Social learning approach: interactional, interdisciplinary and multimodal. person =agent of change and is capable of self-efficacy/people are capable of self directed behavior CBT: integration of cognitive and behavioral dimensions. adds self-talk as mediator of behavioral change. way we think is the way we behave. brain = behavior. the behavioral view of human nature: people have to capacity to chose how they will respond to external events in their environment, which makes it possible for therapist to use behavioral methods to attain humanistic ends. basic characteristics and assumptions of BT: 7 of them. 1. BT is based on the principles and procedures of the scientific method. 2. Behavior is not limited to overt actions a person engages in that we can observe behavior also includes internal processes such as cognitions, images, beliefs and emotions. KEY characteristic: things can be operationally defined. 3. BT deals w the clients current problem and the factors influencing them 4. clients in BT are expected to assume an active role by engaging in specific actions to deal with their problems. do something not just talk about their condition. 5. This approach assumes than change can take place without insight into underlying dynamics and without understanding the origins of a psychological problem. 6. Assessment is an ongoing process of observation and self-monitoring that focuses on the current determinants of behaviors, including identifying the problem and evaluating the change; assessments inform the treatment process. 7. Behavioral treatment interventions are individually tailored to specific problems experienced by the client. Key futures of classical conditioning, operant and observational learning

BT

observational learning based therapies: founded by bandura observational learning (modeling) learn from the observed consequences others receive for their behavior. participant modeling - good for phobias, modeling then step by step imitation of a behavior, and reinforcement for correct limitation of a model social skill training: deals w an individuals ability to interact effectively with others in various social situations helps clients develop and achieve skills in interpersonal competence, may involve various behaioral procedures such as assessment direct instruction and coaching modeling role playing and hw, feedback and reinforcement clients receive assists them in conceptualizing and using a new set of social skills enables them to communicate more effectively assertive training teaching ppl to be more assertive in varied situations works thru faulty thinking negative self statements and defeating beliefs make the choice of whether to behave assertively and or set boundaries -------------------- multimodal therapy: 7 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 application to group counseling: rely on empirical support and tend to be brief, emphasize self management skills and thought restructuring. leaders-use brief directive psychoeducation approach and conduct behavioral assessments leaders and members: create collaroative, precise treatment goals, specific treatment plan and measure treatment outcome objectively

Techniques and procedures of RT:

practice of RT and the cycle of change: two major components: creating the counseling environment and implementing specific procedures that lead the clients to assess their choices and to make changes in their behavior in order to better meet their needs The "WDEP" system: procedures that lead to change: W want what do you want to be and do? D doing and direction what are you doing and where do you want to go E evaluation does your present behavior have a reasonable chance of getting you what you want P planning "SAMIC" use of SAMIC: S simple and easy to understand A attainable within the capabilities of the client M measurable outcomes I immediate and involved plan can be implemented now by the client C controlled plan is under the control of the client Multicultural perspective:help clients cultural values by helping them explore how satisfying their current behavior is both to themselves and others, sign of respect that therapist allows client to decide what behaviors should be changed, with this focus on thinking and acting rather, less likely to display resistance to counseling, the principles underlying choice theory are universal, which makes choice theory applicable to all people, reality therapy principles and procedures need to be applied diff in various cultures and must be adapted to the psychological and developmental levels presented by individuals L- clients to take change of their own lives and not pay attention to systematic and environmental factors, limited attention to helping ppls address environmental and social problems, some clients are reluctant to directly verbally express what they need limitations and contributions: L- RT is often construed as simple and easy to master , does not adequalty address important psychological concepts such as the unconscious dreams and trasnference, may have trouble viewing psychological disorders as behavioral choices, danger of therapist of imposing his or her personal views on clients, more empirical support is needed C- short term focused and deals with, taking responsibility for what we are doing, with the emphasis on responsibility and choice, self direction and empowerment , clients who manifest reluctance and who are often highly resistant, addiction and treatment and recovery programs