Theories of Counseling
persona
a mask or public face, that we wear to protect ourselves.
most important tool as a therapist?
ability to connect with people
You Must Break Confidentiality
-Child Abuse (known or suspected) -Elder abuse known or suspected -Danger to self/others s.a. suicide or homicidal risk. Other Related Concerns: -When a therapist believes a client under 16 is a victim of incest, rape, child abuse, or other crime. -Determined that client needs hospitalization (Need immanent risk s.a. suicide, homicide, psychotic, or dementia. Must have plan, intent, and means) -info is made an issue in a court action -Client request records for themselves or others
Ego Defense Mechanisms
-Denial -Displacement -Intellectualize -Projection -Rationalization -Reaction Formation -Regression -Repression -Sublimation
Issues Facing New Therapists
-anxiety -being yourself -avoiding perfectionism -being honest about limitations -understanding and tolerating silence -demanding clients -lack of commitment from client -tolerating ambiguity -being aware of "counter-transference"
What to do to avoid being sued
-document -be concerned with clients welfare -respect clients -remain ethical
Things to consider about experiential therapy
-safety guidelines -existing team dynamics, challenging, and learning opportunities -intro of the activity -inclusion of salient metaphors that incorporate sig. themes. -most successful when they combine emotional experience with the physical.
Dimensions of Competency
1) Beliefs & Attitudes 2) Knowledge 3) Skills
Issues Faced by Beginning Therapists
1. Dealing with Anxiety 2. Being Yourself and Self-Disclosure 3. Avoiding Perfectionism 4. Being Honest About Your Limitations 5. Understanding Silence 6. Dealing with Demands from Clients 7. Dealing with Clients Who Lack Commitment 8. Tolerating Ambiguity 9. Becoming Aware of Countertransference 10. Developing a sense of humor 11. Sharing responsibility with Client 12. Declining to Give Advice 13. Defining Your Role as a Counselor 14. Learning to Use Techniques Appropriately 15. Developing Your Own Counseling Style 16. Maintaining Your Vitality as a Person and as a Professional
Personal Characteristics of Effective Counselors
1. Effective therapists have an identity 2. respect and appreciate themselves 3. are open to change 4. make choices that are life oriented 5. are authentic, sincere, and honest 6. have a therapist 7. make mistakes and are willing to admit them 8. generally live in the present 9. appreciate the influence of culture 10. have a sincere interest in the welfare of others 11. possess effective interpersonal skills 12. become deeply involved in their work and derive meaning from it 13. are passionate 14. are able to maintain healthy boundaries
Steps in Making Ethical Decisions
1. Identify the problem or dilemma. 2. Identify potential issues 3. Look at the relevant ethic codes 4. Consider the applicable laws and regulations, and determine how they may have a bearing on an ethical dilemma 5. Seek consultation from more than one source to obtain various perspectives on the dilemma 6. Brainstorm various possible courses of action. 7. Enumerate the consequences of various decisions
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
Psychoanalytic or psychodynamic therapy differs from traditional psychoanalysis
1. The therapy has more limited objectives than restructuring one's personality. 2. The therapists is less likely to use a couch 3. There are fewer sessions each week 4. There is more frequent use of supportive interventions such as reassurance, expressions of empathy and support, and suggestions. 5. There is more emphasis on the here-and-now relationship between therapist and client. 6. There is more latitude for therapist self-disclosure without "polluting the transference" 7. Less emphasis is given to the therapist's neutrality 8. There is a focus on mutual transference and countertransference enactments. 9. The focus is more on pressing practical concerns than on working with fantasy material
Shortcomings of Psychoanalytic
1. based on upper- and middle-class values. 2. ambiguity inherent in most psychoanalytic approaches. 3. criticized for failing to adequately address the social, cultural, and political factors that result in an individual's problems.
The 6 basic techniques of psychoanalytic therapy
1. maintaining the analytic framework 2. free association 3. interpretation 4. dream analysis 5. analysis of resistance 6. analysis of transference
4 essential aims of existential humanistic therapy
1. to help clients become more present to both themselves and others 2. to assist clients in identifying ways they block themselves from fuller presence 3. to challenge clients to assume responsibility for designing their present lives 4. to encourage clients to choose more expanded ways of being in their daily lives.
The Search for Meaning
A distinctly human characteristic is the struggle for a sens of significant purpose in life. Existential neurosis is the experience meaninglessness. We might ask ourselves what's the point? Meaninglessness in life can lead to the existential vacuum, which is an emptiness and hollowness. Logotherapy is designed to help clients find meaning in life. The therapist's function is not to tell clients what their particular meaning in life should be but to point out that they can create meaning even in suffering.
superordinate goals
A goal or objective that requires the cooperation of 2 or more people. Typically resulting in shared reward.
restricted existence
A state of functioning with a limited degree of awareness of oneself and being vague about the nature of one's problems. They may see few, if any, options for dealing with life situations, and they tend to feel trapped, helpless, and stuck.
Contributions of the existential approach
Brings the person back into central focus. It concentrates on the central facts of human existence: self-consciousness and our consequent freedom. Contributed a new meaning to the understanding of anxiety, guilt, frustration, loneliness, and alienation. Can be used regardless of what type of therapy you use. Highlights the essential First theory that looked at the person and inter-personal connections...let's be human together.
How theories view diagnosis and assessment
CBT-See A and D as equally important Relational and Experiential-See A and D as external-puts much less emphasis on them Feminist-Sees D as oppressive based on too much white/male/western constructs Postmodern and Family Systems-View D as underestimating cultural and environmental factors. Incorporate Assessments.
Experiential Therapy
Combines traditional therapeutic interventions with challenging, educational, collaborative, and or exhilarating activities. It's good for those who don't like therapy, good research, it works. Some cons are that it's expensive.
Skills
Counselors take responsibility for educating their clients about the therapeutic process, including matters such as setting goals, appropriate expectations, legal rights, and the counselor's orientation
Knowledge
Culturally effective practitioners possess certain knowledge. They know their own racial and cultural heritage and how it affects them personally and professionally.
Self psychology
Emphasizes how we use interpersonal relationships (self objects) to develop our own sense of self. Put empathy in the forefront of psychoanalytic healing and choose interventions based on them being genuinely empathically attuned to clients
free association
In classical psychoanalysis clients lie on a couch and try to say whatever comes to mind without self-censorship. It is known as the fundamental rule.
bracketing
Managing your personal values so that they do not contaminate the counseling process
The Capacity of Self-Awareness
Must realize that we are finite, inaction or action is out decision, we partially create our own destiny, we are subject to loneliness, meaningless, emptiness, guilt and isolation, we are basically alone. We must affirmation from ourselves, we choose how we want to look at problems and how we are going to react to suffering. We must accept our limitations. And we must not become so preoccupied with the past, future, or death that we forget to live.
3 Types of anxiety in Psychoanalytic
Reality=fear of danger from external world e.g. eaten by bear Neurotic=fear of instincts will get get out of hand e.g. I'm gonna eat a bear Moral=fear of ones own conscious e.g. Can't forgive myself for eating bear
Beliefs & Attitudes
Realize that traditional theories and techniques may not be appropriate for all clients or for all problems. Culturally skilled counselors monitor their functioning through consultation, supervision, and further training or education
Anxiety as a Condition of Living
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. Anxiety isn't necessarily a bad thing. Normal anxiety is an appropriate response to an event being faced. Neurotic anxiety is anxiety about concrete things that is out of proportion with the situation. It tends to immobalize the person.
individuation
The harmonious integration of the conscious and unconscious aspects of personality.
Right of Informed Consent
The right of the client to be informed about their therapy and make decisions appropriately. -empowers client -build the relationship Includes: -confidentiality, general goals of therapy, responsibility of client, responsibility of therapist. -legal and ethical parameters, qualifications and background of therapist, fees involved, services client can expect, approximate length of therapy, risks, information regarding information disclosures.
Maintaining the analytic framework
Therapist uses a range of procedural and stylistic factors (e.g., the analyst's relative anonymity, the regularity and consistency of meetings)
Freedom and Responsibility
We have the freedom to become within the context of natural and self-imposed limitations, we have the capacity to reflect on the meaning of our choices, and we have the capacity to act on the choices we make. We may not choose the circumstances of our birth we create our own destiny by the choices we make. Although we long for freedom we try to escape from it by remaining static. This is referred to as inauthenticity which is when you do not accept responsibility for your actions. We should have freedom which implies that we are responsible for our lives, for our actions, and for our failures.
Striving for Identity and Relationship to Others
We must have the courage to be. Courage entails the will to move forward in spite of anxiety. Part of the human condition is experiencing loneliness. We want relatedness. We want to be significant in someone's life.
Resistance
a concept fundamental to the practice of psychoanalysis. Anything that works against the progress of therapy and prevents the client from producing previously unconscious material.
sequencing
a deliberate selection of activities with the purpose of exposing participants to appropriate levels of increasing challenges. -reoccurs daily and throughout the entire therapeutic context. -Requires constant reassessment of team dynamics -
mandatory ethics
a level of ethical functioning at the minimum level of professional practice.
countertransference
a phenomenon that occurs when there is inappropriate affect, when therapists respond in irrational ways, or when they lose their objectivity in a relationships because their own conflicts are triggered. A therapist's unconscious emotional responses to a client based on the therapist's own past, resulting in a distorted perception of the client's bx.
positive ethics
an approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble
analytical psychology
an elaborate explanation of human nature that combines ideas from history, mythology, anthropology, and religion.
Dream analysis
an important procedure for uncovering unconscious material and giving the client insight into some areas of unresolved problems. During sleep defenses are lowered and repressed feelings surface. Have two levels of content: 1. latent 2. manifest
classical psychoanalysis
an intensive, long-term therapy process. Looks at past conflicts, many of which are unconscious. Based on Id psychology.
relational model
based on the assumption that therapy is an interactive process between client and therapist. Less authoritarian than classic psychoanalytic model.
bracketing
being aware of and managing one's own values so they don't negatively affect (contaminate) the session.
latent content
consists of hidden, symbolic, and unconscious motives, wishes, and fears.
worked-through
consists of repetitive and elaborate explorations of unconscious material and defenses, most of which originated in early childhood. Clients learn to accept their defensive structures and recognize how they may have served a purpose in the past.
Interpretation
consists of the analyst's pointing out, explaining, and even teaching the client of the meanings of behavior that is manifested in dreams, free association, resistances, defenses, and the therapeutic relationship itself.
shadow
deepest part of the collective unconscious that contains all the animalistic urges that characterized our prehuman existence
psychodynamic therapy
emerged as a way of shortening and simplifying the lengthy process of classical psychoanalysis.
object-relations theory
encompasses the work of a number of rather different psychoanalytic theorists who are especially concerned with investigating attachment and separation. Their emphasize is how our relationships with other people are affected by the way we have internalized our experiences of others and set up representations of others within ourselves.
assessment
evaluation of relevant issues
aspirational ethics
focuses on doing what is in the best interests of clients.
archetypes
images of universal experiences contained in the collective unconscious
Countertransference
includes an of our projections that influence the way we perceive and react to a client. This phenomenon occurs when we are triggered into emotional reactivity, when we respond defensively, or when we lose our ability to be present in a relationship because our own issues become involved.
limitations of existential therapy
lacks systemic statement of the principles and practices of psychotherapy. Some take issue with it's mythical language and concepts. Places primary emphasis on a subjective understanding of the world of clients. Not easily researchable. Not for people in extreme crisis or low cognitive fucntioning or limited speech.
ego psychology
part of classical psychoanalysis with the emphasis placed on the vocabulary of the id, ego, and superego
diagnosis
provides working hypothesis and informs treatment.
Value Imposition
refers to counselors directly attempting to define a client's values, attitudes, beliefs, and behaviors
animus/anima
represent both the biological and psychological aspects of masculinity and femininity, which are thought to coexist in both sexes
existential tradition
seeks a balance between recognizing the limits and tragic dimensions of human existence on one hand and the possibilities and opportunities of human life on the other hand. Grew out of a desire to help people engage the dilemmas of contemporary life, such as isolation, alienation and meaninglessness.
Awareness of Death and Nonbeing
the awareness of death as a basic human condition gives significance to living. Distinguishing human characteristics is the ability to grasp the reality of future and the inevitability of death. Death is positive force that gives meaning to life. Death is motivation to take advantage of the present. Those who fear death also fear life.
Transference
the client's unconscious shifting to the analyst of feelings, attitudes, and fantasies (both positive and negative) that are reactions to significant others in the client's past.
collective unconscious
the deepest and lest accessible level of the psyche, which contains the accumulation of inherited experiences of human and prehuman species.
manifest content
the dream as it appears to the dreamer. This is because sometimes unconscious motives are too painful or disturbing so they're transferred to more acceptable content.
Evidence Based Practice
the integration of: -Best available research -clinical expertise -in context of patient characteristics, culture and preferences. Helpful when dealing with specific cognitive, emotional, or bx issues. Less helpful when client wants to pursue a greater fulfillment.