Midterm Theories
GESTALT
-Every moment is an experience to embrace and confront. -The goal of Gestalt therapy is self-awareness. -Cultivate self-awareness by paying attention to the body. -Gestalt is a German phrase that means, "unified whole."
26. According to Gestalt therapy, what are the goals of counseling? Which types of questions are used and which are discouraged when adhering to Gestalt therapy?
-Gestalt theory is a composite of many different theoretical perspectives including psychoanalysis, field theory, existentialism, phenomenology, and holism. -Gestalt therapists form an I-Thou relationship with clients, work in the here-and-now, and ask "what" and "how" questions about their moment to moment experiences. -Contact with other people and life experiences are essential components of Gestalt therapy. -Gestalt experiments can be very emotionally activating for clients and counselors should work collaboratively and follow ethical guidelines.
Describe the five different contact boundary disturbances according to Gestalt therapy: Introjection, projection, retroflection, DEFLECTION, and confluence.
-Involves a distraction that diffuses or reduces contact. -May involve avoiding physical contact, using humor excessively, and talking about others instead of self. -"Aboutism" *People are using distractions to get away from convo at hand
24. Describe the five different contact boundary disturbances according to Gestalt therapy: INTROJECTION, projection, retroflection, deflection, and confluence.
-Involves uncritical acceptance of other's beliefs and standards. -Individuals who use introjection through most of their lives take some things from outside and make it a part of themselves without critical analysis. *Someone says "ugh youre borderline" and walks away and you just go with it without much thought.
Describe the five different contact boundary disturbances according to Gestalt therapy: Introjection, projection, RETROFLECTION, deflection, and confluence.
-May occur when people turn back on themselves something they would like to do to another person. -May involve the doing to ourselves what we would like someone in the environment to do for us. *Someone who wants to kill themselves, might want to kill someone else *Who does my client want to commit suicide at
Describe the five different contact boundary disturbances according to Gestalt therapy: Introjection, projection, retroflection, deflection, and CONFLUENCE.
-Occurs when boundaries merge. -Style can be associated with overaccommodating behavior among people who desperately want to be liked and approved by others. Sarah wilshire LOL over accomodating
Describe the five different contact boundary disturbances according to Gestalt therapy: Introjection, PROJECTION, retroflection, deflection, and confluence.
-Occurs when people project their emotions or traits onto others. -Emotions or traits may be: Those we would like to disown Those that make us uncomfortable *Husband is feeling attracted to another person they sort of project it on the wife, You hang out with coworker bob do you have feelings for him?
What is the figure-formation process?
-Refers to our ability to shift between cognitive or perceptual focus. -We are always just a little aware of the background and the purpose of counseling is to turn up the background noise by shifting focus of awareness. -The primary or dominant needs of an individual can emerge from background (ground) into focus (figure) at any given moment. -A client's unfinished business from the past will inevitably be brought into focus as counselors keep clients in the here and now.
21. According to Gestalt therapy, what is the process of self-regulation?
-The process of self-regulation requires self-awareness. -One goal of Gestalt therapy is to help clients become aware of their needs, sensations, and desires so they can be dealt with more directly and authentically. The process includes: -Initial state of equilibrium -Disruption occurs through the emergence of a need, sensation, or desire. Dis-equilibrium occurs but may still not have completely emerged from the background -Development of awareness of the need, sensation, or desire. Counselors help clients bring the need from the background to the figure. -Take actions or make contacts to deal with the dis-equilibrium. Intentional actions addresses the situation to finish whatever "business" needs finishing. -Return to equilibrium.
25. According to Rogers, what are the core conditions required for constructive personality change?
1.Two persons are in psychological contact 2. The first, whom we shall term the client, is in a state of incongruence 3. The second person, who we shall term the therapist, is congruent 4. The therapist experiences unconditional positive regard to the client 5. The therapist experiences an empathic understanding of the client's internal frame of reference and endeavors to communicate this experience to the client. 6. The communication to the client of the therapists' empathic understanding and unconditional positive regard is to a minimal degree achieved.
Describe the common therapeutic factors and
>Elements that exist across a wide range of different therapy approaches. >Some researchers and practitioners view common factors as the primary reason why therapy is effective. Includes: -Culturally appropriate or sanctioned explanation for client distress combined with a similarly sanctioned rationale for the treatment procedures -Healing setting where the therapy occurs -Advice or education (psychoeducation) -Emotionally charged relationship bond between client and counselor -Exposure to feared stimuli -Feedback from the counselor -Insight into one's problems -Positive expectations (hope) -Working alliance -Counselor credibility or expertise -Trust in the counselor
Compare and contrast the biomedical, religious/spiritual, PSYCHOSOCIAL, and feminist/multicultural perspectives.
>Examines how verbal and relational interactions influence thoughts, mood, and behavior. >The power of words, our relationships, and the meanings we create from these interactions are important.
18. What are the counseling goals of Existential theory?
>Facilitate self—awareness including the awareness of death, freedom, isolation and life's meaning. >Instead of techniques, the primary therapeutic force is the interpersonal therapeutic encounter. >By being present with the client in the immediate moment, existential therapists partner with clients through self-discovery and growth.
22. Describe the following Gestalt theoretical factors: I and Thou, Here and Now, What and How.
>I and Thou: Authentic therapist-client relationship >Here and Now: Immediacy or being present in the here and now >What and How: An emphasis on process over content; moment-to-moment examination of what is happening and how. -Avoid asking, "why" because is is believed to promote intellectualization. Instead, ask "what" or "how" questions to promote process over content
What is a theory? What is the purpose of using a theory in counseling? What are some of the strengths and challenges associated with how traditional counseling theories were developed?
>Involves gathering together and organizing knowledge about a particular object or phenomenon. >Used to generate hypothesis A good one is Accurate, Explains, Describes, Predicts, & uses specific strategies & interventions. psychotherapy's history was written by privileged white men who advocated for specific theories
16. What is logotherapy? Who developed logotherapy?
>Logotherapy was developed by Victor Frankl >Centered around helping clients find meaning. >There is no single theorist or theory of existential psychotherapy. >Rollo May has been credited with formally introducing and integrating existential thought into counseling and psychotherapy. >Psychopathology results from diminished self-awareness or self-understanding.
20. Define the following Existential ways of being: Mitwelt, Eigenwelt and Uberwelt
>Mitwelt: Being-with-others or the social world >Eigenwelt: Being-with-oneself or the world of the self >Uberwelt: Being-with-the-spiritual or over world
19. Identify and describe the following Existential counseling techniques: Paradoxical intention, cognitive reframing, feedback and confrontation.
>Paradoxical Intention -Clients are taught to intentionally exaggerate, rather than avoid, their existential realities. >Cognitive Reframing - Reframing clients' meaning from the message >Feedback- Providing information about what they see and hear in session. >Confrontation- Feedback that focuses on client inconsistencies and discrepancies
11. Compare and contrast the following defense mechanisms: Repression, denial, projection, reaction formation, displacement, rationalization, regression, sublimation. What are the four primary characteristics of defense mechanisms?
>Repression - Involves forgetting an emotionally painful memory. >Denial - Distorting what one thinks, feels or perceives in a traumatic situation. >Projection - Occurs when clients push their unacceptable thoughts, feelings, or impulses outward onto another person. >Reaction formation - Occurs when people develop conscious attitudes and behaviors that are diametrically opposed to disturbing desires >Displacement - Occurs when the aim of sexual or aggressive impulses is shifted from a more dangerous person or activity to a less dangerous person or activity. >Rationalization - Occurs when clients use excessive explanations to account for their behaviors. >Regression - Occurs when one justifies specific behaviors to alleviate anxiety/disappointment >Sublimation - Occurs when primal sexual or aggressive energy is channeled into socially acceptable (and often) adaptive channels Primary Characteristics: 1. They are automatic. 2. They are unconscious. 3. They ward off unacceptable impulses. 4. They distort reality.
15. How do Existential counselors approach symptoms, instinctual drives, and environmental stimulus-response determinants? What are the foci of Existential therapy?
>Symptoms are not cured or minimized >Symptoms are meaningful >Existentialists reject unconscious or instinctual drives of human behavior >Existentialists reject environmental stimulus-response determinants Focuses on: -Self-awareness -The unavoidable conditions of human existence -Authentic living
Describe the "I-Am" and "I-Though" relationships. According to Existential therapy, what is the nature of guilt and anxiety?
>The I-AM experience is the experience of being. >A major focus of existential therapy consists of exploring immediate individual human experience. >Thus, existential therapy is in the service of promoting and expanding self-awareness and/or self discovery. >The I-THOUGH relationship involves the deepest of all possible connections between two individuals. It is a mutual and celebratory relationship in which both self and other are fully experienced. *Existentialists believe the entirety of an individuals human experience is accessible to the consciousness. A: -Anxiety is viewed as leading to authenticity and freedom. -Anxiety is normal and an essential by-product of human existence. -Anxiety should be explored, experienced, engaged, and redirected into constructive activities. -Normal versus neurotic anxiety. G: -Normal guilt inspires people to act in thoughtful and conscientious ways. -Neurotic guilt consists of a twisted, exaggerated, or minimized version of normal guilt. -According to existential theory, psychopathology arises from neurotic guilt.
13. Compare and contrast transference and countertransference.
>Transference - Occurs when counselors utilize the "blank-screen" approach. Avoiding self-disclosure and maintaining neutrality leads to client projections. >Countertransference - The counselor's tendency to see the client in terms of his or her own previous relationships. Transference directed from the counselor toward the client. -Contemporary psychoanalytic counselors broadened the definition to include all therapist emotional-cognitive-physical reactions toward the client.
Compare and contrast the biomedical, religious/spiritual, psychosocial, and FEMINIST/MULTIICULTURAL perspectives.
>Uses social and cultural oppression and liberation from oppression as primary explanations for mental disorders and therapeutic recovery. >Human history and knowledge is influenced by the writers. >Mutual empathy, client empowerment, and informed consent are feminist values. >Cultural sensitivity and cultural humility improve counseling outcomes with diverse client populations. >Emphasizes relationship and community over individuality.
12. Describe the theory of object relations.
>object relations theory focused on the dynamics and motivation captured within the context of earlier parent-child relationships. >Objects are not things, but internalized versions of people. >Object relations theorists believe humans mentally internalize both a representation of self and early caretaker figures. >These internalized self and other representations are carried within the individual into adulthood. >A major goal of object relations therapy is to "exorcise" old maladaptive internalized representations and replace them with healthier representations. >Within the therapeutic setting, counselors act as the "good object" to help clients replace the original bad internalized object.
Compare and contrast the BIOMEDICAL, religious/spiritual, psychosocial, and feminist/multicultural perspectives.
Biomedical: Involves belief that biological, genetic, or physiological factors cause mental and emotional problems and are central to therapeutic strategies. Trephining: was a shamanic treatment to release evil spirits from the brain. Prefrontal lobotomy: intended to destroy portions of white matter in the prefrontal cortex of the brain.
10. Describe the psychosexual stages of development. In which stage does the Electra complex and Oedipal complex occur?
Children move through four developmental stages and a latency period. Progress through each stage is driven by biological maturation which forces individuals to confront demands inherent to each stage. At each stage, if parents are overly indulgent or withholding, the child can end up with fixations or complexes. Oral: Birth to 1 year old Anal: 1 to 3 years old Phallic: 3 to 5 years old Latency: 5 to 12 years old Genital: Adolescence to adulthood -Oedipal conflict - Involves the male child's sexual attraction and wish to possess or marry his mother. Resolved when the boy identifies with his father. -Electra complex - Involves the female child's sexual attraction and wish to possess or marry her father. OCCURS IN PHALLIC STAGE
4. Briefly describe each of the following ethical essentials: confidentiality, multiple roles, doing no harm, competence, informed consent, and multicultural competencies.
Competence: -Adequate knowledge and skills to perform specific professional services. -Aspirational goal -Strategies include working out your own issues, working within a learning community, and skills practice and feedback. Informed Consent: -Clients' rights to know about and consent to ways you intend to work with them. -Clients have the right to know your training status, supervision arrangements, type of counseling offered, rationale for treatment approaches, duration of counseling, and potential benefits and harm associated. -Includes a written statement and an interactive discussion. Multicultural Competencies: -Include self-awareness, multicultural knowledge, culturally specific techniques, and advocacy. Confidentiality: -Information clients share is private and not shared without client permission. -Builds trust. -Keep identity of your clients confidential, keep notes and videos secure, and do not discuss content of therapy sessions in ways that may identify your clients. Multiple Roles: -Restrict work to people you don't know from other contexts. -Avoid holding multiple roles in clients lives includes roles or relationships with friends, partners, or business colleagues. -Seek supervision and consultation when potential multiple roles emerge. -Doing No Harm -Psychotherapy can and does produce negative outcomes (client deterioration) in approximately 3-10% of cases.
6. Compare and contrast efficacy research and effectiveness research. Identify the strengths and challenges associated with both types of research.
Efficacy Research: -Employs experimental designs that emphasize internal validity, Uses randomly assigned treatment and control groups, Treatment is efficacious if the active medication relieves symptoms at a rate significantly higher than the placebo. APA Division 12 publishes empirically validated treatments. Empirically validated treatments are manualized and shown to be superior to a placebo or other treatment, or equivalent to an already established treatment in at least two good group design studies or in a series of single case design experiments conducted by different investigators. , May be most effective when directly "exported" to clinical settings. Effectiveness Research: Uses experimental designs that emphasize external validity (generalizability), Considers the outcome of treatment as it is delivered in real-world settings, Do not include random assignment to treatment conditions or placebo control groups, Focuses on collecting data within real-world-settings rather than in a laboratory, More consistent with clinical practice where clients report a mix of varying symptoms and/or diagnoses.
briefly identify how each factor from the Four Factor Model may influence positive counseling outcomes.
Extratherapeutic Factors: -Includes client factors such as severity, motivation, ability to relate to others, ego strength, psychological-mindfulness, ability to identify a single problem to work on, and sources of help and support in client environments. -Estimated to account for approximately 40% of the variation in treatment outcomes. Therapeutic Relationship: -Includes factors that contribute to rapport and a positive working relationship between client and counselor. -Rogers (1957) core conditions of congruence, unconditional positive regard, and empathic understanding. -Bordin's (1979) tripartite model of the working alliance includes a positive interpersonal bond between counselor and client, identification of agreed upon counseling goals, counselor and client collaboratively working together on therapeutic tasks linked to goals. -Estimated to account for approximately 30% of the variation in treatment outcomes. Expectancy: -Hope for positive outcomes. -Expectancy, hope, and placebo factors account for approximately 15% of the variation in treatment outcomes. Techniques: -Extratherapeutic factors, the relationship, and expectations are activated when counselors employ specific therapy techniques. -Counseling techniques account for approximately 15% of the variation in treatment outcomes. -Other researchers estimate specific techniques account for only 1%.
23. Which theorists are primarily associated with Psychoanalytic, Existential, Person Centered, Gestalt, and Adlerian theory?
Humanistic P: Freud E: Rollo May PC: Carl Rogers G: Fritz Perls AT:Alfred Adler
9. What are the three components of the Psychoanalytic structural approach? How would describe each one?
Involves interrelationships of the id, ego, and superego. DEVIL>Id - Biological desires that functions on the pleasure principle. Described as, "a chaos, a cauldron full of seething excitations" (Freud, 1964, p. 73). Id impulses can be seen within dreams, fantasies, and powerful pleasure-seeking urges. MIDDLE MAN>Ego - Includes memory, problem solving abilities, and logical thought. The Ego helps individuals cope with primary sexual and aggressive drives while balancing the admonitions and expectations of the superego. Because this can be challenging, the ego may use defense mechanisms to deal with these battling forces. ANGEL>Superego - Develops when children resolve their Oedipal or Electra issues and begin to identify more with same sex parents and parental demands or expectations. -Conscience - Develops as a function of parental "rules" which are internalized and later used to self-punish or prohibit unacceptable impulses. -Ego-ideal - Positive desire to emulate adult standards.
14. According to Existential theory, what are the inevitable human conditions? Describe each of the human conditions.
Primary foci include the inevitable human conditions of death responsibility: freedom pursuit of meaning. Avoids scientific research due to its inauthentic artificiality.
7. According to Freud, which two forms of mental or psychic energy are associated with life and sex and death and aggression, respectively? What is psychic determinism?
Proposed a dynamic approach to human psychology, also known as drive theory or instinct theory. >Humans are filled with mental or psychic energy that are in constant conflict. -Eros (life instincts): Associated with life and sex. Also referred to as libido. -Thanatos (death instincts): Associated with aggression. Psychic determinism - Proposes an underlying psychological explanation for every emotion, thought, impulse, and behavior.
28. According to Psychoanalytic theory, Person centered theory, Gestalt theory, Existential Theory and Family Systems theory, what are the causes of psychopathology?
Psycho: The goal of psychoanalytic therapy is to bring automatic, dysfunctional impulse-gratification cycles into awareness so they can be replaced with more adaptive and intentional behavior patterns. PCT:If psychopathology stems from one's experience of judgment or invalidation of the self by significant others, a nonjudgmental atmosphere will facilitate psychological health. If counselors can trust clients and provide a therapeutic relationship, clients will begin trusting themselves. The client is the expert. G:Gestalt therapists view psychopathology through the lens of contact and resistance to contact. When individuals have characteristic styles of interrupting or resisting contact, psychopathology occurs. According to Gestalt theorists, psychopathology occurs when natural processes of contact, excitement, self-regulation, and new learning are disturbed. EXI:Psychopathology results from diminished self-awareness or self-understanding. FST:
Compare and contrast psychotherapy and counseling.
Psychotherapy: >Conversations with a therapeutic purpose through which one individual in distress receives help from another person. >Incorporates the importance of talking (expressive-catharsis) and listening and learning from therapist (receptive-educational). >Are less directive, more deeply examine issues, work longer, and charge more. Counseling: >An artful application of scientifically derived psychological knowledge and techniques for the purpose of changing human behavior. >Intended for working with relatively normal-functioning individuals who are experiencing developmental or adjustment problems across the lifespan. >Are more directive, focus on developmentally normal but troubling issues, work more overtly on practical client problems, work more briefly, and charge less. * definition: a) a process that involves (b) a trained professional who abides by (c) accepted ethical guidelines and has (d) competencies for working with (e) diverse individuals who are in distress or have life problems that led them to (f) seek help
Compare and contrast the biomedical, RELIGIOUS/ SPIRITUAL, psychosocial, and feminist/multicultural perspectives.
Religious/Spiritual: Emphasizes spiritual explanations for human distress and recovery. Dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT) use Buddhist mindfulness approaches to promote emotional regulation Matching client spirituality with spiritually oriented treatments tends to improve outcomes.
27. Describe the following techniques used in Gestalt therapy: Staying with the feeling, Taking responsibility for, Exaggeration, Dream Work, and Empty Chair.
Staying with the feeling Taking responsibility for Exaggeration Dream Work Empty Chair LOOK AT PICS
What are the counseling goals of Psychoanalytic theory?
The methods and techniques of psychoanalytic therapy have the following goals: -To make the unconscious conscious or increase client awareness. -To help clients develop greater self-control over maladaptive impulses. -To help clients rid themselves of maladaptive or unhealthy internalized objects and replace them with more adaptive internalized objects. -To repair self-defects through mirroring, presenting a potentially idealized object, and expressing empathy during optimal therapeutic failures.
8. Describe the topographical approach of Psychoanalytic theory. How is the psychoanalytic mind divided, and which types of constructs exist within each region?
The psychoanalytic mind is divided into three interrelated regions: -Unconscious: Dreams, slips of the tongue, "Heavy, dirty backpack representing old relationship he took no matter where he went" -Preconscious: -Conscious. >Because awareness of primitive sexual and aggressive impulses would be disruptive to our daily lives, our brain protects us from them. >By bringing unconscious impulses to awareness, we are better able to mange them. If we do not acknowledge primitive impulses, they may influence us in indirect and destructive ways.
Define client deterioration and describe how various factors may influence client deterioration.
Usually due to therapist factors, client factors, or specific psychological interventions. Therapist Factors: Failing to demonstrate empathy or warmth in client interactions, Using overly confrontational or intrusive approaches, Using poor assessment procedures, Lack of fit between counselor and client personality Client Factors: Low motivation , High client psychopathology (comorbidities, paranoia, antisocial behavior), Limited personal resources (intelligence, insight, family, or social support) Psychological Intervention Factors: Specific therapy approaches that provide unacceptable negative effects are potentially harmful therapies (PHTs). Includes Critical incident stress debriefing, scared straight interventions, facilitated communication, attachment therapies (rebirthing), recovered-memory techniques, DID-oriented therapy, induction of "alter" personalities, grief counseling for people with normal bereavement reactions, Boot camp interventions for conduct disorder, and drug abuse resistance education (DARE) programs.
