Unit 7: Approaches to Psychotherapy I - Seminar Unit 7: Approaches to Psychotherapy I - Seminar This week we read chapters 12 and 13, the topic for the Seminar Discussion: This week we read chapters 12 and 13, the topic for the Seminar Discussion: Humanistic Case Study

Discussion Scenario Part 1 Dr. Greenwald is a clinical psychologist who identifies his approach to psychotherapy as humanistic. As such, he believes that it is important to provide each client with unconditional positive regard (UPR), or to communicate to the client that he or she is valued, appreciated, accepted, and "prized" regardless of what he or she may say or do. Dr. Greenwald is a clinical psychologist who identifies his approach to psychotherapy as humanistic. As such, he believes that it is important to provide each client with unconditional positive regard (UPR), or to communicate to the client that he or she is valued, appreciated, accepted, and "prized" regardless of what he or she may say or do.

Discussion Scenario Part 2 Several weeks ago, Dr. Greenwald began working with a new client named Steven, who struggles with generalized anxiety disorder. As Steven's trust and rapport with Dr. Greenwald has increased, he has admitted more and more about himself. After a number of sessions, Steven confided in Dr. Greenwald that many years ago, he raped a woman. Dr. Greenwald views rape as a reprehensible act. Several weeks ago, Dr. Greenwald began working with a new client named Steven, who struggles with generalized anxiety disorder. As Steven's trust and rapport with Dr. Greenwald has increased, he has admitted more and more about himself. After a number of sessions, Steven confided in Dr. Greenwald that many years ago, he raped a woman. Dr. Greenwald views rape as a reprehensible act.

Discussion Scenario Part 2 Several weeks ago, Dr. Greenwald began working with a new client named Steven, who struggles with generalized anxiety disorder. As Steven's trust and rapport with Dr. Greenwald has increased, he has admitted more and more about himself. After a number of sessions, Steven confided in Dr. Greenwald that many years ago, he raped a woman. Dr. Greenwald views rape as a reprehensible act. Several weeks ago, Dr. Greenwald began working with a new client named Steven, who struggles with generalized anxiety disorder. As Steven's trust and rapport with Dr. Greenwald has increased, he has admitted more and more about himself. After a number of sessions, Steven confided in Dr. Greenwald that many years ago, he raped a woman. Dr. Greenwald views rape as a reprehensible act.

Discussion Question What is the fundamental foundation of the school of Humanistic Psychotherapy? What is the fundamental foundation of the school of Humanistic Psychotherapy?

Humanistic Psychotherapy Carl Rogers was a leading figure Carl Rogers was a leading figure –Abraham Maslow was another Humanism was a reaction against Freud’s approach Humanism was a reaction against Freud’s approach Assumed that human nature wasn’t so bad (e.g., id-driven) Assumed that human nature wasn’t so bad (e.g., id-driven) Overlapping terms for humanism include “nondirective,” “client-centered,” and “person-centered” Overlapping terms for humanism include “nondirective,” “client-centered,” and “person-centered”

Humanistic Concepts: Clinical Implications People have an inborn tendency toward self-actualization People have an inborn tendency toward self-actualization People also have a need for positive regard—warmth, acceptance, “prizing” People also have a need for positive regard—warmth, acceptance, “prizing” Sometimes, people are forced to sacrifice self-actualization in order to obtain positive regard from important others (e.g., parents) Sometimes, people are forced to sacrifice self-actualization in order to obtain positive regard from important others (e.g., parents)

Goal of Humanistic Psychotherapy Primary goal of humanistic psychotherapy is to foster self-actualization Primary goal of humanistic psychotherapy is to foster self-actualization Problems stem from stifled self-actualization or growth Problems stem from stifled self-actualization or growth Therapist’s task is to create a climate in which the client can resume their natural growth toward psychological wellness Therapist’s task is to create a climate in which the client can resume their natural growth toward psychological wellness

Goal of Humanistic Therapy (cont.) In humanistic therapy, there are no conditions of worth on the client In humanistic therapy, there are no conditions of worth on the client –Clients’ real selves can match their ideal selves –This match is known as congruence, and is the root of psychological wellness –Mismatch between real and ideal selves is known as incongruence, and is the root of psychopathology

Three Essential Therapeutic Conditions Empathy Empathy –the therapist is able to sense the client’s emotions just as the client would –a deep, nonjudgmental, compassionate understanding of the client’s experiences Unconditional Positive Regard Unconditional Positive Regard –Accepting or “prizing” the client “no matter what” and without judgment Genuineness Genuineness –Honesty toward client, rather than playing a role

Discussion Question In your opinion, what role should unconditional positive regard play in Steven's psychotherapy? In your opinion, what role should unconditional positive regard play in Steven's psychotherapy?

Necessary and Sufficient? Rogers boldly argued that empathy, unconditional positive regard, and genuineness were necessary and sufficient for successful therapy with any client Rogers boldly argued that empathy, unconditional positive regard, and genuineness were necessary and sufficient for successful therapy with any client –No other techniques needed for anyone A controversial claim A controversial claim Research is inconsistent; generally supports necessary, but not sufficient Research is inconsistent; generally supports necessary, but not sufficient

Discussion Question In your opinion, can Dr. Greenwald's positive regard for Steven be truly unconditional, especially if he knows that Steven committed an act he finds reprehensible? In your opinion, can Dr. Greenwald's positive regard for Steven be truly unconditional, especially if he knows that Steven committed an act he finds reprehensible?

Therapist Attitudes, Not Behaviors Rogers emphasized that empathy, unconditional positive regard, and genuineness are attitudes, not specific behaviors Rogers emphasized that empathy, unconditional positive regard, and genuineness are attitudes, not specific behaviors Therapy should not be mechanical or formulaic Therapy should not be mechanical or formulaic –Attitudes, not specific techniques or skills, should be emphasized

Discussion Question In your opinion, what role should genuineness play in Steven's psychotherapy? In your opinion, what role should genuineness play in Steven's psychotherapy?

Reflection: An Important Therapist Response Reflection of feeling is one therapist response that humanists do emphasize Reflection of feeling is one therapist response that humanists do emphasize Reflection takes place when a therapist responds to a client by rephrasing or restating the client’s statements in a way that highlights the client’s feelings or emotions Reflection takes place when a therapist responds to a client by rephrasing or restating the client’s statements in a way that highlights the client’s feelings or emotions Communicates all three key ingredients Communicates all three key ingredients Should be done with humility and not mechanically Should be done with humility and not mechanically

Discussion Question Is there any reason you should violate the privilege of confidentiality because of the information that Steven committed rape? If so, who should you tell? Is there any reason you should violate the privilege of confidentiality because of the information that Steven committed rape? If so, who should you tell?

Alternatives to Humanism Historical alternatives Historical alternatives –Existential psychotherapy Rollo May, Victor Frankl, Irvin Yalom Rollo May, Victor Frankl, Irvin Yalom Address anxiety of inescapable solitude of life Address anxiety of inescapable solitude of life –Gestalt therapy Fritz Perls Fritz Perls Holistic approach to enhancing current experience (“the now”); often uses role-plays Holistic approach to enhancing current experience (“the now”); often uses role-plays

Alternatives to Humanism (cont.) Contemporary Alternatives Contemporary Alternatives –Motivational Interviewing William Miller William Miller Address clients’ ambivalence or uncertainty about making major changes to their way of life Address clients’ ambivalence or uncertainty about making major changes to their way of life Help clients see the discrepancy between their behavior and their own values Help clients see the discrepancy between their behavior and their own values –Positive Psychology movement Martin Seligman Martin Seligman Overlaps with humanism by emphasizing human strengths, assets, and potential Overlaps with humanism by emphasizing human strengths, assets, and potential

Outcome Issues Carl Rogers was a pioneer of psychotherapy outcome research, despite inherent problems in defining and measuring humanistic concepts Carl Rogers was a pioneer of psychotherapy outcome research, despite inherent problems in defining and measuring humanistic concepts However, in more recent years humanistic outcome research has decreased However, in more recent years humanistic outcome research has decreased Recent meta-analyses suggest it is beneficial, at about the same rate as most other major therapies Recent meta-analyses suggest it is beneficial, at about the same rate as most other major therapies

Questions?