1. © 2016. Cengage Learning. All rights reserved.  Chapter 4: Individual Approaches to Counseling  Chapter 5: Counseling Skills 1 SECTION II: The Helping Relationship I: Theory and Skills

2. © 2016. Cengage Learning. All rights reserved. Chapter 4 Individual Approaches to Counseling 2

3. © 2016. Cengage Learning. All rights reserved.  Offers us a framework  Knowledge builds on knowledge (Paradigm Shifts)  See Box 4.1, p. 100  Theories are heuristic  Based on our view of human nature  Helps us work in an organized manner  Today, there are hundreds of counseling theories, but only some have gained prominence 3 Why Have a Counseling Theory?

4. © 2016. Cengage Learning. All rights reserved.  Psychodynamic Approaches  Existential-Humanistic Approaches  Cognitive-Behavioral Approaches  Post-Modern Approaches 4 Four Conceptual Orientations and Associated Theories

5. © 2016. Cengage Learning. All rights reserved.  Overview  Dominated early part of 20 th century  Common elements  Unconscious and conscious affects person’s functioning  Early child-rearing has some affect on development of personality  One’s past, in interaction with the conscious and unconscious, affects person’s development  Have tended to be longer term therapeutic approaches  Some approaches: psychoanalysis (Freud), analytical therapy (Jung), individual psychology (Adlerian) 5 Psychodynamic Approaches

6. © 2016. Cengage Learning. All rights reserved.  Developed by Sigmund Freud  First comprehensive approach to therapy  Psychic energy (instincts) drive behavior  Life instinct (Eros): love, intimacy, sex, survival  Death instinct (Thanatos): fear, hate, self-destructive behavior aggression  All life and death instincts = libido  Structure of personality  Id (pleasure principle)  Ego (reality principle)  Superego (moral imperatives) 6 Psychodynamic Approaches (Psychoanalysis: Freudian Therapy)

7. © 2016. Cengage Learning. All rights reserved.  Psychosexual Stages: Oral, Anal, Phallic, Latency, Genital  Parenting affects developmental through stages  Defense mechanisms reflect that development  Name some defense mechanisms!  Deterministic Approach  See Figure 4.1, p. 105  Long term approach that relies on making a little more of the unconscious conscious 7 Psychodynamic Approaches (Psychoanalysis: Freudian Therapy)

8. © 2016. Cengage Learning. All rights reserved. Psychodynamic Approaches (Psychoanalysis: Freudian Therapy) 8  Techniques  Free Association  Dream Analysis  Empathy  Developing transference relationship  Techniques  Interpretation of:  Resistance  Defense mechanisms  Parapraxes  Dreams (manifest and latent meanings)  Transference

9. © 2016. Cengage Learning. All rights reserved.  Developed by Carl Jung  Less pessimistic and less deterministic than Freud  8 Psychological Types—include combinations of:  Extraversion and Introversion (E or I) with  Mental Functions: Thinking and Feeling (T or F); Sensing and Intuiting (S or N)  Information that matches psychological type goes into consciousness; information that doesn’t match goes into personal unconscious.  Our collective unconscious is inherited. Contains archetypes —tendency to perceive things in ways we call “human”  Well known archetypes: persona, anima and animus, shadow 9 Psychodynamic Approaches (Analytical Therapy: Jungian Therapy)

10. © 2016. Cengage Learning. All rights reserved.  Jung believed we can make almost anything conscious  If we understand our personal and collective unconscious, we are “whole”  Techniques:  Goal of techniques—to make unconscious conscious  Some techniques include: e xamining our dreams, meaning of symbols, creative techniques (e.g., working with clay), and active imagination 10 Psychodynamic Approaches (Analytical Therapy: Jungian Therapy)

11. © 2016. Cengage Learning. All rights reserved.  Developed by Alfred Adler  “Teleology”—we inherently are goal directed  We move to fulfill one drive—striving for perfection.  All other drives subsumed by this one  Part of being human: having feelings of inferiority  Feelings of inferiority lead us to our subjective final goal  Our private logic leads us toward our final goal  Drive toward our subjective goal results in development of behaviors that compensate for feelings of inferiority  You can tell how a person is driven toward his/her goal through his/her style of life 11 Psychodynamic Approaches (Individual Psychology: Adlerian Therapy)

12. © 2016. Cengage Learning. All rights reserved.  Work through feelings of inferiority, and you will move toward social interest (gemeinschaftsgefühl)  Followers: Dreikrus and Dinkmeyer  Worked with children whose typical behaviors from feelings of inferiority yield:  Attention seeking, use of power, revenge seeking, and inadequacy  Sometimes seen as an early humanistic approach (through education and counseling one can change)  One of first approaches to work with families 12 Psychodynamic Approaches (Individual Psychology: Adlerian Therapy)

13. © 2016. Cengage Learning. All rights reserved. Psychodynamic Approaches (Individual Psychology: Adlerian Therapy) 13  Phase of therapy  Building relationship  Assessing lifestyle  Insight and interpretation  Reeducation and reorientation  Techniques:  Exploring family constellation  Examining early recollections  Encouragement  Democratically held discussion groups  Limit setting  Acting “as if”  Spitting in the client’s soup  Setting logical and natural consequences

14. © 2016. Cengage Learning. All rights reserved.  Overview  Loosely based on existential philosophy  Deals with struggles of living and how we construct meaning in our lives  Tends to be optimistic and not deterministic  Phenomenological perspective  Focus on consciousness and the relationship  Help people “self-actualize”  Three approaches:  Existential Therapy, Person-Centered, Gestalt Therapy 14 Existential-Humanistic Approaches

15. © 2016. Cengage Learning. All rights reserved.  A number of theorists developed this approach  Frankl (Logotherapy), May, Bugental, Yalom  Central tenets of most existential approaches  Born into a world with no inherent meaning  We make our meaning  Struggle throughout life to be “human”  Most people live a life of limited self-reflection  We are born alone, die alone, and mostly live alone  Choice about who we are  Can gain awareness about choices we have made  See Box 4.4, p. 111 15 Existential-Humanistic Approaches (Existential Therapy)

16. © 2016. Cengage Learning. All rights reserved.  Developed by Carl Rogers (“client-centered therapy”)  We all have need to be regarded  Conditions of worth placed on us by significant others  Help people become more congruent and gain a more realistic sense of ideal self  "Necessary & sufficient conditions" (pp. 112)  “Techniques”  Congruence/genuineness  Unconditional positive regard  Empathic understanding  See Box 4.5, p. 112 16 Existential-Humanistic Approaches (Person-Centered Counseling)

17. © 2016. Cengage Learning. All rights reserved.  Developed by Fritz Perls  Based on Gestalt psychology, phenomenology, & existentialism  More directive and confrontational  Self-regulation, need identification, and need-fulfillment  Only aware of needs in “foreground”  “Blockages” or “impasses” yield “unfinished business”  Now = experience = awareness = reality  Anti-deterministic  Techniques “push” one into experiencing the “now” 17 Existential-Humanistic Approaches (Gestalt Therapy)

18. © 2016. Cengage Learning. All rights reserved.  Overview  Pavlov (1848-1936): Classical Conditioning  Skinner (1904-1990): Operant Conditioning  Bandura: Modeling or Social Learning (1940s)  Recent Years:  Cognitive Structures  illogical Ways of Thinking  See common assumptions (p. 117)  Approaches:  Modern-Day Behavior Therapy, Rational Emotive Behavior Therapy, Cognitive Therapy, Reality Therapy and Choice Theory 18 Cognitive-Behavioral Approaches

19. © 2016. Cengage Learning. All rights reserved.  Developed by many different individuals  Based on an understanding of classical condition, modeling, and operant conditioning  Therapeutic stages 1. Building the relationship 2. Clinical Assessment 3. Focusing on Problem Areas and Setting Goals 4. Choosing Techniques and Working on Goals 5. Assessment of Goal Completion 6. Closure and follow-up  Some techniques: See Box 4.8 19 Cognitive-Behavioral Approaches (Modern-Day Behaviorism)

20. © 2016. Cengage Learning. All rights reserved.  REBT: Developed by Albert Ellis  Complex interaction between thinking, feeling, & acting  Mostly, focus on Rational vs. Irrational Thinking  People have cognitive distortions  People often driven by 1 or more of 3 core irrational beliefs (see Box 4.9, p. 120)  ABCs of feeling and behaving  Relationship important, but not critical (see Box 4.10, p. 120) 20 Cognitive-Behavioral Approaches (Rational Emotive Behavior Therapy: REBT)

21. © 2016. Cengage Learning. All rights reserved.  Developed by Aaron Beck  Continuity hypothesis: older emotional responses continue into modern day world  Diathesis-stress model  Biological/genetic/environmental model—under stress, our (unique) disorders are shown  Rational, pragmatic, antideterministic, educative, empirical  We all have “core beliefs” that drive us—embedded beliefs often out of our awareness  We can have negative core beliefs (see Box 4.11) 21 Cognitive-Behavioral Approaches (Cognitive Therapy)

22. © 2016. Cengage Learning. All rights reserved.  Cognitive Therapy (cont’d)  Core beliefs lead to intermediate beliefs (“attitudes, rules, and expectations”)  Intermediate beliefs lead to automatic thoughts  Automatic thoughts related to certain “cognitive distortions” (see Box 4.9, p. 121)  Automatic thoughts lead to possible reactions to certain situations (see Figure 4.2, p. 125)  Treatment: focus on automatic thoughts, get to intermediate beliefs, then get to core beliefs—change core beliefs through thinking and acting differently 22 Cognitive-Behavioral Approaches (Cognitive Therapy)

23. © 2016. Cengage Learning. All rights reserved.  Developed by Glasser—originally called Reality Therapy  Five genetically based needs: survival, love and belonging, power, freedom, and fun  Unique “need-strength profile”  We can only satisfy our needs and control our behaviors in the present  Since birth, we create a “quality world” to determine how to satisfy our needs  Some quality worlds lead to destructive behaviors 23 Cognitive-Behavioral Approaches (Reality Therapy and Choice Theory)

24. © 2016. Cengage Learning. All rights reserved.  Reality Therapy (cont’d)  Can change the pictures in our quality worlds and our behaviors  Total behavior: We can only choose our actions and thoughts  Use internal-control language, not external control language  Techniques: see WDEP system (Figure 4.3, p. 128)  Anti-deterministic 24 Cognitive-Behavioral Approaches (Reality Therapy and Choice Theory)

25. © 2016. Cengage Learning. All rights reserved.  Overview  Based on post-modernism, social constructionism, post- structuralism  Post-modernists: Questions modernism and many assumptions and beliefs we take for granted  Social Constructionism: Values are transmitted through language via social milieu (family, culture, society)  Post-structuralism: Questioning of “inherent truths” or “structures” we have believed  Two approaches  Narrative Therapy and Solution-Focused Brief Therapy 25 Post-Modern Approaches

26. © 2016. Cengage Learning. All rights reserved.  Developed by White and Epston (and others)  Underlying premises:  Realities are socially constructed  Realities are constituted through language  Realities are organized and maintained through narrative  There are no essential truths  Anti-deterministic and anti-objectivist  Deconstruct problem-saturated stories (narratives)  Construct new narratives 26 Post-Modern Approaches (Narrative Therapy)

27. © 2016. Cengage Learning. All rights reserved.  Narrative Therapy (cont’d)  We all are multistoried  Look at “thin” and “thick” stories  Look for exceptions to stories (see Fig. 4.4, p. 130)  Be respectful, curious, show awe, ask questions  Phases:  1) Joining, 2) Examining patterns, 3) Re-authoring, and 4) Moving on  Use journaling, retelling new stories, symbols to reinforce new stories 27 Post-Modern Approaches (Narrative Therapy)

28. © 2016. Cengage Learning. All rights reserved.  SFBT: Developed by Berg and de Shazer (and others)  Developed at Brief Family Therapy Center of Milwaukee  Rejected “disease model” and believed that clients could work quickly to reach goals  Pragmatic, optimistic, anti-deterministic, future-oriented  Miracle Question  Questions: evaluative, coping, exception-seeking, solution-focused  Find exceptions to client problems  Often under 6 sessions 28 Post-Modern Approaches (Solution-Focused Brief Therapy: SFBT)

29. © 2016. Cengage Learning. All rights reserved.  Six Stages of SFBT  Stage 0: Pre-Session Change  Stage 1: Forming a Collaborative Relationship  Stage 2: Describing the Problem  Stage 3: Establishing Preferred Goals  Stage 4: Problem-to-Solution Focus  Stage 5: Reaching Preferred Goals  Stage 6: Ending Therapy 29 Post-Modern Approaches (Solution-Focused Brief Therapy: SFBT)

30. © 2016. Cengage Learning. All rights reserved. Extensions, Adaptations, and Spinoffs of the Major Theories  Erikson’s Psychosocial Theory  Object-Relations Theory  Relational and Subjectivity Theory  Dialectical Behavior Therapy (DBT)  Acceptance and Commitment Therapy (ACT)  Constructivist Therapy  Eye Movement Desensitization Therapy (EMDR)  Motivational Interviewing  Gender-Aware Therapy  Positive Psychology and Well-Being Therapy  Complementary, Alternative, and Integrative Approaches 30

31. © 2016. Cengage Learning. All rights reserved.  Combine varying theoretical approaches into helping clients  Integrative Approach (formerly called “eclecticism)  Four stages  Stage 1: Chaos  Stage 2: Coalescence  Stage 3: Multiplicity  Stage 4: Metatheory 31 Integrative Counseling and Psychotherapy (Integrative Approach)

32. © 2016. Cengage Learning. All rights reserved.  Bias in Counseling Approaches  Many theories developed by White men, European heritage  Their values impacted their theories  Some of these values included:  Importance of individualism  Expression of feelings  Search within “self” to discover truth  If you work hard, you’ll succeed  Mind-body dualism  Truth can be found or uncovered  Facts can be found, values are opinions  External factors of little impact on internal psychological states 32 Multicultural/Social Justice Focus

33. © 2016. Cengage Learning. All rights reserved.  It’s time to take into account other cultures and become more multicultural sensitive in our theories  Many of the theories can be adapted to address these issues  Sometimes, new theories will need to be undertaken  And, let’s not forgot our own biases and how they interplay with existing bias in theories 33 Multicultural/Social Justice Focus

34. © 2016. Cengage Learning. All rights reserved.  Theory and the ACA Code  Counselors should only practice in an area for which they have been trained  Importance of Using theory that is based on sound scientific evidence  Obtaining supervision so that counselors practice at their optimal levels 34 Ethical, Professional, and Legal Issues

35. © 2016. Cengage Learning. All rights reserved.  Working effectively with all clients  Tarasoff Case and Foreseeable Harm  “Duty to warn”  Julea Ward v. Board of Regents of Eastern Michigan University (EMU)  Counselor referral of client in same sex relationship  Sexual Orientation Change Efforts  Conversion and Reparative Therapy 35 Ethical, Professional, and Legal Issues

36. © 2016. Cengage Learning. All rights reserved.  Embracing a Theory but Open to Change  Theory development is an ongoing process  Be open to changing your approach throughout your career  How do you think your approach might change? 36 The Counselor in Process