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Couseling Notes 2010

School of Social Work, Marian College

Kuttikkanam

Counseling Notes Counseling Introduction

Session 1

Definitions

Counseling is an interactive processconjoining the counselee who needsassistance and the counselor who is

assistance

Perez,1965

Counseling is that interaction which

Occurs between two individuals calledcounselor and client

Is initiated and maintained to facilitatechanges in the behavior of client

Pepinsky & Pepinsky (1954)

Process involving interpersonal

relationships between a therapist and oneor more clients by which the former

systematic knowledge of the human

personality in attempting to improvemental health of the latter

Patterson (1959)

Counseling is a process by which the

structure of the self is relaxed in the safetyof the clients relationship with the

,experiences are perceived and then

integrated into an altered self Rogers (1952)


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Counseling is a learning oriented process, carried on ina simple, one to one social environment, in which the

counselor, professionally competent in relevantpsychological skills and knowledge, seeks to assist theclient by methods appropriate to latter's needs and within

,how to put such understanding into effect in relation tomore clearly perceived, realistically defined goals to theend that the client may become happier and moreproductive member of society Gustad (1953

Psychotherapy: Definition

Psychotherapy is a set of techniques intended to

cure or improve psychological and behavioralproblems in humans. The commonest form ofpsychotherapy is direct personal contactbetween therapist and patient, mainly in the formof talking. Because sensitive topics are oftendiscussed during psychotherapy, therapists areexpected, and usually legally bound, to respectpatient privacy and client confidentiality.

Psychotherapy is term used to describe a varietyof different talking therapies used to treatpsychological disorders. Psychotherapy involvestalking to a licensed professional during ascheduled series of appointments. It has provento be effective in treating different psychologicaldisorders, and can be combined with drugtherapy to treat all degrees of disorders.

A treatment by psychological means, of problemsof an emotional nature in which a trained personestablishes a professional relationship with thepatient with the object of (1) removing,

, ,mediating disturbed patterns of behavior, and (3)promoting positive personality growth anddevelopment. (Wolber, The Technique ofPsychotherapy, 1977).

Psychotherapy is a set of techniques used totreat mental health and emotional problems andsome psychiatric disorders. It helps the person

to understand and accept their strengths andweaknesses, as well as what makes them feelpositive or anxious. Identifying feelings and waysof thinking helps the person to cope withsituations they find difficult, and new ways ofapproaching them.

Psychotherapy is often used to deal with psychologicalproblems that have built up over a number of years. Thisrequires a trusting relationship between the person andthe psychotherapist, and treatment usually lasts for

months or sometimes years. Psychotherapy may becarre ou on an n v ua as s, as par o a group orwith your spouse or partner. Sessions are normallyhourly, each week or fortnight.

Psychotherapy is sometimes referred to as a 'talkingtreatment', as it is often based on talking to a therapist ora group of people who have similar problems.


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Counseling and PsychotherapyCounselingCounseling PsychotherapyPsychotherapy

Counselors,

pastoral couns,couns psycholo etc.

Practiced by psychiatrist, Clinical

Psychologist and Psy. Social Worker

Aims at better Aims at creating personalitypersonal adj. change/restructuring personality

Often for treatment

Shorter duration Longer in duration and number ofsessions

Practiced indifferent settings

Mostly in medical/clinical setting

Counseling and Psychotherapy

Similarities: uses Similar approaches and techniques

Objective for assisting clients

Further reading:Rao, S.N. (2002). Counselling and Guidance. New Delhi: Tata Mc

Graw Hill Publishing Company Ltd. pp. 24-32

SIMILARITIES &

DIFFERENCES INCOUNSELING &

Characterized byCharacterized bywords likewords like

EDUCATIONALEDUCATIONAL

PREVENTIVEPREVENTIVE Characterized by wordsCharacterized by words

--

PROBLEMPROBLEM--SOLVINGSOLVING

RECONSTRUCTIVERECONSTRUCTIVE

SEVERE EMOTIONALSEVERE EMOTIONALPROBLEMSPROBLEMS

REMEDIATIONREMEDIATION

LONGLONG--TERMTERM

EVERYDAY NORMALEVERYDAY NORMALPROBLEMS LIKEPROBLEMS LIKE

ADJUSTMENTSADJUSTMENTS

SCHOOL ANDSCHOOL AND

Characterized byCharacterized bywords likewords like

PROBLEMSPROBLEMS

Terms:Terms:

COUNSELORCOUNSELOR

CLIENTCLIENT

DYSFUNCTIONSDYSFUNCTIONS

CLINICAL PROBLEMSCLINICAL PROBLEMS

PATIENTPATIENT

THERAPISTTHERAPIST


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DIFFERENCES AND SIMILA RITIESGUIDANCE & COUNSELING PSYCHOTHERAPY

1. Concentrates on

helping normal

individual

1. People with

emotional,

Psychologicaldisturbance

2. To assist young

people with adjustment

problem

2. With behavioral/

mental disorder

(psychogenic origin)

3. Concerns withvocational areas,academic problems,interpersonal,educational, marital,personal, and socialadjustments

3. With total personalitystructure

G U I D A N C E & C O U N S E L I N G PSYCHOTHERAPY

4. Helps the person toadjust to a situation

5. A Relationship toimprove restoreadjustments orfunctioning

4. PsychologicalProcedures,Psychoanalysis,Play Therapy,BehaviorModification

Counselors:* Give, interpret psy

tests, interview,observe

* Offer practicalapproaches in

Psychotherapists:*Treat specific

mental or emotionaldisorder

*Usually apsychiatrist,

resolving a problem

* Mostly in schools

* Not necessarilytrained in doctoral

level

clinical psychologist

*Trained underdoctoral level orPost-Doctoral

Counse l ing & Psychot herapy* Respect Clients as unique / worthyindividual, right to freedom of choice and

to self-determination

* No coercion / pressure

* Help person to take responsibility,restore self-esteem and functioning

Psychiatry

1. Psychiatry: The medical specialtyconcerned with the prevention,diagnosis, and treatment of mental

.

2. The branch of medicine that deals withthe diagnosis, treatment, and preventionof mental and emotional disorders.

Guidance

Assistance given to individuals in makingintelligent choices and adjustments

Makes people self dependent and self

directed through romotng ut zat on o ones own potenta

Performs a complimentary educationalfunction, assisting normal developmentand personal autonomy

Applied in educational systems

Ref: Rao, S.N. (2002). Counselling and Guidance. New Delhi: Tata Mc Graw Hill PublishingCompany Ltd. pp. 34-39


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Counseling Process

Session 2&3

Process -ARPIE

Fuster, J. M. (2002).Personal Counselling.

Mumbai: BetterYourself Books.

Preparatory Stage: Attending

First Stage: Responding

Second Stage: Personalizing

Third stage: Initiating

Subsequent Stage: Evaluating

Preparatory Stage: Attending

AttitudesAttitudes SkillsSkills

RespectGenuinenessEmpathy

Social skillsAttendingPhysicallyObservingListening

First Stage: Responding

Attitudes

Respect

Genuineness

Empathy

Skills

Responding to content

Responding to feeling

Responding to questions

Concreteness

Self Disclosure

Making summaryresponses

End the stage with a neatsummary of the dominantfeeling and their reasonsand get it checked by the

counselee

Attitudes

All of first stage

Confrontation

Skills

Personalizing theproblem and goal

together

Second Stage: Personalizing

Third stage: Initiating

Attitudes

All the above

Skills

State the goal clearly

Identify appropriate

steps to reach the goal Formulate the first

step


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Subsequent Stage:Evaluating

Attitudes

All the above

Skills

Evaluate afterimplementation andmodify plan of actionbased on feedback

Sustain motivation

Phases of Counseling

Relationship building Phase

Exploration and understanding phase Problem Solving Phase

Termination and Evaluation Phase

Yeo,Anthony.(1993). Counselling a Problem Solving Approach. Boa Vista: APECA publications inIndia.

Problem Solving Steps

Problem definition

Attempted Solutions

Desired changes

Intervention plan

Yeo,Anthony.(1993) pp.107-148

Five Stage Model

1. Preparation

2. Assessment

3. Contracting

4. Engaging

5. Terminating

Adapted fromCarroll, Michael.,(1996). Workplace Counseling: As systematic Approach to Employee

Care.London: Sage Publications. pp 102-137

A Problem Solving Approach toCounseling (Five-Stage Model)

Five Stage Model

Steps in Counseling Process

Stage 1: Awareness of need for help

Stage 2: Relationship building

Stage 3: Expression of feelings &Clarification of problem

Stage 4: Exploration of deeper feelings

Stage5: Synthesis &Integration client

potentialities and direction ofneeds to goals


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Stage 6:Focusing on the present and

understanding the past Stage 7: Awareness/insight of the problem

Stage 8:Generalising gains to the day today life

Rao, S.N. (2002). Counselling and Guidance. New Delhi: Tata Mc Graw HillPublishing Company Ltd pp.122-124

STAGE ONE

Forming rapport and gaining the students

trust Assuring confidentiality and discussing

Allowing ventilation

Allowing expression of feelings

1

Exploring the problems), asking the clientto tell her story

Clarifying client expectations of counseling

1

Describing what the counsellors can offerand their method of working

Statement from the counsellor about their

STAGE TWO

Definition and understanding of roles,boundaries and needs

xp a n ng ro es an oun ar es o e

counselling relationship

Establishing and clarifying client goals andneeds

2

Prioritizing client goals and needs

Detailed history taking telling the story inspecific detail

Exploring client beliefs, knowledge andconcerns


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STAGE THREE

Process of ongoing supportive counseling

Continued expression of thoughts andfeelings

Identifying options

Identifying existing coping skills

3

Development of further coping skills

Evaluating options and their implications Enabling behaviour change

Supporting and sustaining work on clientproblems

3

Monitoring progress towards identifiedgoals

Altering plans as required

Referral as appropriate

STAGE FOUR4

Closure or ending the counsellingrelationship

Client acting upon plans

Client managing and coping with daily

functioning

Existence of a support system andsupports being accessed

4

Identification of strategies for maintenance

of change

Closure discussed and planned

Appointment intervals lengthened

4

Available resources and referrals identified

and accessed

Assurance provided to the client of the


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THE GATHER STEPS

G Greet clients in an open, respectfulmanner. Give them full attention. Talk in a

private place if possible. Assure the client ofconfidentiality. Ask the client how you can help,and explain what the clinic can offer in response.

A Ask clients about themselves. Payattention to what clients express with their wordsandtheir gestures and expressions. Try to putyourself in the clients place. Express yourunderstanding. Find out the clients knowledge,needs, and concerns so you can respondhelpfully.

T Tell clients about choices.

H Help clients make an informedchoice. Help the client think about what

situation and plans. Encourage the clientto express opinions and ask questions.Respond fully and openly.

E Explain fully how to use thechosen method.

R Return visits should be welcomed.

return for follow-up & always invite theclient to come back any time for any

reason.

Factors influencing Counselingprocess

Counselor variables

National Vocational GuidanceAssoc.

Interest in people

Patience Sensitiveness

Hamrin & Paulson

Understanding Sympathetic attitude

Friendliness

Sense of humor Stabil it y

mot ona sta ty Objectivity

Patience

Objectivity

Sincer ity Tact

Fa irness Tolerance

Neatness calmness

Mowrer(1951)

Personal maturity

Counselling Skills


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Counseling Introduction

Role Play 1

Team of three Counselor, counselee, observer

ocus on e eg nnng o e counse nginterview (first session)

Ask

the counselor put the client at ease?

the counselor introduced herself? the counselor assured confidentiality and

discussing limits of confidentiality

The Counselor Allowed free expression of theproblem/ask the client to tell her story

The counselor allowed expression of feelings

Clarifying client expectations of counseling

Rate : Excellent (5)- Poor (0)

Role Play 2nonverbal skills

Team of three

Counselor, counselee, observer

Focus on the nonverbal communication of thecounselin interview

SOFTEN

Smiling

Open Posture

Forward Lean

Touching

Eye to eye contact

Nodding

Verbal following skills

Furthering

Paraphrasing

Closed ended and open ended questions Seeking concreteness

Providing and maintaining focus

summarizing

Furthering

Minimal prompts I see, yes, then what

etc

Accent responses repeating certain

tone


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Paraphrasing

Use fresh words to restate the clients

message concisely

Seeking concreteness

Clients tends to generalize issues

Making the clients responses specific Used for

Clarifying the meaning of vague or unfamiliarterms

Explore basis of conclusions drawn by clients

Help to personalize statements

Elicit specific feelings

Explore details

Importance of verbal and nonverbalcommunication

Nonverbal communication

ys ca atten ng

Nonverbal communication facialexpression

Desirable

Direct eye to eye contact

Warmth and concernreflected in facial

Undesirable

Avoidance of eye contact

Eye level above or lowerthan the clients

expresson

Eyes at same level asclients

Appropriate facialexpressions

Occasional smiles

Lifting eyebrow critically

Nodding headexcessively

Frozen or rigid facialexpressions

Inappropriate slight smile

Pursing or biting lips

Nonverbal communication posture

Desirable

Arms and handsmoderately expressive,appropriate gestures

Body leaning slightly

Undesirable

Rigid body posture, armstightly folded

Body turned at an angle

to clientforward, attentive butrelaxed

Fidgeting with hands

Squirming or rocking inthe chair

Slouching or placing feeton desk

Hand or fingers overmouth

Pointing finger foremphasis

Nonverbal communication voice

Desirable

Clearly audible but notloud

Warmth in tone of voice

Undesirable

Mumbling or speakinginaudibly

Monotonic voice

Voices modulated toreflect nuances of feelingand emotional tone ofclients messages

Moderate speech tempo

Halting speech

Prolonged silences

Excessively animatedspeech

Slow or rapid speech

Consistent clearing ofthroat

Speaking loudly


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Nonverbal communication physical proximity

Desirable

3-5 feet betweenchairs

Undesirable

Excessive closenessor distance

Role Play 3Listening skills

Team of three

Counselor, counselee, observer Focus on the listening and summarizing

SOLER

Sit Squarely

Open posture

Leaning forward

Etec

Relaxed

Empathy

Very good empathic response

Good

Moderate

Slight

No empathy

Situation 1

Woman to marital conselor

I cant make up my mind whether to get divorc or not.There are so many things to consider. Also I am scared ofbeing my own

Counselor Responsea e , ow ong you een marre an are t ere any c reninvolved

b) Youre undecided about divorce since there are so manyangles, including yours fears of being alone

c) Youre too frightened to get divorced at the moment

Situation 2

My firm is making me redundant. Im 45 andshould be at the height of my career. It reallyhurts

ResponseA) youre angry at the way you are treated

B) youre wallowing at self pity at this moment

C) youre in a lot of pain because you have beenmade redundant when you should be at yourpeak


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Situation 3

When things get on top of me I get this craving.Its like I simply must have a fix to get somehappiness and relief

Response

) av ng a x s your way o cop ng w t psy pa n

B) you feel compelled to have a fix when life getstoo much for you

C) when you feel vulnerable and overwhelmeddrugs seem the only way out

Restating content

My husband was a fine man.His

unexpected death was a great shock. I stillmiss him terribly

Restating content 2

My mother says do this. father says dothat. I really dont know where I stand

The professional ethics to beheld in counseling

1.Confidentiality

2.Respecting the right of Privacy

3.Respecting the gender identity of the Client

4. Respecting the Profession

5. Acce tin the Client

6. Unnecessary probing

7. An appropriate time and place

8. Prolonging the counseling sessions

9. Respecting the freedom

10.Unnecessary dependency


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Dual relationships

Guidelines for ethical and legalpractice

Aware of own needs how needs influence

clients Should have training and experience

Res onsibilit for a ro riate stands in ethicaldilemma

Theoretical framework of behavior change

Client is primary

Continuous learning and updated knowledge

Discuss limits of confidentiality

Know boundaries of competence

Should become models Rational Emotive therapy

RET/REBT

Proposed by Albert Ellis

Emphasized the role of thinking in humanbehavior

Basic Concepts

Propositions

People are born with a potential to be rational(self constructive) as well as irrational (self

destructive Peoples tendency to irrational thinking ,self

damaging habituations wishful thinking areformed from their culture and families

Humans perceive, think, emote and behavesimultaneously


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RET do not believe in warm relationships as

necessary condition for making change ratherbelieve in active directive therapeutic process

Uses variety of techniques such as role playing,assertion training, desensitization, humor,suggestion etc.

RET asserts that insights often do not lead tomajor personality change

RET think beyond the S- R ideology

ABC Concept Ellis (1989)

Activating Event Belief Consequence

Disputing Effect New Feeling

Therapy process

Goal: decrease clients self defeatingoutlook and to acquire more realistic,

tolerant hiloso h of life

Therapist uses a rationalizationapproach in assisting the client

Techniques

Continuum used for assessing theemotions and feelings of the client ( help inestablishing a baseline)

Personal discovery challenges the clientto do selected self help exercises thathelp achieve deep seated cognitivechange

Self Exploration

REBT self help form

Positive Self talk Triple column technique

Automatic thought

Cognitive distortion

Rational response

Humor

Confronting

Unconditional positive self- regard

Forceful coping statements Analogies and images


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Rational Self Analysis

Client Centered Therapy

Client Centered Therapy

Proposed by Carl R Rogers (1902-1987)

Based on humanistic view

Also called human centered therapy

Central Concepts

The growth potential of any individual willtend to be released in which the helpingperson is experiencing and communicating

, ,nonjudgmental understanding

Central Concepts

IT - THEN hypothesis

IF certain conditions are present in theattitudes of the person designated therapist in

a relationshi namel con ruence ositiveregard, and empathetic understanding, THENgrowthful change will take place in the persondesignated client

Basic Concepts

Inner resources of client could be brought

out through basic optimism

( belief that individuals know their need and

True understanding of clients subjectiveexperiences


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Trust in the constructive directional flow

toward the realization of each individualspotential

Necessary core conditions for facilitating

client growth and change Empathy

Warm regard

Accepting the clients world as the clientperceives and values it-

reduces the resistance of the client and

encoura es ersonal rowth

provides positive sense of self worth and, personaldirection and

a capacity to take personal risks

Self Concept persons perceptions andfeelings about self ( Rogerian Therapy Focuses onaltering the self concept)

Incongruence between self andexperience ( (private world of the individual )

The nature of relationship is viewed as thekey element in creating positive change

Therapy Process

Conditions for the therapy to occur

The client and therapist should be in psychologicalcontact

The client must be experiencing some anxiety,vulnerability or incongruence

The client must receive the or experience theconditions offered by the therapist

The therapist must create a nonthreateningatmosphere of acceptance and genuine caring

The therapists role is NONDIRECTIVE

Techniques

Empathy

Congruence consistency in thought andbehavior transparent, authentic,

genu ne and honest Warm regard/Positive regard


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Techniques Contd.

Setting the therapeutic environment

Confirmation of confidentiality Consent

Active listening

Reflection

Restate content

Characteristics of a fullyfunctioning Person

Openness to all experiences

No defenses used to distort experiences Self concept congruent with experiences

Unconditional positive regard for themselves

Enjoys others because of reciprocal positiveregard

Socially effective and approved by significantothers

Adlerian Therapy

Corey,Gerald.(1986).Theory and Practice of Counseling andPsychotherapy. California: Brooks/Cole Publishing House

Adlerian Therapy Focus

Importance of the feelings of self (ego)that arise form interactions & conflicts

Sense of self(ego) central core of

Ego = core individuality of person

Start from Psychoanalysis

Emphasis on motivation & socialinteraction

Alfred Adlers IndividualPsychology

A phenomenological approach-subjectiveperception of reality

Personality as a unity, an invisible whole Behavior purposeful and goal directed - - Birth order and sibling relationships Therapy as teaching, informing and

encouraging Basic mistakes in the clients private logic The therapeutic relationship a collaborative

partnership

Adlers IndividualPsychology

Based on the unique motivations ofindividuals

Importance of each persons perceived

niche in society Importance of goal directness of human

nature teleological aspect

Concern with social conditions-need totake preventive measures to avoiddisturbances in personality


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The PhenomenologicalApproach

Adlerians attempt to view the world from

the clients subjective frame of reference How life is in reality is less important than howthe individual believes life to be

It is not the childhood experiences that arecrucial ~ It is our present interpretation ofthese events

Unconscious instincts and our past do notdetermine our behavior

Social Interest

Adlers most significant and distinctive concept

Refers to an individuals attitude toward andawareness of being a part of the humancommunity

Mental health is measured by the degree towhich we successfully share with others and areconcerned with their welfare

Happiness and success are largely related tosocial connectedness

Role of Birth Order

Motivates later behavior:

First-born: favored, only, pseudo-parent-high achievers

Second-born: rivalry & competition

Last-born: more pampered, baby-creative, rebellious, revolutionary, avant-garde

Birth Order

Adlers five psychological positions:

1. Oldest child ~ receives more attention,spoiled,center of attention

2. econ o on y two ~ e aves as n arace, often opposite to first child

3. Middle ~ often feels squeezed out

4. Youngest ~ the baby

5. Only ~ does not learn to share or cooperatewith other children, learns to deal with adults

Encouragement

Encouragement is the most powerfulmethod available for changing a personsbeliefs

Hel s build self-confidence and stimulatescourage

Discouragement is the basic condition thatprevents people from functioning

Clients are encouraged to recognize thatthey have the power to choose and to actdifferently

Complexes

Inferiority Complex: normal feelings ofincompetence and exaggerates them-impossible to to achieve goals-hopeless

Superiority Complex: very high opinionof self-bragging and quick to arguepersonal solutions to problems are rightone-convince others of being valuable tothem and to self


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Kuttikkanam 2

Other Adler Concepts

Organ Inferiority: everyone is born

with some physical weakness-motivate life choices

Aggression Drive: reaction toperceived helplessness orinferiority-lashing out against theinability to achieve or master

More Adler Concepts

Masculine protest: Kids work to becomeindependent from and = adults & people

in power-autonomous-positive assertive

Perfection striving: people who are notneuro ca y oun o an n er or ycomplex spend their lives trying to meettheir fictional goals.

Elimination of their perceived flaws

as if philosophy

Gives motivation and focus

More Adler Concepts

Social Responsibility &Understanding-social issues

Occupational tasks-career-self-worth

Societal task-creating friendships-ne wor s

Love tasks-life partner

Positive & Goal Oriented Humanity-people striving to overcome weaknessesto function productively-contributing tosociety

Adlers PersonalityTypology

Adlers Types GreekHumors

Greek Types SocialInterest

Activity

Ruling-Dominant Yellow Bile Cholericirritable

Low High

Getting-Learning Phlegm PhlegmaticLethargic

Low Low

Avoiding Black Bile Melancholicbrooding

Very Low Low

Socially Useful Blood Sanguinecheerful

High High

How an Adlerian does Therapy

Comprehensive Assessment using: Family Constellation-questionnaire-social

world assessment

Early Reflections-single incidents fromchildhood

Lifestyle Assessment-develop targets fortherapy by identifying major successes andmistakes in the clients life

What Clients do in Therapy

Explore private logic-concepts about self,

others, & life philosophy lifestyle isbased

symptoms and basic mistakes associatedwith their coping

Learning how to correct faultyassumptions & conclusions


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Kuttikkanam 2

Client Therapist Relationship

Relationship based on mutual trust,

respect, confidence, & alignment of goals Collaborative relationship

Develop a therapeutic contract-goals for

therapy

Emphasis of responsibility of client for hisor her own behaviors

Therapeutic Techniques &Procedures

Establishing the Relationship

Exploring the psychological dynamicsoperating in the client-assessment

Encouraging development of self-

understanding-insight into purpose

Helping client make new choices-reorientation & reeducation

1. Establishing Relationship

Therapist get to know the client as aperson

Collaborate on goals for therapy

uppor ve erap s -car ng umanconnection

Therapist works to make client feel deeplyunderstood and accepted

Client focuses on what needs to changed

in therapy

2. Exploring IndividualsDynamics

Subjective interview Client tells own story as expert on own life

Therapist listens for clues to clients coping andapproach to life

,what would you do differently, if you did not have thissymptom or problem?

Objective interview ~ Life Style Assessment Family constellation

Early Recollections

Personality Priorities

Integration and Summary

3. Encouraging Self-Understanding & Insight

Insight = understanding of motivations thatoperate in clients life

Client-disclosure & Therapist-interpretation

Therapist interpretations offered in open-endedmanner to: Make unconscious process conscious

Confront resistance so to help client & therapist toalign

Explore purposes of symptoms, feelings, behaviors &human difficulties or blocks

4. Helping with Reorientation &Reeducation

Encouragement process to build

courage to change to overcomediscouragement-personal growth is

Change and search for new possibilities

Making a difference-through change in

behavior, attitude or perception


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Kuttikkanam 2

Where Adlerian Approaches areApplied

Education

Parent Education-Children the Challenge-Rudolph Dreikurs & Soltz, 1964

Marriage Counseling

Family Counseling

Group Work

Reality Therapy

Introduction

William Glasser

Individuals are responsible for theirbehavior

Therapy aim at creating more responsible

behavior

Basic needs

Power (which includes achievement and feelingworthwhile as well as winning).

Love & Belonging (this includes groups as wellas families or loved ones).

Freedom (includes independence, autonomy,your own 'space').

Fun (includes pleasure and enjoyment).

Survival (includes nourishment, shelter, sex).

Behavior is for fulfilling these needsBehavior is for fulfilling these needs

Characteristics

Existential-phenomenological orientation People are moved by inner forces

Perceive world in the background of our needs

Behavior is the result of choices

Control theory All living organisms constantly act to control the world

around them acco. to some purpose within them

Behavior is the control of our perceptions

Concepts

Rejection of the medical model Neurosis and psychosis as behaviors

attempted to control the external world

Success Identit and ositive addiction Persons with success identity have strengths

Positive addiction as psychological strength

Emphasis on responsibility

De-emphasis on exploration of past

De-emphasis on transference


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Kuttikkanam 2

Therapeutic Process

Helping individuals to be emotionally

strong Helps individuals to achieve autonomy

GOALS OF REALITY THERAPY

The basic goal of reality therapy is to help

individuals meet their psychological needsfor belonging, power, freedom, and fun.

These goals are met in such a way thatthey do not infringe on the needs ofothers.

The focus is on responsibility and choices.

Therapist Roles

Focus on clients strengths, attributes, andpotentials that can lead to success

Pinning down

Confrontation

Therapeutic Techniques andProcedures

Assist client to develop a success identity1. Create a relationship

2. Focus on current behavior

3. Invite clients to evaluate their behavior

4. Help clients to develop an action plan

5. Get commitment

6. Refuse to accept excuses

7. Refuse to use punishment

8. Refuse to give up

Action Plan

Simple and clear

Short and able to be broken into smallunits

Something the client will do

Dependent on what the client does

Specific, what, when, where, how often

Repetitive, daily

immediate

REALITY THERAPYSTRATEGIES

Reality therapists do not emphasize specific techniques. However, they are more likely to use some techniques than

others. Because of the focus on exploring and evaluating behavior,

reality therapists are likely to ask many questions.

when talking to clients. Because much of reality therapy focuses on making plans and

commitment to them, using humor and being positive can behelpful in encouraging clients.

Confrontation helps therapists deal with clients when they donot follow up on plans.

Paradoxical techniques are ways to help clients when they maybe resistant to carrying out plans.


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Kuttikkanam 2

QUESTIONING

Questions can be used to help clients

explore their wants, needs, andperceptions.

They are also good approaches tounderstanding how the client thinks, togather information, to giving informationand making sure its understood, and inhelping clients take more effective control.

BEING POSITIVE

Reality therapists take many opportunities toreinforce the constructive planning of theirclients and their success in following through onthe plans.

Reality therapists may turn negative occurrencesinto positive ones by taking advantage ofopportunities to communicate hope to clients.

METAPHORS

When clients talk, they sometimes usemetaphors such as When I got caught,the whole world fell apart.

Therapists listen to those metaphors andrespond to the metaphor such as, Whathappened when the world fell apart?

HUMOR

Because humor is spontaneous andidiosyncratic, it can only occur at themoment so that it can fit in naturally.

Humor is a part of friendly involvement astherapists can sometimes laugh atthemselves which encourages clients todo the same.

CONFRONTATION

When clients dont follow through on

plans, confrontation is unavoidable.

Not accepting excuses, being positive, andusing humor can be ways of confrontingclients.

PARADOXICAL TECHNIQUES

When clients are reluctant to carry out plans or resistmaking plans, sometimes paradoxical techniques can beused.

They are among the most difficult techniques for- .

Reframing the way clients think about a topic can helpthem believe a previously undesirable behavior isdesirable. (like spitting in the clients soup)

Another paradoxical technique is to prescribe a symptomsuch as telling an anxious person to schedule timeswhen they are anxious.


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Kuttikkanam 2

ProcedureWDEP- Robert Wubbolding

W = Want

D = Direction and DoingE = Evaluation

P = Planning

W = Want

Clarify clients wants: their quality worldQuestions:

What do you want that you are getting?

What do you want that you are not getting?

How will you know whether you are getting it or

not?

D = Direction and Doing

Overall direction and specific actions that

occurred recently

Questions:

Where are you heading?

What are your recent successes? Recent

challenges?

What have you tried so far?

E = Evaluation

Getting clients to evaluate their behavior

Questions

Is what you are doing helping you?

Is it working?

P = Planning

Characteristics of good plans: SAMIC

S = Simple A = Attainable

M = Measurable

I = Immediate

C = Controllable

Existential Therapy


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Kuttikkanam 2

Existential Therapy

Defined as an attitude that transcends

orientation (May, Angel, & Ellenberger,1958), a dynamic therapy that addresses

, ,

practically any antideterministicpsychotherapy (Edwards, 1982)

Existential Therapy Is a diffuse school of theorists and

practitioners more aligned in their

philosophical emphasis than in technique orpractical consequences

More of a philosophy of therapy than asystem of therapy.

Many American clinicians have assembledthe many strands of the philosophy into acoherent clinical approach (Rollo May, JamesBugental and Irving Yalom)

Existential TherapyPhilosophical/Intellectual Approach to Therapy

BASIC DIMENSIONS ~ OF THE HUMANCONDITION

The capacity for self-awareness

The tension between freedom & responsibility

The creation of an identity & establishingmeaningful relationships

The search for meaning

Accepting anxiety as a condition of living

The awareness of death and nonbeing

The Capacity for Self-Awareness

The greater our awareness, the greater ourpossibilities for freedom

Awareness is realizing that:

We are finite - time is limited

We have the potential, the choice, to act ornot to act

Meaning is not automatic - we must seek it

We are subject to loneliness,meaninglessness, emptiness, guilt, andisolation

Freedom and Responsibility

People are free to choose among

alternatives and have a large role inshaping personal destinies

become are result of our choices

People must accept responsibility for

directing their own lives

Identity and Relationship

Identity is the courage to be ~ We must trust ourselvesto search within and find our own answers

Our great fear is that we will discover that there is nocore, no self

Aloneness ~ we must tolerate being alone with self-musthave a relationship with self

Struggling with identity-trapped in doingmode to avoidexperience of being

Relatedness ~ At their best our relationships are basedon our desire for fulfillment, not our deprivation

Relationships that spring from our sense ofdeprivation are clinging, parasitic, and symbiotic


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Kuttikkanam 2

The Search for Meaning

Meaning ~ like pleasure, meaning must bepursued obliquely

Finding meaning in life is a by-product of acommitment to creating, loving, and working

e w to mean ng s our pr mary str v ng

Life is not meaningful in itself; the individualmust create and discover meaning

Goals deal with

Discarding old values

Coping with Meaninglessness

Creating new meaning

Anxiety A Condition of Living

Anxiety-arises from strivings to survive &maintain own being

Existential anxiety is normal - life cannot belived, nor can death be faced, without anxiety

nxety can e a st muus or growt as webecome aware of and accept our freedom

We can blunt our anxiety by creating theillusion that there is security in life

If we have the courage to face ourselves andlife we may be frightened, but we will be ableto change

Awareness of Death &Nonbeing

Awareness of death is a basic humancondition which gives significance to living

We must think about death if we are tothink si nificantl about life

If we defend against death our lives canbecome insipid & meaningless

We learn to live in the now, one day at atime-results in zest for life & creativity

Ultimate Concerns

1. Freedom

2. Death

3. Isolation

4. Meaninglessness

Goals of Existential Therapy

1. Help clients be more aware of themselves

2. Face defense mechanisms3. Engage in action that is based on the

authentic purpose of creating a worthyexistence.

Existential TherapeuticTechniques

1) Write their eulogy

2) Imagine their own death3) Focus on the loss of another, milestones

or major life events

4) Self-imposed isolation

5) Engagement

6) Who Am I


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Kuttikkanam 2

Who Am I Exercise

Write down ten phrases that best describewho you are

Order them in terms of priority and

centrality to yourself

Cross out each description, beginning withthe least central one

Reflect

Write Your Own Obituary

Write Your Own Obituary during the next48 hours

Existential Theory ofPersonality

Uncomfortable with the term personality

Seems to be a fixed set of traits

Existence is an emerging and becoming process

Existence occurs not only for the individual but

Existence = being-in-the-world

Person and environment are an active unity

Reject dualism of mind-body, and experience andenvironment

Existential Theory ofPersonality

Being and world are inseparable because they arecreated by the individual

Phenomenologically, the world we relate to is ourown construction

We exist in relation to three levels in the world

Umwelt- equates to the physical and bio aspects

Mitwelt-social world or being-with-others

Eigenwelt-own world, the way we reflect upon,evaluate, and experience ourselves (being-for-oneself)

In the process of creating a healthy existence,we are faced with dilemma of choosing the bestway to be in-nature, with-others, and for-

ourselves Best alternative is to be authentic which is its own

reward

An authentic existence brings with it anopenness(awareness) to nature, to others, and toourselves. Also brings spontaneity with others with nofear that we might contradict what we pretend to be

Authentic existence brings integration with others, notconflict

Tillich talked about existential anxiety Awareness that we, at some unknown time, must die,

bein im lies nonbein

Conscious beings We make choices and are alone responsible

Meaninglessness is another contingency ofhuman existence that produces anxiety. Sourcesof meaning can disappear and be replaced


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Kuttikkanam 2

The conclusion that ones existence is totally absurdcan be immobilizing

Our isolation or fundamental aloneness also causesanxiety We share experiences with others but can never be them

Death reflects our finiteness, accidents reflect ourlimits of power, anxiety over decisions, inadequacy ofour knowledge, the threat of meaninglessness, thefiniteness of our values, isolation, the finiteness of ourempathy, and rejection the finiteness of control overothers

Gestalt Therapy

Introduction

Developed by Frederick Fritz Perls &Laura Perls

Focused on the awareness of environmentin the thera eutic rocess

Organisms primary inborn motives aretoward self preservation and actualizationof the self

People have inner wisdom to change fortheir own well being

Concepts

Awareness is considered as the primarygoal and tool

The therapy focuses on building awareness

take responsibility and control of self

Believe that once client becomes aware of theNOW , they are in a position to own their individualchoices

Done through allowing the client the opportunity to

Resistance to awareness things thatimpairs awareness

The NOW

Emphasis on the here and now the present

Anxiety is described as gap between now and

Why questions lead to rationalizations andself deceptions and encourage resistance topresnt


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Kuttikkanam 3

Unfinished business refers to

unexpressed feelings Persists till the individual faces and deals

Results into compulsive, self destructivebehaviors

Personality

The core of personality is seen as peeling

of individual layers of onion Five layers of onion

ony ayer reac ng o o ers nstereotypical and inauthentic ways

Phobic Layer avoiding the emotional painassociated with seeing ourselves the way wereally are

Impasse Layer the point where we are stuckin our own maturation

Implosive layer exposing our defenses andbeginning to make contact with our authenticselves

Explosive layer- releasing an enormousamount of energy as we let go of phony rolesand pretences

Therapeutic Process

Therapeutic Goals:

Move from environmental support to selfsupport

Attaining awareness of reality

Uses a series of EXPERIMENTS to create

awareness in the client

Experiments facilitate clients ability to deal

Experience the feelings associated withconflicts, ( not just talking about them)

Forms of experiments

Imagining a threatening future encounter

Setting up a dialogue between the clientand some significant person

Reliving in the present a particularly

profound early experience

Assuming the identity of ones father ormother in role playing


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Focusing on gestures, posture, and other

nonverbal signs of inner expression Carrying out a dialogue between

COUNSELOR SHOULD HAVEPERSONALLY EXPERIENCED THESEEXPERIENCES BEFORE DOING WITHCLIENTS

HELPS THE CLIENT IN THE HERE AND

NOW Uses the Gestalt process make client

,

Techniques

The dialogue exercise empty chair or chairexercise helps in building awareness of

various sides of conflicts

Substitute Phrase

Exaggeration helps to exaggerate then

emotions expressed by the client

Making the rounds

Guided fantasy

Playing the projection

counseling notes 2010 -6slide [compatibility mode]

Documents