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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the Transparency
Wadsworth Group, a division of Cengage Learning, Inc.
Theory and Practice of Counseling
and Psychotherapy
Chapter 1
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Introduction
n The author’s perspective:
u No single model can explain all the facets of human experience
• Eleven approaches to counseling and psychotherapy are
discussed
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Theory and Practice of Counseling and Psychotherapy - Chapter 1 (1)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Where Corey Stands
n He is strongly influenced by the existential approach and so
believes:
u Clients can exercise freedom to choose their future
u The quality of the client/therapist relationship is key
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 1 (2)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Where Corey Stands (2)
n He believes:
u “…counseling entails far more than becoming a skilled technician”
• Who you are as a therapist is critical
• Students should experience being a “client” and feel anxiety
over self disclosure, and learn to model courage and growth
u It is not “sufficient to be merely a good person with good intentions”
• Also essential are a knowledge of counseling theory and
techniques, theories of personality, and supervised experiences
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 1 (3)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Suggestions for Using the Book
n Relate readings to your own experiences
u Reflect on your own needs, motivations, values, and life experiences
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 1 (4)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Case of Stan (Chapter 16)
n As you read about Stan ask yourself:
u What themes in Stan’s life merit special attention?
u What techniques and methods would best meet these goals?
u What characterizes the relationship between Stan and his therapist?
u How might the therapist precede?
u View the DVD or online program entitled “Theory in Practice: The Case
of Stan” for each chapter.
u Read the section on each theory chapter that deals with counseling
Stan from the various theories.
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Theory and Practice of Counseling and Psychotherapy - Chapter 1 (5)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Therapeutic Relationship
n The therapeutic relationship is an important component of effective
counseling
n Research shows that both the therapy relationship and the therapy
used contribute to treatment outcome
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 1 (6)
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the Transparency
Wadsworth Group, a division of Cengage Learning, Inc.
Theory and Practice of Counseling
and Psychotherapy
Chapter 2
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Effective Counselor
n The most important instrument you have
is YOU
u Your living example of who you are and how you struggle to live
up to your potential is powerful
n Be authentic
u The stereotyped, professional role can be shed
u If you hide behind your role the client will also hide
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 2 (1)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Counseling for the Counselor
n In your experience of being a client you can:
u Consider your motivation for wanting to be a counselor
u Find support as you struggle to be a professional
u Have help in dealing with personal issues that are opened through your
interactions with clients
u Be assisted in managing your countertransferences
n Corey believes that“...therapists cannot hope to open doors for clients that
they have not opened for themselves.”
n Research shows that many therapists who seek personal counseling find it:
u Personally beneficial
Transparency
u Important for their professional development
n Find ways to manage value conflicts between you and your clients
Transparency
n Begin therapy by exploring the client’s goals
Theory and Practice of Counseling and Psychotherapy - Chapter 2 (3)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Multicultural Counseling
n Become aware of your biases and values
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Theory and Practice of Counseling and Psychotherapy - Chapter 2 (4)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Multicultural Counseling (2)
n Study the historical background, traditions, and values of
your client
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Theory and Practice of Counseling and Psychotherapy - Chapter 2 (5)
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Issues Faced by Beginning Therapists
n Achieving a sense of balance and well-being
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n Developing healthy helping relationships with clients
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Theory and Practice of Counseling and Psychotherapy - Chapter 2 (7)
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the Transparency
Wadsworth Group, a division of Cengage Learning, Inc.
Theory and Practice of Counseling
and Psychotherapy
Chapter 3
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Professional Ethics
n Ethics codes are a fundamental component of effective counseling:
u Guidelines that outline professional standards of behavior and
practice
u Codes do not make decisions for counselors
u Counselors must interpret and apply ethical codes to their
decision-making
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 3 (1)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Ethical Decision Making
n The principles that underlie our professional codes
u Benefit others, do no harm, respect other’s autonomy, be just, fair and
faithful
Transparency
u To the degree it is possible, include the client in your decision making
process
Theory and Practice of Counseling and Psychotherapy - Chapter 3 (2)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Informed Consent
n Clients need enough information about the counseling process to be
able to make informed choices
Transparency
u Supervision
u Privileged communication
u Limits of Confidentiality
Theory and Practice of Counseling and Psychotherapy - Chapter 3 (3)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Limits of Confidentiality
n Confidentiality is essential but not absolute
u Exceptions:
• Duty to Warn (Tarasoff Case)
– The client poses a danger to self or others
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 3 (4)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Multicultural Issues
n Biases are reflected when we:
u Neglect social and community factors to focus unduly on
individualism
u Assess clients with instruments that have not been normed on
the population they represent
u Judge as psychopathological – behaviors, beliefs, or
experiences that are normal for the client’s culture
u Strictly adhere to Western counseling theories without
considering its applicability to the client’s diverse cultural
background
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 3 (5)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Assessment and Diagnosis
n Assessment is an ongoing process designed to help the counselor
evaluate key elements of a client’s psychological functioning
u Assessment practices are influenced by the therapist's theoretical
orientation
u Requires cultural sensitivity
u Can be helpful in treatment planning
Transparency
u Counselors debate its utility in understanding the client’s subjective world
u Can be helpful in treatment planning
Theory and Practice of Counseling and Psychotherapy - Chapter 3 (6)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Evidence-Based Practices
n Strengths
u Counselors use treatments that have been validated by empirical research
u Treatments are usually brief and are standardized
u Are preferred by many insurance companies
u Calls for accountability among mental health professionals to provide effective
treatments
n Criticisms
u Some counselors believe this approach is mechanistic and does not allow for
individual differences in clients
u Is not well-suited for helping clients with existential concerns
u It is difficult to measure both relational and technical aspects of a psychological
treatment
u Has potential for misuse as a method of cost containment for insurance companies
Transparency
instead of a method of efficacious treatment for clients
Transparency
u Can I recognize and manage professionally my attraction to my client?
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Structure of Personality
n THE ID—The Demanding Child
u Ruled by the pleasure principle
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 4 (1)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Conscious and Unconscious
Conscious:
What’s on the surface
i.e. logic, reality
Unconscious:
What lies deep,
below the surface
Transparency
i.e. drives, instincts
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 4 (3)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Anxiety
n Feeling of dread resulting from repressed feelings, memories and
desires
u Develops out of conflict among the id, ego and superego to control
psychic energy
n Reality Anxiety
n Neurotic Anxiety
n Moral Anxiety
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 4 (4)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Ego-Defense Mechanisms
n Ego-defense mechanisms:
u Are normal behaviors which operate on an unconscious level and tend
to deny or distort reality
u Help the individual cope with anxiety and prevent the ego from being
overwhelmed
u Have adaptive value if they do not become a style of life to avoid facing
reality
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 4 (5)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Development of Personality
n ORAL STAGE First year
u Related to later mistrust and rejection issues
Transparency
n GENITAL STAGE Ages 12-60
u Sexual energies are invested in life
Theory and Practice of Counseling and Psychotherapy - Chapter 4 (6)
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Transference and Countertransference
n Transference
u The client reacts to the therapist as he did to an earlier significant other
• This allows the client to experience feelings that would otherwise be
inaccessible
• ANALYSIS OF TRANSFERENCE — allows the client to achieve insight into
the influence of the past
n Countertransference
u The reaction of the therapist toward the client that may interfere with
objectivity
• Not always detrimental to therapeutic goals; can provide important means
of understanding your client’s world
• Countertransference reactions must be monitored so that they are used to
Transparency
promote understanding of the client and the therapeutic process.
n Interpretation
u Therapist points out, explains, and teaches the meanings of whatever is
revealed
n Dream Analysis
u Therapist uses the “royal road to the unconscious” to bring
unconscious material to light
Transparency
u Latent content
u Manifest content
n Analysis of Resistance
u Helps the client to see that canceling appointments, fleeing from
therapy prematurely, etc., are ways of defending against anxiety
• These acts interfere with the ability to accept changes which could lead
to a more satisfying life
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 4 (9)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Application to Group Counseling
n Group work provides a rich framework for working through
transference feelings
u Feelings resembling those that members have experienced toward
significant people in their past may emerge
u Group members may come to represent symbolic figures from a client’s
past
Transparency
n Projections experienced in group provide valuable clues to a client’s
unresolved conflicts
Transparency
n Lengthy treatment may not be practical or affordable for many clients
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Alfred Adler’s Individual Psychology
n Based on the holistic concept
n A phenomenological approach
Transparency
n Basic mistakes in the client’s private logic
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Theory and Practice of Counseling and Psychotherapy - Chapter 5 (2)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Social Interest
n Adler’s most significant and distinctive concept
u Refers to an individual’s attitude toward and awareness of being a part
of the human community
u Embodies a community feeling and emphasizes the client’s positive
feelings toward others in the world
u Mental health is measured by the degree to which we successfully
share with others and are concerned with their welfare
u Happiness and success are largely related to social connectedness
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 5 (3)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Lifestyle
n A life movement that organizes the client’s reality, giving meaning
to life
u “fictional finalism” or “guiding self ideal”
u Psychiatric symptoms are “failed attempts” at achieving our lifestyle
u Adlerian therapy helps clients to effectively navigate lifestyle tasks
Transparency
u Makes all our actions “fit together”
n Superiority Feelings
u Promote mastery
u Enable us to overcome obstacles
n Related Complexes
Transparency
u Inferiority Complex
u Superiority Complex
Theory and Practice of Counseling and Psychotherapy - Chapter 5 (5)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Birth Order
n A concept that assigns probability to having a certain set of
experiences based on one’s position in the family
Transparency
to deal with adults
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 5 (7)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Four Phases of Therapy
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Theory and Practice of Counseling and Psychotherapy - Chapter 5 (8)
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Encouragement
n Encouragement instills self confidence by expecting clients to
assume responsibility for their lives and embrace the fact that they
can make changes
Transparency
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Application to Group Counseling
n Group provides a social context in which members can develop a
sense of community and social-relatedness
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 5 (10)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Limitations of the Adlerian Approach
n Adler spent most of his time teaching his theory as opposed to
systematically documenting it
u Hence, some consider Adlerian theory simplistic
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 5 (11)
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the Transparency
Wadsworth Group, a division of Cengage Learning, Inc.
Theory and Practice of Counseling
and Psychotherapy
Chapter 6
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Existential Psychotherapy
Transparency
u “Will I die alone?”
u “How am I going to get to where I want to be in my life?”
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (1)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Existential Therapy
A Philosophical/Intellectual Approach to Therapy
n BASIC DIMENSIONS OF THE HUMAN CONDITION
u The capacity for self-awareness
u The tension between freedom & responsibility
u The creation of an identity & establishing meaningful relationships
u The search for meaning
u Accepting anxiety as a condition of living
u The awareness of death and nonbeing
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (2)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Capacity for Self-Awareness
n The greater our awareness, the greater our possibilities for
freedom
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Theory and Practice of Counseling and Psychotherapy - Chapter 6 (3)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Identity and Relationship
n Identity is “the courage to be”– We must trust ourselves to search
within and find our own answers
u Our great fear is that we will discover that there is no core, no self
u Being existentially “alone” helps us to discover our authentic self
Transparency
u Balancing aloneness and relatedness helps us develop a unique identity
and live authentically in the moment
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (4)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
The Search for Meaning
n Meaning– like pleasure, meaning must be pursued obliquely
u Finding meaning in life is a by-product of a commitment to creating,
loving, and working
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (5)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Anxiety – A Condition of Living
n Yalom’s four givens of existence create anxiety
Transparency
in life
u If we have the courage to face ourselves and life we may be frightened,
but we will be able to change
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (6)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Goals of Existential Psychotherapy
n Helping clients to accept their freedom and responsibility to act
n Encouraging clients to recognize the ways in which they are not living fully
authentic lives
Transparency
n Assisting clients in developing a deep understanding of themselves and the
ways they can effectively communicate with others
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (7)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Relationship Between Therapist and Client
n Therapy is a journey taken by therapist and client
u The person-to-person relationship is key
u The relationship demands that therapists be in contact with their own
phenomenological world
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (8)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Application to Group Counseling
n Provides an ideal environment for therapeutic work on responsibility
u Clients are responsible for their behavior in group
u Group settings provide a mirror of how clients may act in the world
u Through feedback members learn to view themselves through another’s eyes
u Members learn how their behavior affects others
Transparency
u Learning to experience anxiety as a reality of the human condition
u Making choices in the face of uncertainty
u Discovering there are no ultimate answers for ultimate concerns
Theory and Practice of Counseling and Psychotherapy - Chapter 6 (9)
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Limitations of Existential Psychotherapy
n The individualistic focus may not fit within the world views of clients from
a collectivistic culture
n The high focus on self-determination may not fully account for real-life
limitations of those who are oppressed and have limited choices
n The approach may prove difficult for clients who experience difficulty
conceptualizing or have limited intellectual capacities
Transparency
difficult to standardize
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Person-Centered View of Human Nature
Transparency
move forward and fulfill their creative nature
n Challenges:
u The assumption that “the counselor knows best”
u The validity of advice, suggestion, persuasion, teaching, diagnosis,
and interpretation
u The belief that clients cannot understand and resolve their own
problems without direct help
u The focus on problems over persons
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 7 (2)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Person-Centered Therapy
n Emphasizes:
u Therapy as a journey shared by two fallible people
u The person’s innate striving for self-actualization
u The personal characteristics of the therapist and the quality of the
therapeutic relationship
u The counselor’s creation of a permissive, “growth-promoting” climate
u People are capable of self-directed growth if involved in a therapeutic
relationship
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 7 (3)
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Therapy is a Growth-Promoting Climate
n Congruence
u Genuineness or realness in the therapy session
u Therapist’s behaviors match his or her words
Transparency
u Helper attitudes are more important than knowledge
• The therapist need not experience the situation to develop an understanding of it from
the client’s perspective
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 7 (5)
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The Therapist
n Focuses on the quality of the therapeutic relationship
n Can openly express feelings and attitudes that are present in the relationship
with the client
Transparency
n Is invested in developing his or her own life experiences to deepen self-
knowledge and move toward self-actualization
Theory and Practice of Counseling and Psychotherapy - Chapter 7 (6)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Application to Group Counseling
n Therapist takes on the role of facilitator
u Creates therapeutic environment
u Techniques are not stressed
u Exhibits deep trust of the group members
u Provides support for members
u Group members set the goals for the group
Transparency
change alone and grow from the support of group members
n Individuals explore new facets of the self and uncover insights that transform
them, creating wholeness
u Discovery of wholeness leads to understanding of how we relate to the outer world.
Transparency
n The client’s inner world and outer world become unified.
n A non-judgmental setting
n Empathy
n Psychological freedom
Transparency
n Safe, creative environments give clients permission to be authentic and to
delve deeply into their experiences
n Does not focus on the use of specific techniques, making this treatment
difficult to standardize
Transparency
n Limits of the therapist as a person may interfere with developing a genuine
therapeutic relationship
Theory and Practice of Counseling and Psychotherapy - Chapter 7 (10)
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the Transparency
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Theory and Practice of Counseling
and Psychotherapy
Chapter 8
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Gestalt Therapy
n Existential & Phenomenological – it is grounded in the client’s
“here and now”
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Principles of Gestalt Theory
n Holism:
u The full range of human functioning includes thoughts, feelings, behaviors, body,
language and dreams
n Field theory:
u The field is the client’s environment which consists of therapist and client and all that
goes on between them
u Client is a participant in a constantly changing field
Transparency
n Organismic self-regulation:
u Emergence of need sensations and interest disturb an individual’s equilibrium
Theory and Practice of Counseling and Psychotherapy - Chapter 8 (2)
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The Now
n Our “power is in the present”
u Nothing exists except the “now”
u The past is gone and the future has not yet arrived
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Unfinished Business
n Feelings about the past are unexpressed
u These feelings are associated with distinct memories and fantasies
u Feelings not fully experienced linger in the background and interfere
with effective contact
n Result:
u Preoccupation, compulsive behavior, wariness oppressive energy and
self-defeating behavior
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 8 (4)
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Contact and Resistances to Contact
n Contact
u Interacting with nature and with other people without losing one’s
individuality
Transparency
• Retroflection
n The experiment
Transparency
n Process-oriented diagnosis
Theory and Practice of Counseling and Psychotherapy - Chapter 8 (6)
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Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Therapeutic Techniques
n The experiment in Gestalt Therapy
n Rehearsal exercise
n Reversal technique
n Exaggeration exercise
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n Making the rounds
n Dream work
Theory and Practice of Counseling and Psychotherapy - Chapter 8 (7)
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Application to Group Counseling
n Encourages direct experience and action
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n Group leaders actively engage with the members to form a sense of
mutuality in the group
Theory and Practice of Counseling and Psychotherapy - Chapter 8 (8)
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Limitations of Gestalt Therapy
n The approach has the potential for the therapist to abuse power by
using powerful techniques without proper training
n This approach may not be useful for clients who have difficulty
abstracting and imagining
n The high focus on emotion may pose limitations for clients who
have been culturally conditioned to be emotionally reserved
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 8 (9)
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the Transparency
Wadsworth Group, a division of Cengage Learning, Inc.
Theory and Practice of Counseling
and Psychotherapy
Chapter 9
Learning
Gerald Corey
nBrooks/Cole,
division of
nCengage
nby
nA
Wadsworth Group, a division of Cengage Learning, Inc.
Copyright © 2009 Wadsworth Group. Brooks/Cole is an imprint of the
Behavior Therapy
n A set of clinical procedures relying on experimental findings of
psychological research
u Based on principles of learning that are systematically applied
• Treatment goals are specific and measurable
u Focusing on the client’s current problems
• To help people change maladaptive to adaptive behaviors
u The therapy is largely educational - teaching clients skills of self-
management
Transparency
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Exposure Therapies
n In Vivo Desensitization
u Brief and graduated exposure to an actual fear situation or event
n Flooding
u Prolonged & intensive in vivo or imaginal exposure to stimuli that evoke high
levels of anxiety, without the opportunity to avoid them
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Four Aspects of Behavior Therapy
n 1. Classical Conditioning
u In classical conditioning certain respondent behaviors, such as knee
jerks and salivation, are elicited from a passive organism
n 2. Operant Conditioning
u Focuses on actions that operate on the environment to produce
consequences
• If the environmental change brought about by the behavior is
reinforcing, the chances are strengthened that the behavior will
occur again. If the environmental changes produce no
reinforcement, the chances are lessened that the behavior will
recur
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Four Aspects of Behavior Therapy
n 3. Social-Learning Approach
u Gives prominence to the reciprocal interactions between an individual’s
behavior and the environment
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Functional Assessment of Behavior
n A-B-C model
u Antecedent(s)
u Behavior(s)
u Consequence(s)
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Therapeutic Techniques
n Relaxation Training – to cope with stress
Transparency
n Self-Management Programs – “giving psychology away”
Transparency
n Acceptance and Commitment Therapy - learning acceptance and non-
judgment of thoughts and feelings as they occur
Theory and Practice of Counseling and Psychotherapy - Chapter 9 (7)
Application of Behavior Therapy to Group
n Leaders
u use a brief, directive, psychoeducational approach
u conduct behavioral assessments
Transparency
u devise a specific treatment plan to help each member meet goals
u objectively measure treatment outcome
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Limitations of Behavior Therapy
n Heavy focus on behavioral change may detract from client’s experience of
emotions
n There is potential for the therapist to manipulate the client using this
approach
Transparency
n Some clients may find the directive approach imposing or too mechanistic
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Theory and Practice of Counseling
and Psychotherapy
Chapter 10
Learning
Gerald Corey
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Rational Emotive Behavioral Therapy
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The Therapeutic Process
n Therapy is seen as an educational process
n Clients learn
u To identify the interplay of their thoughts, feelings and behaviors
u To identify and dispute irrational beliefs that are maintained by self-
indoctrination
u To replace ineffective ways of thinking with effective and rational
cognitions
u To stop absolutistic thinking, blaming, and repeating false beliefs
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View of Human Nature
n We are born with a potential for both rational and irrational thinking
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The A-B-C Theory of Personality
n A
B C
n activating belief consequence
n event
D E F
disputing effective New feeling
intervention philosophy
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Irrational Ideas
n Irrational ideas lead to self-defeating behavior
n Some examples:
u “I must have love or approval from all the significant people in my life.”
u “If I don’t get what I want, it’s terrible, and I can’t stand it.”
Transparency
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Application of CBT to Group Counseling
n Tailored for specific diagnoses such as anxiety, panic, eating
disorders and phobias
Transparency
n Heavy emphasis on psychoeducation and prevention of symptoms
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Aaron Beck’s Cognitive Therapy (CT)
n Insight-focused therapy
n Theoretical Assumptions
u People’s internal communication is accessible to introspection
u Clients’ beliefs have highly personal meanings
u These meanings can be discovered by the client rather than being
taught or interpreted by the therapist
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Theory, Goals & Principles of CT
n Basic theory:
u To understand the nature of an emotional episode or disturbance it is
essential to focus on the cognitive content of an individual’s reaction to the
upsetting event or stream of thoughts
n Goals:
u To change the way clients think by using their automatic thoughts to reach
the core schemata and begin to introduce the idea of schema restructuring
n Principles:
u Automatic thoughts: personalized notions that are triggered by particular
stimuli that lead to emotional responses
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CT’s Cognitive Distortions
n Arbitrary inferences
n Selective abstraction
n Overgeneralization
n Personalization
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n Labeling and mislabeling
n Polarized thinking
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Beck’s Cognitive Triad
n Pattern that triggers depression
2. Selective Abstraction
u Client interprets life events through a negative filter
u “The world is a negative place where bad things are bound to happen
to me”
Transparency
3. Client holds a gloomy vision of the future
u “The world is bleak and it isn’t going to improve”
Theory and Practice of Counseling and Psychotherapy - Chapter 10 (10)
Donald Meichenbaum’s Cognitive
n Premise:
u As a prerequisite to behavior change, clients must notice how they
think, feel, and behave, and what impact they have on others
n Basic assumption:
u Distressing emotions are typically the result of maladaptive thoughts
Transparency
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Meichenbaum’s CBM
n Self-instructional therapy focus:
u Trains clients to modify the instructions they give to themselves so that
they can cope
u Emphasis is on acquiring practical coping skills
n Cognitive structure:
u The organizing aspect of thinking, which seems to monitor and direct
the choice of thoughts
u The “executive processor,” which “holds the blueprints of thinking”
that determine when to continue, interrupt, or change thinking
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Behavior Change & Coping (CBM)
n 3 Phases of Behavior Change
u 1. Self-observation
u 2. Starting a new internal dialogue
u 3. Learning new skills
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Limitations of Cognitive Behavior Therapy
n Extensive training is required to practice CBT
Transparency
n Some clinicians think CBT interventions overlook the value of
exploring a client’s past experiences
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Reality Therapy Basic Beliefs
n Symptoms are the result of choices we’ve made in our lives
u We can chose to think, feel and behave differently
Transparency
n We act responsibly when we meet our needs without keeping
others from meeting their needs
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Basic Needs
n All internally motivated behavior is geared toward meeting one or
more of our basic human needs
u Belonging
u Power
u Freedom
u Fun
u Survival (Physiological needs)
Transparency
n Our quality world consists of our visions of specific people,
activities, events, beliefs and situations that will fulfill our needs
Theory and Practice of Counseling and Psychotherapy - Chapter 11 (2)
Procedures That Lead to Change:
n E
Evaluation - Does your present behavior have a reasonable
chance of getting you what you want?
n P Planning – “SAMIC3”
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Planning For Change
n S Simple - Easy to understand, specific and concrete
n A Attainable - Within the capacities and motivation
of the client
n M Measurable - Are the changes observable and helpful?
n I Immediate and Involved - What can be done today?
What can you do?
n C Controlled - Can you do this by yourself or will
you be dependent on others?
n - Can you do this on a continuous basis?
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Total Behavior
Our Best Attempt to Satisfy Our Needs
n DOING – active behaviors
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Application of Reality Therapy to Group
n In group, members explore new courses of behavior that will bring them
closer to getting what they want out of life
n Feedback from leaders and group members can help individuals design
realistic and attainable plans
Transparency
n Group setting encourages members to take an active stance in attaining
change in their lives
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Limitations of Reality Therapy
n Some feel it does not adequately address important psychological concepts
such as insight, the unconscious, dreams and transference
n There is a danger for the therapist of imposing his or her personal views on
clients by deciding for the client what constitutes responsible behavior
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n More empirical support is needed
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Theory and Practice of Counseling
and Psychotherapy
Chapter 12
Learning
Gerald Corey
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division of
nCengage
nby
nA
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Key Concepts of Feminist Therapy
n Problems are viewed in a sociopolitical and cultural context
n The client knows what is best for her life and is the expert on her
own life
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n It is assumed that individual change will best occur through
social change
n Clients are encouraged to take social action
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Four Approaches to Feminist Therapy
n 1. Liberal Feminism
u Focus
• Helping individual women overcome the limits and constraints of their
socialization patterns
u Major goals
• Personal empowerment of individual women
• Dignity
• Self-fulfillment
• Equality
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Four Approaches to Feminist Therapy
n 2. Cultural Feminism
u Focus
• Oppression stems from society’s devaluation of women’s strengths
• Emphasize the differences between women and men
• Believe the solution to oppression lies in feminization of the culture
• Society becomes more nurturing, cooperative, and relational
u Major goal
• the infusion of society with values based on cooperation
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Four Approaches to Feminist Therapy
n 3. Radical Feminism
u Focus
• The oppression of women that is embedded in patriarchy
• Seek to change society through activism
• Therapy is viewed as a political enterprise with the goal of
transformation of society
u Major goals
• Transform gender relationships
• Transform societal institutions
Transparency
• Increase women’s sexual and procreative self-determination.
Transparency
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Principles of Feminist Therapy
n The personal is political
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Goals of Feminist Therapy
n To affirm diversity and strive for social change and equality
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n To become personally empowered
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Intervention Techniques in Feminist Therapy
n Bibliotherapy
u Reading assignments that address issues such as
• Coping skills • Gender inequality
• Gender-role stereotypes • Ways sexism is promoted
• Power differential • Society's obsession
• between women and men with thinness
• Sexual assault
u Self-disclosure
• To help equalize the therapeutic relationship and provide modeling for
the client
• Values, beliefs about society, and therapeutic interventions discussed
Transparency
– Allows the client to make an informed choice
n Reframing
u Changes the frame of reference for looking at an individual's behavior
• Shifting from an intrapersonal to an interpersonal definition of a client’s
problem
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Intervention Techniques in Feminist Therapy
n Relabeling
u Changes the label or evaluation applied to the client's behavioral
characteristics
u Generally, the focus is shifted from a negative to a positive evaluation
n Social Action
u Encourages clients to embrace social activism
u Develops clients’ thorough understanding of feminism by building a
link between their experiences and the sociopolitical context they live in
Transparency
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Application of Feminist Therapy to Group
Transparency
n Provides a setting where clients learn to use power appropriately
by providing support for each other and taking social/political
actions
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Diversity in Feminist Approaches
n Postmodern feminists provide a model for critiquing both
traditional and feminist approaches
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examining women’s experiences across national boundaries
Transparency
n More empirical support is needed for this approach
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Theory and Practice of Counseling
and Psychotherapy
Chapter 13
Learning
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Constructivist Narrative Perspective
n Therapeutic task:
u Help clients appreciate how they construct their realities and how they
author their own stories
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Social Constructionism
n The client, not the therapist, is the expert
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Social Constructionism
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Key Concepts of Social Constructionism
n Postmodernists assume there are multiple truths
Transparency
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Key Concepts of
Transparency
n Emphasis is on constructing solutions rather than problem solving
Transparency
n
construct a solution
Transparency
n Questions can open up possibilities for clients to do something
different
Theory and Practice of Counseling and Psychotherapy - Chapter 13 (7)
Three Kinds of Relationships in
Transparency
Theory and Practice of Counseling and Psychotherapy - Chapter 13 (8)
Techniques Used in
n Exception questions
u (Direct clients to times in their lives when the problem did not exist)
n Miracle question
u (If a miracle happened and the problem you have was solved while you were
asleep, what would be different in your life?)
Transparency
n Scaling questions
u (On a scale of zero to 10, where zero is the worst you have been and 10 represents
the problem being solved, where are you with respect to __________?)
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Application of SFBT to Group Counseling
n Group is focused on solutions and the members’ ability to find solutions in
their own lives
n Group members can offer input and point out exceptions to problematic
situations in each others’ lives
Transparency
n Goals for therapy are small, realistic and achievable
n The person is not the problem, but the problem is the problem
Transparency
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The Therapeutic Process in
Transparency
n Create an audience to support the new story
Theory and Practice of Counseling and Psychotherapy - Chapter 13 (12)
The Functions of the
Transparency
n To create a collaborative relationship-- with the client being the senior
partner
Theory and Practice of Counseling and Psychotherapy - Chapter 13 (13)
The Role of Questions in
Transparency
n Questions can lead to taking apart problem-saturated stories
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Externalization
n Living life means relating to problems, not being fused with them
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Deconstruction and Creating
Transparency
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Application of Narrative Therapy to Group
Transparency
u Academic management
u An adventure-based program
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Limitations of Postmodern Approaches
n Therapists must be skilled in implementing brief interventions
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n More empirical research is needed
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The Family Systems Perspective
n Individuals– are best understood through assessing the
interactions within an entire family
n Problematic behaviors–
u Serve a purpose for the family
u Are a function of the family’s inability to operate productively
u Are symptomatic patterns handed down across generations
Transparency
n A family– is an interactional unit and a change in one member
effects all members
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Adlerian Family Therapy
n Adlerians use an educational model to counsel families
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Adlerian Family Therapy
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Multigenerational Family Therapy
n The application of rational thinking to emotionally saturated systems
u A well-articulated theory is considered to be essential
n Triangulation
u A third party is recruited to reduce anxiety and stabilize a couples’
Transparency
relationship
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Human Validation Process Model
n Enhancement and validation of self-esteem
n Family rules
n Sculpting
n Nurturing triads
Transparency
n Family mapping and chronologies
Theory and Practice of Counseling and Psychotherapy - Chapter 14 (6)
Human Validation Process Model
n Enhancement of self-esteem
u Family decisions are based on individual needs
n Encouragement of growth
u Differences are acknowledged and seen as opportunities for growth
Transparency
u Families have many spoken and unspoken rules
Transparency
and now in the family
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Structural Family Therapy
n Focus is on family interactions to understand the structure, or
organization of the family
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Structural Family Therapy
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Strategic Family Therapy
n Focuses on solving problems in the present
Change results when the family follows the therapist’s directions &
Transparency
n
change transactions
Transparency
stage to the next
Transparency
overlook the importance of extended family when working with
families from other cultures