MODULE 6: RECENT TRENDS IN THE COUNSELING PROCESS

MOST ESSENTIAL LEARNING OUTCOME:

At the end of this module, the students are able to:

 Address diversity issues relating to the counseling process

This section addresses three emerging trends that constitute paradigm shifts in conceptualizing the counseling
process. The first trend explores the role of emotions in the counseling process. For instance, emerging theories
of emotions, such as emotional balancing, can provide clients

Postmodern Trends
Postmodernism is an emerging trend in counseling that potentially may constitute a paradigm shift in
conceptualizing the counseling process. Bitter and Corey (1996) differentiate modern from postmodern in terms of
different ways of viewing reality. Modernists believe in an objective reality that is independent from the observer,
whereas postmodernists contend there is a subjective reality that varies contextually in relation to the observer.
The modernist position IS similar to behaviorist theory, which f6CQtses on overt mea'Q1iåble behavior, such state
of depression when a person has problems with sleep and appetite, loses interest in things that used to be fun,
and so forth. The postmodernist position parallels experiential theories, contending that people are depressed
when they experience depression as defined within the context of social—cultural forces such as language and
narratives internalized by the individual.
Constructivism and social constructionism are two psychological perspectives that have evolved from
postmodernism. Constructivism is primarily associated with cognitive behavioral approaches, and social
constructionism has become an important dimension of marriage and family. Gutterman (1996) contrasts
constructivism and social constructionism by noting that constructivists contend that knowledge is based on the
subjective cognitions of the individual, whereas social constructionists hold that reality is constructed from the
conversations of people.
The postmodern theoretical perspectives of constructivism and social constructionism appear to have more
similarities than differences. Both are concerned with issues relating to epistemology, "the theory of knowledge, or
how we know what we think and what we think we think" (Durrant, 1995, p. 3). The theories appear to suggest
that human experience is a highly individualized process based contextually on the interactions of cognition,
sociaI—cultural forces, language, and narratives. Knowledge and the concept of "truth" are therefore subjective
and generate the possibility of multiple realities best understood from a phenomenological perspective.
Postmodernists also emphasize the role that narratives and storytelling play in psychological functioning.
According to this theory, people are constantly constructing stories about their lives, creating "storied lives" (Bitter
& Corey, 1996).
The process of counseling and psychotherapy is therefore one of exploring life stories to gain insight into how
clients generate personal meaning. When necessary, counselors can help clients engage in narrative repair,
reauthoring life stories to help clients create opportunities to cope effectively and generate new meaning for life.
Other goals of counseling include helping clients generate solution-focused approaches to problem solving and
enhancing awareness of the effects of the dominant culture on human life (Bitter & Corey, 1996).
DIVERSITY ISSUES
An aspect of cultural diversity with great potential for integration into counseling is spirituality (including religion)
(Bishop, 1995). Spirituality can be broadly defined as "attunement with God, the Spirit of Truth, or the divine
intelligence that governs or harmonizes the universe" (Richards & Bergin, 1997, p. 77). This perspective
considers that all people recognize the spiritual (but not necessarily religious) realm of existence (Ingersoll, 1995).
Richards and Bergin (1997) refer to spiritual trends in counseling as the New Zeitgeist (spirit of our times), which
is reflected in the increased interest in the healing power associated with spirituality and holistic health (Richards
& Bergin, 2004; Witmer & Sweeney, 1995).
Historically, counseling and spirituality have to a large degree been kept separate. More recently, the counseling
literature is suggesting that spirituality is another form of diversity that should be carefully and sensitively
addressed to obtain an accurate understanding of a client's worldview (Bishop, 1995). Many people turn to
spirituality and religion for strength and support during times of crisis to derive meaning from life. This is especially
true for people as they get older (Smith, 1993). Miranti and Burke (1995) suggest that recognition of the spiritual
domain in counseling enables counselors to relate to the core essence of a client's being.
A number of individuals are beginning to provide a structure for how spirituality and religion can be integrated into
the counseling process (Ingersoll, 1995; Richards & Bergin, 1997). Ingersoll suggests that counselors should
attempt to recognize and affirm clients' concepts of spirituality, enter the clients' spiritual worldviews to gain a
phenomenological perspective, and consult with other "healers" in clients' lives as necessary. Richards and
Bergin (1997) provide extensive guidelines, such as assessment and intervention, for addressing spiritual issues
throughout the various phases of the counseling process. For example, spiritual forms of intervention can require
special training and may include such strategies as cognitive restructuring of irrational religious beliefs, methods
of fostering forgiveness, and meditation and prayer. The spiritual domain appears to possess a large but mostly
untapped potential in counseling. Additional theory, research, and practice will be necessary to facilitate a
meaningful incorporation of this important dimension into the counseling process.
In terms of exploring diversity in terms of multicultural issues, Day-Vines, Wood, Grothaus, Craigen, Holman,
Dotson-Blake, and Douglas (2007) suggest that counselors should take an active role. They refer to this process
as "broaching," implying that counselors should bring up the subjects of race, ethnicity, and culture to ensure they
are considered and addressed appropriately in counseling. Day-Vines et al. (2007) believe this position is
consistent with the multicultural competency, which suggests counselors acknowledge cultural factors in the
counseling relationship. Day-Vines et al. (2007) identified five ways counselors could "broach" multicultural issues
with clients. The degree of "broaching" is influenced by the counselor's level of racial identity development.
"Avoidant" represents one end of the spectrum—a counselor at level I of identity development (counselors not in
contact with their own identity development) who does not value the importance of exploring multicultural issues
with clients. "Infusion" represents the other end of the spectrum—a counselor who has developed a well-
formulated, autonomous identity who believes that exploring multicultural issues is an integral aspect of the
counseling process.
Liberation Psychology (Duran, Firehammer, & Gonzalez, 2008) is an example of a counseling approach that
requires counselors to actively explore multicultural issues with clients. This theory suggests that psychological
distress is the result of oppressive forces that wound the very soul of a people and culture. Liberation Psychology
involves identifying these wounds and metaphorically transforming and liberating clients through soul healing.
Counselors and clients explore the historical roots of oppression and how factors such as privilege reflected in the
worldview of counselors and the counseling profession can contribute to social injustice. Counselor awareness of
these multicultural issues can result in liberation of the oppressor and soul healing of the client.
MODULE 7: COMMON PROBLEMS FOR BEGINNING COUNSELORS

MOST ESSENTIAL LEARNING OUTCOME

At the end of this module, the students are able to:

 Identify problems of beginning counselors;

Problems are the roadblocks to the counseling process. The following roadblocks are:
1. Focusing on the first issue in a session – do not focus on the first problem the client presents in a
session, instead counselors can overcome this roadblock by first obtaining an overview of the client’s
concerns and then selecting a counseling goal with the client.

2. Overlooking Physical or Medical issues – it is important to conduct background check, i.e medical
history or history of alcohol or drug use

3. Wanting to Rescue Clients from their Unhappiness. Some beginning counselors have a naïve notion
that counseling is a process that makes clients happier. But counseling is also a process that requires the
client to take risks and have the courage to face difficult issues. For ex., a client may need to become

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 aware of personal inadequacies or self-defeating patterns of behavior. This can make a client feel
uncomfortable or sad and may
There are several ways that a counselor may rescue a client
a. Reassuring a client. Reassuring clients. When clients feel bad about their situation, the
counselor may be tempted to say, "Don't worry, things will get better." It is important, however, for
the counselor and client to have a realistic view of the counseling process. If the client does not
make necessary changes, things probably will not get better. In fact, the client's situation may
worsen.
b. Offering instant advice. When clients are uncomfortable with their situation, the counselor may
attempt to rescue the client by offering advice. In counseling, giving advice is usually
unproductive, can foster dependency, and can be a superficial solution to a complex problem.
c. Rescuing clients from intense emotions. Some beginning counselors tend not to allow clients
to experience any intense emotions. When clients express intense emotions such as anger or
grief, the counselor may want to calm them or get them to think about something else. This type
of rescuing prevents clients from getting in touch with and working through their feelings.

4. Having Perfectionist Tendencies. Some beginning counselors may have perfectionist tendencies. They
may fear making mistakes bad. These tendencies may cause several problems, including counselors
being reluctant to explore a new idea or technique for fear of not learning or using it correctly, avoiding
supervision because they believe seeking assistance might reflect their inadequacy, and being hesitant to
refer a client because they think a referral might imply they could not handle the situation. The following
Personal Note provides some suggestions for helping beginning counselors overcome perfectionist
tendencies.

A Personal Note (Nystul)

1 have found several ways to help counselors overcome perfectionist tendencies. First, counselors
should avoid absolutistic, or right-versus-wrong views of the counseling process. Once counselors realize
there is no right or wrong way of doing counseling, they can stop worrying about making mistakes. The
counseling-as-an-art model maintains a realistic, pragmatic view of counseling. It suggests that when the
client seems to be making progress, the counselor and client should continue using that counseling
approach. When the client does not appear to be making gains, the counselor and client should make the
necessary adjustments to the counseling process.

I identified the "monkey on the back" phenomenon as another way to help student counselors overcome
perfectionist tendencies. It is not productive to carry the monkey on one's back by trying to look perfect
while learning new counseling skills. I explain to students that a counselor training program is in some
ways like having a "monkey" put on their back. The "monkey"—instructions from the professor—may tell
students to do some things differently from what they would ordinarily do. For example, the instructions
might be to use open rather than closed questions during active listening.

When the "monkey" suggests that students stop to consider different ways of responding, they may feel
the "monkey" is interfering with their spontaneity. If they focus on having their professor perceive them as
spontaneous, they may avoid trying new behaviors. Unfortunately, these students will also not learn much
from their counseling program. I tell students that the feeling of the "monkey" interfering with their
spontaneity is a good sign. It indicates that they are trying some new skills and are in the process of
becoming a more effective counselor. In time, the new skills will become integrated into their natural way
of working with clients and their spontaneity will be restored.

5. Having Unrealistic Expectations

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 Some beginning counselors have unrealistic expectations for their clients. They may therefore become
frustrated when the client does not make steady progress. When a client has a setback and regresses to
old, negative patterns of behavior, counselors may feel they have failed the client. In time, the counselor
may project these negative feelings onto the client (Nystul, 1979b). The art-of-counseling model suggests
that counselors develop a balanced set of expectations, blending optimism with realism. These
expectations involve believing that clients can improve and realizing that change can take time.

6. Getting Carried Away with the Latest Technique

Some beginning counselors tend to get carried away after learning a new technique, wanting to use it with
all clients (Nystul, 1981). For example, after attending an extensive training program in hypnosis, a
counselor may believe that every client could benefit from hypnosis. This enthusiasm may continue for a
period of time until the counselor gets excited about another new technique. It is important for counselors
to get excited and be enthusiastic about their education. At the same time, they must learn to channel
these energies into a positive direction rather than imposing their current interest on the client.

7. Getting Lost in the Counseling Process

Clients often feel overwhelmed by issues when they begin counseling. Each time they come to a
counseling session; they may talk about many different concerns. They may describe these concerns in a
very interesting manner, and the concerns may begin to seem like an ongoing television soap opera.

As counselors hear these stories, they may find themselves taking a passive role. I call this the popcorn
syndrome (Nystul, 1981). It is as if counselors are eating popcorn at the movies, listening to their client's
latest struggle with life. Counselors who find themselves with the Popcorn syndrome usually enjoy the
counseling sessions, but they often have the feeling they are not accomplishing much. Mien this occurs,
counselors can feel lost in the ongoing storytelling. To overcome this problem, the counselor can focus
the counseling process by exploring with the client what has happened in counseling—where they have
been, what they are currently working on, and where they seem to be headed. Together they can make
the necessary adjustments for future sessions. If the popcorn syndrome is occurring, the counselor may
also want to create more of a sense of shared responsibility in the counseling process and work toward
clearer counseling goals.

8. Using Inappropriate Phrases

Although I contend there are no right or wrong ways to approach counseling, I believe that certain
phrases are usually inappropriate and unproductive in counseling. The following are three examples:

 "Why" questions. "Why" questions usually provoke a defensive response, causing people to
believe they need to justify their behavior. Instead of asking "Why did you and Tim break up?" the
counselor might ask, "Could you tell me what happened regarding your breakup with Tim?"

 I know how you feel. Counselors may use this phrase to show that they have been through a
similar situation and can therefore understand the client. Actually, no two people have exactly the
same reaction to a situation. For example, take the varied reactions to a house burning down.
One person might feel relief at the prospect of insurance money, whereas another might be
heartbroken because of losing priceless family mementos. A client may have negative reactions
to a counselor saying "I know how you feel." The client may think, "No, she does not. She is not
me. Who does she think she is?" Another client might react by thinking "If this counselor knows
how I feel, why bother exploring my feelings with him?"

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  Let me tell you what I would do. This phrase can lead to instant advice. As mentioned earlier,
advice-giving usually does not promote positive outcomes in counseling.

9. Having an Excessive Desire to Help

Many students are drawn to counseling because they truly want to help others. Wanting to help can be
beneficial to the counseling process because it communicates enthusiasm, desire, and caring. Some
counselors can have an excessive need to help, however, to the point of being overly invested in the
counseling process. A useful indicator that counselors may have gone too far in wanting to help is feeling
they are working harder than the client. Students should also explore their motives for wanting to become
counselors. A positive motive would be to enjoy helping a client overcome self-defeating forces to move
toward self-realization. A negative motive would be an excessive desire to feel needed by someone. This
desire could foster unnecessary dependency in the counseling relationship. Another negative motive
would be a need to feel power or control over others. 'l his need could lead to intimidating clients,
undermining their self •esteem, and fostering dependency'. counselors discover they have inappropriate
motives for providing counseling services. they should refer the client and seek counseling for
themselves.

10. Having an Excessive Need to Be Liked

Most people, including counselors, enjoy being liked. At times, however, the counselor may need to do
things that could make the client angry or unhappy, such as confronting the client. It is therefore not
necessary for the client always to like the counselor. Instead, it is essential to establish mutual respect to
maintain a rapport throughout the counseling process.

11. Getting Too Emotionally Involved

Some beginning counselors tend to get too emotionally involved with the counseling process. There can
be many reasons for developing this tendency. One is what I call the stray cat syndrome, which involves
counselors wanting to take responsibility for the client's welfare. counselors with this syndrome may tend
to want to go out of their way to help all living creatures—including stray cats—that appear to need
assistance. As a result, whenever they see a client suffering, they want to find a way to take away the
pain and fix things, leading to the rescuing process described earlier.

Counselors can become so emotionally invested in their clients that they lose professional objectivity.
They can also become emotionally exhausted and burned out. The art-of-counseling model suggests that
for counseling to be effective, the counselor must be affected. At the same time, counselors should not
assume ownership of the client's problems. They should instead help clients become capable of resolving
their own problems.

12. Taking Things Too Personally

Beginning counselors may take things too personally when a client expresses intense emotions. For
example, a client may react as if the counselor were another person with whom the client has had a close
relationship, for example, a father or mother figure. During this process of transference, the client may
become angry with the counselor. It would be inappropriate for the counselor to take this personally and
retaliate against the client. Instead, the counselor should view the transference as an important part of
therapy. Freudian psychoanalysis, for example, contends that transference is therapeutic in that it allows
the client to work through unresolved emotional trauma (Freud, 1969).

13. Having Difficulty Differentiating Between Normal and Abnormal

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 Beginning counselors often have a difficult time deciding whether clients suffer from some form of
psychopathology. For example, a counselor may wonder if a client is acutely suicidal and need:
hospitalization or mildly suicidal and only requires monitoring. Another dilemma may be differentiating a
clinical depression, such as a major depression, from a normal depressive reaction to life event relating to
the death of a loved one.

The reason some beginning counselors have trouble differentiating between .normal and abnormal may
be their lack of exposure to psychopathology. Student counselors may overcome this obstacle by taking
advantage of internships and other clinical placements during their education to obtain experience
working with clients who suffer from mental disorders.

14. Being Uncertain About Self-Disclosure

Another problem that beginning counselors commonly experience is determining how much they should
self-disclose. Although there are no hard-and4ast rules on this issue, the following suggestions may be
useful:

 Answer questions about yourself that you feel comfortable with—just answer the questions
without elaborating. Feel free to offer information about your professional qualifications. Be willing
to share immediate reactions to what is taking place in the session.

 Don't tell your life story to your clients—they are there to tell you their story, not listen to yours.
Don't say, "This is how I handled it." It could lead to ineffective advice-giving.

15. Being Uncertain About Confidentiality

Many beginning counselors are unclear about the limits of confidentiality. One of the most common
sources of confusion relates to the question "With whom can I discuss a client, and what information can I
disclose?" Some suggestions regarding this issue are: A counselor may discuss a case with a supervisor
or when required by law, such as reporting child abuse or neglect. It is also permissible to break
confidentiality when clients pose a serious threat in terms of harming themselves or others. It is not
appropriate to discuss a case with a secretary, friends, or family members, even if you change the name
of the client.

SUMMARY

A six-stage approach to counseling involves relationship building, assessment and diagnosis, goal
setting, intervention and problem solving, termination and follow-up, and research and evaluation.

Current trends in the counseling process, such as postmodernism and brief counseling, offer new ways of
conceptualizing the counseling process i f terms of narrative psychology, counseling as story-telling, and
brief-solution-focused approaches These counseling trends appear to offer specie promise for addressing
issues involved in multicultural counseling and managed care. Addressing diversity issues and the
emerging trends in counseling, such as taking into account spirituality and religion, offer much hope and
promise for enriching the counseling process.

Problems that beginning counselors experience include focusing only on the first issue in session,
overlooking medical issues, wanting to rescue clients, having perfectionist tendencies or unrealistic
expectations, getting carried away with the latest technique learned, getting lost in the counseling
process, using inappropriate phrases, having an excessive desire to help or to be liked, getting too

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 emotionally involved or taking things too personally, and being uncertain about psychopathology issues,
self-disclosure, or confidentiality.

Counseling is a process that varies in length and content according to the concerns of the client. In this
process, the client may appear to make some progress and then regress to self-defeating habits. When
things appear to be going wrong, the counselor, like a navigator on a ship, can adjust course. Counseling
may be considered successful when the overall direction of therapy is positive.

Reference(s):
Nystul, M. (2011). Introduction to Counseling, 4th Ed. NJ: Pearson

GRADED ACTIVITY
Instruction: Answer the following:
1. How would you assess your listening skills, and how can the listening skills facilitate your ability to
listen

2. Why is the phenomenological perspective important in listening?

3. What are some common problems of beginning counselors that you can identify with, and why might
these be issues for you?

ASSESSMENT: (thru schoology, sample only)

Identification: Identify the stage of the following counseling processes:
___________1. This stage is also known as the “intervention” stage
___________2. This stage answers the question “how will you know if your work helped this client?”

Reviewed and approved by:

Marilyn T. Alcala, LPT, PhD

Dean

VERSES OF THE WEEK

Theme: December Verses (Growing in Grace and Mercy)
Nov. 30- Dec. 4, 2020 “He has shown you, O man, what is good; and what does the Lord require of you
but to do justly, to love mercy, and to walk humbly with your God?” Micah 6:8.

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 Dec.7-11, 2020 “Be merciful, even as your Father is merciful.” Luke 6:36

MODULE 8: THEORIES OF COUNSELING

MOST ESSENTIAL LEARNING OUTCOMES
INPUT
I. Psychodynamic Counseling
Background
 Sigmund Freud launched the fields of counseling and psychotherapy.
 Freud's conception regarding the development of neurosis arose from his studies in hysteria and
hypnosis.
 Pleasure Principle: Human motivation is guided by the drive to seek pleasure.
 Other prominent contributors include: Carl Jung, Alfred Adler, Harry Stack Sullivan, Theodore
Reik, Anna Freud, Melanie Klein, Karen Horney and Eric Fromm.
 All of the aforementioned practitioners were at one time disciples of Freud but left to form their
own schools.
 Many psychoanalytic principles were incorporated into later developing theories.

Frame of Reference
 It is often presented as a “historical” approach.
 It has practical application for today.
 Influenced by the work of Sigmund Freud, out of which came many other prominent theories and
therapies.
Basic Constructs
 The associative process allows one to access unconscious material.
 Present mental functions can be explained by earlier experiences.
 Psychic continuity is a lifelong process.
 Mental life has meaning.
 Nothing is accidental.
 Instinct drives motivation.
Basic Constructs and Concepts
 Id, Ego, and Superego: The three parts of the personality.
 Ego Defense Mechanisms: Used by the ego to reduce anxiety associated with threatening
situations or feelings.
 Developmental stages (oral, anal, phallic, latency and genital).
 Id, Ego, Superego and intrapsychic conflicts: Psychological symptoms are self-defeating
patterns brought on by internal struggles.
 The past: Current problems stem from unresolved issues that occurred in early childhood.
 Dreams: Dreams are viewed as the gateway to the unconscious.
 Catharsis: The release of pent-up emotion.
 Corrective Emotional Experience: The therapist helps clients alter their self-perceptions and
behavior.

 The Pleasure Principle: The drive within us to reduce tension and seek pleasure.
 Instincts: Organic motivational forces, also called drives. There are two types of instincts: life
(libido) and death (thanatos).
 Identification: One form of identification is the incorporation of the qualities of another person into
one’s own personality. There are four types of identification: Narcissistic, goal-oriented, object-
loss, and authority.
 Displacement: The process whereby psychic energy from the instincts can be rechanneled from
one object to another.

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  Transference/countertransference: Transference is when the client’s feelings are directed toward
the therapist as though the therapist were the source of the feelings instead of someone from the
client’s past. Countertransference is when the therapists feelings are placed on the client.
 Free Association: When a client states whatever enters his or her mind without censure.
Theory of Personality
 Determinism: Mental events are not accidental or random but are related to earlier events.
 Topography: All mental elements are judged according to accessibility to consciousness.
 Dynamic Viewpoint: Libidinal and aggressive impulses are biologically based on drives.
 Genetic Viewpoint: Conflict, character traits, neurotic symptoms and psychological structures are
related to childhood events, wishes and fantasies.
Object Relations Theory
 Examines the relationship between and among people.
 Examines how the history of interpersonal relationships are transferred from the past to the
present through behavior.
 Looks at the primary caregiver (this is culturally defined and might be the mother, father,
grandparents, extended family or community.)
Self-Psychology Theory: Doesn’t just explore the past but also here-and-now issues. Defenses are
identified in a sensitive manner leading to greater ego strength and resilience.
John Bowlby
 Stresses the importance of the child developing in relation to context and environment.
 Provided theory of attachment.
 The child impacts the environment and the environment impacts the child.
 Attachment styles: Secure, anxious/resistant, anxious/avoidant.
 Securely attached children are able to successfully separate and individuate.
Psychodynamic Worldview
 Believes that the unconscious plays a role in both human development and psychological
problems.
 Client developmental history is an important consideration in understanding the individual.
 The people and relationships we have had are Important in our history
 We are unaware of our biological needs, past development of human relationships and cultural
influences and how those impact our present behavior.
 We constantly act out our developmental history and our unconscious biological drives.
 Counseling is aimed at helping the individual discover past influences on their present lives.
General Principles
 Help the person to tell his or her story.
 Establish a solid working alliance.
 Deal with resistance.
 Gather background information and history.
 Select the problem or issue to be worked on.
 Explore the precipitating events.
 Collaborate with the client to form a diagnosis and treatment plan.
 Increase the client’s awareness regarding defensiveness.
 Revisit resistance to interventions.
 Explore the client’s transference.
 Monitor the therapist’s countertransference.
 Examine how the past is impacting the present.
 Help the client behave more effectively.
 Provide feedback and confront discrepancies.
 Negotiate with the client regarding homework assignments.
 Remind the client of the termination date.
 End therapy as agreed upon with the client.
 Schedule follow-up as needed.

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Treatment Procedures
 Therapy is long-term and focuses on exploring unconscious issues through interpretation,
dream analysis, free association, transference and other methods.
 Detachment: The therapist is detached, objective and neutral so that the client can project
onto the therapist things from the client’s unconscious.
 Transference: Traditionally, transference is a projection of unconscious desires onto the
therapist.
 Countertransference: This are projections the therapist makes onto the client.
Multicultural Issues and Psychodynamic Counseling
 It has received a lot of criticism from women and minority groups because it tends to be seen as
male and elitist.
 Its beginning had sexist concepts such as “penis envy.”
 Historically, patriarchy, domination and lengthy treatment hold to oppressive views and patronage
by only the wealthy.
 Insight is not a highly valued concept in many cultures or lower socioeconomic statuses.
 Might be used to help women and minority groups learn how to present their concerns as related
to past histories of oppression and domination.
 Insight might be used with some clients to fuel new actions and behaviors and the concept of self
within a social and cultural context.
 Multicultural factors could be used in free association and the insight process.
Contemporary Developments
 Many contemporary psychoanalytic practitioners have abandoned many of Freud’s original tenets
(e.g. the couch).
 Therapy has become more brief.
 Sessions focus both on the past and on the present.
 Focus in on identified goals and not a entire restructuring of the personality.
 Contemporary psychoanalytic theories are especially helpful for borderline and narcissistic
personalities.
Limitations
 Might be tempting to do too much analysis and not enough working toward change.
 Amateurs apply it too readily without serious study.
 Transference and countertransference can be hard to deal with without training and awareness.
 Doesn’t take all the client’s needs into consideration. (e.g. sometimes clients have a need to be
alone or regress.)
 Psychoanalysis isn’t for everyone and it is still long in duration compared to more brief theories.
 The writings of some psychoanalytic theorists (Freud and Jung In particular) are technical and
hard to read.
II. Cognitive Behavior Therapy
Basic Tenets
 The main theories are Cognitive Behavior Therapy, Rational Emotive Behavior Therapy and
Cognitive Behavior Modification.
 The way individuals structure and interpret experiences, determines their moods and behaviors.
 Changing conceptualizations lies at the heart of cognitive behavioral therapy.
 Combines both cognitive and behavioral approaches.
 Cognitive therapy rests upon the belief that what one thinks determines how one feels.
 The therapist is supportive and empathic and uses experiments and empirical processes along
with a collaborative alliance with the client, to explore thinking and alternatives.
 Cognitive therapy has been used with a variety of disorders and problems (e.g. anxiety, phobias,
depression).
Theory of Personality
 Personality includes both genetic endowment and social influence.

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  It reflects the individual’s cognitive organization and structure.
 Emotions and behaviors are based on perceptions, interpretations, and assumptions.
 Schemas have an important impact on how one operates cognitively.
 Schemas: A person’s core beliefs and basic assumptions.
 Schemas can either be functional or dysfunctional and more than one schema can compete with
another.
 Cognitive Vulnerability: When a person’s beliefs and assumptions predispose him or her to
psychological distress.
Nature of Maladjustment.
 Maladjustment stems from irrational beliefs and distorted cognitions.
 Maladaptive cognitions come from:
 Selective attention
 Misperception
 Maladaptive focusing
 Maladaptive self-arousal
 Repertory deficiencies
 Maladaptive cognitions lead to maladaptive, self-defeating behaviors.
 Adaptive, self-enhancing behaviors come from a client’s self-enhancing thoughts and this can be
taught.
 Clients can be taught to shift from self-defeating thoughts to self-enhancing thoughts.
The Counseling Process
 Cognitive therapy and cognitive behavior modification uses a variety of techniques or procedures
to assist clients in changing negative, self defeating responses.
 The therapist might range from directive to unconditionally accepting, from scientific to empathic,
from systemic to open or from suggestive to instructive.
 It is highly eclectic and utilizes resources and techniques that fit with the client’s thought
processes.
 Both cognitive and behavioral strategies might be used.
 Client and therapist work together:
 to help the client gain cognitive and behavioral control over his or her problem.
 to look at different ways of behaving.
 to analyze thoughts and emotions.
 to practice new cognitive and behavioral patterns.
Strategies for Helping Clients
Beck’s cognitive psychotherapy
 The goals are to correct faulty information processing and help clients modify their assumptions
that maintain their maladaptive behaviors and emotions.
 Collaborative Empiricism: Therapist and client are co-investigators.
 Guided Discovery: Guided by the therapist, the client engages in experiments
that result in more adaptive ways of thinking.
Relaxation Training and Relaxation Therapy
 A person cannot be in a state of complete physical relaxation while at the same time be
emotionally anxious.
 Works well for stress, anxiety, physiological problems, workplace pressures, and coping with
modern lifestyles.
Mental and Emotive Imagery
 Mental Imagery is a process through which a person focuses on vivid mental pictures of
experiences or events—past, present or future.
 Emotive Imagery: It is a procedure where the client imagines the emotional sensations and
feelings of an actual situation or behavior.
 Cognitive Modeling: Identification of what maladaptive or bad thoughts or emotions the client
wishes to be rid of and then the therapist models with self-talk that the client will incorporate.

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  Covert Modeling: A client imagines engaging in the desired behaviors he or she wants to learn or
adopt.
 Thought Stopping: Interruption of unwanted thoughts when they occur by shouting “stop”
whenever the unwanted thought pops into consciousness.
 Cognitive Restructuring: Replacement of negative, maladaptive thoughts with positive, adaptive
ones.
 Reframing: To modify or restructure a person’s view or perception regarding a problem or
behavior.
 Stress Inoculation: A process of teaching clients both cognitive and physical skills for
autonomously coping with future stressful and distressing situations.
 Meditation and Relaxation: Helps the client concentrate on some internal or external stimulus
that serves to focus the client’s attention away from aversive stimuli.
 Biofeedback: Uses technology to communicate to a client what his or her own body is doing and
then allows that person to use mental processes to control bodily functions.
 Neurolinguistic programming: Using the client’s sensory language to fully experience the client’s
inner world (e.g. I see that (visual); I feel that (kinesthetic) ; I hear that auditory).
 Eye Movement Desensitization Reprocessing (EMDR):
 Used primarily to treat traumatic memories.
 The client imagines the scene, is aware of the negative statement regarding that scene
(along with noxious feelings), and then follows the therapist’s finger with his or her eyes.
 Then the client erases the image from his or her mind.
 This is continued over a series of steps until hopefully the painful image and noxious
feelings and memories are removed.
Advantages of Cognitive Behavior Therapy
 It has established human thought processes as data or events that can be studied.
 It validated a number of relaxation techniques.
 It has enhanced the rational therapies such as Rational Emotive Behavior Therapy.
 Uses the systematic scientist-practitioner model.
Disadvantages of Cognitive Behavior Therapy
 It has been harshly judged by feminists, multiculturalists and ecologists because it mirrors
masculine and Euro-American worldviews and does not adequately take culture into
consideration.
 It requires a lot of training and skill.
 The therapist needs to not only understand cognitive techniques but also have a vast
understanding of behavioral and learning theories.
 The therapist needs to have strong discipline and there is less tolerance for error.
Cognitive Behavior Therapy with Diverse Populations
 It matches problems to treatments without regard for race or cultural considerations.
 It can be used effectively if culture and the client’s worldview is take into consideration.
 Therapy is a collaboration and depends upon trust between counselor and client and this can
work well with culturally diverse clients.
III. Adlerian Theory
History of Adlerian Theory
 Inspired by Freudian psychoanalysis.
 Founded by Alfred Adler, championed in America by Rudolf Dreikurs.
 Dissemination throughout American elementary schools during the guidance movement by Don
Dinkmeyer.
Basic Tenets of Adlerian Theory
 Inferiority vs. superiority.
 Humans are constantly becoming.
 It is holistic and phenomenological .
 Society is viewed as teleological.

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  Adlerians are considered to be technical eclectives.
Theory of Personality
 The person is viewed as a unified organism.
 Humans are motivated by social interest.
 People want to belong.
 Life Tasks: Friendship, occupation, love, spirituality, understanding the individual self ( I and the
me).
Theory of Personality (Continued)
 Nomothetic Principles:
 The basic dynamic force is striving for a fictional goal—superiority.
 Successful adaptation to life depends upon the degree of social interest in goal striving.
 Goal striving may be considered active and can be considered according to type.
Theory of Personality (Continued)
 Fictional Goals: The outcome of unconscious notions that have no counterpart in reality.
 The are concerned with the future.
 They start early in life--as young as infancy.
 Fictional conceptualizations become the first goals of what will become lifestyle.
 Fictional goals are our attempt to belong and be significant in the eyes of others.
 Types of People
 Ruling: Is dominant in relationships.
 Getting: Is expectant and dependent.
 Avoiding: Shies away from problems.
 Driving: Is achievement oriented.
 Controlling: Likes order and certainty.
 Being victimized or martyred: Both like suffering.
 Being good: Likes being competent and better.
 Being socially useful: Cooperative and humble.
 Idiographic Principles

 Everyone has his or her own style of life

 Style of life is the overall pattern that affects a persons thinking, feeling and behaving.
 Perception guides behavior.

Nature of Maladjustment
 A person has a mistaken opinion of himself or herself and of the world.
 A person engages in abnormal behavior to protect his or her opinion of self.
 A person will do this when threatened with failure and insecurity.
 The person becomes self-centered rather than other-centered.
 The individual is unconscious of these events.
 Inferiority complex: The individual is overwhelmed by a sense of inadequacy.
 Family constellation: Mediates the genetic and constitutional factors brought by the child and the
cultural factors that influence the child.
 Safeguarding: Symptoms are developed for the purpose of safeguarding the fictional goal.

The Counseling Process

 The Client-Counseling Relationship: Collaborative, egalitarian, respectful and cooperative.
 Understanding the Client: How is the client behaving? What does the client gain from this
behavior? Why does the client do this in this manner?
 Assessment and Analysis: Family Atmosphere and Constellation, Birth Order, Early
Recollections, Dreams, and Priorities.
 Insight and Interpretation: Helps the client see his or her priority and ask whether or not the price
for achieving it is worth paying.

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  Reorientation: Counselor offers alternative ideas or beliefs for the client’s consideration.
 Prescribing New Behavioral Rituals: The client is assigned “homework” that engages him or her
in repetitive acts to reinforce the client’s new belief system, behaviors and rules of interaction.
Strategies for Helping Clients
 Restatement: Restating the client’s words to form clarity and convey understanding.
 Reflection: Restating the client’s words to give deeper meaning regarding the underlying feeling.
 Guesses, Hunches, Hypotheses: Making statements to explain what is happening.
 Questioning: To get a better understanding but also reframe the symptoms for the client.
 Interpretation: Takes guesses, hunches and hypotheses one step further. Focuses on the
“whys” of behavior.
 Nonverbal Behavior: Adlerians bring the client’s nonverbal behavior to the attention of the client
and interpret it.
 Immediacy: Dealing with what is in the here and now.
 Active Wondering: Proposes an alternative to the presenting problem.
 Confrontation: Pointing out discrepancies between what the client says and what the client does.
 Paradoxical Intention: Asking the client to amplify target behavior to show the client how
ridiculous it is.
 Creating Images: Asks the client to imagine a ridiculous scene as he or she enters into a
threatening situation.
 Asking “The Question”: “If your problem were to disappear overnight, how would things be
different?”
 Catching Oneself: Having the client catch himself or herself when engaging in irrational behavior.
 Acting As If: Acting out a role that the client thought impossible.
 Spitting in the Soup: Spoiling the game of the client.
 Encouragement: Promotes client self-awareness. Client’s aren’t sick but only discouraged.
 Midas Technique: Exaggerating the client’s neurotic demands.
 Pleasing Someone: Helps put the client back into society. The client is instructed to go out and
do something nice for someone else.
 Avoiding the Tar Baby: Acting contrary to what the client expects.
Advantages of Adlerian Theory
 It can be used for numerous issues and disorders.
 Uses encouragement.
 It is phenomenological.
 It does not consider people to be predisposed to anything.

Disadvantages of Adlerian Theory

 The amount of family and lifestyle information that is collected.
 Sometimes difficult to do the interpretations, especially the dreams.
 Adlerian therapy works best with highly verbal and intelligent clients. This might leave out many
people who do not fit that category.
 Might be too lengthy for managed care.
 Adlerians do not like to make diagnoses as it labels people.
Adlerian Theory and Diversity
 Adlerians were pioneers in multiculturalism.
 Adlerian relationships are equitable, cooperative, and empathic.
 Adlerian theory’s focus on inferiority is understanding of the disenfranchised.
 Adlerian theory can be used successful with many diverse groups.
IV. Behavioral Approaches
Development of Behavioral Approaches
 John Locke: Blank Slate
 John Watson: Learned Neuroses
 B. F. Skinner: Operant Conditioning

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  Ivan Pavlov: Classical Conditioning
Albert Ellis/Rational-Emotive Behavior Therapy (REBT)
Theoretical Constructs and Techniques
 Focuses on dysfunctional, irrational, unrealistic and distorted thoughts.
 Feelings and behavior are also addressed.
 Unconditional acceptance is important.
 Ellis also believed in authenticity.
 Clients are encouraged to think rationally.
 Philosophy and Beliefs
 Understanding belief systems is important.
 Belief systems are organized ways of thinking about reality.
 Belief systems affect one’s self-view.
 The language a client uses, will speak to their philosophy and belief system.
 Clients create their own emotional disturbances by believing in absolute and irrational beliefs.
 Clients can choose their belief system.
 Counselors can help clients by identifying irrational beliefs and helping the client find meaning in
their lives.

Identifying Irrational Thinking

 Helpless thinking is the result of irrational thinking.
 It usually includes “all or nothing” statements.
 It usually includes the words should, ought, never and must.
 Five common irrational or dysfunctional ideas:
“Life isn’t fair.”
“It’s awful.”
“I can’t stand it.”
“I must get what I want.”
“I’m incompetent.”

A-B-C-D-E-F
A = The activating event.
B = The irrational belief about the event.
C = The emotional consequence.
D = Disputing the irrational beliefs.
E = The emotional effect of disputing the belief.
F = New feelings and behavior.

Rational-Emotive Behavior Therapy and Multiculturalism

 The therapy fails to address contextual-situational factors that adversely impact client’s lives.
 REBT uses the ethnocentric approach to mental health care.
 Does not focus on the phenomenological experience of the client.
 Does not address the different ways irrational beliefs are manifested by the culturally different.
William Glasser/Reality Therapy/Choice Theory
The Basics
 Instead of seeking to change behavior, Reality Therapy works on changing awareness of
responsibility.
 Once responsibility is acknowledged by the client, it is then possible to work on behavior change.
 The locus of the decision is placed on the client.
 The Reality therapist might borrow skills, techniques or ideas from other theories if it benefits the
client.
 The Reality therapist will be himself or herself, use humor, sarcasm and confrontation in personal
ways to assist the client in greater understanding.

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  Role-playing, systematic planning, and teaching intentional living are all important in Reality
Therapy.
 The client has control over his or her life, choices and personhood.
 There is no need to explore a client’s past because the past is over and the client’s problems
occur in the present.
 Reality therapy puts the power into the client’s hands and shows the client how he or she can
help himself or herself.
 The client and counselor explores the client’s wants and needs.
 It focuses on conscious, planned behavior.
 The therapy focuses on responsibility and choice.
 Trust and the relationship between client and counselor are critical.
 Since it is often used in institutions, the counselor’s communication of trust, warmth, respect and
caring is especially important.
 Reality therapy helps clients look at the consequences of their own actions.
 This therapy is often used in settings other than the counseling office (e.g. playground or
detention center) and is practiced by those other than counselors (e.g. teacher and prison guard).

Cognitive Aspects of Reality Therapy

 Reality therapy aids the client in examining the types of thoughts he or she has about himself or
herself and the external world.
 It helps clients exert control over their own actions, lives, choices and feelings.
 Clients choose misery and symptoms. This becomes a way a client has of dealing with the world
(e.g. depressing, headaching).
 There are negative additions (e.g. drugs, stealing) and positive addictions (e.g. walking,
meditation).
 We choose our addictions and therefore our fate.
 Reality therapy helps clients to: Explore their wants and how that relates to their needs; look at
what they are doing to meet those needs; evaluate behaviors in relationship to those needs and
helps the client plan to change behavior to more effectively meet needs
 There are negative additions (e.g. drugs, stealing) and positive addictions (e.g. walking,
meditation).
 We choose our addictions and therefore our fate.
 Reality therapy helps clients to: Explore their wants and how that relates to their needs; look at
what they are doing to meet those needs; evaluate behaviors in relationship to those needs and
helps the client plan to change behavior to more effectively meet needs.

Reality Therapy and Multiculturalism

 Many of the tenets of Reality therapy fits well with other cultures.
 Helping the client explore wants and needs keeps the focus on the client’s values and concerns
within the client’s cultural context.
 Reality therapy challenges the client to see the self in relationship to his or her context. This
includes the client’s cultural context.
Donald Meichenbaum’s Ten Central Tenets of Cognitive Behavioral Therapy
 Behavior is reciprocal between a client’s thoughts, feelings, psychological processes and resultant
consequences.
 Cognitions do not cause emotional difficulty.
 Counselors help clients understand how they construct and construe reality.
 CBT therapists dissuade from the rationalist or objectivist position.
 There is an emphasis on collaboration with the client.
 Relapse prevention is central to cognitive behavioral therapy.
 The client/therapist relationship is critical for change to occur.
 Emotions play a critical role in cognitive-behavioral therapy.

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  CBT is used with couples and families.
 CBT can be used in a variety of setting with a variety of issues.
Applied Behavioral Analysis: Central Constructs

 Client-counselor relationship is imperative and counselors exhibit high levels of empathy, self-
congruence and interpersonal contact. The relationship is collaborative and relationship variables
differ according to client and culture.
 Operationalization of Behavior: Focuses on the concreteness and specifics of behavior.
Vagueness is transformed into objective, observable actions.
 Reinforcement: Behavior develops and maintains itself through a system of punishments and
rewards.
 Goals: These are designed to make specific behavioral changes. Goals are concrete, specific,
observable and measurable.
 Functional Analysis: The ABC’s of behavior. An individual's behavior is directly related to events
and stimuli in the environment.

References:
Ivey, A. E., D’Andrea, M., Ivey, M. B. and Morgan, L. S. (2002). Theories of counseling
and psychotherapy: A multicultural perspective, 5th ed. Boston, MA.: Allyn &
Bacon.
James, R. K. & Gilliland, B. E. (2003). Theories and strategies in counseling and
psychotherapy, 5th ed. Boston, MA: Allyn & Bacon.
Kottler, J. A. (2002). Theories in counseling and therapy: An experiential approach.
Boston, MA: Allyn & Bacon.

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