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120 Cards in this Set
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What is counseling |
Understanding and overcoming a problem -talking over problems
There is overlap between counseling and Psychotherapy (Done in a wide range of professionals in a variety of settings) |
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What Is Psychotherapy |
Diagnosing and treating mental health disorder (Done in a wide range of professionals in a variety of settings)
-intervention -treatment -therapy -talk therapy |
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Directive vs nondirective counseling |
Directive (Cognotive Behavioral therapy) -counselor sets you with tasks, tell you what to talk about and give you homework
Nondirective (person centered) -counselor gives you the space to talk about whatever is bothering you -you are in control of the sessions |
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What are some of the purposes of therapy |
Treat mental illness
Support individuals through regular life changes
Connecting people and groups going through the same thing
Teaching skills (coping strategies)
Providing information (psychoeducation)
Validating, normalizing comforting accepting
Insight
Identification of patterns
Planting seeds for change |
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What is a theory (scientific method) |
A general explanation for a broad range of observations
-expalain previous research and leads to new testable Hypotheses
-intergrate numerous findings
-they can be supported or proven false which is different from an opinion which isn't testable |
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What is a hypothesis (scientific method) |
A specific testable prediction about a process that can be observed or measured
Must be falsifiable -precise enough that it could be proven false
Can never be proven true because future research can always show the hypothesis was limited or wrong (use words like supported, confirmed) |
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Counseling theories should |
Provide us with a conceptualization of clients and identify interventions to use
Should be grounded in science and out current understanding of human development
Be comprehensive and generate new research question |
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Counseling theories help us to |
Determine how to best support clients and facilitate change
Used to understand, organize and simplify the information client's present in counseling |
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Counseling in late 19th century |
Began to develop in late 19th century
Little was know about mental and emotional difficulties
People forcibly confined to institution and exposed to ineffective therapies or no treatment (lessor or mild difficulties weren't treated) |
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1st force in Psychology |
Psychodynamic approaches led by Sigmund Freud
Focus on past experiences and the unconscious |
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2nd force in Psychology |
Cogntive and behavioral approaches -led by B. F. Skinner, Albert Ellis, Aaron Beck, William Glasses, Donald Meichenbaum
Focus on the present and the interaction between thoughts, feelings and behaviors
Action- oriented approachs |
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3rd force in Psychology |
Existential humanistic approaches -led by Carl Roger's, Fritz Perls, Victor Frankl
Focus on emotions, sensations, meaning making, and therapeutic relationship
Relationship- orientated approaches |
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4th force of psychology |
Contextual/ systemic approachs
Focus on individual identity, context, and culture that impacts clients experiences |
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Strength based perspective |
A focus on clients strengths, resources, wellness and capacities
A more holistic, balance and optimistic approach to counseling
Believes that clients have the ability to provide their own solutions to their problems
Should work with clients to identify already existing strengths and build upon them to promote resiliency and postive change |
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4 areas to explore and promote resiliency through strengths based perspective |
Social competence Problem solving Autonomy Sense of purpose |
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Goal for clinicians |
Is for clinicians to develop their own theoretical orientation (basic set of beliefs that guides actions) and acquire a concealing style tailored to their personality and values |
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Different kinds of non traditional therapy |
Art/ music therapy Horticultural therapy Animal assisted intervention Religion/ faith Cultural healing practices Meditation |
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What is ethics |
Involves therapist's behaving in moral, virtuous or principled ways and taking preofessional actions that support clients well being
Guidelines thar outline professional standards of behavior and practice
Counselors must interpret and apply ethical codes to their decision making |
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What do ethics do |
They are not codes that make decisions for counselors
Educate us about responsibilities
Are a basis for accountability and improving professional practice and protect clients
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Processes of ethics |
Identifiy the problem Review relevant codes Seek consultation Brainstorm List consequences Decide and document the reasons for your actions
To a degree you can include the client in your decision making process |
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Laws and ethics |
Laws are the minimum standard of behavior |
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What are mandatory ethics |
Is the view of ethical practice that deals with the minimum levels of professional practice |
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What are aspirational ethics |
A high level of ethical practice that addresses doing what is in the best interest of the clients |
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What are postive ethics |
An approach taken by practitioners who want to do their best for clients rather than simply meet standards to stay out of trouble |
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What are the 4 fundamental ethical principles the CPA code of ethics is based upon |
These principles may vary somewhat in the context of different cultural beliefs and expectations |
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1st principle |
Respect for the dignity of all persons and people's
-recognizes the inherent worth of all human beings -foundation for other ethical principles |
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2nd principle |
Responsible caring
-means that all interactions involving clients are made for the clients benefit |
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3rd principle |
Integrity in relationships
-to have ethical integrity counselors remain aware of their values and the values of their communities
-they are honest and straightforward in their communications, honeslty assess and seek feedback on their performance and avoid conflicts of interest that may compromise their professional activities |
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4th principle |
Responsibility to society
Have a responsibility to the society in which they live and work and have dedicated themselves to the well being of human beings in the society.
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Informed consent |
Formal action of consenting to counseling which serves as an agreement between all parties involved that they understand what will happen in counseling |
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Competence |
Possessing the knowledge, skills, and diligence required to effectively function and meet professional expectations and standards |
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Evidence based practices |
Research based treatments and interventions used in addressing and treating those who have various mental disorders |
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What is informed consent |
Providing clients with the information they need to make informed choices
Educating clients about their rights and responsibilities
Empowering clients and building a trusting relationship with them
Addressing privacy issues with clients, including the implications of using technology to communicate |
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Some aspects of informed consent process include |
Therapy procedures Risks/ benefits and alternatives Right to withdraw from treatment Cost and length of treatment Qualifications of the practitioner Privileged communication Limits of confidentiality |
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Clients should give their informed consent only with full knowledge of information such as |
Information must be provided in language the client can understand
Someone may not have the capacity or competency to provide informed consent -It can be from a guardian or legal representative |
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Informed consent gives test takers the right to know |
Why they are being evaluated How the test data will be used What info will be released and to whom |
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Compenets of capacity include |
Demonstrating a factual understanding of the issues Appreciating the nature of the situation Being able to reason about the facts of a treatment, or whatever it is to which consent is sought Being able to evidence a choice as to whether one wants to participate |
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What is confidentiality |
Is developing a trusting and productive client therapist relationship Is essential but not absolute Pertains to proper storage and disposal of records |
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Privileged communication |
Is a legal concept that protects clients from having their confidential communications shared |
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Limits and exceptions of confidentiality |
Client poses a danger to self or others (imminent) Suspect a child, dependent or older adult is victim of abuse (past or present) Sexual abuse by a health professional (past or present) Court subpoena Regulatory body reviews records Client requests a release of records |
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What are dual/ multiple relationships |
When counselors assume multiple roles with a client -these are not deemed inherently unethical in ethic codes (except sexual relations) -must be managed in an ethical way to eliminate non professional interactions and protect client well being -can pose a challenge to practitioner and risk to client -inherent in therapeutic relationships is an imbalance of power |
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How beneficial is counseling |
About 75% to 80% of clients benefit from counseling |
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What two things contribute to treatment outcome |
Therapy relationship Therapy strategies
(Nature vs nurture) |
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What are some common factors to all therapeutic approaches |
Improvement in clients ability to identify and change their thoughts feelings and behaviors
Counselors and clients expectations for change
The therapeutic relationship
The therapist as a person is also key part of the effectiveness of therapeutic treatments |
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Therapist as a person and the therapeutic relationship |
Is the most important component of effective counseling (therapeutic relationship)
Two primary determinants of therapeutic outcome and key factors in successful therapy
Practitioners possess wide knowledge, both theoretical and practical and if they lack human qualities of compassion, caring ect they are merely technicians |
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Demographics of effective therapist's |
There is not a particular age, race, gender, professional orientation, or background that is associated with successful counseling outcomes
-clients may perfer therapists in a certain age race gender professional orientation or background -prefer congruence
Both personal and professional characteristics are important |
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In class personal characteristics of effective counselors |
Have a sincere interest in the welfare of others
Effective interpersonal skills
Authentic -everyone has different level of self-disclosure which is part of theoretical orientation
Willing to grow, risk, car and be involved
Maintain hrslthy boundaries |
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Personal characteristics of effective counselors |
Strong interpersonal skills Emotionally mature High levels of thinking and conceptualizing Good insight into themselves and others Ethical Flexible Encouraging and affirming Have an identity Open to change Authentic, sincere, honest Sense of humor Make mistakes and admit it Live in present Appreciate influence of culture Passionate Derive meaning from work |
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Effective therapist professional qualities |
Interpersonal skills
Form working alliance with diverse clients
Explain clients problems in acceptable adaptive and culturally sensitive way
Provide treatment consistent with explanation
Monitor progress
Adjust approaches and be flexible
Address difficult material and topics
Communicate hope, enthusiasm and optimism
Display sensitivity to characteristics
Self monitor and self aware
Continually improve
Maintain knowledge and stay aware of research |
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Self reflection in counseling |
Most important therapeutic tool is you -your living example of who you are and how you struggle to live up to potential is powerful
The person and professional are intertwined facets that can be separated |
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Personal therapy contributes to the therapist's professional work in 3 ways |
1) as part of the therapist's training -offers a model of therapeutic practice in which the trainee observes a more experienced therapist at work and learns what is helpful
2) a beneficial experience in personal therapy can further enhance a therapist's interpersonal skills
3) can contribute to a therapist's ability to deal with the ongoing stresses associated with clinical work |
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Prethetapy and learned characteristics that positively influence counseling |
Motivation -clients readiness for change and an ability to engage productively in process
Client expectations -hope and optimism that counseling us meaningful and beneficial -role induction
Client engagement -activity participating in counseling by self disclosing, adapting problem solving approach, taking steps toward change |
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Role induction |
Process of orienting clients to counseling so theu can comprehend and make good use of the therapeutic process
-helps instill hope |
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What is the therapeutic alliance |
Quality and strength of the collaborative relationship between a client and a practitioner in counseling and Psychotherapy |
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To have a therapeutic alliance therapist's must learn how to... |
Develop an alliance Monitor the relationship Mend any ruptures |
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3 main components in developing and maintaining a therapeutic relationship (Carl Rogers) |
Empathy -ability to see the world through the clients eyes and to communicate that understanding so that the clients feels heard and validated Unconditional positive regard -emotional warmth, appropriate reassurance, the communication of confidence and interest in the client Congruence -being genuine with a client |
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What can negatively impact therapeutic alliance |
Disagreements related to therapeutic tasks Poorly negotiated goals Week emotional connections |
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What is Culture |
Culture is a set of beliefs, attitudes and value systems that we learn early in life and permeates how we think and behave |
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Culture and diversity |
Counselors must adopt a culturally competent and culturally sensitive approach What is normal behavior may differ between cultures Interventions, skills and communication styles need to be adapted to meet the needs of each individual |
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3 important areas if cultural competence |
Self awareness of any biases Knowledge and understanding of cultures Ability to use culturally appropriate interventions |
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How to become an effective multicultural counselor |
Become -become aware of personal biases, values or problems Seek -seek to examine and understand your client's world view Understand -understand the dynamics of oppression, racism, stereotypes Possess -posses knowledge about historical background, traditions and values Become -become responsible for educating clients about the therapeutic process Seek out -seek out educational, consultative and remaining experiences to enhance abilities to work with diverse clients |
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The role of values in counseling |
Assist clients in finding answers that are most congruent with their own values Supervision to learn to effectively manage values differences with your clients |
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Value imposition |
Refers to counselors directly attempting to define a client's values, attitudes, beliefs and behaviors -avoid imposing their own values, attitudes, beliefs and behaviors -should not refuse to render services to clients because of differing values |
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What is development |
A process of growth that involves cogntive, physical, social, personal and emotional maturity |
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Developmental considerations |
Therapist's should have an understanding of their clients developmental needs to tailor their approach Must use interventions that are appropriate to their clients developmental level |
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Where do some counselors believe mental health issues come from |
Are the result of disruptions in notable developmental processes which can lead to opportunities for growth and psotive change |
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Some developmental factors |
Attachments -bonds that youth from with caregivers which involves trust and emtional connectedness Social and emotional development -emtion regulation, self awareness, social skills Moral development -connection with concepts of justice and equality Educational development -general knowledge Physical development/ genetic factors -physical health, biochemical considerations Cogntive development -mental processes such as learning and memory |
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Who is Carl Roger's |
Early childhood was isolated from other children, teased by bothers, close to his mother and had many illnesses
Was taught the importance of hard work, humility, a sense of responsibility and science |
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Carl Roger's education |
Learned about the phenonenoligcial perspective
Took courses in psychology while in seminary and realized his goal was to help people grow and change
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Phenomenological perspective |
Born out of Edmond husserls philosophical postion that the starting point for knowledge was the self experience of phenomena
Involves making sense of the meaning structures of the lived experience of a research participant |
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What did Carl Roger's do |
Developer of person centered therapy Generally classified as a phenomenlogist Was first to conduct research done on Psychotherapy -first to transcribe and analyze transcripts of counseling sessions Applied person centered counseling to families, businesses, education, cross cultural settings, conflict resolution and promotion of world peace |
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Stages of person centered therapy?? |
1) nondirctive counseling suggests that the main role of therapist's is to help people express and gain insight into their emotions and experiences through reflection and empathic listening 2) counseling should not be completely nondirective 3) Roger's reaching educational settings and developing encounter groups 4) there is concern for all of humanity bot just the counseling relationship |
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Basis of person centered therapy |
People know how to solve their problems but need the proper environment to do so PCT is the basis of therapy as we know it What most therapeutic approaches today have in common Importance of the therapeutic alliance and how to develop it stems from Carl Roger's seminal work |
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Was was before PCT |
Psychoanalysis -medical model -big push and pull in the field currently -part of why there are so many different professions that do counseling |
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Person centered theory challenges what |
The assumption that counselors know best The validity of advice, suggestions, persuasion, teaching, diagnosis and interpretation Belief that clients cannot understand and resolve their own problems without direction Focus on problems over persons |
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PCT emphasizes |
Therapy as a journey shared by two fallible people The person's innate striving for self actualization The personal characteristics of the therapist and quality of the therapeutic relationship The counselors creation of a growth promoting climate People are capable of self directed growth if involved in a therapeutic relationship |
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What are the key concepts of person centered therapy |
Based on the assumption that all people are basically good -humanistic perceptive -humans are capable of making changes and living productive lives Organismic valuing process -peopled intuitive ability to know what theu need to feel fulfilled and self actualized -innately gravitate towards self actualization and know when they not -incongruence when don't listen to to internal sense Human potential and self actualization -people have an innate need towards growth and can reach their full potential -mastery of ongoing challenges -people rquite the right conditions to grow |
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Self actualizing tendency |
Maslow hierarchy of needs Is the ongoing process of moving towards ones full potential and self congruence Directional process of striving toward realization, fulfillment, autonomy, self determination and perfection We are all drawn forwards in out own self actualization process Process is feed through the provision of the core conditions for change |
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Hierarchy of needs stages |
Self actualization Esteem Belonging Safety Physiological |
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What is a fully functioning person |
Awareness and acceptance of inner most feelings and desires including Openness to experience Sense of meaning and purpose Trust and congruence in self Unconditional psotive regard Internal locus of evaluation Being fully aware in the morning Living creatively |
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Carl Roger's conditions of worth |
Believed that we received messages as children which impact how we see ourselves
Children's self concepts are shaped by messages they receive This can lead to mental health issues, lack of authenticity and low self worth |
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What are conditions of worth |
Judgmental and critical messages
Expectation that people must act a certain wah to be loved |
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What is conditional positive regard |
People only receive praise and attention when they act in accordance with expectations |
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Unconditional psotive regard |
People recive messages that they are special for who they are More likely to be fully functioning actualizing |
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Know |
A therapeutic alliance is needed to counteract this and provide an environment where certain core conditions are met PCT suggested that the core conditions (empathy, Unconditional postive regard, genuineness) are essential to the therapeutic alliance -these conditions are needed in all approaches for postive therapeutic outcomes PCT is a way of being with clients and providing the core conditions to facilitate change |
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What are the 6 conditions that facilitate personality change (therapeutic process) |
1) a relationship exists
2) clients are in a state incongruence
3) therapist is congruent in the relationship
4) therapist experiences Unconditional psotive regard for client
5) therapist expresses empathy to client
6) the therapist's empthay, Unconditional postive regard, genuiness is perceived by the client |
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The results of these 6 conditions that facilitate change |
Conditions create a safe and accepting space for clients to truly work The therapist is viewed as a follower explorer who attempts to understand the client's phenomenological world in an interested, accepting and open way This therapist is not doing therapy at the client but is being with the client while they do work (Mind shift from the medical model) |
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What are the main goals of therapeutic PCT |
Facilitate cliente trust and ability to be in the present moment Clients have honesty with themselves and therapist's by fully expressing emotions and thoughts
Development of congruence (authenticity and genuiness) - encourage clients to process through incongruence and to become self aware and understanding |
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Some other goals of PCT and therapeutic alliance |
Promoting self awareness, empowerment, optimism, responsibility and autonomy Management of lives and concerns Self actualization Ability to create meaningful life Therapists don't provide solutions but clients provide their own |
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What is a PCT therapist |
Invested in developing his or her own life experiences to deepen self knowledge and move toward self actualization
Therapist's use themselves to promote change
Is personable, genuine, supportive, integrated, empathic and authentic (Encurages clients to open up)
Can openly express feelings and attitudes that are present in the relationship with the client
Serves as a model of human being struggling toward greater realness |
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The relationship between therapist and client |
Therapeutic relationship is what creates psotive change (growth)
Egalitarian relationship
Immediacy and present moment awareness is important
The relationship positively adds to the lives of both therapist and client |
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3 core conditions necessary for therapeutic relationship and promote growth |
Accurate Empathy understanding -ability to deeply grasp the subjective world of another person Congruence -genuiness or relaness Unconditional psotive regard -acceptance and caring (Three therapist attributes create a growth promoting climate in which individuals can move forward and become what theu are cable of becoming) |
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Congruence |
Is characterized by the match of one's outward responses with one's internal experience -inner and outer selves are consistent
Promotes trust and openness
May involve therapist self disclosure -personal identity/ experiences -professional identity/.experiences -emotional responses |
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Congruent communication |
When ones words are in line with one's thoughts
Therapist is aware of their genuine self and they are able to convey this genuiness to the client -messages are clear and coherent |
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What is Unconditional postive regard |
Caring about, accenting, respecting and liking others without placing judgment or expectations on them
Is characterized by believing in or demonstrating the value and worth for the individual at all times
Doesn't mean you accept all of people's behavior all the time
It must come from a place of congruence on behalf of the therapist |
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What is empathy |
Characterized as a deep level of understanding of the subjective experience of the from their point of view (PCT) Must be communicated to be effective (reflective listening) Gives clients space to fully experience and express emotions and experiences |
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What is the role of assessment |
Focuses on the quality of the therapeutic relationship Engages in co assessment with clients and does not value traditional assessment and diagnosis Clients involved in a collaborative process in making decisions |
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Techniques and procedures in PCT |
There are no specific techniques to this approach The use of therapist and therapeutic relationship is what promotes change Facilitive conditions -quantities of the therapist and relationship promote change Nondirectinveness -clients take the lead and are the focus of counseling process |
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Strategies that deepen the communication I'm PCT include |
Empathic reflections Paraphrasing Therapist self disclosure |
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What is the purpose of empathic responding |
Purpose us to encourage deeper exploration of emotions and experiences Help clients feel normalized, understood, validated and respected Empathy helps create now meaning |
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3 steps in empathic responding |
Therapist understands the client's feelings Therapist accurately expresses those feelings to the client Client recognizes the empathic attunement |
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The therapist in PCT |
Focus on the quality of the therapeutic relationship Does not find trraditi9nal assessment ans diagnosis to be useful Provides a supportive therapeutic environment in which the client is the agent of change and healing Serves as a model of human being struggling toward greater realness There is no list of things to say or do Who you are as a practitioner is what matters Paraphrasing, reflecting feelings and asking open ended questions help |
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Techniques of active listening |
Paraphrasing Verbalizing emotions Asking Summarizing Clarifying Encouraging Balancing |
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Mindful listening practice |
Active listening is a mindfulness practice Listener is trying to stay focused in the present with what is being shared and then are working to accomplish this without judgment |
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Effectiveness of PCT |
Is effective with a wide range of clients and problems of all age groups Effective for depression, anxiety, interpersonal problems, personality disorders, trauma, schizophrenia Used with individuals and groups |
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PCT contributions |
Carl Roger's opened the field to research Philosophy and principles of PCT permeate the practice of most therapies -core conditions used in all approaches Lead to the development of other approaches -Natalie Roger's |
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What did Natalie Roger's do |
Used nonverbal methods and expressive arts to enable individuals to heal and develop has expanded her fathrrs pioneering work |
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PCT application to crisis intervention |
When people in crisis the frist step is to give them an opportunity to express themselves
Genuine support, caring, and warth can motivate people to do somthing to work through and resolve a crisis |
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Multicultural strengths of PCT |
Applicable to diverse groups
Had major impact on field of human relations with diverse cultural groups
Work reached in 30 countries and translated into 12 languages
Core conditions are helpful for understanding cultural beliefs |
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Multicultural limitations of PCT |
May be uncomfortable due to emphasis of self disclosure, emotions and indirect communication
Clients may be put off by nondirective counselor
May not value insight
May not value internal locus of control (collectivist cultures)
Focus on individual autonomy and personal growth May be viewed as selfish |
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Overall strengths of PCT |
Carl was frist to measure effectiveness of theory
Emphasis on therapeutic relationship
Optimistic, affirming and postive perspective
Easily integrated with other approaches
Frist to introduce therapist transparency
Impact other therapeutic approaches |
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Overall Limitations of PCT |
Emphasis on emotions may not be applicable to diverse cultures
Some may prefer directive approach
Exhausting and requires attention
Does not use specific techniques
May find it difficult
Limits of a therapist as a person my affect genuine therapeutic relationship |
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Person centered expressive arts therapy |
Natalie Roger's
Intergrated aspects of person centered therapy with creativity and various art forms
Intergrates the mind, body, emotions and spirit |
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Process experimental therapies |
Focuses on the role of emotion in processing experiences
Processing through emotions gives people a sense of meaning and purpose
Deep understanding of emotions helps people grow
Emotion focused therapy |
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Emotions focused therapy |
type of process experimental therapy
Involves awareness and regulation of emotion |
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Parent effectiveness training |
Parents learn person centered ways of communicating with their children including empathic responding, active listening, nonconforntational disciple , and conflict resolution |
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Experiential focusing |
Clients are asked to non-judgmentally pay attention and notice the source of feelings or experiences in their bodies
When they tune into this body sensation they can access information and connect to present moment
Somatic feeling is called the felt sense |
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6 steps if experimental focusing |
Clearing a space Felt sense Handle Resonating Asking Receiving |
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Motivational interviewing |
Purpose is to resolve ambivalence by eliciting clients own reason for change
Reflective listening is one of the most important techniques Assist clients to become their own advocates for change and primary agents of change |
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Motivational interviewing stages |
Precintemplation Contemplation Preparation Action Maintenance |
