Helping Relationship Cpce

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Psychological contact

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between the counselor and client. A relationship between the counselor and clientmust exist.

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Client incongruence.

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The client experiences incongruencebetween experience and awareness. The experienceof incongruence leaves the client feeling vulnerableand anxious.

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Counselor congruence.

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The counselor demonstratescongruence within the therapeutic relationship and mayuse self-disclosure to establish and build rapport with theclient.

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Counselor unconditional positive regard.

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The counselordemonstrates a non-judgmental attitude toward theclient and unconditionally accepts the personhood of theclient.

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Counselor empathy.

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The counselor experiences anempathetic understanding of the client’s worldview andcommunicates this empathy to the client in order to reinforcethe counselor’s unconditional positive regard.

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Client perception of the relationship.

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The client perceivesthe counselor’s empathetic understanding andunconditional positive regard.

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Resistance

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is characterized by clients’ unwillingness to workon their problems and initiate changes in their lives

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ANXIETY CONTROL

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Proposed by SigmundFreud, asserts that resistance is due to clients’ attempts torepress unsavory, anxiety-causing memories that are part oftheir unconscious ( Otani, 1989 ).

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NEGATIVE SOCIAL INFLUENCE

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In this model,resistance is caused by the presence of a negative dynamic inthe counselor–client relationship or a client’s desire for poweror control within the counseling relationship

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Five Factor Model

OCEAN

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is an evidence-based model of personality(frequently referred to as the “Big Five”) that is consideredto be one of the most important, influential, and comprehensiveexplorations into personality ever developed ( Costa & McCrae,2005 ). The model breaks the construct of personality down intofive factors: openness, conscientiousness, extraversion, agreeableness,and neuroticism

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Openness

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ten have richimaginations, a strong awareness of their emotions, intellectualcuriosity, and the desire to seek out new experiencesand ideas. People who are not very open areconsidered to be closed or more conventional

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Conscientiousness

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often plancarefully, act responsibly, strive for achievement, and areadept at self-regulating their behavior. People with lowdegrees of conscientiousness are more spontaneous andoften considered to be risk-takers.

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Extraversion

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are often social,outgoing, and energetic. Introverts characterize the otherend of the spectrum, preferring to spend more time aloneand engaged in quieter activities.

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Agreeableness

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are oftenfriendly, easy to get along with, interested in other people,sympathetic, compassionate, and trusting. Conversely,disagreeable individuals care less about otherpeople’s feelings and more about achieving their ownwants and needs.

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Neuroticism

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often emotionallyimbalanced, anxious, or depressed. They frequentlyhave trouble coping with stress and experiencenegative moods. People with low degrees of neuroticismare typically more stable and better able to regulate theiremotions.

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The NEO Personality Inventory–Revised (NEO-PI-3; Costa & McCrae, 2005

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is commonlyused to measure these factors in clients, and clinicians can usethe results to help formulate useful interventions to help clientsimprove the quality of their lives.

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Stages of Counseling

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thecounseling process generally consists of three key stages:relationship-building (beginning stage), action/intervention(middle stage), and termination (end stage). In each stage, thecounselor has different tasks to accomplish with the client

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relationship-building (beginning stage)

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, it is essential that thecounselor establish an open, trusting, and collaborativerelationship with the client. In addition, the counselormust explain the concept of informed consent, discussthe counseling process, and clarify the roles and responsibilitiesof both the counselor and client.

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action/intervention(middle stage)

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in the action/intervention stage, the counselorworks with the client to target the issues to be addressedduring counseling and establish meaningful goals. Goalsshould be specific, attainable, observable, and relevant( Young, 2013 ). At this point, the counselor often conductsan assessment, either directly or indirectly. Forexample, the counselor may observe the client’s nonverbalcommunication and appearance, create a genogram tobetter understand the client’s background, administer

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Termination (end stage)

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it is the professional counselor’sresponsibility to effectively end the counselingrelationship ( Young, 2013 ). Termination is usually initiatedafter clients have achieved their goals. At this stage,it is crucial that the counselor help clients process theiremotions about ending the counseling relationship, highlightclient successes and progress, encourage futureprogress, and summarize the entire experience. Terminationmay also be initiated when it is evident that the clientis not making progress or if the counselor decides he orshe does not have the adequate skills to help the client. Inthese circumstances, it is the ethical duty of the counselorto make a referral to another counselor.

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Stages of Change (SOC)

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Precontemplation:

Contemplation:

Preparation:

Action:

Maintenance:

Termanation

Termination:

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COLLABORATIVE-DEPENDENT MODEL

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the consultee still relies onthe consultant for help while both parties contribute theirunique background and skills to resolve the problem ( Erford,2015 ). For example, a teacher may approach a school counselorabout a student who has been disrupting class. Althoughthe teacher is counting on the school counselor for advice, theschool counselor draws on the teacher’s familiarity with thestudent, as well as information about the teacher’s teachingstyle and strategies that have not worked, to formulate a planand potential solution. In this way, the consultee and consultantmust collaborate to help the client, because they both possessdistinctive abilities and information that are critical toreaching a resolution.

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COLLABORATIVE-INTERDEPENDENT MODEL

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is ideal for addressingproblems that are intricate and involve the larger society( Erford, 2015 ). No “expert” is part of this model. Everyone who participates in the consultation process holds equal authorityand depends on the others for their specialized knowledge,making it necessary for each member to contribute to the problem-solvingprocess. For example, this model could be used toapproach a problem such as how to reduce the number of homelessyouth. Participants would include a counselor but also parents,students, social workers, and community members, andeveryone would be responsible for sharing their ideas andworking cooperatively and collaboratively to brainstorm andimplement potential solutions.

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CAPLAN’S MENTAL HEALTH CONSULTATIONMODEL

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The mental health consultation model, developed by Caplan and Caplan (1993) , provides a consultation process thatassists mental health professionals in dealing with the psychologicalaspects of their job. In particular, the model involvesconsultation between two professionals (the consultant andconsultee) about a current work problem (e.g., difficult clientcase). The overarching goal of Caplan’s consultation approachis to improve the consultee’s ability to deal with current andfuture work problems and to improve job performance. Thereare four types of mental health consultation that can beemployed. • Client-C

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Client-Centered Case Consultation:

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The consultantassesses and diagnoses the client in order to help the consulteedevelop a plan for dealing with the client’s issues.

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Consultee-Centered Case Consultation:

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Helps theconsultee handle the difficulties presented by a particularclient. However, this consultation model focuses onremediating the professional functioning of a consulteein order to improve client functioning. Caplan and Caplan( 1993 ) stated that consultants may help consulteesimprove their knowledge, skills, confidence, and/orobjectivity.

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Program-Centered Administrative Consultation:

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Theconsultant assists an organization in assessing a problemregarding a new program or a specific part of organizationalfunctioning. The consultant then works with consultee(the organization) to develop an action plan toresolve the issue.

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Consultee-Centered Administrative Consultation:

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Theconsultant works to improve the professional functioningand problem-solving skills of employees within anorganization.

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BEHAVIORAL CONSULTATION MODEL

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The primary focus of this model is on behaviormodification, with the primary goals being to change a client’sbehavior, change the consultee’s behavior, or create organizationalchange. Behavioral consultation is a four-step process:(1) problem identification, (2) problem analysis, (3) plan implementation,and (4) problem evaluation

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The consultationprocess

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is fairly straightforward. First the consultant establishesrapport with the consultee, explains the process, anddefines the responsibilities of each participant. Next, the consultantworks with the consultee to assess and define the problemin clear, specific terms, and set a goal related to theidentified problem. Once a goal has been set, solutions arebrainstormed, evaluated, selected, and implemented. After anintervention has been executed, the consultant and consulteedetermine its effectiveness and whether it makes sense to eitherterminate the consultative relationship because the goal hasbeen achieved or return to the drawing board to devise anotherstrategy. This process continues until the overarching objectivehas been met

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Psychological first aid (PFA)

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is an evidence-basedapproach used to respond to individuals who have experienceda disaster, terrorist attack, or other disturbing event ( NationalChild Traumatic Stress Network and National Center forPTSD, 2006 ). Professional counselors who would like to offertheir assistance in such circumstances are encouraged to followspecific guidelines and seek training in PFA.

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Association for Humanistic Counseling (AHC)

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a division of ACA that was founded in 1931 as the TeachersCollege Personnel Association. Today, AHC is committedto promoting humanistic principles in counseloreducation and clinical practice.

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International Association of Marriage and FamilyCounselors (IAMFC),

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a branch of ACA, was createdin 1989 to provide training in marriage and family counseling,as well as promote excellence in the clinical practiceof couple and family counseling.

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Sigmund Freud

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(1856–1939) is considered the father of psychoanalysis.Developed over a hundred years ago, psychoanalysiswas the first psychological theory to be widely accepted inEurope and North America and influenced the work of innumerabletherapists around the world. Psychoanalysis is basedon Freud’s belief that psychological disorders stem from people’sunconscious conflicts and repressed desires.

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conscious mind

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is aware of everything occurring inthe present.

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preconscious mind

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d combines characteristics of boththe conscious and unconscious minds. For example,although the preconscious mind contains forgotten memoriesand vast stores of knowledge and information, withassistance or cues, they can easily be recalled.

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unconscious mind

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is the most nebulous part of aperson’s mind. It contains memories, instincts, and drivesthat are exceedingly difficult to bring to a person’s consciousawareness

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PERSONALITY DEVELOPMENT

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ID, EGO,SUPER EGO

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ID

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is present from the time of birth and operates on thepleasure principle ( Gladding, 2005 ). Residing in a person’sunconscious, the id is considered the unprincipled, selfishpart of the personality. It is impetuous, ruled by primitivedrives (e.g., food, sex, aggression), and concerned solelywith achieving pleasure, no matter what the consequences

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EGO

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operates on the reality principle and balances theid and the superego. Found mainly in the conscious partof the mind, it exists to “keep the person from beingeither too self-indulgent or too morally restrained[;] theego moderates the wishes and desires of the id and thesuperego” ( Gladding, 2005 , p. 18 ). Essentially, the ego isthe logical, rational part of the personality that allows theperson to function effectively in society.

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SuperEgo

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operates on the moralityprinciple . Like the id, the superego also exists in theunconscious. The superego is a person’s conscience, theinner voice that urges the person to do the right thing andalways expects perfection. Children develop the superegoon the basis of interactions with their parents andsocietal norms, through which a sense of morality isengrained. When people fail to follow their conscience,the result is often a sense of guilt.

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Alfred Adler

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developed the theory of individualpsychology (also known as Adlerian psychology), which isbased around the core belief that healthy individuals have socialinterest and compassion for other people ( Gladding, 2005 ).Adler’s view of human nature is highly optimistic and holistic.He believed that all individuals “strive to become successful”and “that each person strives for growth” (p. 35 ). As part of thecounseling process, Adler often examined clients’ lifestyles,cognitive fictions, and family constellations to help themdevelop insight into their lives and change their lifestyles to onethat promoted greater growth and wholeness. The ultimate goalsof counseling are to help clients increase their social interest andreduce feelings of inferiority. Adlerian counselors achieve theseobjectives by developing a trusting, egalitarian relationship withclients, assessing their lifestyles, and using teaching and interpretationto help clients learn new ways of living. In this section,the following Adlerian concepts are reviewed: inferiority complex,birth order, lifestyle, fictions, and techniques.

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Birth Order

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To help understand clients’ thoughtsand behavior, Adler examined their family constellations, andbirth order in particular. Adler believed that where a person fallsin their family birth order influences personality development.

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Firstborns

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are often the leaders of the family—the“reigning monarchs” ( Gladding, 2005 , p. 36 ) before thesecond child arrives—and take over familial responsibilityshould a parent be impaired or unavailable.

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Second children

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strive to differentiate themselves fromthe firstborn and, thus, may become competitive. Theyare often more relaxed and easygoing than firstborns butexpend more energy seeking their parents’ attention.

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Middle children

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often feel left out and that they do notreceive adequate parental attention, but they are the childrenbest able to adapt to new situations.

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Youngest children

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are sometimes pampered or spoiledand, thus, may have a hard time later in life acting independently.They usually receive the same amount ofattention as firstborns and benefit from the examples setby their siblings.

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Carl Gustav Jung

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was a follower of Freud buteventually broke ties with Freud after disagreements over someof the central tenets of Freud’s psychoanalytic theory.

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Jungian Analytic Psychology

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whichfocuses on the role of the larger culture, spirituality, dreams,and symbolism in understanding the human psyche. Jungbelieved that through exploring the unconscious, people’s psychologicalhealth could be improved. Thus, the goal of analyticpsychology is to help people develop appropriate contact withtheir unconscious so that they are neither overwhelmed by itnor completely unaware of its forces

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B. F. SKINNER B. F. Skinner

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was influenced byThorndike’s research. The premise of Skinner’s theory, whichproposes that a response is either strengthened or diminishedbecause of the consequence that follows, is very similar toThorndike’s Law of Effect. Skinner considered Pavlov’s theoryto involve respondent behaviors, so he only involved automaticreflexes (e.g., fear, anxiety). Skinner ( 1953 ) termed his theory

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operant conditioning

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because he viewed the vast majority oflearning to occur either when an individual operates on theenvironment or when the environment controls the contingenciesof reinforcement for the individual. According to Skinner,all learning was controlled by the contingencies surroundingthe stimulus and response. Skinner’s research produced numerousconcepts and learning principles, including these:

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Positive reinforcement.

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Occurs when the addition of astimulus (e.g., reward) immediately following theresponse increases the likelihood that the behavior willreoccur.

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• Negative reinforcement

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Occurs when the removal ofa stimulus (e.g., loud noise) increases the likelihood thata behavior will reoccur.

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Punishment

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The addition or removal of a stimulusthat decreases the frequency of a given behavior. It isalso commonly referred to as an aversive behavioraltechnique (e.g., spanking, extra chores, removing allowanceor privileges).

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Reinforcement schedules

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dictate how frequently reinforcementsare administered. Skinner described a continuousreinforcement schedule, during which areinforcement is administered immediately followingeach response, and an intermittent reinforcement schedule,during which a reinforcement is not administeredevery time a response is made. Intermittent reinforcementschedules are of four types:

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fixed ratio (FR)

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) schedules, a reinforcer is administeredeach time a participant makes a certain number ofresponses (e.g., every response [FR1], every 5th response[FR5], every 10th response [FR10]). FR schedules usuallylead to the quickest acquisition of a response, particularlywhen the FR is low at the start. However, thisschedule may lead to high quantity with low quality. Forexample, a factory worker who gets paid for every bundleof 10 products produced would likely reason that hewould get paid more if he produces more bundles, and hewould likely do so at the expense of quality.

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variable ratio

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) schedules, reinforcements arepresented periodically so that, on average, they occurevery other, every 5th, or every 10th time. Thus, a participanton a VR10 schedule may be reinforced after 5,8, 12, and 15 responses (with an average of 10responses). Due to the lack of predictability, VR schedulesproduce high response rates and are more resistantto extinction, such as in the case of individuals whoplay slot machines.

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fixed interval

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schedules, reinforcements are presentedafter a fixed period of time (e.g., every 15 seconds,every hour). FI schedules produce low rates ofresponding since administration of the reinforcer isdependent on the passage of time rather than frequencyof responding. For example, paying hourly wages in awork setting tends to produce minimal levels of workbecause an individual gets paid the same amountregardless of the amount of work produced.

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variable interval (VI

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schedules, the time interval ofthe reinforcement administration is varied. Pop quizzesare an example of a VI schedule; one knows they arecoming but not precisely when, which usually leads tomaximal response rates.

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Shaping

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is a technique that reinforces successive approximationsof a desired behavior. Thus, a difficult, anxietyprovoking,or new task is broken down into smaller steps,with the successful accomplishment of each step beingreinforced, gradually building up to the performance ofthe target behavior.

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token economy

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is most commonly used with children(usually in a classroom setting) and provides clients withrewards for demonstrating desired behavior. Generally,teachers give tokens (i.e., secondary reinforcers) to studentswhen they behave appropriately. The tokens canthen be traded in for primary reinforcers (rewards, e.g.,privileges, candy, toys). To implement a token economy,a goal that details the desired behavior must first be set.

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Extinction

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is the termination of a behavior by withholdingreinforcement. For example, a child who discoversthat she can get her teacher’s attention by standing on herchair would reduce that behavior when the teacher nolonger pays attention to her behavior. However, the undesiredbehavior would likely increase in frequency andintensity at the onset of this technique, a phenomenonknown as the extinction burst .

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Ivan Pavlov

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a Russian physiologistbest known for his studies on the salivation of dogswhen presented with food powder ( Pavlov, 1960 ). He noticedthat the dogs salivated not only when they could taste, see, orsmell the food powder, but also when he, Pavlov, entered theroom, or when the dogs entered the room where he was.

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classical conditioning

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experiments,Pavlov demonstrated that pairing an unconditioned stimulus(US), such as meat powder, that automatically elicited theunconditioned response (UR), such as salivation, with a neutral,conditioned stimulus (CS), such as something that ordinarilywould not elicit salivation (e.g., a tone, buzzer, or bell),would, after a number of pairings, result in the CS eliciting theUR, now called the conditioned response (CR).

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neutral stimulus

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means that, ordinarily, the stimuluswould not elicit the response. That is, dogs ordinarily do notsalivate when they hear a buzzer; only after pairing the buzzerrepeatedly with the food will the dog salivate.

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Simultaneous conditioning

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occurs when theUS and the CS are presented at the same instant. Delayedconditioning occurs when the CS begins first but overlapspresentation of the US; it is the most effective conditioningprocedure.

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Stimulus generation

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occurs when the participant’sCS/CR connection is generalized to other stimuli similar to the original CS.

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Counterconditioning.

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A strong pleasant stimulus ispaired with a weak aversive stimulus.

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Psychoanalytic Therapy

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Freud

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Analytical Psycology

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Carl Jung

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Sigmund Freud

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People are selfish, irrational, driven by

sexual instinct

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Libido

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sexual energy

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Neurosis:

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superego imposes guilt on ego

to limit id impulses

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Dream Content

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a.Manifest: literal content

b. Latent: hidden meaning

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Catharsis

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Burst of emotion

ii. Collapse of defense mechanisms

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Transference

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i. Client projects feelings toward others

onto the therapist

ii. Types of transference:

-positive

-negative

-ambivalent

-counter-transference

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Defense Mechanisms

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Repression:

force painful feelings into the

unconscious

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Regression

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retreat to earlier stage of

developmen

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Rationalization:

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assign socially acceptable

motive to irrational behavior

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Projection

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assign unacceptable thoughts

onto someone else

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Displacement:

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transfer emotion to a

second, less threatening person

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Sublimation:

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channel inappropriate impulses

into socially acceptable behavior

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Reaction Formation:

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express opposite of

actual desires

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Analytical Psychology-

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Carl Jung

Founder of analytical psychology

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. Individuation

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process of becoming whole,

true self

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Techniques

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Empty chair

b. Exaggeration/ Repetition

c. Reversal

d. Staying with Feelings

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Adlerian Therapy

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1. Individual psychology

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Rational Emotive Behavior Therapy

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(Albert

Ellis- REBT

Irrational self-talk leads to emotional

disturbance

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ABC framework for change

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Activating Event

b. Belief (Irrational)

c. Consequent effect

d. Disputing of irrational belief

e. Effect

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Techniques include:

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Bibliotherapy

b. Activity-based homework

c. Didactic discussion

d. Role-playing

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Cognitive Therapy

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Aaron Beck)

Identify cognitive patterns/schemas

2. Distorted reality exists on three levels:

a. View of self

b. View of experiences

c. View of the future

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Cognitive-Behavior Therapy

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(Meichenbaum)

1. Replace self-defeating thoughts with coping

thoughts

2. “Self-talk” technique: change underlying

assumptions behind illogical thoughts

2. Stress inoculation: practice positive selfstatements

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Person-Centered Therapy

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(Carl Rogers)

Counselor displays three essential traits:

a. Empathy

b. Genuineness

c. Unconditional Positive Regard

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Congruence:

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perceived self is in line with

actual self

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Gestalt Therapy

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(Fritz Perls)

Personal responsibility, unfinished business,

here-and-now

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Layers of Neurosis:

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a. Phony layer

b. Phobic layer

c. Impasse layer

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Techniques

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Empty chair

b. Exaggeration/ Repetition

c. Reversal

d. Staying with Feelings

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Five channels of resistance

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i. Introjection

ii. Projection

iii. Deflection

iv. Retroflection

v. Confluence

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Transactional Analysis

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(Eric Berne)

“Transaction” is basic unit of communication

2. Developed for group therapy

3. Two levels of communication:

a. Overt Social Level

b. Covert Psychological Level

4. Independent, observable ego states:

a. Parent

b. Adult

c. Child

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Reality Therapy

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(William Glasser)

1.Face reality without excuses

2. Identify goals & evaluate methods of

achieving these goals

3. Two psychological needs:

a. Need to love and be loved

b. Need to feel worthwhile to self/other

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Existential Therapy

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(Viktor Frankl, Rollo

May, Irving Yalom)

Healing through discovery of meaning

2. Major themes include freedom, isolation,

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Family Therapy

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Family is psychological unit

2. Changes in individuals affect entire family

functioning

3. Family is multi-generational network, sensitive

to cultural/stereotypical belief systems

4. Families are self-regulating. They tend

towards homeostasis

5. e process of homeostasis many times creates

additional problems for the family

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Mitwelt

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relationship with others

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Umwelt:

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relationship with environment

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Eigenwelt:

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relationship with self

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Uberwelt:

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ideal world of the individual