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Counseling Psychology Final Exam
Terms in this set (95)
Femimist Therapy History
Doesn't have a single author, doesn't boundaries and there are many ways to practice it.
Eclectic and inclusive.
o Eclectic: ideas, style, or taste from a broad and diverse range of sources.
o Inclusive: covering all the services, facilities, or items normally expected or required.
Explores attitudes about gender and power (oppression) and how they affect people
Believes social forces, society, politics, hierarchies, and paternalistic cultural factors contribute to the psychological problems individuals are dealing with
Sexism, classism, racism, patriarchy. Therapy cannot be done without understanding and addressing these issues
predecessor of cognitive therapies ("tyranny of shoulds"), opposed to classic Freudian notions (womb envy NOT castration anxiety)
patriarchic mental system which labels women as disturbed if they do not want to engage in full-time parenting
conducted research on how broad generalizations about women are done by experimental psychologists without including women as subjects
Client and the therapist work together and use tools of psychotherapy to undermine the internalized and external patriarchal realities. Sources of distress and brakes on growth and personal power.
Not mainly focused on males, many women participate in dominant hierarchical patriarchy. Model of power and social relationships built on oppression, discrimination and holding others back.
Pathological use of power over others and damage caused by it.
Feminist Therapy: 4 types of power
1. Somatic Power
2. Intrapersonal Power
3. Interpersonal Power
4. Existential Power
meaninglessness and disconnection VS. feeling free to embrace preferred spiritual or religious practices
related to body image and comfort; acceptance of one's real body as it is VS. preoccupation with media images
excessive focus on caring for others and others' opinions. Self-awareness, clarity and attunement to one's own emotions
feelings of hopelessness, helplessness and isolation, feeling invisible; ability to be assertive, self-efficacy
• Used to facilitate therapy
• Models openness and transparency
• Enhances connection
• Shares experiences
• Egalitarian relationship
Therapists may share their own experiences, when appropriate, to normalize, equalize, and liberate the experiences and emotions of the person in therapy.
Focus on Sexuality
•People feel rigid about their gender role and there is shame if they don't fit
•People don't understand their bodies and cannot articulate what they want
•Therapy is safe space
Personal and political context
A person's issues are contemplated within the framework of the person's culture, political, or social context.
*Commitment to social change
The aim of therapy is not only to help the individual but also to make a positive impact on society.
Value of diverse perspectives
The therapeutic process honors and welcomes diverse perspectives
An egalitarian relationship
The therapeutic relationship is set up to demystify therapy and to prevent a power imbalance between the therapist and the person in treatment.
A strength-focused approach
A therapist may avoid diagnostic labels, redefine mental health issues, and highlight the strengths of the person in therapy.
Recognition of all types of oppression
Therapists typically express recognition of the fact that oppression is harmful to all people.
Gender-role analysis and intervention
An exploration of the impact of gender roles on mental health may be conducted to develop the person in treatment's insight.
Therapists and those in treatment often examine the various ways unequal power has impacted the ability to grow and achieve.
Therapists can help shift the perspectives of those in treatment by identifying social factors that may affect mental health issues, reframing them in strength-based ways.
Therapists may encourage those in therapy to engage in social activism as a method of achieving greater empowerment.
Goals of Feminist Therapy
1. Helping clients see the social forces that have diminished their sense of power and control
2. Encouraging clients to reclaim power, authority, and direction in their lives
3. Allowing clients to experience this shared power in the therapeutic relationship
4.Honoring and facilitating female ways of being (including growth stemming from deep, intimate relationships)
1) Two Branches
• Constructivists believe that all reality is constructed within the individual
• Social constructivists focus on how people join to create realities (dialogue)
Basic Assumptions Guiding Practice
• Use positive "solution talk"
• Clients can behave effectively once the recognize effective behaviors
• Exceptions to every problem can help with solutions
• Clients need help to see other sides of story they are presenting
• Small changes pave the way for larger ones
• Therapists should take cooperative stance rather than a controlling one
• Each solution is unique, no "right" solutions
• Postmodern philosophy: "object reality" is individually or socially constructed; there is no claim to objectivity.
• Freud said "words were originally magic"
Solution-Focused Brief Therapy
Steve de Shazer & Insoo Kim Berg (1978):
Clients don't need to know anything about why or how their problem originated. Focus is helping clients generate solution. Interventions: "formula tasks" and "skeleton keys"
William O' Hanlon & Michele Weiner-Davis:
o 1980's based on SFBT
♣ Focused on validating client's emotions and experience
♣ Less directive and formulaic
♣ More collaborative
• Clients describe problems, therapist asks, "How can I be useful to you"?
• Develop well formed goals, "What will be different in your life if when your problems are solved"?
• Inquires about times when problems were not present
• Therapist offers summary feedback after each session and provides encouragement
• Evaluate progress with client using a rating scale and form plan together.
Ask what has been done since calling for appointment
• Customer - client and therapist work together to identify and solve problem
• Complainant - client states problem but not willing to take a role in constructning solution
• Visitor - client in therapy due to someone else thinking client has problem
Identify times when the problems didn't exist, "news of difference"
The Miracle Question
IF a miracle happened and the problem was solved overnight, how would you know it was solved and what would be different?
Asking people to rate feelings, moods, progress on a numerical scale
Formula First Session Task
Homework after first session that asks the client to observe what in their life they would like to continue to have happen in their lives. Discussed in second session.
take break during session and formulate feedback and discuss it. Compliments, bridge, suggested tasks (observational, behavioral)
Identify changes that mean success and encourage the maintenance of these changes
Key Concepts of solution focused brief therapy
Unique focus of SFBT: focus on what is possible and have little to no interest in how the problem started. It is not necessary to know the originality of the problem to promote change.
Positive Orientation: people are healthy and competent and have the ability to create solutions to enhance their lives.
Looking for what is Working: focus on what is working in the client's life and encouraging clients to replicate these patterns is very important.
♣ Personal narrative metaphor is the story that defines and organizes each individuals life and relationship with the world
♣ As we live we develop a personal story, people can oppress themselves through personal narratives or be trapped by them, written through a perspective of personal freedom
Externalization and Deconstruction
View the problem as the problem, not the person. Externalization one way of deconstructing the power of a narrative and separating the person from identifying with it.
1. map influence on person's life
2. map influence of person's life on problem
o All systems strive for homeostasis. Families too.
o Homeostatic balance = safety and familiarity
o Patterns that are familiar = safety, even if they are painful or pathological
o Families tend to return to the familiar
o Change = stress and resistance
o Systems must be allowed time to accommodate.
Theories of Psychopathology:
2 main determinants of client's problems:
1. The client has gotten stuck using ineffective solutions. Clients become stuck because they construct their experiences, using language in a manner that leads to stuckness. Therapist examines problems and psychopathology for the sole purpose of deconstruction
2. The client believes in an unhealthy, pathology-based self-, couple, or family narrative. E.g. clients write themselves into their self-narratives as losers, or construct a narrative in which "problems" obscure "strengths". Deconstructing and reconstructing
Assessment of Psychopathology
• Avoid focusing on problem too much
• Use of scaling ad percentage questions
• Assessing motivation
• Credulous ( "if you don't know whats wrong with the person, ask him; he may tell you")
Main Techniques of Psychopathology
• Variety of question in SFBT (e.g. pretreatment change question)
• Externalizing conversations: people often blame themselves or others for problems and it's unhelpful; many clients come to therapy because their narratives are saturated with problems for which they are responsible; ECs are designed to help people take these problems out of their intrapsychic realm (e.g. how long have you been working against this addiction problem? How might you tell your anxiety thank you and goodbye?)
• Relabeling and reframing: often using language.
• Formula tasks (SFBT): e.g. first session formula task (what you want to continue to have happen), write-read-burn task etc.
• Do something different task
• Letter writing (in narrative therapy): therapists write to clients (e.g. summary letter, redundancy letter, letters of prediction etc.)
Circular causality Identified patient
o Similar to feminist, constructive and multicultural approaches, family systems theory places the problem outside of the individual
o Entire family as the client
o Example of linear thinking: A(Dad) + B(alcohol abuse) = C (unhappy family)
o Circular thinking takes in context and other players.
o Families usually have an identified patient: "if he or she would just change, things would be much better for our family"
o Having an IP serves a role: the problem is localized in one person, everyone is safe. No need to examine own behavior and take responsibility.
o When the family walks in, everybody wants to talk about the IP
o Shifting to family lens is a challenge
o Family therapists face resistance there are many tempting moments to collude with family members and view the IP as the "true patient"
o Focus must be on relational interactions (otherwise it's just individual therapy with other people present in the room)
o Achieving family's buy-in of the systems idea is the major task. Getting the family to see themselves as the collective client.
First- and second-order change
o Change that addresses symptoms vs. change that addresses patterns
o First-order: change in symptoms. Superficial. Ignores family dynamics. Difficult to maintain new behaviors because the underlying patterns remain themselves
o Second-order: changing deeper interactional patterns. The goal of therapy.
o Questions to ask: What's happening in the family that maintains Dad's drinking? What purpose does Dad's drinking serve for the family?
Ability to attend to process
Subsystems, Boundaries, Coalitions, Alliances, Triangles, Hierarchies, Roles & Rules
Alliance, coalition and triangulation
forming alliances is natural for gaining connection and support. Coalition is a type of alliance when, for instance, two family members side together against the third. Triangulation is when dyad in conflict pulls in a third party. This 3rd party becomes a focus of relieving dyadic distress. Usually a less powerful member, often a child.
sets of expectations; overt rules are spoken and direct; covert rules are unspoken and often very powerful;
someone can be a "problem child" for the family; family roles are limitless (breadwinner, caretaker, logical one, emotional one etc.); individual member can have multiple roles; family roles and rules provide predictability;
Group Counseling vs. Group Therapy
Counseling groups focus on growth, development, enhancement, prevention, self-awareness, and releasing blocks to growth. Usually problem-oriented (educational, career, social or personal)
Salvador Minuchin's Structural Family Therapy
o More attention to homeostasis, subsystems, boundaries and coalitions in current functioning
o Focus on changing the organizational structure of a family
o Role of the counselor: directive, relation is essential
o Key idea: family behavior is a function of its structure
o Focus on family boundaries: rigid and diffuse; boundaries between subsystems, individual members
o Goal = development of clear and intentional boundary making
o How do you do that?
1. Mimesis: join the family, embrace similar affective styles and mannerisms -> foundation of a trustworthy relationship
2. Family mapping: conceptualize the family structure (boundaries, roles etc.)
3. Evoke family enactments: here and now; have conflict play out in session; dysfunctions seen not merely described
4. Re-structuring: delicate balance between stability and change; use interventions to help open or close boundaries
5. Use techniques: unbalancing (therapist intentionally forms an alliance with the weak family member); intensifying (encourage strong emotional expression; heighten distress); reframing (restatement of the family's problem from another perspective)
Murray Bowen's Intergenerational Family Therapy
o Psychodynamic foundations, largely focusing on family's history and patterns across generations
o Firs to formulate such key concepts as triangulation, emotional cutoff, enmeshment; also introduced the use of genograms
o Goal = differentiation: establishment of a calm, observant and logical self in the face of family turmoil. Ability to resist the unconscious grasp of the family of origin's rules and roles. Achieve individuation while remaining connected.
o Role of the therapist: investigator and later coach - exploring patterns and guiding towards differentiation. Objective, detached, avoids enmeshment
o Genograms: often used as a primary instrument in assessment
Jay Haley's Strategic Family Therapy
o Insight is not necessary for change. Families can change by following a counselor's suggested strategies
o Role of the counselor: expert role; directive
o The assumption is that families are using ineffective problem-solving strategies
o Focus on these strategies
o Real problem involves one of the three maladaptive solutions:
1. Needing to act, but failing to do so
2. Needing to stop acting, but failing to do so
3. Solving the problem at a level that is ineffective
o The goal is to interrupt old, ineffective solution patterns
o Give paradoxical directives, advise the opposite of the necessary: prescribing the symptoms, creating ordeals and positioning
o "I know you say you are depressed, but I am not sure you are quite depressed enough. For the next week, really commit to your depression; make it obvious and allow it to really get in your way"
Virginia Satir and Carl Whitaker's Humanistic and Experiential Family Therapy
o The relationship is central. Attentive and emotionally attuned tone.
Encourage families to explore, discover and make new changes in the moment
o Role of the counselor:
attuned to the family, uses self-disclosure, models personal congruence; use of co-therapy team is recommended practice (models communication, conflict etc.)
o Depathologize clients
o Talk about families being stuck in their unique growth process
o To help get unstuck:
openly articulate feelings, take risks to become flexible and move into the unknown Humanistic and Experiential Models
o Experience produces change
o Goal = create an experience with the family that allows for freedom of expression and new interaction patterns
o Recognize covert patterns and promote open communication
o Example of experiential technique: family sculpting - allows to communicate the unspoken clearly
Willingness to challenge oneself
self-awareness implies taking an honest look at oneself; awareness of personal conflicts and problems, vulnerabilities and countertransferences;
being emotionally present = being moved by the joy and pain others experience; recognize and give expression to own emotions; not fragmented and preoccupied by other matters; "being there" for clients
self-confidence and awareness of one's influence on others; it is not possible to give to others what you don't possess
interact bravely and don't hide behind the professional role; admitting mistakes; model being yourself for the clients
Sincerity and authenticity
sincere interest in well-being of others; sincerity includes being direct; sincerity + respect; authenticity means appropriate selfdisclosure
Sense of Identity
clear values; awareness of strengths, limitations, needs, fears, motivations etc.; cultural heritage, ethnicity, sexual and gender identities
Belief in the Group Process and Enthusiasm
enthusiasm is contagious
Inventiveness and Creativity
avoid getting trapped in ritualized technique
leading a group can be demanding; can feel energy being drained; be aware of own energy levels and sources of nourishment
Commitment to Self-Care
habits of thinking and action that promote wellness
sensitive to what is being communicated; undivided attention on the speaker; do not focus exclusively on the content; teach members how to listen to each other
respond to confusing aspects of message, help clarify and sort out thoughts and feelings
pulling together the important elements of a group interaction; aids transition from topic to topic, necessary at the end of the session Skills
most overused by inexperienced leaders; negative impact on group interaction; open-ended questions; questions at the group level
share hunches with members; don't be dogmatic
powerful instrument of challenging members to take an honest look at themselves; entails risks; many leaders shy away from confrontation
responding to the essence of what was communicated;
encouraging and reinforcement when members disclose personal information, experience strong feelings etc.; being psychologically present; supporting too soon is a problem
forces that result from the interaction of group members
Factors included: leadership, roles, interaction patterns, cohesiveness etc.
o Stages of group development:
1. Pre-group (formation) stage
2. Initial stage
3. Working stage
4. Final stage
• Must be able to move on!
♣ Considerable time dedicated to planning
♣ Written proposal must include:
• basic purposes, population to be served, clear rationale, recruitment, screening and selection process, size and duration of group; open or closed; frequency of meetings; evaluation and follow-up procedures
♣First thing to be done: announcing group and recruiting members
♣ Screening and selecting group members
• an ethical requirement; counselors select group members whose needs and goals are compatible with goals of the group, who will not impede the group process and whose well-being will not be jeopardized by group work. At least do a pre-group interview. Explore fears and concerns.
♣ Probably should be excluded: actively psychotic, severely limited in interpersonal skills, unable to abide by a contract + suicidal, sociopathic, prone to bizarre behaviors
♣ Open vs. Closed groups
• population and setting; closed groups foster dynamics and cohesion; in open groups new member might have problems fitting in, all may have problems sharing
♣ Determining the structure of the group, getting acquainted, exploring expectations
♣ At the initial sessions members tend to keep a "public image"
♣ Certain degree of anxiety and insecurity
♣ Primary tasks: inclusion and identity
♣ Will I be accepted? How much do I want to reveal myself? Do I fit and belong here? Likes and dislikes.
♣ Trust = foundation of the group
♣ People make the decision of whether to trust the group or not. Is it safe? Role of the leader
♣ Role of the group leader
•modeling (e.g. state expectations openly at the outset); helping identify goals (help participants get involved); division of responsibility (active vs, passive style); structuring (can be useful or inhibiting -> anxiety vs. dependency)
♣ Deal with anxiety, defensiveness, doubts etc.
♣What if I lose control? What if I cry?
♣ Stems from the fear of letting other see beyond the public image
♣ Fear of being judged and misunderstood Transition
♣ Dealing with Reluctance
♣ "You push people too much. I feel you aren't willing to accept a "no"
♣ Distinguish between a challenge and an attack. Attacks don't leave space for your response.
♣ Reluctance and guardedness
• some are reluctant to explore deep or painful feelings; serves a protective purpose; defensiveness can severely interfere with group process if unexplored.
♣ Group cohesion is achieved
♣ Less dependency on the leader; trust and communication
♣ Characteristics of an effective working group: here-and-now focus; members more readily identify their goals and concerns/take responsibility for them; willing to work and practice; most of the members feel included; an orchestra feeling; members assess their level of satisfaction and take steps to change things if they are not working out well
oConsolidation and Termination
♣ Transfer skills to outside environments
♣ Review and reinforce changes
♣ Learn how to face future challenges
♣ Termination evokes themes of death, mortality, separation, abandonment, and hopes for a new beginning
♣ Express and process feelings. What the group meant.
♣ Effective termination includes: dealing with feelings, examining the effect of the group on oneself; giving and receiving feedback; completing unfinished business
the ability to assume the worldview of others
enhancing the group experience and helping members reach their goals; facilitate open and direct communication; help assume increasing responsibility for the group
using catalysts to focus members on meaningful work; providing links between themes; use techniques
help group members clarify and set goals
ongoing process; after each session think of what was going on in the group and with individual members;
specific and honest; encourage members to give feedback; how a person appears to others Skills
an intervention to help members develop alternative course of thinking or action; may include homework assignments, behavioral experiments in group, advice etc.; not only from leader; some risks (e.g. belief in simple solutions)
from unnecessary risks associated with the group; some interactions must be stopped
in an appropriate way
members learn by observing group leader's behavior
connect members; greater independence and connectedness to group
sometimes the leader must stop some counterproductive activity; must be done without attacking; focus on specific behavior not on character of the person; examples of things that must be stopped: criticisms, invading privacy, perpetually giving advice, storytelling, gossiping, inappropriate and inaccurate interpretations
each session and the whole process; closure and openness; transfer skills to life, prevent future problems, sources of further help etc.
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