Psychotherapy and Counseling Overview

Introduction to Counselling in Social Work

• Counselling is a face-to-face communication process to help people make decisions or solve problems.
• It's a helping process aimed at problem-solving across a person's lifespan.
• A holistic view of emotional, social, vocational, educational, health-related, developmental, and organizational concerns is incorporated.
• It involves the delivery of evidence-based psychological therapy.
• Counselling is a method of identifying practical solutions to problems (e.g., family conflicts, personal problems, difficulty adjusting with others).
• A professional relationship empowers diverse individuals, families, and groups to achieve their mental health, wellness, education, and career goals.
• Personal history, combined with the explicit use of psychological theories, is necessary to analyze the process of a particular therapy or counseling.

Practical Definition of Counselling

• A helping profession involving one person (counselor) helping another (client) to overcome difficult emotional, behavioural, or relationship problems.
• An understanding and acceptance of one's personal history is crucial, alongside the explicit use of psychological theories to analyse therapy processes.
• The American Counseling Association (ACA) defines counseling as a professional relationship that empowers individuals, families, and groups.

Brief History and Trends of Counselling

• Counselling, in the 19th century, was primarily advice-giving and informational to address emotional problems.
• Early counselors were called teachers and social advocates focused on child welfare, education, employment, and legal reform.

Early Counselling Pioneers

• Frank Parsons, considered a father of vocational guidance, founded Boston's Vocational Bureau in 1908.
• Jesse B. Davis created the first systematized guidance program in public schools.
• Clifford Beers founded the Mental Hygiene Movement in the early 1900s, focusing on mental health, to improve the conditions of mental institutions.

Mental Hygiene Movement (1908)

• The goal was educating the public regarding treatment of disturbed persons.
• The community mental health center emerged due to the Mental Hygiene Movement.
• Improvements like psychopathic hospitals, community aftercare services, and diagnostic/outpatient clinics followed.
• Standards for treatment and prevention were raised.

Rapid Growth in Scientific Research (1904-1929)

• Statistical analysis, test theory, human and animal learning, social and abnormal psychology, and empirical bases of psychology saw development.
• A significant advance in this area included Alfred Adler, a student of Freud, pioneering family counseling and child treatment.
• Adler was among the first to apply public education for addressing community health issues.

Setting the Counselling Ground

• Vocational guidance started gaining momentum in the early 1900s.
• The National Vocational Guidance Association (NVGA) was founded in Michigan.
• The Smith Hughes Act, also known as the National Vocational Education Act, was passed in 1917. This provided federal aid for vocational education in agricultural and industrial trades as well as home economics.

Counselling in the 1930s

• Abraham and Hannah Stone established the first marriage and family counseling center in New York in 1929, marking a move towards a broader counseling approach.
• E.G. Williamson created the trait and factor theory, which posits that individuals have unique patterns of traits (interests, values, abilities, and personality characteristics) and that counselling helps determine suitable education and career paths.
• The trait and factor approach utilizes measurement tools to assess talents, abilities, interests, behavior, and personality, to predict suitable education and life paths.

Emergence of ACA

• The American Personnel and Guidance Association (APGA) was initially the name. This changed over time to the American Association for Counseling and Development (AACD).
• The ACA was formed as a result of these name changes. Today the American Counseling Association acts as an organization representing Licensed professional counselors, counseling students, and other counseling professionals in the United States.

Today's Counsellors

• Counsellors assist clients to adapt to life changes (e.g., loss of a loved one, unemployment, divorce).
• Counsellors help develop skills and strategies for personal and interpersonal challenges.
• Counsellors help clients recognize and modify behaviours that hinder well-being.
• Counsellors help clients cope with and manage mental health concerns (e.g., anxiety, substance abuse, depression).
• Counsellors assist clients with defining and achieving goals.

Counselling in 1986

• Sigmund Freud developed psychoanalysis as a therapy for internal emotional conflict.
• Psychotherapies focus on unconscious processes, repressed memories, and emotions.

Session Two: Types of Counseling

• One-to-one/Individual Counseling: focuses on personal growth, problem-solving, and decision-making needs; individuals gain empathy, and skills to discuss personal matters.
• Family Counseling: improves family communication, interpersonal relationships, and cohesiveness for various issues.
• Group Counseling: A treatment for people who share similar experiences; this enables them to listen to each other, offer support, gain better self-awareness, learn new ways to interact with others and develop confidence.

Topics to discuss in Group Therapy

• Substance Abuse, Mental Health Conditions, Emotional Wellness, Grief, Criminal Behavior, Divorce, and Trauma are potential discussion topics.

Group Counseling Advantages

• Group atmosphere mirrors real world interaction, allowing members to practice new behaviors, interpersonal skills, and gain empathy.
• Groups help members see that they aren't alone (universalizing). Members gain support and develop a sense of belonging.

Group Counseling Disadvantages

• Less individualized attention with a focus on group as a whole; privacy can be compromised.

Irvin Yalom's Therapeutic Factors of Groups

• Group members experience instillations of hope, and a sense of universality from successes of others, allowing them to feel less alone in similar struggles.
• Sharing information fosters learning, and altruism results from helping others and gaining valuable feedback for personal growth.
• Group settings can be the source of significant personal growth, self-esteem boosts and an increased sense of self-worth.

Yalom's Therapeutic Factors (continued)

• Corrective recapitulation of the family group, socialization, imitative behaviours, group cohesiveness, release of intense emotions are all relevant themes with regard to group therapy. Existential factors also come into play in considering the meaning of all human experiences, which can promote a sense of universality despite varied personal struggles.

The Group Contract

• This outlines the goals, location, time, frequency, and attendance expectations for the group, ensuring a shared understanding amongst group members.

Group Leadership Techniques and Responsibilities

• Facilitating communication enhances member interactions and reduces negative behaviours.
• Process discussion or "Group Processing" improves group dynamics and focuses attention on current issues (here and now); "Experimentation" helps try out new behaviors while "Universalizing" builds a sense of connection and belonging.
• Discipline, rule enforcement, participation encouragement, communication, active listening, and questioning are important leadership responsibilities.

Group Leadership Tasks (continued)

• Interpretation helps to identify patterns of behaviour, highlighting the importance of emotional stimulation, in a safe environment, as well as encouraging members to support each other. Effective leadership is demonstrated via modeling appropriate behavior and administering assignments/homework.

Concerns in Group Work

• Group size, from 3-4 to even hundreds, impacts session effectiveness.
• Participant selection needs careful screening.
• Time constraints and session durations.
• Ethical considerations for confidentiality.

Types of Groups

• Task Groups achieve pre-defined goals; social/action groups, education, and learning groups also fall within this category.
• Guidance groups provide information about a specific topic.
• Counseling groups resolve interpersonal problems through a safe and caring environment.
• Psychotherapy groups focus on deep-seated psychological problems.
• Support groups deal with issues and offer support for a specific condition (e.g., cancer, addiction).
• Self-Help groups are self-organized, run by volunteers and aim to promote recovery from a shared specific condition.

Session Three: Where Counselling Works

• Counselling work takes place in various settings (e.g., in primary care, mental health teams).
• Counselling settings include hospitals, residential treatment centres, community mental health centres, and private practice settings.
• Social work settings such as prisons and probation services, social services, voluntary and charitable organizations, employee assistance programmes, occupational health, and student counseling departments are also relevant venues for counselling support.

Nature of Problems Handled by Counselors

• Counselors address diverse issues, including relationship breakdown, domestic violence, trauma, psychological disorders, effects of abuse, and conditions such as substance abuse, school dropout problems and homelessness.
• Collaboration and support enable exploration of underlying issues, empowering clients to confront changes.

What Counselors Do

• Counselors help people with physical, emotional, behavioral, and psychological disorders, supporting their well-being by alleviating distress and maladjustment
• Counselors enable clients to resolve crises, increase functioning, and develop coping skills to improve overall well-being
• Counselors work with many roles (Individuals, couples, families, Groups)

Basic Principles of Counseling

• The counseling program must recognize the client's right and ability to make decisions, respecting their worth and dignity.
• The unique characteristics of each individual are to be respected and recognized.
• Social workers/counselors should model positive, unbiased human relations and provide equal treatment.
• Counselors should maintain appropriate ethical guidelines and confidentiality.

Results of Counseling

• Counseling leads to self-awareness, understanding, changed beliefs/mental models, improved self-control, development of skills, and increased motivation for positive behavior, improving relationships and resolving personal problems.
• Improvements in relationships with others and/or resolution of problems and social involvement may result.

Goals of Counseling

• Counseling aims to enhance a person's well-being; this assists in clearly understanding and identifying options that align with a person's needs, values, feelings and/or beliefs.
• The goal is for clients to make decisions, act on them, cope better with issues, and develop life skills.

Don'ts of Counseling

• Avoid giving advice, making decisions for clients, interfering in their lives, or engaging in blaming, preaching, imposing personal beliefs, or arguing with them.
• Avoid judgment from the therapist's perspective.

Elements of Counselling Relationship (Congruence, Warmth, Respect, Trust, Confidentiality, Commitment)

• Congruence: Authenticity and genuineness in the counsellor-client relationship.
• Warmth: Unconditional positive regard and acceptance, treating clients with respect without evaluation or judgment.
• Respect: Acknowledging the client's worth, ability, and capacity to cope; being a supportive and facilitative presence.
• Trust: Authenticity and a sense of reliability that's maintained by adhering to ethical standards, placing the client's needs first.
• Confidentiality: Ensuring clients feel safe, fostering open communication.
  • Using benevolent power by addressing and using influence carefully and effectively.
• Commitment: Adherence to responsibilities in maintaining the counselling relationship, alongside trust.

Roles of Counsellors and Clients

• Counselors are responsible for delivering specified services and ethical guidelines.
• Counselors are expected to have the necessary knowledge and training to assist clients systematically.
• Client's responsibilities include commitment to working on their problems and investing time into the counselling process.

Group Counselling: Additional Notes

• Counselors should ensure an understanding of a client's condition or problem by providing complete information.
• A safe and protective counseling environment is paramount for successful communication and client interactions.
• A spirit of collaboration and respect from both clients and counselors is encouraged; clients learn, identify with and trust their counselors and use them as role models.
• Procedures, goals, and client-counselor agreements are important for a successful counseling experience.