Counseling Mid-term Study Guide PDF

*Mid-term study guide* Article Questions: **Prosek article questions** In the Leech study which is discussed in the introduction to this article, what were the findings when the study compared differences between counseling required and non-required programs? - Found that students in counselin...

*Mid-term study guide* Article Questions: **Prosek article questions** In the Leech study which is discussed in the introduction to this article, what were the findings when the study compared differences between counseling required and non-required programs? - Found that students in counseling-required programs reported lower levels of distress and higher social support. No difference between groups attitudes toward counseling and self concealment In the Snyder and Anderson (2009) article which is also discussed in the introduction, what was found regarding the outcomes for clients mandated to services? - It did not have a negative impact on the students because there were lower levels of mental health distress How did the majority of the participants in the study score for the Total Problems, DSM-orientated Depressive problems, and DSM-oriented Anxiety Problems subscales? - Normal range What does this article suggest about how students with minor distress and clinical distress respond to brief counseling? - educators may want to consider how required counseling services may benefit counseling students participating in services required early in the program sequence as a preventive intervention. Both parties benefited from brief counseling services **Storey et al. article** What are the barriers (listed by the article) to integrating mental health services in school settings? - School responsibilities and priorities - Health insurance ( financial sustainability of such services) - Engagement levels of parents and staff What are the benefits to telehealth in schools? - Reduced travel - Reduced Cost - Reduced Stigma - Promotes greater access to care and consultation among providers and school staff How does the RFP-C program conceptualize disruptive disorders? - Defenses that offer protection from painful emotions, essentially these externalizing symptoms are a form of emotion regulation that help the child cope with feelings that cannot be effectively managed How did the authors explain the difficulties they had with enrollment? - School employees attitudes towards school based mental helath programs, parents attitudes towards mental health, only schools could refer **Longhurst article** According to the introduction, what have been some historical challenges in delivering statutory Child and Adolescent Mental Health Services? - Stigma around counseling - Lack of consideration for individual differences - Difficulty getting appointments One of the superordinate themes identified was the context of the counseling. What two aspects did this theme specifically measure? - Home environment - School environment With regards to the school environment, what were the benefits perceived by parents of having counseling being delivered in the school environment? What were the concerns? - a familiar setting. - Accommodated fitting in around the students\' daily routines \"more acceptable\" - Kids were coming back to class or home upset - Missing class due to counseling, and having to make that work up.  - No received adequate information from the school regarding the counseling - Lack of engagement - Having named points of contact \"mental health lead\" in every school - Self-referral process \"drop-in services\" - Schools should actively publicize the service - Encourage young people to attend appointments by utilizing appointment slips or text reminders **Chapters 1 & 2 (Introduction)** - Book overall serves **11 different approaches** to counseling, and is meant to have each person find what works for them... which is based on personality - It is good to know all so that you can have a nice mix and use them when needed with different clients - Corey's approach is more **existential,** "we are our own best technique" That clients have the freedom to choose their future. He also believes it is important to experience what its like to be a client - It is important to use the book as a way to understand your own experiences and find what works best for you - **Psychotherapy** is a process of engagement between two people, both of whom are bound to change through a therapeutic venture - The importance of working on our own personal issues and staying mindful of our selves and authenticity - Clients place more value on the personality and character of the therapist instead of techniques used - Categories of theories: **Psychodynamic approaches** Psychoanalytic & Adlerian therapy. **Experiential and relationship-oriented therapies** Existential, Person-centered, Gestalt therapy. **Cognitive behavioral (or action-oriented) approaches** Cognitive behavior & Choice/Reality therapy. **Systems & Postmodern Perspective** Feminist/ social justice, solution-focused brief therapy & family systems - The **contextual factors**---the alliance, the relationship, the per-sonal and interpersonal skills of the therapist, client agency, and extra-therapeutic factors---are the primary determinants of therapeutic outcome. - **Countertransference**, defined broadly, includes any of our projections that influence the way we perceive and react to a client - **Chapter 4 (Psychoanalytic)** - Founder: Sigmund Freud. A theory of personality development, a philosophy of human nature, and a method of psychotherapy that focuses on unconscious factors that motivate behavior. Attention is given to the events of the first six years of life as **determinants** of the later development of personality - He believes **libido** is our life instinct which drives us - **Death instinc**t is the aggressive drive. Which is the idea that people tend to manifest thorough unconscious behaviors because they wish to die or hurt themseleves in a way - Considered a psychodynaminc approach - Uncouncoious motivation and reconstruction of the personality - **The EGO** attempts to organize and mediate between the id and the reality of dangers posed by the id's impulses. Aka traffic cop... mediates between the insticints and the surrounding environment. The ego is the middle guy. It is realistic, logical and formulates plans of action for satisfying needs. Conscious and pre conscious level. - **The ID** is the original system of personality, at birth a person is all id, follows the pleasure principle. Id is illogical, amoral and driven by satisfaction. Like a spoiled brat. Mostly uncounsious. Very avoidant to actual triggers for example me in relationships instead of spending more time with myself i want my partner to fill that space in for me - - **The SUPEREGO** is the judicial branch of personality. Includes moral code, looks at things as good or bad, right or wrong. Strives for perfection. Lives up to society norms and ideas handed down from parents etc. Basically id's enemy. The rewards are feelings of pride and self-love; the punishments are feelings of guilt and inferiority. Preconscious and unconscious. For example, the superego won\'t let you have a rest day - Ways freud believes the unconscious exists dreams, slips of the tongue, posthypnotic suggestions, free association, projective techniques, and psychotic symptoms - **Anxiety** is a feeling of dread that results from repressed feelings, memories, desires, and experiences that emerge to the surface of awareness - Three different kinds of anxiety.. **Reality** which is fear of the outside world or external forces. **Neurotic** is the fear that instinct will take over and cause a person to get in "trouble". **Moral** anxiety is the fear of ones own conscience - Ego defense mechanisms: **Repression, denial, reaction formation** (opposite reaction to how you feel), **projection** (putting what you are feeling onto another), **displacement** (abusing wife due to a bad day at work), **rationalization,** **sublimation** (diverting sexual or aggressive energy into something else), **regression, introjection** (swallowing values and internalizing others) **identification** (identifying with success things to make you feel better), **compensation** (masking, over masculine man with big truck and bunch of gyals) - The **psychosexual stages** refer to the chronological phases of development, starting during infancy... which are oral stage, anal stage, and phallic stage - **Oral stage,** which deals with the inability to trust oneself and others, resulting in the fear of loving and forming close relationships and low self-esteem. - **Anal stage**, which deals with the inability to recognize and express anger, leading to the denial of one's own power as a person and the lack of a sense of autonomy. - **phallic stage**, which deals with the inability to fully accept one's sexuality and sexual feelings, and also to difficulty in accepting oneself as a man or a woman - **Erickson's psychosocial perspective:** - Clients in psychoanalytic therapy make a commitment to the therapist to stick with the procedures of an **intensive therapeutic process**. They agree to talk because their verbal productions are the heart of psychoanalytic therapy. - Goals of psychoanalytic therapy is to strengthen the ego so that clients make rational decisions instead of irrational guilt. To make the unconscious conscious by bringing everything to the surface. Goal is to achieve insight and have better self understanding. - As the counselor it is important to maintain a **blank screen approach**, remain non judgmental, avoid self disclosure and foster a transference relationship so the client can projection onto the therapist. This helps enable free association - **Transference** is the client's unconscious shifting to the analysis of feelings, attitudes, and fantasies (both positive and negative) that are reactions to significant figures who played important roles during the developmental process. As therapy progresses childhood feelings and conflicts begin to surface from the depths of the unconscious and clients regress emotionally which is where the transference comes from - The working through process consists of repetition and elaboration of unconscious material and defenses. - The **6 basic techniques** of therapy are maintaining the analytic framework (therapy relationship and environment), free association, interpretation, dream analysis, analysis of resistance, and analysis of transference. - Two different levels dream content which are **latent content** and **manifest content.** Latent deals with the hidden, symbolic, and unconscious motives, wishes and fears. Since latent is too painful it then turns into manifest content which is the dream as it appears to the dreamer. This process is called **dream work**, which happens naturally within - **Dream analysis** is figuring it out with the therapist what the dreams mean unconsciously - - Carl Jung which has a midlife crisis, focused on the midlife period. Individuation is the harmonious integration of the conscious and unconscious aspects of personality is an innate primary goal - Jung believes there is an archetypes which are **persona** is the mask to other people, **animus/anima** is the masculine and feminine side everyone has both male and females, and lasty the **shadow** which is our dark side - - Ego psychology (anna freud) which emphasizes id, ego, superego. **Object relations theory** focus on investigating attachment and separation. How we have dealt with others is how we deal with others, connects to (narcissistic disorder/ borderline personality)**Relational psychodynamic** which is focused on the relationship between client and therapist. **Self-psychology** is when we use our relationships with others to help grow and develop ourselves (everyone is a reflection of us) **Chapter 5 (Adlerian)** - Founder: Alfred Adler. Key Figure: Rudolf Dreikurs. Following Adler, Dreikurs is credited with popularizing this approach in the United States. This is a growth model that stresses assuming responsibility, creating one's own destiny, and finding meaning and goals to create a purposeful life. Key concepts are used in most other current therapies - Considered a psychodynamic approach - An analytic approach - Focuses on meaning, goals, purposeful behavior, conscious action, belonging, and social interest - **Does not believe people have personalities**, instead that everything in human life is goal directed. From birth to death we engaged in striving, overcoming and compensating. - What others would consider an individuals personality, adler believed it to be a person's style of living. Each person's style includes a life aim or goal - General movement by individuals: - **Fictional finalism**: because we never reach the goal of perfection, the goal is fictional a guiding ideal that serves a final endpoint off in the distance. - **Community feeling** which goes hand and hand with **social interest,** is what connects an individual to all of human kind, a feeling of belonging/purpose and feeling like one is contributing to the whole. Feeling good enough, feeling at home. The opposite of community feeling is **neurosis** which is an exaggerated feeling of inferiority that leads to withdrawal and isolation - For Adler, those who are unable to connect with their fellow human beings develop a private intelligence, **a private logic**. Which often leads to self absorption and isolation. - Adler believes all humans needs to address 3 life tasks. **Social task, love/marriage task, work task.** - Birth order: **oldest child** (model child, hard working, and dependable), **second child of two** (in competition with the oldest, tend the please the parents, opposite of first born), **middle child** (feels squeezed out, can become a problem child, peacemaker, holds things together), **youngest child** (baby, spoiled, gets their way, outshines), and **only child** (high achievement drive, independent, does not learn to share) - Similar to birth order **culture** is a vantage point from which individuals view of life. Culture expresses itself in community values, beliefs, and convictions. People can leave their culture but will still hold onto to certain values and perspectives. Within areas there is always a dominant culture for example in the US it is male, white, rich, straight, able bodied, Christian. If you are apart of the dominant culture you will receive automatic privileges. - The **therapeutic process** includes forming a relationship based on mutual respect, a holistic psychological investigation or lifestyle assessment, and disclosing mistaken goals and faulty assumptions within the person's style of living. Which is then followed by the reeducation or reorentation of the client toward the useful side of life - The main aim of therapy is to develop the client's sense of belonging and to assit in the adoption of behaviors characterized by community feeling and social interest. - Adlerians see the need to help clients with **first order change** which is addressing and managing severe symptoms. (doing more or less of what we are already doing to solve problems) - Adlerians believe clients will feel and behave better once they discover and address their **basic mistakes**. Mistake examples could be, mistrust, selfishness, unrealistic expectations, lack of confidence etc. Therapists also assist clients to explore their core fears, such as being vulnerable or not enough. It is all about perception - The **relationship between client and therapist** needs to be collaborative and aligned in goals. Special value is placed on the counselor's modeling of [communication and acting in good faith.] Therapists help clients change their maladaptive patterns for an adaptive one - The **four objectives/phases of adlerian therapy are**, establish the proper theraputic relationship, explore the psychological dynamics operating in the client (assesment), encourage the development of self understanding (insight translated into action, and help the client make new choices (reorientation and reeducation). THESE STEPS ARE NOT RIGID (minor psychology) - During the **subjective interview** of clients, adlerians actively listen and have a sense of wonder. The goal during this interview is to find patterns and gain understanding on why clients are moving through life the way they are and what the possible reason can be. This interview usual ends in the "question" " how would your life be different and what would you be doing differently if you did not have this issue" which usually revels a missing lif task - The **objective interview** seeks to discover information about more concrete issues such as medical issues, medications, how issues began, events, social history, why the client chose therapy, the clients copig with life tasks, and a lifestyle assesment. The lifestlye assesment investigate the family constellation and early childhood history. This assessment will help develop a holistic narrative of clients, to make sense of the way the person copes with life tasks and uncover private interpretations - During the **reorientation/reeducaion phase**, the goal of therapy is not just to reduce symptoms (first order change) also not just the emergence of a more adaptive orientation to life (second order change). Instead, it is more so the development of a preferred life and the styles of living and patterns that support it. - **Third-order change** is the ultimate therapeutic goal as it allows the client to effectively respond to life stressors in an adaptive way without the need for continuing therapy. At the heart of third order change is the development of psychological muscle. The psychological muscle includes the traits and capacities required for meeting the challenges posed by life tasks - The **crucial Cs,** feeling capable, feeling connected, feeling that one counts, and having courage - It is important to **encourage** during all therapeutic phases. Point of strengths to clients and bring it to their awareness. A way of being for Adlerian therapists - The action oriented phase is a time for solving problems and making decisions - **Psychological muscle** is the exercise of responsibility, cooperation, respect for self and others, and courage in the daily approach to the life tasks - **Techniques** Adlerian therapists use: immediacy, advice, humor, silence, paradoxical intention, acting as if, catching ones self, the push button technique, externalization, reauthoring, avoiding the traps, confrontation, use of stories and fables, early recollection analysis, lifestyle assessment, encouragement, metta meditation, task setting and commitment, homework, and terminating and summarizing - The **push button technique** is used on clients with depression. It is used to help clients become aware of their role in the unpleasant feelings. - Reminders for school counselors understand students in their totality, think about behavior teleologically, provide appropriate encouragement to students, and foster empathic students - Addressing ones self, life, mistakes and family is what is most important **Chapter 7 (Person Centered)** - Founder: Carl Rogers (major spokesperson for humanistic psychology) Key Figure: Natalie Rogers (a pioneer in expressive arts therapy). And Leslie Greenberg. This approach was developed during the 1940s as a nondirective reaction against psychoanalysis. Based on a subjective view of human experiencing, it places faith in and gives responsibility to the client in dealing with problems and concerns. - Considered an existential approach (experienial and relationship oriented) - What it means to be fully human - It suggests certain themes that are part of the human condition, such as freedom and respon-sibility, anxiety, guilt, awareness of being finite, creating meaning in the world, and shaping one's future by making active choices. - The **four periods of development** are nondirective counseling, next was client-centered therapy, third was "becoming self a self actualizing person", lastly person centered therapy - this approach assumes that clients have the capacity for self-direction without active intervention and direction on the therapist's part. - **Emotion-focused therapy (EFT)** which is empirically supported and research-informed, emerged as a person-centered approach informed by understanding the role of emotion in human functioning and psychotherapeutic change. Emphasizes the importance of increasing self-awareness, acceptance and understanding. Once clients increase awareness of emotions they can make use of it. This approach is an integration of person-centered relational principles, gestalt therapy methods, and contemporary emotion theory - **EFT's two major tasks** are to Helps clients who show too little emotion access their emotions and help clients who show too much emotion contain their emotions. Clients can not change how they feel by just talking about them, but by identifying, expressing, accepting, experiencing, exploring, and transforming in order to manage - A strength of EFT is that it is an **empirically validated** brief therapeutic approach with demonstrated effectiveness in treating anxiety, intimate partner violence, eating disorders, and trauma - **Humanistic psychology**, is referred to as a Third Force in therapy. Which is seen to be an alterntive to psychoanalytic and behavioral approaches - Existentialism and humanism are similar but also very different. Both approaches place little value on the role of techniques in the therapeutic process and empasize a having a genuine connection. Existentialists believe we are faced with the anxiety of choosing to create an identity in the world that lacks intrinsic meaning. Humanists in contrast believe in a more optimistic view that each of us has a natural potential that we can actualize and through that find meaning - **Abraham Maslow** was a pioneer in the development of humanistic psychology and was influential in furthering the understanding of self actualization individuals. Rogers ideas of being a positive fully functioning person are influenced by Maslow. Self actualization was the central theme of his work. - The **core characteristics of self actualization** people are self awareness, freedom, basic honesty and caring, and trust/autonomy. Also being able to be uncertain in life, accepting others, need for privacy and solitude, having deep relationships, genuine care for others, inner directedness, and absence of artificial dichotomies (work vs play, love vs hate), sense of humor - Maslow also postualted a **hierarchy of needs** as a source of motivation, with basic needs being *physiological needs*. If we are hungry/thirsy our attentionis riveted on meeting these basic needs. Next are the *safety needs* which has to do witha sense of security/stability. Once our physical and safety needs are fulfilled, we become concerned with meeting our needs of *belonging/love,* followed by our need for *esteem* from both ourselves and others. We are able to strive for *self actualization* only after neeting these needs. Maslow also added self transcendence as a need because it provides more meaning, purpose, and communion beyond self  - The **positive psychology** movement that has come into prominence shares many concepts on the healthy side of human exsitence with the humanistic approach. Advocates of postive psychology call for an increased study of hope, courage, contentment, authentic happiness, well being, perseverance, resilience, grit, tolerance, and personal resources. - **Three attributes Rogers** maintained are, congruence (realness/genuineness), unconditional positive regard (acceptance/caring), accurate empathic understanding (grasping the subjective world of another person) - **Actualizing tendency** is a directional process of striving toward realization, fulfillment, autonomy, and self determination - Research indicates that the attitude of therapists, rather than their knowledge, theories, or techniques, facilitate personality change in clients more - **The therapists goal** is to be a companion on the client's journey of self discovery. By being warm, empathic, accepting, and genuine, the therapist provides an atmosphere in which the client's own thrust toward growth can operate - Clients come to the counselor in a state of incongruence, that is a discrepancy exists between their self-perception and and their experience in reality - The t**herapeutic core conditions** explained are - Two persons are in psychological contact - The first, which is the client, is in a state of incongruence, being vulnerable or anxious - The second person, which is the therapist, is congruent (real or genuine) in the relationship, and this congruence is perceived by the client - The therapist experiences unconditional positive regard for the client - The therapist experiences an empathic understanding of the client's internal frame of reference and endeavors to communicate this experience to the client - The communication to the client of the therapist's empathic understanding and unconditional positive regard is to a minimal degree achievd Rogers believes that as long as these \^ are happening sufficiently, therapeutic change will occur - Person-centered therapy rests on the assumption that clients can create their own self-growth and are active self-healer - **Immediacy** or addressing what is going on between client and therapist, is highly valued in this approach - Overall it is viewed as holding space for clients and allowing them to come to their own conclusions and solutions with empathy and no judgment. - Natalie rogers expanded on her father's theory of creativity using the **expressive arts** to enhance personal growth for individuals and groups. Expressive arts therapy extends the person centered approach to spontaneous creative expression, which symbolizes deep and sometimes inaccessible feelings and emotional states. Through things like movement, visual art, journaling, sound, and music to express their feelings and gain insight. This approach lacks empirical evidence **Chapter 8 (Gestalt therapy)** - Founders: Fritz and Laura Perls. Key Figures: Miriam and Erving Polster. An experiential therapy stressing awareness and integration; it grew as a reaction against analytic therapy. It integrates the functioning of body and mind and places emphasis on the therapeutic relationship. - Considered an existential, phenomenological, and process-based approach (experiential and relationship-oriented), created on the premise that individuals must be understood in the context of their ongoing relationship with the environment. - **Contemporary relational** Gestalt therapy stresses dialogue and the I/Thou relationship between client and therapist - **Cornerstones** of the practice are awareness, choice, and responsibility - Clients are supposed to do their own seeing, feeling, sensing, and interpreting, as opposed to waiting passively for the therapist to provide them with insights and answers - Perls style of doing therapy involved two personal agendas: moving the client from environmental support to self-support and reintegrating the disowned parts of one's personality. He would want to intentionally frustrate clients during confrontations to enhance awareness. In hopes that clients can eventually handle their growth on their own. - **The paradoxical theory of change** which was suggested by Beisser, that authentic change occurs more from being who we are then from trying to be who we are not. Knowing and accepting the truth of our situation builds wholeness and supports growth - It is believed that clients can self regulate once they become aware of what is happening in and around them - **Basic principles of Gestalt therapy**: Holism, field theory, Figure formation process, and organismic self regulation - What it means to be fully human. **Holism:** The full range of human functioning includes thoughts, feelings, behaviors, body, language and dreams - **Field theory** asserts that the organism (person) must be seen in its environment, or a part of a constantly changing field. Behaviour is a function of a person in an environment. This means that a person\'s behaviour can\'t be viewed in isolation from the situation they are in. Emphasis may be placed on a **figure** (aspects of a client's experience that are most important at any moment) or the **ground** (those aspects of the client's self that are often out of their awareness). **Cues** to this can be found through the clients demeanor, tone of voice, body language, other non verbal content. Therapist often refer to this as attending to the obvious, while paying attention to how things fit and how the client makes contact with their environment and integration - **Figure Formation Process**: How an individual organizes experiences from moment to moment. Contemporary Gestalt therapists (stresses dialouge), facilitate the client's movement toward and away from this figure of interest. The need of the client at that present moment influences this process. \*For example, if an individual wants coffee, this coffee need is what comes out of the defused background and becomes \"figural\" (comes to the forefront of the client\'s environment or field) and when the individual enters a room, the \"figural\" will be related to the coffee need. - **Organismic self regulation**: the figure formation process is intertwined with this principle. Our natural capability of creative adjustment based on our moment to moment needs. What emerges in therapeutic work is what is of interest to the client or what the client needs to gain equilibrium or to change - **Contact-** Interacting with nature and with other people without losing one's individuality and becoming one with it. Prerequisites for good contact are clear awareness, full energy, and the ability to express ones self. After a contact experience it is necessary for healthy functioning to withdrawal to integrate what was learned. - **Boundary Disturbances/ resistance to contact** - The defenses we develop to prevent us from experiencing the present fully because it is too painful or triggers a negative feeling that clients want to run away from. A way to cope - **Five different kinds of contact boundary disturbances**: **Introjection** (accepting behaviors and believes regardless of one's own), **Projection (**opposite of introjection, pushing ones beliefs or needs onto another)**, Retroflection** (turning back onto ourselves what we would like to do to someone else for ex. Self harm), **Deflection (**avoiding)**, Confluence** ( blurring the differentiation between the self and the environment becoming one with environment) - - **Phenomenological inquiry** involves paying attention to what is occurring now. Also involves suspending any preconceived ideas, assumptions, or interpretations concerning the meaning of a clients experience. Therapists will ask alot of how and what questions, but will rarely ask why. "What is going on now? What are you experiencing? How does it feel right now?" Therapist direct clients to bring fantasies and traumas to the present. For example if I have a traumatic experience with an Ex I would be directed to act as though it was happening now and speak as if I am talking to my ex about how i currently feel in that traumatic situation - Instead of experiencing their feel-ings in the here and now, clients often talk about their feelings, almost as if their feelings were detached from their present experiences - - **Unfinished business** happens when figures from the background emerge but are not resolved. Which can be manifested into uncomfortable feelings such as guilt,shame, resentment, pain, anxiety, grief, worry etc. Un - The **impasse**, or stuck point, occurs when external support is not available or the customary way of doing not work. The therapist's task is to accompany clients in experiencing the impasse without rescuing or frustrating them. By completely experiencing the impasse, they are able to get into contact with their frustrations and accept whatever is rather than wishing they were different - **Blocked energy** is another form of defensive behavior, can be manifest by physically holding onto emotions and numbing them out. This often results in unfinished business. Special attention is given to where energy is located, how it is used, and how it can be blocked. It can be manifested by tension in some part of the body, by posture, keeping ones body tight,not breathing deeply, by looking away when talking, numbing feelings, speaking a certain way etc. Therapist many encourage clients to exaggerate their tension to fully experience it - - Gestalt therapy aims to guide clients to increased awareness of self in order to make changes. Gestalt does not believe change can happen without awareness. - - The **Gestalt process expects clients to do** the following: - Move toward increased awareness of themselves - Gradually assume ownership of their own experience instead of making others responsible for what they are thinking, feeling, and doing - Develop skills and acquire values that will enable them to satisfy their needs without violating the rights of others - Become more aware of their senses - Learn to accept responsibility for what they do, including accepting the consequences of their actions - Be able to ask for and get help from others and be able to give to others - The **Gestalt therapist's job** is to invite clients into an active partnership where they can learn about themselves by adopting an experimental attitude toward life. Gestalt therapists value self discovery and assume that clients can discover for themselves the ways in which they block or interrupt their awareness and experience - It is important for Gestalt therapists to pay close attention to **non verbal** cues, it provided rich information as they often represent feelings of which the client is unaware. For example, asking clients what are your eyes saying? - **Language** that Gestalt therapists focus on: - "**It**" talk when clients say it instead of saying I they are using depersonalizing language to order to not take responsibility for their feelings - "**You**" talk, this tends to keep the person hidden - **Questioning**, questions tend to keep the questioner hidden, safe and unknown. Therapist suggest clients change questions to statements - **Language that denies power,** when clients deny their own power by adding disclaimers to their statements. Therapists may try to omit these terms from clients ( maybe, perhaps, sort of, i guess, possibly). Along with the use of I cant but instead say I wont which is more in truth. - **Client metaphors**, Erving polster emphazied the importance of listening to client metaphors. He believed therapist can get alot o insight of client internal struggles through the metaphors they used. For example, it is hard for me to spill my guts here. Under the metaphor lies a suppressed internal dialogue that represent unfinished business to a present interaction. - **Listening for language that uncovers a story,** Polster also teaches the value of what he calls "fleshing out a flash". He believes clients often use language that illustrates their life struggles. - - Miram Polster described a **three-stage integration sequence** that characterizes client growth in therapy: First part of this sequence consists of **discovery** which is when cleints come to a new realization about themselves or to acquire a noval view of an old situation. Second part is **accommodation** which is when clients realize they have a choice to make changes. Thirdly, **assimilation** which is when clients learn how to influence their environment. At this point clients feel more confident to make changes in their environment - Gestalt therapists are encouraged to self-disclose in an appropriate way. - **Exercises** are ready-made techniques that are some-times used to make something happen in a therapy session or to achieve a goal - **Experiments**, in contrast, grow out of the interaction between client and therapist, and they emerge within this dialogic process and provide clients with an opportunity to increase their awareness and try out new ways of thinking and behaving. An opportunity for the client to get to know themselves on deeper levels. Makes them very vulnerable. - Experiments encourage spontaneity and intentiveness by bringing the possibilities for action directly into the therapy session. **Experiments can take many forms**: imaging a threatening future encounter, setting up a dialogue between a client and some significant person in his or her life, dramatizing the memory of a painful event, reliving a particularly profound experience in the present - - Resnick states techniques and exercises are the least important part of Gestalt therapy and is not necessary. Here are the methods that can be used: - **The Internal Dialogue Exercise**, which is to pay attention to the personality split in clients of "top dog" and "under dog" and the war between them and integrate the two. The conflict between the two is rooted in the mechanism of introjection. - **The empty chair technique** is used for role reversal. The therapist uses two chairs and asks the client to sit in one and be fully the top dog then shift to the other chair and become the underdog. The dialogue can continue between both sides of the client. This exercise can help clients integrate both sides of themselves and the side they may be denying. - **Future projection technique**, an anticipated event is brought into the present moment and acted out to identify fears and hopes for the outcome of the event - **Making the rounds,** is a gestalt exercise that involves asking a person in a group to go up to others in the group and either speak to or do something with each person. The purpose is to confront, risk, and disclose self and grow and change. - **The reversal exercise**, is when the client will act the opposit of how they are feeling. For example, a client that is very positive would behave very negative - **The rehearsal exercise**, is just as it sounds - **The exaggeration exercise** is also as it sounds, clients exaggerate their movements etc in order to be come more aware of them. For example, posture, movements, and gestures - **Staying with the feeling**, this is when clients are asked to sit with how they feel instead of trying to run away from it because it is uncomfortable - **Gestalt approach to dream work**, which is when clients are asked to act as all parts of their dreams as if they were in the present and have dialogue with each part