CPCE Study Guide PDF

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Can be preventative, growth-oriented, or remedial. ▪ Found in social service agencies, mental health settings, and universities o Structured: focus on a central theme ▪ For example: learning job seeking skills, anger management, loss/ grief o Self-help: these groups are support systems that help with psychological stress ▪ Usually not professionally led ▪ Focused on issues such as weight control, survivors of trauma, parents who have lost a child etc o T-Group: training group, the focus of these groups is to improve interpersonal skills ▪ How one functions within a group is examined o Task/Work Groups: teams of people operating independently and sharing one or more goals ▪ Committees, planning groups, study groups Group Dynamics: refers to the development and interaction of the forces inherent between and among members of the group Forces relating to the roles members play, the goals of the group, and the norms members adopt will influence how the group behaves Group behavior may range from positive and socially acceptable to negative and destructive Content: the subject under discussion Process: how the interaction or discussion is occurring o Focusing on the process allows examination of the meaning of an experience with its attendant feelings, which leads to affective learning and the development of trust within the group o The leader of the group must be skilled in processing and is able to model this skill for group members Each group session can be characterized as having a warm up, action, and closure section o In successful groups, there is a balance between content and process in all 3 sections Group cohesion: a cohesive group means that embers find the group attractive and it provides them a feeling of belonging and inclusion Cohesion is not automatic but occurs when group members take risks including self-disclosure, drop defenses, and make commitments to each other A cohesive group leads to an effective working group Group member are likely to identify with members who are perceived as attractive or having power When a group displays little or no cohesion, it is viewed as fragmented Roles of group members: Group members may assume different roles which impacts the dynamics of the group 1 o Facilitative/building role: may help group members feel a part of the group and contribute to the positive and constructive functioning of the group o Maintenance role: contributes to the bonding of the group by 2 encouraging the social and emotional bonding of the group members, helps maintain or strengthen group processes o Task role: help solve problems, aid in terms of goal setting and keeping 3 the group focused providestructure direction o Blocking role/Self-serving Role: often attempts to hinder group 4 formation and accomplishment of goals through negative and diverting behaviors, refuses to participate, serve the individual and not the group Mutuality/Universality: the feeling that one is not alone or unique, and that others have similar problems or have been in similar situations Intellectualization: the process of keeping material or content in the group on a cognitive level Scapegoating: a process whereby several members of a group gang up on an individual member and dump on them Resistance: individual or group behavior that impedes group progress o Arriving late, appearing unable to set goals, silence, talking too much, preoccupation with other issues, fear o May psychologically protect the group member 0 Role conflict: a situation where there is a discrepancy between the way a member is expected to behave and the way they actually behave frictionconflict Leadership Styles of leadership o Autocratic/Authoritarian: quick decision making but may generate member resentment o Democratic: liked by members, but doesn’t always generate the most productive group o Laissez-Faire: members are free to do as they choose, if the group is committed to a goal, it often yields the best results General knowledge and responsibilities of leader: 0o Know theories of group counseling  0 o Understand the principles of group dynamics o Know ethical issues of group work o Linking: look for themes and connect them o Blocking: stop unproductive behaviors such as scapegoating, storytelling, and gossiping Discussing resistive behavior with the group before they begin may help prevent them Oo Counselors can address resistive behaviors and model for others how to deal with them o Confrontation is a powerful technique Co-Leaders Oo Group members benefit from experiences and insights of two leaders o Co-leaders can recreate roles and serve as models so more linking is possible o Give each other feedback o Helpful if one is male and the other is female o Different reactions from the leaders may enhance group energy and O discussion o Co-leaders should have a good working relationship and should have conflicting theoretical orientations o A power struggle could fragment the group o Process the co-leading experience regularly o Pairing an inexperienced counselor with an experienced one is a good way to learn Group formation issues: P Homogenous: groups composed of similar kinds of members belonging Heterogeneous: more like the real world and stimulates interaction understanding diversity o If it is too hetero, members may not be able to relate to each other and ftp.tfifeff their problems g Open group: replace members who leave, new members provide new ideas, stimulation, and resources y Closed group: do not admit new members, building and maintaining trust and cohesion is emphasized Group size: o For an adult group with no co-leader, optimum size is 8 o Children: 3-4 + 10 Duration: o The number of weeks a group will run should be set in advance and group members should be advised of the duration o The time length of a session with adults may be up to 2 hours o Children: 20-30 minutes 90 around mins Screening: selection of appropriate members for the group o Usually conducted through an interview with the group leader ▪ Goals and purposes are explained to prospective members  o Characteristics of the potential member and motivation should be assessed theiremotionalmaturity o Should include a review of group norms/rules, confidentiality, and appropriateness of that particular group focus to the member Ethical Guidelines for Group Counseling: Informed consent: tell the client before counseling about the rights and expectations o Should be obtained before counseling begins Confidentiality: difficult to assure in group counseling o Leader must impress the need for it on all group members o Exceptions: danger to self or others, court actions, or signed waivers Research: group members are asked for permission before participating in research Group counselor training: counselors have acquired skills and competencies through education and experience Group member’s rights include: o Freedom from undue pressure participationdisclosureistheircbice o Participation is voluntary o Freedom of exit o Right to use of the group’s resources ifthegroupisnstrightforthemo.ua Norms Group rules of behavior which provide parameters to members about acceptable behavior Formal: spoken rules uestexpectations Informal: unspoken rules The rules may be different from the norms in the real world become o Ex: sharing and expressing is okay theirownmicrocosy May be pressure on members to conform to the norms o o Consequences for not doing so may be established Stages of a Group Tuckman identified 5 stages: o Forming: In this stage, most team members are positive and polite. Some are anxious, as they haven't fully understood what work the team will do. Others are simply excited about the task ahead. o Storming: people start to push against the boundaries established in the forming stage conflict inevitable is ▪ Disagreements and personality clashes must be resolved before the team can progress out of this stage, and so some teams may never emerge from "storming" or re-enter that phase if new challenges or disputes arise o Norming: all team members take the responsibility and have the ambition to work for the success of the team's goals setrules  ▪ The danger here is that members may be so focused on preventing conflict that they are reluctant to share controversial ideas o Performing: The team members are now competent, autonomous and able to handle the decision-making process without supervision ▪ Dissent is expected and allowed as long as it is channeled through means acceptable to the team o Adjourning/mourning: termination Yalom identified 4 stages: o Orientation: Search for meaning, attempts to determine group structure and meaning; search for similarities among group members; members look to leader for approval, acceptance, and answers o Conflict: Members attempt to establish preferred amount of initiative 2 and power; establish a control hierarchy; members may express hostility toward therapist (resistance) 3o Cohesion: Unity, intimacy, closeness emerge; trust and self disclosure increase; attendance improves; cohesiveness becomes analogous to therapist-client relationship connection o Termination Corey identified 6 stages (middle 4 are commonly known as CORE): o 1: Formation – Pregroup Activities ▪ planning, leader prep, recruiting, screening ▪ Leader: identifies goals and purposes of group and announces the group o 2: Orientation and Exploration g ▪ orientation and structuring of the group process, inclusion, identity, and establishing cohesion and trust ▪ Leader: models interpersonal honesty, helps identify goals and structures, states expectations and ground rules, psychologically present and genuine o 3: Transition – Dealing with Resistance ▪ anxiety, conflict, resistance, intellectualization, questioning, challenging leader ▪ Leader: creates a supportive and trusting climate, addresses anxiety and resistance, provides a role model, identifies positive and negative behaviors to group process, keeps group goals in focus, supports and challenges members o 4: Working – Cohesion and Productivity ▪ cohesion, effective working group, using resources within the group, less dependent on leader, self exploration increases, more focus on here and now ▪ Leader: provides reinforcement, links themes, supports risks, models appropriate behavior, encourages translating insights into action o 5: Consolidation and Termination  ▪ Final stage of the group process and will determine how effective the group experience was for the members ▪ Feelings about termination including sadness and anxiety, unfinished business, feedback, preparing for outside world, decision making ▪ Leader: deals with feelings, reinforces changes, helps members make plans O o 6: Postgroup Activities – Evaluation and Follow-Up o ▪ evaluation of outcomes, follow-up referral for other services ▪ Leader processes the group experience with others (supervisor), evaluates the process and outcomes, conducts follow up session with group members to reinforce learnings Irvin Yalom: 0 11 curative factors that exist in successful group work o altruism abletohelpothers isepesteem o universality disolationts.name 0oo interpersonal learning imparting information o developing socialization techniques o imitative behavior o group cohesiveness o catharsis o corrective recapitulation of the primary family group o instillation of hope seeingotherssuceedihspeporsep Y.fi'ts d h o existential factors (individual alone is responsible) ftp.fhfhhip Yalom identified group leader function that are present in group counseling no matter what the theoretical orientation of the counselor: o Emotional stimulation: encouraging the expression of feelings, values, and beliefs, and deep emotional concerns ▪ Leader uses: confrontation, challenge, self-disclosure, modeling behavior o Caring: characterized by warmth, acceptance, genuineness, and concern ▪ Leader uses: honesty, openness, promotes the growth of trust o Meaning attribution: provides cognitive understanding of the events in the group, experiences are named and feelings are put into words ▪ Leader uses: interpretation, clarification, explanation o Executive leadership function: leader structures, suggests limits and norms, and provides direction ▪ Leader uses: pacing, blocking, stopping, managing the group as a social system Michael Waldo: Suggested different levels of Yalom’s leadership function were needed depending on needs/diagnostic criteria of the group and the clinical setting different leadersarenecessaryfordifferentgroups Jacob Moreno: Theater of Spontaneity in Vienna, 1921 Psychodrama: emphasizes enacting conflicts or crisis situations in the present o Focus is on the here and now o Goal is to reorganize individual’s perceptions o Allows for catharsis, insight, reality testing Psychodrama includes: o Director/producer: group leader o Protagonist: a group member (volunteer or selected) o Auxiliary ego: may be several members, representing people or objects o Audience Psychodrama occurs on a stage which may be an actual stage or a part of the room Three parts: o Warm up (preaction) o Action o Integration Family Counseling and Couples Counseling Family counseling is a special application of group counseling Family can be seen together and often individually as well Much of the emphasis is on identifying family problems, defining personal and family goals, and teaching family members new behaviors and interaction patterns Couples counseling often focuses on educating couples to improve communication between themselves and their children, resolve conflicts, and learn parenting skills Prevention Groups Primary Prevention Groups: emphasis is on preventing problems and developing healthy behaviors o Guidance or psychoeducational groups o Educational groups on drugs/alcohol Secondary Prevention Groups: have preventative and remedial elements, focus may be on reducing the length or severity of a problem o Counseling groups o Dealing with grief, problem solving Tertiary Prevention Groups: focus of these groups is to return individuals to healthy, full functioning o May involve personality change or rehabilitation o Counseling or therapy groups o Counseling individuals with PTSD Group Counseling and Multicultural Issues Cross cultural clients may not understand how counseling works  Extent of group members’ acculturation may be a significant factor in their understanding and willingness to participate Some cultures discourage sharing of personal problems with others o May appear as resistance in groups Silence is valued in some cultures Participants in diverse counseling groups may be insensitive or lack understanding of cultural differences among members Confrontation may have a different impact cross-culturally Leaders should be aware of how their own cultural background influences their perceptions and actions Systemic and historical factors pertinent to the group must be recognized Research on Groups Outcome research: shows evidence of effectiveness of group work o Date supports group counseling Process research: higher level of quality of research o Demonstrates perceptions, expectations, and beliefs of group members can be changed Counseling Theory Applied to Group Work See Chart on page 162 Organizations for Group Therapy: Association for Specialists in Group Work o The division of the ACA that focuses on group intervention American Society for Group Psychotherapy  CPCE Human Growth and Development Study Guide Development is defined as systematic changes and continuities in the individual that occur between conception and death. Physical changes Cognitive changes Psychosocial changes A theory is a group of logically organized and related hypotheses that attempts to explain a problem lenses Theories of how humans grow and develop fall into broad categories: Learning: behavioral theories, social learning theories, and information processing theories Cognitive Psychoanalytic: neo-Freudian and ego psychology theories Humanistic: Self psychology theories Changes can be viewed as: Quantitative: change in number, degree, or frequency (intellectual development) Qualitative: chance in structure or organization (sexual development) Continuous: changes are sequential and cannot be separated easily (personality development) Discontinuous: certain changes in abilities and behaviors can be separated from others which argues for stages of development (language development) Mechanistic: reduction of all behavior to common elements (reflexive, instinctual) Organismic: because of new stages, there is change or discontinuity, the organism is including the use of cognition (moral development) Developmental Concepts: Nature: genetic and hereditary factors Nurture: learning and environmental factors Genotype: genetic or inherited makeup of the individual Phenotype: the way an individual’s genotype is expressed through physical and behavioral characteristics Tabula rasa: john locke ! children are a blank slate and acquire traits through experience Plasticity: for most individuals, development is plastic representing an easy and smooth transition from one stage to the next abilitytoadapt Resilience: the ability to adapt effectively when experiencing adverse circumstances abilitytocope  I. Neurobiology Neuroscience is sometimes referred to as the missing link the mental health professions Through the use of different theories, skills, and interventions, counselors promote the release of various neurotransmitters which lead to related brain changes A. Neurotransmitters They carry messages between neurons that stimulate reactions in the brain These chemical reactions stimulate different parts of the brain leading to cognitive, emotional, psychological, and behavioral outcomes Four principal neurotransmitters: o Acetylcholine: important for memory, optimal functioning, emotional balance, and control serotonin Polepression Serotonin: affects feelings, behaving, thinking; critical for o emotional and cognitive processes; sleep and anxiety control mood anxiety o Dopamine: important for emotional wellness, motivation, pleasurable feelings Pmotivation o GABA: helps reduce anxiety, ADHD promotes relaxation andsymptoms sleep II. Freud (Psychoanalytic/psychosexual) on the unconsciousmind impactofearlychildhood experiences There is an interaction between our internal needs/forces and the environment We have unconscious needs that need to be met; goal of therapy is to make the unconscious conscious through dreams, free association, and transference analysis o Manifest content: what happens in the dream o Latent content: hidden meaning of the dream Libido is the basic energy force of life consisting of life instincts and death instincts A. Structural Model Id: desires, love and aggression, pleasure basicinstincts Ego: grows out of the id, balances the drives of the id and the values/morals of the superego operatesaccording Superego: desire to follow rules, be the best we canreality be, reality, formed by resolution of the oedipal conflict attemptingto balance theother B. Five Stages of Development Oral stage (Birth-18 months) o Chief source of pleasure occurs through the mouth (eating) o Total dependence on the mother o Too much dependence leads to oral fixation, addiction o Orally aggressive when your needs are not met Anal Stage (18 months – 3 years) o Main source of bodily pleasure is expelling feces o What should I keep and what should I let go of? o Anal retentive: overly obsessed with cleanliness o Anal expulsive: unclean o Can progress into OCD Phallic Stage (3 – 5 yrs) o Source of satisfaction in genital area o Freud thought this was the most important o Oedipal complex/Elektra complex ▪ The child realizes there is a father and not just the mother and infant, realizes the mother loves somebody else which creates a need to learn to share love ▪ Once this issue is resolved, the superego develops ▪ Oedipal complex causes neuroses, most psychopathology is developed due to incorrect resolution of Oedipal Complex o Latent (6 – 12 years) ▪ Social interests replace sexual interests ▪ Sexual drives are not as prominent ▪ Learning, hobbies, and social interests take over o Genital (12 – 19 years, may be indefinite) Fixation: incomplete or inhibited development at one of the stages Erogenous zones: areas of the bodily excitation such as mouth, anus, and genitals C. Defense Mechanisms Unconscious protective processes that help us control primitive emotions and anxiety Repression: denying or forgetting the impulse or idea that provokes anxiety Projection: avoiding conflict with oneself by ascribing the ideas or motives to someone else Reaction formation: expressing a motive or impulse in a way that is directly opposite what was originally intended  Rationalization: providing a reason for a behavior and thereby concealing the true motive or reason for the behavior Displacement: substituting a different object or goal for the impulse or motive that is being expressed Introjection: identifying through fantasy the expression of some impulse or motive Regression: retreating to earlier or more primitive childlike behaviors Denial: refusing to see something that is a fact or true in reality Sublimation: energy is channeled into socially acceptable activities such as work III. Erik Erikson (psychosocial) howyoudevelopthroughsocialinteraction Ego psychology: Ego has it’s own drive of mastery and competence 0 Ego is responsible for learning new things, making plans, decisions, and adapting to the external environment Erikson: identified 8 stages wherein a psychosocial crisis or task is to be mastered over the course of the lifespan continue adulthood through A. Stages of Psychosocial Development Trust vs Mistrust MET Birth – 1.5 years Infant develops trust if basic needs are met Autonomy vs Shame 1.5 – 3 years Infant asserts self; develops independence and doubt if allowed Initiative vs Guilt 3 – 6 years Children meet challenges and assume responsibility; identify the rights of others Industry vs Inferiority 6 – 11 years Children master social and academic skills or feel inferior Identity vs Role Adolescence Individual establishes social and Confusion vocational roles and identities or is confused about adult roles Intimacy vs Isolation Early Adulthood Young adult seeks intimate relationships or fears becoming lonely and isolated Generativity vs Middle Middle aged adults desire to produce Stagnation Adulthood something of value and contribute to society Integrity vs Despair Later Adulthood Older adults view life as meaningful or with regrets e IV. Jean Piaget Kidsactivlyconstructtheirknowledgethroughexperiences Studied cognitive development (intelligence) We inherit two tendencies: o Organization: how we systematize or organize mental processes and knowledge o Adaptation: how we adjust to the environment ▪ Assimilation: modifying the relevant environmental events so g they can be incorporated into the individuals existing structure ▪ Accommodation: modifying the organization of the individual pyre t L in response to environmental events adjust schemato newinfo Equilibration: people assimilate (take in) new info and accommodate fit (change) their cognitive schemas accordingly Schema: a mental structure that processes information, perceptions and experiences Claimed his stages existed in all cultures but ages may vary A. Four Stages of Cognitive Development Sensorimotor FTO Birth – 2 years The child differentiates self from objects Can think of an object not actually present Seeks stimulation Preoperational 2 – 7 years Language development is occurring Child is egocentric (cannot take in the views of others) Classifies objects by one feature Centration: focusing on a key feature of a given object while not noticing the rest of it Symbolic schema: allow language and symbolism in play to occur (milk carton is a spaceship) Concrete 7 – 11 years Begins logical operations Operational Can order objects (small to large; first to last) Understands conservation (mass and volume) Reversibility: an object can return to it’s initial shape Formal 11 – 15 years Moves towards abstract thinking Operational Can test hypotheses Logical problem solving can occur Deduction Child learns best from his or her own actions, not lectures LI V. Behavioral Influenced by empiricism, john locke’s idea that scientists can only learn from objective facts and experience is the source for acquiring knowledge o Developmental changes are quantitative, meaning they can be measured Behaviorists believe the environment manipulates biological and psychological drives and needs resulting in development If it was learned it can be unlearned A. Classical Conditioning Pavlov assosiations A neutral stimulus is paired with an unconditioned innate stimulus which elicits an unconditioned response Over time the neutral stimulus becomes the conditioned stimulus and elicits a conditioned response Learning through associations Extinction: unlearning, extinguishing the pairing B. Law of Effect Edward Thorndike When a stimulus-response connection is followed by a reward, that connection is strengthened Behaviors consequences determine the probability of it being repeated C. Operant Conditioning Skinner and Watson rewards punishmentsimpactbehaviors consequenses Behavior is maintained by consequences Reinforcement: something that will increase the likelihood of a behavior o Positive: adding something rewarding (new toy, gold star) o Negative: removing something distressing (removing inattention) Punishment: something that will decrease the likelihood of a behavior i  o Positive: adding something to decrease the behavior (time out) o Negative: removing something to decrease a behavior (taking away a toy) Schedules of Reinforcement o Fixed interval: specified amount of time between reinforcement i.e. paid every two weeks, elicits least amount of desired behavior o Variable interval: reinforced on a variable time schedule that averages out to the same amount of reinforcement o Fixed ratio: reinforced for every five good behaviors o Variable ratio: intermittent, not sure when reinforcement is coming, elicits maximum amount of desired behavior VI. Kohlberg Moral Development Identified three levels relating to the relationship between self and society A. Moral Development Stage Model Preconventional o Stage 1: a punishment or obedience orientation exists o Stage 2: an instrumental and hedonistic orientation exists (obtaining rewards) Conventional o Stage 3: interpersonal acceptance, maintain good relations with family and meet societal standards; approval of others o Stage 4: Law and order; conform to legitimate authority Postconventional o Stage 5: Social contracts; most values and rules are relative o Stage 6: People develop their own set of moral guidelines, universal ethical principles apply; stage is not always reached VII. Albert Bandura Social learning models see the importance of the social environment and cognitive factors Go beyond behaviorism Self-efficacy: the belief that we can perform some behavior or task impacted experianc One’s self efficacy is facilitated through 4 mechanisms: by o Modeling: after other’s behavior o Vicarious experience: watching others perform a behavior o Receiving verbal persuasion from others that one can do a task s  o Paying attention to one’s own physiological states such as emotional arousal and anxiety involved with doing the behavior VIII. Maslow (Humanistic) focusedperspective person Rejected psychoanalytic and behavioral psychology because they dehumanize Self actualization: a person fulfills their complete potential Only when one need is met can you focus on achieving the next need Most people do not achieve self actualization o Physiological: Food/water o Safety: security, resources o Belonging/love: friendship, family, intimacy o Self esteem: confidence, achievements o Self actualization: morality, creativity, spontaneity, problem solving Other important people: John Bowlby Attachment; child bonds for survival. If no bond develops with an adult by age 3, child will have serious social issues If the bond is severed at an early age, it is known as object loss, and can breed abnormal behavior Urie Bronfenbrenner ecological approach to the study of human development believed it was important to look at all levels and systems impacting a person multipleinteractingsystems Daniel Levinson early adult transition (17 – 22 years) mid-life transition (40 – 45 years) late adult transition (60 - 65 years) believed that the majority of men he studied had mid-life crises during mid-life transition mid life crises are positive, if they do not occur it may lead to stagnation William Perry developed a scheme for intellectual development and ethical development stresses “dualism” which is common in teenagers (seeing things as black & white/right & wrong) as mature into adults, develop relativistic thinking (uncertainty is okay) final stage is a commitment to relativism Lev Vygotsky O Disagreed with Piaget’s notion that developmental G stages take place naturally Educational intervention and environment drive development Zone of proximal development: difference between what kid can do on her own vs what she can do with help from an adult Scaffolding Jean Baker Miller A large part of women’s lives has been spent helping others develop emotionally, socially, and intellectually “caretaking” differentiates the development of men and women Carol Gilligan women view relationships and experience them differently than men do women use different criteria than men in making moral judgments and score lower on Kohlberg’s moral dilemma test Gail Sheehy passages are transitional periods between life stages and are different for most individuals passages provide opportunities for growth Robert Havigurst Stages of growth are epigenetic: each one requires completion of the last one for success and happiness Developmental tasks: arise from physical maturation, influences from culture and society, and desires and values of the person Robert Kegan Adult cognitive development Focus on interpersonal and how people construct peoplecontinuetogrow throughoutlifeadulthood it their own reality doesnotstopin Counseling is “holding environment” where people can handle crises and develop new meanings for them 6 stages: incorporative, impulsive, imperial, interpersonal, institutional, interindividual Arnold Lazarus systematic desensitization to help clients cope with phobias gradualexposure relaxationtechniques Harry Stacks Sullivan Psychology of interpersonal relations 0 Biological determination is less important than interpersonal issues and the sociocultural demands of society childhoodexperiences early impactonesconcept Harry Harlow Attachment is an innate tendency and not one selfthere which is learned toconnect Monkey study they preferred terry cloth mother belong is Purslimenta over wire mother who dispensed milk Herthpmen Eleanor Gibson 0 Measured infant depth perception by having infants crawl towards person on a visual cliff (window ofwellbeing persona through floor) biologicallybasedbutcanchange through experience Babies will not cross cliff. Konrad Lorenz Imprinting, an instinctual (innate/not learned) behavior in which an infant follows the first moving object it encounters, usually the mother Critical periods: certain behaviors must be learned at an early time in development or they won’t be learned Aggressiveness is part of our evolution and necessary for survival Abnormal Human Behavior Psychological dysfunction: a breakdown in cognitive, emotional, or behavioral functioning. The dysfunction is unexpected in its cultural context Associated with personal distress or substantial impairment of functioning Psychopathology: the scientific study of psychological disorders Etiology: what causes a disorder, i.e., why does it begin? Biological, psychological, and social dimensions are involved Equifinality: there may be multiple paths to a given outcome, i.e., depression may be caused by physical injury, loss, or substance abuse Adaptive functioning: when defense mechanisms are used to cope with stressors; humor and sublimation Ego dystonic: the individual perceives the symptoms or traits as undesirable Ego syntonic: the individual perceives the symptoms or traits as acceptable A. Causal Models One dimensional o This model assumes that a disorder is caused by one factor such as chemical imbalance o Research does not support this linear model Multidimensional o Assumes that a disorder is caused by the interaction or several O factors and dimensions G o Includes biology and behavior of the individual as well as cognitive, emotional, social, and cultural dimensions B. Assessment Clinical assessment: process of determining the psychological, biological and social factors Diagnosis: process of determining whether the presenting problem meets the criteria for a psychological disorder set forth in the DSM 5 Mental status exam covers the following 5 areas o Appearance and behaviors o Thought processes o Mood and affect o Intellectual functioning o Sensorium – orientation and awareness to surrounding, time, place etc Behavioral assessment o use of direct observations to assess an individuals thoughts, feelings, and behaviors in specific contexts  o clinical interview provides one avenue of behavioral assessment Psychological assessment o Measure cognitive functioning, emotional or behavioral responses, or personality characteristics o Projective tests: rorshcach o Personality tests o Intelligence tests Neuropsychological assessment o Measure brain dysfunction and abilities such as language, attention, concentration, memory etc Treatment plan: therapeutic road map  CPCE Appraisal Study Guide Measurement: general process of determining dimensions of an attribute or trait Assessment: processes and procedures for collecting information about human behavior identify Assessment patterns tools include tests and inventories, rating scales, observations, interview data and other techniques Appraisal: implies going beyond measurement to making judgments about human attributes and behaviors interpret Is used interchangeably theresults with evaluation Interpretation: making a statement about the meaning or usefulness of measurement data according to the professional counselor’s knowledge and judgment Psychometric: Any form of mental testing Test Battery Horizontal test: Measures various factors in same test (math, science) Measures of Central Tendency A distribution of scores can be examined Mean: the arithmetic average Median: the middle score in a distribution of scores Mode: the most frequent score in a distribution of scores All three of these fall in the same place when the distribution is normally distributed Skew The degree to which a distribution of scores is not normally distributed Positive Skew: The right tail is longer; the mass of the distribution is concentrated on the left of the figure Negative Skew: The left tail is longer; the mass of the distribution is concentrated on the right of the figure Measures of Variability Range: the highest score minus the lowest score Inclusive range: highest score minus the lowest score plus one Standard deviation: the variability within a distribution of scores o the mean of all the deviations from the mean demeansclosetomeantomeans 0 Variance: square of the standard deviation parpromtheme.am o Does not describe the dispersion of scores as well as the standard deviation Normal Curve 0 Distributes the scores into six equal parts ! 3 above the mean, 3 below the mean One standard deviation = 68% ! 34% above the mean, 34% below the mean Two standard deviations = 95% ! 13.5% above the mean, 13.5% below the mean Three standard deviations = 99% ! 2% above the mean, 2% below the mean Percentile: a value below which a specified percentage of cases fall Stanine: converts a distribution of scores into nine parts, with 5 in the middle and a standard deviation of about 2 Standardized Scores A standardized score scale is like a common language that we can use to compare several different test scores for the same individual Standardized scores occur by converting raw score distributions These derived scores provide for constant normative or relative meaning, allowing for comparisons between individuals Standardized test scores express the person’s distance from the mean in terms of standard deviation of that standard score distribution Most commonly used standardized scores: o Z Score: the mean in 0, SD is 1 o T Score: the mean is 50, SD is 10 ▪ The standard score is transformed to eliminate negative scores Regression Towards the Mean  If one earns a very low score or a high score on a pre-test, it is likely that the individual will score closer to the mean on the posttest This is because of error occurring due to chance, personal, and environmental factors These factors can be expected to be different at the posttest Difficulty Index/Value Indicates % of people who answered an item correctly Higher the number, the easier the item 0.25 = 25% answered correct Correlation Coefficient r Ranges from -1 to 1 A statistical index which shows a relationship between two sets of numbers Bivariate: a correlation between 2 variables Multivariate: a correlation between multiple variables Cannot determine causal relationship couralation causation Reliability The degree to which the test can be expected to provide similar results for the same subjects on repeated administrations consistency Can be viewed as the extent to which a measure is free from error o If the instrument has little error it is reliable A correlation coefficient is used to determine reliability Types of reliability: o Test-Retest Reliability: the same group is tested twice with the same instrument, results are correlated o Equivalence: alternate forms of the same test are administered to the same group and the correlation between them is calculated o Split-half: the test is divided into 2 halves, the correlation between the halves is calculated o Inter-Item: the more homogenous the items, he more reliable the test o Standard Error of Measurement (SEM) ▪ Confidence band or confidence limits ▪ Helps determine the range within which an individual’s test score probably falls o True and Error Variance: ▪ True Variance: attributed to the actual psychological trait or characteristic that the test is measuring o Can be calculated through the correlation of two tests squared ▪ Error Variance: attributed to other factors ▪ Coefficient of determination: the degree of common variance between two tests  o It is the index of 81% that results from squaring a correlation of.9 ▪ Coefficient of nondetermination: the unique variance, and is not common between the two tests o Represents the error variance, 19% Validity The degree to which a test measures what it purports to measure Situation specific, depending on the purpose and the population Types of validity: o Face: the instrument appears valid o Content: the instrument contains items drawn from the domain of items which could be included o Predictive: the predictions made by the test are confirmed by later behavior o Concurrent: the results of the test are compared with other tests’ results or behaviors at or about the same time o Construct: a test has construct validity to the extent that it measure some hypothetical construct ▪ Convergent validity: when there is a high correlation between the construct under the investigation and others ▪ Discriminant validity: when there is no significant correlation between the construct under investigation and others Tests may be reliable but not valid Valid tests are reliable unless of course there is a change in the underlying trait or characteristic which might occur though maturation, training, or development Tests Spiral Test: Items get progressively more difficult Cyclical Test: Go from easy to difficult within each section Parallel Test: Two versions given to same group Power based: no time limits on tests, or very generous time limits Speed based: timed, and the emphasis is placed on speed and accuracy Format Subjective: Relies on scorers opinion o Essay o Free Choice/Short Answer o Test taker can respond in any way o Increased subjectivity and more time to score Objective: No judgment from rater o Forced choice/Multiple Choice o Also known as recognition items o Multipoint: Three or more choices (a,b,c,or d) o Dichotomous: Two choices  ▪ T/F Projective: Client is shown neutral stimuli and projects personality on unstructured task using the unconscious mind o Types: ▪ Association: Ex: What does this remind you of? ▪ Completion: Ex: complete these sentences with real feelings ▪ Construction: Ex: drawing a person Assessments Norm Referenced: comparing individuals to others who have taken the test before o May be national, state, or local norms o How you compare with others is more important than what you know Criterion Referenced: comparing an individual’s performance to some predetermined criterion which has been established as important Ipsatively Interpreted: comparing the results on the test within the individual Maximal performance test: may generate a person’s best performance on an aptitude or achievement test and a typical performance may occur on an interest or personality test Standardized: the instruments are administered in a formal, structured procedure and scoring is specified Non-Standardized: there are no formal or routine instructions for administration or for scoring Purposes for Using Tests Helps the counselor decide if the client’s needs are within the range of his or her services Helps the client gain self understanding Helps the counselor gain better understanding of the client 8 Assists the counselor in determining which counseling methods, approaches, or techniques will be suitable Assists the counselee to predict future performance in education, training or work Helps the counselee make decisions about their educational futures Helps identify interests not previously known Helps evaluate the outcomes of counseling Situations under which testing may be helpful Placement in education or work settings Admissions Diagnosis Counseling Educational planning 8 Evaluation Licensure or certification Self understanding Tests and Inventories Intelligence: the ability to think in abstract terms; to learn o Stanford-Binet Intelligence Scales o Wechsler Adult Intelligence Scale (WAIS-IV) o Wechsler Intelligence Scale for Children (WISC-IV) 0 o Cognitive Abilities Test Specialized Ability Tests skillsin specific o Kaufman Assessment Battery for Childrenareas o ACT o SAT o GRE Achievement: measures the effects of learning or a set of experiences o May be used diagnostically o California Achievement Tests, Iowa Test of Basic Skills Specialized Achievement Test: o GED o College Board AP Tests Aptitude: also called ability tests, these measure the effects of general learning and are used to predict future performances o DAT o O*NET Ability Profiler Personality: the dynamic product of genetic factors, environmental experiences, and learning to include traits and characteristics o Projective tests: unstructured task or stimulus ▪ Rorschach ▪ Thematic Apperception Test (TAT) o Inventories: ▪ MMPI ▪ Beck Depression Inventory ▪ MBTI o Specialized ▪ Tennessee Self Concept Scale Interests: often not stable in teen years o Strong Interest Inventory o Self Directed Search o Career Assessment Inventory o O*NET Interest Profiler Types of Rating Scale True/False Likert Scale Semantic Differential: asks respondents to report where they are on a dichotomous range between two polar opposites Observation  Intrusive: reactive, means the participant knows he or she is being watched or questioned and this knowledge may effect his or her performance Unobtrusive: nonreactive, data is collected without the awareness of the individual and without changing the natural course of events In observation, you can use schedules, coding systems, and record forms Case study: an analytical or diagnostic investigation of a person or a group Rating Scales: may be used to report the degree to which an attribute or characteristic is present Sociometry 0 Can be used to identify isolates, rejectees, or stars You can measure the structure and organization of social groups which could be a classroom of fourth graders who have been together for a few months It requires revealing personal feelings about others Sociogram: a figure or map showing the interrelationships or structure of the group Using and Interpreting Test Scores You need training in test theory and background info about the tests you use You must study the test’s mechanical manual Understand the scores, profiles, and implications of the results before you counsel the individual Describe the test to the person in non-technical terms and explain what is being measured Describe the nature of the scores you are reporting, explain percentiles, stanines etc Organize the data so that it makes the most sense to the client Consider and explain interrelationships between scores and between tests if more than one was sued Remind the client that test scores are additional data for them to consider and are not infallible Go slowly Grade and Age Equivalent Scores Scores on achievement tests are often reported as grade equivalent scores An individual’s score is compared to the average score of others in the same age/grade Percentile Ranks An individual’s score can be compared to a group (norm group) already examined The individual’s percentile rank indicates what percentage of individuals in that group has scores above or below this individual Computer Based Assessment Advantages:  o Standardizes administration and scoring o Feedback and results may be available immediately o Assuming computers are available, costs will be reduced o Profiles of results and reports can be generated Disadvantages: o Not all assessments are available on the computer o Testing by computer may be scary for some test takers o Expensive o Personal contact with proctor may not be available Ethical Issues: Tests may be biased against POC, women etc Counselors must be trained and competent to select and administer tests and to interpret results Test results should be released only to competent professionals and with the consent of the test taker Tests may be used to label and stereotype May be invasive of privacy Confidentiality may be in issue Biases Social desirability Halo effect IQ Tests Galton o Researched intelligence based on genetics o Believed intelligence to be normally distributed like height and weight o Single or unitary factor Guilford o 120 factors add up to intelligence o Known for convergent and divergent thinking Stanford-Binet Intelligence Quotient Test o Created 1905 ▪ To discriminate normal from MR Parisian children o Americanized by Terman o Age related tasks ▪ ½ of population can answer ▪ Age 2-adulthood o Old Ratio Formula: Mental Age/Chronological Age x 100 ▪ MA/CA X 100 o Standardized measure ▪ Formal scoring and administration procedures ▪ Standard Age Score (SAS) Replaced formula Mean= 100; SD=16  Wechsler o Created his own IQ test with performance skills because he felt Binet was more focused on verbal skills o 3 measures: ▪ Verbal IQ ▪ Performance IQ ▪ Full-scale IQ o Mean=100; SD=15 o Types: ▪ WPPSI-III Weschler Preschool and Primary Scale of Intelligence Age 2-7 ▪ WISC-IV Weschler Intlligence Scale for Children Age 6-16 ▪ WAIS-III Weschler Adult Intelligence Scale Age 16+  CPCE Helping Relationships Study Guide 0 The relationship in counseling is the determining factor of whether or not counseling is successful Theories of counseling provide the underlying philosophy and strategies for building and maintaining this relationship Four Key Elements: o Human relations core: identified by Carl Rogers; empathy, respect, and genuineness o Social influence core: identified by Stanley Strong; competence, power, intimacy, expertness, attractiveness, trustworthiness o Skills core: identified by Allen Ivey; communication skills such as attending, inquiry, and reflection o Theory core: help the counselor understand the self, interpersonal relationships, and skills. They also help to understand the problems of the client and help to choose the interventions that are likely to be effective with the identified problems I. Psychoanalytic Sigmund Freud – deterministic, people are controlled by biological instincts, are unsocialized, irrational, and driven by unconscious forces such as sex and aggression Identified a structure of personality:impacted childhood by s o Id: unconscious motivation or energy o Ego: controlled by the reality principle 2 o Superego: internalized ethics shouldstmusts Therapy techniques include: o Free association: people talk without constraints and s censoring o Interpretation of dreams: latent content (unconscious representations) and manifest content (what you remember) symbolic representationsofunconscious o Transference analysis: desires transference interpreting 8 Transference: projections onto the therapist must be worked through Countertransference: projections of the therapist onto the client II. Neo-Analytic/Neo-Freudian Many psychoanalysts moved away from Freud’s emphasis on the id Placed more emphasis on the ego socialtculturalinfluence A. Karen Horney The core of all neuroses are problematic human relations These relations emanate from the environment instead of intrapsychic issues  0 Security is each person’s major motivation and the person becomes anxious when it is not achieved Irrational ways to mend disrupted human relationships may become neurotic needs B. Eric Fromm The individual must join with others to develop self-fulfillment and social character G Otherwise, they may become lonely and non-productive Society offers opportunities to experience mutual love and respect C. Harry Stack Sullivan An interpersonal approach can lead to understanding human behavior Behavior can best be understood in terms of social interactions III. Object Relations Based on psychoanalytic concepts Focuses on our internalizations of relationships such that they act as templates for later relationships The interpersonal becomes intrapsychic We develop structure and charge through love and nurturance ▪ The absence of love and nurturance means our batteries do not charge, and we do not develop (arrested development), which causes psychopathology Object: a significant person or thing that is the object or target of one’s feelings or drives Object relations: interpersonal relationships that shape an individual’s current interactions with people Four stages of development (MAHLER): impacthowshape all o Fusion with mother: normal autistic phase (3 – 4 weeks) o Symbiosis: with mother (3rd-8th month) o Separation and individuation (5th month – 3 years) relationship ▪ Differentiation: mother and self are two separate people ▪ Practicing: resistance to separation from mother ▪ Rapproachment: increased awareness of separateness from mother o Constancy of object and self (36 months/3 years) Progressing through these stages provides the child a secure base for later development The child develops trusts that their needs will be met  Attachment disorder, borderline, and narcissistic disorders may occur when normal progression through the stages is not met IV. Person Centered (Rogerian) humanistic Against the psychoanalytic approach of ofcus on the past ocus was on the persons’s phenomenological world or how they perceive their experiences Reflecting and clarifying their verbal and nonverbal communication Process of becoming: moving clients to self actualization Relationship between client and counselor is critical Focus of counseling was on the present and feelings Core or Facilitative Conditions of Effective Counseling: f be o Unconditional positive regard o Congruence (genuineness) ieveinprogressreguardlessofPlawsol o Empathic understanding Aim of counseling is to be in touch with your true self and know that it is valued Robert Carkhuff – 5 point scale to measure empathy, genuineness, concreteness, and respect o Rating of 1 = poorest o Rating of 3 = minimal level of acceptance o Rating of 5 = most desirable V. clientistheexpert Gestalt (Fritz-Perls) focus thepresentexperience on Based on existential principles GESTALT: an organized whole that is perceived as more than the sum of its parts Here and now focus Holistic systems theory view point Individuals experience needs o Figure: A need in the forefront, aspects of the individual’s experience that are more salient o Ground: Aspects of a client’s experience that are out of awareness As a need is met, it completes the gestalt and a new need takes it place The goal of individual therapy is to become whole, or complete all the gestalts Key concepts: o Personal responsibility o Unfinished business I o Awareness of the now Experiential therapy through encouraging the taking of responsibility by the client  0 The counselor uses confrontation and encourages the client to stay with feelings and relive experiences to finish business emptychairtechnique Role playing Two chair technique Dream work is used Interpretation is done by the client and not the counselor 0 Emphasis is on increasing psychological well being and increasing bodily awareness VI. Individual Psychology (Alfred Adler) Belief in the uniqueness of each individual is influenced by social factors Each person has a sense of inferiority and strives for superiority We choose a lifestyle which gives meaning to our experiences o Includes habits, family, career, attitudes etc Neuroses: a failure in learning which results in distorted perceptions Counseling goals are to help the client understand their lifestyle and identify appropriate social and community interests o Psychological health can only be achieved when we are cooperative with others o Fostering a better relationship in therapy encourages the client to explore the world Focus on changing belief Encourage connection and social connection Counseling strives to explain clients to themselves and for them to overcome inferiority Techniques of counseling: o Counselor is egalitarian – it’s a collaborative effort o Stress is on client’s responsibility Life histories, Homework assignments, Paradoxical intentions Birth order o Children in the same family have different psychological environments because of birth order o Oldest child: gets much attention, dependable, hard-working, achievement oriented; may feat losing love when a new child arrives o Second child: shares attention, sees self as if in a race to compete with first child, often succeeds where older fails o Middle child: feels left out, may see life as unfair o Youngest child: baby in family, pampered, tends to go own way, often develops in direction that no one else thought of o Only child: does not learn to share and cooperate, deals with adults well Relied on paradox techniques VII. Transactional Analysis (Eric Berne) The personality has three ego states o Parent s ▪ Synthesis of the messages received from parental figures and significant others in childhood, incorporated into the personality o Adult i ▪ Corresponds to Freud’s ego ▪ Rational, logical, and does not focus on feelings o Child ▪ Resembles Freud’s id ▪ Spontaneous, impulsive, untrained ▪ Acts on hunches ▪ Learns how to comply to avoid conflict Structural analysis: when a counselor analyzes out of which ego state a client is primarily operating Secondary structural analysis: when a counselor analyzes an ego state within an ego state A life script develops in childhood and influences a person’s behavior Many transactions with others can be characterized as games with the intent to avoid intimacy Complementary transactions: Adult to Adult ! good communication Crossed transactions: Adult to Child or Child to Parent ! barriers to communication The goal of therapy is to teach the client the language and ideas of TA in order to recognize ego state functioning and analyze one’s transactions Teaching concepts, helping diagnose, interpretation, use of contracts and confrontation VIII. Existential Existentialism is considered a humanistic form of helping in which the counselor helps the client discover meaning in their life by doing a deed, experiencing a value, or suffering Stresses growth and self actualization Individuals cannot blame others or childhood circumstances for a lack of fulfillment Phenomenology is the basis of existential therapy o focuses on the person’s experiences and how they are perceiving them Ontology or the philosophy of being and existing We have freedom of choice and are responsible for our fate 0 We search for meaning and struggle with being alone, unconnected from others  I-Thou relationship: horizontal, or that the client and counselor are equal Concerns: o inevitability of death o fundamental isolation o meaninglessness of life Anxiety: the threat of non-being Guilt: when we fail to fulfill our potential The goal is the understanding of one’s being, one’s awareness of who one is and who one is becoming The authentic relationship is important; client centered techniques Logotherapy: o Victor Frankl o Healing through meaning o Paradoxical techniques which defy logic as the client is instructed to engage in maladaptive behavior ▪ Client may be advised to purposely exaggerate a dysfunctional behavior in the imagination o Motivation to find meaning in their life journey 0 o Freedom to choose what they do, think, and how they react o With freedom of choice comes personal responsibility IX. Cognitive and Behavioral Counseling becomeaware distortions confrontt ofnegative Joseph Wolpe o Theory of reciprocal inhibition – person cannot be anxiouschange and them relaxed at the same time o Systematic desensitization: counterconditioning, goal is to reduce anxiety by pairing negative stimuli with positive events Donald Meichenbaum o Cognitive behavior modification – shift from self-defeating 8 thoughts to coping o Stress inoculation: practicing positive or reinforcing self statements 0 Aaron Beck o Cognitive therapy o Identified automatic thoughts in clients, similar to the preconscious o There is an internal communication system ▪ In depressed people, it was negatively focused resulting in low self esteem, self blame, and negative interpretations of experiences o Developed Beck Depression Inventory Albert Bandura o Social learning model I  I o Dynamic interplay of behaviors, cognitions and the environment o All three are assessed in problem identification o Modeling, rehearsing, and changing cognitions We are the product and producer of our environment Belief is that behavior is learned and can be unlearned and relearned Goals of counseling are to identify antecedents of behavior and the nature of the reinforcements meaning the behavior The counselor helps create learning conditions and may engage in direct intervention Counseling techniques may include operant and classical conditioning, social modeling, problem solving, direct training, reinforcement, and decision making, token economy, X. Dialectical Behavior Therapy buildingskills Marsha Linehan developed this approach for the treatment of BPD Now used more widely with a variety of disorders including traumatic brain injury, eating disorders, and mood disorders Group component usually complements individual work O Use cognitive behavioral techniques Basic principle is to help clients increase cognitive and behavioral regulation by learning the triggers that lead to their undesired behavior Dialectical principle of recognizing two sides to a situation Viewed as a long term therapeutic approach because it requires learning, practicing and acquiring skills Four modules: o Mindfulness: paying attention to the present moment S nonjudgmentally o Distress tolerance: accepting and tolerating oneself and the current situation copewith discomfortinhealthyways o Interpersonal effectiveness: developing effective strategies for asking for what one needs, saying no as appropriate, and coping with interpersonal conflict o Emotion regulation: identifying emotions and obstacles to changing them, reducing vulnerability, and increasing positive emotions XI. Rational Emotive Behavior Therapy (Albert Ellis) Based on the philosophy that it is not the events we experience but our interpretation or perception of those events that is important Individuals have the potential for rational thinking In childhood we learn irrational beliefs and re-indoctrinate ourselves on a regular basis 0 Belief system, self talk, and crooked thinking are major concepts  o A: activity or action (external event) o B: belief in the form of self-verbalization (cause of emotional disturtbance) o C: consequent affect, may be rational or irrational o D: disputing of the irrational belief which is causing the affect/behavior o E: effect, cognitive change in the self verbalization Emotive techniques include role playing and imagery Self talk is the source of emotional disturbance Musturbation: should, ought, must Catastrophizing: the worst thing in the world XII. Multimodal Therapy (Arnold Lazarus) D Comprehensive, holistic approach Has strong behavioral ties Addresses 7 interactive yet discrete modalities o B = Behaviors s o A = Affective responses o S = Sensations o I = Images (how we see selves, dreams) o C = Cognitions o I = Interpersonal relationships o D = Drugs (biology, nutrition) Assessment covering all 7 modalities is necessary to determine total human functioning Counseling techniques from a variety of theoretical perspectives are used o Anxiety management training o Modeling o Positive imagery L o Relaxation training XIII. Reality Therapy (Glasser) o Individuals determine their own fate and are in charge of their lives Our perceptions control our behavior (BCP) and we behave appropriately or inappropriately to fill our needs Five genetically based needs: o Survival o Love and belonging o Power or achievement o Freedom or independence o Fun  0 Choice theory: that we act to control the world around us and the real world is important to the extend that it helps us satisfy our needs Taking responsibility is a key concept 8 Dwelling on past failures can reinforce a negative self concept Identity is a persons most important psychological need o Failure identity: an irresponsible person, will feel frustrated in an attempt to feel loved and worthwhile, will develop a faulty perception of reality o Success identity: a responsible person, feels worthy and significant to others Characteristics: o Emphasize choice and responsibility 8 o Reject transference o Keep the therapy in the present o Avoid focusing on symptoms o Challenge traditional views of mental illness Robert Wubbolding o W = exploring clients wants as these relate to perceived needs o D = encouraging clients to discuss actions and feelings o E = refers to self evaluation by clients concerning their behaviors o P = planning in order to effect change XIV. Feminist Therapy Gender as central to therapeutic practice 8 Awareness and understanding of the role of sociocultural influences as they manifest themselves in therapy The need to empower women and address social changes Basic principles: o The personal is political – the problems of the client have societal and political roots which often result in marginalization, oppression o Commitment to social change – therapy is not only for the individual but to advance a transformation in society o Women’s voices and ways of knowing are valued and their experiences are honored o The counseling relationship is egalitarian – clients are experts on themselves and their oppression is recognized o Focus on strengths and reformulated definitions of psychological distress o All types of oppression are recognized Gender role analysis, empowering techniques, self-nurturance, assertiveness training, social action  XV. Solution Focused Brief Therapy focus onfindingsolutions Does not address the history of the past experience of a problem Understanding the nature of the problem is not necessary to generating solutions to the problem Maintain a positive orientation believing that the client can construct solutions Exceptions question: what were the circumstances when the problem did not exist Miracle question: if a miracle happened, how would you know what would be different? Scaling question: using a scale from 1 to 10, identify changes in client’s affect etC Brief therapy ! setting specific goals Focus is on the development of coping skills Intermittent counseling: client sees a counselor on and off as problems arise over several years XVI. Narrative therapy Philosophical base is social constructionism Independent objective reality exists through subjective experiences This reality is based on language and words clients se to represent their situation Client’s lives are stories in progress Stories use words and language to give meaning to experiences and help determine feelings and attitudes Client often tells a problem saturated story and the therapist encourages other perspectives or interpretations Therapeutic techniques: o Questions and clarifications o Externalization and deconstruction – person is not the problem, the problem is the problem o Re-authoring – helping the client find a more appropriate alternative story o Documenting the evidence through writing of letters Integrative counseling: beyond eclectic counseling Synthesizing existing theories and practices Counselor develops a personal theory based on their worldview XX. Neurobiology and Psychotherapy The brain grows and differentiates through continuous interactions with the environment  0 The experience of counseling can restructure the neural networks in the brain Neuroplasticity is the brains’ ability to produce new neurons and reorganize itself brain isconstantlychanging CBT promotes cognitive restructuring Biofeedback: devices are used primarily to teach clients to relax or tyoucanchangei.to control autonomic nervous system functions such as blood pressure or pulse rate; attempt to rewire mental networks, found useful for sleep disorders, anxiety, phobias Medication can reduce or control symptoms EMDR: Eye Movement Desensitization and Reprocessing o Used to facilitate the client’s accessing of memories of painful and traumatic experiences through eye movements similar to those in REM sleep XXI. Analytic Therapy - Carl Jung Believed in the collective unconscious Collective unconscious is determined by the evolutionary development of the human species and it contains brain patterns for the most intense emotional responses that humans experience universal experianc Archetype: a response pattern that occurs universally in the human experience o Anima: female traits o Animus: male traits o The persona: the mask or role we present to others to hide our o true self o The shadow: the mask behind the persona which contains 0 desires hiddendesires Men operate on Logos principle or logic; women operate on intuitive principle or Ethos Goals of Jungian therapy: o Transformation of the self o Gaining knowledge of the self o Recognition and integration of the self Therapy is viewed as a healing process Introduced concepts of introversion and extraversion Mandalas: drawings balanced around a center point to analyze himself, his clients, and dreams Counseling Skills and Conditions that Influence Counseling Empathic understanding: ability to experience the client’s subjective world Congruence: also called genuineness, implies that the counselor is authentic and present Unconditional Positive Regard: acceptance, implies the counselor is caring without condition and is nonjudgmental Concreteness: the extent to which the client and the counselor deal with issues in specific terms rather than in vague generalities Immediacy: dealing with what is going on in the counseling process at the present time Interpretation: a therapeutic technique used to uncover and suggest meanings and relationships often underlying Self disclosure: counselor shares personal affect and experiences relative to the client’s issues Attending: listening, engaging in eye contact, being psychologically present Restatement: repeating what the client has stated with emphasis on the cognitive message Reflection: repeating what the client has stated with emphasis on the affective message Paraphrasing: restarting the message of the client to show or gain understanding Summarizing: a process whereby the counselor client brings together several ideas or feelings usually following a lengthy interchange Silence: quietly thinking, boredom, hostility, waiting for the counselor to lead, preparing, or emotional integration Confrontation: Occurs when the counselor identifies and presents discrepancies between a client’s verbal and nonverbal behaviors or between counselors and clients perceptions Compassion fatigue: evidenced by counselors who work with difficult client issues and may result in a loss of empathy and interest in the client’s concerns FAMILY COUNSELING Systems perspective Every member can influence and be influenced by every other member in a continuous process Linear causality: one vent causes another in a unidirectional fashion o Content may explain what is occurring O Circular causality: there are forces moving in many directions at the same time so the influences and results impact each other resulting in a complex array of outcomes o Explanation of what is occurring focuses on the process O Locus of pathology: family counseling views pathology no within the individual but within the social context of the individual ordinarily the family Focus of treatment interventions: on the family rather than the individual Unit of treatment: the family, not the individual Duration of treatment: attempts to provide brief counseling to resolve current family problems Life cycle of the family o Leaving home – single young adults accepting emotional and financial responsibility o Joining of families through marriage or cohabitation – commitment to new system o Families with young children – accepting new members into system o Families with adolescents – increasing flexibility of family boundaries with adolescents and aging grandparents o Launching children: accepting a multitude of exists from and entries into the family system o Families in later life: accepting the shifting of generational roles Family and ethnicity o Family is defined differently in cultures and ethnic groups o Child rearing practices may differ o Nature and use of severity in puni