PG Diploma Material Sep 2024 PDF

1. Personal Helping Vs Professional Helping People use many terms – advice, suggestion, guidance, life coaching, psycho- education, consultation, counselling and psychotherapy interchangeably. Out of these 8 words, advice and suggestions are part of Personal Helping as given below....

1. Personal Helping Vs Professional Helping People use many terms – advice, suggestion, guidance, life coaching, psycho- education, consultation, counselling and psychotherapy interchangeably. Out of these 8 words, advice and suggestions are part of Personal Helping as given below. Advice: Given by authority figures – a parent to child transaction. If the advice is not followed by the receiver, the giver might force some negative consequences. No choice at all. It has to be followed. Highly subjective and opinionated. No professional training is required. Suggestion: Given without authority. If the suggestion is not followed by the receiver, no negative consequences will occur. At least two choices – to follow and not follow. Mostly subjective. No professional training is required. So, both Advice & Suggestion can be given by anyone and they involve subjective opinions. Most of the time, they are based on personal experiences or popular psychology concepts. Often, they are talks on Problems and Solutions for lesser amount of time which would lead to Drama Triangle. There are better ways of helping people scientifically. Pop-Psychology Professional Psychology The psychological concepts which gained The psychological concepts which are popularity through a book, TV show, or taught in most of the Universities and blog post. Mostly the reference would be Colleges all over the world. Available in a single source or very minimal sources. the academic text books. Mostly the reference would be multiple text books. Oversimplified, out of date, unproven or Comparatively, complex to understand proven in few researches, and proven in meta-analysis (Meta misunderstood or misinterpreted or Analysis refers to the examination of data have been heard for so long and spread from a number of independent studies of so far that the general public believes it. the same subject, in order to determine overall trends) Often associated with quick fixes as it Mostly associated to addressing promises easy solutions to difficult individual’s specific circumstances and problems. provide evidence-based interventions that are tailored to their goals and challenges. Can be taught in lesser amount of time. Takes lots of time to learn and master it. Requires supervision. © Chennai Counseling Services/CCS Academy Page 1  Hypnotism, Mesmerism, Positive Cognitive Behaviour Therapy, Gestalt Thinking, Law of Attraction, Right Brain Therapy, Transactional Analysis, Activation, Dermatoglyphics Multiple Triangular Theory of Love, Stages of Intelligence Test, Handwriting Analysis, Behaviour Change and many other Signature Analysis, Auto suggestions, concepts which we are going to learn in Affirmations, Male/Female Psychology, this training. Body Language Reading, (NLP), Mind Reading and Motivational Self-Help Books are generally parts of Popular Psychology. The professionals/practitioners provide the things given in the next passages. They are professional forms of helping. CCS Academy/Easy Integration Model (Hereafter referred as EI Model – will be taught in detail in chapter no. 4) attempts to give relationship between these terms. Guidance/ Psycho-education/ Life Coaching/ Consultation: Suggestion/Information is objectively given with evidence/back up from scientific theories proven through Meta Analysis (NOT from personal experiences/Popular Psychology). It is given when the client has sound mental health or given after improving their mental health. e.g., Career Guidance/Pre-Marital Guidance/Life Coaching.  When psychological knowledge is given for preventing problems, it is called as Guidance.  When it is given for developing a person’s psychological aspects, it is called as Life Coaching.  When a practitioner provides information based on the facts of Psychology, he/she provides Psycho-education  Consultation is given when the client wants to take a decision and practitioner provides help by giving scientifically based ideas. These above 4 terms may be used interchangeably as they are very similar to each other. Just based on the context, we use different terms. Counselling: Helping people to deal with psychological issues mostly without the help of medical professionals. Psychotherapy: Helping people to deal with psychological disorders mostly with the help of medical professionals. All these require professional training. They are non-judgmental and objective. Their subject matter is usually the subject matter of Psychology with the back up from scientific theories proven through Meta Analysis aimed at improving their mental © Chennai Counseling Services/CCS Academy Page 2  health which would lead to the winner’s triangle. In the second chapter, the similarities and differences are given in detail. Drama Triangle (by Karpman) - Takes place when Suggestion and Advice are given ◉ A “Rescuer” is someone “rescues” those whom he/she sees having problems. The trait of a Rescuer is that may offer “help” unasked, rather than find out if and how the other person wants to be supported. ◉ The Rescuer takes responsibility for the perceived Victim whom he/she rescues. Rescuer may blame the victim if the help provided does not work out. ◉ The Rescuer may sooner or later end up becoming the Victim. When advice/suggestion is given without being asked, the giver is perceived as Persecutor by the victim. ◉ A “Victim” is someone who usually feels overwhelmed by his/her own sense of inadequacy or powerlessness, and does not take responsibility for himself/herself and therefore looks for a Rescuer to take care of them. ◉ The position of “Persecutor” is synonymous with being unaware of one’s own power to empower the other person and hurts the other people intentionally or unintentionally. ◉ Both by Persecutor and Rescuer, the power used is negative and often destructive and end up as a victim sooner or later. © Chennai Counseling Services/CCS Academy Page 3  Winner’s Triangle (By Acey Choy) - Takes place when Guidance/Coaching, Counseling and Psychotherapy are given ◉ Caring & Empowering: When the Rescuer takes care and empowers the other person to take care of himself/herself. ◉ Showing Vulnerability (Weakness): When the Victim owns his/her vulnerability and takes responsibility for himself/herself and also recognizes that he/she has the power and is able to use it appropriately and ask for appropriate help. ◉ Being Assertive: When the Persecutor owns his/her power to convey the things in such as way it does not hurt the other person and at the same not hurting oneself. How Professional Helping differs from personal helping/casual conversations? Casual Conversation/Personal Helping Professional Helping Much ordinary conversation is Active listening which involves the conscious characterized by rather casual, perhaps discipline of setting aside one’s own inattentive listening. Advice and preoccupations in order to concentrate fully Suggestions will be given mostly. as possible on what the other person is expressing. This may involve a high level of awareness one’s own prejudices and habits. May contain a great deal of interaction, Involves the discipline of responding mainly to anecdotes, sharing thoughts and ideas and the other person in a purposeful, non- changing the subject aimlessly. judgmental and often rather sincere way. Not usually constrained by any agreements Usually backed up by either an implicit or about confidentiality. explicit understanding about confidentiality. Wanders across many subjects with no Generally associated with some sort of goal necessary goals. such as decision making, offering an opportunity to discharge emotions, offering alternative interpretations or guiding strategies related to feelings, thoughts and behaviour for making desired changes. May involve interest in one’s own welfare. Genuine interest in others’ welfare. © Chennai Counseling Services/CCS Academy Page 4  2. Relationship between Guidance/Life Coaching, Counselling and Psychotherapy S.No. GUIDANCE/LIFE COUNSELLING PSYCHOTHERAPY COACHING & ITS DERIVATIVES 1 To help people who To help people who have To help people with some want to prevent day to day issues e.g. severe problems often problems or develop relationship issues, career major psychological themselves. It is done issues and minor disorders along with when the client is in psychological disorders medical help of a sound mental health e.g. such as acute depression, Psychiatrist. Career Guidance, acute anxiety and tobacco Relationship Guidance dependence. and Wellness coaching 2 Generally, Client brings Client brings the general Psychotherapist specific goals. Guide/Life agenda. Counselor takes determines the agenda. Coach brings the the back seat. Client takes the back seat. direction 3 Coaches often work in Counselors most often Psychotherapists work in private practice work in educational, private practice and consultation/ organizational and hospital Setups where a corporate setup. private practice setup. psychiatrist/other medical professionals would be available. 4 Usually happens for less Usually happens for less Usually happens for more number of sessions. number of sessions. number of sessions. 5 Commitment from both Commitment from both Commitment from both life coach and the client counselor and the client Psychotherapist and client is relatively less. is relatively less. is relatively high. Because of the high commitment requirement, Psychotherapists work as a team with other psychotherapists and psychiatrists. 6 Life Coaches often Counselors often identify Psychotherapists often identify themselves with themselves professionally identify themselves with the concerns they work with the setting or the the approach they use. e.g.: with or the concepts population or the Cognitive Behaviour they follow. e.g.: concerns they work with. Therapist or Transactional Relationship Coach, e.g.: School counselor, analyst or Integrative Emotional Intelligence Adolescent counsellor and Therapist Coach and Leadership Career Counselor. Coach © Chennai Counseling Services/CCS Academy Page 5 Though guidance/coaching, counselling and psychotherapy have the above differences, practically speaking, they share 1. The same theoretical background. 2. The same techniques to work on feeling, thoughts and behaviors to help the client. 3. The ultimate goal of all of them is to help the client. EI Model believes that they are in a continuum Guidance/Coaching/Psycho- Education/Consultation being in the left end, counselling being in the middle and psychotherapy being in the right end. Guidance/Life Coaching/Psy.-Edu./Consult. Counselling Psychotherapy (Sound Mental Health) (Mild Problems in Mental Health) (Severe Problems in Mental Health)  Some people in the field use the terms counseling and psychotherapy interchangeably as they are in a continuum or they use the term “Counselling & Psychotherapy” as a singular phenomenon.  Most of the American text books and approaches originated from the US do not differentiate counselling from psychotherapy.  With 250 different schools of thought and practice, life coaches, psychotherapists and counselors agree on almost nothing.  ‘What is right in one approach/practice’ is wrong in other practice/approach.  To be a practitioner, we need to take sides and strongly market ourselves.  Being a mediocre may put ourselves down. © Chennai Counseling Services/CCS Academy Page 6  3. Subject Matter of Professional Helping Feelings: E.I. Model believes that there are 6 basic Feelings (Adapted from Transactional Analysis). They are as follows, S.No. Emotion/Feeling Perception/Belief/Thought Probable Behavior about Event(s) 1 Threat Trembling, Freezing & FEAR/WORRY* Escaping 2 Injustice or something unfair Shouting, Scolding and ANGER/UPSET^ Aggression. 3 Needs are fulfilled A physical sensation of HAPPINESS well- being, calm and satisfaction 4 SADNESS# Loss or missing Crying and Withdrawal someone/something 5 Loss of dignity Avoiding the people, SHAME places related to the event 6 Mistake of doing something against Self-harm GUILT/REGRET^ their conscience/values/principles in an event and are angry on themselves *Worry– If the intensity of threat is low or it would occur after a long time, it is called as worry. If the intensity is high and it is immediate, it is called as fear. Anxiety is a diagnostic term used by clinicians for worry and fear along with some more symptoms.^ - If the intensity of the injustice is low, it is called as upset. If the intensity of the mistake done is low, it is called as regret. #- Depression is the diagnostic term used by clinicians for sadness along with some more symptoms. Stress is the umbrella term for all 5 distressing feelings. Needs: E.I. Model believes that there are 8 human needs. No hierarchy is followed. (Adapted from Maslow’s Needs Theory and Glasser’s Choice Therapy) 1. Physiological Needs: The needs of oxygen, food, water, and maintenance of body temperature (food, shelter, clothing & sex). 2. Safety & Security Needs: Protection from harm, the need for law and order. 3. Love & Belongingness Needs: The need for friendship, the search for a mate and the © Chennai Counseling Services/CCS Academy Page 7  desire to be part of a family are all reflections of this need. 4. Esteem Needs: The need for self-respect, recognition, confidence and competence. 5. Self-Actualization Needs: Self-actualization is the need to become what one is capable of becoming. Need to utilize one’s potentials to the maximum extent and desire to become what one is capable of becoming. 6. Fun Needs: The need for fun is the need to find pleasure, to play and to laugh. Should you doubt that this is as important as any of the others, imagine a life without hope of any enjoyment. Glasser links the need for fun to learning. All of the higher order animals (dogs, dolphins, primates, etc.) play. As they play, they learn important life skills. Human beings are no different. It is true that "play is a child's work." 7. Power Needs: Having at least someone who can be influenced. This need can be used to empower the other person. 8. Freedom Needs: The need to be free is the need for independence, autonomy, to have choices and to be able to take control of the direction of one's life. If the above needs are met, happiness will be the emotion. If they are not met, any of the other 5 emotions – Shame, Guilty, Anger/Upset, Sadness and Fear/Worry can occur according to the perception of the individual about the event. Thoughts & Beliefs: Thoughts and Beliefs (Beliefs are stronger thoughts which are not evaluated often) can be about 4 things (Adapted from Rational Emotive Behaviour Therapy, Cognitive Therapy and Transactional Analysis) 1. Oneself 2. Others (significant ones such as marital partner, parent, children, colleague, teacher and social institutions such as marriage, family and education) 3. One’s Life/Future – Generalized form of beliefs about oneself 4. World - Generalized form of beliefs about others Behaviour: It is simply the way in which one acts. There is no categorization of the behaviour in EIM. © Chennai Counseling Services/CCS Academy Page 8  Physiology: It is about neurotransmitters, hormones, mutations, hereditary and other biological/physiological processes. Easy Integration Model believes that counsellor/life coach cannot directly work on Physiology as it is not their subject matter but can work on it indirectly through working on thoughts, beliefs, emotions/feelings and needs. Thoughts & Beliefs Behaviour Feelings /Emotions & Needs Physiology (Neurotransmitters & Harmones) Thus the technical definition of all professional forms of helping is helping people to improve their mental health by empowering them with the techniques to work on their thoughts, feelings, needs and behavior. © Chennai Counseling Services/CCS Academy Page 9  4. Easy Integration Model of Mental Health TM - How to choose a school of thought or approach for a client? School of Thought/Approach: A school of thought or a tradition is the perspective of a group of people who share common characteristics of opinion or outlook or view of a philosophy/discipline/field. e.g. Different Schools of Thought/Traditions in Music: Carnatic Music, Hindustani Music, Western Music and etc. | In Medicine: Ayurvedha, Homeopathy, Allopathy, Naturopathy, Siddha, Unani and etc. Counselling and Psychotherapy being an art has many of schools of thought/approaches/therapies/theories/traditions. It is estimated that there are around 250 approaches being used all over the world. Introduction: Integrative Approach in Mental Health is a combined approach that brings together different elements of specific schools of psychology. Integrative practitioners take the view that there is no single approach that can treat each client in all situations. Techniques must be tailored to their individual needs and personal circumstances. Integrative approach maintains the idea that there are many ways in which human psychology can be explored and understood - no one theory/school of thought/approach alone holds the answer. All theories are considered to have value, even if their foundational principles contradict each other. Integrative approach is a progressive form of counseling that combines different approaches to fit the needs of the individual client. With an understanding of normal human development, an integrative counsellor/life coach modifies standard treatments to fill in development gaps that affect each client in different ways. By combining elements drawn from different schools of psychological theory and research, integrative counselling becomes a more flexible and inclusive approach to treatment than more traditional, singular forms of counselling and psychotherapy. It also takes care of the side effects of each approach. © Chennai Counseling Services/CCS Academy Page 10  Easy Integration Model is one of the models of integrative counselling and psychotherapy where the approach to each client is decided based on the personality mode of the client. (A model in counseling refers to a structured framework that guides counselors in understanding and helping clients through different approaches. A model provides a conceptual lens through which counselors interpret clients’ thoughts, feelings and behaviours and develop effective therapeutic interventions.) The central idea of this model which makes it different from other models such as Patterson’s model and Egan’s model is “If Counsellor/Therapist takes the suitable approach based on the personality mode of the client (and NOT based on the problem of the client), client will benefit more and soon”. It takes 10 widely used approaches and integrates. It is highly structured for the beginners to understand. Integrative approach is different from eclectic approach as follows: Eclectic Approaches Easy Integration Model (One of the Integrative Approaches) 1 Approaches and Techniques are chosen Approaches and Techniques are chosen based on the counselor’s expertise or based on client’s personality mode. problem of the client. When the client has When the client has different problems, different problems, techniques which are same/similar techniques will be used unrelated would be used which would which would help the client to get clarity confuse the client. in the shorter amount of time. 2 Randomly bringing different approaches Logically bringing different approaches together based on intuition of the counselor. together based on similarities between Sometimes they don’t fit with each other. approaches. Since similar approaches Whenever new approach is being used, new are mostly used, whatever data set of data has to be obtained. obtained before will be enough to help the client. 3 Uniqueness of each approach is lost like Uniqueness of each approach is kept mixed fruit jam. alive like mixed fruit salad. 4 Because it is mostly based on intuition, it Because it is mostly based on logic, it cannot be taught to beginners. can be easily taught to beginners. 5 No structure to guide when the counselor is Structured to guide when the counselor © Chennai Counseling Services/CCS Academy Page 11  stuck. is stuck. Algorithm is available. 6 If approaches are chosen based on the Since the approaches are chosen based problem of the client, different approaches on the personality modes of the client, need to be learnt for every new problem same approaches learnt can be utilized coming up. for every new problem. No big need to learn new approaches. E.I. Model proposes 4 Personality Modes Theory (Adapted from Personality Adaptation Theory of Vann Joines) 4 PERSONALITY MODES PEOPLE OPERATE (Based on the mood, situation, relationship with the other person etc.) Feeling Thinking Reactive Behaviour (Doing) Inactive Behaviour (Observing) © Chennai Counseling Services/CCS Academy Page 12  Mode/Criterion FEELING THINKING REACTIVE INACTIVE BEHAVIOUR BEHAVIOUR GESTURE Body movements Hand gestures More facial No or Less and gestures within such as expressions, more gestures their small private counting movement of circle. Feelings fingers body and shown in the facial gestures while expressions comparing with the feeling mode. TONE Friendly/pleasing Interested tone Enthusiastic Low tone tone (with ups & - usually in the (Sometimes too downs according to content loud). Pace of the emotions) (sometimes speech may be monotonous) high EYE Lots of inclusive Brief and More of running Very less eye/face CONTACT eye contact steady eye eye contact contact contact – looking away while thinking CONTENT I care, I love, Family, “I think”, “I Wow”, “I like”, “not sure”, “hold happy, sad, I love believe” “my “Don’t want”, back ““Own “Can’t stand”, Emotion /feeling opinion”, pace”, “Doesn’t “Great”, “Bottom related words “according to line”, “Make it matter” me”, “data”, happen”, “Go for “Evidence” it”. POSTURE Leaning forward – repeated Often changing Still body Less physical distance upright body posture- Appropriate physical distance. If you are not able to find the right mode in the beginning of the session, use the rejection method. Try to find out which mode is not there in this particular client and then you will be able to get an idea which mode the client belongs to. © Chennai Counseling Services/CCS Academy Page 13  Formula for 4 Personality Modes Feeling Mode Thinking Mode FTB TFB Reactive Behaviour Inactive Behaviour Mode Mode BFT BTF F- Feeling, T- Thinking & B- Behaviour Three Doors Contact Door – First in the Formula – Used for Trust Building and Initial Intervention that would give mild to moderate relief from the issues faced. Target Door – Second in the Formula- To give intervention for helping the client become self-dependent to solve his problems on his own. Trap Door –Last in the Formula- Never directly go there. Go after spending enough time on Contact Door and Target Door. Used for strengthening the person’s mental health further. If the client is into a feeling mode, the practitioner would also try to change him/ herself to feeling mode in terms of posture, gesture, eye contact, content and tone. Practitioner would also follow the order of elements given in the formula. First work on the contact door, only after spending time on the contact door go to the target door. Try your best to touch the target door in the first session itself. If clients need more time to work on the contact door do not rush to target door. Working on Contact door may help the client to get insights that may push the client to work on the target door on his own. If the client comes for the next session, counselor may work on the target door if required. Never directly go to trap door if you do so, counselling will be going no way and the session will be trapped. Only after spending enough time on contact door and target door, move to trap door. Easy Integration model has taken widely used 10 approaches which are already proven to be effective. Hence the founder supposes the model would also be proven to be effective if we do researches. Founder’s reviews (on Google & Practo) are also forms of evidence for the model. The box below gives the list of 10 approaches. © Chennai Counseling Services/CCS Academy Page 14  Feeling Dominated Approaches (Use any one or a combination of these wherever is ‘F” in the formula) 1. Person Centered Therapy - PCT by Carl Rogers 2. Needs Theory by Abraham Maslow 3. Gestalt Therapy by Fredric Pearls Thinking Dominated Approaches (Use any one or a combination of these wherever is ‘T” in the formula) 4. Rational Emotive Cognitive Behaviour Therapy – RECBT by Albert Ellis 5. Cognitive Behaviour Therapy – CBT by Aeron Beck 6. Transactional Analysis - TA by Eric Berne & his followers Behaviour Dominated Approaches (Use any one or a combination of these wherever is “B” in the formula) 7. Choice/Reality Therapy by William Glasser (usually for B in Reactive Behaviour) 8. Solution Focused Brief Therapy –SFBT by Steve de Shazer, Insoo Kim Berg and his team (usually for B in Reactive Behaviour) 9. Behaviour Therapy by Wolpe, Skinner, Bandura, Eyesenk and many others (usually for B in Inactive Behaviour) 10. Life Skills Approach based on the concepts given World Health Organization (usually for B in Inactive Behaviour) CASE EXAMPLE: When a client appears in front of the practitioner, he/she observes the client using the 5 criteria – posture, gesture, eye contact, content and tone for first few minutes and if the client falls into Thinking mode where all the given 5 criteria are matching, initially one of the 3 thinking dominated approaches or a combination of 2 or all 3 would be used to touch the contact door and then to touch the target door, one of the 3 feeling dominated approaches or a combination of 2 or all 3 would be used. If required and time permits, one of the 4 behaviour dominated approaches or combination of 2 or 3 or 4 can be used for touching the trap door. Here when it is said to use the approaches, counsellor/life coach would keep the key concepts in his head and use the techniques given in the approach to help the client. (We are going to learn them in detail in the coming chapters) A client can be between two modes such as feeling & thinking or thinking & inactive behaviour or feeling & reactive behaviour. If so, out of five criteria if any three or four are matching to one mode and 1 or 2 matching to another mode. The client can be between 3 modes also in case 2 criteria matching with feeling, 2 other criteria matching with thinking and 1 criterion matching © Chennai Counseling Services/CCS Academy Page 15 with reactive behaviour. In these cases, you may use the common entity of the two/three modes to start with and then based on the response, a formula may be followed. Common entity is found by looking at either the contact door or target door. In this way, there are 12 possibilities and the element with which counselor would start the session is given in brackets. 1. Feeling (F) 2. Thinking (T) 3. Reactive Behaviour (B) 4. Inactive Behaviour (B) 5. Feeling & Thinking (Common entities are F & T – never go to B) 6. Feeling & Reactive Behaviour (Common entity is F) 7. Thinking & Inactive Behaviour (Common entity is T) 8. Reactive Behaviour & Inactive Behaviour (Common entity is B – Practically it is not possible as the both seem like opposite to each other) 9. Feeling & Inactive Behaviour (Common entity is T) 10. Thinking & Reactive Behaviour (Common entity is F) 11. Feeling, Thinking and Reactive Behaviour (Common entity is F) 12. Feeling, Thinking and Inactive Behaviour (Common entity is T) Philosophical Assumptions (The assumptions one may believe to practice EI Model. The Founder assumed the following to be true and built the model): 1. All professional forms of helping are always voluntary and it is not going to be effective if the client has not given consent. 2. Clients have the ability to problem solve. When they meet the practitioner, the situation may be overwhelming for them and so they seek help. 3. One approach is not enough to help all kinds of clients because every client is unique. So if one approach is not working, move to the other and try or use combination of different approaches. 4. Personality mode is not stable. It may keep changing less often or more often in © Chennai Counseling Services/CCS Academy Page 16  individuals according to the mood, situation and relationship with the other person in the situation. 5. Counselling and Psychotherapy are for working on the process goal of improving the emotional wellness of the client and outcome goal of solving the problem is in the hands of the client. 6. Problems occurring in the client’s life can be multi-factorial i.e. there can be multiple psychological reasons. Practitioners find out those factors and work on them one by one. 7. It is purely the responsibility of the practitioner to choose the approaches and techniques based on his assessment of the client’s personality mode. Easy Integration Model TM proposes a useful algorithm that can guide the practitioner to choose the suitable approach(es) and techniques. 8. There are some differences and similarities between life coaching, counseling and psychotherapy. (Refer Relationship between Guidance, Counselling and Psychotherapy topic) 9. Core conditions of Counselling (given by Carl Rogers) – Empathy, Unconditional Positive Regard, Genuineness and Concreteness are qualities of an effective practitioner and they play a vital role in improving the success of the counseling session. (Refer Qualities of an effective counsellor/life coach topic) 10. All human beings deserve acceptance irrespective of their moral/educational/economic/ethnic stands. What is good in them and what is bad in them are all based on the perceptions of the individual. There is no absolute good or bad that exists. (Refer Qualities of an effective counsellor/life coach topic) 11. Genetics cannot be blamed completely for any psychological issue/disorders which are developed/ diagnosed after infancy (After 2 years of age). There exists some free will from Adolescence. 12. If the emotions – sadness, anger, fear, guilt, shame are rated 5 or above, they may be overwhelming and may not help to problem-solve. 13. Only if the client processes what has been discussed in the session and continues to use the techniques given by the practitioner in some way or other, it is possible to have a significant development in their mental health. 14. Basically Counselling is counselling. Based on the venue of counseling, it is named such as Corporate Counselling, School Counseling and Hospital Counselling. Based on the concerns addressed, it is named as marital counseling, family counseling, grief counseling and career counseling. Based on the population, it is named as Adolescent Counselling, Child counseling and Geriatric Counselling. In Psychiatric setup, it is simply called as © Chennai Counseling Services/CCS Academy Page 17  Psychotherapy. (Refer Adapting to Different Settings & Concerns and Scope of Counselling & Psychotherapy Chapter) Methodology (How to conduct the sessions if following EI Model): 1. Probe only the things that would be useful for your intervention and do NOT spend time in asking demographic details using a uniform case history format as it may take away lots of time unnecessarily. 2. Confidentiality should be maintained irrespective of the age of client. In case informants asking for the updates about the session, tell that the practitioners would try to empower the client to give updates to the informants. 3. Talk to the client first and avoid talking to the informants even after the session. 4. Believe the client’s version of his/her cognitions, emotions and behaviours and accept the client unconditionally. (Refer Qualities of an Effective Practitioner) 5. Do not get into the right/wrong paradigm. It is not the subject matter of counselors. (It is the subject matter of judiciary and public administrators) Counselors should work to improve the clients’ mental health and not judge the clients. (Refer Qualities of an Effective Practitioner) 6. In case of marital/couple/relationship/family counseling, treat the clients as individual clients and meet them individually to improve their mental health first and later empower them to take care of their relationship with the other person(s). (Refer Marital/Family Counseling Chapter) 7. When the client cries or discharges any emotions, wait for the client to come back on his/her own. Things to be avoided: Asking whether the client needs water, tissues and saying it is ok as they may inhibit the client from discharging the emotions. 8. Minimal use of psychological tools is encouraged. It should be used when the client is in thinking element. If in any other door, always get the views of the clients about your interpretations and respect their views. Never use the scales to label the clients. (Refer Psychological Tools for Counseling Practice Chapter) 9. Abnormal psychology should be used only to find out who would benefit from our intervention and should not be used for labelling the client with the names of disorders. Avoid telling the diagnostic terms to clients. If severe pathology is found, refer him/her to a competent professional such as special educator and psychiatrist. Tell the client that the concern to be addressed does not seem to be coming under your purview and when they meet the specialized professionals, those qualified professionals would give them full explanation. (Refer abnormal Psychology for Practitioners & Networking with other professionals Chapter). Complete the session with Person Centered therapy. © Chennai Counseling Services/CCS Academy Page 18  10. If the client seems not being able to benefit from counselling as he has persistent sadness or fear, or anger or sleep issues, psychiatric/homeopathic/Ayurvedhic/any form of medical drug intervention may be suggested for which appropriate referral has to be done. Later drug may be tapered down as they improve as per the treating physician’s consultation (Refer Networking with other professionals Chapter) 11. Take one or more hypotheses from the approaches according to the contact door or common element to interpret your client’s problematic cognitions/emotions/behaviour and collect the required data. Then explain your hypothesis why the problem occurred to your clients. (You will learn “Why people get into problems and what kind of data you need to collect” in the chapters on the 10 approaches) If they seem to accept it, go by it and do the appropriate intervention. 12. If the intervention works, then your hypothesis is right. If it does not work, go to the next best hypothesis from the same approach or another approach. 13. When you touch the contact door, go with the client and then when you come to target door, slightly pull the client to your way and see whether it works. 14. The handout of the techniques used may be shared with the client to help the client further. © Chennai Counseling Services/CCS Academy Page 19 © Chennai Counseling Services/CCS Academy Page 20  5. Qualities of an Effective Practitioner (Adapted from Carl Rogers) EI Model believes that the counselors and life coaches need to possess the 4 qualities given by Carl Rogers. To encourage disclosure, Rogers described 4 trust promoting environment/climatic conditions otherwise called as core conditions of counseling. 1. Empathy 2. Unconditional Positive Regard 3. Genuineness 4. Concreteness Empathy & Unconditional Positive Regard Definition of Empathy: Trying to see and think the things from the client’s point of view as if it were your own without ever losing the “as if” quality and communicating the same. Definition of UPR: Caring for your client without setting conditions for your caring. (avoiding the message “I will care about you if you do what I want”) Can you believe at least one of the following statements? – Human beings are basically good and trustworthy by Rogers, Developer of Person- Centered Therapy – People are neither good nor bad by Fritz Pearls, Co -Founder of Gestalt Therapy – People are (born) ok by Eric Berne, Founder of Transactional Analysis – ‘What is right and wrong’ is based on the consequences and situation. I can’t judge all of them (based on Teleology and not Deontology – Schools of Ethics) – When human being’s needs are not fulfilled, they get into trouble (Based on Maslow’s needs theory) Exercise If you have a client who is – A rapist – A corrupt politician – A murderer – A child abuser – A person with multiple affairs © Chennai Counseling Services/CCS Academy Page 21  Things that impede Communicating Empathy Don’ts Why (What you should believe) Clients may take the last statement and Adding “but” with Empathy Statement think counselors do not understand and giving them. We can’t generalize and we don’t Predispositions/Judgments/Pop have the power to mind read/judge. We Psychology Concepts/Solutions are professionals who would go by professional psychology concepts only. People have the ability to solve their Lecturing and Advice giving (e.g. Why issues. They have a successful past. don’t/didn’t you do this solution? and They are not intellectually disabled. Can/Did you try this solution?) They have the ability to think Story Telling (Telling things which It is against genuineness/honesty. never happened to the counselor) That’s what others do. Let us not do Criticizing/Analyzing them. Sermonizing – bringing religious concepts We are secular We are not doing investigation. We Too much probing/Excessive cannot understand everything in the Questioning client’s life. It may be taken by the client that the Normalizing (Saying that everyone or counselor is not giving his special many undergo this) attention Formula for Communicating Empathy – 3R’s (Adapted from Steven Covey) Repeat – Central Content – May be the first or main statement (take notes with the consent of the client) Rephrase (Using the synonymous words to summarize whatever was told by the client) – When there is a lot of things said by the client Reflect feelings or/and thoughts or/and behaviours (may turn into judgments. Be careful) Exercise I do lot of good things for others. I don’t know what happens to me. I can solve others’ problems easily but I cannot solve mine. (Loud Voice, with lots of gestures) I don’t want many things in life. All I want is some love and affection from my © Chennai Counseling Services/CCS Academy Page 22  husband. I feel he keeps me away in many situations. (With a pity tone, Crying) I don’t show my feelings to others. I only know what I am going through… (pause) Nothing else…. (Very slowly) Communicating empathy helps people to open up further and add some more ideas for us to analyse their thoughts, feelings and behaviors. After acknowledging the content through Repeating, Rephrasing and reflecting the feeling in the client’s statement of initial concern, further clarifications needed can be asked. Genuineness Definition: Patterson defined genuineness as being you seem to be, consistent over time and dependable in the relationship. Rogers defined genuineness as the characteristic of transparency, realness, honesty, or authenticity To be fully genuine in the sense described by Rogers, counselors must know themselves – Personal Work is required Self-Disclosure may be done but very minimal (only if feeling contact door). May move to story telling Exercise Can you tell the following in the beginning itself? – Number of sessions – Expecting significant outcomes – Fee What if the client develops dependence on you? – Talk about it openly with empathy Concreteness Definition: Using clear language to describe the client’s life situation. A concrete counselor promptly seeks specifics rather than vague generalities. Counselors should be interested in specific feelings, specific thoughts and specific behaviours Vagueness, Abstractness and Obscurity are the opposites of Concreteness New insights will emerge when concreteness is followed by both client and © Chennai Counseling Services/CCS Academy Page 23  counsellor Concreteness increases by asking directly for specific examples of troublesome events. Rating scales can be used to rate the feelings or intensity of thoughts Exercise If the clients give the following generic statements during the counselling session, what will be your questions to make their statements more concrete?  I am feeling bad  Many people do not like me  I am worried about my studies  I want to become a teacher  My life is not going good. © Chennai Counseling Services/CCS Academy Page 24  6. Rogers’ Person Centered Therapy (A Feeling Dominated Approach in EI Model) History  Born in a suburb of Chicago (Oak Park), the USA in 1902, Carl Rogers was the fourth of six children (five were boys). Rogers (1961) describes his parents as loving, affectionate, and in control of their children’s behavior.  He received his Ph.D. in clinical psychology in 1931.  He was trained on Psycho-analysis during his clinical psychology studies. However when he worked with children, he understood that listening to the children, letting them be to be on their own and thereby giving treatment worked better than autocratic psychoanalytic treatment.  Based on his experience with children, he published “The Clinical Treatment of the Problem Child” in 1939.  In 1942, he published another book “Counseling & Psychotherapy: Newer Concepts in Practice” which popularized the term Counseling. He used the term “non directive approach” in the book.  In 1951, he wrote another book, “Client Centered Therapy” where he started using the term client instead of patient  He changed the name of his approach to person Centered therapy in 1968 when he helped to found “The Center for Studies of the Person” in La Jolla, California.  He applied his system to education, politics, & international conflicts  He is the first person to “open therapy room” to cameras, studies, etc.  In 1987 at the age of 85, he passed away. Philosophical Assumptions  Human Beings are basically good and trustworthy  All humanity has but one basic motivational force: an inborn tendency toward actualization  They have the ability to understand and guide themselves.  Every human being has a self-concept that includes our perceptions of what is characteristic of “I” or “me”, perceptions of our relationships to others/world, and the values attached to these perceptions.  Incongruence takes place when there is a difference between what is being experienced and what is symbolized as part of a person’s self-concept.  People are in touch with constantly changing world and so they keep changing. © Chennai Counseling Services/CCS Academy Page 25 Key Concepts To encourage disclosure, Rogers described 4 trust promoting conditions otherwise called as core conditions of counseling. If the counselor follows these 4 qualities, client will open up and resolve their issues. (Refer Qualities of an Effective practitioner Topic for full notes) 1. Empathy 2. Unconditional Positive Regard 3. Genuineness 4. Concreteness Techniques: No techniques were given by Rogers however communicating empathy can be called as a technique. If the client is in feeling mode, please give empathy for some more time and probe to understand the emotions. For example, if the client says sadness is the emotion he/she goes through, probing about what is that he/she is missing/has lost. In EI Model, techniques from other approaches such as Gestalt Therapy may be combined with Empathy to go further. As per the algorithm, all the counseling sessions start as Person Centered Therapy irrespective of the personality mode that would be found later. Probable Side Effects if used as a How to take care of the Side Effect? Singular Approach Clients may keep on talking about their problems. They may take more sessions to get clarity. By Using techniques from other Since there is no specific technique, the approaches of EI Model, we help the client beginner counselors may see it be very to get the clarity soon abstract and may have difficulty in using this approach. Summary: Why Data Required for Techniques Problem/Abnormality/Pathology using the occurs? Techniques  Incongruence  List of  Unconditionally Accepting emotions with the client rating out of 10  Being Genuine to the client  Communicating Empathy through 3 R’s  Asking questions for Concreate emotions & thoughts. © Chennai Counseling Services/CCS Academy Page 26  7. Application of Abraham Maslow’s Needs theory in Counselling & Psychotherapy (A Feeling Dominated Approach in EI Model) History Abraham Harold Maslow was born and raised in Brooklyn, New York; he was the oldest of seven children. Maslow attended the College of the City of New York and spent one semester at Cornell. Eventually, he transferred to the University of Wisconsin where he was exposed to psychology courses; he earned his bachelor’s degree in psychology in 1930. He taught as an assistant instructor at the university, and worked under psychologist Harry Harlow, earning his MA in 1931 and PhD in 1934. He married Bertha Goodman in 1928, and the couple raised two children. Maslow died of a heart attack in 1970. Professional Life: In 1935, Maslow returned to New York to work at Columbia Teachers College where he met and was mentored by Alfred Adler. Later, he worked as a psychology instructor at Brooklyn College, beginning in 1937, where he developed a relationship with Max Wertheimer, a gestalt psychologist, and an anthropologist named Ruth Benedict. These two people were not only Maslow’s friends, but quickly became the subject of his research. He observed and assessed them and this formed the foundation for his theories on human potential and psychological well-being. From 1951–1969, Maslow was chair of the psychology department at Brandeis University in Massachusetts. In the late 1950s, humanistic psychology became increasingly popular, with Maslow widely regarded as its founding father. He was recognized for his contributions to the humanistic approach to psychology when he received the honor of Humanist of the Year by the American Humanist Association in 1967. He passed away in 1970 at the age of 62. Philosophical Assumptions:  Man is a wanting being, i.e. his wants are growing continuously even when some wants are satisfied. Human needs are of varied and diversified nature.  Each individual human being has a fundamentally unique experience of life. As much as we think we know how another person feels or what they are thinking, we really can't know what it is like to be them. Each person's view of reality is unique to them, and should be valued by others.  He believed psychological problems occur when their needs are not fulfilled. If one cannot satisfy one’s needs, pathology is the result.  Everyone is born with a will toward health, and a tendency to grow towards self- actualization. © Chennai Counseling Services/CCS Academy Page 27 Key Concept: The Needs are as follows: 1.Physiological Needs 2.Safety & Security Needs 3.Love & Belongingness Needs 4.Esteem Needs 5.Self-Actualization Needs As part of EI Model, we take fun, freedom and power also to be the needs. Explanations are given under Subject Matter of Counselling Topic itself. Technique: Based on the story given by the clients, assess which need was not met and help them fulfill it and thereby improve their mental health. This technique can be used by rating out of 10, how much of their needs are fulfilled. If it is less than 5, help them come up with ways to fulfill the needs or you may probe what feeling is felt when their needs are not met if they are comfortable to talk about it and empathize with the clients. As this does not require deeper understanding of the problems, it can be easily used with clients who do not want to talk about their deeper feelings. As needs and feelings are very closely connected to each other, it can enhance the well-being of feeling mode clients. Usually non/partial fulfillment of love and belonginess need leads to Sadness. Usually non/partial fulfillment of safety & security need leads to Fear or Worry. Usually non/partial fulfillment of physiological need leads to Anger. Usually non/partial fulfillment of esteem need leads to Shame feeling. Usually non/partial fulfillment of Self Actualization need leads to Guilt related to oneself and anger on others. Usually non/partial fulfillment of fun need leads to Anger. Usually non/partial fulfillment of power leads to sadness and non/partial fulfillment of freedom leads to anger. Techniques from Solution Focused Brief Therapy and Gestalt Therapy may be combined with these techniques to help the client. Probable Side Effect if used as a Singular Approach: Not Applicable as it is not a core counselling approach. Whatever approach’s technique is used, the side effects of the approach may occur. Note: In EI Model we believe that the hierarchy given by Maslow does not seem to be applicable to all clients. Some give more importance to Esteem Need or Love and Belongingness needs instead of Physiological Needs which is contradictory to the hierarchy given by Maslow. © Chennai Counseling Services/CCS Academy Page 28 Summary: Why Data Required for using Techniques Problem/Abnormality/Pathology the Techniques occurs?  Needs are not  List of needs not  Helping them to fulfilled enough met and rating on how fulfil the needs at much each need is least to the level of 5 fulfilled Finding out the emotion when the needs are not fulfilled 8. Gestalt Therapy (A Feeling Dominated Approach in EI Model) History  Developed by Fritz Perls & Laura Perls.  Fritz Perls was born in Berlin, Germany, in 1893.  Against his family’s wishes, Perls served in the army during World War I. After the war, Perls studied medicine and began treating soldiers with brain injuries. He was drawn to the work of Sigmund Freud as a teenager, and his experiences treating patients pulled him further down the path toward Freudian psychoanalysis. He studied at the Berlin Institute of Psychoanalysis and in Vienna.  In 1930, Perls married Lore Posner, later known as Laura Perls; the couple had two children and fled the Hitler regime by relocating to Johannesburg, South Africa, in 1933. There, Perls founded a training institute to serve the psychoanalytical community. During World War II, Perls again joined the military and became a psychiatrist with the South African army.  In 1946, the Perls family moved to New York where Perls worked briefly with Wilhelm Reich and Karen Horney. Perls eventually settled in Manhattan and began working with the intellectual Paul Goodman. In 1951, in collaboration with Ralph Hefferline, Goodman and Perls produced the book Gestalt Therapy: Excitement and Growth in the Human Personality, based mostly on Perl’s own research and clinical notes. Shortly after the publication in 1951, the Perls founded the New York Institute for Gestalt Therapy and began conducting training from their apartment in Manhattan. Perls began sharing his theories with all of North America and began traveling extensively to conduct seminars and training workshops.  Later in life, Perls moved to California and became affiliated with the Esalen Institute, in 1964, where he provided workshops and continued to practice and develop Gestalt therapy. In 1969, Perls moved to Vancouver Island, Canada, to establish a training community for therapists. He died the following year - 1970 in Chicago at the age of 76. © Chennai Counseling Services/CCS Academy Page 29  Laura Perls is a co-founder of gestalt therapy. She lived from 1905-1990. Though her contributions to gestalt therapy were at times underestimated in the past, her importance has become more widely recognized in the recent years.  Gestalt means “whole” in German. The basic principle behind Gestalt Therapy is: The whole is greater than the sum of the parts and the organism functions as a whole. Philosophical assumptions  People neither good nor bad.  Understanding the non-verbal behaviour of the physical means is important to understand the whole individual.  Unexpressed (authentic/refer Transactional Analysis) emotions are the obstacles that stop us from reaching solutions.  The best way to understand and express the unexpressed emotions is to recreate the situations in which emotions were felt. One can freely express the emotions to those with whom they felt those emotions.  Abnormality occurs because people do not live “here and now” but “then and there” due to unfinished business. Key concepts: Concept of the Whole: The whole is greater than the sum of the parts and the organism functions as a whole. The concept of the whole applies to 1. interaction between physiological and psychological (thoughts, feelings and behaviour) aspects of a person, 2. interaction between past, present and future 3. interaction between Verbal and Non-verbal Language. The emotions are often expressed through physical means. Understanding the non-verbal behaviour of the physical means is important to understand the whole person. Physical means can be interpreted as body language in popular terms. Unfinished Business:  Unfinished business refers to the event in which authentic/original emotions were not expressed and no closure was obtained.  People with unfinished business often resent the past and because of this, they are unable to focus on the here and now.  One of the major goals of Gestalt Therapy is to help people work through their unfinished business and work towards closure.  How to find out whether there is any unfinished business? - When you have nothing to do or you are doing something physically and no mental work is involved, do you get thoughts about an event or a person and they bother you? If the answer is “Yes”, it seems like an unfinished business. © Chennai Counseling Services/CCS Academy Page 30   In order to finish the unfinished business or trying to bring a closure, empty chair or double chair or role play techniques may be used. Empty Chair, Double Chair and Role play techniques can help the counselors to find out the authentic emotion(s) also. If the emotion is rated 6 or above out of 10, then double chair technique or role play technique is suggested. If it is 5 or below, empty chair technique may be enough. Techniques: Empty Chair The empty chair technique is a “method of facilitating the role-taking dialogue between the client and others”. Two chairs are placed facing each other: one represents the client and the other represents another person with whom the client has unfinished business or nurturing figure. Client first takes his his/her role and vent out his/her authentic feelings. The therapist may simply observe as the dialogue progresses being outside the vision of the client or may instruct the client, suggest sentences to say, call the client’s attention to what has been said, or ask the client to repeat or exaggerate words or actions. Client facing an empty chair and talking in the vernacular language he/she would talk to the other person with whom he has unfinished business. No censors. Counselor does not have to understand the conversation. Double Chair After empty chair, client going to the other chair and talk whatever the client wants to hear from the other person with whom he has unfinished business. Counselor may give triggers and ideas to talk. Role Play It is a technique where the Counselor taking the role of the other person with whom client has unfinished business and have a conversation with the client. Counselor taking the role of the other person should talk whatever the client may like to hear from the other person and NOT exactly what the other person would say as this technique is utilized to improve the mental health of the clients. If the counselor talks in the same way like the person with whom the client has unfinished business, it may put the client down and he/she may not express the unexpressed feelings. Points to be remembered during the role play by the counselor:  Try to find out the authentic emotion of the client. If role play is done on the racket emotion, it does not serve the purpose of helping the client to express the authentic emotions. If you do not know what is the authentic emotion, use the guidelines of all the possible authentic emotions and engage in the conversation during role and see for which emotion the client is able to express a lot and you may understand those for which the client expresses more may be the authentic emotion(s) © Chennai Counseling Services/CCS Academy Page 31   If it is an ongoing issue, give a neutral response in the role play when the counselor plays the role of the other person and no closure should be brought. (e.g. I cannot assure that I will change, I am just here to get your side of the story)  If it is an issue which got over in the past and client will never meet the other person, then closure may be brought. (e.g. Apology, I assure you that I will never repeat this, I will try to change it. )  During role play, it is better to use the exact vernacular language spoken between the client and the other person.  The goal is not to give answers to all the questions clients have but helping them to express the unexpressed emotions. So, whenever the client asks some question, find out the emotion and redirect the conversation.  If the following emotions are shown in the role play by the client, the counselor can do the corresponding things given. Authentic Guidelines for Counselor’s Conversation Example Scenarios Emotion in the Role play Technique as the other showed by person with the whom client has unfinished business Client (Whatever is appropriate) Anger Asking what was unfair to the client, Client was not given the marks Getting Punishment/Scolding/Harsh he deserves. He is angry with Words-adjectives such as selfish, cunning, show off, hypocritic etc. that may make the the Teacher. Counselor takes unfair person realize the mistake done, the role of teacher. What the unfair person should have ideally done. What to do if the unfair person realizes his mistake, how the client is going to cope with the difficulties Guilt* Asking what was mistake/unfair thing done Client has abused a person by the client, what client should have emotionally. He feels guilty. ideally done, what was the contribution of the client in the mistake and what would Counselor takes the role of be the compensation the victim of abuse. Sadness* Asking what client misses/has lost and how Client has lost her husband. is life without him/her/it. How nice it was She is missing him in almost when the person was available. Telling how all parts of her life. Counselor much the client is being missed by the takes the role of the husband. other person. Fear* Ask what was the threat to the client, who Client has fear towards was responsible for the threat, how to Mathematics. Counselor takes overcome the threat. Asking how much to the role of mathematics. fear, how to be careful, how courageous was the person before © Chennai Counseling Services/CCS Academy Page 32  *Counselor takes the role of a nurturing person asks about the courage of the client in the earlier issues. Shame* Asking the client how much her/his Client was insulted by his dignity was damaged and what should colleagues in his organization. have been ideally done. Asking how to He felt like not going to the achieve in front of those who insulted the office. Counselor takes the client. How the client is going to deal with role of one of the colleagues. such people in the future *Whenever the client feels sad or guilty or shameful or fearful or you are not able to find any character with whom you can do a role play, counselor can ask for a nurturing figure(s) in the client’s life and that nurturing person would take the other chair in double chair activity. If it is role play, counselor can take the role of nurturing figure, listen to the client and empower the client. Getting some information about the nurturing figure will be required for the counselor to do the role play. Once the role play technique is over, counselor says “Role Play is over” may ask the client to what extent it was realistic, how he/she feels, what he/she heard from the other person and suggest the client to remember them and tell within himself/herself to bring a closure. Clients may write it in a paper or record it in their cell phone to remember. This Empty chair/double chair/role play technique would help the client to reduce the intensity of the distress and may not solve the problem fully. If the client is prepared to talk to the other person with the authentic feelings, problem may get resolved fully. In cases where expression is not possible, clients can use their logic derived from RECBT or any other thinking dominated approach to bring the closure within oneself. If the client is not willing for the role play, the counselor may try to take the conversation in the third person- he/she/they (not 1st – I/we or 2nd Person-You) using the guidelines given in the way of Person Centered Therapy. Example: Role Play of Gestalt Therapy– What is the unfair thing done by me? PCT- What is the unfair thing done by him/her? Equivalents of Empty Chair may be given to the client to take care of unfinished business. 1. Talking to a non-judgmental and empathic person who will not advice. Telling the empathic person not to advise but just to listen in the beginning itself. 2. writing in a paper & tearing, typing in cell phone/laptop & deleting – while writing or typing – no description but as a conversation whatever you wanted to tell the other person © Chennai Counseling Services/CCS Academy Page 33  3. Recording the talk to the other person in mobile phone and deleting it. 4. writing a poem or story describing the emotions in the first person with lots of conversations and not in 3rd person description 5. Assigning colours for the emotion you are going through and painting or drawing the people with whom you have unfinished business and add conversations (Do not store these materials. Remove them from the environment. Finish the unfinished businesses) Probable Side Effects if used as a How to take care of the Side Effect? Singular Approach Churning feeling as the clients get the Empathizing more from PCT awareness that they have many unfinished businesses. Re-living the past and going through all Using SFBT/Choice Therapy at the appropriate the emotions the client has felt during time to talk about the future the time of traumatic events. Blaming the others fully for their Using RECBT/ TA / CBT at the appropriate time to unfinished business. see their contributions. Why Data Required for using Techniques Problem/Abnormality/Pathology the Techniques occurs?  Unexpressed  List of authentic  Empty Chair and (Authentic) emotions and their its equivalents/ Emotions rating Double Chair  Unfinished  Role Play Business © Chennai Counseling Services/CCS Academy Page 34  9. Rational Emotive Cognitive Behaviour Therapy (A Thinking Dominated Approach in EI Model) History Rational emotive cognitive behavior therapy (RECBT), previously called rational therapy and rational emotive therapy, is a philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral problems and disturbances and to help people to lead happier and more fulfilling lives. RECBT was developed by the American psychotherapist and psychologist Albert Ellis, who was inspired by many of the teachings of Asian, Greek, Roman and modern philosophers. Albert Ellis (September 27, 1913 – July 24, 2007. Died at the age of 93) did his MA and PhD degrees in clinical psychology from Columbia University and the American Board of Professional Psychology (ABPP) respectively. He described his father as unaffectionate and his mother as emotionally distant. Since his parents were rarely around, he often found himself in the position of caring for his younger siblings. Ellis was often sick throughout his childhood. Between the ages of 5 and 7, he was reportedly hospitalized eight different times. One of these hospitalizations lasted about 10 months, during which time his parents rarely visited or offered comfort and support. Ellis recalled being quite shy when he was young. At 19, he set out to change his behavior and forced himself to speak to every woman he encountered at a park bench near his home. One month, he spoke to over 130 women and while only one agreed to go out with him and then she didn't show up for the date, he found that he had desensitized himself and was no longer afraid of speaking to women. He utilized the same approach to get over his fear of public speaking. Philosophical Assumptions:  A fundamental premise of RECBT is humans do NOT get emotionally disturbed by unfortunate circumstances, but by how they construct their views of these circumstances through their language, evaluative beliefs, meanings and philosophies about the world, themselves and others.  The idea that our beliefs upset us was first articulated by Epictetus around 2,000 years ago: "Men are disturbed not by events, but by the views which they take of them."  Human Beings have the ability to think rationally and irrationally.  The beliefs that upset us are all variations of three common irrational beliefs. Each of the three common irrational beliefs contains a demand. These beliefs are known as © Chennai Counseling Services/CCS Academy Page 35  "The Three Basic Musts."  I must do well and win the approval of others for my performances or else I am no good.  Other people must treat me considerately, fairly and kindly, and in exactly the way I want them to treat me. If they don't, they are no good and they deserve to be condemned and punished.  I must get what I want, when I want it; and I must not get what I don't want. It's terrible if I don't get what I want, and I can't stand it.  The first belief often leads to anxiety, depression, shame, and guilt. The second belief often leads to rage, passive-aggression and acts of violence. The third belief often leads to self-pity and procrastination. It is the demanding nature of the beliefs that causes the problem. Less demanding, more flexible beliefs lead to healthy emotions and helpful behaviours. Key Concept: ABCD Model  In RECBT, clients usually learn and begin to apply this premise by learning the A-B-C-D model of psychological disturbance and change. The A-B-C-D model states that it is not the activating event (A) that cause disturbed and dysfunctional emotional and behavioral consequences (C), but also what people irrationally believe (B) about the activating event.  A, activating event can be an external situation, or a thought, a feeling or other kind of internal event, and it can refer to an event in the past, present, or future.  The Bs, irrational beliefs that are most important in the A-B-C-D model are explicit and implicit philosophical meanings and assumptions about events, personal desires, and preferences. The Bs, beliefs that are most significant are highly evaluative and consist of interrelated and integrated cognitive, emotional and behavioral aspects and dimensions.  According to RECBT, if a person's belief (B) about the A, activating event is rigid, absolutistic, fictional and dysfunctional, the C, the emotional and behavioral consequence, is likely to be self- defeating and destructive. Alternatively, if a person's belief is preferential, flexible and constructive, the C, the emotional and behavioral consequence is likely to be self-helping and constructive.  Through RECBT, by understanding the role of their mediating, evaluative and philosophically based illogical, unrealistic and self-defeating meanings, interpretations and assumptions in disturbance, individuals can learn to identify them, then go to D i.e. disputing and questioning.  They can recognize and reinforce the notion no evidence exists for any psychopathological must, ought, have to, need do or should and distinguish them from healthy constructs, and subscribe to more constructive and self-helping philosophies. © Chennai Counseling Services/CCS Academy Page 36  Technique: Client can be helped to find out irrational beliefs by asking the following questions towards the thought/belief statements of the clients. Question If the given answer How to convert to a rational is arrived, it is belief? irrational thought/belief 1. Is there 100% No Coming up with a statement with evidence for my a specific Percentage thought/belief?/ Is there of truth/possibility 100% possibility for it to happen? / Is it a fact? / Is it always in such a way? 2. Does my thought/belief No Acknowledging the difficulties help me to problem solve? such as feeling sad, angry, worry, or Does it make me feel fear and add statements like better or healthy or good? “however let me see what can be Or Does it preserve my done” mental health? 3. Is there a rule that it has No Understanding the pathology of to be in such a way only? Musterbation and shifting to use i.e. thoughts with flexible words “Prefer to”, “like must/should/ought to”, “try one’s best to”, “wish”, to/need to/have to (Whose “want” instead of should and their rule is that? – equivalents Musterbation) 4. Is my expectation No Come up with a statement with a completely under my specific Percentage control? Am I the only stake of contribution. Accepting the holder in the responsibility for my contribution only and not full. Trying my best to process? think about the things which are completely under my control. Plans to deal with if the expectation is not met. The rational belief will have 95%- 100% evidence/possibility, will help to problem solve, have words like prefer to, wish, want, try my best to, will be about something which is under one’s control and plans to deal with if the expectation is not met. If the clients talk about their thoughts and beliefs, directly counselor can apply asking the above questions. If not, a recent event or most distressing event can be asked and find out © Chennai Counseling Services/CCS Academy Page 37  the C and then B. Before asking the questions, the concept that the events cannot cause distress but the beliefs cause the distress should be established. For one of the questions, if the given answer is arrived, then it can be an irrational belief. Counselor can choose the best suitable question from the above and ask. Not all questions have to be asked. If the belief is found to be irrational, client will be asked for a rational belief that would satisfy all the criteria for replacing in the place of irrational belief. If the client is not able to come up with a rational belief, counselor may give statements for the consideration of the client. Clients can be trained to substitute the rational belief on a daily basis when they find an irrational belief thereby their brains are trained to think rationally. Usually Counselor initially takes one activating event to introduce the idea of rational beliefs. Later counselor can take different activating events to examine the beliefs and help the client to identify the irrational beliefs they possess and then help them to come up with constructive and functional beliefs. Clients learn to think rationally during the counseling sessions and they would practice the techniques for some time and train their brain to think rationally. Only after practicing, they may be able to significantly reduce the irrational thoughts/beliefs. Counselors help the clients understand this is different from positive thinking and not a quick fix as positive thinking can be irrational most of the times. Probable Side Effects if used as a How to take care of the Side Effect? Singular Approach It may be seen as a harsh approach Empathizing from PCT in between the by some clients as the techniques questions of RECBT do not seem to be giving importance for emotions. The needs of clients may be termed Acknowledging the needs of the clients from as irrational by the counselors Maslow’s needs theory © Chennai Counseling Services/CCS Academy Page 38  Summary: Why Data Required for using Techniques Problem/Abnormality/Pathology the Techniques occurs?  Irrational Beliefs  Belief about the  4 Questions about the Events event and belief about that will help the  3 Basic Musts/ others mostly client to find out Musterbation the irrational beliefs and then ways to convert them to rational beliefs  Home Work to practice the technique 10. Cognitive Behaviour Therapy (A Thinking Dominated Approach in EI Model) History Cognitive Therapy (CT) was pioneered by Dr. Aaron T. Beck in the 1960s, while he was a psychiatrist at the University of Pennsylvania. Having studied and practiced psychoanalysis, Dr. Beck designed and carried out several experiments to test psychoanalytic concepts of depression. Fully expecting the research would validate these fundamental concepts, he was surprised to find the opposite. As a result of his findings, Dr. Beck began to look for other ways of conceptualizing depression. He found that depressed patients experienced streams of negative thoughts that seemed to arise spontaneously. He called these cognitions “automatic thoughts.” He found that the patients’ automatic thoughts fell into three categories. The patients had negative ideas about themselves, the world and/or the future. Dr. Beck began helping patients identify and evaluate these automatic thoughts. He found that by doing so, patients were able to think more realistically. As a result, they felt better emotionally and were able to behave more functionally. When patients changed their underlying beliefs about themselves, their world and other people, therapy resulted in long- lasting change. Dr. Beck called this approach “cognitive therapy.” Some books say that Beck’s © Chennai Counseling Services/CCS Academy Page 39  Cognitive Therapy was renamed to Cognitive Behaviour Therapy (CBT) whereas some other books claim that CBT is an umbrella term for cognitive oriented therapies and behaviour- oriented therapies. He passed away in 2021 at the age of 100. Note: The term “Negative” refers to “Irrational” and “Positive” refers to “Rational” as termed by Ellis and should not be taken from the sense of popular psychology or lay man’s understanding. Philosophical Assumptions:  Cognitions affect and cause behaviour and emotions.  Cognitions can be measured, monitored, and altered.  Pathology (abnormality) occurs when people have negative/irrational core beliefs. Key Concepts: Automatic thought: It is a brief stream of thought about ourselves and others. Automatic thoughts largely apply to specific situations and/or events and occur quickly throughout the day as we appraise ourselves, our environment, and our future. Automatic thoughts are situation-specific thoughts that pop into our head. They’re referred to as “automatic” because they largely arise from subconscious awareness – we aren’t choosing actively to have those thoughts. They might be positive, negative, or neutral in tone. Intermediate Belief/ Assumption: Intermediate beliefs exist as a mediator between automatic thoughts and core beliefs. These are personal perceptions of how things work that influence how you interpret the current situation. They can be rules, assumptions, “shoulds,” or attitudes that apply to a variety of situations with a broader reach. Intermediate beliefs can often be stated as conditional rules: “If x , then y.” They may be about oneself, Others and Life/World If… then, I need to…. (will be with conjunctions) Core belief: Core beliefs are often formed in childhood and solidified over time as a result of one’s perceptions of experiences. Generally core beliefs tend to be rigid and pervasive. It is usually about oneself. Core beliefs are a filter through which we see the world. We observe and remember evidence that serves to confirm these beliefs, and you ignore evidences that don’t fit. We may even find ourselves creating situations that reinforce these beliefs as a self-fulfilling prophecy. Or we may re-write positive information that doesn’t fit in with or core belief to fit the negative belief (i.e. “They gave me a compliment BUT they must have just felt bad for me because I’m so ugly.”) All the 3 are simply different levels of cognitions. Core Belief is the deepest one. Intermediate Belief is the one in between and automatic thought is the one on the surface level. © Chennai Counseling Services/CCS Academy Page 40  Following diagrams will help you understand the process. Core Belief I am a failure(70%) Behaviour I blame myself (70%) Feeling/Emotion Important Event I am frustrated (70%) Failure in Exam (70%) Automatic Thought I keep failing (70%) Intermediate Belief If I lose/fail, I don't deserve to live (70%) Core Belief I am born to win (70%) Behaviour Important Event I console myself(70%) Failure in Exams - (70% it is not an Feeling/Emotion important event) I feel sad (30%) Automatic Thought Let me pass next Intermediate Belief time(70%) Getting failed in exam is normal (70%) ) © Chennai Counseling Services/CCS Academy Page 41  Core Beliefs Formed by our early/past experiences What we do and what we feel Important Events Trigger our core beliefs to come up Automatic Thoughts Intermediate Belief Helps to predict what is going to happen in lifeo Techniques: Here are 3 techniques given from CBT which are as follows, 1. Cognitive Restructuring 2. Cost Benefit Analysis 3. Downward Arrow Technique. Cognitive restructuring: It involves four steps 1. Identification of cognitions known as automatic thoughts (ATs), Intermediate beliefs and core beliefs which are dysfunctional or negative views of the self, world, or future based upon already existing beliefs about oneself, the world, or the future. 2. Identification of the cognitive distortions in the ATs and/or intermediate beliefs and/or core beliefs 3. Restructuring them through persuasion, instruction and discovery of new ways of thinking (In EI model, using the questions of REBT can be done instead of this step) 4. Development of a positive/rational replacement to the ATs/Intermediate beliefs/core beliefs Cognitive Distortions: Some common cognitive distortions (errors) are given below. They will overlap with each other. © Chennai Counseling Services/CCS Academy Page 42  1. Filtering A person engaging in filter (or “mental filtering) takes the negative details and magnifies those details while filtering out all positive aspects of a situation. For instance, a p