CCRT Therapeutic Plan PDF

CHAPTER I 2 CCRT Therapeutic Plan CCRT Reality Key: CCRT Number one through five, are human needs and wants. They are not learned behavior. A definition oflearned behavior which is good, and just as good as the other thousand learning behavior...

CHAPTER I 2 CCRT Therapeutic Plan CCRT Reality Key: CCRT Number one through five, are human needs and wants. They are not learned behavior. A definition oflearned behavior which is good, and just as good as the other thousand learning behavior theories and definitions. We will just use Bandura's concept and definition. Learning is a remarkably complex process that is influ- enced by a wide variety of factors. Albert Bandura proposed a social learning theory which suggests that observation, imitation, and modeling play a primary role in this process. Bandura's theory combines elements from behavioral theories, which suggest that all behaviors are learned through conditioning, and cognitive theories which take into ac- count psychological influences such as attention and memory. The individual needs and wants are universal to all human beings. All individuals pos- sess and express the same needs and wants. Man, as he moves through life, changes his expression of wants but never his needs. A young person wants marriage and a baby, an older person wants security and grandchildren. Understanding Reality 1herapy states, "Our motivation is "bic et nun/' (here and now)." (Wubbolding, 1991) The CCRT therapeutic plan is always the same and is not dependent on the age of the individual. It is no different for a man or a woman. The plan is not driven by the wants 183 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY of the individual, but the plan is always shaped by the wants. The core of the plan is to address the needs of the individual's life situation, rewriting life's script and redirection of the wants. CCRT Therapeutic Plan Guidelines The following is a practical set of reality guidelines and summary of CCRT. The Five Needs In Reality Therapy With A Christian Understanding: 1. Survival- physical instinct The remainingfour basic needs are Mind, Body and Spirit. 2. Love- Positive relationships 3. Power - Self worth 4. Freedom- Free will 5. Fun- Joy The Five Conflicts: 1. Children 2. Money 3. Extended family and friends 4. Sex 5. Religion The Five Rules of the Harvest: 1. You reap what you sow 2. You reap more than you sow 3. You reap exactly what you sow 4. You reap each and every time you sow 5. You reap later than you sow 184  CHAPTER 12 CCRT Each and every individual knows their needs. 1hey know the conflict. 1hey know the solution, but they need a guide and accountability to activate the solution. Knowledge and action are different. The Five Toxic Stages of relationships identified by CCRT: 1. Survival- the individual's need to have a relationship. This is a physical instinct preor- dained and encoded into human DNA by God at creation. 2. Love -The Toxic Predator projects love and manipulates the truth in all relationships. 3. Power -The Toxic Predator grooms the victim and installs a negative self- worth. 4. Freedom -The Toxic Predator controls the victim's reality and free will. 5. Fun - Joy -The normal reality of the victim is replaced with abnormality and the toxic cycle oflife events are perpetuated. The victim will become a mutated pretoir. Each person has five basic core needs. From these five needs all other human needs and wants are created. There are five basic conflicts that are created by these basic needs. 1hese conflicts are universal to all humans. A want is different from a need. A want is always driven by desire, culture and society. A need is an individual, naturally occurring process. A need is all natural; you are born with needs. A want is always learned. A want is a man-made idea which the individual chooses to meet natural needs. A want can be turned into an abnormal and toxic action or desire. A natural need can never become abnormal. Needs are encoded into our DNA at our conception. (Only the perversion of the natural need can be abnormal.) Example, sex is a natural need of the human condition, but individuals have chosen to pervert the need, thus human choice turns the natural (normal need) into abnormal (want). 185 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY SUMMARY TO GUIDE COUNSELING UNDERSTANDING MANY F THE FOLLOWING CAN PRESENT AT THE SAME TIME AND THIS IS NOT A CHRONOLOGICAL RDER BUT A GUIDE TO DEEPER UNDERSTANDING. Chapter 1 - Reality Therapy Integration to Christ Centered Reality Therapy CCRT Reality Key: There is a behavioral expectation for Christians. The behavioral expectation is based on God's normal expectations regardless of the individual mental condition. This excludes physical illness or truly diminished capacity. (i.e., a new born baby, pervasive mentally handicapped individual and so on... ) CCRT Reality Key: Reality Therapy fully aligns with Christian absolutes without ren- dering any redefinition of Dr. Glasser's original intent. Christ Centered Reality Therapy will complete and elevate Reality Therapy to its highest potential effectiveness. CCRT Reality Key: Jesus Christ, first and foremost, would always deal with a person (a sinner) in their immediate present condition. Theologically Jesus would point out the guilt associated with the individual's sin. Next, He made it expressly clear the need for His (Jesus) forgiveness is not optional. 186  CHAPTER 12 CCRT Chapter 3 -The Worlds System The Longer the conflict's endurance, the larger and more intensive the abnormality will grow. The longer the conflicts exist, the more a person will seek out a failed abnormal system of unrealistic wants to meet their needs. CCRT Reality Key Idea: The world system makes Abnormality socially accepted, politically correct and desirable. Abnormality reality systematically and actively seeks to destroy normal and natural reality. Abnormal cannot coexist peacefully with normal. Abnormal reality is like cancer, left unchecked it will invade and destroy all normal life. CCRT Reality Key Idea: For the distortion of normal to occur, normal and accept- able behaviors must be replaced with abnormal behaviors. CCRT Reality Key Idea: Abnormal behavior must be adopted by an individual be- cause it is the individual which gives abnormal its power,just as a person gives words their power. Words in and of themselves are not powerful until a person emboldens the words to action. Abnormality will not exist until the individual integrates the abnormal into their belief system. CCRT Reality Key Idea: Emotional response is neutral, not good or bad. It is always the motivation behind the emotion or the choice that makes the emotion normal or ab- normal. Crying at a funeral is normal and natural; crying to manipulate the cop giving you a ticket is abnormal. Yelling at a football game for your team is normal; screaming at your wife because you got a speeding ticket is abnormal. Thus, emotion is neutral; it is the choice that is abnormal or normal. (We control all of our choices) CCRT Reality Key: the master designer built into His design a set of needs to be met in order for the design to function properly. 187 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY CCRT Reality Key Idea: Man is both the creation and design of God's work and the op- erator of God work. Man should learn as much as possible about how the design should operate. This is logical, but man does it backwards. We start driving long before we read the operation manual. Until something goes wrong then we will read the book. CCRT Reality Key: God has a master plan which is unchanging and available for all men. To follow this plan will lead to success. Chapter 7 Hope - Addiction Christ Centered Reality- (CCRT). The power of reality directly attacks the cause of mental illness minimizing the destructive idea that it is a need. One of man's primary sources of self-destruction is the lack of hope or perceived power. Being a successful shop- lifter or not getting caught in a lie will provide a sense of power, control and achievement but is ultimately self-destructive. The lack ofindividual hope is congruent with the conse- quences of being out of control. CCRT Reality Key: Abnormal behavior always began at an early age and is an imita- tion of the environment. (Children often go into the family business) CCRT Reality Key: For a counselor the unwavering resolve that there is a normal reality is essential. Uncompromising normal reality will mean, as a counselor, it will be necessary to redirect the client back to normal reality in a loving manner. CCRT Reality Key: Addiction states that you drink to feel good so thus there must be a reason you feel bad. Pain is THE great motivator. CCRT Reality Key: CCRT identifies these typical statements in a self-diagnosis about the abnormal reality of addiction 188  CHAPTER 12 CCRT CCRT Reality Key: CCRT cannot over stress the necessity to remove the misguided mythology that substance abuse and addiction represents one set of counseling issues. It is not necessary to learn every intricate detail about God to understand the entire scope of a new reality. CCRT Reality Key: Regaining Hope, Control, and Power is an incremental process, and a clear plan of action and direction is required. The counselor must lay out an uncom- promising plan of action with measurable and clearly defined goals. Lifeguards do not ask the drowning man what he wants; they know what is needed and take action (they are the trained professionals). CCRT is directive and uncompromising. The CCRT intake process is an ongoing goal assessment of the counseling client. All three counseling elements (MBS) should have measurable goals. The treatment plan must have mental, physical and spiritual goals. The reinstallation of power (control) must occur on all three levels. It is not necessary that the goals be achieved at the same rate or frequency. It does not matter what order is achieved first. CCRT Reality Key: When Jesus completes a healing work in an individual, they are absolutely and completely healed. Chapter 9 Freedom CCRT Reality Key: The corresponding negative to freedom is becoming a prisoner of your mind, body and spirit, incarcerated in unforgiveness, lust, pain, hate, addiction, spiritual death and the past. The elements of the list are endless, but the results are always the same: abnormal reality CCRT Reality Key: The core of authentic Christian beliefs and hope lies in the fact that when Jesus Christ becomes both Savior and Lord, Christians are eternally changed, 189 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY mentally reorganized, and spiritually powerful. Hope of Christ's salvation and recreation lies at the dead center of the absolute restoration of the process. CCRT Reality Key: Fundamental concept that a cure is absolute. There is no mental illness or counseling client need that cannot be 100% cured. The exception to the rule is any and all diagnosable biologi.cal illness, i.e., ADS or Down's Syndrome, are excluded from a 100% cure; they are not emotional, behavioral illnesses. The example comes from Jesus Christ and His healing ministry. At no time did any person or people who were miraculously healed by Jesus Christ return to their illness. When Jesus was no longer present, the person remained healed. Jesus Christ provides permanency of salvation and the absolute filling power of the Holy Spirit. CCRT: provides the complete ability for a Christian to be healed- mind, body, and spirit. Christ Centered Reality Therapy principles and diagnostic guidelines state the following: CCRT: The counseling client's abnormal reality is not greater than authentic reality which is the cure. CCRT: Morality is well-defined and contained within Christian absolutes. Other moral- ities can be applied as long as they do not contradict Christian absolutes. CCRT: No external abnormality is greater than internal reality. CCRT: The problem's cure or restored authentic reality will need to be in direct propor- tion to the size, scope, duration, network, and magnitude of the problem. CCRT Reality Key: It is essential to the healing process to install hope and freedom on all three empirical levels. It is not enough to give a drug for depression and armchair, feel-good psychology to the counseling client and call the client fixed. 190  CHAPTER 12 CCRT CCRT Reality Key: It is cured when abnormal reality no longer reoccurs. Counseling today has come to expect mental illness is not incurable and can only be maintained. This is a form of learned helplessness. If you do not expect normalcy, there is no hope of achieving normalcy. CCRT Reality Key: How does one know if one is cured? Abnormal reality causes destruction and damage to self and others. Normal Reality creates, restores, teaches and flourishes in love. Either it is growing or dying; it cannot do both! CCRT Reality Key: Each and every person is born incomplete spiritually. ''Do not be amazed that I said to you, 'You must be born again.' John 3:7 NASB CCRT Reality Key: The question is why do we hang on to yesterday's abnormality? We are willing to shed most of the abnormality for a new spiritual life and the promised help of renewal and life. Each of us has private memories of our abnormality and its reality of yesterday. Yesterday's sins and yesterday's problems are held like prized possessions in a secret part of our mind. CCRT Reality Key: First, name the problem. Recognize the problem for what it is. Call it by name. Realize that you must deal with the problem outside the areas of normal- ity to reinstall hope. If a friend's home catches fire, you would call the fire department. If a child is sick, you would take him to the doctor. If a person cannot identify the problem, then get help! CCRT Reality Key: Secondly, recognize recurrence. When a problem pattern recurs, track the actions and the actions of the problem. Look for signs on a daily, weekly, and monthly basis. It is easier to fix a small leak than a big leak. Likewise, it is easier to find a cure for a problem that has leached in from.Yesterday's abnormal reality at the problem's earliest onset. 191 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY CCRT Reality Key: Thirdly, know what to watch. Be ever vigilant and identify a list of positive and negative signs so that you will know when something is wrong. In indi- viduals and others, all abnormal realities have signs. All internal problems are first no- ticed outwardly. CCRT Reality Key: The early onset of the installation of hope is important for the individual and/or counselor to track the abnormal reality of yesterday on a daily basis. If the occurrences of any problem are chronic and pervasive (that is, it happens over and over again) the counseling client should get help with the specific problem. CCRT Reality Key: If you cannot forgive the people of your past, then ask God to bless them.Jesus taught people how to overcome their pain of the past and stop living in the past pain and start living in the present. CCRT Reality Key: Forgiveness is a free gift to man from God. We should not rely on our capacity to forgive but place our trust in God's ability to forgive through us. God can change our hearts, reshape our past, and directly affect our futures through forgiveness. ChapterlO Diagnostic Rules and Intake CCRT Reality Key: Number one through five, are human needs and wants. They are not learned behavior. The needs and wants are universal to all human beings. All individuals possess the same needs and wants. Understanding Reality 7herqpy states, "Our motivation is "bic et nunc" (here and now)." (Wubbolding, 1991) 192  CHAPTER 12 CCRT CCRT Reality Key: Resolve means that one works on the plan at all costs no matter the level of resistance. Positive redundancy, which is change, is always resisted by abnormal reality. Positive resolve promotes change. The combination of redundancy and resolve will ultimately cure abnormal reality. CCRT Reality Key: CCRT can project the future by the examination, inspection, and assessment of what forces are driving an individual's life events. This is determined by a time tracker. Life events in the time tracker will demonstrate how much personal time, production, resources, and action are devoted to a specific life event. CCRT Reality Key: What was once abnormal has become socially acceptable but is still abnormal. The legal status of an abnormal behavior does not make it not abnormal. Abortion is a legalized abnormality, but this does not make it morally right. CCRT Reality Key: Abnormal reality always creates out of balanced lives and unnat- ural forces. The absolute fact is that force always creates motion. Examine closely the long and short-term direction of an individual life and how it is being driven. Driven is a good word because force is always felt and can be observed. CCRT Reality Key: The effective cure is the want (to stop drinking for example) must become greater than the perceived need (to drink). Simultaneously, the need (to stop drinking) must become greater than the want (to drink). CCRT Reality Key: You can stand completely still in a single space motionless, but time is a constant force. Time continues whether an individual does anything or not. "Time is the fire in which we burn." (Schwartz) 193 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY HOWTO EFFECTIVELY PRACTICE CCRT 1. The intake process is ongoing with each client visit. A sports team is constantly in practice and preparation for the next game regardless of the win or loss of the last competition. The coach and players evaluate what is going well and what is not going so well. Next, they make necessary adjustments. This is universal to all sports teams worldwide. "Nothing is more dangerous than an idea, when you only have one idea" (Chartier). Sometimes the adjustment is only the attitude of the team as a whole. Professional athletes who are experts at their craft still have coaches to help them refine their profession. Part of the role of a counselor is to see for the client what they cannot or will not see for themselves. This is where the counselor utilizes their personal counseling skill set. 2. The intake process for the counselor in CCRT is a discovery process. All clients are made of moving parts and contradictions. Once the clients share their initial story of what they believe to be the presenting problem, the next step is to discover the under- lying complex problem. No problem exists in a vacuum or is simple. Utilizing the five core problems of CCRT is a real and quantifiable measurement of a treatment plan. The goal is not to undo a lifetime of damage but to go forward with success. Utilizing and understanding the rules of the harvest, no one can re-harvest last year's crop; you can only sow abundantly into today and the future. The client must change what they are planting to see different results. 3. Reality1herapy stresses accountability and no excuses. There is also no condemnation, only constant redirection and accountability for working the positive plan of action. The counselor is very directive in the counseling role at this point. Clients need help. They also need responsibility and guidance to secure their new future of success and escape the failure of the past. 4. The counselor and client together must define the treatment plan and expectations clearly. The counselor is very directive in the expectations and goals for the client. The client's lifetime of abnormality and failure will not be cured in a one-hour visit with 194  CHAPTER 12 CCRT the counselor once per week. It is necessary to treat the whole person- mind, body and spirit. Once the assessment and intake protocol has created a mutually agreed upon treatment plan, the next step is accountability. 5. Reasonable expectation of the client's reality of their life's experience, ability to handle truth, resources, and support systems is critical to success. It is better to lower expecta- tions to meet incremental goals than to set the goals too high to achieve. Goals must be set in each category: mind, body and Spirit. 6. Geography plays a role in counseling/ client relationships. Treatment centers often have excellent group programs which clients attend while in residency. The discharge treatment plan calls for ongoing weekly or daily programs and group work at the fa- cility. This is a good idea except the client lives 100 miles away and has a daily job. The client is not clear on local resources and has no clue how to integrate these on-going treatment plans. This is one of the reasons for relapse and failed thinking. It is critical to not have gaps in treatment. Consistency is key to restoring Normal Reality. We form both bad habits and good habits based on consistency. My personal example: Whenever I helped someone into residential treatment, upon their discharge I would pick them up and immediately take them that very day to a group meeting close to their home. I would often attend the first meeting with them to lower their level of anxiety and help to acclimate them to the new group. 7. One of the educational drills of the seminary for clergy and counseling students is to create a resource list of local resources, churches, ministries, counseling groups, and other services. In the age of the internet, you would think accessing resources would be easy for the client; it is not. They are in counseling for a reason. The client is desperate, vulnerable and needy. One of the easiest ways to help the client is to provide guidance to vetted resources, everything from local day care, moving companies, resume services, food pantries, to counseling groups. I would also add to the list a number ofYouTube videos and books which apply to the client's circumstances. 8. Most of the clients feel "God must have loved the common people: He made so many of them" (Unknown). Most clients do not have thousands of dollars to process a divorce, 195 CHRIST CENTERED REALITY THERAPY FOR THE 21 ST CENTURY marriage counseling, or family illness. The client's life schedule is already full. There is not a built-in time slot for counseling and or group work. It is critical to set reasonable timeline expectations for the treatment plan. CCRT is based on never quitting and never giving up. It is also based on a plan of success (Rule of 52). For success to be achieved, there must be a plan, goals outlined, benchmarks to reach, and quantifiable. 9. A written set of expectations and guidelines tied to a calendar and resources is always part of the treatment plan. Keep it simple. Do not use psychobabble language in the client's plan, and you must update it weekly. Track all the success. Keep the success mo- mentum in progress going. Everyone loves to get a 100% on their test paper. Especially when the client's life is wrapped in abnormality and crises. The counseling may be the first thing they have been successful at in years and possibly the only thing they are in real control 0£ Build upon every success. Do not focus on failure but promote positive goals. Failure is not ok, making no excuses for bad or failure driven abnormal behavior. The counselor is not God and should not scold or judge but help the reality of the sit- uation to become a learning moment, then move on to the plan. Often the client will have to make many attempts to redirect their behavior. Never give up, keep the client motivated and moving in the right direction. The old hymn, I'm pressing on the upward way, New heights I'm gaining every day; Still praying as I'm onward bound, "Lord, plant my feet on higher Ground" by Johnson Oatman, Jr. 196