Counseling and Psychotherapy Theories and Interventions PDF

Sixth Edition Counseling and Psychotherapy Theories and Interventions edited by David Capuzzi and Mark D. Stauffer For technical support with this product, please contact Wiley by phone (800-762- 2974 USA or 317-572-3994 International) or through the Wiley website (http:// support.wiley.com). WILEY END USER LICENSE AGREEMENT Go to www.wiley.com/go/eula to access Wiley's ebook EULA. Sixth Edition Counseling and Psychotherapy Theories and Interventions edited by David Capuzzi and Mark D. Stauffer AMERICAN COUNSELING ASSOCIATION 6101 Stevenson Avenue, Suite 600 Alexandria, VA 22304 www.counseling.org Sixth Edition Counseling and Psychotherapy Theories and Interventions Copyright © 2016 by the American Counseling Association. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the written permission of the publisher. American Counseling Association 6101 Stevenson Avenue, Suite 600 Alexandria, VA 22304 Associate Publisher Carolyn C. Baker Digital and Print Development Editor Nancy Driver Senior Production Manager Bonny E. Gaston Copy Editor Beth Ciha Cover and text design by Bonny E. Gaston. Library of Congress Cataloging-in-Publication Data Names: Capuzzi, David, editor. | Stauffer, Mark D., editor. Title: Counseling and psychotherapy : theories and interventions/edited by David Capuzzi and Mark D. Stauffer. Description: Sixth edition.|Alexandria, VA : American Counseling Association, |Includes bibliographical references and index. Identiiers: LCCN 2015049585|ISBN 9781556203541 (pbk. : alk. paper) Subjects: LCSH: Counseling.|Psychotherapy.|Counseling—Case studies.| Psychotherapy—Case studies. Classiication: LCC BF636.6.C6735 2016|DDC 158.3—dc23 LC record available at http://lccn.loc.gov/2015049585 Table of Contents Preface v Acknowledgments ix Meet the Editors xi Meet the Contributors xiii Part 1 Foundations for Individual Counseling and Psychotherapy Chapter 1 The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 3 David Capuzzi, Mark D. Stauffer, and Douglas R. Gross Chapter 2 Diversity and Social Justice Issues in Counseling and Psychotherapy 35 Manivong J. Ratts, Julian Rafferty McCullough, and Deborah J. Rubel Part 2 Theories of Counseling and Psychotherapy Chapter 3 Psychoanalytic Theory 73 Adrianne L. Johnson Chapter 4 Jungian Analytical Theory 97 Kimberly Nelson and Abbé Finn Chapter 5 Adlerian Theory 121 Roxane L. Dufrene, Kathryn L. Henderson, and Emeline C. Eckart iii iv Table of Contents Chapter 6 Existential Theory 147 Mary Lou Bryant Frank Chapter 7 Person-Centered Theory 169 Richard J. Hazler Chapter 8 Gestalt Theory 195 Melinda Haley, Sarah H. Golden, and Rebecca D. Nate Chapter 9 Cognitive Behavior Theories 227 Yurandol O. Powers and Cynthia R. Kalodner Chapter 10 Dialectical Behavior Theory 253 Laura R. Haddock Chapter 11 Rational Emotive Behavior Therapy 283 Ann Vernon Chapter 12 Reality Therapy/Choice Theory 311 Robert E. Wubbolding Chapter 13 Family Theory 339 Cass Dykeman Chapter 14 Feminist Theory 367 Barbara Herlihy and Candace N. Park Chapter 15 Transpersonal Theory 391 Jonathan W. Carrier and Nathanael G. Mitchell Part 3 Constructivist Theories and Creative Approaches Chapter 16 Constructivist Theories: Solution-Focused and Narrative Therapies 419 Cirecie A. West-Olatunji and Marilyn Rush-Ossenbeck Chapter 17 Creative Approaches in Counseling and Psychotherapy 445 Thelma Duffey, Shane Haberstroh, and Heather Trepal Name Index 469 Subject Index 483 Preface This sixth edition of Counseling and Psychotherapy: Theories and Interventions pres- ents a variety of theories and conceptual frameworks for understanding the pa- rameters of the helping relationship. These parameters can include models for viewing personality development; explaining past behavior; predicting future behavior; understanding the current behavior of the client; diagnosing and plan- ning treatment; assessing client motivations, needs, and unresolved issues; and identifying strategies and interventions for use during the counseling and psycho- therapy process. Theories help organize data and provide guidelines for the prevention and intervention efforts of counselors and therapists. They direct a professional helper’s attention and observations and offer constructs, terminology, and viewpoints that can be understood by colleagues and used during supervision and consultation sessions. Theory directly inluences the interventions used by counselors and therapists to promote a client’s new insight, new behavior, and new approaches to relationships and problem solving. The greater a counselor or therapist’s awareness of the strengths and possibilities inherent in numer- ous theoretical frames of reference, the greater the potential for understand- ing the uniqueness of a particular client and for developing the most effective treatment plan. This book is unique in both format and content. All of the contributing authors are experts who provide state-of-the-art information about theories of counsel- ing and psychotherapy (see the “Meet the Contributors” section for their back- grounds). In addition, each chapter discusses applications of theory as they relate to one particular case study: a hypothetical client named Maria to whom we are introduced in the introduction to Part 2. This book also includes information that is sometimes not addressed in other counseling and psychotherapy textbooks, such as the core dimensions of and brief and integrative approaches to the help- ing relationship, diversity and social justice issues in counseling, feminist theory, dialectical behavior theory, transpersonal theory, constructivist theories, and cre- ative approaches in counseling and psychotherapy. The book’s unique approach enhances its readability and should increase reader interest in the material. v vi Preface FEATURES OF THE TEXT This book is designed for students who are beginning their study of individual coun- seling and psychotherapy. It presents a comprehensive overview of each of the fol- lowing: psychoanalytic, Jungian, Adlerian, existential, person-centered, Gestalt, cog- nitive behavior, dialectical behavior, and rational emotive behavior theories; reality therapy/choice theory; and family, feminist, transpersonal, constructivist, and cre- ative approaches. Each theory is addressed from the perspective of background, hu- man nature, major constructs, applications (which includes a discussion of the goals of counseling and psychotherapy, the process of change, traditional intervention strate- gies, and brief intervention strategies), clients with serious mental health issues, cross- cultural considerations, and evaluation (which evaluates both the supporting research and the limitations of the theory). Each discussion also includes a summary chart and a case study consistent with the theoretical model. We know that one text cannot adequately address all of the factors connected with a given theory; entire texts have been written discussing each of the theories in this book. We have, however, attempted to provide readers with a consistent approach to analyzing and studying each theory and have included examples of how to apply the theory to a case study. The format for this text is based on the contributions of the coeditors, who con- ceptualized the content and wrote the irst chapter, as well as the contributions of 30 authors selected for their expertise in various theories. Each chapter contains theoretical and applied content. The text is divided into the following three parts: “Foundations for Individual Counseling and Psychotherapy,” “Theories of Counsel- ing and Psychotherapy,” and “Constructivist Theories and Creative Approaches.” Part 1, “Foundations for Individual Counseling and Psychotherapy” (Chapters 1 and 2), begins by offering general information about the helping relationship and individual counseling as well as information on brief approaches to counsel- ing and psychotherapy. This introductory information is followed by a chapter ti- tled “Diversity and Social Justice Issues in Counseling and Psychotherapy,” which sets the stage for developing awareness of the limitations of traditional Western theories and subsequent cross-cultural/diversity discussions. Part 2, “Theories of Counseling and Psychotherapy” (Chapters 3–15), presents in- formation on the 13 theories selected for inclusion in this portion of the text. Each of these chapters—“Psychoanalytic Theory,” “Jungian Analytical Theory,” “Adlerian Theory,” “Existential Theory,” “Person-Centered Theory,” “Gestalt Theory,” “Cogni- tive Behavior Theories,” “Dialectical Behavior Theory,” “Rational Emotive Behavior Therapy,” “Reality Therapy/Choice Theory,” “Family Theory,” “Feminist Theory,” and “Transpersonal Theory”—presents the theory and then applies the theory to the case study of Maria. Part 3, “Constructivist Theories and Creative Approaches,” is focused on the fourth force of counseling and psychotherapy and the use of creativity in counseling. NEW TO THIS EDITION This edition of our text includes some additional features that we think will be of great interest to readers. Chapter 1 has been updated and also includes a brief dis- cussion on integrative counseling. An updated chapter on diversity and social jus- tice issues in counseling and psychotherapy presents state-of-the-art information Preface vii and perspectives to counselors who will be practicing with increasingly diverse client populations. Readers should really enjoy the new rendition of the psycho- analytic theory chapter, which now goes beyond a discussion of classical psycho- analysis and includes brief psychodynamic theory, psychodynamic interpersonal theory, and interpersonal psychotherapy. The cognitive–behavioral chapter pro- vides the reader with general background about both behavioral and cognitive behavior theoretical views and discusses how the cognitive behavior approach developed from the behavioral point of view. The updated chapter on family theory is included to sensitize the reader to the fact that counselors and therapists engaging clients in individual work must keep in mind the systemic variables inluencing clients and the fact that some clients may need family counseling and psychotherapy as part of a comprehen- sive treatment plan. Completely new to this sixth edition are chapters on constructivist theories and creative approaches to counseling and psychotherapy. Few counseling textbooks of this nature address these conceptual frameworks. We think readers will be stimulated by these features. Finally, professors adopting this text can request the PowerPoint slides and quiz items that have been developed for use with this text. We, the coeditors, and the 30 other contributors have made every effort to give the reader current information and content focused on both theory and application. It is our hope that this sixth edition of Counseling and Psychotherapy: Theories and Interven- tions will provide the foundation that students need to make decisions about follow- up study of speciic theories as well as the development of their own personal theory of counseling and psychotherapy. Acknowledgments We would like to thank the authors who contributed their time and expertise to the development of this book for professionals interested in individual counseling and psychotherapy. We also thank our families, who supported and encouraged our writing and editing efforts. Thanks go out to Carolyn Baker and other staff members of the Publications Department of the American Counseling Associa- tion for their collaborative and thorough approach to the editing and production of this book. Special thanks go to Doug Gross, who so expertly and conscientiously served as coauthor and coeditor of the irst ive editions of this book, which could never have become a reality without his efforts. ix Meet the Editors David Capuzzi, PhD, NCC, LPC, is a counselor educator and member of the core faculty in clinical mental health counseling at Walden University and profes- sor emeritus at Portland State University. Previously he served as an afiliate professor in the Department of Counselor Education, Counseling Psychology, and Rehabilitation Services at The Pennsylvania State University and scholar in residence in counselor education at Johns Hopkins University. He is past presi- dent of the American Counseling Association (ACA), formerly the American Association for Counseling and Development, and past chair of both the ACA Foundation and the ACA Insurance Trust. From 1980 to 1984, Dr. Capuzzi was editor of The School Counselor. He has authored a number of textbook chapters and monographs on the topic of pre- venting adolescent suicide and is coeditor and coauthor with Dr. Larry Golden of Helping Families Help Children: Family Interventions With School Related Prob- lems (1986) and Preventing Adolescent Suicide (1988). He coauthored and coedited with Douglas R. Gross Youth at Risk: A Prevention Resource for Counselors, Teach- ers, and Parents (1989, 1996, 2000, 2004, 2008, 2014), Introduction to the Counseling Profession (1991, 1997, 2001, 2005, 2009, 2013), Introduction to Group Work (1992, 1998, 2002, 2006; and with Mark Stauffer in 2010), and Counseling and Psycho- therapy: Theories and Interventions (1995, 1999, 2003, 2007, 2011; coauthored and coedited with Mark Stauffer in 2016). Other texts are Approaches to Group Work: A Handbook for Practitioners (2003), Suicide Across the Life Span (2006), and Sexu- ality Issues in Counseling (2002), the last coauthored and coedited with Larry Burlew. He has also coauthored and coedited with Mark Stauffer Career Coun- seling: Foundations, Perspectives, and Applications (2008, 2012) and Foundations of Addictions Counseling (2008, 2012, 2016). He has authored or coauthored articles in a number of ACA journals. A frequent speaker and keynoter at professional conferences and institutes, Dr. Capuzzi has also consulted with a variety of school districts and commu- nity agencies interested in initiating prevention and intervention strategies for adolescents at risk for suicide. He has facilitated the development of suicide prevention, crisis management, and postvention programs in communities xi xii Meet the Editors throughout the United States; provides training on the topics of youth at risk and grief and loss; and serves as an invited adjunct faculty member at other universities as time permits. An ACA Fellow, he is the irst recipient of ACA’s Kitty Cole Human Rights Award and is also a recipient of the Leona Tyler Award in Oregon. In 2010, he received ACA’s Gilbert and Kathleen Wrenn Award for a Humanitarian and Caring Person. In 2011, he was named a distinguished alumni of the College of Education at Florida State University. Mark D. Stauffer, PhD, NCC, is a core faculty member in the clinical mental health counseling program at Walden University. He specialized in couples, marriage, and family counseling during his graduate work in the Counselor Education Program at Portland State University, where he received his mas- ter’s degree. He received his doctoral degree from Oregon State University, De- partment of Teacher and Counselor Education. As a clinician, Dr. Stauffer has worked in the Portland Metro Area in Oregon at crisis centers and other nonproit organizations working with low-income individuals, couples, and families. He has studied and trained in the Zen tradi- tion and presents locally and nationally on meditation and mindfulness-based therapies in counseling. His research focus has centered on Eastern methods and East–West collaboration. In private practice, Dr. Stauffer has worked with couples and families from a family systems perspective. Dr. Stauffer was a Chi Sigma Iota International Fellow and was awarded the American Counseling Association’s Emerging Leaders Training Grant. He recently served as the cochair of the American Counseling Association Interna- tional Committee. In addition to this counseling textbook with Dr. David Capuzzi, Dr. Stauffer has coedited several textbooks in the counseling ield: Introduction to Group Work (2010), Career Counseling: Foundations, Perspectives, and Applica- tions (2006, 2012), Foundations of Addictions Counseling (2008, 2012, 2016), and Foundations of Couples, Marriage and Family Counseling (2015). Dr. Stauffer and Dr. Capuzzi are currently working on a new textbook on human growth and development across the life span to be published by Wiley for use in counselor education programs. Meet the Contributors Jonathan W. Carrier, MS, is the assistant director of the Center for Teaching and Learning and a psychology instructor at Laramie County Community College in Cheyenne and Laramie Wyoming. Mr. Carrier has been teaching psychology, statistics, and research methodology courses for the past 9 years and was previ- ously a rehabilitation and mental health counselor for 4 years. In addition to his roles as an assistant director and college educator, Mr. Carrier also spends time writing scholarly articles, book chapters, and giving presentations in the ields of counseling, psychology, and adult education. His published work focuses on suicide assessment, counseling theory, group work, classroom management skills, and best practices in adult education. Thelma Duffey, PhD, president of the American Counseling Association (ACA), is a professor and department chair in the Department of Counseling at the University of Texas at San Antonio and owner of a multidisciplinary private practice. Dr. Duffey was the founding president of the Association for Creativ- ity in Counseling, a division within the ACA, and she served two terms on the ACA Governing Council. Dr. Duffey is a past president of the Texas Association for Counselor Education and Supervision and served on the Executive Board of the Southern Association for Counselor Education and Supervision. Dr. Duffey is editor of the Journal of Creativity in Mental Health and served as guest coeditor for a Journal of Counseling & Development (JCD) special issue on counseling men. She is currently coediting a JCD special section on relational-cultural theory. Dr. Duffey, an ACA Fellow, received the Association for Counselor Educa- tion and Supervision (ACES) Counseling Vision and Innovation Award, the ACES Distinguished Mentor Award, and the ACA Professional Development Award. Dr. Duffey is a licensed professional counselor, a licensed marriage and family therapist, and a clinical member of the American Association for Mar- riage and Family Therapy. She has more than 50 publications in the areas of creativity, innovations in grief and loss counseling, relational competencies (re- lational-cultural theory), and addictions. Her collaborative research project on relational competencies won the 2010 Texas Counseling Association Research Award, and her collaborative publication on assessment practices in counselor xiii xiv Meet the Contributors education programs received the 2014 American Association of Rehabilitation Counseling/Council of Rehabilitation Counseling Outstanding Outcome Re- search Award. Her edited book Creative Interventions in Grief and Loss Therapy: When the Music Stops, a Dream Dies (2007) was published by the Taylor & Francis Group, and she is coeditor of A Counselor’s Guide to Working With Men (2014), published by the ACA. Roxane L. Dufrene, PhD, LPC-S, LMFT, NCC, is an associate professor of counsel- ing in the Department of Educational Leadership, Counseling, and Foundations at the University of New Orleans. She holds a doctorate in counselor education from Mississippi State University and a master’s degree in counseling psychol- ogy from Nicholls State University. Dr. Dufrene has clinical experience in out- patient and inpatient state mental health treatment, college counseling, crisis intervention, training clinics, collaboration in schools, and private practice. Dr. Dufrene is a Louisiana-licensed marriage and family therapist, a li- censed professional counselor, a licensed professional counselor approved supervisor and a national certiied counselor. Dr. Dufrene is also certiied in critical incident stress management and psychological irst aid, has Louisiana appraisal privilege, and is an American Red Cross mental health counselor. Her research and teaching interests include disaster mental health, crisis counsel- ing, student remediation, counseling ethics, both qualitative and quantitative research in counseling, and supervision. Cass Dykeman, PhD, is an associate professor of counselor education at Oregon State University. He earned his doctorate in counselor education from the Uni- versity of Virginia and his master’s degree in school counseling from the Uni- versity of Washington. Before becoming a counselor educator, Dr. Dykeman served as a school counselor in Seattle, Washington. Dr. Dykeman has served as the principal investigator for two federal grants and is the author of numerous books, book chapters, and scholarly articles in the area of counseling. Emeline C. Eckart, MS, NCC, is the clinical coordinator for the University of New Orleans Counselor Education Department, in which she oversees the counsel- ing lab and collaborates with the practicum and internship coordinator. She holds a master’s degree in mental health counseling from Capella University and is currently a doctoral candidate in the University of New Orleans Coun- selor Education Program. Ms. Eckart also serves as a lieutenant commander in the U.S. Naval Reserves. Ms. Eckart’s clinical experience includes work in community mental health settings, addiction treatment, court-ordered child custody cases, and private practice. Her research interests include best practices for work with military clients, gender issues, supervision, and work–family conlict in women. She has taught at the University of New Orleans and was an international teaching assistant during the summer of 2015 at the University of Malta. Abbé Finn, PhD, is the program coordinator for the Department of Counseling in the College of Health Professions and Social Work at Florida Gulf Coast Uni- versity. She has worked extensively in the mental health ield with individuals as well as groups in counseling. Before joining the university faculty full time, she was an employee assistance counselor with the U.S. Postal Service employ- ee assistance program and worked at a residential treatment facility. Dr. Finn specialized in working with groups in crisis response, survivors of childhood Meet the Contributors xv sexual trauma, and clients in addiction recovery. Her areas of research include group counseling with people with addictions, suicide prevention, violence prevention, and addiction prevention. Dr. Finn holds a doctorate in counselor education from the University of New Orleans; a master’s degree in counseling from Loyola University, New Orleans; a master’s degree in early childhood education from Tulane University; and a bachelor’s degree in speech pathology and audiology. Mary Lou Bryant Frank, PhD, currently serves as chief operating oficer of the Southern Women’s History Center and Fellow at the Institute for Higher Edu- cation at the University of Georgia, professor of psychology at Middle Georgia College, and an adjunct faculty member at Brenau University. Her doctorate in counseling psychology is from Colorado State University. She served as vice president for academic affairs at Middle Georgia College, associate vice presi- dent at Gainesville State College, dean of undergraduate and university studies at Kennesaw State University, and department head of psychology and sociology at North Georgia College and State University. She has served as a professor of psychology at Middle Georgia College, Gainesville State College, and Kennesaw State College and an associate professor at the University of Virginia at Wise. Dr. Frank’s research has focused on existential psychotherapy, academic success, as well as leadership. She received the Distinguished Provider Award in Counseling and has been the recipient of grants, national leadership awards, teaching and diversity leadership awards, and awards for community service. She has worked internationally on collaborations with universities in China, Morocco, Belize, and Dubai. Dr. Frank served as the president of the Georgia Association for Women in Higher Education and currently is the vice presi- dent and cofounder of the Georgia Women’s Institute, vice chair of the Georgia Woman of the Year Committee, and secretary and cofounder of Possible Wom- an Foundation. As a mediator, she also serves on the International Association of Dispute Resolution Board of Directors. Sarah H. Golden, MA, LPC, NCC, received her master’s in counselor education from Western Michigan University and completed her undergraduate work at Hope College. She is currently working on her doctorate in counselor educa- tion and supervision with a concentration in consultation from Walden Univer- sity. Sarah is a licensed professional counselor in Michigan, national certiied counselor, and credentialed school counselor in California. Sarah is currently working in Los Angeles with diverse populations at USC Hybrid High School, an urban college preparatory charter high school that emphasizes positive mul- tigenerational change. She is also the consulting counselor for an online/onsite blended learning charter school, where she saw a need for a counseling pro- gram and so developed and implemented counseling services. In addition to her school roles, Sarah is also a disaster mental health volunteer for the Ameri- can Red Cross. Her other professional interests include working with marginal- ized populations, consultation, crisis intervention, program development, and multicultural counseling. In addition to her career interests, Sarah is an enthusiast for volunteer work and giving back to the community. She is passionate about international work and has done short-term volunteering with youth in Rwanda, Africa. These projects included working with youth of preschool to high school age in various capacities. She is striving to develop counseling programs for youth xvi Meet the Contributors through platforms of athletics or creative outlets in order to promote physical and mental health, positive personal growth, empowerment, and team build- ing. Sarah is an avid runner and marathoner and has been a cross-country and track coach. She has also taught marathon classes. Sarah is passionate about utilizing her education, passions, and skills to create and promote change. Douglas R. Gross, PhD, NCC, is a professor emeritus at Arizona State University, Tempe, where he served as a faculty member in counselor education for 29 years. His professional work history includes public school teaching, counsel- ing, and administration. He is currently retired and living in Michigan. He has been president of the Arizona Counselors Association, president of the West- ern Association for Counselor Education and Supervision, chairperson of the Western Regional Branch Assembly of the American Counseling Association, president of the Association for Humanistic Education and Development, and treasurer and parliamentarian of the American Counseling Association. Dr. Gross has contributed chapters to seven texts: Counseling and Psycho- therapy: Theories and Interventions (1995, 1999, 2003, 2007, 2011, 2016), Youth at Risk: A Resource Guide for Counselors, Teachers, and Parents (1989, 1996, 2000, 2004, 2008, 2014), Foundations of Mental Health Counseling (1986, 1996), Counsel- ing: Theory, Process and Practice (1977), The Counselor’s Handbook (1974), Introduc- tion to the Counseling Profession (1991, 1997, 2001, 2005, 2009), and Introduction to Group Work (1992, 1998, 2002, 2006, 2010). His research has appeared in the Journal of Counseling Psychology; Journal of Counseling & Development; Counselor Education and Supervision; Journal of Educational Research, Counseling and Human Development; Arizona Counselors Journal; Texas Counseling Journal; and the Journal of Mental Health Counseling. Shane Haberstroh, EdD, is currently an associate professor and doctoral program director in the Department of Counseling at the University of Texas at San An- tonio. He served on the founding board for the Association for Creativity in Counseling (ACC) and as the ACC president and treasurer. He is currently the Governing Council representative for the ACC and the Governing Council li- aison for the Research and Knowledge Committee of the American Counseling Association (ACA). He was awarded the Professional Service Award from the ACC in 2006. He served as a delegate on the 20/20: A Vision for the Future of Counseling initiative for the ACA from its inception. Dr. Haberstroh serves as the associate editor for the Journal of Creativity in Mental Health. He has published more than 30 articles and book chapters primar- ily focused on developmental relational counseling, online counseling, creativity in counseling, and addiction treatment and recovery. His collaborative research project on relational competencies won the 2010 Texas Counseling Association Research Award, and his collaborative publication on assessment practices in counselor education programs was recognized with the 2014 American Asso- ciation of Rehabilitation Counseling/Council of Rehabilitation Counseling Out- standing Outcome Research Award. Dr. Haberstroh began his career in 1992 as a residential technician in a 28-day drug treatment program and worked for many years as a counselor and supervisor in addiction treatment centers, private prac- tice, and criminal justice settings. He has been a counselor educator since 2003, and he joined the faculty of the University of Texas at San Antonio in 2004. Laura R. Haddock, PhD, received her doctorate in counselor education from the Uni- versity of Mississippi. She currently serves as the Counselor Education and Su- Meet the Contributors xvii pervision PhD Program coordinator at Walden University. Dr. Haddock has been a counselor educator since 2001, supported by more than 2 decades of work as a mental health counselor. Her clinical practice includes work with a variety of pop- ulations, with a particular focus on trauma resolution. She is a licensed professional counselor, national certiied counselor, and approved clinical supervisor. Dr. Haddock is an active counseling professional and has served on the Mississippi Licensed Professional Counselors Board of Examiners and the ex- ecutive boards for the Mississippi Counseling Association and Mississippi Li- censed Professional Counselors Association. She routinely presents research at the state, national, and international levels and publishes scholarly writings for professional counseling journals and textbooks. She is a two-time winner of outstanding research awards by state counseling organizations and serves as a member of the editorial boards of the Journal of Counseling Research and Practice; Journal of Social, Behavioral and Health Sciences; and Tennessee Counseling Associa- tion Journal. Her research interests include counselor wellness and secondary trauma, spirituality, crisis response, cultural diversity, and supervision. Melinda Haley, PhD, received her master’s degree in counselor education at Port- land State University (Oregon) and her doctorate in counseling psychology from New Mexico State University (Las Cruces) and was an assistant professor in the counseling and guidance program at the University of Texas, El Paso, for 5 years. Dr. Haley currently works as a core faculty member in the counselor education and supervision doctoral program at Walden University. She has written numerous book chapters and journal articles on diverse topics related to counseling. She has extensive applied experience working with adults, adolescents, children, inmates, domestic violence offenders, and culturally diverse populations in the areas of assessment, diagnosis, treatment planning, crisis management, and intervention. Dr. Haley’s research interests include multicultural issues in teaching and counseling, personality develop- ment over the life span, personality disorders, the psychology of criminal and serial offenders, trauma and posttraumatic stress disorder, bias and racism, and social justice issues. Richard J. Hazler, PhD, is a professor of counselor education at The Pennsylvania State University. He is known for work in the areas of peer-on-peer abuse, youth violence, and humanistic approaches to counseling and counselor education. His professional work with youth began when he was an elementary school teacher and later a school counselor and counselor in a university, the Army, a prison, and private practice. During his 34 years as a counselor educator, Dr. Hazler’s research and experience have resulted in a wealth of journal articles, book chapters, and books. Some recent books on counseling youth include Breaking the Cycle of Violence: Interventions for Bullying and Victimization (1996) and Helping in the Hallways: Expanding Your Inluence Potential (2nd ed., 2008). A sample of other books for counseling students and professionals includes The Therapeutic Environment (2001), The Emerging Professional Counselor: Student Dreams to Professional Realities (2nd ed., 2005), and What You Never Learned in Graduate School: A Survival Guide for Therapists (1997). Dr. Hazler also has a long history of serving the profession. He has been elected president of numerous national and state professional organizations, some of which include Chi Sigma Iota, the Association for Humanistic Educa- tion and Development, and the Kentucky and Ohio Counseling Associations. xviii Meet the Contributors He has been an editor and editorial board member of major national and inter- national counseling journals. Counseling students have always been a focus of his work, including his inception and editing for 20 years of the Student Focus column in Counseling Today. Kathryn L. Henderson, PhD, LPC, NCC, is an assistant professor of counselor edu- cation at Georgia Regents University in Augusta. She received her doctorate and master’s degree in counselor education from the University of New Or- leans (accredited by the Council for Accreditation of Counseling and Related Educational Programs). Dr. Henderson is a licensed professional counselor (Texas) and a national certiied counselor. Dr. Henderson’s clinical background includes working in a variety of settings, including public schools and com- munity agencies. Her research interests include ethical and legal issues in coun- seling, trauma and crisis counseling, and working with children and adoles- cents. Dr. Henderson has published on student remediation and gatekeeping, child abuse and mandated reporting, and creative counseling practices. She is a member of the American Counseling Association, Association for Counselor Education and Supervision, Southern Association for Counselor Education and Supervision, and Chi Sigma Iota. Barbara Herlihy, PhD, LPC-S, is a university research professor in the Counselor Education Program at the University of New Orleans. She is the coauthor of three current books and numerous book chapters and articles, primarily on the topics of ethics, feminist therapy, and diversity and social justice. Her recent work has focused on issues in the globalization of counseling. Dr. Herlihy is a recipient of the Southern Association for Counselor Educa- tion and Supervision Courtland Lee Social Justice Award and the Association for Counselor Education and Supervision Outstanding Mentor Award. She is a past chair of the American Counseling Association (ACA) Ethics Committee and served on the ACA Code of Ethics Revision Taskforce in 2005. She chaired the ACA International Committee in 2011–2012. She has presented seminars and workshops across the country and internationally, most recently in Malta. Adrianne L. Johnson, PhD, is an assistant professor in the clinical mental health counseling program at Wright State University. She earned her doctorate in counselor education from the University of Arkansas in 2007 and holds a pro- fessional clinical counseling license in Ohio. Dr. Johnson is active in various organizations committed to mental health advocacy and strongly promotes excellence in counselor education through teaching, research and publication, and international presentation. Dr. John- son’s research interests and professional experience include higher education leadership, community mental health counseling, multicultural counseling, and chemical dependency counseling. Cynthia R. Kalodner, PhD, is a professor of psychology at Towson University. She received her doctoral degree in counseling psychology from The Pennsylvania State University in 1988. She has been employed in academic positions at The University of Akron and West Virginia University and also maintains a limited private practice focusing on adults with mood and anxiety disorders using a cognitive–behavioral focus. Dr. Kalodner’s current research focus is the effects of international service- learning on the personal and professional development of students. Meet the Contributors xix Julian Rafferty (Rafe) McCullough, MS, is currently a doctoral student in the coun- selor education and practice program at Georgia State University. He holds a master’s degree in education in school counseling from Seattle University. He served on the Professional Education Advisory Board for school counseling at Seattle University from 2008 to 2013 and on the American Counseling Asso- ciation Council for Accreditation of Counseling and Related Educational Pro- grams Revisions Committee in 2013. He was an adjunct instructor in the coun- seling program at Seattle University from 2010 to 2013. Mr. McCullough was one of the founding members of Seattle University Counselors for Social Justice, one of whose goals was to increase awareness and support of lesbian, gay, bisexual, transgender, and queer (LGBTQ) students in kindergarten–Grade 12 settings and on college campuses. He was a profession- al school counselor for 5 years in an urban Seattle middle school. He currently serves on the Multicultural Competency Revision Committee for the Association for Multicultural Counseling and Development. His writing and research inter- ests are centered on advocacy, social justice, and LGBTQ issues in counseling. Nathanael G. Mitchell, PhD, is an assistant professor at Spalding University School of Professional Psychology, a doctoral program in clinical psychology located in Louisville, Kentucky. He serves as the director of the Health Psychology Empha- sis Area, training doctoral psychology students in health promotion, behavioral medicine, and integrated care. His research expertise includes the areas of health disparities, the promotion of health behaviors in underserved and marginalized populations, psychosocial correlates of obesity, and provider bias toward patients. In addition, Dr. Mitchell works part time as a psychotherapist focusing on treating anxiety, depression, and grief and coping with chronic illness. He incorporates the transpersonal components of mindfulness and spirituality in psychotherapy when appropriate to meet client needs. Rebecca D. Nate, MS, is a doctoral student in the counselor education and su- pervision program at Walden University. She received her master’s degree in mental health counseling from Walden University and her bachelor’s degree in psychology from the University of Texas at San Antonio. Ms. Nate has worked in behavioral health for the U.S. Air Force; as a children’s therapist at Family Violence Prevention Services in San Antonio, Texas; and as an adjunct professor at San Antonio College. Ms. Nate has also contributed to newsletters, presented at the Air Force Di- abetes Champion Course at Lackland Air Force Base, and served the counseling profession as a bylaws committee member for the Association for Humanistic Counseling. Ms. Nate has published in the American Counseling Association’s VISTAS on counselor supervisor requirements and has a dissertation focus on professional advocacy in counselor educators. Ms. Nate’s research interests in- clude behavioral health, professional advocacy, and supervision. Kimberly Nelson, PhD, is a core faculty member in the Clinical Mental Health Counseling Program at Walden University. She received her master’s degree in psychology from Eastern Washington University and her doctorate in coun- selor education and supervision from the University of Northern Colorado. Dr. Nelson is a licensed professional counselor, approved clinical supervisor, and chartered psychologist in Alberta, Canada. Her nearly 20 years of higher education experiences are varied, including several years of teaching at tradi- xx Meet the Contributors tional universities and colleges, with the past 10 years spent teaching exclu- sively online in counseling graduate programs. Her clinical work is diverse and includes community mental health work, private practice, as well as assess- ment and counseling in kindergarten–Grade 12 schools. Candace N. Park, PhD, obtained her doctoral degree in counselor education from the University of New Orleans. She is a licensed professional counselor supervisor in the state of Louisiana and a national certiied counselor. Her research is primar- ily in the area of sexual assault and the reporting process for college women, and her publications have included topics such as ethics, theories, and sexual assault. She has presented nationally on topics related to feminist theory, multicul- tural counseling, ethics, and supervision and contributed to the ACA Ethical Standards Casebook (7th ed., 2014). She has taught feminist therapy as a spe- cial topics course and served as a guest lecturer for theories courses to speak on her experience and knowledge in feminist theory. She is a clinical manager for Magnolia Family Services, LLC, in Thibodaux, Louisiana, where she also teaches as an adjunct faculty member at Nicholls State University. Yurandol O. Powers, PhD, received a master’s degree in professional counseling from Argosy University and a doctorate in counselor education and supervi- sion from Walden University. She is a nationally certiied counselor as well as a licensed professional counselor, a certiied school counselor, and a certiied pro- fessional counselor supervisor in the state of Georgia. Dr. Powers is the owner of Powerful Alternatives Counseling & Consulting, LLC, in Atlanta, Georgia, serving children, adolescents, adults, and families. In addition to working in her private practice, she teaches part time and supervises doctoral students and individuals seeking licensure. Dr. Powers has presented at the local, state, regional, and national levels on multicultural supervision, counselor education, and counseling military families. Dr. Powers’s professional research interests include diversity issues, multicultural supervision, and the use of creative and innovative techniques in working with members of the military and their families. Manivong J. Ratts, PhD, is an associate professor of counseling at Seattle Univer- sity. He has three major lines of research: (a) lesbian, gay, bisexual, transgender, intersex, and questioning status and minority health disparities (e.g., the impact of oppression on psychological health and well-being); (b) the psychological impact privilege has on privileged groups; and (c) multicultural and social justice compe- tent care (e.g., balancing culturally relevant individual counseling with systems- level advocacy). He has published in various peer-reviewed counseling journals and is lead author of the book Counseling for Multiculturalism and Social Justice: Inte- gration, Theory, and Application (2014) with Dr. Paul B. Pedersen. He is also the lead coeditor of the book ACA Advocacy Competencies: A Social Justice Framework for Coun- selors (2010) with Dr. Judy Lewis and Dr. Rebecca Toporek. He has produced two videos through Alexander Street Press, titled Four Approaches to Counseling One Cli- ent: Medical, Intrapsychic, Multicultural, and Social Justice Counseling Paradigms (2011) and Five Forces of Counseling and Psychotherapy: Psychoanalytic, Cognitive-Behavioral, Existential-Humanistic, Multicultural, and Social Justice (2013). In addition, he is past president of Counselors for Social Justice, a divi- sion of the American Counseling Association, and founder of Seattle University Counselors for Social Justice, an advocacy organization that addresses issues of equity impacting individuals, communities, and schools. Dr. Ratts has also Meet the Contributors xxi served on the editorial boards of the Journal of Counseling & Development and Journal for Social Action in Counseling and Psychology. Dr. Ratts received his doc- torate in counseling from Oregon State University (OSU). He also holds an as- sociate’s degree from Yakima Valley Community College, a bachelor’s degree in psychology from Western Washington University, and a master’s degree in counseling from OSU. Deborah J. Rubel, PhD, was raised in a bicultural household in Salcha, Alaska. She trained as a food scientist at Utah State University and worked in the ield of food research and development for 10 years before deciding to become a coun- selor. Deborah received her master’s degree in mental health counseling and doctorate in counselor education and supervision from Idaho State University. After inishing her doctorate, she began working at Oregon State University. Her areas of specialization are diversity issues, qualitative research methods, group work, and pedagogy. Marilyn Rush-Ossenbeck, MA, graduated from Miami University in Oxford, Ohio, in 2012 with a bachelor’s degree in psychology and family studies. During her undergraduate career, she fell in love with family counseling, especially re- search about families. She then attended the University of Cincinnati, where she earned a master’s degree in clinical mental health counseling in 2015 and continued her research on military veterans and their families. Currently, she is employed full time as a mental health and substance abuse counselor at an inpatient drug rehabilitation facility. She hopes to pursue a doctoral degree in counseling in the future and further her research on both substance abuse and military veteran populations and their families. Heather Trepal, PhD, LPC-S, is an associate professor in the Department of Coun- seling at the University of Texas at San Antonio. She is a licensed professional counselor and board-approved supervisor in the state of Texas. Dr. Trepal’s counseling experience includes working in rape crisis, college counseling centers, and private practice. Her research focuses on self-harm (nonsuicidal self-injury and eating disorders), relational-cultural Theory, gender issues, and counselor education and supervision. She has more than 30 publications in the areas of creativity, innovations in grief and loss counseling, relational compe- tencies (relational-cultural theory), and addictions. Her collaborative research project on relational competencies won the 2010 Texas Counseling Association Research Award, and she was the recipient of the Association for Counselor Education and Supervision Research Award. Dr. Trepal has served in a number of national, regional, and state profes- sional service roles, including president of the Association for Creativity in Counseling, a division of the American Counseling Association (ACA); chair of the ACA graduate student committee; president of the Southern Association for Counselor Education and Supervision; and president of the Texas Associa- tion for Counselor Education and Supervision. Ann Vernon, PhD, is a professor emerita at the University of Northern Iowa, where she served as coordinator of the school and mental health counseling programs for many years. In addition, she had a large private practice. Dr. Vernon has published more than 20 books, as well as numerous chapters and articles, most of which focus on effective counseling strategies with children and adoles- cents. Dr. Vernon is president of the Albert Ellis Institute and is considered to be a leading expert on applications of rational emotive behavior theory with xxii Meet the Contributors children and adolescents. She is an international consultant and does rational emotive and cognitive behavior therapy training in various parts of the world, including Greece, Romania, Australia, and South America. She also provides pro bono counseling services to low-income clients at a clinic in Tucson, Ari- zona. Cirecie A. West-Olatunji, PhD, is an associate professor of counseling at Xavier University in New Orleans. Prior to moving to New Orleans she served as as- sociate professor and director of the Center for Traumatic Stress Research at the University of Cincinnati. She is also a past president of the American Counseling Association (ACA). At the national level, Dr. West-Olatunji has initiated several clinical research projects that focus on culture-centered community collaborations designed to address issues rooted in systemic oppression, such as transgeneration- al trauma and traumatic stress. Dr. West-Olatunji has conducted commissioned research under the auspices of the National Science Foundation, ACA, Kellogg Foundation, federal Witness Assistance Program, Spencer Foundation, American Educational Research Association, and African-American Success Foundation. Dr. West-Olatunji’s publications include two coauthored books, numer- ous book chapters, and more than 40 articles in peer-reviewed journals. In addi- tion to national presentations, Dr. West-Olatunji has delivered research papers in the Americas, in West and southern Africa, in Eastern and Western Europe, and throughout the Paciic Rim. In addition, she provided consultation to a Public Broadcasting Service initiative to create a children’s television show focusing on diversity through KCET-TV in Los Angeles, California (Puzzle Place). Dr. West-Ola- tunji has also provided consultation to the Center for American Education in Sin- gapore and to the Buraku Liberation Organization in Japan to enhance their early childhood and counseling initiatives. Over the past decade, she has coordinated disaster mental health outreach projects in post-Katrina New Orleans, southern Africa (Botswana and South Africa), and Haiti. Dr. West-Olatunji is a graduate of Dartmouth College (New Hampshire) and received her master’s degree and doc- torate in counselor education from the University of New Orleans (Louisiana). Robert E. Wubbolding, EdD, clinical counselor, psychologist, board-certiied coach, is the director of the Center for Reality Therapy in Cincinnati, Ohio; past direc- tor of training for the William Glasser Institute (1988–2011); a professor emeri- tus of counseling at Xavier University; and the author of 13 books on reality therapy, including Reality Therapy for the 21st Century (2000), Counselling With Reality Therapy (1999), A Set of Directions for Putting and Keeping Yourself Together (2001), and Reality Therapy: Theories of Psychotherapy Series (2010). Dr. Wubbolding has taught choice theory/reality therapy in North America, Asia, Australia, Europe, the Middle East, and North Africa. His work has focused on making reality therapy a cross-cultural approach with extended applications to edu- cation, management, addictions, and corrections. He has also developed the central procedure of self-evaluation to include 22 interventions based on choice theory. His current interest is reviewing research studies validating the use of reality therapy, thereby rendering reality therapy respected as a freestanding and validated system of counseling. In the past, he was an elementary and high school counselor, high school teacher, private practitioner, administrator of adult basic education, and cor- rectional counselor. In 2014, he received recognition as a living legend of counseling at the American Counseling Association conference in Honolulu. Part 1 Foundations for Individual Counseling and Psychotherapy CHAPTERS 1. The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 2. Diversity and Social Justice Issues in Counseling and Psychotherapy Counseling and psychotherapy encompass a number of relationship and personal and professional modalities in which the counselor or therapist needs to be pro- icient. These modalities include the creation of essential core conditions that are both foundational to the establishment of a helping relationship and prerequisite to change on the part of the client. In addition, because brief approaches to coun- seling and psychotherapy are a rapidly developing area and their development has been encouraged by managed care, and because counselor awareness of di- versity and social justice issues is so important in the context of the counseling and psychotherapy process, these areas, along with the possibility of taking an integra- tive approach to working with clients, are also addressed in Part 1 of our text. The helping relationship is the foundation on which the process of counseling and psychotherapy is based. It is not possible to use the concepts and associated 2 Foundations for Individual Counseling and Psychotherapy interventions of a speciic theory unless such applications are made in the con- text of a relationship that promotes trust, insight, and behavior change. Chapter 1, “The Helping Relationship: From Core Dimensions to Brief and Integrative Pos- sibilities,” is designed to aid students in both the development and delivery of the helping relationship. To achieve this purpose, we present the helping relationship in terms of deinitions and descriptions, stages, core conditions and personal char- acteristics, and helping strategies and their application with diverse populations. Chapter 1 also introduces the reader to the importance of considering brief ap- proaches to counseling and psychotherapy and how traditional theories can be adapted for briefer, more focused work in the counseling and psychotherapy pro- cess. Because so many counselors combine elements of different theories as they work with clients, an introduction to integrative counseling is also provided. Au- thors of Chapters 3 through 17 provide follow-up information by discussing both traditional and brief interventions in the applications sections of their chapters. To address the limitations of traditional counseling theories and practices, Chapter 2, “Diversity and Social Justice Issues in Counseling and Psychotherapy,” enhances counselor awareness of the variety of diversity and social justice issues that need to be addressed in the context of the counseling and psychotherapy pro- cess. The chapter provides this context by clarifying key concepts and reviewing the history of diversity and social justice issues in counseling; increasing reader understanding of how diversity inluences individual and group functioning; increasing reader awareness of how diversity may inluence the counseling and psychotherapy process; providing several perspectives on diversity-appropriate interventions; and making suggestions for how counselors and therapists can develop their self-awareness, knowledge of diverse populations, and counseling skills relevant to diversity and social justice. As these chapters indicate, practitioners must achieve high levels of competence, effectiveness, and expertise to create a helping relationship beneicial to clients. They must also become sensitive to diversity and social justice issues as they affect their work with clients. We have made every attempt to introduce readers to these topics in the chapters included in this section of the text. Readers are encouraged to do additional reading and follow-up coursework and to commit to personal counseling or therapy to achieve the purposes we have outlined in these chapters. Chapter 1 The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities David Capuzzi, Mark D. Stauffer, and Douglas R. Gross The helping relationship is the cornerstone on which all effective helping rests (Berto- lino & O’Hanlon, 2002; Seligman, 2001; Skovholt, 2005; Sommers-Flanagan, 2007, 2015). Words such as integral, necessary, and mandatory are used to describe this relationship and its importance in the ultimate effectiveness of the helping process. Even though different theoretical systems and approaches use different words to describe this rela- tionship (see Chapters 3–17), each addresses the signiicance of the helping relationship in facilitating client change. Kottler and Brown (1992), in their Introduction to Therapeutic Counseling, made the following comments regarding the signiicance of this relationship: Regardless of the setting in which you practice counseling, whether in a school, agency, hospital, or private practice, the relationships you develop with your clients are crucial to any progress you might make together. For without a high degree of intimacy and trust between two people, very little can be accomplished. (p. 64) In further support of the signiicance of the helping relationship, Brammer and MacDonald (1996) noted, The helping relationship is dynamic, meaning that it is constantly changing at verbal and nonverbal levels. The relationship is the principal process vehicle for both helper and helpee to express and fulill their needs, as well as to mesh helpee problems with helper expertise. Relationship emphasizes the affective mode, because relationship is commonly deined as the inferred emotional quality of the interaction. (p. 52) 3 4 Foundations for Individual Counseling and Psychotherapy Barry Farber and Erin Doolin (2011) commented, While the Rogerian inluence on clinical practice has diminished in the last three decades—or, more accurately, has been incorporated into the psycho- therapeutic mainstream with minimal awareness or explicit acknowledgment (Farber, 2007)—therapists of varying persuasions, even those from theoretical camps that had traditionally emphasized more technical factors, have begun to acknowledge the importance of the relationship. (p. 58) Most recently, John Sommers-Flanagan (2015) emphasized the importance of the helping relationship by using a relationally oriented evidence-based practice mod- el to achieve competence as a mental health counselor. The ideas expressed by these and other authors describe the essential value of the helping relationship in the process of counseling and psychotherapy and the signiicant role that the counselor or therapist plays in developing this relation- ship. Through the counseling relationship and the therapeutic alliance that devel- ops, client change occurs. Although the creation of this relationship is not the end goal of the process, it certainly is the means by which goals are met. It serves as the framework within which effective helping takes place. This chapter has three purposes. First, it aids the reader in understanding the various factors that affect the helping relationship: deinitions and descriptions, stages, core dimensions, strategies, and issues of diversity. Second, because we have asked each of our theory authors to discuss brief approaches as applied to the theory under consideration, we provide our readers with an overview of se- lected brief approaches, because these approaches, plus the impact of managed care, have precipitated an emphasis on using traditional theories in shorter term counseling. Third, because we know that, after reading this book, readers will have questions about whether to be a purist, in the literal sense of the term, and base all of their work with clients on a single theoretical set or somehow integrate the possibilities for working with clients into a more lexible way of helping, we also provide an overview of integrative counseling. We hope that the information presented in this chapter will not only help readers to understand the dynamics of the helping relationship and their application in both theory-speciic and brief approaches but also aid them in incorporating these dynamics into an integrative theoretical approach. DEFINITIONS AND DESCRIPTIONS Although agreed-on deinitions and descriptions of the helping relationship should be easy to ind, this is not the case. Despite the importance of this relationship in the overall helping process, a perusal of textbooks and articles dealing with coun- seling and psychotherapy shows the lack of a common deinition. Rogers (1961), for example, deined a helping relationship as one “in which at least one of the parties has the intent of promoting the growth, development, maturity, improved functioning and improved coping with life of the other” (p. 39). Okun (1992) stated that “the development of a warm, trustful relationship between the helper and helpee underlies any strategy or approach to the helping process and, therefore, is a basic condition for the success of any helping process” (p. 14). According to Mi- ars and Halverson (2001), “The ultimate goal of a professional helping relationship The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 5 should be to promote the development of more effective and adaptive behavior in the clients” (p. 51). Skovholt (2005) provided an overview of the evidence-based research on counseling outcomes and overwhelmingly concluded that the coun- seling relationship is key to successful client outcomes. Sommers-Flanagan (2015) noted that “each mental health counselor will inevitably display therapeutic rela- tional factors in unique ways that may be dificult for other practitioners to rep- licate, because anything relational or interpersonal is alive, automatically unique, and therefore resists sterile descriptive language” (p. 100). Sommers-Flanagan then went on to recommend that counselors implement core relational attitudes and behaviors based on evidence-based practice principles (see Sidebar 1.1). It is easy to see the dificulty in categorically stating an accepted deinition or description of the helping relationship, regardless of which of the aforemen- tioned statements one chooses to embrace. However, despite the differences, each carries with it directions and directives aimed at a single goal: the enhancement and encouragement of client change. The following deinitive characteristics of the helping relationship embrace this goal and describe our conceptualization of this relationship: A relationship initially structured by the counselor or therapist but open to cooperative restructuring based on the needs of the client A relationship that begins with the initial meeting and continues through termination A relationship in which all persons involved perceive the existence of trust, caring, concern, and commitment and act accordingly A relationship in which the needs of the client are given priority over the needs of the counselor or therapist A relationship that provides for the personal growth of all persons involved A relationship that provides the safety needed for self-exploration for all per- sons involved A relationship that promotes the potential of all persons involved The major responsibility in creating this relationship rests initially with the counselor or therapist, with increasing demands for client involvement and com- mitment over time. It is a shared process, and only through such shared efforts will this relationship develop and lourish. This development evolves in stages that take the relationship from initiation to closure. The stages in this evolving process are the subject of the following section. Sidebar 1.1. The Importance of a Constructive Therapeutic Alliance One of the most important things a counselor (beginning or experienced) must provide to all clients is a safe and constructive therapeutic alliance. Whether the counselor follows the constructs of a specific theory or develops an integrative ap- proach, the helping relationship must be established in a way that encourages client self-disclosure and motivation to establish and work toward the attainment of goals. No matter how much expertise a counselor or therapist has to contribute to the coun- seling process, the helping relationship must be established in a way that provides a safe and affirming holding environment so that the client can move toward greater self-acceptance and decision making. 6 Foundations for Individual Counseling and Psychotherapy HELPING RELATIONSHIPS: STAGES The helping relationship is a constant throughout the counseling or psychothera- peutic process. The deinitive characteristics we have already presented indicate that the relationship must be present from the initial meeting between the client and the counselor or therapist and continue through closure. Viewing the helping relationship as a constant throughout the helping process leads to visualizing this process from a developmental perspective. This development can best be viewed in terms of a narrow path whose limits are established by the client’s fear, anxiety, and resistance. Such client reactions should not be seen as lack of commitment to change; rather, they need to be understood in terms of the unknown nature of this developing alliance and the fact that this may be the irst time the client has expe- rienced this type of interaction. These reactions are often shared by the counselor or therapist based on his or her level of experience. The path broadens through the development of trust, safety, and understanding as this relationship develops. The once narrow path becomes a boulevard along which two persons move coura- geously toward their inal destination—change. The movement along this broad- ening path is described by various authors in terms of stages or phases. Osipow, Walsh, and Tosi (1980), in discussing the stages of the helping relationship, stated: Persons who experience the process of personal counseling seem to progress through several stages. First, there is an increased awareness of self and others. Second, there is an expanded exploration of self and environment (positive and negative behavioral tendencies). Third, there is increased commitment to self- enhancing behavior and its implementation. Fourth, there is an internalization of new and more productive thoughts and actions. Fifth, there is a stabilization of new behavior. (p. 73) Brammer (1985) divided this developmental process into two phases, each with four distinctive stages. Phase 1, Building Relationships, includes preparing the cli- ent and opening the relationship, clarifying the problem or concern of the client, structuring the process, and building a relationship. Phase 2, Facilitating Positive Action, involves exploration, consolidation, planning, and termination. Purkey and Schmidt (1987) set forth three stages in building the helping re- lationship, each containing four steps. Stage 1, Preparation, includes having the desire for a relationship, expecting good things, preparing the setting, and reading the situation. Stage 2, Initiating Responding, includes choosing caringly, acting appropriately, honoring the client, and ensuring reception. Stage 3, Follow-Up, includes interpreting responses, negotiating positions, evaluating the process, and developing trust. Egan (2013) stated that the helping relationship can be broken down into a mini- mum of three phases—building the relationship, challenging the client to ind ways to change, and facilitating positive client action. The goal in the irst phase is to build a foundation of mutual trust and client understanding. In the second phase, the counselor challenges the client to try on new ways of thinking, feeling, and behav- ing. In the third phase, the counselor aids the client in facilitating actions that lead to change and growth in the client’s life outside the counseling relationship. Authors such as Corey and Corey (2015), Gladding (2012), and Egan (2013) have provided other models of the developmental nature of the stages of the helping The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 7 relationship. Although the terms used to describe these stages may differ, there seems to be a consistency across these models: The stages move from initiation of the relationship through a clinically based working stage to a termination stage. The following developmental stages show our conceptualization of this relation- ship-building process and are based on the consistency found in our research and our clinical experience: Stage 1: Relationship development. This stage includes the initial meeting of the client and counselor or therapist, rapport building, information gather- ing, goal determination, and informing the client about the conditions un- der which counseling will take place (e.g., conidentiality, taping, counselor/ therapist–client roles; see Sidebar 1.2). Stage 2: Extended exploration. This stage builds on the foundation established in the irst stage. Through selected techniques, theoretical approaches, and strategies, the counselor or therapist explores in depth the emotional and cognitive dynamics of the client, problem parameters, previously tried solu- tions, and decision-making capabilities of the client. There is also a reevalua- tion of the goals determined in Stage 1. Stage 3: Problem resolution. This stage, which depends on information gained during the previous two stages, is characterized by increased activity for all parties involved. The counselor or therapist’s activities include facilitating, demonstrating, instructing, and providing a safe environment for the devel- opment of change. The client’s activities focus on reevaluation, emotional and cognitive dynamics, trying out new behaviors (both inside and outside of the sessions), and discarding those behaviors that do not meet goals. Stage 4: Termination and follow-up. This stage is the closing stage of the helping relationship and is cooperatively determined by all persons involved. Meth- ods and procedures for follow-up are determined prior to the last meeting. It is important to keep in mind that people do not automatically move through these identiied stages in a lockstep manner. The relationship may end at any one of these stages based on decisions made by the client, the coun- selor or therapist, or both; nor is it possible to identify the amount of time that should be devoted to any particular stage. With certain clients, much more time will need to be devoted to speciic stages. D. Brown and Srebalus (1988), in addressing the tentative nature of these relationship stages, had the follow- ing caution for their readers: Before we describe a common sequence of events in counseling, it is important to note that many clients, for one reason or another, will not complete all the Sidebar 1.2. Client Transparency In the first stage of a helping relationship, the client may not be entirely forthcoming about what he or she really wants to address. Often this is because the client needs time to feel safe and comfortable with the counselor. However, many times some clients will move very quickly to the core of the issue or concern. Neither possibility should be a surprise to the counselor. 8 Foundations for Individual Counseling and Psychotherapy stages of counseling. The process will be abandoned prematurely, not because something went wrong, but because of factors external to the counselor-client relationship. For example, the school year may end for a student client, or a client or counselor may move away to accept a new job. When counseling is in process and must abruptly end, the participants will feel the incompleteness and loss. (p. 69) Viewing the helping relationship as an ongoing process that is composed of developmental stages provides counselors and therapists with a structural frame- work within which they can function effectively. Inside this framework it the core conditions and strategies that serve the goals of movement through the relation- ship process and enhancement and encouragement of client change. We discuss these core conditions and strategies in the following two sections. HELPING RELATIONSHIPS: CORE CONDITIONS The concept of basic or core conditions related to the helping relationship has its basis in the early work of Rogers (1957) and the continued work of such authors as Carkhuff and Barenson (1967), Combs (1986), Egan (2013), Ivey (1998), and Truax and Carkhuff (1967). More recent studies (Coutinho, Silva, & Decety, 2014) con- necting the neurobiological correlates of a wide range of human behaviors, includ- ing those connected with core conditions of the helping relationship, have piqued the interest of counselors and therapists and point to some interesting ways this line of research can be applied to enhance the helping relationship. Ivey, Ivey, and Zalaquett (2013), for example, expressed the idea that counseling can change the brains of both the counselor and the client and promote healthier interpersonal relationships. This concept incorporates a set of conditions that, when present, en- hance the effectiveness of the helping relationship. The terminology for these con- ditions varies from author to author but generally includes the following: empathic understanding, respect and positive regard, genuineness and congruence, concreteness, warmth, and immediacy. It should be obvious in reviewing this listing that the concept of core or basic conditions relates directly to various personal characteristics or behaviors that the counselor or therapist brings to and incorporates into the helping relationship. It is dificult to pinpoint with any exactness how such characteristics or behaviors develop. Are they the result of life experiences, classroom instruction, or some combination of both? Our experience in education favors the last explanation. The ability to provide clients with core conditions in the context of a helping relation- ship must already be present to some degree in graduate students for supervision, instruction, and mentoring to enhance or expand the ability to cocreate core condi- tions (see Sidebar 1.3). The remainder of this section deals with the core conditions and relates these directly to personal characteristics or behaviors of counselors or therapists that should enhance their ability to effectively utilize these conditions in the process of helping. Although deinitions, emphases, and applications of these conditions dif- fer across theoretical systems, there appears to be agreement about their effective- ness in facilitating change in the overall helping relationships (Brammer, Abrego, & Shostrom, 1993; Brems, 2000; Clark, 2010; Farber & Doolin, 2011; Freedberg, 2007; Gatongi, 2008; Gladding, 2012; Prochaska & Norcross, 2013). The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 9 Sidebar 1.3. Supervision Responsibility and the Counselor Educator The idea that graduate students must already be able to provide clients with core conditions in a helping relationship for supervision, instruction, and mentoring to enhance or expand this ability raises some interesting questions about the role of the counselor educator in the process of working with a graduate student enrolled in a counselor education program. Is the role of the counselor educator to help raise aware- ness on the part of a beginning counselor with respect to inherent traits and ways of relating to others that automatically contribute to the provision of therapeutic core conditions that can be enhanced and strengthened, or is it possible for the counselor educator to help a mentee develop such traits if they are not already present? What is the responsibility of the counselor educator if an individual who wants to be a licensed, professional counselor cannot seem to provide the core conditions needed to establish a safe working alliance with clients? Empathic Understanding Empathic understanding is the ability to feel with clients as opposed to feeling for clients. It is the ability to understand feelings, thoughts, ideas, and experiences by viewing them from the client’s frame of reference. The counselor or therapist must be able to enter the client’s world, understand the myriad aspects that make up that world, and communicate this understanding so that the client perceives that he or she has been heard accurately (Coutinho et al., 2014; Freedberg, 2007; Gatongi, 2008; Singer, Critchley, & Preuschoff, 2009). Egan (2013) identiied both primary and advanced levels of empathic understand- ing. At the primary level, it is the ability to understand, identify, and communicate feelings and meanings that are at the surface level of the client’s disclosures. At the advanced level, it is the ability to understand, identify, and communicate feelings and meanings that are buried, hidden, or beyond the immediate reach of a client. Such feelings and meanings are more often covert rather than overt client expressions. Personal characteristics or behaviors that enhance a counselor or therapist’s abil- ity to provide empathic understanding include, but are not limited to, the following: The knowledge and awareness of one’s own values, attitudes, and beliefs and the emotional and behavioral impact they have on one’s own life The knowledge and awareness of one’s own feelings and emotional response patterns and how they manifest themselves in interactive patterns The knowledge and awareness of one’s own life experiences and one’s per- sonal reactions to those experiences The capacity and willingness to communicate these personal reactions to one’s clients Respect and Positive Regard Respect and positive regard are deined as a belief in each client’s innate worth and potential and the ability to communicate this belief in the helping relationship. This belief, once communicated, provides clients with positive reinforcement rela- tive to their innate ability to take responsibility for their own growth, change, goal determination, decision making, and eventual problem solution. It is an empower- ing process that delivers a message to clients that they are able to take control of 10 Foundations for Individual Counseling and Psychotherapy their lives and, with facilitative assistance from the counselor or therapist, foster change. Communicating and demonstrating this respect for clients takes many forms. According to Baruth and Robinson (1987), it “is often communicated by what the counselor does not do or say. In other words, by not offering to intervene for someone, one is communicating a belief in the individual’s ability to ‘do’ for himself or herself” (p. 85). Personal characteristics or behaviors that enhance a counselor or therapist’s ability to provide respect and positive regard include, but are not limited to, the following: The capacity to respect oneself The capacity to view oneself as having worth and potential The capacity to model and communicate this positive self-image to clients The capacity to recognize one’s own control needs and the ability to use this recognition in a manner that allows clients to direct their own lives We think it is worth noting, however, that in no type of counseling is it possible for the counselor, a conditioned cultural product, to provide unconditional positive regard unless he or she is sensitive to the cultural norms of the client (Ibrahim & Dykeman, 2011). Genuineness and Congruence Congruence or genuineness is a relational quality that has received renewed inter- est in recent years (Klein, Michels, Kolden, & Chisolm-Stockard, 2001). Genuine- ness and congruence describe the ability to be authentic in the helping relationship (D. W. Sue & Sue, 2013). The ability to be real as opposed to artiicial, to behave as one feels as opposed to playing the role of the helper, and to be congruent in terms of actions and words are further descriptors of this core condition (Kolden, Klein, Wang & Austin, 2011). According to Schnellbacher and Leijssen (2009), The indings underline the signiicance and value of genuineness in commu- nication with the client. Indeed, the results indicate that therapist genuineness can be a crucial process for healing and personality change and that self-disclo- sure can be [a] powerful and directional [intervention]. (pp. 222–223) Implicit in this statement is the idea of the counselor’s ability to communicate and demonstrate this genuineness, not only for relationship enhancement but also to model this core condition so that clients can develop greater authenticity in their interactions with others. Personal characteristics or behaviors that enhance a counselor or therapist’s ability to prove genuineness and congruence include, but are not limited to, the following: The capacity for self-awareness and the ability to demonstrate this capacity through words and actions The understanding of one’s own motivational patterns and the ability to use them productively in the helping relationship The ability to present one’s thoughts, feelings, and actions in a consistent, uniied, and honest manner The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 11 The capacity for self-conidence and the ability to communicate this capacity in a facilitative way in the helping relationship Concreteness Concreteness is the ability not only to see the incomplete picture that clients paint with their words but also to communicate to clients the igures, images, and struc- tures that will complete the picture. In the process of exploring problems or issues, clients often present a somewhat distorted view of the actual situation. Concrete- ness enables the counselor or therapist to help clients identify the distortions in the situation and it them together in such a way that they are able to view the situa- tion in a more realistic fashion. The concreteness helps clients clarify vague issues, focus on speciic topics, reduce degrees of ambiguity, and channel their energies into more productive avenues of problem solution. Personal characteristics and behaviors that enhance a counselor or therapist’s ability to provide degrees of concreteness include, but are not limited to, the following: The capacity for abstract thinking and the ability to read between the lines The willingness to risk being incorrect as one attempts to ill in the empty spaces The belief in one’s own competence in analyzing and sorting through the truths and partial truths in clients’ statements The ability to be objective while working with clients in arriving at the reality of clients’ situations Warmth Warmth is the ability to communicate and demonstrate genuine caring and con- cern for clients (Skovholt, 2005). Using this ability, counselors and therapists con- vey their acceptance of clients, their desire for clients’ well-being, and their sincere interest in inding workable solutions to the problems that clients present. The demeanor of the counselor or therapist is often the main avenue for communicat- ing and demonstrating warmth, for it is often through nonverbal behaviors—a smile, a touch, tone of voice, a facial expression—that genuine caring and concern are communicated. The counselor or therapist’s capacity for transmitting concerns and caring to clients, either verbally or nonverbally, enables clients to experience, often for the irst time, a truly accepting relationship. Personal characteristics or behaviors that enhance a counselor or therapist’s ability to demonstrate warmth include, but are not limited to, the following: The capacity for self-care, and the ability to demonstrate this capacity in both actions and words The capacity for self-acceptance, basing this acceptance on one’s assets and liabilities The desire for one’s own well-being, and the ability to demonstrate this de- sire through both words and actions The desire to ind, and successful personal experience in inding, workable solutions to one’s own problems, and the ability to communicate this desire through words and actions 12 Foundations for Individual Counseling and Psychotherapy Immediacy Immediacy is the ability to deal with the here-and-now factors that operate within the helping relationship (Clemence et al., 2012). These factors are described as overt and covert interactions that take place between the client and the counselor or therapist. A client’s anger at a counselor or therapist, the latter’s frustration with a client, and the feelings of the client and counselor for each other are all examples of factors that need to be addressed as they occur and develop (Mayotte-Blum et al., 2012). Addressing such issues in the safety of the helping relationship should help participants in two ways: Participants can (a) gain insight into personal behavioral patterns that may be conducive and not conducive to growth and (b) use this in- sight in relationships outside the helping relationship. As an example, a counselor might ask, “How is sharing with me right now given our cultural difference and the mistrust you feel?” or “How is our work together going?” when a client has mentioned that it is hard to share. Dealing with these factors can be threatening, as it is often easier to deal with re- lationships in the abstract and avoid personal encounters. A counselor or therapist needs to be able to use this factor of immediacy to show clients the beneits that can be gained by dealing with issues at they arise. According to Egan (2013), immediacy not only clears the air but also is a valuable learning experience (see Sidebar 1.4). Personal characteristics or behaviors that enhance a counselor or therapist’s ability to use immediacy effectively include, but are not limited to, the following: The capacity for perceptive accuracy in interpreting one’s own feelings for, thoughts about, and behaviors toward clients The capacity for perceptive accuracy in interpreting clients’ feelings for, thoughts about, and behaviors toward the counselor or therapist The capacity for and willingness to deal with one’s own issues related to clients on a personal as opposed to an abstract level The willingness to confront both oneself and clients with what one observes to be happening in the helping relationship HELPING RELATIONSHIPS: STRATEGIES The previous section identiied the core conditions that need to be present for the effective development of the helping relationship. The difference between these core conditions and strategies is the subject of this section. The core conditions relate to speciic dynamics present in the personality and behavioral makeup of counselors or therapists that enable them to communicate to clients. The term strategies refers to skills gained through education and experi- ence that deine and direct what counselors or therapists do within the relation- Sidebar 1.4. Personal Characteristics of the Counselor Candidate In conjunction with each of the core conditions described in this chapter (empath- ic understanding, respect and positive regard, genuineness and congruence, concreteness, warmth, and immediacy), there is a list of personal characteristics the counselor should have to draw on. Do you think you are a person with such attributes? If not, do you view this as a dilemma given your choice to become a counselor? The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities 13 ship to obtain speciic results and to move the helping relationship from problem identiication to problem resolution. Various terms have been used to address this aspect of the helping relationship Some authors prefer the term strategies (Combs & Avila, 1985; Cormier, Nurius, & Osborn, 2013; Gilliland, James, & Bowman, 1989), others prefer skills (Halverson & Miars, 2005; Ivey, 1998), and still others prefer the term techniques (Belkin, 1980; J. A. Brown & Pate, 1983; Osipow et al., 1980). The terms, however, are interchangeable. We decided to use the term strategies, which denotes not only deliberative plan- ning but also action processes that make the planning operational. We feel that both factors are necessary. For the purpose of the following discussion, we have grouped the strategies into the following categories: (a) strategies that build rap- port and encourage client dialogue, (b) strategies that aid in data gathering, and (c) strategies that add depth and enhance the relationship. Note that speciic strategies, such as those stemming from various theoretical systems, are not included in this section. They are presented in Chapters 3 through 17, which deal with speciic theories. It is also important to understand that there is much overlap between these arbitrary divisions. Strategies designed to build rapport and encourage client dialogue may also be used to gather data and en- hance relationships. With this caveat in mind, we present the following strategies. Strategies That Build Rapport and Encourage Client Dialogue This group of strategies includes the active listening strategies that enhance the listening capabilities of counselors and therapists. When used effectively, these strategies should provide an environment in which clients have the opportunity to talk and to share their feelings and thoughts with the assurance that they will be heard. By using such strate- gies, counselors and therapists enhance their chances of providing such an environment. This set of strategies includes attending and encouraging, restating and paraphrasing, relecting content and relecting feeling, clarifying and perception checking, and summa- rizing. The following paragraphs present explanations and examples of these strategies. Attending and Encouraging These strategies use the counselor or therapist’s posture, eye contact, gestures, facial expressions, and words to indicate to clients not only that they are being heard but also that the counselor or therapist wants them to continue sharing information. Example Encouraging Counselor/Therapist: (smiling) Please tell me what brought you in today. Client: I’m having a hard time trying to put my life in order. I’m very lonely and bored, and I can’t seem to maintain a lasting relationship. Attending/Encouraging Counselor/Therapist: (leaning forward) Please tell me more. Client: Every time I think I have a chance of developing a relationship, I screw it up by saying or doing something dumb. Encouraging Counselor/Therapist: (nodding) This is helpful, please go on. 14 Foundations for Individual Counseling and Psychotherapy Restating and Paraphrasing These strategies enable a counselor or therapist to serve as a sounding board for the client by feeding back thoughts and feelings that the client verbalizes. Restating involves repeating the exact words used by the client. Paraphrasing is repeating the thoughts and feelings of the client but in the words of the counselor or therapist. Example Client: I don’t know why I do these dumb things. It’s almost as if I did not want a relationship. Restating Counselor/Therapist: You don’t know why you do dumb things. It may be that you don’t want a relationship. Client: I do want a relationship, but each time I get close I seem to do everything in my power to destroy it. Paraphrasing Counselor/Therapist: You are very sure that you want a relationship, but each time you have the opportunity you sabotage your chances. Relecting Content and Relecting Feeling These strategies enable the counselor or therapist to provide feedback to the cli- ent regarding both the ideas (content) and the emotions (feelings) that the client is expressing. By relecting content, the counselor or therapist shares his or her perceptions of the thoughts that the client is expressing. This can be done either by using the client’s words or by changing the wo

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