Introduction to Counseling PDF

LESSON 1 : INTRODUCTION TO brought the first comprehensive approach to COUNSELING vocational guidance. Brief History of Guidance and Counseling John Dewey (1859-1952) Guidance...

LESSON 1 : INTRODUCTION TO brought the first comprehensive approach to COUNSELING vocational guidance. Brief History of Guidance and Counseling John Dewey (1859-1952) Guidance – who insisted on more humanistic teaching – first appeared around 1600’s methods and access to public education. – was defined as “the process of guiding an individual” – early guidance work involved individuals Jesse Davis (1871-1955) giving moralistic and direct advice. – developed one of the first guidance curricula that focused on moral and vocational guidance. SOCIAL REFORM MOVEMENTS – of the 1800s a number of reform Eli Weaver (1862-1922) movements occurred simultaneously that – a New York City principal who had written a eventually influenced the development of booklet called Choosing a Career, started the counseling profession. vocational guidance in New York. First professional counselors: vocational guidance workers Anna Reed (1871-1946) At the end of the nineteenth century, dramatic – established guidance services in the Seattle shifts took place in the United States that were school system. partially responsible for the beginnings of the vocational guidance movement and ultimately Frank Parsons (1854-1908) set the stage for the establishment of the counseling profession. – had the greatest impact on the development of vocational guidance in the United States. The rise of social reform movements, the Founder of guidance in the United States. impact of the Industrial Revolution, and an increase in immigration. –Established the Vocational Bureau, which assisted individuals in “choosing an occupation, Although the concepts had been floating preparing themselves for it, finding an opening around in the latter part of the 1800s, the 1900s 1 in it, and building a career of efficiency and should be involved in a variety of functions in the success”. schools, including adjustment counseling, assistance with curriculum planning, – Parsons was a man with a vision. He classroom management, and of course, envisioned systematic vocational occupational guidance. guidance in the schools; he anticipated a national vocational guidance movement; he foresaw the importance of individual Clifford Beers (1909) counseling; and he hoped for a society in which cooperation was more important – he helped to establish the National than competition and where concern Committee for Mental Hygiene, which lobbied replaced avarice. the U.S. Congress to pass laws that would – Parsons’s principles of vocational improve the deplorable conditions of mental guidance greatly affected the broader institutions. field of counseling. – Soon, this committee began to organize – A deeper examination of his work shows the first child guidance clinics, staffed by that many of his principles eventually social workers, psychologists, and became some of the major tenets of the psychiatrists. counseling profession. –This created a new need for mental health A. Expert guide when making difficult clinics and psychological assistants. decisions B. Personal choice (individual must choose Edmund Griffith Williamson (1900-1979) for himself/herself) – developed what is considered to be the C. Genuineness first comprehensive theory of D. Assist the client in the development of counseling called Minnesota Point of analytic skills View or trait-and-factor theory. – The trait-and-factor approach involved a John Brewer (1932) series of five steps, which included the following: – suggested that guidance should be seen in a total educational context and that “guidance counselors” (now called school counselors) 2 1. Analysis: Examining the problem and HISTORY obtaining available records and testing for the 1950 — the counseling profession shifted client. increasingly toward a humanistic, nondirective 2. Synthesis: Summarizing and organizing the orientation. This decade saw the promulgation information to understand the problem. of the developmental theories in the areas of: 3. Diagnosis: interpreting the problem 1. Career Counseling 4. Counseling: aiding the individual in finding 2. Child Development solutions 3. Lifespan Development 5. Follow-up: ensuring proper support after 1957 — Launching of Sputnik (Russian counseling had ended. Space vessel) - provided the impetus for Congress passing the National Defense Education Act (NDEA) which allocated funds for Carl Rogers training institutes that would quickly graduate – one of the most influential psychologists and secondary school counselors for identification of psychotherapists of the twentieth century. gifted students in math and science. Revolutionized the practice of counseling with his client-centered approach. 1960 — new approaches to counseling began to take shape: Rational Emotive Approach, Social Darwinism Behavioral Approach, Reality Therapy, Gestalt Approach, Transactional Analysis, – that suggested individuals should fervently and Existential Approach. follow their supervisors and “fight their co- workers for advanced status”—i.e., survival of the fittest. 1970s — Expansion of the Community Mental With the rise of Nazism during the 1930s and Health Centers Act to include more services 1940s, many humanistic philosophers, including: Alcoholism services, Drug abuse psychiatrists, and psychologists fled Europe for services, Special services for children and the United States and dramatically influenced elderly, etc. the field of psychotherapy and education in their Passage of legislation for individuals with new country. disabilities: Vocational rehabilitation services 3 and counseling for employable adults, the right 350 B.C. — Plato Believed that introspection to an education within the least restrictive and reflection were the road to knowledge. environment for all children identified as having 350 B.C. — Aristotle Considered by many to be a disability that interfered with learning. “first psychologist”—studied objectivity and reason. 1980s & 1990s — saw a continued expansion 250 — Plotinus Believed in dualism—the and diversification of the field of counseling, as concept that the soul is separate from the body. well as a settling-in phase marked by an 400 — Augustine Examined the meaning of increased emphasis on professionalism. consciousness, self-examination, and inquiry. 1250 — Thomas Aquinas Examined the 21st Century: Current Issues meaning of consciousness and self- examination, and inquiry. 1. Credentialing 1468 — Sanchez de Arevalo Wrote first job 2. Changing in Ethical Guidelines classification system in Mirror of Men’s Lives. 3. Culturally Alert Counseling: Cross-Cultural 1500s — Elizabethan Poor Laws Established Counseling and Advocacy legislation for the Church of England to help the 4. Counselor Efficacy: Evidence-based Practice destitute in England. and Common Factors 1650 — René Descartes Believed that 5. Crisis, Disaster and Trauma Training knowledge and truth come through deductive 6. Technology and Online Counseling reasoning. 1700 — John Locke Believed the mind is a blank slate upon which ideas are generated. YEARS 1800 — James Mill Believed the mind is a blank 3000 B.C. — Ancient Egypt “Psychological” slate upon which ideas are generated. writings found on papyrus. 1800 — Philippe Pinel Founder of the field of 400 B.C. — Hippocrates Wrote first reflections psychiatry; viewed insanity scientifically; on the human condition that include something advocated humane treatment. like modern-day sensibilities. 4 1800 — Benjamin Rush Founder of American Education. 1889 Jane Addams Established Hull psychiatry; advocated for humane treatment of House in Chicago. mentally ill. 1900 — Emil Kraepelin Developed one of the 1800 — Anton Mesmer Discovered first uses of first classifications of mental diseases. hypnosis. 1900 — Pierre Janet Saw a relationship 1800s — COS Volunteers offered assistance to between certain psychological states and the poor and destitute. organic disorders. 1850 — Jean Martin Charcot Used hypnosis to 1900 — Ivan Pavlov Developed one of the first understand disorders; saw relationship between behavioral models of learning. psychological and organic states. 1900 — William James Originated the idea of 1850 — Dorothea Dix Advocated for humane philosophical pragmatism: reality is continually treatment of the mentally ill; helped establish 41 constructed as a function of its utility or practical “modern” mental hospitals. purpose. 1875 — Wilhelm Wundt First experimental 1906 — Eli Weaver Developed vocational psychologist. guidance in New York City schools. 1875 — Sir Francis Galton Early experimental 1907 — Jesse Davis Developed one of the first psychologist. guidance curricula in the schools in Grand Rapids, Michigan. 1890s — Sigmund Freud Developed theory of psychoanalysis. 1908 — Anna Reed Established vocational guidance in the Seattle school system. 1890s — G. Stanley Hall Founded the APA; early American experimental psychologist. 1908 — Frank Parsons Founder of vocational guidance; developed first comprehensive 1890s — James Cattell Early American approach to vocational guidance. experimental psychologist. 1908 — Clifford Beers Institutionalized for 1890s — to mid-1900s John Dewey schizophrenia; wrote A Mind That Found Itself; Educational reformer who advocated for humanistic teaching methods. advocated humane treatment. 1896 — Alfred Binet Developed first individual 1913 — NVGA National Vocational Guidance intelligence test for the French Ministry of Public Association formed; distant forerunner of ACA. 5 1917 — Army Alpha Test First large-scale use 1952 — APGA American Personnel and of test of ability. Guidance Association formed out of four associations; 1917 — Woodworth Personal Data Sheet One of the first structured personality tests. forerunner of ACA. 1927 — Strong Interest Inventory One of the 1955 — NASW National Association of Social first interest inventories to assist in the career Workers founded from merger of seven counseling process. associations. 1930 — E. G. Williamson Developed first 1958 — NDEA National Defense Education comprehensive theory of counseling; called Act; Minnesota Point of View, or trait-and-factor provided. training for and expansion of school approach. counselors. 1932 — John Brewer Suggested that guidance 1961 — Ethical Codes Development of first be seen in a total educational context. APGA guidelines for ethical behavior. 1932 — Wagner O’Day Act Established U. S. 1960s — Great Society Initiatives Numerous Employment Service. laws passed under President Johnson; development of social service agencies 1921 — American Psychiatric Association nationally. American Psychiatric Association took current name (originally founded in 1844). 1963 — Community Mental Health Centers Act Federal law provided for establishment of 1940s — Carl Rogers Developed nondirective community mental health centers nationally. approach to counseling; advocate of humanistic counseling and education. 1970s — Development of micro counseling skills training (e.g., Carkhuff, Ivey, Egan). 1940s — Division 17 of APA Division 17 formally became part of APA. 1970s — Cross-cultural Issues Seminal works published in the area of cross-cultural 1945 — AAMFT officially formed. counseling by such individuals as Donald 1950s — Virginia Satir One of first social Atkinson, William Cross, Paul Pedersen, and workers to stress contextual or systems Derald Sue. thinking. 1950s — DSM first developed. 6 1973 — Rehabilitation Act Ensured access to 1992 — ACA becomes the American vocational rehab services for adults; increased Counseling Association. need for trained rehabilitation counselors. 1994 — Family Therapy Certification IAMFC 1973 — CORE Council for Rehabilitation offers national certification as a family therapist. Education; first credentialing for counselors. 1991 — Multicultural Counseling 1975 — PL94-142 Education of All Competencies Proposed and adopted by Handicapped Children Act; access to education AMCD: Competencies suggest how to address within the least-restrictive environments; multicultural training. passage of this act extended need for school 2001 — New CACREP Standards. counselors. 2002 — Advocacy Competencies endorsed by 1975 — Donaldson v. O’Connor Supreme ACA. Court decision leading to deinstitutionalization of mental hospital patients. 2003 — ASCA National Model. 1979 — NACMHC National Academy for 2009 — New CACREP standards; licensure for Certified Mental Health Counselors; offered counselors in all 50 states achieved. national certification. 2010 — 20/20: A vision for the future of 1981 — CACREP Councils for Accreditation of counseling; Counseling and Related Programs founded; 45,000 National Certified Counselors. established accreditation standards for 2014 — New ethics code. Current issues counseling programs. Division expansion and autonomy, 20/20 1982 — NBCC National Board for Certified Standards; Counselors; generic certification for counselors. credentialing; changes in ethical code; cultural 1983 — AACD APGA name changed to the alertness; cross-cultural counseling and American Association for Counseling and advocacy, counselor efficacy, evidenced-based Development (AACD). practice, and common factors focus; crisis, disaster, and trauma counseling; technology 1990s — Increased Emphasis Increased focus and online counseling; on ethical issues, accreditation, professionalism, and multicultural issues; new divisions of ACA founded. 7 changes in health care system; DSM-5; adopted the word counseling rather than use the globalization of counseling; life-coaching; new word guidance, with its moralistic implications. theories; and new drugs. PSYCHOTHERAPY GUIDANCE – is a type of treatment that can help –is a general term which means helping people individuals experiencing a wide array of to make wise choices and solve their mental health conditions and emotional educational, vocational and personal challenges. problems. –Psychotherapy can help not only alleviate –It is a process by which the individuals are symptoms, but also, certain types of assisted in making adequate adjustments to psychotherapies can help identify the life's situations. psychological root causes of one’s condition so a person can function better and have enhanced –First appeared around the 1600s and was emotional well-being and healing. defined as “the process of guiding an individual.” –Started with the with the development of psychoanalysis near the end of the nineteenth –Early guidance work involved individuals giving century. moralistic and direct advice. PSYCHE COUNSELING – spirit/soul – is the skilled and principled use of relationship to facilitate self- knowledge, THERAPEUTIKOS emotional acceptance and growth and the – caring for another optimal development of personal resources. Psyche Therapeutikos / Psychotherapy –The overall aim is to provide an opportunity to work towards living more satisfyingly and – Meaning “caring for the soul,” resourcefully –As mental health workers became more prevalent during the mid-1900s, they too 8 FOUNDATIONAL PRINCIPLES OF – Simply stated, it means to do good, to be COUNSELING proactive, and also to prevent harm when possible. –Beneficence can come in many forms, such as 1. AUTONOMY prevention and early intervention actions that –is the principle that addresses respect contribute to the betterment of clients. for independence, and self- determination –The essence of this principle is allowing an individual the 4. NON-MALEFICENCE freedom of choice and action. – is the concept of not causing harm to – It addresses the responsibility of the counselor others. to encourage clients, when appropriate, to Often explained as “above all, do no harm,” make their own decisions and to act on their own this principle is considered by some to be the values. most critical of all the principles, even though theoretically they are all of equal weight. 2. JUSTICE – This principle reflects both the idea of not – as Kitchener (1984) points out, is inflicting intentional harm, and not “treating equals equally and engaging in actions that risk harming unequal’s unequally but in proportion others. to their relevant differences”. – Weighing potential harm against potential – Justice does not mean treating all individuals benefits is important in a counselor’s efforts the same. If an individual is to be treated toward ensuring “no harm”. differently, the counselor needs to be able to offer a rationale that explains the necessity and appropriateness of treating the individual 5. FIDELITY differently. – involves the notions of loyalty, faithfulness, and honoring commitments. 3. BENEFICENCE – Clients must be able to trust the counselor and have faith in the – reflects the counselor’s responsibility to therapeutic relationship if growth is to contribute to the welfare of the client. occur. 9  – Therefore, the counselor must take care 1. THE OFFICE –The counseling relationship not to threaten the therapeutic requires the quiet, comfort, safety, and relationship or to leave obligations confidentiality that the office provides: unfulfilled. a. Soundproofed b. Soft lighting GOALS OF COUNSELING c. Uncluttered – The goal of counselling is to build such a strong relationship between counsellor and d. Appropriately stored client records client that there is space for growth and e. Free from distractions exploration. It starts by: –No matter how you arrange your office, it is A. BUILDING EMPATHY difficult, or even impossible, to not offend B. NON-JUDGEMENTAL & ACCEPTING somebody. SPACE –Thus, it is probably best if one tries to arrange C. TRUST & CONFIDENCE one’s office in a manner that is likely to offend the fewest people. D. GUIDANCE & EXPLORATION –Of course, it may be that you will want to attract E. SHARING OF SKILLS a certain clientele who would feel comfortable F. DISCOVERING RESOURCES with a particular ambiance. G. EMPOWERING THE CLIENT COUNSELING ENVIRONMENT 2. NONVERBAL BEHAVIOR – The importance of our nonverbal interactions LESSON 2: NATURE OF A COUNSELOR’S with clients is vastly underrated. WORK –A number of nonverbal behaviors can affect The Counseling Environment our relationship with our clients. Example: It creates: a. Posture b. Eye contact 1. The office c. Tone of voice d. Personal space 2. Nonverbal behaviors e. Touch 3. Counselor’s attitude towards the client. 10 What about Physical contact? –The counselor who struggles with his or her own issues will attend poorly to the client, and Brammer and MacDonald (2003) suggest that the counselor who cannot understand cultural whether one has physical contact with a client differences will have difficulty relating to his or should be based on: her client. 1) The helper’s assessment of the needs of the –The counselor who is not cognitively complex helpee will view the client’s situation in a limited way, 2) The helper’s awareness of his or her own and the counselor who lacks knowledge of and needs commitment to a theory will proceed awkwardly 3) What is most likely to be helpful within the with his or her clients. counseling relationship –Building an effective working alliance 4) Risks that may be involved as a function of (empathy, acceptance, genuineness, etc.) agency, policy, customs, personal ethics, and – Effective delivery of your theoretical approach the law (ability with and belief in your theory, competence, and cognitive complexity) –Counselors should be acutely sensitive to client responses to nonverbal behaviors. CASE CONCEPTUALIZATION a. lean forward – is a method that allows the counselor b. make a good eye contact (depending on to understand a client’s presenting culture) problems and subsequently apply appropriate counseling skills and c. speak in a voice that meets the client’s affect treatment strategies based on the d. rarely touch the client counselor’s theoretical orientation. – Whereas experienced counselors develop their own systematic method of 3. COUNSELOR’S ATTITUDE TOWARDS conceptualizing client problems, THE CLIENT beginning counselors, who are often still –The counselor who seems false, judgmental, struggling with their theoretical and closed-minded will create an atmosphere of orientation, have a more difficult time defensiveness during the session. conceptualizing client problem. 11 INVERTED PYRAMID METHOD d. Assist in our understanding of whether clients have made progress –Schwitzer’s inverted pyramid method (IPM). e. Can be useful when we obtain supervision –IPM is a step-by-step method that can be used to identify and understand client f. Can help us remember what our clients say concerns while offering a visual guide for g. Are needed by insurance companies, counselors in how to organize client information; agencies, and school to support the treatment see connections among client concerns, we are providing to our clients. symptoms, and behaviors; and consider different areas to focus on in counseling. Step 1. Problem identifications: Identify and list ISSUES FACED BY BEGINNING client concerns THERAPISTS Step 2. Thematic groupings: Organize concerns 1.Dealing With Your Anxieties into logical constellations –Most beginning counselors have ambivalent Step 3. Theoretical inferences: Attach thematic feelings when meeting their first clients. A groupings to inferred areas of difficulty certain level of anxiety demonstrates that you are aware of the uncertainties of the future with Step 4. Narrow inferences: Suicidality and your clients and of your abilities to really be deeper difficulties there for them. – Self-doubts are normal; it is how we deal with CASE NOTES them that matters. One way is to openly discuss our self-doubts with a supervisor and peers. –Reasons why the writing of careful case notes has become so critical: a. Are important in the case conceptualization 2.Being Yourself And Self-disclosure process Because you may be self-conscious and b. Can help us pull together our thoughts when anxious when you begin counseling, you may making a diagnosis have a tendency to be overly concerned with what the books say and with the mechanics of c. Are a measure of our standard of care and how to proceed. subsequently can be used in court, if necessary, to show adequate client care 12 –If we are able to be ourselves in our therapeutic should give unselfishly, regardless of how great work and appropriately disclose our reactions in clients’ demands may be. counseling sessions, we increase the chances –One way of heading off these demands is to of being authentic. make your expectations and boundaries clear during the initial counseling sessions or in the disclosure statement. 3.Avoiding Perfectionism – Perhaps one of the most common self- defeating beliefs with which we burden 6.Dealing With Clients Who Lack ourselves is that we must never make a mistake. Commitment To be sure, you will make mistakes, whether you –Practitioners must begin by openly discussing are a beginning or a seasoned therapist. the nature of the relationship. Counselors who –If our energies are tied up presenting an image omit preparation and do not address clients’ of perfection, this will affect our ability to be thoughts and feelings about coming to present for our clients. counseling are likely to encounter resistance. –It is critical that therapists not promise what they cannot or will not deliver. In working with 4.Being Honest About Your Limitations involuntary clients, it is especially important to –You cannot realistically expect to succeed with prepare them for the process; doing so can go a every client. It takes honesty to admit that you long way toward lessening resistance. cannot work successfully with every client. –It is important to learn when and how to make 7.Tolerating Ambiguity a referral for clients when your limitations prevent you from helping them. –Many beginning therapists experience the anxiety of not seeing immediate results. Tolerate the ambiguity of not knowing for sure 5.Dealing with demands from your clients whether your client is improving, at least during –Because therapists feel they should extend the initial sessions. themselves in being helpful, they often burden –Oftentimes clients may seemingly “get worse” themselves with the unrealistic idea that they before they show therapeutic gains. Also, realize that the fruitful effects of the joint efforts 13 of the therapist and the client may manifest 9.Developing a sense of humor themselves after the conclusion of therapy. –Both clients and counselors can enrich a relationship through humor 8.Becoming aware of your –It is important to recognize that laughter or countertransference humor does not mean that clients are not respected or work is not being accomplished. –Working with clients can affect you in personal The therapist needs to distinguish between ways, and your own vulnerabilities and humor that distracts and humor that enhances countertransference are bound to surface. the situation. Beginning counselors need to learn how to “let clients go” and not carry around their problems until we see them again. 10.Sharing responsibility with the client –If we become lost in clients’ struggles and –One mistake is to assume full responsibility for confusion, we cease being effective agents in the direction and outcomes of therapy. This will helping them find solutions to their problems. If lead to taking from your clients their rightful we accept responsibility for our clients’ responsibility of making their own decisions. decisions, we are blocking rather than fostering –It could also increase the likelihood of your their growth. early burnout. Another mistake is for you to refuse to accept the responsibility for making accurate assessments and designing COUNTERTRANSFERENCE appropriate treatment plans for your clients. –includes any of our projections that influence the way we perceive and react to a client. 11.Declining To Give Advice –This phenomenon occurs when we are triggered into emotional reactivity, when we –Therapists help clients discover their own respond defensively, or when we lose our ability solutions and recognize their own freedom to to be present in a relationship because our own act. issues become involved. Even if we, as therapists, were able to resolve clients’ struggles for them, we would be fostering their dependence on us. 14 –Our task is to help clients make independent LESSON 3 : CODE OF ETHICS AND choices and accept the consequences of their PSYCHOTHERAPY choices. Principle I: Respect for the Dignity of The habitual practice of giving advice does not Persons and Peoples work toward this end. Respect for the Dignity of Persons and Peoples 12.Learning to use techniques appropriately Respect for the dignity of persons and peoples is the most fundamental and universally found –Relying on techniques too much can lead to ethical principle across geographical and mechanical counseling. Know the theoretical cultural boundaries, and across professional rationale for each technique you use, and be disciplines. sure the techniques are appropriate for the goals of therapy. It provides the philosophical foundation for many of the other ethical principles put forward –Ideally, therapeutic techniques should evolve by professions. from the therapeutic relationship and the material presented, and they should enhance Respect for dignity recognizes the inherent the client’s awareness or suggest possibilities worth of all human beings, regardless of for experimenting with new behavior. perceived or real differences in social status, ethnic origin, gender, capacities, or other such characteristics. 13.Developing Your Own Counseling Style A) respect for the unique worth and inherent –There is no one way to conduct therapy, and dignity of all human beings wide variations in approach can be effective. B) respect for the diversity among persons and –You will inhibit your potential effectiveness in peoples (including those from indigenous reaching others if you attempt to imitate another communities) therapist’s style or if you fit most of your C) respect for the customs and beliefs of behavior during the session into the procrustean cultures, to be limited only when a custom or a bed of some expert’s theory. belief seriously contravenes the principle of respect for the dignity of persons or peoples or causes serious harm to their well-being 15 D) free and informed consent, as culturally It also requires the ability to establish defined and relevant for individuals, families, interpersonal relationships that enhance groups, and communities potential benefits and reduce potential harm. E) privacy for individuals, families, groups, and Another requirement is adequate self- communities knowledge of how one’s values, experiences, culture, and social context might influence one’s F) protection of confidentiality of personal actions and interpretations. information, as culturally defined and relevant for individuals, families, groups, and A) Active concern for the well-being of communities individuals, families, groups, and communities in the delivery of psychological services, G) fairness and justice in the treatment of whether face-to-face or via online platforms persons and peoples B) taking care to do no harm to individuals, H) respect for the environment, which ultimately families, groups, and communities ensures a safe haven for a dignified human existence. C) maximizing benefits and minimizing potential harm to individuals, families, groups, and communities Principle II: Competent Caring for the Well- D) correcting or offsetting harmful effects that Being of Persons and Peoples have occurred as a result of their activities Competent Caring for the Well-Being of E) developing and maintaining competence Persons and Peoples F) self-knowledge regarding how their own Competent caring for the well-being of persons values, attitudes, experiences, and social and peoples involves working for their benefit contexts influence their actions, interpretations, and, above all, doing no harm. choices, and recommendations It includes maximizing benefits, minimizing G) respect for the ability of individuals, families, potential harm, and offsetting or correcting groups, and communities to make decisions for harm. themselves and to care for themselves and Competent caring requires the application of each other. knowledge and skills that are appropriate for the nature of a situation as well as the social and cultural context. 16 Principle III: Integrity E) avoiding conflicts of interest and declaring them when they cannot be avoided or are Integrity is vital to the advancement of scientific inappropriate to avoid. knowledge and to the maintenance of public confidence in the discipline of psychology. Integrity is based on honesty, and on truthful, Principle IV: Professional and Scientific open and accurate communications. Responsibilities to Society It includes recognizing, monitoring, reporting, Psychology functions as a discipline within the and managing potential biases, multiple context of human society. As a science and a relationships, and other conflicts of interest that profession, it has responsibilities to society. could result in harm and exploitation of persons or peoples. These responsibilities include contributing to the knowledge about human behavior and to Complete openness and disclosure of persons’ understanding of themselves and information must be balanced with other ethical others, and using such knowledge to improve considerations, including the need to protect the the condition of individuals, families, groups, safety or confidentiality of persons and peoples, communities, and society. and the need to respect cultural expectations. They also include conducting its affairs within society in accordance with the highest ethical A) Honest, truthful and prudent, open and standards, and encouraging the development of accurate communications. social structures and policies that benefit all persons and peoples. B) avoiding incomplete disclosure of information unless complete disclosure is culturally inappropriate, or violates confidentiality, or a) the discipline’s responsibility to increase carries the potential to do serious harm to scientific and professional knowledge in ways individuals, families, groups, or communities. that allow the promotion of the well-being of C) maximizing impartiality and minimizing society and all its members biases b) the discipline’s responsibility to use D) not exploiting persons or peoples for psychological knowledge for beneficial personal, professional, or financial gain purposes and to protect such knowledge from being misused, used incompetently, or made useless 17 c) the discipline’s responsibility to conduct its In court cases, data should be limited only to affairs in ways that are ethical and consistent those pertinent to the legitimate request of the with the promotion of the well-being of society court. and all its members 4. We seek for freely given and adequate d) the discipline’s responsibility to promote the informed consent for psychotherapy. We inform highest ethical ideals in the scientific, clients in advance the nature and anticipated professional, and educational activities of its course of therapy, potential risks or conflicts of members interests, fees, third party involvement, client’s commitments, and limits of confidentiality. e) the discipline’s responsibility to adequately train and supervise its members in their ethical 5. We respect client’s rights to commit to or responsibilities and required competencies withdraw from therapy. f) the discipline’s responsibility to develop its 6. In instances where there is a need to provide ethical awareness and sensitivity, and to be as generally recognized techniques and self correcting as possible. procedures that are not yet established, we discuss with our clients the nature of the treatment, its developing nature, potential risks, Ethics in Psychotherapy alternatives and obtain consent for their A. Confidentiality voluntary participation. 1. We regard confidentiality as an obligation 7. We discuss with our clients both our rights that arises from our client’s trust. We therefore and responsibilities at appropriate points in the restrict disclosure of information about our working relationship. clients except in instances when mandated or 8. In instances where the therapist is still regulated by the law. undergoing training, we discuss this matter with 2. For evaluation purposes, we discuss the the client and assure them that adequate results of clinical and counseling relationships supervision will be provided. with our colleagues’ concerning materials that will not constitute undue invasion of privacy. 3. B. Client’s Wellbeing We release information to appropriate individuals or authorities only after careful 1. We engage in systematic monitoring of our deliberation or when there is imminent danger to practice and outcomes using the best available the individual and the community. 18 means in order to ensure the well-being of our 6. We do not engage in sexual intimacies with clients. our former clients, their relatives, or their significant others for at least 2 years after 2. We do not provide services to our clients in cessation of our therapy with them. instances when we are physically, mentally, or emotionally unfit to do so. 3. We are responsible for learning and taking D. Record Keeping into account beliefs, practices and customs that – We keep appropriate records with our clients pertain to different working contexts and and protect them from unauthorized disclosure cultures. unless regulated by the court. C. Relationships E. Competent Practice 1. We do not enter into a client- clinician 1. We keep up to date with the latest knowledge relationship other than for professional and scientific advancements to respond to purposes. changing circumstances. We carefully review 2. We do not enter into multiple relationships our own need for continuing need for that can have unforeseeable beneficial or professional development and engage in detrimental impact on our clients. appropriate educational activities. 3. We maintain a professional relationship with 2. We responsibly monitor and maintain our our clients, avoiding emotional involvement that fitness to provide therapy that enables us to would be detrimental for the client’s well-being. provide effective service. 4. We do not allow our professional therapeutic 3. When the need arises, we seek supervision relationships with our clients to be prejudiced by or consultative support. any personal views we hold about lifestyle, gender, age, disability, sexual orientation, beliefs and culture. F. Referrals 5. We do not engage in sexual intimacies with 1. We ensure that referrals with colleagues are our current therapy clients, their relatives or their discussed and consented by our clients. We significant others. We do not terminate therapy provide an explanation to our clients regarding to circumvent this standard. 19 the disclosure of information that accompany COMPETENCIES the referral. A. Boundaries of Competence 2. We ensure that the recipient of the referral is 1. We shall provide services, teach, and conduct competent in providing the service and the client research with persons, populations in areas only will likely benefit from the referral. within the boundaries of our competence, based 3. In considering referrals, we carefully assess on our education, training, supervised the appropriateness of the referral, benefits of internship, consultation, thorough study, or the referral to the client and the adequacy of professional experience. client’s consent for referral. 2. We shall make appropriate referrals, except as provided in Standard A.2, Providing Services in Emergencies, where our existing G. Interruption competencies are not sufficient to ensure –We assume orderly and appropriate resolution effective implementation or provision of our of responsibility for our client in instances when services. our therapy services are terminated. 3. When we plan to provide services, teach, or conduct research involving populations, areas, H. Termination techniques, or technologies that are new to us and/or are beyond our existing competence, we –We terminate therapy when we are quite sure must undertake relevant education, training, that our client no longer needs the therapy, is supervised experience, consultation, or not likely to benefit from therapy, or would be thorough study. harmed by continued therapy. 4. So as not to deprive individuals or groups of – In cases when therapy is prematurely necessary services, which we do not have terminated, we provide pretermination existing competence, we may provide the counseling and make reasonable efforts to service, as long as: a. we have closely related arrange for an orderly and appropriate referral. prior training or experience b. we make a reasonable effort to obtain the competence required by undergoing relevant research, training, consultation, or thorough study. 20 5. In those emerging areas in which generally C. Delegation of Work to Others recognized standards for preparatory training do 1. Avoid delegating such work to persons who not yet exist, but in which we are required or have a multiple relationship with those being requested to make available our services, we served that would likely lead to exploitation or shall take reasonable steps to ensure the loss of objectivity; competence of our work and to protect our clients/patients, students, supervisees, 2. Authorize only those responsibilities that such research participants, organizational clients, persons can be expected to perform and others from harm. competently, on the basis of their education, training, or experience, either independently or 6. We shall be reasonably familiar with the with the level of supervision being provided; 3. relevant judicial or administrative rules when See that such persons perform these services assuming forensic roles. competently. B. Providing Services in Emergencies D. Personal Problems & Conflicts –We shall make available our services in 1. We shall refrain from initiating an activity emergency situations to individuals for whom when we know or anticipate that there is a the necessary mental health services are not substantial likelihood that our personal available even if we lack the training appropriate problems will prevent us performing work- to the case to ensure these individuals are not related activities in a competent manner. deprived of the emergency services they require at that time. 2. When we shall become aware of personal problems that may interfere with performing –However, we shall immediately discontinue work-related duties adequately, we shall take said services as soon as the emergency has appropriate measures, such as obtaining ended and ensure that appropriate competent professional consultation or assistance, and services are made available. determine whether we should limit, suspend, or –We shall undertake continuing education and terminate these work-related duties. training to ensure our services continue to be relevant and applicable. 21 LESSON 4 : MANAGING THE COUNSELLING OVERVIEW OF THE FOUR BROAD SESSION AND CONCEPTUAL CONCEPTUAL ORIENTATIONS ORIENTATIONS IN PSYCHOLOGY Why have a Theory of Counseling? STAGES AND ELEMENTS OF COUNSELING Theory Stage 1: Rapport and Trust Building is the road map that guides the therapist from Stage 2: Problem Identification Point A to Point B. Indeed, there can be no therapy without therapeutic actions, and the Stage 3: Deepening Understanding and Goal therapeutic actions emanate from theory. Setting Stage 4: Work Cogent treatment Stage 5: Closure is a fundamental element of psychotherapy. Stage 6: Post-interview stage Choice of a theory involves multiple LIVE (Listen, Investigate, Verify, Enlighten, consideration part of the therapist and the client. and See the whole) - counseling theory offers us a comprehensive Listen – understand the nonverbal and verbal system of doing counseling and assists us in information. conceptualizing our clients’ problems, knowing Investigate – get the counselee to talk using what techniques to apply, and predicting client open ended questions. change. Verify – perceive another’s experience and - Having a theory indicates that we are not then communicate that perception back to the practicing chaotically; rather, that there is some individual to clarify or amplify their own order in the way we approach our clients. experience and meaning. - probably the most important aspect of any Enlighten – enlighten the counselee or theory is its view of human nature, which is condense the client’s messages in the session. critical to the formation of the theory’s template. See the Whole – help the client feel, understand, express and manage more feelings, differentiate these feelings from one another. 22 Four Conceptual Orientations to Biological Determinism Counseling - or the notion that instincts and drives greatly 1. Psychodynamic Approaches affect behavior. –Beginning with Freud’s theory of -Freud suggested that we are born with raw psychoanalysis in the late 1800s. psychic energy called instincts. – Sigmund Freud (1856–1939), who developed quite a following early in the twentieth century, dominated the The life instinct (Eros) —meets our basic psychodynamic field for almost half a need for love and intimacy, sex, and survival for century. the individual and the species. – An unconscious and a conscious affect the functioning of the person in some deeply personal and dynamic ways. The death instinct (Thanatos)— seeks our – They all look at early childrearing own demise and dissolution and that fear, hate, practices as being important in the self-destructive behaviors, and aggression development of personality. toward others (death instinct projected outward) is a reflection of this instinct. – Examining the past, and the dynamic interaction of the past with conscious and The libido— psychic energy that drives the life unconscious factors, are important in the and death instincts. therapeutic process. – The first comprehensive Traditional Psychoanalysis — is a long- psychotherapeutic approach is term, in-depth process in which the client may psychoanalysis which dramatically meet with a therapist three or more times a week changed the Western world’s for five or more years. understanding of the individual’s psychological makeup. Transference Relationship - the client – Developed by Freud projects past patterns from significant early relationships onto the counselor. 23  To encourage this relationship, the counselor our complexes) and our collective unconscious remains relatively aloof from the client. (our archetypes) are critical goals in analytical therapy and are achieved by examining our Psychoanalysts initially use a fair amount of dreams. empathy while encouraging clients to share their deepest thoughts. b. Individual Psychology (Adlerian Therapy) – The purpose of the therapeutic relationship in individual Free Association - where clients are psychology is to help clients gain insight encouraged to say anything that comes to their into how their current style of life is not minds to allow for the uninhibited expression of working for them and develop new unconscious desires and repressed memories. behaviors that will lead to healthier Interpretation of client resistance, relationships highlighted by empathy, a interpretation of defense mechanisms, and sense of belonging, and cooperation. interpretation of parapraxes (errors of speech, slips of tongue, or misspeaks) are also used to 2. Existential-Humanistic Approaches reveal unconscious meanings that may be –explorations of the struggles of living and how symbolic of repressed wishes and desires. people construct meaning in their lives, Analysis of the transference relationship – eventually embracing some of their concepts where the therapist interprets client projections, and adapting them to the counseling including client projections onto the therapist, relationship. are examined in terms of how they relate to past –Optimistic, less deterministic, and more patterns in early relationships (e.g., humane than the earlier psychodynamic relationships with parents). approaches and became known as existential– humanistic approaches to counseling. Examples of Psychoanalytic Approach to Existential–humanistic approaches embrace Counseling a phenomenological perspective by stressing a. Analytical Psychology (Jungian the subjective reality of the client, Therapy) deemphasizing the role of the unconscious, and –understanding our personal focusing on the importance of consciousness unconscious (e.g., our repressed and awareness. attitudes and mental functions; 24  Existential–humanistic therapy stresses the Examples of Existential-Humanistic counselor’s personal qualities and how the Approach to Counseling counselor uses himself or herself in the 1. Person-Centered Counseling relationship to effect change. – Carl Rogers (1902–1987) greatly Self- actualization and fulfillment of true changed the face of psychotherapy with potential. the development of his nondirective approach to counseling. Considered Major Points of Existential Therapy most influential psychotherapist of the 1. We are born into a world that has little twentieth century. inherent meaning – First called client-centered therapy and 2. We are born alone and will die alone later person-centered counseling. 3. We alone make our lives meaningful –His approach was seen not only as a means of assisting clients, but also as a way of living. 4. We bring meaningfulness into our lives through the choices that we make 5. Meaningful choices occur only if we are Core Conditions of Person-Centered conscious of our aloneness and our limited time Counseling on earth a. Congruence or Genuineness 6. Anxiety, feelings of dread, and having – Rogers believed that the counselor struggles are natural part of living and are needs to be in touch with his or her important messages about how we live and feelings toward the client, regardless of relate to others what they may be. 7. Limited freedom is experienced through the b. Unconditional Positive Regard realization that we choose our existence –Rogers believed that counseling 8. With the recognition that we choose our relationships should be highlighted by a existence comes the responsibility to choose sense of acceptance, regardless of what wisely for ourselves and to recognize how those feelings are expressed by the client. choices affect those close to us and all people. c. Empathic Understanding –empathy, or deep understanding, was Rogers’s third crucial element. 25 2. Gestalt Therapy In summary, the Gestalt therapist is an active, directive therapist who has an existential– — Was created by Fritz Perls (1893–1970), a humanistic orientation. German Jew who fled Nazi Germany. Although this type of therapist shares many –Perls developed a highly directive approach similar goals with the existential and person- that pushes clients to confront their unfinished centered therapists, the ways of reaching those business and live a more real and sane life. goals vary dramatically. –Today, most Gestalt therapists believe that from birth, the individual is in a constant state of self-regulation through a process of need 3.Cognitive-Behavioral Approaches identification and need fulfillment. - Ivan Pavlov (1848–1936) –They believe that the individual’s pressing – classical conditioning need dictates his or her perceptual field (what – B.F. Skinner (1904–1990) the person sees), or, as Gestalt therapists state, – reinforcement and punishment, operant the individual is only aware of the need that is in conditioning. the foreground. Albert Bandura (1940s) Semipermeable Boundary - social learning or modeling. – The healthy individual has a –In recent years, cognitive therapists have semipermeable boundary that allows the focused on how deeply embedded cognitive individual to maintain a sense of self, structures, or illogical and irrational ways of while also allowing material from the thinking, can be conditioned in a similar way as environment to be engulfed, “chewed,” behaviors. and taken in as it becomes assimilated. – This person has a constant free-flowing –Old dysfunctional cognitions can be exchange between self and other (all that extinguished and new, more functional is outside of self), and this exchange cognitions can be adopted through counter- causes the self, or ego, to be constantly conditioning. changing; that is, as needs are met, the Some of the common assumptions self-changes. underlying these approaches include the following: 26 1. The individual is born capable of developing c. Cognitive Behavioral Therapy a multitude of personality characteristics. –is a talking therapy that can help you manage your problems by changing the 2. Significant others and cultural influences play way you think and behave. –Your a particularly important role in how the individual thoughts, feelings, physical sensations is conditioned. and actions are interconnected, and that 3. Genetics and other biological factors may negative thoughts and feelings can trap play a significant role in who we become. you in a negative cycle. 4. One needs to determine what behaviors and thoughts need to be changed and focus on changing them. d. Reality Therapy –focuses on improving present 5. Behaviors and cognitions are generally relationships and circumstances, with conditioned in very complex and subtle ways. less concern and discussion of past events. –This approach is based on the idea that Overview of 4 Cognitive-behavioral our most important need is to be loved, to Approaches: feel that we belong and that all other a. Modern-day Behavior Therapy basic needs can be satisfied only by –uses a wide variety of techniques from building strong connections with others. operant conditioning, classical Reality therapy sees behavior as choices, and it conditioning, and modeling in an effort to teaches us that while we cannot control how we help the client change behaviors and feel feel, we can control how we think and behave. better about himself or herself. b. Rational Emotive Behavior Therapy 4. Postmodern Approaches (REBT) –Postmodernism suggests that there is no –asserts that we are fallible human one way to understand the world, no beings who have the potential for rational foundational set of rules to make sense of or irrational thinking. who we are, and no one approach to communication in understanding a person. 27 –The process of postmodern therapy starts by Phase 2: examining patterns examining the clients’ knowledge and theories — is when the client is invited to examine stories regarding the problems that made them seek that contradict, deny, or oppose the problem- therapy. saturated story; Phase 3, reauthoring Overview of postmodern approaches: — is when the client begins to build new, more 1. Narrative Therapy positive stories; and –is a method of therapy that separates a person Phase 4, moving on from their problem. It encourages people to rely is when the client has developed a new, more on their own skills to minimize problems that positive outlook on life and is ready to leave exist in their lives. therapy. –Throughout life, personal experiences become personal stories. –People give these stories meaning, and the stories help shape a person’s 2. Solution-Focused Brief Therapy identity. –is a pragmatic, optimistic, anti- –Narrative therapy uses the power of these deterministic, and future-oriented approach stories to help people discover their life purpose. that believes in the ability of the client to This is often done by assigning that person the change. role of “narrator” in their own story. –SFBT rejects the notion that individuals have an inherent tendency toward mental health problems or illnesses and focuses Narrative therapy can be viewed in four almost exclusively on solutions and on client phases. strengths, not on client deficits or problems. Phase 1: the joining phase — occurs when the therapist meets the client, begins to build a relationship, and invites the client to share his or her problem-saturated story; 28 To work quickly and effectively with clients, RUDIMENTARY SKILLS IN COUNSELING SFBT uses a variety of techniques that can be seen through the following six stages: Five Errors of Communication 1. Error of approach Stage 0: Pre-Session Change –counselor inhibits communication in that Stage 1: Forming a Collaborative Relationship they tend to stifle clients’ willingness to Stage 2: Describing the Problem expose their psychological worlds. Stage 3: Establishing Preferred Goals Stage 4: Problem-To-Solution Focus 2. Error of interpretation Stage 5: Reaching Preferred Goals –fail to interpret what clients are communicating or failure to have Stage 6: Ending Therapy accurate understanding of client’s emotions. Because therapy is brief, as soon as the 3. Error of language preferred goals are reached, therapy is finished. –failure to circumvent client’s fight or Follow-up can be conducted to ensure that flight response. (essential so as to be clients are continuing their solution focused heard and to talk so as to be understood) orientation. 4. Error of judgment SFBT is one of the newest and most –failure to evaluate others with popular forms of counseling and seems to fit unconditional positive regard or in well with the fast-paced world and the acceptance without conditions. demands by some insurance companies to help clients quickly. 5. Error of omnipotence –thinking that you are responsible for the decisions of others, what they do, and how they feel. 29  Herrigel (1953) noted the fundamental need 3.Reflection for people to act precisely and repetitiously in –helps therapists attend to what is being pursuit of mastery. communicated by conveying to clients a sense Therapists who take for granted the basic skills of what they are picking up from them. of counseling (i.e., those who are not precise in their repetitions) do not seem to fare well with implementing more advanced techniques. Parroting – repeating everything the client says (or the last part) Audio-taped sessions of Advanced counseling skills build on the Carl Rogers’s counseling demonstrate that he fundamental skills Rudimentary Skills in utilized the skill of reflection effectively and did Counseling not simply repeat clients’ words. Counselors may choose to reflect the content 1.Attending (what is said) or process (how it is said) of clients. –involves actively paying attention to clients. - The fundamental skill of attending is accomplished through presence and focus. 4.Validating To be present or fully focused on clients –demonstrating that they have heard what their means paying attention to what they say (the client has conveyed and accepting people content) and how it is said (the process). without conditions. Bracketing - involves counselors putting aside their (personal) issues to attend to clients. Effective communication is predicated on the skill of circumventing others’ fight or flight responses in a way that allows them to hear 2.Active Listening what is trying to be conveyed (without –Active listening may entail nodding one’s head, withdrawing or reacting strongly). verbal tracking (i.e., staying on the topic the Validation, then, is the key to circumventing client brings up), accurate summarization, and others’ fight or flight responses. an ability to have the client feel heard. The faster a solution is presented to a client, the less her autonomy has been considered. 30 Validating clients then, seems to be more 6.Empathizing effective than handing them answers. –understanding and sharing the feelings of Validation is necessary, but by no means is it another. always sufficient for change. Once a person believes he has been heard, he 7. Self-Disclosure will be more open to the process of counseling. –Self-disclosure means telling someone something about your life, something about you 5.Gathering Information personally. Outside of the counseling world normal conversation involves a ping-pong game –getting as much information as is necessary. approach to sharing. Many novice counselors and psychotherapists Remaining veiled means that a therapist’s mistakenly assume things about their clients personal life is hidden. about which they have not asked. Asking is the only way counselors can initiate an Reciprocity is the concept that we want to give understanding of clients’ stories. back to others when they have given to us. Self-disclosure seems to be most effective when it is controlled. A simple, yet effective Questioning - effective questioning is often guideline for appropriate self-disclosure is accomplished when counselors are aware of the generally to self-disclose only when attempting difference between content (what is said) and to heighten rapport. process (how it is said). Essentially, by focusing on the client’s process rather than content, counselors move the focus 8.Focusing from external to internal. –the counselor’s job is to help the client focus on the issue at hand. Open-ended questions - allow clients to The tendency for clients to deviate from explore their inner selves for answers that can the issue at hand may occur for several reveal a great deal about their psyches. reasons: Close-ended questions - can be an excellent tool to use with an overly loquacious client. 31 1. Get sidetracked in the details of their story 10.Confrontation 2. Subconsciously noticing that the therapist is –Kell and Mueller (1966) described effective reinforcing certain parts of the story. counseling relationships as antithetical rather than complementary. 3. Strong sense of ambivalence (they want to change; they don’t want to change) Therapeutic relationships are often most productive at the antithetical level. Counselors who go along with all deviation clients make run the risk of not being very When therapists hold metaphorical mirrors to productive. Non-productiveness can stem from clients’ lives, clients are more likely to view the counselors being led on a “wild goose chase” of inconsistencies they espouse. content-laden comments. Demonstrating inconsistencies to clients Focusing involves cutting clients off, usually produces a challenge to seek order out confronting, and facilitating clients staying on of chaos. the topic. A counseling relationship is not always filled with pleasantries, but this by no means makes