Direct and Indirect Practice - Micro and Macro (22%)
Clinical Practice
Community Practice
Clinical Practice
Clinical Theories and Interventions
Behavioral Theory / Behaviorism (WATSON, SKINNER)
Behavioral Theory (Behaviorism) ,
Behaviorism ,
Behavior Therapy
We practice with human beings in their
social environments, so this comment from one of the founding fathers of Behaviorism speaks volumes about the causes of human behavior, as well as methods we can employ to assist them in changing those very things that challenge them:
Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I'll guarantee to take any one at random and train him to become any type of specialist I might select -- doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. --John Watson, 1930
Its roots are in behaviorism. In behavior therapy, environmental events predict the way we think and feel. Our behavior sets up conditions for the environment to feed back on it. Sometimes the feedback leads the behavior to increase (reinforcement), and sometimes the behavior decreases (punishment).
Ecological Theory
Therapy focuses on the social environment, which contains the causes of one’s life challenges.
Ego Psychology (HARTMANN)
Ego psychology
Therapy focuses on providing ego support. common themes including examination of
transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state.
Cognitive Theory (BECK) and Cognitive Behavioral Therapy / CBT (MICHENBAUM)
grew out of
cognitive psychology and
behaviorism. CBT is based on the theory that how we think (cognition), how we feel (emotion), and how we act (behavior) are related and interact together. Dysfunctional ways of interpreting and appraising the world (often through
schemas or
beliefs) can contribute to emotional distress or result in behavioral problems. Behavior will follow one’s thoughts and reasoning about the world, so thoughts are the target of change. Therapy might include worksheets to record distressing cognitions, in order to dispute and reframe them into more realistic, less threatening positive thoughts. Taking action itself will also in some cases help to disprove unrealistic beliefs that we act on, causing negative consequences for our self-esteem and relationships. Focus is on making changes in how one thinks and acts. The object of many cognitive behavioral therapies is to discover and identify the biased, dysfunctional ways of relating or reacting and through different methodologies help clients transcend these in ways that will lead to increased well-being.
[50] There are many techniques used, such as
systematic desensitization,
socratic questioning, and keeping a cognition observation log. Modified approaches that fall into the category of CBT have also developed, including
dialectical behavior therapy and
mindfulness-based cognitive therapy.
[51]
Existential Psychology (FRANKL, MAY, YALOM)
existential psychology
postulates that people are largely free to choose who we are and how we interpret and interact with the world. It intends to help the client find deeper meaning in life and to accept responsibility for living. As such, it addresses fundamental issues of life, such as death, aloneness, and freedom. The therapist emphasizes the client's ability to be self-aware, freely make choices in the present, establish personal identity and social relationships, create meaning, and cope with the natural anxiety of living.
[54] Important writers in existential therapy include
Rollo May,
Victor Frankl,
James Bugental, and
Irvin Yalom.
Group Dynamics and Therapy (YALOM)
Stages of Group Development
ORDER
|
STAGE NAME
| DESCRIPTION of Milestones |
1
|
Pre-affiliation
| development of trust |
2
|
Power & Control
| struggles for individual autonomy vs. group affiliation |
3
|
Intimacy
| utilize self to serve others, AKA “norming” |
4
|
Differentiation
| acceptance of others and self as distinct individuals |
Social Identity Theory (TAJFEL)
Social identity is dependent on group affiliation. People inherently over-value their own groups because it enhances their self-esteem. We naturally favor the ingroup.
The family is a
psychological unit, in which changes in one member affect other members and the
family's functioning. Family therapy is geared toward helping individual members become aware of their defensive reactions and to
communicate more openly with each other; it usually focuses on present problems and their practical solutions. Families are also
self-regulating and tend toward
homeostasis, though returning to it may bring about additional challenges. A family is a
multi-generational network, that employs its
cultural beliefs. Family therapy is inappropriate in circumstances where
domestic/family violence, destructive behavior, or abuse between members is present. Systems or family therapy works with couples and families, and emphasizes family relationships as an important factor in psychological health. The central focus tends to be on interpersonal dynamics, especially in terms of how change in one person will affect the entire system.
[53] Therapy is therefore conducted with as many significant members of the "system" as possible. Goals can include improving communication, establishing healthy roles, creating alternative narratives, and addressing problematic behaviors.
Types of family therapy:
Family Systems (
Bowen) , Experiential (
Satir,
Whitaker) ,
Narrative (
Epston,
White),
Strategic (
Haley, Madanes),
Structural (
Minuchin),
Solution-Focused (
de Shazer) , Psychodynamic (Scharff),
Communications Model (Jackson,
Haley),
Feminist (
Bern)
Feminist Therapy (BEM, MILLER, BROWN, JORDAN)
Feminist therapy is an orientation arising from the disparity between the origin of most psychological theories (which have male authors) and the majority of people seeking counseling being female. It focuses on societal, cultural, and political causes and solutions to issues faced in the counseling process. It openly encourages the client to participate in the world in a more social and political way.
[61]
Gestalt Therapy (PERLS)
Focuses on the Here-and-Now, the present and how to adapt to it, refusing to search the past for answers about the causes of problems. It came out of existential therapy in the 1950s.
Gestalt techniques might focus on immediate interactions between client and therapist, designed to increase insight and self-awareness—the best-known perhaps being the "empty chair technique"—which are generally intended to explore resistance to "authentic contact," resolve internal conflicts, and help the client complete "unfinished business."
[55]
Narrative Therapy
A postmodern therapy
Positive psychology (SELIGMAN)
Positive psychology is the scientific study of human happiness and well-being, which started to gain momentum in 1998 due to the call of
Martin Seligman,
[62] then president of the APA. The
history of psychology shows that the field has been primarily dedicated to addressing
mental illness rather than mental wellness. Applied positive psychology's main focus, therefore, is to increase one's positive experience of life and ability to flourish by promoting such things as optimism about the future, a sense of flow in the present, and personal traits like courage, perseverance, and altruism.
[63][64] There is now preliminary empirical evidence to show that by promoting Seligman's three components of happiness—positive emotion (the pleasant life), engagement (the engaged life), and meaning (the meaningful life)—positive therapy can decrease clinical depression.
[65]
REBT / Rational Emotive Behavior Therapy (ELLIS)
Self Psychology (KOHUT)
common themes including examination of transference and
defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state.
Solution-Focused Therapy
A postmodern therapy in which the Focus is on making changes in how one thinks and acts
Person- or Client-Centered Therapy / Rogerian (ROGERS)
Humanistic therapy in which interventions center on the here-and-now interaction between client and therapist, viewing the whole person and seeking to integrate the whole self (self-actualization). Rogers believed that a client needed only three things from a clinician to experience therapeutic improvement: congruence, unconditional positive regard, and empathetic understanding.
[47] As compared to previous negative estimations of the client as sinful, evil and “dirty” or inappropriate Person-centered therapy considers each individual person as already having the inbuilt potentials and resources that might help them to build a stronger personality and self-concept. The mission of the humanistic psychologist is to help the individual employ these resources.
PRINCIPLE
|
DESCRIPTION
|
|
| attempt to put a therapist in closer contact with a person by listening to the person's report of their recent subjective experiences, especially emotions of which the person is not fully aware. For example, in relationships the problem at hand is often not based around what actually happened but, instead, based around the perceptions and feelings of each individual in the relationship. The phenomenal field focuses on "how one feels right now". |
|
| referring to the relationship between people, especially the therapist and client; how each feels about it, the interplay between the two affecting each other and the relationship |
first-person categories
| |
Reality Therapy (GLASSER)
Object Relations Theory
common themes including examination of transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state.
Psychoanalytic theory ,
Psychodynamic psychotherapy
common themes including examination of transference and defenses, an appreciation of the power of the unconscious, and a focus on how early developments in childhood have shaped the client's current psychological state. The core object of psychoanalysis is to make the unconscious conscious—to make the client aware of his or her own primal drives (namely those relating to sex and aggression) and the various
defenses used to keep them in check. Defense mechanisms are completely unconscious.
DEFENSE MECHANISM
|
DESCRIPTION
|
Denial
| there is no problem, so no need to make changes (common in substance abuse). |
Repression
| symptomatic forgetting, amnesia, serving to banish unacceptable (threatening) thoughts or impulses; e.g., threatening thoughts about sexual identity. |
Regression
| return to infantile thought or behavior. |
Idealization
| overestimation of the admired characteristics of another. |
Therapy focuses on gaining insight into the unconscious mind, in order to resolve problems caused by one’s internal drives (usually unacceptable). Goal is to gain a greater understanding of the motivations underlying one's thoughts and feelings. A
psychoanalyst might encourage
free association of ideas to gain that understanding. Also important is an examination of the client's
transference towards the therapist, defined as the tendency to take unconscious thoughts or emotions about a significant person (e.g. a parent) and "transfer" them onto another person.
Social Learning Theory (BANDURA)
Social learning theory
Community Practice
