Class: Foundations of Clinical Psychology Class book for the reference: Title: Theories of Psychotherapy & Counseling: Concepts and Cases Author: Richard Sharf Publisher: Cengage Learning Edition: 6th ISBN Code: 9781305087323 ISBN Code 2: 9781305087323 Originality ReportSafeAssign enabled Discussion Question 3: Person-Centered Therapy In person-centered therapy, core conditions such as unconditional positive regard, empathy, and congruence are essential to successful therapy. Discuss why these conditions are so crucial in establishing the relationship between therapist and client and how might the therapeutic process be affected if these conditions are lacking?
Theories of Psychotherapy and
Counseling: Concepts
and Cases
6th Edition
Richard S. Sharf
Chapter 6
Person-Centered Therapy
© 2016 Cengage Learning. All rights reserved.
© 2016 Cengage Learning.
All rights reserved.
Carl Rogers’s Four Phases
of Person-Centered Therapy
Developmental
–
forming his approach
Nondirective
–
focus on understanding the client and
communicating understanding
Client-centered
–
theoretical development of therapeutic
change
Person-centered
–
application to family, groups, and
political activism as well as the
individual
Slide 1 Chapter 6
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Influences on Carl Rogers’s
Development of Person-Centered
Therapy
Early theological training
Otto Rank
–
creativity of individuals
Alfred Adler
–
value of the individual and good
relationships
Abraham Maslow
–
self-actualization
Martin Buber
–
“I-Thou”
Rollo May
–
existentialism
Slide 2 Chapter 6
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Person-Centered View of
Psychological Development
Infancy
–
monitoring of pleasantness
of environment
Children
–
develop trust in their
reactions to the environment
Older children
–
develop a need for positive
regard from others
Older children and adults
–
develop a sense of self-worth
or self regard
Slide 3 Chapter 6
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Person-Centered Theory
of Personality
Conditions of worth
–
lead to incongruence
Conditional regard
–
a sense of alienation
Psychological disturbance is related to the amount of incongruence
between individual experience and self-concept
Congruent relationships
–
Fully functioning person
–
Psychological maturity
–
Slide 4 Chapter 6
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a sense of being heard and
understood
provide positive regard to
others and receive it from
others – a goal
openness, creativity, and
responsibility
Goals of Person-Centered
Therapy
Client determines goal
More deeply understand various aspects of oneself
Accept oneself and others
More self-direction which leads to better problem solving
ability and less defensiveness
Slide 5 Chapter 6
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Necessary and Sufficient
Conditions
for Person-Centered Change
1. Psychological contact between two people
2. Client is incongruent
Therapist provides
3. Congruence and genuineness
4. Unconditional positive regard or acceptance
5. Empathy
The client perceives
6. Empathy and acceptance
Slide 6 Chapter 6
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What the Client Experiences
in Person-Centered Therapy
Responsibility for self
The therapist’s empathy and unconditional positive regard
which stimulates
The process of exploring oneself
which allows the client to
Experience oneself
Experience therapeutic change
Slide 7 Chapter 6
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Psychological Disorders:
Examples of the Person-Centered
Approach
Disorder
Therapist
Patient
Depression
Rogers, C.
Female graduate student
Grief and loss
Rogers, D.
7 year old boy
Anxiety/ phobia
Van Fleet, Sywulak,
& Sniscak
5 year old boy
Slide 8 Chapter 6
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Current Trends in
Person-Centered Therapy
Application of person-centered principles to international
concerns regarding conflict and peace
Incorporating other theoretical models into person-centered
therapy
Constructionist trends – empathy with the individual in a cultural
context
Training trends – person-centered ideals applied to graduate
training
Slide 9 Chapter 6
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Gender Issues in
Person-Centered Therapy
Can therapists truly understand clients of the other
gender?
Focus on intimacy in relationships
Therapists values and lesbian, gay, bisexual, or
transgendered clients
Slide 10 Chapter 6
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Multicultural Issues and
Person-Centered Therapy
Person-centered therapy is practiced world wide, especially
in areas of conflict.
Are genuineness, acceptance, and empathy cultural values
that are limited to certain cultures?
Does Rogers’s emphasis on the individual, conflict with the
family values of some cultures?
Slide 11 Chapter 6
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Theories of Psychotherapy and
Counseling: Concepts
and Cases
6th Edition
Richard S. Sharf
Chapter 7
Gestalt Therapy: An Experiential Therapy
© 2016 Cengage Learning. All rights reserved.
© 2016 Cengage Learning.
All rights reserved.
Influences on Perls’s
Development of Gestalt Therapy
•Kurt Goldstein
–
•Wilhelm Reich
•Sigmund Freidlander
•Alfred Korzybski
•Kurt Lewin
•Existentialism
–
•Gestalt psychology
–
•Laura Posner Perls
–
Slide 1 Chapter 7
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holistic perspective, self actualization, importance of
language usage
bodily awareness within individuals
observation of balance and polarities
role of language in therapy
field theory, studying the whole field
phenomenology, direct experience of
existence
the whole is more than the sum of its
parts
respect for personal relationships
Gestalt Psychology
Psychological phenomena are organized by wholes rather
than by parts
Studied visual and auditory perception, mainly
Basic concepts
Field
Figure
Ground
Development of laws of perception
Gestalt psychologists critical of loose application of their
work by gestalt therapists
Slide 2 Chapter 7
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Examples of Complete,
Incomplete, and Weak Gestalts
1
2
1
4
3
2
Slide 3 Chapter 7
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5
6
7
Complete gestalt
8
9
5
7
Incomplete gestalt
6
Weak gestalt
9
8
Gestalt Theory of Personality:
Contact
Levels of Contact – Five layers of neurosis
_____________________________________________________________
Phony – inauthentic communication
_____________________________________________________
Phobic – avoiding emotional pain
_________________________________________
Impasse – afraid to change
__________________________
Implosive – awareness
of feeling
_________________
Explosive- authentic
Slide 4 Chapter 7
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Gestalt Theory of Personality:
Contact Boundaries
Four types of boundaries for viewing I-boundaries
Body boundaries
Value boundaries
I – boundaries
Familiarity boundaries
Slide 5 Chapter 7
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Expressive boundaries
Gestalt Theory of Personality:
Contact Boundary Disturbances
Introjection
–
Taking in views of others uncritically
Projection
–
Pushing out or dismissing aspects of ourselves
by assigning them to others
Retroflection
–
Bending back on ourselves – doing to ourselves
what we want to do to someone else or have
done to us
Deflection
–
Indirect or minimal contact – avoiding the issue,
not getting to the point
Confluence
–
Lessening the boundary between ourselves and
others
Slide 6 Chapter 7
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Gestalt Theory of Personality:
Awareness
Contact within self and with others:
Awareness of
Sensations
–
Seeing, hearing, touching, etc.
Feelings
–
Emotional and physical
Future events
–
Wants and desires
Values
–
Social, spiritual, and relationship
issues
Slide 7 Chapter 7
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Gestalt Theory of Personality:
The Present
Past (unfinished business)
PRESENT
Future
Slide 8 Chapter 7
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Goals of Gestalt Therapy
Become fully aware of oneself – Perls
Develop awareness of one’s
•Body
•Feeling
•Environment
•Experiences
•Needs
•Skills
•Sensations (seeing, hearing)
•Power to care for oneself
•Actions and their consequences
•Fantasies
Slide 9 Chapter 7
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Gestalt Therapy: Enhancing
Awareness
Basic Awareness Techniques
Statements and questions
Emphasis through repetition or exaggeration
Language usage
I not you
won’t not can’t
want not need
choose to, not have to
Nonverbal behavior
Self – “Be the angry part of you.”
Slide 10 Chapter 7
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Others – “Be your father.”
Gestalt Therapy: Enhancing
Awareness
More Advanced Awareness Techniques
Feelings
–
Act out the emotion
Self-dialogue
–
Use of the empty chair to express polarities
Enactment
–
Dramatizing an experience or characteristic
Dreams
–
Acting out parts of the dream
Homework
–
Write dialogues, perform tasks
Avoidance
–
An active process that can be confronted
Creativity
–
Slide 11 Chapter 7
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Gestalt Therapy: Risks
Because of the potential to hurt, therapists
need concern for client
focus on client not technique
need understanding of gestalt theory
apply the technique within the context of gestalt theory
Slide 12 Chapter 7
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Psychological Disorders:
Examples of Gestalt Approaches
Disorder
Therapist
Patient
Depression
Strumpfel and
Goldman
Depressed woman
Anxiety
Naranjo
Anxious man
Posttraumatic stress
Serok
Holocaust survivor
Substance abuse
Clemmons
Mike
Slide 13 Chapter 7
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Current Trends in
Gestalt Therapy
Integrating concepts from
self psychology
object relations
relational psychoanalysis
other psychoanalytic approaches
Attention to issues such as shame
Slide 14 Chapter 7
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Gender Issues and Gestalt
Therapy
Leadership of gestalt therapy by both men and women
Gestalt therapy can help women develop a sense of
empowerment
Gestalt therapy can help men become more aware of emotions
and blocks that interfere with different roles
Slide 15 Chapter 7
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Multicultural Issues and
Gestalt Therapy
Experiments designed to help individuals deal with their culture
Bicultural clients can see the two cultures as a polarity – two
chair technique
Gestalt therapy can arouse deep emotions in individuals whose
culture discourages emotionality
Apply gestalt therapy to treat social needs
Slide 16 Chapter 7
© 2016 Cengage Learning.
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Theories of Psychotherapy and
Counseling: Concepts
and Cases
6th Edition
Richard S. Sharf
Chapter 8
Behavior Therapy
© 2016 Cengage Learning. All rights reserved.
© 2016 Cengage Learning.
All rights reserved.
Behavior Therapy:
Early Research
Classical Conditioning: Focus on antecedents of behavior
UCS
UCR
CS
CR
A neutral conditioned stimulus is presented just prior to the
unconditioned stimulus. Similar responses then are given
(unconditioned response, conditioned response) to the
conditioned stimulus.
Originator: Ivan Pavlov
Slide 1 Chapter 8
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Behavior Therapy:
Early Research
Operant Conditioning:
Focus on antecedents and consequences of overt
behavior
Reinforce correct responses
Ignore incorrect responses
Shape behavior by controlling amount, frequency, and
conditions under which reinforcement occurs
Originators: E.L. Thorndike and B.F. Skinner
Slide 2 Chapter 8
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Behavior Therapy: Contemporary
Research
Social cognitive theory: Covert behavior, includes role of thoughts
and behavior
Triadic Reciprocal Interaction System
Behavioral Actions
SELF-SYSTEM
Personal Factors
Originator: Albert Bandura
Slide 3 Chapter 8
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Environment
Behavior Theory: Concepts Derived
From Operant Conditioning
Positive reinforcement – The introduction of a stimulus
increases the likelihood that behavior will be repeated
Negative reinforcement- An undesirable consequence of a
behavior is removed, increasing the likelihood the behavior
will be performed again.
Extinction – the process of no longer presenting a
reinforcement
Generalization- transferring the response from one type of
stimuli to similar stimuli
Discrimination- responding differently to stimuli based on cues
or antecedent events
Shaping- gradually reinforcing parts of a behavior to more
closely approximate the desired behavior
Slide 4 Chapter 8
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Behavior Therapy: Concepts
Derived From
Observational Learning
Attending to a model
Retaining information about the model
Motor reproduction – Reproducing the behavior of the model
Motivational processes – Repeat reinforced behavior
Vicarious
Self-reinforcement
Self-efficacy – perceptions of one’s ability to perform in different
situations
Slide 5 Chapter 8
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Goals of Behavior Therapy
Changing target behaviors – ones that can be defined clearly and
accurately
Goals preferably arrived at in collaboration with clients by
evaluating goals and possible outcomes
Goals for clients who can not choose raise ethical questions
Slide 6 Chapter 8
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Behavioral Assessment
Assessing discrete behaviors and their antecedents and
consequences through the use of
Behavioral interviews – specific questions
Behavioral reports and ratings – e.g., BDI
Behavioral observations – natural or simulated
Physiological measurements – blood pressure, heart rate,
respiration
Slide 7 Chapter 8
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Behavioral Therapies: Overview
Imaginal
In vivo
Virtual reality
Slide 8 Chapter 8
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Gradual
Flooding
Systematic
desensitization
Implosive therapy
Behavior Therapy: Systematic Desensitization
Relaxation
–
Anxiety hierarchies
–
Relax body by learning a variety of
relaxation methods
a ladder of graded degrees of anxiety
using a subjective units of
discomfort scale (SUDs).
Example: Fear of exams
1.
2.
3.
10.
Slide 9 Chapter 8
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Five minutes before the psychology mid-term (80)
Walking to the psychology mid-term (70)
Midnight before the psychology mid-term (65)
Thinking about last year’s math final (20)
Desensitization
Relax the client
Present a neutral scene
Present scenes of increasing anxiety
Relax the client if the client becomes anxious
Return to a less anxious scene
Continue to move slowly up the hierarchy
Behavior Therapy:
Imaginal Flooding Therapy
Develop scenes that the client imagines and are anxiety
producing to the client
Repeat the scenes again and again in the therapy hour
Rationale: Fear will be extinguished
Slide 10 Chapter 8
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Behavioral Therapy:
Modeling Techniques
Types of Modeling
Live- Watching a model
Symbolic- Watching films, DVDs, photographs, or pictures
Role playing- Acting the part of someone or oneself in
different situations
Participant modeling- Therapists model behaviors and guide
the client in using them
Covert modeling- The client imagines a model that the
therapist describes
Slide 11 Chapter 8
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Meichenbaum’s Self-Instructional
Training
•
Model appropriate behavior
•
Have client practice behavior
•
Client repeat’s instructions to self
•
Instructions may be taped
•
Records of practicing the instructions may be made
Slide 12 Chapter 8
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Meichenbaum’s Stress
Inoculation Approach
•Conceptual phase
–
Gather information; teach client
how to think about problem
•Skills acquisition
–
Teach skill such as relaxation,
cognitive restructuring, or selfreinforcement
•Application
–
Rehearse statements, visualize
scenes, practice behavior
Slide 13 Chapter 8
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Psychological Disorders:
Examples of Behavioral Approaches
Disorder
Therapist
Client
Anxiety
Brown, O’Leary and
Barlow
Claire
Depression
Hoberman and Clarke Jane
ObsessiveCompulsive
Riggs and Foa
June
Phobia
Johnson and
McGlynn
Six-year-old girl
All research-supported therapies
Slide 14 Chapter 8
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Current Trends in
Behavior Therapy
•Behavioral activation therapy
•Eye movement desensitization and processing
•Dialectical behavior therapy
•Ethical issues
Slide 15 Chapter 8
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Behavioral Activation
Therapy
1. Designed to treat depression
2. Based on positive reinforcement
3. Goal to change behavior which will change depressed
mood
4. Techniques increase clients activities
5. Therapist and clients plan a schedule of gradual
behaviors
6. Clients use a daily activity sheet
Slide 16 Chapter 8
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Eye-Movement Desensitization
and Reprocessing (EMDR)
1.
2.
3.
4.
5.
Client history
Explanation of EMDR
Gather baseline data
Desensitization phase
Increase positive cognitions- eye movement processing
introduced
6. Body scan performed
7. Client maintains a log of distressing thoughts or images
8. Process reevaluated and reviewed
Slide 17 Chapter 8
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Dialectical Behavior Therapy
•
Individual Therapy
• Therapeutic skills
• Validation and acceptance strategies
• Problem-solving and change strategies
• Dialectical persuasion
• Group Skills Training
Slide 18 Chapter 8
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Gender Issues in
Behavior Therapy
Behavior therapy can be viewed in a social or
environmental context
Are gender stereotyped behaviors reinforced?
Are gender stereotyped behaviors modeled?
Slide 19 Chapter 8
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Multicultural Issues in
Behavior Therapy
Environmental factors (including culture) interact with
behavior
Specify vague expressions of distress in culturally specific
terms
Use cultural norms to specify treatment strategies
Be aware of cultural definitions of what constitutes deviant
behavior
Slide 20 Chapter 8
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All rights reserved.