INTRODUCTION TO COUNSELING
AND PSYCHOTHERAPY
BY:
HARDIE GIEBEN M. CRUZ, MAED, LPT, RGC
Theory Defined
2
 A practical means or a framework in making
systematic observations and explaining phenomena
 Attempts to explain & provide understanding of what
happens in the counseling relationship
 Summarizes the information base of the philosophy
and draws conclusions
 They explain behaviors
Counseling
3
 a process concerned with helping normally
functioning or healthy people to achieve their goals
or to function more appropriately
 tended to have an educational, situational,
developmental, and problem-solving focus
 the helping professional concentrates on the present
and what exists in the client’s conscious awareness
 may help people put into words why they are seeking
help, encourage people to develop more options for
their lives, and help them practice new ways of acting
and being-in-the world
Psychotherapy
4
 Usually reconstructive, remedial, in-depth work with
individuals who suffer from mental disorders or who
evidence serious deficiencies
 A process of enabling a person to grow in the
directions that he or she chooses
 More long-term, more intense process that assists
individuals who have severe problems of living.
5
Counseling Rudimentary Skills
1. Attending
6
 Attending involves actively paying attention to
clients, and it is a vital aspect of avoiding the error of
approach.
 accomplished through presence and focus
 be present or fully focused on clients means paying
attention to what they say (the content) and how it is
said (the process).
2. Active Listening
7
 Active listening may entail nodding one’s head,
verbal tracking (i.e., staying on the topic the client
brings up), accurate summarization, and an ability to
have the client feel heard (as evidenced by clients’
self-reports, “I feel like you are really listening to me
when I talk”).
3. Reflection
8
 One way to avoid making the error of interpretation,
or the failure to accurately understand what another
person is attempting to convey, is to use reflection.
 Reflection helps therapists attend to what is being
communicated by conveying to clients a sense of
what they are picking up from them.
 Counselors may choose to reflect the content (what is
said) or process (how it is said) of clients.
4. Gathering Information
9
 The skill of gathering information entails getting as
much information as is necessary
 Counselors become more effective as they learn
when to gather information and what type of
information is relevant.
 To gather information a counselor needs to make a
few basic inquiries
5. Questioning
10
 Effective questioning is often accomplished when
counselors are aware of the difference between
content (what is said) and process (how it is said).
 By focusing on the client’s process rather than
content, counselors move the focus from external to
internal.
6. Empathizing
11
 If we were to not only walk in another’s shoes, but
live in another’s body, experiencing the other
person’s cognitive functioning, affective range, every
emotional experience, memory, and even only have
access to that person’s psyche, we would have made
every single decision that person has made
7. Self-Disclosure
12
 If you want people to listen to what you are about to
say, tell them it’s confidential.
 Self-disclosure means telling someone something
about your life, something about you personally
8. Focusing
13
 four steps to effective counseling: building rapport,
establishing a contract, focusing the client, and
funneling the session.
 the counselor’s job is to help the client focus on the
issue at hand.
9. Providing Feedback
14
 Two primary skills for counselors:
 to be able to accept feedback themselves,
 to be able to circumvent the error of language.
 People are much more likely to respect what they see
as opposed to what they are told.
 Counselors must live out what they preach, and that
begins with being able to accept feedback.
10. Confrontation
15
 effective counseling relationships as antithetical
rather than complementary.
 An antithetical relationship is one in which
confrontation is essential. Antithetical literally
means to “set in opposition”; this very definition is
set in opposition to the literal meaning of the word
complementary, which means “identical with”
11. Silence
16
 Some clients process ideas and concepts in silence;
 Some have difficulty in silence and feel a need to fill
what they perceive to be a void.
 Regardless of the reason, counselors have a
responsibility to allow clients to own the silence
 The more counselors are comfortable with their own
silence, the more they will allow clients to own the
silence.
12. Goal Setting
17
 Goal setting is contracting with clients about what
they want.
 Short term and long term goals
13. Modeling
18
 genuineness stems from congruence between the
real or actual self (who we truly are) and the ideal
self (either who we believe we are or who we strive to
be
 Counselors are charged with the life- long pursuit of
self-awareness.
14. Reframing
19
 When people process events, they do so
egocentrically at first, and usually only after time can
they begin to develop a broader perspective on the
event.
 To reframe what someone says, a counselor merely
has to reflect what clients say in a different way from
how the clients presented it.
15. Termination
20
 Knowing the boundaries of professional
relationships is important to preparing for the final
or termination stage.
 Understanding when to terminate clients is a skill
that takes experience, practice, and, most often,
guidance from an outside entity, such as a
supervisor.
Components of Choosing a Theoretical Orientation to Therapy
21
Personal therapeutic belief systems
Theoretical school affiliation-self-reported
adherence to one or more theoretical schools
Espoused theory- what the therapist says he or
she does
Theory-in-action- what is inferred by people
observing the therapist’s behavior when working
with clients
1
ETHICAL ISSUES IN COUNSELING
PRACTICE
Ethical Decisions
2
Mandatory ethics

involves a level of ethical functioning at the minimum level of professional practice.
Aspirational ethics

focuses on doing what is in the best interests of clients.
Positive ethics

is an approach taken by practitioners who want to do their best for clients rather
than simply meet minimum standards to stay out of trouble (Knapp & VandeCreek,
2006).
Some Steps in Making Ethical Decisions
3
 Identify the problem or dilemma.
 Identify the potential issues.
 Look at the relevant ethics codes for general guidance on the matter.
 Consider the applicable laws and regulations, and determine how they
 may have a bearing on an ethical dilemma.
 Seek consultation from more than one source to obtain various
perspectives on the dilemma, and document in the client’s record the
suggestions you received from this consultation.
Some Steps in Making Ethical Decisions
4
 Brainstorm various possible courses of action.
 Enumerate the consequences of various decisions, and reflect on the
implications of each course of action for your client.
 Decide on what appears to be the best possible course of action.
The Right of Informed Consent
5
 Informed consent involves the right of clients to be informed about
their therapy and to make autonomous decisions pertaining to it.
 Providing clients with information they need to make informed choices
tends to promote the active cooperation of clients in their counseling
plan.
 By educating your clients about their rights and responsibilities, you
are both empowering them and building a trusting relationship with
them. Seen in this light, informed consent is something far broader
than simply making sure clients sign the appropriate forms.
 It is a positive approach that helps clients become active partners and
true collaborators in their therapy.
Dimensions of Confidentiality
6
 Confidentiality is an ethical concept, and in most states it is the legal
duty of therapists not to disclose information about a client.
 Privileged communication is a legal concept that protects clients
from having their confidential communications revealed in court
without their permission (Herlihy & Corey, 2015a).
Ethical Issues in the Assessment Process
7
The Role of Assessment and Diagnosis in Counseling
 Assessment consists of evaluating the relevant factors in a client’s life
to identify themes for further exploration in the counseling process.
 Diagnosis, which is sometimes part of the assessment process,
consists of identifying a specific mental disorder based on a pattern of
symptoms. Both assessment and diagnosis can be understood as
providing direction for the treatment process
Ethical Aspects of Evidence-Based Practice
8
 Evidence-Based Practice (EBP): “the integration of the best
available research with clinical expertise in the context of patient
characteristics, culture, and preferences”(APA Presidential Task Force
on Evidence-based Practice, 2006, p. 273).
Managing Multiple Relationships in Counseling Practice
9
 Dual or multiple relationships, either sexual or nonsexual, occur
when counselors assume two (or more) roles simultaneously or
sequentially with a client.
 This may involve assuming more than one professional role or
combining professional and nonprofessional roles.
 The term multiple relationship is more often used than the term dual
relationship because of the complexities involved in these
relationships, but both terms appear in various professional codes of
ethics, and the ACA (2014) uses the term nonprofessional
relationships.
Ways of Minimizing Risk
10
 Set healthy boundaries early in the therapeutic relationship.
 Involve clients in ongoing discussions and in the decision-making
process, and document your discussions.
 Consult with fellow professionals as a way to maintain objectivity and
identify unanticipated difficulties.
 When multiple relationships are potentially problematic, or when the
risk for harm is high, it is always wise to work under supervision.
 Self-monitoring is critical throughout the process.
Establishing Personal and Professional Boundaries
11
 A boundary crossing is a departure from a commonly accepted
practice that could potentially benefit a client.
For example, attending the wedding of a client may be extending a boundary, but it could be
beneficial for the client
 A boundary violation is a serious breach that harms the client and is
therefore unethical. A boundary violation is a boundary crossing that
takes the practitioner out of the professional role, generally involves
exploitation, and results in harm to a client
Social Media and Boundaries
12
 Limit what is shared online.
 Include clear and thorough social networking policies as part of the
informed consent process.
 Regularly update protective settings because social media providers
often change their privacy rules.
Becoming an Ethical Counselor
13
 Ethical decision making is an evolutionary process that requires you to
be continually open and self-reflective.
 Becoming an ethical practitioner is not a final destination but a journey
that will continue throughout your career
1
THE COUNSELOR: PERSON AND
PROFESSIONAL
The Counselor as a Therapeutic Person
2
Personal Characteristics of Effective Counselors










Effective therapists have an identity.
Effective therapists respect and appreciate themselves.
Effective therapists are open to change
Effective therapists make choices that are life oriented
Effective therapists are authentic, sincere, and honest
Effective therapists have a sense of humor
Effective therapists make mistakes and are willing to admit them
Effective therapists generally live in the present
Effective therapists appreciate the influence of culture
Effective therapists have a sincere interest in the welfare of others
The Counselor as a Therapeutic Person
3
Personal Characteristics of Effective Counselors




Effective therapists possess effective interpersonal skills
Š
Effective therapists become deeply involved in their work and derive meaning from
it.
Effective therapists are passionate
Effective therapists are able to maintain healthy boundaries
The Counselor’s Values and the Therapeutic Process
4
Value imposition


Refers to counselors directly attempting to define a client’s values , attitudes,
beliefs, and behaviors.
It is unethical for counselors to impose their values in the therapeutic
relationship.
Acquiring Competencies in Multicultural Counseling
5
 Beliefs and Attitudes
 Knowledge
 Skills and Intervention Strategies
Issues Faced by Beginning Therapists
6
 Dealing With Anxiety
 Being Yourself and Self-Disclosure
 Avoiding Perfectionism
 Being Honest About Your Limitations
 Understanding Silence
 Dealing With Demands From Clients
 Dealing With Clients Who Lack Commitment
 Tolerating Ambiguity
Issues Faced by Beginning Therapists
7
 Becoming Aware of Your Countertransference
 Developing a Sense of Humor
 Sharing Responsibility With the Client
 Declining to Give Advice
 Defining Your Role as a Counselor
 Learning to Use Techniques Appropriately
 Developing Your Own Counseling Style
 Maintaining Your Vitality as a Person and as a Professional
8
 Countertransference, defined broadly, includes any of our
projections that influence the way we perceive and react to a client.
 This phenomenon occurs when we are triggered into emotional
reactivity, when we respond defensively, or when we lose our
ability to be present in a relationship because our own issues
become involved.
1
PSYCHOANALYTIC THERAPY
(Freud)
View of Human Nature
2
 Deterministic
 Maintains that an individual’s personality is fixed
largely by the age of 6.
 People do not have free will, their behavior is
determined by innate drives that have to do with sex
and aggression or love and death
Levels of Consciousness
3
 Conscious Level:
 All of our thought processes operate;
 Only 10%; everything we are aware of
 Preconscious Level
 Contains our memories and thoughts that are not at the
conscious level but that may threaten to break into the
conscious level at any moment
 Events, thoughts, and feelings are easily recalled
 About 10-15% of the mind
Levels of Consciousness
4
 Unconscious Level
 The lowest and deepest level of awareness, or unawareness
 Hold the bulk of our past experiences, including all the
impulses and memories that threaten to debilitate or
destabilize our minds.
 Constitutes 75-80% of the mind
Structure of the Mind
5
 Id
 Biological self; most basic of the three
 Contains instincts, needs and wishes
 Preoccupied with its own needs and desires; self-centered
 Functions on primary process thinking: preverbal and
dreamlike original, irrational state of libido; sets into
operation a means for forming an image of something that
helps reduce a drive
 Governed by pleasure principle, illogical, amoral, and driven to
satisfy its instinctual needs and desires
Structure of the Mind
6
 Ego
 Develops most clearly about 6-8 mos
 Lies within the realms of the conscious, preconscious, and
unconscious
 Rational, capable of forming realistic plans, functions as a
liaison between the id and superego
 Reality oriented seeks to protect the self
 Functions on secondary process thinking: thinking directed
toward problem-solving and self-preservation
 Has the capacity for rational decision making and decides
when not to satisfy the urgings of the id
Structure of the Mind
7
 Superego
 Represents parental values and societal standards
 Operates on morality principle
 Seeks perfection and is oriented toward the past rather than
the present or the future
 Uses introjections: involves a process of the individual’s
incorporating the norms and standards of a culture into his or
her culture. It is aided by the individual’s identification with
significant adults during childhood
8
Common Defense Mechanisms
9
 Repression
 Rationalization
 Regression
 Identification
 Displacement
 Reaction Formation
Psychosexual Stages of Development
10
 Oral
 Birth to 18 mos.
 Source of gratification: feeding and body organs associated
with this function-mouth, lips, and tongue, along with the
infant’s feelings of security that occur as a result of his or her
being held
 Oral Personality: pessimism/optimism,
suspiciousness/gullibility, self-belittlement/cockiness,
passivity/manipulativeness; dependency
Psychosexual Stages of Development
11
 Anal
 18 mos to 3 years old
 Main source of pleasure: anal area
 Involves power struggle; children become fixated at the anal
phase if their caretakers are too demanding or overindulgent
 Anal Personality: stinginess, constrictedness, stubbornness,
messy, disorganized, reckless, careless
Psychosexual Stages of Development
12
 Phallic
 3-5 or 6 years old
 Settling for the most sexual conflict
 Source of gratification: genital area
 Oedipus and electra complex
 Phallic personality: reckless, narcissistic, excessively vain and
proud; afraid or incapable of close love ( could be a major
cause of homosexuality)
Psychosexual Stages of Development
13
 Latency
 6-12 or puberty
 Child’s sexual drive lies dormant; unparalleled repression of
sexual desires
 Children repress their sexual energy and channel it into school,
friends, sports, hobbies, and direct their attention to the larger
world
 It is a time for ego development and for learning the rules of
society
Psychosexual Stages of Development
14
 Genital
 13-18; signals the onset of adolescence
 Focus their sexual energy toward opposite sex or same sex
 More altruistic and less selfish than others
 People unable to make psychological attachments during
adolescence and young adulthood will manifest abnormal
personality patterns.
15
The Therapeutic Process
16
 Begins with asking the person to lie down on a a
couch, looking away from the therapist
 The person expresses whatever thoughts, feelings, or
images that come to mind, without censoring,
suppressing, or prejudging them
 The therapist sits behind the couch and listens in a
nonjudgmental manner to the client
The Therapeutic Process
17
 Periodically, the therapist interrupts the client’s
associations, helping him or her to reflect on the possible
connections and significance of his or her associations.
 The therapist’s goal is to make the unconscious
conscious, to interpret transferences, to work through
and resolve such transferences, and to strengthen the
client’s ego
 Childhood experiences are reconstructed, interpreted,
and analyzed. Analytic therapy is directed toward
achieving insight and self-understanding.
Goals of Therapy
18
 To bring about changes in an individual’s personality
and character structure
 Helping those who are willing and able to participate
in a lengthy and often painful process to achieve a
resolution of some intrapsychic conflicts so that they
might experience life in a mature manner.
Goals of Therapy
19
 To help clients achieve self-awareness, honesty , and
more effective interpersonal relationships and gain
better control over their irrational and id impulses.
 Ultimate goal: reorganization that promotes the
integration of dissociated psychic material and
results in a fundamentally changed, firmly
established new structure of personality
Role of the Therapist
20
 Begins by evaluating whether the client is suitable
for psychoanalysis
 People who do not dare regress from reality and
those who cannot return readily to reality are poor
risks for psychoanalysis
 Clients who have been diagnosed as schizophrenic,
manic-depressive, schizoid, or borderline
personalities are believed to be poor risks for
psychoanalysis
Role of the Therapist
21
 Compassionate neutrality attitude should be




maintained
The therapist does not offer advice or extend
sympathy
The therapist is seen as very passive and detached.
Focuses on intrapersonal conflicts
The ideal client is one who is capable of pregenital
fixations; genital personality is the ideal.
Role of the Therapist
22
 1. Opening Phase:
 Consists of therapist’s first contact with the client and lasts
from 3-6 weeks
 Therapist notes everything that the client says and does for
possible late ruse in treatment.
 Therapists assesses the nature of the client’s problems
 Introducing clients to the couch and techniques of
psychoanalysis
 Focuses primarily on conflicts that are readily accessible to the
client’s consciousness
Role of the Therapist
23
 2. Development of Transference
 The client was unconsciously reenacting forgotten childhood
memories and repressed unconscious fantasies
 Transference prevents us from seeing others entirely
objectively
 It is a form of memory in which the client repeats in therapy
conflicts from his or her early childhood as if they currently
existed.
 It helps clients distinguish fantasy from reality and the past
from the present
Role of the Therapist
24
 3. Working-through phase
 Slow, gradual process of working again and again with the
insights that have emanated from the therapist’s
interpretations of resistance and transference.
 Entails clients’ gaining insights to their issues as a result of
transference analysis
 Clients come to understand that they do not have to fear their
impulses as they did when they were children, because in the
transference relationship, they expressed those same impulses
in intense words and were not castrated, rejected, or
abandoned
Role of the Therapist
25
 4.Resolution of transference
 Both the therapist and client agree on a date to end the
therapy.
 They must resolve any remaining attachments issues the client
has with the therapist.
Therapy Techniques
26
 1. Free Association
 Cardinal technique which allows clients to say anything and
everything that comes to mind regardless of how silly, painful,
or meaningless it seems.
 One association leads to another that is deeper in the
unconscious
 Permits clients to abandon their usual ways of censoring or
editing thoughts.
27
Therapy Techniques
28
 2. Dream analysis
 Pathway to the unconscious
 Manifest content: surface meaning of the dream
 Latent content: contains the deeper, hidden, and symbolic
meaning
 Therapist’s task is to help the client uncover disguised
meanings by studying the symbols in the manifest content of
the dream
29
Therapy Techniques
30
 3. Analysis of Resistance
 Resistance exists when client behaviors interfere with or
hinder the analytic process
 It is an unconscious situation clients use to defend against
anxiety
 Client resistance is an opportunity to gain insight into their
client’s unconscious motivations or defensive mechanisms
 It is designed to help clients become aware of the reasons for
resistance so that they can confront them.
Therapy Techniques
31
 4. Analysis of Transference
 Therapist interprets the distorted displacements of significant
relationships clients experience during their transference onto
the therapist
 Interpret client’s buried feelings, traumatic conflicts and
unconscious fixations of early childhood
 Helps clients gain insights into the influence of their past on
their present lives.
 Clients learn how to work through old conflicts that hindered
their psychological growth.
Libido Persona
Consciousness
Ego
Introjections
incorporated from
outside the psyche
Defense Mechanisms Subconscious
Displacement
Regression
Denial
Reaction Formation
Confirmation Bias
Projections from inside
the psyche onto the
outside world
Unconscious
Ebullition General Projections
Anima/Animus Shadow
True
Self
Complexes
Archetypes
Collective Unconscious
Libido
32
1
ADLERIAN PSYCHOTHERAPY
View of Human Nature
2
 People are basically self-determined and that they
forge their personalities from the meaning they give
to their life experiences.
 People create their own lives by using their creative
power
 It is the individual who must ultimately be
responsible for making good use of his abilities
 People are motivated by their present perceptions
and by their present expectations of the future.
View of Human Nature
3
 People do not determine meanings by situations, but
they determine themselves by the meanings they give
to situations.
 People create their own personalities, and they can
change their personality by developing new attitudes
 His view is essentially optimistic, holistic, and
phenomenological in orientation
Theory of Personality
4
 1. Social Interest
 Refers to the individual’s sense of being part of the human
community and their attitudes toward others.
 An individual’s ability to empathize with others
 Social interest provides us with a basically positive outlook on
life and an interest in developing the welfare of others
Theory of Personality
5
 2. Masculine Protest
 The desire to be a “real man”, a desire to be superior, to strive
to be perfect.
 Men carefully hide their feminine traits through exaggerated
masculine wishes and efforts
Theory of Personality
6
 3. Lifestyle
 Behaviors is lawfully organized and that each person develops
a generalized pattern of responses to most situations
 Habitual pattern of behavior unique to each person
 Considered as the major key of our behavior
 Includes our goals, opinions of ourselves and the world, and he
habitual behaviors we use for achieving desired outcomes
Theory of Personality
7
 4. Goal-directed and purposeful behavior
 All behavior is purposeful and goal directed
 As counselors we must first understand our client’s goals.
 When counselors help clients analyze their goals, they are
taking important steps to helping them lead more productive
lives
Theory of Personality
8
 5. Feelings of Inferiority
 All human beings begin their psychological life with feelings of
inferiority
 It is the presentation of the person to himself and others that
he is not strong enough to solve a given problem in a socially
useful way
 It is more than a sense of inadequacy
 Its is inevitable, universal, and normal
Theory of Personality
9
 6. Striving for Superiority
 Used to explain our drive to master external obstacles, to gain
power and status, and to arrive at a positive state
 Positive striving for perfection
Theory of Personality
10
 7. Fictional Finalism
 Can help us deal more effectively with reality, or they may
block our attempts to accept reality.
 Fictional goals develop during early childhood, and they exist
primarily at the unconscious level of awareness throughout
one’s life.
 Our fictional goals influence the way we think, and act
throughout our lives.
Theory of Personality
11
 8. Family Constellation
 Describes the composition of a family and one’s position
within that system
 It is not what we are that determines our behavior, but rather,
it is what we think we are that has the most impact on us.
Theory of Personality
12
 9. Birth Order
 First born:
“reigning monarch”, given undivided attention
 Best understands the significance of power and the exercise of it
 Conservative in outlook, nostalgically look at the past, highly
organized, responsible, conscientious
 One feels a sense of responsibility and takes care of others.

Theory of Personality
13
 Second Born
 Grows up knowing that he or she has to share parental time
and attention
 Optimistic, competitive, and ambitious
 Strives in directions different from the first born
Theory of Personality
14
 Middle Child
 They are in a difficult and unfair position
 They are ambitious and develop a strong social interest
 Unfavorable outcomes they are rebellious and envious, they
often experience difficulty being a follower
Theory of Personality
15
 Youngest Child
 Tends to be pampered within the family constellation
 May excel over all others o establish their place within the
family
 Competitive orientation and become high achievers
Theory of Personality
16
 Only Child
 Not likely to develop a competitive spirit
 Develops exaggerated views of their own importance
 May develop rich imaginations
 Likely to be deficient in social interest
17
18
The Therapeutic Process
19
 Usually time-limited, supportive therapy focused on
specific problems
 Designed to bring about moderate insight, attitude
change, and behavioral change
 May focus on parenting, marital relationships, and
career choice and development
 Overall goal: to help a person develop from a
partially functioning person into a person who lives
life more cooperatively, more courageously. And with
a greater sense of contribution to his community.
Goals of Therapy
20
 Establishing and maintaining a good client-therapist




relationship
Uncovering the client’s dynamics, which include his
lifestyle, goals, family constellation, childhood illnesses ,
basic mistakes included in his lifestyle
Developing interpretations that culminate in client
insight
Reorienting the client
Three entrance gates to an individual’s mental life:
 Birth order position in the family of origin
 First childhood memory
 Dreams
Role of the Therapist
21
 Establish friendly relationship between equals
 Encourage clients to use their talents to help others---to





develop a social interest
Counselors tend to be active and talkative in therapy
Confront clients with their basic mistakes, misplaced
goals, and self-defeating behaviors.
Encourage clients to develop new alternatives for
reaching their revised goals
Take a non-pathological view of clients’ difficulties
Avoid labeling clients with the traditional medical
model’s diagnoses. Instead help clients better understand
themselves and to modify their life’s stories.
Phases of Therapy
22
 1. Establishing the Therapeutic Relationship
 Use humor and small talk to establish therapeutic alliance
 Help the client become a more cooperative person
 Therapist offers genuine warmth, empathy, acceptance and
understanding
 Remain neutral in order to discuss possible improvements in
their situations
Phases of Therapy
23
 2. Uncovering the Client’s Dynamics
 a.Assessment and Diagnosis
Assess the client’s lifestyle
 Assess and interpret the client’s early recollections


b. Analysis of Client’s Basic Mistakes (5 basic mistakes)
Overgeneralizations: “People are no good”
 False or impossible goals of security: “I must please everyone, if I
am to be loved”
 Misperceptions of life and life’s demands: “I never get any breaks”
 Minimization or denial of one’s worth: “I’m stupid”
 Faulty values: “I must be first, regardless of who gets hurt in the
process”

Phases of Therapy
24

c. Early Recollections as an Assessment Technique
We select memories that coincide with our basic beliefs about
ourselves and the rest of the world
 Earliest memories provide the therapist with an understanding of
our mistaken beliefs, social interests, and future actions

Phases of Therapy
25
 d. Analysis of Client’s Dreams
 Dreams were a way of dealing with our insecurities
 Help us try out strategies for overcoming our limitations
 Can serve as bridge to what we want
 More problems you have, the more dreams you are likely to
have
 Adlerian dream work involves examining the parts of a dream
and analyzing what problems or inferiorities they might
represent
Phases of Therapy
26


Dreaming is purposive. Dreams prepare clients to solve their
current problems or to overcome their present circumstances
by rehearsing them for potential future actions
Common dream symbols:
Flying (moving or striving from below to above)
 Falling (moving or striving from above to below)
 Being chased ( an expression of inferiority or weakness in relation
to others)
 Being unclothed in public ( fear of disclosure or being found out)

Phases of Therapy
27
 e. Integration and Summary of Adlerian
Uncovering and Assessment

Client’s subjective experience and life story; family
constellation and developmental data, early recollections,
personal strengths, basic mistakes and coping strategies
Phases of Therapy
28
 3. Client Insight and Self-Understanding
 Insight: client’s understanding of the purposive nature of his
behavior and the mistaken beliefs that sustained it.
 Self-understanding results when therapists help clients make
conscious hidden lifestyles and goals
Phases of Therapy
29
 4. Reorientation
 To help the client gain or regain the courage to face life’s
challenges-to put insight into action and to redirect goals
 Client is encouraged to develop more social interest in others
 Client has learned to feel and function better
Therapy Techniques
30
 Time limits must be set with clients
 Sessions with children usually last for 30 minutes
 Adults: 45 to 50 minutes
 Homework assignments are usually made near the
end of the therapy session
A. Offering Encouragement
31
 It is both a principle and a technique that pervades all of
Adlerian therapy
 Encouragement is necessary for children’s healthy
development
 Used in working with clients when they express faith and
belief in them
 Therapist does the following:





Values the client as he or she is
Demonstrates faith in the client
Tries to build a positive self-concept within the client
Gives the client recognition for his or her efforts
Concentrates on the strengths and assets of the client
B. Asking the Question (Miracle Question in Solution
Focused)
32
 “If I could magically eliminate your symptoms
immediately, what would be different in your life?”
 “What would be different if you were well?”
C. Asking “As If”
33
 Clients who state that they would do thus and so if
only they possessed certain qualities are encouraged
to act for a short period of time as if they possessed
the qualities they believe they lack.
 It is based on the belief that clients must change
their behaviors to elicit different responses from
others.
D. Using the Push-Button
34
 Would ask clients to imagine pushing a button then
direct them to picture a pleasant experience in as much
as detail and vividness as possible
 Request clients to make note of the pleasant memory that
made them feel good as they engaged in the imaginary
push-button exercise
 Give the same directions—only this time asking clients to
imagine a negative experience in as much detail as
possible
 Tell clients that they can exercise inner control regarding
how they feel at any moment by controlling what they
think about
Push-button technique
35
E. Catching Oneself
36
 Permits clients to become aware of their self-
destructive behaviors or thoughts without feeling
guilty about them
 Clients are told to “catch themselves” when they are
just about ready to revert back to their old ways and
to substitute the new behavior.
 The goal is to help clients change maladaptive old
habits
F. The Midas Technique
37
 Entails exaggerating the client’s irrational demands
 Helps clients to see that their wishes, when taken to
their logical extreme, can be absurd. Clients laugh at
their own wishes and positions taken
G. Pleasing Someone
38
 Designed to increase clients’ social interest
 Therapist suggests that the client do something nice
or someone else
 Therapist might recommend that a client volunteer
his or her service and have no expectation of a
reward other than that which comes from serving
another person
 The technique of pleasing someone helps put the
client back into society
H. Socratic Questioning
39
 Leading an individual to insight through a series of
questions
 Makes the client responsible for his or her own
conclusions
I. Task Setting
40
 Therapists give homework assignments to give
clients practice with a behavior
 The client finds threatening situations less and less
frightening
J. Creating Images
41
 Used to describe clients with a single phrase, such as
the beggar as a king
 Adlerians use images to describe clients
K. Brainstorming
42
 Brainstorms with clients’ alternatives beliefs and
convictions.
 E.g. in place :”I never get what I want”; “Sometimes I
get what I want”.
L. “Spitting the in the client’s soup”
43
 The intent is to spit in the client’s soup of excuses
and hidden goals
 When therapists reveal the hidden purpose of a
client’s symptom or behavior, they deprive him or
her of the secondary gains that the symptoms
provide
M. Paradoxical Intention
44
 The therapist helps the client overcome his own
opposition by encouraging him to do that which he is
complaining about.
 E.g. “never do anything you don’t like”; “don’t stop
worrying”.
 Can be used to encourage a client symptom or to give
him permission to do something.
 Asking clients to exaggerate or to amplify the target
behavior to show the client how ridiculous the
behavior is.
1
EXISTENTIAL THERAPY
(ROLLO MAY AND VIKTOR
FRANKL)
View of Human Nature
2
 Main focus deals with human existence and what it




means to be alive
To be human means asking questions about our very
existence
Searching for meaning in life is a distinctly human
characteristic
Our validation must come form within rather than
from others
People create their own values. People are free when
they choose freely and when they accept the
consequences of their actions.
Existential Therapy
3
 Individuals define who they are by their choices even
though there may be factors beyond one’s control that
restrict one’s choices
 Ontological experience, the science of “being”
 Basic concept: “being in the world”
 Umwelt: physical; Mitwelt: Social
 Eigenwelt: Psychological or self-knowing
 Uberwelt: Spiritual
 Therapists may help clients recognize outmoded ways of
life and become willing to take the responsibility to change,
to expand, and to find meaning in their lives that is unique
to them.
View of Human Nature
4
 Levels of Being the World:




Umwelt (Biological/Physical World): living cycles of organisms such
as sleep patterns, drives, instincts
Milwelt (Social World): refers to existence as influenced by our
social relationships
Eigenwelt (Self-Knowing/Psychological experience): refers to our
own individual world, represents an attempt to understand
ourselves; consists of our awareness, introspection and self-knowing
Uberwelt (Spiritual World): refers to the spiritual world of being;
people relate to the unknown and create a sense of an ideal world, as
well as philosophical outlook on that world. It often leads to people
finding something for which they are willing to live or die.
5
Goals of Therapy
6
 Finding personal meaning: the client is encouraged
to find his or her own personal meanings and truths
about life.
 Taking responsibility for one’s decisions about living.
 Living in the present so that the client experiences
life more fully each moment.
 Increasing self-awareness and authentic living
Role of the Therapist
7
 Facilitate client’s encounters with themselves
 Focus on the issue of client responsibility
 Assist clients in learning how to embrace
responsibility rather than avoid it
 Assists clients in making choices, removing the
obstacles that block their decision-making ability,
and understanding the methods they use in arriving
at decisions.
Therapy Techniques
8
 Free to use techniques across the broad schools of
thought, including diverse techniques such as
desensitization and free association
 Primary guideline: address the uniqueness of each
person



Initial Phase: help clients identify and clarify their beliefs
about their worlds. Clients are encouraged to explore the ways
in which they make sense of their being
Middle Phase: examines clients’ values and their sources
Final Phase: focuses on helping clients take action regarding
the kind of life they want.
Logotherapy
9
 3 Basic Assumptions:
 Life has meaning under all circumstances
 People have a will to meaning
 People have the freedom under all circumstances to activate
the will to meaning and to find meaning in life
Logotherapy
10
 Techniques:
 Socratic Dialogue:
Conversational method used to raise clients’ consciousness about
their possibilities
 Therapist asks specific questions to raise into consciousness the
possibility to find, and the freedom to fulfill, meaning in one’s life


Paradoxical Intention


Directs a client to do something contrary one’s actual intentions
Labeled Dereflection
People encounter problems because they put too much emphasis
on themselves
 When people shift their attention to others, their own personal
problems seem to lessen

11
BEHAVIOR THERAPY
1
John Watson, B.F. Skinner, Joseph
Wolpe, Donald Meichenbaum
View of Human Nature
2
 People are basically neutral at birth; they are neither
good nor bad
 People are influenced by what happens to them and
by what they learn
 Learning can result in the development of any
pattern of human behavior, provided that the person
has a certain learning history and biological
capability
 Includes both personal and environmental
determinants of human behavior
Theory of Personality
3
 1. Classical Conditioning (Pavlov)
 2. Operant Conditioning (Skinner and Thorndike)
 Consequences that follow behavior help learning
 Behavior is changed by systematically changing the
consequences
 It occurs when a behavior is followed by a consequence, and
the nature of the consequence changes a person’s or an
organism’s tendency to repeat the behavior in the future.
 We are more likely to increase behavior that is rewarded and
to decrease behavior that is either punished or not reinforced.
Theory of Personality
4
 3. Reinforcement
 To strengthen some behavior. It refers to any stimulus that
strengthens or increases the likelihood of a specific response
from a person.
 Positive Reinforcement: adding something to increase a
response
 Negative Reinforcement: when a certain stimulus is removed
after a specific behavior is exhibited. It involves taking
something away to increase a response
 Punishment: adding something aversive for the purpose of
decreasing a behavior; helps decrease a behavior
Theory of Personality
5
 4. Extinction
 Takes place when reinforcers are withdrawn or unavailable,
and people stop demonstrating a behavior
 A process of removing an unwanted response by not
reinforcing it.
 5. Generalization
 When behavior is reinforced on a consistent basis, it may
become generalized to other situations
Theory of Personality
6
 6. Discrimination
 Learning how to respond differently to stimuli, depending on
the situation with which we are presented
 7. Shaping
 Behavior that is learned gradually in steps by successive
approximation
 Shaping takes place when a person actually practices a
behavior.
Theory of Personality
7
 8. Counterconditioning
 E.g. desensitization
 Because anxiety can be learned through conditioning, it can be
unlearned by a process of counterconditioning
 9. Token Economies
 To shape client behavior when approval and other reinforcers
do not work
 Provide a concrete measure of a person’s motivation to change
specific behaviors
 Individuals can decide how to use their tokens, thereby giving
them a sense of control over their lives
The Therapeutic Process (Perspectives)
8
 Counseling and psychotherapy should focus on
client’s observable behavior and their life responses,
not on their unresolved, unconscious conflicts.
 Learning is a central principle for understanding and
changing a client’s behavior.
 Clients’ changes in behavior are governed by the law
of effect: “behavior that is followed by satisfying
consequences will be more likely to be repeated and
behavior that is followed by unsatisfying
consequences will be less likely to be repeated.
The Therapeutic Process (Perspectives)
9
 Learning is also governed by contingencies. Clients
change their behaviors as they discover relationships
between sequences of events and their behaviors—
associate learning
 Behavior therapy is an individual-focused approach.
 It takes a non-pathological approach to what other
schools of thoughts label as mental illness.
The Therapeutic Process (Perspectives)
10
 Most abnormal behavior is assumed to be acquired
through learning and maintained in the same
manner as normal behavior
 Instead of focusing on the past, behavioral
assessment examines the current determinants of
behavior.
 The therapist conducts a prior analysis of the
problem into its components or subparts
The Therapeutic Process (Perspectives)
11
 Therapist develops treatment strategies that are
individually tailored for each client, depending on
the issue for which they request assistance
 It is not essential for a behavior therapist to
understand the origins of a psychological problem in
order to produce positive client behavioral change.
 Behavior therapists must commit to the scientific
method in their work with clients
The Therapeutic Relationship
12
 Behaviorists establish a warm and empathic
relationship with clients
 It is central in behavior therapy because the
therapists must be able to get clients to trust them in
such sensitive issues as dealing with their deepest
fears.
Goals of Therapy
13
 The counselor informs the client about the need for
goals, the role that they play in therapy, and the client’s
involvement in the goal-setting process.
 The client indicates the positive changes he or she desires
from therapy. Emphasis is placed on what the client
wants rather than what he or she does not want.
 The therapist highlights that change can only come from
the client and the fact that the client must accept
responsibility for the desired change in behavior.
 Throughout the therapy process, the client and therapist
work on identified goals, revising them as the need
arises. A plan of action is developed to achieve the
identified goals.
Role of the Therapist
14
 Function as consultants in producing behavioral
change
 Active and directive during counseling
 Conduct a complete functional assessment to
identify the variables that maintain the conditions
about which the client complains
 Generate initial treatment goals and construct a
treatment plan to achieve these goals
Role of the Therapist
15
 Teach concrete skills to the client by instruction,
modeling, and performance feedback
 Use therapy techniques to promote maintenance of
behavior change
 Measure the effectiveness of treatment procedures
 Complete follow-up assessments
Role of the Client
16
 Agreeing to perform homework assignments and by
engaging in behavioral rehearsal until skills are
learned.
 Clients who come to therapy are motivated to change
Behavior Therapy Techniques
17
 1. Relaxation Training Techniques: should be
individualized for each client
 2. Reciprocal Inhibition and Systematic
Desensitization


Reciprocal inhibition: based on the inhibition of responses by
the occurrence of another response that is incompatible with
it. E.g. relaxation training
Systematic desensitization
Training in deep muscle relaxation
 Construction of anxiety hierarchies
 Matching specific anxiety situations from the hierarchies with
relaxation training

Behavior Therapy Techniques
18
 3. Stress Inoculation Training
 Designed to help inoculate people against collapse as they
experienced stress.
 Goal: to change individual’s beliefs about the behaviors and
statements they make to themselves regarding how they deal
with stress
 Helps clients to induce a relaxation response, engage in
cognitive restructuring, and perform effective problem-solving
skills
Exposure Therapies
19
 General category of behavior techniques that are
designed to treat phobias and a wide range of other
behaviors
 Therapists introduce clients to the situations that
have contributed to their problems
 1. Flooding: constitutes either an in vivo or imaginal
exposure to anxiety-evoking stimuli for a prolonged
period of time. The therapist exposes the client to a
safe version of the fearsome stimulus at maximum
intensity
Exposure Therapies
20
 2. In Vivo: refers to procedures that takes place in
the client’s actual environment
 3. Implosive Therapy:



Client imagines all anxiety situations
The imagined anxiety scene are exaggerated to elicit as much
anxiety as possible
The imagined scenes are based on hypothesized sources of
anxiety, which are psychodynamic in nature
21
REBT (Albert Ellis)
View of Human Nature
22
 People are born with a potential for irrational or
rational thinking
 Human beings have predispositions for selfpreservation, happiness, and growth actualization
 People are constructivists and have a great deal of
resources for human growth.
Theory of Personality
23
 ABC Model of personality
 A: activating event or experiences, such as family problems or
early childhood trauma, that trigger stress or worry
 B: belief system—the cognitive component in our reaction to
events. Especially important are irrational, self-defeating beliefs
that form the source of our unhappiness
 C: consequences (the neurotic symptoms and negative emotions,
such as depression, anger, and rage) that come from our beliefs
 D: Disputing Irrational Thoughts and beliefs



Detecting
Debating
discriminating
 E: Cognitive and Emotional effects of revised beliefs
24
The Therapeutic Process
25
 Designed to help clients gain a more realistic,
rational philosophy of life
 Therapist does not devote much time to examining
the morbid details of the client’s life
 Challenges clients’ irrational beliefs in the first few
sessions
 Intended to be a brief therapy (1-10 sessions)
The Therapeutic Process
26
 Clients with sever disturbances are encouraged to
come to individual and/or group sessions for at least
6 months
 2 techniques:


Tape the entire session. Clients then listen to the recordings
several times so they can ascertain their problems and the
REBT way of handling them
To give REBT Self-Help Form to teach clients how to use the
method when they experience emotional problems between
therapeutic sessions
The Therapeutic Relationship
27
 General REBT: similar to CBT
 Preferential REBT, which stresses a deep philosophical
change in the client’s life and way of relating to people
 3 powerful insights:



Person’s self-defeating behavior usually stems from the interaction of
A and B; such that A+B=C
People have made themselves emotionally disturbed because they
keep indoctrinating themselves with similar irrational beliefs
Clients recognize that only hard work and practice will correct
irrational beliefs. Clients must commit themselves to repeated
challenging of irrational thoughts until they are fully extinguished.
Role of the REBT Therapist
28
 Must understand belief systems and how to
distinguish rational and irrational beliefs.
 Primary role: focus on the main irrational ideas that
lie behind the feelings clients have expressed in
therapy, especially their ideas that is awful the way in
which people have treated them
Role of the REBT Therapist
29
 3 phases:
 Cognitive Phase: therapist presents the cognitive rationale for
REBT to the client. It is devoted to clients writing down their
troublesome thoughts.
 Emotive Phase; clients are instructed that they can learn to
control their emotions by becoming fully aware of the thoughts
that support such emotions and by learning to substitute
alternative thoughts
 Behavioristic Phase: clients are taught to change their
behavior
Role of the Client
30
 Individuals who are out of contact with reality, in a
highly manic state, seriously autistic or brain
injured, and in lower ranges of mental deficiency are
not good candidates for REBT
 More effective clients who have a single major
symptom such as depression.
 Clients are instructed to focus on the present and not
on the past
 Expected to participate actively in the therapeutic
process and to complete assignments.
Counseling Techniques
31
 Uses a variety of therapeutic techniques: didactic
discussion, bibliotherapy, role playing, assertion
training, operant conditioning, activity-oriented
homework assignments
 Changing one’s language


Imprecise language contributes to distorted thinking
Clients learn how to change their “musts” to “preferences”
 Humor: emotional disturbance comes from taking
oneself too seriously
Counseling Techniques
32
 Shame-attacking exercises:

to help clients reduce shame over how they behaved. Such exercises
are designed for increasing client self-acceptance.
 Disputing


Detailed examination sentence by sentence of any irrational belief
that the client states during therapy
Using three forms of disputation:
Cognitive: attempts to persuade the client by asking direct questions;
e.g. “Can u prove it?”; “How do u know”?
 Imaginal: ask client to imagine themselves in the situation about
which they feel uncomfortable
 Behavioral: if clients continue practicing rational emotive imagery,
they can reach the point where they no longer feel upset over negative
events

Counseling Techniques
33
 Emotional Control Card
 Wallet sized and contains four emotionally debilitating
categories: anger, self-criticism, anxiety and depression; a list
of inappropriate feelings, and a parallel list of appropriate
feelings
 The goal is to get clients to become aware of the feelings that
they are using and to encourage them to rationally choose the
emotions they display.
1
GESTALT THERAPY (PERLS)
Contributions of Gestalt Psychology to Gestalt
Therapy
2
 An individual’s behavior is a Gestalt, a whole that is




greater than the sum of its parts.
An individual experiences the world according to the
principles of a figure-ground relationship.
An individual will seek closure of an incomplete
gestalt. An incomplete gestalt draws an individual
attention until it is unified and stabilized
An individual will complete gestalts on the basis of
his or her most prevalent need
A person’s behavior can be most meaningfully
understood only in its immediate context.
Gestalt Counseling
3
 A therapeutic approach in which the therapist
assist the client toward self-integration and toward
learning to utilize his energy in appropriate ways to
grow, develop, and actualize
 Primary focus: here and now
 Major objective: integration of the person/ “getting
it all together”
 Therapist seeks to increase the client’s awareness
 Client must also learn to take responsibility for
themselves
Framework for Gestalt
4
 Individuals are composite wholes made up of




interrelated parts
Individuals are also part of their own environment
and cannot be understood apart from it
People choose how they respond to external and
internal stimuli. They are actors, nor reactors
People have the potential to be fully aware of all
their sensations, thoughts, emotions, and
perceptions
Individuals are capable of making choices because
they are aware
Framework for Gestalt
5
 Individuals have the capacity to govern their own
lives effectively
 People cannot experience the past and the future.
They can only experience themselves in the present
 People are neither basically good nor bad.
Emphasis on the “NOW”
6
 E.g “what are you doing now?”
 Avoids the why or cause questions
 Emphasize the Eigenwelt ( the relation to oneself)
rather than the past.
 “lose your mind and come to your senses”
The Therapeutic Process
7
 Highly verbal and experiential
 Therapy focuses on what is happening in the
moment-to-moment therapeutic process rather than
on what is being discussed (the content).
 Therapist is highly intuitive and can be compared to
an artist
 Clients become aware of what they are doing, how
they are doing it, and what they need to do to bring
about desired change
Here-and-Now Principles
8









Live now; stay in the present.
Live here; be with the present.
Stop imagining; experience reality.
Stop unnecessary thinking.
Expressing rather than manipulating, explaining,
justifying, or judging.
Do not restrict your awareness; give in to your awareness
of unpleasantness.
Accept no “should” or “ought” other than your own.
Take full responsibility for your own actions, feelings,
and thoughts.
Surrender to being who you are right now.
Gestalt Rules for Therapists
9
 1. The principle of Now: always use the present tense
and deal with life in the present rather than in the
past.
 2. The use of I instead of It: helps clients substitute
personal pronouns (take responsibility for feelings)
for impersonal ones.
 3. Focusing on how and what rather than why:
gestalt therapists maintain that when clinicians ask
why questions, they are requesting a
rationale/excuse from clients.
Gestalt Rules for Therapists
10
 4. The conversion of questions to statements: People
sometimes hide behind their questions. Gestalt
clinicians ask clients to change their questions into
statements
 5. Paying attention to client’s language patterns: a
client’s language can both describe and conceal. Eg.
Perhaps, sort of, possibly, I can vs I won’t
 6. Listening to clients metaphors: you learn about
their internal and external struggles. The therapist
translates the meaning of these metaphors into
manifest content so that it can be dealt with in therapy
11
Techniques
12
 1. The Hot Seat
 Designed to bring about greater self-awareness among clients
who are usually in a group setting
 Members are told that anyone who wants to work may sit in a
chair facing the leader
 The person who decides to sit in the chair is told to begin by
stating a specific life problem
 10-30 minutes or until the individual or the leader feel closure
has been reached
13
Techniques
14
 2. Now and How
 NOW refers to a person’s immediate awareness of
experiencing. E.g. “Now I am feeling like a hopeless child, still
clinging to my mother’s apron’s string”.
 HOW refers to a person’s description of the manner in which
certain feelings are experienced. E.g. “What are the sensations
you experience when you feel like a child, clinging to your
mother’s apron’s string?”
Techniques
15
 3. Top dog and Underdog Introjections



Refers to the process by which people take into themselves aspects of
other people, especially their parents.
There may be a split between what they want to do and what they feel
they should do. “should” introjections is known as topdog, it is
equivalent to superego. E.g “if you don’t act like a good girl, then
you’ll be called cheap trash, and nobody will ever respect you.”
Underdog attempts to control top dog by reacting defensively,
apologizing and playing the role of “nobody likes me”. Clients who
operate from the underdog position are usually passive aggressive,
make excuses for behavior, and have countless reasons for delay.
Those who play underdog have great resentment toward those whom
they consider their top dog
Techniques
16
 4. Dreamwork
 ‘messages” that reflect a client’s place at a certain time.
 Clients present dreams and then the therapist directs them to
experience what it is like to be each part of the dream
 The goal is to bring dreams back to life and to relive them as if
they were happening now
 Clients with repetitive dreams are encouraged to understand
that unfinished business is being brought into awareness and
that there is a need to take care of the message the dream
delivered.
Techniques
17
 5. Making the Rounds
 Used primarily in groups; confrontation is at its height
 E.g. ‘I hate everyone in this room”; therapist: “Make that
statement to each person here, and in doing so, express your
feelings about each person.” “Why are you in touch within this
group?”
Techniques
18
 6. Role Reversal
 May be used in group or individual therapy
 Used to help clients understand that their overt behavior may
represent the opposite of their latent impulses
 A client may be asked to role-play a specific feeling or behavior
that seems the opposite of what he or she wants.
Techniques
19
 7. Homework
 Might entail having clients write dialogues between parts of
themselves or between the parts of their bodies.
Techniques
20
 8. Rehearsal
 Clients can gain awareness of how much time they use
preparing to play their social roles or the effort required when
they are trying to be something other than what they are.
 Rehearsal permits practice and modeling of desirable
behaviors, especially in situations that provoke in clients
strong avoidance anxiety
Techniques
21
 9. Exaggeration
 Requires clients to accentuate behavior or gestures of which
they may only be mildly aware
 Exaggeration of body language, including gestures, tone of
voice, posture, and facial expressions, can promote clients’
awareness of incongruences between their verbal messages
and their nonverbal communications.
Techniques
22
 10. Withdrawal
 Individual’s right to withdraw from contact and from therapy.
 It symbolizes the organismic regulation of the person; people
decide for themselves whether they want to be left alone or in
contact with other people
 Helps a participant withdraw psychologically from a group if
that individual indicates he or she wants to do so.
 E.g. “try to relax and imagine that you are going to leave this
group.” What are you experiencing now? Can you try to put
yourself into what you are experiencing now?”
1
REALITY THERAPY
View of Human Nature
2
 Assumes that all behavior come from within
 People choose their behavior, and they choose the
best behavior for their needs at any given time.
View of Human Nature
3
 5 genetic/basic needs that drive us:
 Survival: eating, drinking, sleeping, seeking shelter, avoiding
illness
 Belonging and love: need to love and be loved, to share, and to
cooperate; forming friends and involvement within our
families and other people; it is the primary need in people
 Power: achieving and accomplishing our goals and by being
recognized and respected within our families, at work, and
within the general society
 Freedom: making daily choices in our lives
 Fun: our desire for pleasure and enjoyment
View of Human Nature
4
 Our basic needs provide the general motivation for
everything we do in life
 Our brains continually monitor whether or not our
needs are being met. As a result, people may
experience a gap between their needs and what they
are getting. They choose behavior to close the gap
between their needs and wants
Control: Key Component in RT
5
 “The only person I can really control is myself”
 Trying to control others is a never-ending battle that
alienates one from others and causes pain and
frustration
 RT therapists teach clients to focus on what is in
their control and to respect the right of other people
to seek means to meet their needs
10 Axioms of RT
6
 axiom is a claim that could be seen to be true without





any need for proof
1. The only person whose behavior we can control is our
own.
2. The best a therapist or another person can do is to give
information to a person.
3. All long-lasting psychological disturbances are
relationship problems.
4. A person’s relationship problem is always part of his or
present life.
5. Although the past may affect what we are today, we
can only satisfy our basic needs in the present and plan
to continue satisfying them in the future.
10 Axioms of RT
7
 6. We can only satisfy our needs by satisfying the pictures




in our quality world.
7. All we do is behave.
8. All behavior is total behavior and is made up of four
components: acting, thinking, feeling, and physiology.
9. All total behavior is chosen, but we only have direct
control over the acting and thinking components. We
control our feelings and physiology indirectly through
how we choose to act and think.
10. All total behavior is named by verbs and named by
the most recognizable part.
7 Deadly Habits
8
 Deadly habits:
 Criticizing
 Blaming
 Complaining
 Nagging
 Threatening
 Punishing
 Bribing/rewarding to control
7 Caring Habits
9
 Caring Habits:
 Supporting
 Encouraging
 Listening
 Accepting
 Trusting
 Respecting
 Negotiating differences
The Therapeutic Process
10
 Therapist is directed to establish a friendly personal






counseling relationship
Therapists are involved with clients from the beginning and
create warm, supportive, and challenging relationships
As the therapeutic relationship becomes deeper, the therapist
becomes firmer
Involvement and concern for clients are conveyed throughout
the counseling process.
RT therapist is friendly, warm, and optimistic
The goal is to help clients meet their basic need of belonging
Avoid criticizing clients, accepting their excuses, and giving up
on them
Goals of Therapy
11
 Overarching: To meet their basic needs
 To help clients learn more effective ways of satisfying
all basic needs
 Begin by asking clients what they want and what
brings them to counseling
 Build a satisfying relationship with the client
Role of the Therapist
12
 1. Teacher and Collaborator
 Accept no excuses for irresponsible client behavior
 Does not stay in the past, unless it is related to the present or a
source of strength
 Avoid punishing, criticizing, or arguing with clients
 2. Encourager
 Does not give up on clients when they have failed to implement
their plans
 Convey that there is always hope, no matter how bad things
seem
 Seeks to teach clients how to fulfill their needs
Role of the Therapist
13
 3. Assessment
 Assess clients’ total behaviors
 Do not interpret the clients’ symptoms. Symptoms persist
because they are needed to help a client deal with unsatisfying
relationships or the inability to satisfy basic needs
 4. Focus on the Present rather than the Past
 Therapist only goes back to the past to learn about needs and
how they were satisfied previously
 The goal is to help clients satisfy their needs in the present.
 Reject transference because it allows both the therapist and
client to avoid being who they really are.
Role of the Therapist
14
 5. Importance of Relationship in Client’s Life
 An unsatisfying relationship or the lack of a relationship
causes problems in a client’s life
 Poor relationships are the heart of most unhappiness
 Therapist must guide the client to a satisfying relationship and
teach the client to behave in more effective ways. Clients
discover that their problems are the way they have chosen to
behave.
15
Therapy Techniques (WDEP System, Wubbolding)
16
 W: wants and needs



Seek to help client discover what they want
Assist clients to recognize, define, and redefine their basic needs and
how they would like to meet them
E.g.
Does your behavior help you or hurt you?
 By doing what you are doing, are you getting what you want?
 Are you breaking the rules?
 Are your wants realistic and attainable?
 What would you be doing if you were living the life you would like to
lead?
 Do you really want to change your life?
 What is it that you are not getting from life?
 What stops you from getting what you would like to get out of life?

Therapy Techniques (WDEP System, Wubbolding)
17
 D: Direction and Doing
 Raise clients awareness of their current total behaviors
E.g.
 What are you doing?
 Where are you heading?
 What are your recent success? Recent challenges? What have you
tried so far?
 Hold a mirror before the client and ask: How do you see yourself
now and in the future?


Encourage clients to change what they are doing and thinking
Therapy Techniques (WDEP System, Wubbolding)
18
 E: Evaluation




Therapy is directed towards getting clients to evaluate their behavior
Helping clients engage in an inner evaluation is at the core of RT
Based on the belief that people do not voluntarily change their
behavior until they evaluate that what they are doing is not working
E.g.
Does your current behavior help you get what you want now, and
will take you in the direction that you desire?
 Is what you are doing helping you?
 Is your behavior working for you?
 Is what you are doing in your best interests or in the best interests of
those you care about?
 If nothing outside you changes—such as at work or within your
family---what will you do?

Therapy Techniques (WDEP System, Wubbolding)
19
 P: Planning
 Formulate an action plan that contains possible replacement
behaviors for ineffective ones
 A plan helps clients focus their thoughts and behaviors
 Elements of a good plan: SAMIC (Wubbolding)
Simple
 Attainable
 Measurable
 Immediate
 Controlled by the planner, consistently practiced, and
committed to by the client.

Therapy Techniques (WDEP System, Wubbolding)
20

Some qualities of a good change plan are as follows:
Flexible and open to modification
 Stated positively in terms of what the client is willing to do
(behave)
 Capable of being completed independently without the assistance
of others
 Repetitive and performed daily

21
Person-Centered
Therapy
Learning Objectives
 determine the role of the therapist in the person
centered therapy
 distinguish the therapeutic goals and techniques in
the therapy
Carl Rogers
In my early professional years I was asking
the question: How can I treat, or cure, or
change this person? Now I would phrase the
question in this way: How can I provide a
relationship which this person may use for his
own personal growth?
 The good life is a process, not a state of
being. I t is a direction, not a destination.
Relationship to Existing Theory
Based on concepts of humanistic psychology
brought to the US by Jews fleeing the Nazis
Was developed as non-directive counseling
In reaction to the directiveness of psychoanalytic
theory
Falls into what has been termed the third
force in therapy
An alternative to both psychoanalysis and
behaviorism
Theory Development
 First Period -- 1940s
 Nondirective Counseling
 Developed in reaction to psychoanalytic approach
 Challenged the basic assumption that “counselor knows
best”
 Second Period -- 1950s
 Client-Centered Therapy
 Reflects emphasis on the client rather than on nondirective
methods
 Characterized by shift from clarification of feelings to a
focus on the phenomenological world of the client
 Focused more actualizing as a motivational force
Theory Development
Third Period -- 1950s – 1970s
Openness to experience
Trust in one’s experience
Internal Locus of Evaluation
Willingness to be in process
Encounter Groups, Applied in education as
student-centered
Existentialism & Humanism:
Similarities
 Share a respect for the client’s subjective experience
 Trust in capacity of the client to make positive and
constructive conscious choices
 Emphasize concepts such as freedom, choice,
values, personal responsibility, autonomy, purpose
and meaning
 Parallel concepts with regard to the client-therapist
relationship at the core of therapy
 Both adopt a phenomenological stance
 Call for therapist to enter the subjective world
 Both emphasize client’s capacity for self-awareness
Existentialism & Humanism:
Differences
 Existentialists believe
that, as humans, we are
faced with the anxiety
of choosing to create an
identity in a world that
lacks intrinsic meaning
 Humanists believe
each person has a
natural potential that
we can actualize and
through which we can
find meaning
Major Philosophical Assumptions
Belief that people are resourceful, capable of
self-direction and able to live effectively and
successfully
People will move in positive directions if the way is
clear for them to do so
When people are free to do so, they will find their
own way
Has little faith in the role of experts who
direct others toward self-betterment
Major Philosophical
Assumption, cont…
Humanistic philosophy is compared
to the acorn, which, if provided the
right nurturing conditions will
automatically grow in positive ways,
pushed naturally toward actualization
as an oak tree.
Major Philosophical
Assumption, cont…
Becoming increasingly actualized =
An openness to experience
A trust in oneself
An internal source of evaluation
A willingness to continue growing
Central Constructs & Tenets
Therapist can promote client growth by
demonstrating:
Congruence
Unconditional positive regard
Accurate empathy
Self actualization
These result in people being less defensive,
letting go of rigid perceptions and being more
open to self-actualization
Congruence
Genuineness & Caring
Real without False Front
Considered by Rogers as most important
Trying too hard to be genuine can lead to
incongruence
Therapist does not have to be fully selfactualized in order to be effective:
However, Congruence must be present in
the counseling relationship
Unconditional Positive Regard
Refers to acceptance of the worth of
the person; not acceptance or approval of
all behaviors
Accurate Empathy
Able to grasp the subjective world of
another
Implies that the therapist will sense the
client’s feelings without getting lost in them
(losing own identity)
Easier said than done, learning it sometimes
feels silly (example of mirroring in counselor
training)
Self-Actualization
Looked at the healthy rather than the sick side of
clients and at the value of their moving toward
self-actualization through which they experience
 Tolerance of uncertainty
 Acceptance of self and
others
 Spontaneity and
creativity
 Comfort with solitude
 Autonomy
 Capacity for deep
personal relationships
 Sense of humor
 Genuine caring for
others
 Inner-directedness
 Positive outlook on life
Therapeutic Frame of Reference
Present
Past is important only as it contributes to
current awareness
Therapeutic Goals
To achieve a greater degree of
integration and independence
To focus on the person rather than on the
presenting problem.
No preset goals
Client with the help of a trusted, facilitating
therapist will set own course
View of Pathology
Clients come to therapy in a state of
incongruence (discrepancy between selfperception and their experience in reality) with
resultant anxiety
Feel sense of helplessness and powerlessness
toward making appropriate decisions to direct
their own life
Since the drive toward higher levels of
psychological maturity are deeply rooted,
person-centered therapy can be effective with
normal and maladjusted persons
Therapeutic Objectives
Congruence
Increased trust in self
Increased willingness to explore alternatives
Increased personal resources
Role of the Therapist
To establish a therapeutic climate (i.e.,
congruence, empathy, unconditional positive
regard) that facilitates growth and change.
Clients should be able to:
Feel understood and accepted without judgment
Lower their defenses to self-exploration and feel more
open to experience
Discover hidden aspects of themselves
Become more realistic
Perceive others with greater accuracy
Relationship of Counselor & Client
Quality of relationship determines outcome of counseling
2 people are in psychological contact
Client is in state of incongruence, being vulnerable or anxious
Counselor is congruent or integrated in the relationship
Counselor experiences unconditional positive regard for the
client
 Counselor experiences an empathic understanding of the
client’s internal frame of reference and endeavors to
communicate this experience to the client
 The communication to the client of the counselor’s empathic
understanding and unconditional positive regard is to a
minimal degree achieved





Clients should be able to…
Feel safer and less vulnerable
Accept themselves more as they are
Become truer to themselves and less
affected by others’ expectations
Become more self-directed
Perceive the past as less deterministic
Multicultural Contributions
 Significant contributions to cross-cultural
communication
 Person-centered philosophy and practice is studied
and practiced in many different cultures
 Emphasis on core conditions increases the utility of
approach for understanding diverse worldviews
Multicultural Limitations
Some clients desire more structure
Difficult to translate the core conditions into
actual practice in some cultures
Communication of conditions must be congruent
with client’s cultural framework
Internal Locus of Evaluation
Some cultures value collectivism more than
individualism