Harvard University Gestalt Theory Discussion

User Generated

Naanznl

Humanities

Harvard University

Question Description

I'm working on a psychology discussion question and need an explanation and answer to help me learn.

After reading chapter 8 of the attachment, please answer the following discussion questions 

What possibilities do you see with the Gestalt approach to being “fully human” and an “imperfect role model” with clients? What potential problems might arise with this?

Unformatted Attachment Preview

Theory and Treatment Planning in Counseling and Psychotherapy Second Edition DIANE R. GEHART, Ph.D. California State University, Northridge Australia • Brazil • Mexico • Singapore • United Kingdom • United States Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. This is an electronic version of the print textbook. Due to electronic rights restrictions, some third party content may be suppressed. Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. The publisher reserves the right to remove content from this title at any time if subsequent rights restrictions require it. For valuable information on pricing, previous editions, changes to current editions, and alternate formats, please visit www.cengage.com/highered to search by ISBN#, author, title, or keyword for materials in your areas of interest. Important Notice: Media content referenced within the product description or the product text may not be available in the eBook version. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Theory and Treatment Planning in Counseling and Psychotherapy, Second Edition Diane R. Gehart Product Director: Jon-David Hague Product Manager: Julie Martinez Content Developer: Lori Bradshaw Product Assistant: Nicole Richards Media Developer: Sean Cronin © 2016, 2013 Cengage Learning WCN: 02-200-202 ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form or by any means graphic, electronic, or mechanical, including but not limited to photocopying, recording, scanning, digitizing, taping, Web distribution, information networks, or information storage and retrieval systems, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without the prior written permission of the publisher. Marketing Manager: Jennifer Levanduski Production Management, and Composition: Manoj Kumar, MPS Limited Art Director: Carolyn Deacy, MPS Limited Manufacturing Planner: Judy Inouye IP Analyst: Deanna Ettinger IP Project Manager: Brittani Morgan Text Researcher: Pinky Subi, Lumina Datamatics For product information and technology assistance, contact us at Cengage Learning Customer & Sales Support, 1-800-354-9706. For permission to use material from this text or product, submit all requests online at www.cengage.com/permissions. Further permissions questions can be e-mailed to permissionrequest@cengage.com. Unless otherwise noted, all items © Cengage Learning® Cover Designer: Ellen Pettengell Library of Congress Control Number: 2015931696 Cover Image: Leon Harris/Cultura/Getty Images ISBN: 978-1-305-08961-7 Cengage Learning 20 Channel Center Street Boston, MA 02210 USA Cengage Learning is a leading provider of customized learning solutions with employees residing in nearly 40 different countries and sales in more than 125 countries around the world. Find your local representative at www.cengage.com. Cengage Learning products are represented in Canada by Nelson Education, Ltd. To learn more about Cengage Learning Solutions, visit www.cengage.com. Purchase any of our products at your local college store or at our preferred online store www.cengagebrain.com. Printed in the United States of America Print Number: 01 Print Year: 2015 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Brief Contents Preface xiii Acknowledgements About the Author Introduction SECTION I xvii xix xx Introduction to Theories, Competencies, and Treatment Planning 1 1 Counseling Theory, Competency, Research, and You: Connecting the Dots 3 2 Treatment Planning SECTION II 17 Counseling and Psychotherapy Theories Analytic Theories 31 33 3 Psychoanalytic and Psychodynamic Counseling and Psychotherapy 4 Jungian Analytic Psychology 5 Adlerian Individual Counseling 33 73 95 Humanistic-Existential Counseling 129 6 Person-Centered Counseling and Psychotherapy 7 Existential Counseling and Psychotherapy 8 Gestalt Counseling and Psychotherapy Action-Oriented Approaches 203 9 Foundational Cognitive-Behavioral Approaches 10 Evidence-Based Cognitive-Behavioral Approaches: Dialectic Behavior Therapy and Trauma-Focused Cognitive-Behavioral Therapy 245 11 Systemic Family Counseling and Therapy Postmodern Approaches 335 12 Solution-Based Approaches 13 Narrative and Collaborative Approaches 14 Feminist and Multicultural Counseling and Psychotherapy SECTION III 129 163 181 203 293 335 369 413 Theoretical Integration and Case Conceptualization 433 15 Introduction to Theoretical Integration 16 Integrative Case Conceptualization Name Index Subject Index 435 445 488 492 iii Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Contents Preface xiii Acknowledgements About the Author Introduction SECTION ONE 1 xvii xix xx Introduction to Theories, Competencies, and Treatment Planning 1 Counseling Theory, Competency, Research, and You: Connecting the Dots 3 What Distinguishes a Counselor from a Bartender? 3 Why Theory Matters 3 Connecting with Theory: Do I Have to Choose Just One? Competency in Counseling and Psychotherapy Competency and (Not) You 5 Common Threads of Competency Research and the Evidence Base 4 4 5 8 Common Factors Research: Reframing Theory 9 Show Me Proof: Evidence-Based Treatments and Practice Evidence-Based Practice 14 Research in Perspective 14 13 Rock-Paper-Scissors and Other Strategies for Choosing a Theory To Be Continued … Questions for Personal Reflection and Class Discussion Online Resources 15 References 16 2 Treatment Planning Treatment Planning 15 15 15 17 17 Creative Planning 18 The Brief History of Mental Health Treatment Planning Clinical Treatment Plans 19 Theory-Specific Case Conceptualization 19 Treatment Plan Format 20 Writing Useful Treatment Tasks 22 18 Initial Phase Treatment Tasks 22 Working Phase Treatment Task 23 Closing Phase Treatment Tasks 23 Diversity and Treatment Tasks 23 Client Goals 24 Goal Writing Worksheet 24 The Goal Writing Process 26 Initial Phase Client Goals 27 iv Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Contents Working Phase Client Goals 27 Closing Phase Client Goals 27 Writing Measurable Goals 28 Writing Useful Interventions 28 Do Plans Make a Difference? 29 Questions for Personal Reflection and Class Discussion Online Resource 29 References 30 29 SECTION TWO Counseling and Psychotherapy Theories 3 Psychoanalytic and Psychodynamic Counseling and Psychotherapy 33 Lay of the Land 31 33 Basic Psychodynamic Assumptions Psychodynamic Theory 34 35 In a Nutshell: The Least You Need to Know 35 The Juice: Significant Contributions to the Field 36 Rumor Has It: The People and Their Stories 38 Big Picture: Overview of Counseling Process 40 Making Connection: Counseling Relationship 41 The Viewing: Case Conceptualization 44 Targeting Change: Goal Setting 53 The Doing: Interventions 55 Putting It All Together: Psychodynamic Case Conceptualization and Treatment Plan Templates 57 Theory-Specific Case Conceptualization: Psychodynamic Treatment Plan Template: Psychodynamic 58 57 Research and the Evidence Base 60 Evidence-Based Treatment: Brief Psychodynamic Counseling 61 In a Nutshell: The Least You Need to Know 61 Big Picture: Overview of Counseling Process 61 Making Connection: Counseling Relationship 61 Specific Brief Psychodynamic Approaches 62 Tapestry Weaving: Working with Diverse Populations Cultural and Ethnic Diversity Sexual Identity Diversity 64 Psychodynamic Case Study 66 Case Conceptualization: Psychodynamic Treatment Plan: Psychodynamic 67 66 Questions for Personal Reflection and Class Discussion Online Resources 69 References 70 4 Jungian Analytic Psychology Jungian Analytic Psychology 63 63 69 73 73 In a Nutshell: The Least You Need to Know 73 The Juice: Significant Contributions to the Field 73 Rumor Has It: The People and Their Stories 75 Big Picture: Overview of Counseling Process 75 Making Connection: Counseling Relationship 76 The Viewing: Case Conceptualization 76 Targeting Change: Goal Setting 78 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. v vi Contents The Doing: Interventions 78 Interventions for Special Populations 81 Putting It All Together: Jungian Case Conceptualization and Treatment Plan Templates 83 Theory-Specific Case Conceptualization: Jungian Analysis Treatment Plan Template: Jungian Analysis 84 83 Research and the Evidence Base 85 Tapestry Weaving: Applications with Diverse Populations Cultural Diversity 86 Sexual Identity Diversity Jungian Case Study 86 87 88 Case Conceptualization: Jungian 89 Treatment Plan: Jungian 90 Questions for Personal Reflection and Class Discussion Online Resources 92 References 93 5 Adlerian Individual Counseling Lay of the Land 92 95 95 In a Nutshell: The Least You Need to Know 96 The Juice: Significant Contributions to the Field 96 Rumor Has It: The People and Their Stories 98 Big Picture: Overview of Counseling Process 99 Making Connection: Counseling Relationship 100 The Viewing: Case Conceptualization 101 Targeting Change: Goal Setting 107 The Doing: Interventions 109 Interventions for Special Populations 113 Putting It All Together: Adlerian Case Conceptualization and Treatment Plan Templates 114 Theory-Specific Case Conceptualization: Adlerian Treatment Plan Template: Adlerian 115 114 Tapestry Weaving: Working with Diverse Populations 117 Ethnic and Racial Diversity 117 Sexual Identity Diversity 120 Research and the Evidence Base 121 Evidence-Based Treatment: Systematic Training for Effective Parenting (STEP) 121 Adlerian Case Study 122 Case Conceptualization: Adlerian 122 Treatment Plan: Adlerian 124 Questions for Personal Reflection and Class Discussion Online Resources 126 References 127 6 126 Person-Centered Counseling and Psychotherapy Lay of the Land 129 129 Philosophical Foundations 130 Commonalities Across Humanistic-Existential Theories Person-Centered Counseling 131 133 In a Nutshell: The Least You Need to Know 133 The Juice: Significant Contributions to the Field 134 Rumor Has It: The People and Their Stories 138 Big Picture: Overview of Counseling Process 139 Making Connection: Therapeutic Relationship 140 The Viewing: Case Conceptualization 140 Targeting Change: Goal Setting 144 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Contents The Doing: Interventions 145 Interventions for Special Populations vii 151 Putting It All Together: Person-Centered Case Conceptualization and Treatment Plan Templates 152 Theory-Specific Case Conceptualization: Person-Centered Treatment Plan Template: Person-Centered 152 152 Tapestry Weaving: Working with Diverse Populations 154 Cultural, Ethnic, and Gender Diversity Sexual Identity Diversity 156 154 Research and the Evidence Base 156 Person-Centered Case Study 157 Case Conceptualization: Person-Centered Treatment Plan: Person-Centered 159 157 Questions for Personal Reflection and Class Discussion Online Resources 161 References 161 7 Existential Counseling and Psychotherapy Lay of the Land 160 163 163 In a Nutshell: The Least You Need to Know 163 The Juice: Significant Contributions to the Field 164 Rumor Has It: The People and Their Stories 165 Big Picture: Overview of Counseling Process 166 Making Connection: Counseling Relationship 166 The Viewing: Case Conceptualization 167 Targeting Change: Goal Setting 170 The Doing: Interventions 170 Putting It All Together: Existential Case Conceptualization and Treatment Plan Templates 172 Theory-Specific Case Conceptualization: Existential Treatment Plan Template: Existential 172 172 Research and the Evidence Base 174 Tapestry Weaving: Working with Diverse Populations 175 Cultural and Ethnic Diversity 175 Sexual Identity Diversity 175 Existential Case Study 176 Case Conceptualization: Existential Treatment Plan: Existential 177 176 Questions for Personal Reflection and Class Discussion Online Resources 179 References 180 8 Gestalt Counseling and Psychotherapy Lay of the Land 179 181 181 In a Nutshell: The Least You Need to Know 181 The Juice: Significant Contributions to the Field 182 Rumor Has It: The People and Their Stories 183 Big Picture: Overview of Counseling Process 184 Making Connection: Therapeutic Relationship 184 The Viewing: Case Conceptualization 185 Targeting Change: Goal Setting 188 The Doing: Interventions 189 Putting It All Together: Gestalt Case Conceptualization and Treatment Plan Templates 191 Theory-Specific Case Conceptualization: Gestalt Treatment Plan Template: Gestalt 192 Research and the Evidence Base 191 194 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. viii Contents Tapestry Weaving: Working with Diverse Populations 194 Cultural and Ethnic Diversity 194 Sexual Identity Diversity 196 Gestalt Case Study 198 Case Conceptualization: Gestalt Treatment Plan: Gestalt 199 198 Questions for Personal Reflection and Class Discussion Online Resources 201 References 202 9 200 Foundational Cognitive-Behavioral Approaches Lay of the Land 203 Cognitive-Behavioral Approaches 203 204 In a Nutshell: The Least You Need to Know 204 The Juice: Significant Contributions to the Field 205 Rumor Has It: The People and Their Stories 207 Big Picture: Overview of Counseling Process 208 Making Connection: Counseling Relationship 208 The Viewing: Case Conceptualization 209 Targeting Change: Goal Setting 214 The Doing: Interventions 214 Putting It All Together: Cognitive-Behavioral Case Conceptualization and Treatment Plan Templates 224 Theory-Specific Case Conceptualization: Cognitive-Behavioral Treatment Plan Template: Cognitive-Behavioral 225 Reality Theory 224 226 In a Nutshell: The Least You Need to Know Choice Theory 227 Reality Theory Behavioral Analysis 227 Mindfulness-Based Approaches 226 228 In a Nutshell: The Least You Need to Know 228 A Brief History of Mindfulness in Mental Health 228 Mindfulness Basics 229 Specific Mindfulness Approaches 230 Tapestry Weaving: Working with Diverse Populations Ethnic, Racial, and Cultural Diversity Sexual Identity Diversity 234 232 232 Research and the Evidence Base 235 Cognitive-Behavioral Case Study 236 Case Conceptualization: Cognitive-Behavioral Treatment Plan: Cognitive-Behavioral 238 237 Questions for Personal Reflection and Class Discussion Online Resources 240 References 241 10 240 Evidence-Based Cognitive-Behavioral Approaches: Dialectic Behavior Therapy and Trauma-Focused Cognitive-Behavioral Therapy 245 Lay of the Land 245 Dialectical Behavior Therapy 246 In a Nutshell: The Least You Need to Know 246 The Juice: Significant Contributions to the Field 246 Big Picture: Overview of Counseling Process 248 Making Connection: Counseling Relationship 249 The Viewing: Case Conceptualization 251 Targeting Change: Goal Setting 254 The Doing: Interventions 255 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Contents ix Putting It All Together: Cognitive-Behavioral Case Conceptualization and Treatment Plan Templates 262 Theory-Specific Case Conceptualization: Dialectical Behavior Therapy Treatment Plan Template: Dialectical Behavior Therapy 263 Trauma-Focused Cognitive Behavioral Therapy 262 265 In a Nutshell: The Least You Need to Know 265 The Juice: Significant Contributions to the Field 266 Rumor Has It: The People and Their Stories 266 Big Picture: Overview of Counseling Process 267 Making Connection: Counseling Relationship 268 The Viewing: Case Conceptualization 269 Targeting Change: Goal Setting 273 The Doing: Interventions 273 Putting It All Together: TF-CBT Case Conceptualization and Treatment Plan Templates 280 Theory-Specific Case Conceptualization: Trauma-Focused CBT 280 Treatment Plan Template: Trauma-Focused CBT 281 Research and the Evidence Base 283 Tapestry Weaving: Working with Diverse Clients Cultural Diversity 283 Sexual Identity Diversity DBT Case Study 283 286 286 Case Conceptualization: DBT 287 Treatment Plan: DBT 288 Questions for Personal Reflection and Class Discussion Online Resources 291 References 291 11 Systemic Family Counseling and Therapy Lay of the Land 290 293 293 Systems 101: Philosophical Foundations 295 In a Nutshell: The Least You Need to Know 298 The Juice: Significant Contributions to the Field 298 Rumor Has It: The People and Their Stories 300 Big Picture: Overview of Treatment 302 Making Connection: Counseling Relationship 303 The Viewing: Case Conceptualization and Assessment 306 Targeting Change: Goal Setting 311 The Doing: Interventions 313 Interventions for Specific Problems 318 Putting It All Together: Systemic Treatment Plan Case Conceptualization and Treatment Plan Templates 319 Theory-Specific Case Conceptualization: Systemic Treatment Plan Template: Systemic 320 319 Snapshot: Bowen’s Intergenerational Family Approach 321 Snapshot: Satir’s Human Growth Model 322 Research and the Evidence Base 323 Evidence-Based Therapy: Emotionally Focused Therapy 323 In a Nutshell: The Least You Need to Know Attachment and Adult Love 324 EFT Tasks and Stages 324 323 Tapestry Weaving: Diversity Considerations 325 Ethnic, Racial, and Cultural Diversity Sexual Identity Diversity 326 Systemic Case Study 325 328 Case Conceptualization: Systemic Treatment Plan: Systemic 330 328 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. x Contents Questions for Personal Reflection and Class Discussion Online Resources 332 References 333 12 Solution-Based Approaches Lay of the Land 335 Solution-Based Counseling 331 335 336 In a Nutshell: The Least You Need to Know 336 The Juice: Significant Contributions to the Field 337 Rumor Has It: The People and Their Stories 339 Big Picture: Overview of Counseling Process 340 Making Connection: Counseling Relationship 341 The Viewing: Case Conceptualization 342 Targeting Change: Goal Setting 348 The Doing: Interventions 349 Interventions for Specific Problems 352 Putting It All Together: Solution-Based Treatment Plan Case Conceptualization and Treatment Plan Templates 354 Theory-Specific Case Conceptualization: Solution-Based Treatment Plan Template: Solution-Based 354 354 Solution-Focused School Counseling 356 Tapestry Weaving: Working with Diverse Populations Ethnic, Racial, and Cultural Diversity Sexual Identity Diversity 361 359 359 Research and the Evidence Base 361 Solution-Focused Case Study 362 Case Conceptualization: Solution-Focused Treatment Plan: Solution-Focused 363 362 Questions for Personal Reflection and Class Discussion Online Resources 365 References 366 13 Narrative and Collaborative Approaches 365 369 Lay of the Land 369 Narrative Approaches 370 In a Nutshell: The Least You Need to Know 370 The Juice: Significant Contributions to the Field 370 Rumor Has It: The People and Their Stories 371 Big Picture: Overview of Counseling Process 371 Making Connection: Counseling Relationship 372 The Viewing: Case Conceptualization 373 Targeting Change: Goal Setting 374 The Doing: Interventions 375 Putting It All Together: Narrative Treatment Plan Case Conceptualization and Treatment Plan Templates 383 Theory-Specific Case Conceptualization: Narrative Treatment Plan Template: Narrative 383 383 Collaborative Language Systems and Reflecting Teams 385 In a Nutshell: The Least You Need to Know 385 The Juice: Significant Contributions to the Field 386 Rumor Has It: The People and Their Stories 387 Big Picture: Overview of Counseling Process 388 Making Connection: Counseling Relationship 388 The Viewing: Case Conceptualization 391 Targeting Change: Goal Setting 392 The Doing: Interventions and Ways of Promoting Change 393 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Contents Putting It All Together: Collaborative Treatment Plan Case Conceptualization and Treatment Plan Templates 399 Theory-Specific Case Conceptualization: Collaborative Treatment Plan Template: Collaborative 399 399 Research and the Evidence Base 401 Tapestry Weaving: Working with Diverse Populations 403 Cultural and Ethnic Diversity 403 Sexual Identity Diversity 404 Postmodern Case Study 406 Case Conceptualization: Postmodern Treatment Plan: Postmodern 407 406 Questions for Personal Reflection and Class Discussion Online Resources 409 References 410 14 409 Feminist and Multicultural Counseling and Psychotherapy 413 Lay of the Land 413 Feminist Counseling 414 In a Nutshell: The Least You Need to Know 414 The Juice: Significant Contributions to the Field 414 Rumor Has It: The People and Their Stories 415 Big Picture: Overview of Counseling Process 415 Making Connection: Counseling Relationship 416 The Viewing: Case Conceptualization 417 Targeting Change: Goal Setting 420 The Doing: Interventions 421 Putting It All Together: Feminist Treatment Plan Case Conceptualization and Treatment Plan Templates 423 Theory-Specific Case Conceptualization: Feminist Treatment Plan Template: Feminist 423 423 Research and the Evidence Base 425 Tapestry Weaving: Working with Diverse Populations 426 Cultural and Ethnic Diversity 426 Sexual Identity Diversity 427 Feminist Case Study 427 Case Conceptualization: Feminist Treatment Plan: Feminist 429 428 Questions for Personal Reflection and Class Discussion Online Resources 431 References 431 SECTION THREE Theoretical Integration and Case Conceptualization 433 15 Introduction to Theoretical Integration And Now for the Exciting Conclusion Integration Options 436 431 435 435 Common Factors Approach 436 Theoretical Integration 436 Assimilative Integration 436 Technical Eclecticism 436 Systematic Treatment Selection 437 Syncretism and Sloppy Thinking 437 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xi xii Contents Integration with Integrity 438 Modernism 439 Phenomenology: Humanistic-Existential Systemic 440 Postmodern 441 439 Wrapping Up Integration 443 Questions for Personal Reflection and Class Discussion Online Resources 443 References 443 16 Integrative Case Conceptualization 445 Case Conceptualization and Great Counseling Realistic Expectations 443 445 445 Elements of Case Conceptualization 446 Introduction to Client 447 Presenting Concern 448 Background Information 449 Assessment of Strengths and Diversity 450 Client Strengths 450 Theoretical Conceptualizations 454 Psychodynamic and Adlerian Conceptualization 454 Psychodynamic Defense Mechanisms 455 Object Relations and Attachment Patterns 458 Erickson’s Psychosocial Developmental Stages 458 Basic Mistake Perceptions 462 Humanistic-Existential Conceptualization 462 Expression of Authentic Self 462 Existential Analysis 465 Gestalt Contact Boundary Disturbances 466 Cognitive-Behavioral Conceptualization 467 Baseline Assessment 467 A-B-C Analysis of Irrational Beliefs Beck’s Schema Analysis 469 468 Family Systemic Conceptualization 470 Stage of Family Life Cycle Development 471 Interpersonal Boundaries 471 Triangles/Coalitions: Problem Subsystems and Triangles Hierarchy Between Child and Parents 473 Complementary Patterns 473 Intergenerational Patterns 474 Postmodern-Feminist Conceptualization 474 Solutions and Unique Outcomes 474 Narrative, Dominant Discourses, and Diversity 476 Case Conceptualization, Diversity, and Sameness 477 This End Is Just the Beginning 478 Questions for Personal Reflection and Class Discussion Online Resource 479 References 479 Case Conceptualization Form 480 Name Index Subject Index 473 478 488 492 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Preface Purpose of This Book The second edition of Theory and Treatment Planning in Counseling and Psychotherapy is designed to be an efficient and highly effective means of introducing contemporary counseling theories. The text enables readers to skillfully apply theory in real-world settings by introducing theory-specific approaches to case conceptualization and treatment planning. Furthermore, readers learn about the evidence base for each theory as well as unique applications for specific culturally and sexually diverse populations. Unlike a typical textbook, this book is also intended to be used as a clinical reference manual to assist mental health professionals in their practice settings for years to come as a helpful aid for conceptualizing treatment with a wide range of clients, writing treatment plans, and preparing for licensing exams. Overview of the Text Using state-of-the-art pedagogical methods, the second edition of Theory and Treatment Planning in Counseling and Psychotherapy is part of a new-generation textbook specifically designed to thoughtfully promote student mastery of the material while enabling faculty to easily measure student learning outcomes, a task now required by all regional and professional accrediting bodies. Using a learning- centered, outcome-based pedagogy, the text engages students in an active learning process rather than deliver content in a traditional narrative style. More specifically, the text introduces counseling and psychotherapy theories using two clinically relevant assignments: a) theory-informed case conceptualization and b) theory-specific treatment planning. These assignments empower students to apply theoretical concepts and develop real-world skills as early as possible in their training, resulting in greater and quicker mastery of the material. Furthermore, the author uses a friendly and fun style to explain concepts in clear and practical language that contemporary students appreciate. Instructors will enjoy the simplicity of having the text and assignments work together seamlessly, thus requiring less time in class preparation and grading. The extensive set of instructor materials—which include syllabi templates, detailed PowerPoints, test banks, online lectures, and scoring rubrics designed for accreditation assessment—further reduce educators’ workloads. In summary, the book employs the most efficient and effective pedagogical methods available to teach counseling and psychotherapy theories, resulting in a win-win for instructors and students alike. What’s New in the Second Edition Instructors and students familiar with the first edition will notice a similar style and format and will also appreciate numerous enhancements: ● Significantly Expanded and More Practical Diversity Sections: The diversity sections in each theory chapter have been significantly expanded to include practical xiii Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xiv Preface ● ● ● ● ● ● applications of the theory with specific diverse populations. Each chapter contains a discussion of both a) ethnic/racial diversity as well as b) sexual identity diversity. Expanded sections on specific populations provide students with detailed suggestions, adaptations, and cautions for using a given theory with a specific population, including African Americans, Hispanic/Latinos, Asian Americans, Native Americans/ First Nation/Aboriginals, gay men, lesbians, and gay and transgendered youth. New Chapter on Trauma-Related Evidence-Based Treatments: The second edition includes a new chapter on evidence-based cognitive-behavioral treatments: dialectic behavioral therapy (DBT) and trauma-focused CBT for children. Both approaches are used extensively with clients who have experienced childhood and complex trauma. Theory-Specific Case Conceptualization Templates: Each theory chapter now includes a theory-specific case conceptualization outline that students and therapists can use to develop case conceptualizations using a single theory. This conceptualization can be used to create a theory-specific treatment plan. Each chapter has a sample theory-specific case conceptualization as part of the case study. Revised Case Conceptualization and Treatment Plan Forms: The cross-theoretical case conceptualization and treatment plan forms have been revised to be more succinct and easier to use. Digital forms are available for free download. Jungian Chapter: Jungian analysis is now covered in a separate chapter with a case study. Practice Exercises: Throughout the text, “try it yourself” exercises are provided to allow the reader to practice using assessment and intervention techniques. Questions for Reflection and Class Discussion: This is a new section added to each chapter to promote personal reflection and class discussion and to engage material more thoughtfully. Appropriate Courses A versatile book that serves as a reference across the curriculum, this text is specifically designed for use as a primary or secondary textbook in the following courses: ● ● ● Introductory or advanced counseling and psychotherapy theories courses Pre-practicum skills classes Practicum or fieldwork classes Assessing Student Learning and Competence The learning assignments in the text are designed to simplify the process of measuring student learning for regional and national accreditation. The case conceptualization and treatment plans in the book come with scoring rubrics, which are available on the student and instructor websites for the book at www.cengage.com; select materials are also available on www.masteringcompetencies.com. Scoring rubrics are available for all major mental health disciplines using the following sets of competencies: ● ● ● ● Counseling: Council on the Accreditation of Counseling and Related Educational Programs (CACREP) standards for each of the six areas of specialization Marriage and Family Therapy: MFT core competencies Psychology: Psychology competency benchmarks Social work: Council for Social Work Education (CSWE) accreditation standards Each scoring rubric is linked to competencies identified in these disciplinary standards, and discipline-specific sample syllabi on the website include lists of the competencies covered on the treatment plan and case conceptualization assignments. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Preface xv Organization This book is organized into three parts: ● ● ● Part I: Introduction to Counseling Theories and Treatment Planning provides an introduction to counseling, competencies, research, and treatment planning. Part II: Counseling Theories covers the major schools of counseling and psychotherapy theory. ○ Analytic Theories ● Psychoanalytic and Psychodynamic Theories ● Jungian Analysis ● Adler’s Individual Psychology ○ Humanistic-Existential Theories ● Person-Centered ● Existential ● Gestalt ○ Action-Oriented Theories ● Behavioral and Cognitive-Behavioral ● Dialectic Behavioral Therapy ● Trauma-Focused CBT ● Family Systems ○ Postmodern Theories ● Solution-Focused ● Narrative ● Collaborative ● Feminist Part III: Integration and Case Conceptualization describes current trends toward integration and includes a comprehensive integrative case conceptualization approach to help solidify student understanding of theories. The theory chapters in Part II are organized in a user-friendly way to maximize students’ ability to use the book when developing case conceptualizations, writing treatment plans, and designing interventions with clients. The theory chapters follow this outline consistently throughout the book: ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● In a Nutshell: The Least You Need to Know The Juice: Significant Contributions to the Field: If there is one thing to remember from this chapter it should be… Rumor Has It: The People and Their Stories Big Picture: Overview of Counseling Process Making Connection: Counseling Relationship The Viewing: Case Conceptualization Targeting Change: Goal Setting The Doing: Interventions Case Conceptualization and Treatment Plan Templates Tapestry Weaving: Working with Diverse Clients ○ Cultural Diversity ○ Sexual Identity Diversity Try It Yourself: Exercises to practice skills in the text Questions for Personal Reflection and Class Discussion Case Example: Vignette with ○ Theory-specific Case Conceptualization ○ Theory-specific Treatment Plan Online Resources References Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xvi Preface Accompanying This Text Online Instructor’s Manual The instructor’s manual contains a variety of resources to aid instructors in preparing and presenting text material in a manner that meets their personal preferences and course needs. It includes sample syllabi, assignment templates, and scoring rubrics correlated with national accreditation bodies. Online Test Bank For assessment support, the test bank includes multiple-choice questions for each chapter with references to the text. Online PowerPoint® Slides These vibrant lecture slides for each chapter assist you with your lecture by providing concept coverage using content directly from your textbook. CourseMate Available with the text, Cengage Learning’s CourseMate brings course concepts to life with interactive learning, study, and exam preparation tools that support the printed textbook. CourseMate includes an integrated eBook, glossaries, flashcards, quizzes, videos, downloadable forms, assignment templates, scoring rubrics, and more. CourseMate also includes Engagement Tracker—a first-of-its-kind tool that monitors student engagement in the course. Helping Professions Learning Center Designed to help you bridge the gap between coursework and practice, the Helping Professions Learning Center offers a centralized online resource that allows you to build your skills and gain even more confidence and familiarity with the principles that govern the life of the helping professional. The interactive site includes video activities organized by curriculum area accompanied by critical thinking questions; case studies built around ethics, diversity, and theory; flashcards and practice quizzes; a professional development center; and a research and writing center. Select resources are also available at www.masteringcompetencies.com. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Acknowledgements I would like to thank the following content experts who gave their time and energy to ensure that the information in this textbook was accurate and current: Rie Rogers Mitchell: Jungian sand play, psychodynamic theories Luis Rubalcava: psychodynamic theories Stan Charnofsky: humanistic, person-centered, Gestalt, existential Wendel Ray and his doctoral students, Todd Gunter and Allison Lux: systemic theories Marion Lindblad-Goldberg: systemic theories Scott Woolley: emotionally focused therapy Bill O’Hanlon: solution-based therapies Harlene Anderson: collaborative therapy Gerald Monk: narrative therapy Ron Chenail: Competencies Assessment System Thorana Nelson: Competencies Assessment System William Northey: Competencies Assessment System Jeremy Dastic: Case studies for Jungian and DBT chapters Instructor and student materials second edition: Diana Pantaleo Rena Jacobs Kayla Caceres I would also like to thank the following people for their assistance on the second edition: Kayla Caceres: Research assistant for the second edition Eric Garcia: Librarian extraordinaire Julie Martinez, Product Manager: My amazing and inspiring editor Lori Bradshaw (from S4Carlisle), Content Developer: Editorial guidance and overseeing development of the instructor materials Jean Smith: Permissions assistance Anna and Guenther Gehart: For the extra hours taking care of Michael and Alex Joseph McNicholas: For watching kids when I needed to write and for being my best friend Michael McNicholas: For making each day a new adventure, for the best hugs ever, and for decorating my office with your art Alexander McNicholas: For melting my heart each day with your “crazy cute” baby ways Finally, I would like to thank the following reviewers and survey respondents who provided invaluable feedback on making this book work for faculty: xvii Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xviii Acknowledgements Reviewers: Gregg Allinson, Beaufort County Community College Samantha Anders, University of Minnesota Kathleen Arveson, Regent University Nancy Baily, University of West Alabama Jayne Barnes, Nashua Community College Eric Burns, Campbellsville University Tamara Clingerman, Syracuse University Paul DeSena, Loyola Marymount University Annmarie Early, Eastner Mennonite University Bengu Erguner-Tekinalp, Drake University, Des Moines Yvonne Garza, Sam Houston State University Helene Halvorson, East Tennessee State University Glenda Hufnagel, University of Oklahoma, Norman Donna Huger, South Carolina State University Nithya Karuppaswamy, University of Illinois, Springfield Mary Livingston, Louisiana Technical University Krista Medina, University of Cincinnati Paula Nelson, Saint Leo University Jenny Savage, Jacksonville State University Cheryl Warner, Clemson University Kelly Wester, University of North Carolina, Greensboro Stephanie Hall, Monmouth University Lia Wilson, Hope International University Teressa Wilcox, Hope International University Tim Vandergast, William Paterson University Forrest Kelly, West Texas A&M University Survey Respondents: Ernestine C. Brittingham, Delaware State University Charmaine D. Caldwell, Valdosta State University Mathilda Catarina, William Paterson University Dibya Choudhuri, Eastern Michigan University Nancy DeCesare, Chestnut Hill College Faith Drew, Pfeiffer University Kevin R. Galey, Dallas Baptist University Amy Ginsberg, Long Island University Nicholas Greco, Adler School of Professional Psychology Kathleen Hathaway, Clover Park Technical College James M. Hepburn, Waynesburg University Mary Kay Houston-Vega, University of Texas at San Antonio Stuart G. Itzkowitz, Wayne State University Kelly James, Brigham Young University Randi Kim, Rhode Island College Cynthia N. Lepley, Thomas College David Lutz, Missouri State University Don Lynch, Unity College Jeanie McCarville Kerber, Des Moines Area Community College Polly McMahon, Spokane Falls Community College Richard McWhorter, Prairie View A&M University C. Michael Nina, William Paterson University Gwen Newsom, North Carolina Central University Kate Pandolpho, Kean University Lois Pasapane, Palm Beach State College Kim-Anne Perkins, University of Maine at Presque Isle David Rentler, Northwestern Connecticut Community College Barbara Roland, Grayson County College Allen R. Stata, Judson College Jenny Warren, Liberty University Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. About the Author DR. DIANE R. GEHART is a professor in the Marriage and Family Therapy and Counseling Programs at California State University, Northridge. Having practiced, taught, and supervised for over 20 years, she has authored/edited the following: ● ● Photo by Jones Photo Art ● ● ● ● ● ● Mastering Competencies in Family Therapy Theory and Treatment Planning in Family Therapy Case Documentation in Counseling and Psychotherapy (forthcoming) Mindfulness and Acceptance in Couple and Family Therapy Collaborative Therapy: Relationships and Conversations That Make a Difference (coedited with Harlene Anderson) The Complete MFT Core Competency Assessment System The Complete Counseling Assessment System Theory-Based Treatment Planning for Marriage and Family Therapists (coauthored) She has also written on postmodern therapies, mindfulness, mental health recovery, sexual abuse treatment, gender issues, children and adolescents, client advocacy, qualitative research, and counselor and marriage and family therapy education. She speaks internationally, having given workshops to professional and general audiences in the United States, Canada, Europe, and Mexico. Her work has been featured in newspapers, radio shows, and television worldwide, including the BBC, National Public Radio, Oprah Winfrey’s O magazine, and Ladies’ Home Journal. She is an associate faculty member at three international postgraduate training institutes: the Houston Galveston Institute, the Taos Institute, and the Marburg Institute for Collaborative Studies in Germany. Additionally, she is an active leader in state and national professional organizations. She maintains a private practice in Agoura Hills, California, specializing in couples, families, women’s issues, trauma, life transitions, and difficult-to-treat cases. For fun, she enjoys spending time with her family, hiking, swimming, yoga, meditating, and savoring all forms of dark chocolate. You can learn more about her work at www.dianegehart.com. Author’s Introduction Bridge Across the Grand Canyon Known for making its visitors audibly gasp in awe, the Grand Canyon is so wide at points that it is hard to see the other side. Having inspired reverence for generations, this great natural wonder provides many with a palpable experience of the divine. However, these qualities are not what I believe students over the years were referring to when they told me that the gap between their university coursework and fieldwork experiences was like the Grand Canyon. In marked contrast, my students were referring to the canyon’s gaping and seemingly impassable chasms that appear impossible to traverse, at least not without hiring a personal jet, helicopter, or the starship Enterprise. Clearly, my students were feeling as though they were not able to connect their classroom experiences to their internships with the tools they had been given. Thus, I wrote this book to create a bridge across the Grand Canyon of Counseling—or at least a zip line—to help new counselors and therapists gracefully traverse two worlds that have been far too distant for too long: the worlds of academic theory and real-world practice. You might be thinking, “That is a bold claim. How is she going to achieve this lofty goal?” As often happens in life, the answer lies in the question. In this case, the key is the term goal. As you learn about counseling and psychotherapy theories in this book, you are also going to learn how these theories are used to generate meaningful clinical goals to help clients and their counselors skillfully address the concerns brought to counseling. Thus, you will be introduced to counseling theories from the perspective of a practitioner more so than an academic. You will get less history and more information about how these ideas inform action in the counseling room. Furthermore, you will be given two vehicles for translating theory into practice: case conceptualizations and treatment plans. These tools are what counselors in the field use to help them do their job—and the versions in this book are specifically designed to integrate theoretical knowledge. Enjoy the adventure! Diane R. Gehart, Ph.D., Westlake Village, California xix Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Introduction Start Here: Introduction and Instructions for Using This Book Similar to most people reading this book, I was one of those students in school who always worked hard and went the extra mile. Perhaps I was simply a nerd (ironically, the last four digits of my family’s childhood phone number was 4335, or G-E-E-K). Perhaps it was my immigrant father’s constant reminder that without a good education one becomes a “ditch digger” or worse. Regardless of the reasons, I have always loved the whole school experience far more than playing soccer or watching television (confession: being bad at sports may have also played a role). This love of education may have started with those kindergarten activity books. Few things are more exciting than filling out these workbooks—pictures, colors, dots, lines, puzzles, and mazes—much more engaging than dull, dry, black-and-white textbooks (present text excluded, I hope). In graduate school, this overdo-it tendency took another form: never leaving the library. When it came time to write the doctoral dissertation, which some consider the crowning academic assignment in Western civilization, it only seemed natural that one had to write an exhaustive literature review. It took me two years to write that review. Toward the end, my professor offhandedly mentioned that the review did not have to include every last study related to my topic. After a wave of now-you-tell-me thoughts washed over me, I returned to my personal brand of in-“sanity” (i.e., overdo-it logic) and said, “But I want to,” and just kept searching for everything ever written on the subject (please note: my dissertation was written at a time in history when this was possible—the library had a “card catalogue” and only the earliest forms of digital databases). Given this extreme tendency, it is astounding to look back and realize—and now confess to you—that I never once read the introduction to any of the hundreds of books I “read” in graduate school. Professors never listed them as required reading, the publisher never cared enough to give a formal chapter or real page number, and they were short, seemingly too short to possibly be of value. Now, sitting here writing to you, I realize that it was foolhardy to skip the introduction. In most cases, authors reveal the most important information, summarize the really big idea behind the book, and tell you how to read and learn from it. In short: it’s where the most important information is (I guess that’s why it goes first). Thus, although anyone reading this book is likely to lean toward the industrious end of the spectrum (but not necessarily a geek and failed athlete like me), I am concerned that they may miss reading the information in the introduction, as I had for decades. So, to avoid that error—easily made by even the most devout learners—the introduction has been labeled “start here” in hopes you read those quick-start guides for your electrical gadgets. I hope that you will find that it greatly enhances your ability to get the most out of this book. Also, you may want to take a glace at introductions for your future reads. xx Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Introduction xxi How This Book Is Different and What It Means to You Theory and Treatment Planning in Counseling and Psychotherapy is a different kind of textbook. Based on a new pedagogical model, learning-centered teaching (Killen, 2004; Weimer, 2002), this book is designed to help you actively learn the content rather than my simply delivering the content and hoping that you’ll memorize it. Thus, learning activities are woven into the text so that you have opportunities to apply and use the information in ways that facilitate learning (not unlike my son’s elementary school activity books). The specific learning activities in this book are (a) case conceptualization and (b) treatment plans that translate the theory learned in each chapter to client situations. This book teaches real-world skills that you can immediately use to serve your clients better. Also, this book is different in another way: it is organized by key concepts rather than general headings with long narratives sections. This organization—which evolved from my personal study notes for my graduate school and licensing exams back— facilitates the retention of vocabulary and terms because of the visual layout. Each year, I receive numerous emails from enthusiastic, newly licensed counselors and therapists thanking me for helping them pass their licensing exams—they all say that the organization of the book made the difference. So, spending some time with this text should better prepare you for the big exams in your future (and if you have already passed these, you should be all the more impressed with yourself for doing it the hard way). Lay of the Land This book is organized into three parts: Part I: Introduction to Counseling Theories and Treatment Planning provides an introduction to counseling, competencies, research, and treatment planning. Part II: Counseling Theories covers the major schools of counseling and psychotherapy theory. ● ● ● ● Analytic theories Humanistic-existential theories Action-oriented theories Postmodern theories Part III: Integration and Case Conceptualization describes current trends toward integration and includes a comprehensive integrative case conceptualization approach to help solidify your understanding of theories. Anatomy of a Theory The theory chapters in Part II are organized in a user-friendly way to maximize your ability to use this book to support you when developing case conceptualizations, writing treatment plans, and designing interventions with clients. The anatomy of each of the theory chapters in Part II (Chapters 3–14) follows this outline: Anatomy of a Theory In a Nutshell: The Least You Need to Know The Juice: Significant Contributions to the Field Rumor Has It: The People and Their Stories Big Picture: Overview of Counseling Process Making Connection: Counseling Relationship (continued) Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xxii Introduction The Viewing: Case Conceptualization Targeting Change: Goal Setting The Doing: Interventions Putting It All Together: Case Conceptualization and Treatment Plan Template Snapshot: Research and the Evidence Base Snapshot: Working with Diverse Populations Online Resources References Case Example: Vignette with Case Conceptualization and Treatment Plan In a Nutshell: The Least You Need to Know The chapters begin with a brief summary of the key features of the theory. Although it may not be the absolute least you need to know to get an A in a theory class or help a client, it is the basic information you should have memorized and be able to quickly articulate at any moment to help you keep your theories straight. The Juice: Significant Contributions to the Field In the next section, I use the principle of primacy (first information introduced) to help you remember one of the most significant contributions of the theory to the field of counseling. In most cases, well-trained clinicians who generally use another approach to counseling are likely to be skilled and use this particular concept because it has shaped standard practice in the field. This section is your red flag to remember a seminal concept or practice for the theory. Feedback from students indicates this is often one of their favorite sections. Rumor Has It: The People and Their Stories In this section, you can read about the developers of the theory and how their personal stories shaped the evolution of the ideas. And, yes, some of the rumors are juicier than others. Since the focus of this text is how counseling theories are actually used in contemporary settings, I have deemphasized the history and development of the theory, but you will find brief summaries of such history here. Big Picture: Overview of Counseling Process The big picture provides an overview of the flow of the counseling process: what happens in the beginning, middle, and end, and how change is facilitated across these phases. Making Connection: Counseling Relationship All approaches start by establishing a working relationship with clients, but each approach does it differently. In this section, you will read about the unique ways that counselors of various schools build relationships that provide the foundation for change. The Viewing: Case Conceptualization The case conceptualization section will identify the signature theory concepts that counselors from each approach use to identify and assess clients and their problems. This really is the heart of the theory and where the real differences emerge. I encourage you to pay particularly close attention to these. You can also read more about case conceptualization in Chapters 15 and 16. Targeting Change: Goal Setting Based on the areas assessed in the case conceptualization and the overall counseling process, each approach has a unique strategy for identifying client goals that become the foundation for the treatment plan. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Introduction xxiii The Doing: Interventions Probably the most exciting part for most new counselors, this section outlines the common techniques and interventions for each theory. In some cases, a section for techniques used with special populations is included, if these are notably different from those in standard practice. Putting It All Together: Case Conceptualization and Treatment Plan Template After graduation, you will probably thank me most for this section, which provides a template for a treatment plan that can be used for addressing depression, anxiety, and similar concerns. This plan ties everything in the chapter together. Tapestry Weaving: Working with Diverse Populations This section provides a review of using the approach with a) ethnic and racial diversity and b) sexual identity diversity. In addition, unique applications for specific populations are also covered. Research and the Evidence Base This section reviews the research and evidence base for each theory, and this review is provided to offer a general sense of empirical foundations for the theory. In some cases, influential evidence-based treatments (see Chapter 1 for a definition) are highlighted. Online Resources A list of Web pages and Web documents are included for those who want to pursue specialized training or conduct further research on the theory. References Many students pass right over reference lists and forget all about them. But if you need to do an academic paper or literature review on any of these theories, the references should be your first stop. You might remember my historical difficulty with leaving the library. In this case, I had several hundred books go through my 12-by-12-foot office while writing this book over a two-year period, in addition to having PsychInfo set as my home page for faster lit searches (I discovered the joy of library eBooks). Thus, you can shorten the time it takes to locate key resources by pursuing these before you hit the library yourself (oh, I forgot, no one steps foot in these places any more; I meant “surf” the library’s Web page while still in your bunny slippers—one of the joys of modern technology). Case Example with Case Conceptualization and Treatment Plan Finally, each chapter ends with a case vignette, case conceptualization, and treatment plan to give you a sense of how the theory looks in action and how to put it down on paper. I use examples of adults presenting for individual counseling in this text; see my other text Mastering Competencies in Family Therapy (Gehart, 2010) for examples with couples, families, and children. Again, I think you will find this most useful once your instructor or supervisor asks you to write one yourself. Theoretical Friends and Families Although each theory presented is wholly unique and independent, like the rest of us, each has friends and families with whom they associate. These are generally referred to as “schools” of counseling or therapy, and these are increasingly important as more and more counselors move toward integrated approaches (see Chapters 15 and 16). Unfortunately, like virtually all systems of grouping individuals, these groupings do not capture the full complexity of their characters. For example, in this book, Adlerian individual psychology is in the “analytic approach” section because it includes analytic elements; Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xxiv Introduction however, it also has humanistic, cognitive-behavioral, and even systemic elements. Obviously, reprinting the chapter four times would not help you, so you will have to read each chapter to learn about the similarities and differences between approaches in the same school. The rough and imperfect classifications of theories in this book are as follows: Analytic approaches ● ● ● Psychodynamic Jungian analytic Adlerian individual psychology Humanistic-existential approaches ● ● ● Person-centered Existential Gestalt Action-based approaches ● ● ● Behavioral Cognitive-behavioral Systemic/family Postmodern and multicultural approaches ● ● ● ● ● Solution-based Narrative Collaborative Feminist Reflecting teams Voice and Tone Finally, I should mention that the voice and tone of this textbook is a bit different from your average college read. I hope you have noticed by now that I am talking “right at ya.” I also like to add some humor and have some fun while I write. Why? Well, first, I have more fun writing this way. But, more important, I want to engage you as if you were one of my students or supervisees learning how to apply these ideas for the first time. Counseling and psychotherapy are relationship-based practices, where both parties are fully present in their humanity (at least in most approaches). Thus, it is hard for me to write about how to be genuine and present to clients as a detached, faceless author. So, as I write, I am imagining you as a full and real person eager to learn about how to use these ideas to help others. I am going to try to reach out to you, answer questions I imagine you have, and periodically tap you on the shoulder to make sure you are still awake. Suggested Uses Suggestions for Thinking About Counseling Theories As you read the chapters in this book, you are going to be tempted to identify which ones you like the best and deemphasize the ones you’re less attracted to. This may seem like a great idea at first, but here are some points to consider: Favorite versus Useful: The theories that the average counselor finds personally useful are probably not the same ones that the average client of new counselors is likely to find useful. Many counselors are psychologically minded, meaning that they enjoy thinking about the inner world and how it works. However, most new counselors begin Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Introduction xxv working with diverse, multi-problem clients and families, many (but not all) of whom are not psychologically minded because they are often struggling with issues of survival and/or they come from cultural traditions that place less value on analysis and understanding of the inner world. So the theory you find most useful to you personally may not be a good fit for your first client. Appreciation: The theories in this book are not casually chosen. They have become part of the standard canon of theories because generations of counselors and therapists have found them helpful. Each has wisdom worthy of study. The one lesson I have learned over the years is that the more theories counselors understand, the better able they are to serve their clients because their understanding of the human condition and its concomitant problems is broader. Thus, I recommend approaching each theory with an attitude of searching for its essential and useful parts. I facilitate this for you in the “Juice” section of each chapter that identifies the one thing you should work hardest to remember from the chapter. Common Threads: Counseling theories are ironic: in one sense, they are very different and inform distinct and mutually exclusive behaviors and attitudes. However, the better you understand one, the better you understand them all. In fact, some counselors, the common factors proponents, argue that theories are generally equally effective because they are simply different modes for delivering the same factors (Miller, Duncan, & Hubble, 1997; you will read more in Chapter 1). So, it is quite possible that commonalities across theories are more important than their differences. Suggestions for Using This Book to Learn Theories First, I recommend that you set aside an hour or two to read about a single theory from beginning to end (from “In a Nutshell” to “Putting It All Together”) to help get the full sense of the theory. Some chapters have a couple of theories in one, so for these it is fine to read the chapter in chunks. Additionally, some learners may find it helpful to scan the treatment plan (either the template or the example at the end of the chapter) or some other section first, to provide a practical overview; that said, I have tried to organize the ideas in the way most people seem to prefer. But I encourage you to discover what works best for you, since different learners have different strategies that work best for them. When you are done with a chapter, you might want to try completing a case conceptualization and treatment plan for yourself (you may have to make up a problem if you are nearly perfect) or for someone else, to get a sense of how this would work. Finally, I strongly recommend that either after reading the chapter or after going to class, you take good old-fashioned notes. Yes, I mean it. I recommend that you type up (or, if you prefer, handwrite) a complete outline of the key concepts in your own words. Why do I advocate for such painful torture? All of us, myself included, when we read long, dense books such as this one, fade in and out of alert attentiveness to what we are reading—often lapsing into more interesting fantasies or less interesting to-do lists— and—gasp!—sometimes even skim large sections of the text (no, I am not surprised or offended). The only way to make sure that you really understand the concepts you read about is to put them in your own words and organize them in a way that makes sense to you. If you need to take culminating exams or plan to pursue licensure, you will have to log the concepts in this book into your long-term memory, which requires more than cramming for a final exam. Being a mental health professional requires that you master and build on what you learn, and you will be expected to know what is in this book for the entire time you are active in the profession (seriously—and if you think that is bad, just wait until you get to a class on diagnosis—you’ll have to memorize an even longer book). Thus, if your former study habits included all-night cramming, gallons of espresso (or other favorite caffeine delivery system), and little recall after the exam, you might want to try my note-taking tip or some other strategy as you move forward. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xxvi Introduction Suggestions for Using This Book to Write Treatment Plans Because I know some of you might be tempted to skip ahead to the examples and avoid the boring theory, I feel it necessary to recommend taking a few minutes to read Chapter 2 on treatment planning before trying to quickly write one for class or your supervisor. There are some basic “rules” of good treatment planning that all counselors use and that are clearly spelled out in Chapter 2, and in the end, if you need to get a signature or grade on your treatment plan, it will save you lots of time to read the “howtos” in Chapter 2 first. I want to emphasize that the treatment plan format, templates, and examples in this book are just that: formats, templates, and examples. They do not represent the only approach or the only right approach but simply a solid approach based on the common standards and expectations. You most likely will work at a counseling agency or institution that uses another format, but the same general rules (the ones in Chapter 2) will still apply. That is why understanding the principles of how to write good goals and interventions is more important than memorizing the format. Furthermore, don’t use the templates and examples too rigidly. Feel free to modify the goal statements and techniques to fit the unique needs of your client. I have provided some relatively specific goals as an example of what might work, and I encourage you to tailor these for each client’s unique needs. Suggestions for Use in Internships and Clinical Practice When working as an intern or licensed mental health professional, this book can be useful for teaching yourself theories and techniques in addition to learning how to write treatment plans. You will likely find that when you work with new populations and problems, you may be interested in considering how other therapy models might approach these situations. This book is designed to be a prime resource for quickly scanning to identify other possibilities. Alternatively, you might have a colleague or supervisor who uses a theory with which you are not familiar. You can use this book to quickly review that theory and avoid looking uneducated. In addition, this book is written to help you appreciate and find common ground across theories, which can be of particular benefit when working in a “mixed-theory” context. However, to actually learn to practice any of these theories well, I strongly urge you to take advanced training from experts in that approach. Suggestions for Studying for Licensing Exams Licensing exams are designed not to be unnecessarily tricky or scary but simply to ensure that you have knowledge necessary to practice counseling and psychotherapy without supervision and to not harm anybody. And it is a vocabulary test. If you have honestly engaged your classes, done your homework, avoided cramming for tests and papers, and made it a priority to get decent supervision, you should have a strong foundation for taking your licensing exam. You should already have in your possession books (such as this) that cover all the content to be studied for the exam. If your exam is to be taken on finishing a lengthy post-master’s internship, you should use the entire two- to four-year period to read as many books as possible on the theories and materials covered by the exam (no novels for a few years). I do not recommend that all my students take long, expensive “review courses,” because such courses are not necessary for those who are proactive in mastering the material on the exam long before they sign up to take it. If you start studying only after you are approved to take the test, you are starting about two to four years too late—and then, yes, you will need to take a crash course. My basic suggestion for studying for mental health licensing exams is this: read an original text on each major theory during your post-degree internship, use the Diagnostic and Statistical Manual of Mental Disorders (DSM), keep up with laws and ethics, then buy the practice exams (without the study guides) and take them until you consistently get 5% above the required passing score (e.g., 75% if the passing score is 70%). If you find that you are weak in a particular area, such as theory or DSM, use a text such as this, which is designed with the Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Introduction xxvii license review in mind. Once you consistently get 75%, you are ready to take the test with the most learning and the least expense. Suggestions for Faculty to Measure Competencies and Student Learning This book is designed specifically to help faculty and supervisors simplify and streamline the onerous task of measuring student competencies as required by the various accreditation bodies. The forms and scoring rubrics for assessing student learning using counseling, psychology, social work, and family therapy competencies are available on this book’s Web page for instructors (see www.cengage.com or www.masteringcompetencies.com). On this website, instructors will also find free online lectures, PowerPoints, sample syllabi, and a test bank (test banks are available only from your Cengage sales representative, in order to maintain security of the questions). This text may be used as the primary or secondary text in a counseling theories class or as the primary text in a pre-practicum or practicum/fieldwork class. Because of its combination of solid theory and practical skills, it can easily be used across more than one class to develop students’ abilities to conceptualize theory and write treatment plans, skills that are not likely to be mastered in a single class. When designing a class to measure competencies and student learning using these treatment plans and case conceptualizations, I recommend initially going over the scoring rubrics with students so that they understand how these are used, to clearly define what needs to be done and the expectations for the final product. I have found that it is most helpful to provide two or three opportunities to practice case conceptualization and treatment planning over a semester, in order to provide feedback and enable students to improve and build on these skills in a systematic fashion. The online instructor resources include several example syllabi for the various mental health disciplines. Specifically, I have a small group present a case conceptualization and treatment plan with each theory studied, based on a video the class watches on the theory; that way, students have enough information to actually conceptualize the client dynamics and treatment. Then, the entire class can see an example and discuss the thought process of developing the plan. A later or final assignment for the class can be to independently develop a treatment plan for a case (either one assigned by the instructor or one from a popular movie, personal life, or actual client). By the end of a semester with these activities, students will have developed not only competence but also confidence in their case conceptualization and treatment planning abilities. Student Resources Students will find numerous useful resources for this text on the Cengage website (www .cengagebrain.com), with select resources on the text’s website (www.mastering competencies.com). These include the following: ● ● ● ● ● ● Online lectures: mp4 recordings of yours truly discussing content of the various chapters Digital forms for the treatment plan and integrative case conceptualization Scoring rubrics Links to related websites and readings Glossary of key concepts and terms Web quizzes Instructor Resources Instructors will find numerous resources for the book online on the Cengage website (www.cengage.com) and select resources on the text’s websites (www.masteringcompetencies.com): ● ● Online lectures by the author Sample syllabi for how to use this book in a theory class or practicum class in counseling, family therapy, psychology, or social work. These syllabi include detailed lists of the competencies covered for each discipline—to meet accreditation requirements. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. xxviii Introduction ● ● ● Detailed PowerPoints for all of the chapters Downloadable versions of the integrative case conceptualization, treatment plan, and scoring rubrics (rubrics are correlated to competencies for each of the CACREP specialities as well as the core competencies/benchmarks for family therapy, psychology, and social work) Test bank and Web quizzes Next Steps Now that you are acquainted with the lay of the land, it is time to get down to business. In the chapters that follow, you will learn more about competencies in the field of counseling and psychotherapy and what they mean for you and your future as a professional. Part of this tour includes a review of what it means to be a professional and the ethical duties that come with the job. We will also explore the purpose of counseling theories and consider two streams of research that inform the use and development of these theories: the common factors research and evidence-based treatment studies. Then you will learn about the nuts and bolts of treatment planning in Chapter 2. This one may be a bit dry, but I promise that once you are assigned to write your first treatment plan, you will find it to be one of the most exciting in this book—nothing like the pressure of having to write your first plan to alter your perspective of what is fascinating. The remainder of this book will take you on a grand tour of some of the most exciting ideas from the 20th and 21st centuries. I have confidence that it will be the trip of a lifetime. Bon voyage! And congratulations on reading this book’s introduction! I hope you can see the value now. Online Resources Webpage for this book: www.cengagebrain.com With select resources also on www.masteringcompetencies.com Student Resource Page: ● ● ● ● Treatment plan and case conceptualization forms Scoring rubrics Online lectures Glossary of key concepts and terms Instructor Resource Page: ● ● ● ● ● Sample syllabi with detailed list of competencies covered in the class PowerPoints for each chapter Treatment plan and case conceptualization forms Scoring rubrics correlated to accreditation competencies for counseling, family therapy, psychology, and social work Test bank and Web quizzes Author’s page: www.dianegehart.com References Gehart, D. (2010). Mastering competencies in family therapy: A practical approach to theory and clinical case documentation. Pacific Grove, CA: Brooks/Cole. Killen, R. (2004). Teaching strategies for outcome-based education. Cape Town: Juta Academic. Miller, S. D., Duncan, B. L., & Hubble, M. (1997). Escape from Babel: Toward a unifying language for psychotherapy practice. New York: Norton. Weimer, M. (2002). Learner-centered teaching: Five key changes to practice. New York: Jossey-Bass. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Section I Introduction to Theories, Competencies, and Treatment Planning Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. CHAPTER 1 Counseling Theory, Competency, Research, and You: Connecting the Dots What Distinguishes a Counselor from a Bartender? What makes a counselor or therapist different from a good bartender, hairdresser, or friend? In many cases, the latter are excellent listeners, can be empathetic, and help solve problems. Aside from the obvious fact that bartenders and friends typically charge less for their services—not always true for hairdressers—counselors go beyond these basic helping skills and do something more. Counselors use theory to (a) develop a specific form of helping relationship, (b) articulate more useful understandings of clients’ situations, and (c) identify effective means to resolve clients’ presenting problems. In the end, it is the ability to skillfully translate theory into action that makes counselors different from those helpful others. Counseling theories provide powerful lenses through which to view clients’ situations and identify the most expedient means to resolve their concerns. This book will show you how counselors do it—and perhaps one day you will use this skill set to justify your fee, which might rival that of one of the better stylists in town. Why Theory Matters Although much has changed over recent decades in mental health care—better research to guide us, new knowledge about the brain, more details about mental health disorders, and increased use of psychotropic medication—the primary tool that counselors and psychotherapists use to help people has not: theory. Counseling theory provides a means for quickly sifting through the tremendous amount of information clients bring; then, targeting specific thoughts, behaviors, or emotional processes for change; and finally, helping clients to effectively make these changes to resolve their initial concerns. Even with fancy functional magnetic resonance imaging, neurofeedback machines, and hundreds of available medications, no other technology has taken the place of theory. However, the changing landscape of mental health care has changed how counseling theories are understood and used. 3 Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 4 CHAPTER 1 • Counseling Theory, Competency, Research, and You: Connecting the Dots Connecting with Theory: Do I Have to Choose Just One? Over the years, the role of theory in counseling and psychotherapy has become less rather than more clear. Initially, the general recommendation was to select and train in one theory, which became a counselor’s primary identity and style of working; it was a personal choice, and the story ended there. Textbooks such as this one are grounded around this honorable tradition, a tradition in which I was “raised.” However, many counselors like to “mix it up,” integrating theories, which has been an increasingly popular and justified practice in the field (see the “Common Factors Research: Reframing Theory” section; Miller, Duncan, & Hubble, 2004). Similarly, many of my students, on reading their first theory textbook, enthusiastically exclaim, “I like them all; do I have to choose?” It’s one of those questions that they quickly regret asking. Because rather than give a simple yes-or-no answer (anyone who asks is hoping for “no”), I must instead go into a long lecture on epistemological foundations, developmental stages of becoming a counselor, research on outcomes, evidence-based treatment, and so on. Within 15 minutes, the class gets very quiet. After half an hour, most are scrunching their faces with stress. By the end of the first hour, all have given up hope for a simple answer to their question. So now it’s your turn to listen to the answer to this question, and out of compassion, I will provide you with a quick overview and road map. Counseling theory and how it is being used and understood has been recontextualized by two major movements in recent years: (a) the competency movement, which includes multicultural competency, and (b) the expanding research base and the evidence-based treatment movement. These movements have not ended the need for theory but have instead changed how we conceptualize, adapt, and apply theory. The remainder of this chapter will address these two major movements and discuss their relationship to competency, theory, and you. ● ● Competency: Common Threads in Competent Use of Theory ○ Diversity and multicultural competence ○ Research competence ○ Law and ethics ○ Person-of-the-counselor Research and the Evidence Base: Reframing and Redesigning Theory ○ Common factors (across theories) research ○ Evidence-based practice and treatments ○ Evidence-based practice principles Competency in Counseling and Psychotherapy Stereotypes are dangerous and typically inaccurate. Nonetheless, I am going to risk stating such a generalization, namely, that counselors and therapists care about others. Most counselors feel called to the profession to help others and to make a difference in the world. Few report being motivated by fame and riches, as there are easier and more expedient means to these ends (you may need to chat with a career counselor if this comes as a surprise). Many find inspiration from the work of Carl Rogers (1951, 1961), who radically claimed that accurate empathy, unconditional positive regard, and genuineness are not only necessary but also sufficient conditions for promoting change in clients. At the grassroots level, clients often describe effective counselors as “nice,” good-hearted people. Research indicates that this human connection is one of the strongest predictors of change in the counseling process (Miller, Duncan, & Hubble, 1997). But the counseling relationship does not account for all the change; in fact, many argue that it is not enough. Regardless of whether you side with Rogers or those who claim that more is needed, competent counseling in the 21st century demands that counselors do more than care, that they are more than nice, and that they demonstrate more than the core conditions that Rogers advocated. The standard of practice in today’s treatment environments Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Competency in Counseling and Psychotherapy 5 involves several key elements that counselors must master to be considered competent: having the necessary skills for the job. All mental health professionals who provide counseling and psychotherapy services—including counselors, family therapists, clinical and counseling psychologists, clinical social workers, psychiatric nurses, and psychiatrists—must master a core set of competencies. The core elements of competent counseling are consistent across disciplines, but the specifics of how they are enacted can vary by training and discipline. Competency and (Not) You Although at first it may seem insensitive, the vernacular expression commonly used by my teen clients sums up the mind-set of competency best: “It’s not about you.” It’s not about your theoretical preference, what worked for you in your personal counseling, what you are good at, what you find interesting, or even what you believe will be most helpful. Competent counseling requires that you get outside your comfort zone, stretch, and learn how to interact with clients in a way that works for them. In short, you need to be competent in a wide range of theories and techniques to be helpful to all the clients with whom you work. If you allow me to go on, you might even begin to see how this makes some sense and might even be in your best interest. Perhaps it is best to explain with an example: you will likely either have a natural propensity for generating a broad-view case conceptualization using counseling theories, or you will have a disposition that favors a detail-focused mental health assessment and diagnosis; humans tend to be good either with the big picture or with details. However, to be competent, a counselor needs to get good at doing both, even if one is easier, preferred, and philosophically favored. Similarly, you may prefer theories that promote insight and personal reflection; after all, that may be what works for you in your life. However, that may not work for your client, and/or research may indicate that such an approach is not the most effective approach for your client’s situation or background. Thus, you will need to master theories of counseling that may not particularly interest you or even fit with your theory of counseling. Although at first you may not like this idea, I think that by the time you are done with this book, you might just warm up to it. I first learned this competency lesson when working with families in which the parents had difficulty managing the behaviors of their young children. I was never a huge fan of behaviorism, but it did not take too many hysterically screaming, clawing, and biting two-year-olds before I was preaching the value of reinforcement schedules and consistency. Given my strong—admittedly zealous—attachment to my postmodern approach at the time, I have every faith that you will be driven either by principle (ideally) or by desperation (more likely) to move beyond your comfort zone to become a well-rounded, competent counselor. Common Threads of Competency Although each major mental health profession—such as counseling, marriage and family therapy, psychology, psychiatry, psychiatric nursing, and chemical dependency counseling— uses a different set of competencies, there are many similarities across them. They agree that competent use of theory entails attending four key areas: ● ● ● Diversity and multicultural competence: The use of counseling theory is always contextualized by diversity issues, which means that the application and applicability varies—sometimes dramatically—on the basis of diversity issues such as age, ethnicity, sexual orientation, ability, socioeconomic status, immigration status, and so on. Research and the evidence base: To be competent, counselors must be aware of the research and the evidence base related to their theory, client populations, and presenting problem. Ethics: Perhaps the most obvious commonality across sets of competencies is law and ethics; without a firm grasp of the laws and ethical standards that relate to professional mental health practice, well, let’s just say you won’t be practicing very long. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 6 CHAPTER 1 • Counseling Theory, Competency, Research, and You: Connecting the Dots ● A solid understanding of ethical principles such as confidentiality is a prerequisite for applying theory well. Person-of-the-counselor/person-of-the-therapist: Finally, unlike most other professions, specific personal qualities are identified as competencies for mental health professionals. Diversity and Competency Over the past couple of decades, counselors have begun to take seriously the role of diversity in the counseling process, including factors such as age, gender, ethnicity, race, socioeconomic status, immigration, sexual orientation, ability, language, and religion. These factors inform the selection of theory, development of the counseling relationship, assessment and diagnosis process, and choice of interventions (Monk, Winslade, & Sinclair, 2008). In short, everything you think, do, or say as a professional is contextualized and should be informed by diversity issues. If you think that effectively responding to diversity is easy or can be easily learned, or that perhaps your instructors, supervisors, or some famous author has magic answers to make it easy, you are going to be in for an unpleasant surprise. Rather than a black-and-white still life, dealing with diversity issues is more like finger painting: there are few lines to follow, it is messy for everyone involved, and it requires enthusiasm and openheartedness to make it fun. I have often heard new and experienced counselors alike claim that because they are from a diverse or marginalized group, they don’t need to worry about diversity issues. Conversely, I have heard counselors from majority groups say things such as “I don’t have any culture.” Both parties have much to learn on the diversity front. First of all, we are all part of numerous sociological groups that exert cultural norms on us, with the more common and powerful ones stemming from gender, ethnicity,...
Purchase answer to see full attachment
Explanation & Answer:
8 sentences
Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool's honor code & terms of service.

Explanation & Answer

View attached ex...

WhqlX (17847)
UT Austin

Anonymous
Very useful material for studying!

Studypool
4.7
Trustpilot
4.5
Sitejabber
4.4

Related Tags