Contemporary Counseling Therapy

Wednesday, February 7, 2018Wednesday, February 7, 2018
Syed Md. Sajjad KabirSyed Md. Sajjad Kabir
Chairman and Assistant ProfessorChairman and Assistant Professor
Department of PsychologyDepartment of Psychology
University of ChittagongUniversity of Chittagong
smskabirpsy@cu.ac.bdsmskabirpsy@cu.ac.bdSYED MD. SAJJAD KABIRSYED MD. SAJJAD KABIR UNIVERSITY OF CHITTAGONGUNIVERSITY OF CHITTAGONG

Other Contemporary TherapyOther Contemporary Therapy
 EMDREMDR
 Eclectic CounselingEclectic Counseling
 Integrative CounselingIntegrative Counseling
 Group TherapyGroup Therapy
 Individual PsychologyIndividual Psychology
 Reality therapyReality therapy
 Family TherapyFamily Therapy
 Wednesday, February 7, 2018Wednesday, February 7, 2018
Book Reference: Kabir, SMS (2017).Book Reference: Kabir, SMS (2017).
Essentials of Counseling. Abosar ProkashanaEssentials of Counseling. Abosar Prokashana
Sangstha, Banglabazar, Dhaka-1100; ISBN:Sangstha, Banglabazar, Dhaka-1100; ISBN:
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
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EMDR
(Eye Movement Desensitization and Reprocessing)
Dr. Francine Shapiro
(February 18, 1948 to present) 99
 It is a comprehensive, integrative psychotherapyIt is a comprehensive, integrative psychotherapy
approach. It include psychodynamic, cognitiveapproach. It include psychodynamic, cognitive
behavioral, interpersonal, experiential, and body-behavioral, interpersonal, experiential, and body-
centered therapies.centered therapies.
 Shapiro’s (2001) Adaptive Information Processing (AIP)Shapiro’s (2001) Adaptive Information Processing (AIP)
model posits that EMDR facilitates the accessing andmodel posits that EMDR facilitates the accessing and
processing of traumatic memories and other adverseprocessing of traumatic memories and other adverse
life experience to bring these to an adaptive resolution.life experience to bring these to an adaptive resolution.
 EMDR appears to be a safe therapy, with no negativeEMDR appears to be a safe therapy, with no negative
side effects.side effects.
 After successful treatment with EMDR, affectiveAfter successful treatment with EMDR, affective
distress is relieved, negative beliefs are reformulated,distress is relieved, negative beliefs are reformulated,
and physiological arousal is reduced.and physiological arousal is reduced.
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EMDR What Is EMDR?What Is EMDR? 99
 EMDR is a powerful counseling technique in helpingEMDR is a powerful counseling technique in helping
people who suffer from trauma, anxiety, panic,people who suffer from trauma, anxiety, panic,
disturbing memories, post traumatic stress anddisturbing memories, post traumatic stress and
many other emotional problems.many other emotional problems.
 It is considered a breakthrough techniqueIt is considered a breakthrough technique
because of its simplicity.because of its simplicity.
 It uses a technique called bilateral stimulationIt uses a technique called bilateral stimulation
(using right/left eye movement or tactile(using right/left eye movement or tactile
stimulation) which repeatedly activates thestimulation) which repeatedly activates the
opposite sides of the brain. This assists theopposite sides of the brain. This assists the
neurophysiological system (basis of the mind/bodyneurophysiological system (basis of the mind/body
connection) to free itself of blockages andconnection) to free itself of blockages and
reconnect itself.reconnect itself.
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EMDR
What Can You Expect From EMDR?What Can You Expect From EMDR? 99
 EMDR mostly used in people with PTSD (PostEMDR mostly used in people with PTSD (Post
Traumatic Stress Disorder), it is also used toTraumatic Stress Disorder), it is also used to
treat many other psychological problems –treat many other psychological problems –
• Injury or Loss of a Loved OneInjury or Loss of a Loved One
• Car Accident/ Work Related Accidents &Car Accident/ Work Related Accidents &
InjuriesInjuries
• Witness of Violent CrimesWitness of Violent Crimes
• Test Anxiety/ Relational AnxietyTest Anxiety/ Relational Anxiety
• Trouble Sleeping/ Worrying/ Phobias/ FearsTrouble Sleeping/ Worrying/ Phobias/ Fears
• Low Self-Esteem/ Bad Temper/ Panic AttacksLow Self-Esteem/ Bad Temper/ Panic Attacks
• Physical, Emotional, Verbal & Sexual AbusePhysical, Emotional, Verbal & Sexual Abuse
• Natural Disasters/ Fire/ Childhood Trauma &Natural Disasters/ Fire/ Childhood Trauma &
AbuseAbuse
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EMDR
What Can You Expect From EMDR?What Can You Expect From EMDR? 99
• Depression/ Anger/ Sadness/ AssaultDepression/ Anger/ Sadness/ Assault
• Eating Disorders/ Performance AnxietyEating Disorders/ Performance Anxiety
• Lack of MotivationLack of Motivation
• Memories of a Traumatic ExperienceMemories of a Traumatic Experience
• Fear of Being AloneFear of Being Alone
• Unrealistic Feelings of Guilt and ShameUnrealistic Feelings of Guilt and Shame
• Difficulty in Trusting OthersDifficulty in Trusting Others
• Relationship Problems.Relationship Problems.
 EMDR technique is most effective when used inEMDR technique is most effective when used in
conjunction with other traditional methods ofconjunction with other traditional methods of
therapy.therapy.
 It can help clients replace their anxiety and fearIt can help clients replace their anxiety and fear
with positive images, emotions and thoughts.with positive images, emotions and thoughts.
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 EMDR therapy is an information processingEMDR therapy is an information processing
therapy and uses an eight phase approachtherapy and uses an eight phase approach
to address the experiential contributors ofto address the experiential contributors of
a wide range of pathologies.a wide range of pathologies.
 It attends to the past experiences thatIt attends to the past experiences that
have set the groundwork for pathology, thehave set the groundwork for pathology, the
current situations that trigger dysfunctionalcurrent situations that trigger dysfunctional
emotions, beliefs and sensations, and theemotions, beliefs and sensations, and the
positive experience needed to enhance futurepositive experience needed to enhance future
adaptive behaviors and psychological health.adaptive behaviors and psychological health.
Phases of EMDRPhases of EMDR 99EMDR
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 Generally takes 1-2 sessions at the beginning ofGenerally takes 1-2 sessions at the beginning of
therapy, and can continue throughout thetherapy, and can continue throughout the
therapy, especially if new problems are revealed.therapy, especially if new problems are revealed.
 Therapist takes a thorough history of the clientTherapist takes a thorough history of the client
and develops a treatment plan. These include -and develops a treatment plan. These include -
• recent distressing events,recent distressing events,
• current situations that elicit emotionalcurrent situations that elicit emotional
disturbance,disturbance,
• related historical incidents, andrelated historical incidents, and
• the development of specific skills and behaviorsthe development of specific skills and behaviors
that will be needed by the client in futurethat will be needed by the client in future
situations.situations.
Phase 1:Phase 1: History and Treatment PlanningHistory and Treatment Planning
99EMDR
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 For most clients this will take 1-4 sessions.For most clients this will take 1-4 sessions.
 Establish a relationship of trust betweenEstablish a relationship of trust between
client and therapist in this phase.client and therapist in this phase.
 Therapist may teach client a variety ofTherapist may teach client a variety of
imagery and stress reduction techniques thatimagery and stress reduction techniques that
client can use during and between sessions.client can use during and between sessions.

 Therapist ensures client has adequateTherapist ensures client has adequate
methods of handling emotional distress andmethods of handling emotional distress and
good coping skills.good coping skills.
Phase 2:Phase 2: PreparationPreparation 99EMDR
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 Access each target in a controlled and standardizedAccess each target in a controlled and standardized
way so it can be effectively processed.way so it can be effectively processed.
 For a single trauma reprocessing is generallyFor a single trauma reprocessing is generally
accomplished within 3 sessions.accomplished within 3 sessions.
 During this phase person identifies negative emotionsDuring this phase person identifies negative emotions
(fear, anger) and physical sensations (tightness(fear, anger) and physical sensations (tightness
stomach, cold hands) associates with target.stomach, cold hands) associates with target.
 Client rates disturbance using 0 (no disturbance)Client rates disturbance using 0 (no disturbance)
-to-10 (worst feeling) Subjective Units of-to-10 (worst feeling) Subjective Units of
Disturbance (SUD) scale.Disturbance (SUD) scale.
 Therapist will ask person to estimate how true s/heTherapist will ask person to estimate how true s/he
feels his/her positive belief is using the 1-to-7feels his/her positive belief is using the 1-to-7
Validity of Cognition (VOC) scale.Validity of Cognition (VOC) scale.

Phase 3:Phase 3: AssessmentAssessment 99EMDR
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 Focuses on client’s disturbing emotions and sensationsFocuses on client’s disturbing emotions and sensations
as measured by SUDs rating.as measured by SUDs rating.
 This phase gives opportunity to identify and resolveThis phase gives opportunity to identify and resolve
similar events that may have occurred and aresimilar events that may have occurred and are
associated with the target.associated with the target.
 Therapist leads person in sets of eye movement (orTherapist leads person in sets of eye movement (or
other forms of stimulation) with appropriate shifts andother forms of stimulation) with appropriate shifts and
changes of focus until SUD-scale levels are reduced tochanges of focus until SUD-scale levels are reduced to
zero (or 1 or 2 if this is more appropriate).zero (or 1 or 2 if this is more appropriate).
 Starting with main target different associations to theStarting with main target different associations to the
memory are followed.memory are followed.
 A person may start with a horrific event and soonA person may start with a horrific event and soon
have other associations to it.have other associations to it.
Phase 4:Phase 4: DesensitizationDesensitization 99EMDR
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 Concentrate on and increase the strength ofConcentrate on and increase the strength of
the positive belief that the person hasthe positive belief that the person has
identified to replace his/her original negativeidentified to replace his/her original negative
belief.belief.
 Accept the full truth of positive self-Accept the full truth of positive self-
statementstatement
at a level of 7 (completely true).at a level of 7 (completely true).
 If the person is aware to learn some new skill,If the person is aware to learn some new skill,
such as self-defense training, in order to besuch as self-defense training, in order to be
truly in control of the situation, validity of his/truly in control of the situation, validity of his/
her positive belief will rise to the correspondingher positive belief will rise to the corresponding
level, such as a 5 or 6 on the VOC scale. level, such as a 5 or 6 on the VOC scale.
Phase 5:Phase 5: InstallationInstallation 99EMDR
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 After positive cognition has been strengthenedAfter positive cognition has been strengthened
and installed therapist will ask person to bringand installed therapist will ask person to bring
the original target event to mind.the original target event to mind.
 If s/he notices any residual tension in his/herIf s/he notices any residual tension in his/her
body, these physical sensations are thenbody, these physical sensations are then
targeted for reprocessing.targeted for reprocessing.
 An EMDR session is not considered successfulAn EMDR session is not considered successful
until the client can bring up the original targetuntil the client can bring up the original target
without feeling any body tension.without feeling any body tension.
 Positive self-beliefs are important, but theyPositive self-beliefs are important, but they
have to be believed on more than just anhave to be believed on more than just an
intellectual level.intellectual level.

Phase 6:Phase 6: Body ScanBody Scan 99EMDR
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 Closure ensures person leaves at the end of eachClosure ensures person leaves at the end of each
session feeling better than at the beginning.session feeling better than at the beginning.
 If the processing of the traumatic target event isIf the processing of the traumatic target event is
not complete in a single session, therapist will assistnot complete in a single session, therapist will assist
the person in using a variety of self-calmingthe person in using a variety of self-calming
techniques in order to regain a sense of equilibrium.techniques in order to regain a sense of equilibrium.
 Throughout the EMDR session, the client continue toThroughout the EMDR session, the client continue to
feel in control outside the therapist’s office.feel in control outside the therapist’s office.
 Client is also briefed on what to expect betweenClient is also briefed on what to expect between
sessions (some processing may continue, some newsessions (some processing may continue, some new
material may arise), and which techniques s/hematerial may arise), and which techniques s/he
might use on his/her own to help him feel moremight use on his/her own to help him feel more
calm.calm.

Phase 7:Phase 7: ClosureClosure 99EMDR
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 Opens every new session, therapist checksOpens every new session, therapist checks
to make sure that the positive results (lowto make sure that the positive results (low
SUDs, high VOC, no body tension) haveSUDs, high VOC, no body tension) have
been maintained, identifies any new areasbeen maintained, identifies any new areas
that need treatment, and continuesthat need treatment, and continues
reprocessing the additional targets.reprocessing the additional targets.
 It ensures processing of all relatedIt ensures processing of all related
historical events, current incidents thathistorical events, current incidents that
elicit distress, and future scenarios thatelicit distress, and future scenarios that
will require different responses.will require different responses.
Phase 8:Phase 8: Re-evaluationRe-evaluation 99EMDR
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ECLECTIC COUNSELINGECLECTIC COUNSELING
 It is a therapeutic approach that incorporatesIt is a therapeutic approach that incorporates
a variety of therapeutic principles anda variety of therapeutic principles and
philosophies in order to create the idealphilosophies in order to create the ideal
treatment program to meet the specific needstreatment program to meet the specific needs
of the patient or client.of the patient or client.
 Instead of insisting upon strict adherence toInstead of insisting upon strict adherence to
one particular approach or school of thought,one particular approach or school of thought,
it employ elements from a range of therapeuticit employ elements from a range of therapeutic
techniques that is personally tailored to thetechniques that is personally tailored to the
patient or client.patient or client.
 The key here is to help the patient as quicklyThe key here is to help the patient as quickly
and as effectively as possible.and as effectively as possible.
 It is a therapeutic approach that incorporatesIt is a therapeutic approach that incorporates
a variety of therapeutic principles anda variety of therapeutic principles and
philosophies in order to create the idealphilosophies in order to create the ideal
treatment program to meet the specific needstreatment program to meet the specific needs
of the patient or client.of the patient or client.
 Instead of insisting upon strict adherence toInstead of insisting upon strict adherence to
one particular approach or school of thought,one particular approach or school of thought,
it employ elements from a range of therapeuticit employ elements from a range of therapeutic
techniques that is personally tailored to thetechniques that is personally tailored to the
patient or client.patient or client.
 The key here is to help the patient as quicklyThe key here is to help the patient as quickly
and as effectively as possible.and as effectively as possible.
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1010
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ECLECTICCOUNSELINGECLECTICCOUNSELING
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Benefits of Eclectic TherapyBenefits of Eclectic Therapy
 Primary benefit is customized to meetPrimary benefit is customized to meet
the unique needs of patient.the unique needs of patient.
 By personalizing the therapeuticBy personalizing the therapeutic
experience in order to best addressexperience in order to best address
and respond to the needs of theand respond to the needs of the
patient.patient.
 Eclectic therapist ensures that theEclectic therapist ensures that the
most effective therapeutic techniquesmost effective therapeutic techniques
are integrated into treatment.are integrated into treatment.
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ECLECTICCOUNSELINGECLECTICCOUNSELING
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1010
What Conditions/Disorders Does
Eclectic Therapy Treat?
 Any condition that can be treated viaAny condition that can be treated via
any type of therapy is capable ofany type of therapy is capable of
being treated with eclectic therapy.being treated with eclectic therapy.
 Individuals with addictions, substanceIndividuals with addictions, substance
abuse disorders, eating disorders,abuse disorders, eating disorders,
behavior compulsions, mood disorders,behavior compulsions, mood disorders,
and other forms of emotional orand other forms of emotional or
psychological issues may be effectivelypsychological issues may be effectively
treated by a therapist who embracestreated by a therapist who embraces
the philosophy of eclectic therapy.the philosophy of eclectic therapy.
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INTEGRATING COUNSELINGINTEGRATING COUNSELING
 Integrative Counseling/ Psychotherapy takes intoIntegrative Counseling/ Psychotherapy takes into
account many views of human functioning.account many views of human functioning.
 The psychodynamic, client-centered, behaviorist,The psychodynamic, client-centered, behaviorist,
cognitive, family therapy, Gestalt therapy, body-cognitive, family therapy, Gestalt therapy, body-
psychotherapies, object relations theories,psychotherapies, object relations theories,
psychoanalytic self psychology, and transactionalpsychoanalytic self psychology, and transactional
analysis approaches are all considered within aanalysis approaches are all considered within a
dynamic systems perspective.dynamic systems perspective.
 Each person needs to be considered as a whole andEach person needs to be considered as a whole and
counseling techniques must be tailored to theircounseling techniques must be tailored to their
individual needs and personal circumstances.individual needs and personal circumstances.
 It takes the view that there is no single approachIt takes the view that there is no single approach
that can treat each client in all situations.that can treat each client in all situations.
 Integrative therapist is curious about the “why andIntegrative therapist is curious about the “why and
how”.how”.
 Integrative Counseling/ Psychotherapy takes intoIntegrative Counseling/ Psychotherapy takes into
account many views of human functioning.account many views of human functioning.
 The psychodynamic, client-centered, behaviorist,The psychodynamic, client-centered, behaviorist,
cognitive, family therapy, Gestalt therapy, body-cognitive, family therapy, Gestalt therapy, body-
psychotherapies, object relations theories,psychotherapies, object relations theories,
psychoanalytic self psychology, and transactionalpsychoanalytic self psychology, and transactional
analysis approaches are all considered within aanalysis approaches are all considered within a
dynamic systems perspective.dynamic systems perspective.
 Each person needs to be considered as a whole andEach person needs to be considered as a whole and
counseling techniques must be tailored to theircounseling techniques must be tailored to their
individual needs and personal circumstances.individual needs and personal circumstances.
 It takes the view that there is no single approachIt takes the view that there is no single approach
that can treat each client in all situations.that can treat each client in all situations.
 Integrative therapist is curious about the “why andIntegrative therapist is curious about the “why and
how”.how”.
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1111
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INTEGRATINGCOUNSELINGINTEGRATINGCOUNSELING
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1111Aim of Integrative TherapyAim of Integrative Therapy
 Promote healing and facilitate wholeness – ensuring allPromote healing and facilitate wholeness – ensuring all
levels of a person’s being and functioninglevels of a person’s being and functioning
(psychological, physical and emotional health) are(psychological, physical and emotional health) are
maximized to their full potential.maximized to their full potential.
 Enables to better focus on the fears and hurts thatEnables to better focus on the fears and hurts that
limit psychological freedom and recognize specificlimit psychological freedom and recognize specific
triggers that may be causing disruptive patterns oftriggers that may be causing disruptive patterns of
behavior.behavior.
 Helps clients face each moment openly andHelps clients face each moment openly and
authentically without having formed an opinion,authentically without having formed an opinion,
expectation or attitude beforehand.expectation or attitude beforehand.
 Helps to create a healthy alliance between mind andHelps to create a healthy alliance between mind and
body - empowering clients to start setting goals andbody - empowering clients to start setting goals and
practicing new behaviors that will enable them topracticing new behaviors that will enable them to
move beyond their limitations and discover greatermove beyond their limitations and discover greater
life satisfaction.life satisfaction. 20

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Integrative Psychotherapy in PracticeIntegrative Psychotherapy in Practice
 Common Factors Approach:Common Factors Approach: Emphasis onEmphasis on
therapeutic actions that have beentherapeutic actions that have been
demonstrated to be effective.demonstrated to be effective.
 Technical Eclecticism:Technical Eclecticism: Guided primarily by dataGuided primarily by data
that indicates what has worked best forthat indicates what has worked best for
others in the past.others in the past.
 Theoretical Integration:Theoretical Integration: Requires integratingRequires integrating
theoretical concepts from differenttheoretical concepts from different
approaches.approaches.
 Assimilative Integration:Assimilative Integration: Therapist has aTherapist has a
commitment to one theoretical approach, butcommitment to one theoretical approach, but
also is willing to use techniques from otheralso is willing to use techniques from other
therapeutic approaches.therapeutic approaches.
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1111Client-Therapist RelationshipClient-Therapist Relationship
 Therapist to be non-judgmental,Therapist to be non-judgmental,
interpersonal and intent on establishinginterpersonal and intent on establishing
a supportive and cooperative relationshipa supportive and cooperative relationship
with their client.with their client.
 They must also engage in deep,They must also engage in deep,
attentive listening without the pre-attentive listening without the pre-
suppositions that can distortsuppositions that can distort
understanding.understanding.
 They are committing themselves whollyThey are committing themselves wholly
to their client and their exploration ofto their client and their exploration of
self.self.
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1111Benefits of Integrated TherapyBenefits of Integrated Therapy
 Key advantage is its flexibility and focus onKey advantage is its flexibility and focus on
the whole of an individual.the whole of an individual.
 It can be beneficial for those who want toIt can be beneficial for those who want to
overcome negative patterns of behavior causedovercome negative patterns of behavior caused
by anxieties, fears, phobias or any otherby anxieties, fears, phobias or any other
psychological health issue that is greatlypsychological health issue that is greatly
impacting life satisfaction (i.e. addictions,impacting life satisfaction (i.e. addictions,
depression, past and current trauma,depression, past and current trauma,
bereavement and low self-esteem).bereavement and low self-esteem).
 It has also been found useful in improving dailyIt has also been found useful in improving daily
function in children with autism and learningfunction in children with autism and learning
difficulties.difficulties.
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GROUP THERAPYGROUP THERAPY
 It is a form of psychotherapy in which one orIt is a form of psychotherapy in which one or
more therapists treat a small group of clientsmore therapists treat a small group of clients
together at the same time.together at the same time.
 It is more often used as part of a greaterIt is more often used as part of a greater
treatment plan that may include one-on-onetreatment plan that may include one-on-one
therapy and/or medication.therapy and/or medication.
 One common form of group therapy is familyOne common form of group therapy is family
therapy, which is a branch of psychotherapytherapy, which is a branch of psychotherapy
that works with families and couples inthat works with families and couples in
intimate relationships to nurture change andintimate relationships to nurture change and
development.development.
 Similar to group therapy, family therapy seesSimilar to group therapy, family therapy sees
interactions during therapeutic sessions asinteractions during therapeutic sessions as
direct reflections of real-life problems.direct reflections of real-life problems.
 It is a form of psychotherapy in which one orIt is a form of psychotherapy in which one or
more therapists treat a small group of clientsmore therapists treat a small group of clients
together at the same time.together at the same time.
 It is more often used as part of a greaterIt is more often used as part of a greater
treatment plan that may include one-on-onetreatment plan that may include one-on-one
therapy and/or medication.therapy and/or medication.
 One common form of group therapy is familyOne common form of group therapy is family
therapy, which is a branch of psychotherapytherapy, which is a branch of psychotherapy
that works with families and couples inthat works with families and couples in
intimate relationships to nurture change andintimate relationships to nurture change and
development.development.
 Similar to group therapy, family therapy seesSimilar to group therapy, family therapy sees
interactions during therapeutic sessions asinteractions during therapeutic sessions as
direct reflections of real-life problems.direct reflections of real-life problems.
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Therapeutic Factors/ Principles
 AltruismAltruism: Group members share their strengths and: Group members share their strengths and
experiences in order to help others.experiences in order to help others.
 CatharsisCatharsis: Experience of relief from emotional distress: Experience of relief from emotional distress
through the free and uninhibited expression of emotion.through the free and uninhibited expression of emotion.
 CohesivenessCohesiveness: Because all members share a common goal,: Because all members share a common goal,
there is a shared sense of belonging, acceptance, andthere is a shared sense of belonging, acceptance, and
validation.validation.
 Corrective recapitulation of the primary familyCorrective recapitulation of the primary family
experienceexperience: Seeing the group as a family may help group: Seeing the group as a family may help group
members gain understanding of the impact of childhoodmembers gain understanding of the impact of childhood
experiences on their personality.experiences on their personality.
 Development of socializing techniquesDevelopment of socializing techniques: Group setting: Group setting
provides a safe and supportive environment for membersprovides a safe and supportive environment for members
to take risks by practicing interpersonal behavior andto take risks by practicing interpersonal behavior and
improving social skills.improving social skills.
 AltruismAltruism: Group members share their strengths and: Group members share their strengths and
experiences in order to help others.experiences in order to help others.
 CatharsisCatharsis: Experience of relief from emotional distress: Experience of relief from emotional distress
through the free and uninhibited expression of emotion.through the free and uninhibited expression of emotion.
 CohesivenessCohesiveness: Because all members share a common goal,: Because all members share a common goal,
there is a shared sense of belonging, acceptance, andthere is a shared sense of belonging, acceptance, and
validation.validation.
 Corrective recapitulation of the primary familyCorrective recapitulation of the primary family
experienceexperience: Seeing the group as a family may help group: Seeing the group as a family may help group
members gain understanding of the impact of childhoodmembers gain understanding of the impact of childhood
experiences on their personality.experiences on their personality.
 Development of socializing techniquesDevelopment of socializing techniques: Group setting: Group setting
provides a safe and supportive environment for membersprovides a safe and supportive environment for members
to take risks by practicing interpersonal behavior andto take risks by practicing interpersonal behavior and
improving social skills.improving social skills.
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Therapeutic Factors/ Principles
 Existential factorsExistential factors: Group members realize they are: Group members realize they are
responsible for their own lives, behaviors, andresponsible for their own lives, behaviors, and
decisions.decisions.
 Imparting informationImparting information: Sharing information about: Sharing information about
themselves and one another.themselves and one another.
 Imitative behaviorImitative behavior: Can develop social skills is through: Can develop social skills is through
a modeling process, observing and imitating thea modeling process, observing and imitating the
therapist and other group members.therapist and other group members.
 Instillation of hopeInstillation of hope: Coping or recovery may give hope: Coping or recovery may give hope
to those at beginning stages.to those at beginning stages.
 Interpersonal learningInterpersonal learning: Achieve a greater level of: Achieve a greater level of
self-awareness through the process of interactingself-awareness through the process of interacting
with others in the group.with others in the group.
 UniversalityUniversality: Sharing an experience helps people see: Sharing an experience helps people see
that they are not going through something alone.that they are not going through something alone.
 Existential factorsExistential factors: Group members realize they are: Group members realize they are
responsible for their own lives, behaviors, andresponsible for their own lives, behaviors, and
decisions.decisions.
 Imparting informationImparting information: Sharing information about: Sharing information about
themselves and one another.themselves and one another.
 Imitative behaviorImitative behavior: Can develop social skills is through: Can develop social skills is through
a modeling process, observing and imitating thea modeling process, observing and imitating the
therapist and other group members.therapist and other group members.
 Instillation of hopeInstillation of hope: Coping or recovery may give hope: Coping or recovery may give hope
to those at beginning stages.to those at beginning stages.
 Interpersonal learningInterpersonal learning: Achieve a greater level of: Achieve a greater level of
self-awareness through the process of interactingself-awareness through the process of interacting
with others in the group.with others in the group.
 UniversalityUniversality: Sharing an experience helps people see: Sharing an experience helps people see
that they are not going through something alone.that they are not going through something alone.
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Appropriateness of Group TherapyAppropriateness of Group Therapy
 Very effective for the treatment ofVery effective for the treatment of
depression and traumatic stress, such asdepression and traumatic stress, such as
post-traumatic stress disorder (PTSD)post-traumatic stress disorder (PTSD)
and sexual abuse survivors.and sexual abuse survivors.
 Combination of both individual and groupCombination of both individual and group
therapy is most beneficial for mosttherapy is most beneficial for most
clients.clients.
 It has proven effective in treatingIt has proven effective in treating
schizophrenia, bipolar disorder,schizophrenia, bipolar disorder,
anorexia, and alcohol dependency.anorexia, and alcohol dependency.
 Very effective for the treatment ofVery effective for the treatment of
depression and traumatic stress, such asdepression and traumatic stress, such as
post-traumatic stress disorder (PTSD)post-traumatic stress disorder (PTSD)
and sexual abuse survivors.and sexual abuse survivors.
 Combination of both individual and groupCombination of both individual and group
therapy is most beneficial for mosttherapy is most beneficial for most
clients.clients.
 It has proven effective in treatingIt has proven effective in treating
schizophrenia, bipolar disorder,schizophrenia, bipolar disorder,
anorexia, and alcohol dependency.anorexia, and alcohol dependency.
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1212
GROUPTHERAPYGROUPTHERAPY
27

Theories of Group TherapyTheories of Group Therapy
Important group therapy models are –Important group therapy models are –
 Brief cognitive group therapyBrief cognitive group therapy
 Cognitive-behavioral group therapyCognitive-behavioral group therapy
 Strategic/interactional therapyStrategic/interactional therapy
 Brief group humanistic and existentialBrief group humanistic and existential
therapiestherapies
 Group psychodynamic therapyGroup psychodynamic therapy
 Modified dynamic group therapyModified dynamic group therapy
(MDGT)(MDGT)
 Modified interactional group processModified interactional group process
(MIGP).(MIGP).
Important group therapy models are –Important group therapy models are –
 Brief cognitive group therapyBrief cognitive group therapy
 Cognitive-behavioral group therapyCognitive-behavioral group therapy
 Strategic/interactional therapyStrategic/interactional therapy
 Brief group humanistic and existentialBrief group humanistic and existential
therapiestherapies
 Group psychodynamic therapyGroup psychodynamic therapy
 Modified dynamic group therapyModified dynamic group therapy
(MDGT)(MDGT)
 Modified interactional group processModified interactional group process
(MIGP).(MIGP).
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Gender and Cultural Issues Within GroupsGender and Cultural Issues Within Groups
 Gender, culture and/or sexual preference willGender, culture and/or sexual preference will
help clients in group therapy for sharehelp clients in group therapy for share
 Participation in group therapy may be lessParticipation in group therapy may be less
effective for women than men, perhaps becauseeffective for women than men, perhaps because
groups are often dominated by men and reflectgroups are often dominated by men and reflect
their issues and style of interaction (Jarvis,their issues and style of interaction (Jarvis,
1992).1992).
 It is an effective treatment for women withIt is an effective treatment for women with
posttraumatic stress disorder and abuse disorder.posttraumatic stress disorder and abuse disorder.
 Concerns of ethnicity and race should be handledConcerns of ethnicity and race should be handled
with sensitivity.with sensitivity.
 Cultural issues need to be addressed openly andCultural issues need to be addressed openly and
 Gender, culture and/or sexual preference willGender, culture and/or sexual preference will
help clients in group therapy for sharehelp clients in group therapy for share
 Participation in group therapy may be lessParticipation in group therapy may be less
effective for women than men, perhaps becauseeffective for women than men, perhaps because
groups are often dominated by men and reflectgroups are often dominated by men and reflect
their issues and style of interaction (Jarvis,their issues and style of interaction (Jarvis,
1992).1992).
 It is an effective treatment for women withIt is an effective treatment for women with
posttraumatic stress disorder and abuse disorder.posttraumatic stress disorder and abuse disorder.
 Concerns of ethnicity and race should be handledConcerns of ethnicity and race should be handled
 Cultural issues need to be addressed openly andCultural issues need to be addressed openly and
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 It focuses on creating a therapeuticIt focuses on creating a therapeutic
relationship that is co-operative,relationship that is co-operative,
encouragingencouraging
and practical.and practical.
 Adlerian counselors help clients look atAdlerian counselors help clients look at
theirtheir
lifestyle and personal values to help themlifestyle and personal values to help them
understand and question their usualunderstand and question their usual
patternspatterns
of behavior and hidden goals.of behavior and hidden goals.
 It is a learning process that assists theIt is a learning process that assists the
client to move towards useful involvementclient to move towards useful involvement
andand
contribution to society.contribution to society.
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1313
ADLERIAN THERAPY/ INDIVIDUAL PSYCHOLOGYADLERIAN THERAPY/ INDIVIDUAL PSYCHOLOGY
Alfred W. AdlerAlfred W. Adler
(February 7, 1870 - May 28, 1937)(February 7, 1870 - May 28, 1937)
30

 Social interest is not innate but rather a result ofSocial interest is not innate but rather a result of
social training. Itsocial training. It is individual’s feeling of beingis individual’s feeling of being
partpart
of a whole, spanning the past, present, and theof a whole, spanning the past, present, and the
future.future.
 Those who did not overcome feelings of inferiorityThose who did not overcome feelings of inferiority
developed an inferiority complex and those whodeveloped an inferiority complex and those who
overcompensated for feelings of inferiorityovercompensated for feelings of inferiority
developeddeveloped
a superiority complex.a superiority complex.
 Person’s conscious behavior, not their unconscious,Person’s conscious behavior, not their unconscious,
waswas
the mainstay of personality development.the mainstay of personality development.
 A person is as influenced by future goals as byA person is as influenced by future goals as by
pastpast
experiences (teleology).experiences (teleology).
 Misbehavior would take place when the person hadMisbehavior would take place when the person had
become discouraged or when positive attempts atbecome discouraged or when positive attempts at
goodgood
behavior had failed to get the needed results.behavior had failed to get the needed results.Wednesday, February 7, 2018Wednesday, February 7, 2018
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View of Human NatureView of Human Nature 1313
ADLERIANTHERAPYADLERIANTHERAPY
31

 Birth order of children in family influenced manyBirth order of children in family influenced many
aspects of their personality development.aspects of their personality development.
• Oldest childrenOldest children:: high achievers, parent pleasers,high achievers, parent pleasers,
conforming, and are well behaved.conforming, and are well behaved.
• Second bornSecond born:: outgoing, less anxious, and lessoutgoing, less anxious, and less
constrained by rules.constrained by rules.
• Middle childrenMiddle children:: concerned with perceived unfairconcerned with perceived unfair
treatment, learn to excel in family politics andtreatment, learn to excel in family politics and
negotiation, can become very manipulative.negotiation, can become very manipulative.
• Youngest childYoungest child:: pleasing or entertaining the family,pleasing or entertaining the family,
often high achievers (as the role models ofoften high achievers (as the role models of
siblings).siblings).
• Only ChildOnly Child:: high achievers, lack socialization skills,high achievers, lack socialization skills,
expect pampering, and be selfish. Children born 7expect pampering, and be selfish. Children born 7
oror
more years apart from siblings are more like firstmore years apart from siblings are more like first
born children. Often take on characteristics ofborn children. Often take on characteristics of
theirtheir
parents’ birth order (as the only role models).parents’ birth order (as the only role models).
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 Family is basic socialization unit forFamily is basic socialization unit for
child. Children’s interpretation ofchild. Children’s interpretation of
eventsevents
in their life was determined by thein their life was determined by the
interaction with family membersinteraction with family members
beforebefore
the age of five.the age of five.
 A person with a healthy life styleA person with a healthy life style
contributed to society, had meaningfulcontributed to society, had meaningful
work, and had intimate relationships.work, and had intimate relationships.
 Well adjusted people lived in anWell adjusted people lived in an
interdependent relationship with othersinterdependent relationship with others
inin
a cooperative spirit.a cooperative spirit.
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Family interactions teach children to perceiveFamily interactions teach children to perceive
events and situations through certainevents and situations through certain
subjectivesubjective
evaluations of themselves and theevaluations of themselves and the
environment.environment.
These perceptions that guided children’sThese perceptions that guided children’s
behaviorbehavior
were called fictions.were called fictions.
• Over generalizingOver generalizing: everything is the same or: everything is the same or
alike.alike.
• False or impossible goals of securityFalse or impossible goals of security: try to: try to
pleaseplease
everyone in seeking security and avoidingeveryone in seeking security and avoiding
danger.danger.
• Misperception of life and life’s demandsMisperception of life and life’s demands::
expectexpect
more accommodation than is reasonable andmore accommodation than is reasonable and
interpret failure as never getting any breaks.interpret failure as never getting any breaks.
• Minimization or denial of one’s worth resultsMinimization or denial of one’s worth results::
cannot be successful in life.cannot be successful in life.
• Faulty values resultsFaulty values results: “me first” mentality with: “me first” mentality withWednesday, February 7, 2018Wednesday, February 7, 2018
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 It stresses the unity of personality, needIt stresses the unity of personality, need
toto
view people from their subjectiveview people from their subjective
perspective, and importance of life goalsperspective, and importance of life goals
that give direction to behavior.that give direction to behavior.
 People are motivated by social interestPeople are motivated by social interest
andand
by finding goals to give life meaning.by finding goals to give life meaning.
 Other key concepts are striving forOther key concepts are striving for
significance and superiority, developing asignificance and superiority, developing a
unique lifestyle, and understanding theunique lifestyle, and understanding the
family constellation.family constellation.
 Therapy is a matter of providingTherapy is a matter of providing
encouragement and assisting clients inencouragement and assisting clients in
changing their cognitive perspective.changing their cognitive perspective.
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Key ConceptsKey Concepts 1313
35

Goals of TherapyGoals of Therapy
• Challenge client’s basic premises and life goals.Challenge client’s basic premises and life goals.
• Offer encouragement so individuals can developOffer encouragement so individuals can develop
socially useful goals.socially useful goals.
• Develop client’s sense of belonging.Develop client’s sense of belonging.

Role of the CounselorRole of the Counselor
 Counselor is as a diagnostician, teacher andCounselor is as a diagnostician, teacher and
model.model.
 Counselor helps the client to explore consciousCounselor helps the client to explore conscious
thoughts, beliefs and logic for behaviors.thoughts, beliefs and logic for behaviors.
 Counselor encourages the client to behave “asCounselor encourages the client to behave “as
if”if”
and often provides the client with “homework”and often provides the client with “homework”
assignments outside the sessions.assignments outside the sessions.
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1313
36

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Emphasis is on joint responsibility,Emphasis is on joint responsibility,
mutually determining goals, mutual trustmutually determining goals, mutual trust
& respect, and equality.& respect, and equality.
 A cooperative relationship is manifestedA cooperative relationship is manifested
by a therapeutic contract.by a therapeutic contract.
 Focus is on identifying, exploring, andFocus is on identifying, exploring, and
disclosing mistaken goals and faultydisclosing mistaken goals and faulty
assumptions within the person’sassumptions within the person’s
lifestyle.lifestyle.
Therapeutic RelationshipTherapeutic Relationship 1313ADLERIANTHERAPYADLERIANTHERAPY
37

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Pay more attention to the subjectivePay more attention to the subjective
experiences of clients than to usingexperiences of clients than to using
techniques.techniques.
 Some techniques include gathering life-Some techniques include gathering life-
history data (family constellation, earlyhistory data (family constellation, early
recollections, personal priorities),recollections, personal priorities),
sharing interpretations with clients,sharing interpretations with clients,
offering encouragement, and assistingoffering encouragement, and assisting
clients in searching for newclients in searching for new
possibilities.possibilities.
Techniques of TherapyTechniques of Therapy 1313ADLERIANTHERAPYADLERIANTHERAPY
38

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Most commonly used are establishingMost commonly used are establishing rapportrapport,,
defining style of lifedefining style of life andand helping the client tohelping the client to
gain insightgain insight..
 ConfrontationConfrontation consists of challenging theconsists of challenging the
client’s private logic and behavior.client’s private logic and behavior.
 Asking “Asking “the Questionthe Question” consists of asking the” consists of asking the
client how their life would be different ifclient how their life would be different if
they were well?they were well?
 Acting “as if”Acting “as if” consists of instructing theconsists of instructing the
client to behave “as if” there were noclient to behave “as if” there were no
problemproblem
or as the person that the client would like toor as the person that the client would like to
be.be.
Techniques of TherapyTechniques of Therapy 1313
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978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Spiting in the Client’s soupSpiting in the Client’s soup means that themeans that the
counselor points out the purpose of thecounselor points out the purpose of the
client’s behavior.client’s behavior.
 Catching oneselfCatching oneself consist of helping theconsist of helping the
client learn to bring destructive behaviorclient learn to bring destructive behavior
into awareness and stop it.into awareness and stop it.
 Task settingTask setting consists of helping the clientconsists of helping the client
set short-term goals leading toward theset short-term goals leading toward the
attainment of long-term goals.attainment of long-term goals.
Techniques of TherapyTechniques of Therapy 1313
40

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Because the approach is based on a growth model,Because the approach is based on a growth model,
it is applicable to such varied spheres of life as –it is applicable to such varied spheres of life as –
• child guidance,child guidance,
• parent/child counseling,parent/child counseling,
• marital and family therapy,marital and family therapy,
• individual counseling with all age groups,individual counseling with all age groups,
• correctional and rehabilitation counseling,correctional and rehabilitation counseling,
• group counseling,group counseling,
• substance abuse programs.substance abuse programs.
 It is ideally suited to preventive care andIt is ideally suited to preventive care and
alleviating a broad range of conditions that interferealleviating a broad range of conditions that interfere
with growth.with growth.
ApplicationsApplications 1313ADLERIANTHERAPYADLERIANTHERAPY
41

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Its focus on social interest, collectivism,Its focus on social interest, collectivism,
pursuing meaning in life, importance ofpursuing meaning in life, importance of
family, goal orientation, and belonging isfamily, goal orientation, and belonging is
congruent with many cultures.congruent with many cultures.
 Focus on person-in-environment allows forFocus on person-in-environment allows for
cultural factors to be explored.cultural factors to be explored.
 Some clients may view the counselor as anSome clients may view the counselor as an
authority who will provide answers toauthority who will provide answers to
problems, which conflicts with theproblems, which conflicts with the
egalitarian, person-to-person spirit as aegalitarian, person-to-person spirit as a
way to reduce social distance.way to reduce social distance.
MulticulturalismMulticulturalism 1313ADLERIANTHERAPYADLERIANTHERAPY
42

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 One of the first approaches toOne of the first approaches to
therapy that was humanistic,therapy that was humanistic,
unified, holistic, and goal orientedunified, holistic, and goal oriented
and that put an emphasis on socialand that put an emphasis on social
and psychological factors.and psychological factors.
 Influences the integration ofInfluences the integration of
Adlerian concepts into variousAdlerian concepts into various
contemporary therapies.contemporary therapies.
ContributionsContributions 1313ADLERIANTHERAPYADLERIANTHERAPY
43

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Weak in terms of precision,Weak in terms of precision,
testability, and empirical validity.testability, and empirical validity.
 Few attempts have been made toFew attempts have been made to
validate the basic concepts byvalidate the basic concepts by
scientific methods.scientific methods.
 Tends to oversimplify some complexTends to oversimplify some complex
human problems and is basedhuman problems and is based
heavily on common sense.heavily on common sense.
LimitationsLimitations 1313ADLERIANTHERAPYADLERIANTHERAPY
44

 People act on a conscious level and that they arePeople act on a conscious level and that they are
notnot
driven by instincts and the unconscious.driven by instincts and the unconscious.
 There is a health/growth forces in every personThere is a health/growth forces in every person
thatthat
seeks both physical and psychological health/growth.seeks both physical and psychological health/growth.
ItIt
separates these into the old brain or primitiveseparates these into the old brain or primitive
physicalphysical
needs and into the new brain or psychological needs.needs and into the new brain or psychological needs.
 While the old brain contents itself with maintainingWhile the old brain contents itself with maintaining
life, the new brain seeks belonging, power, freedomlife, the new brain seeks belonging, power, freedom
and fun.and fun.
 Identity or a healthy sense of self is necessary.Identity or a healthy sense of self is necessary. AA
success identity comes from being loved andsuccess identity comes from being loved and
accepted.accepted.
A failure identity comes from not having needs forA failure identity comes from not having needs for
acceptance, love and worth met. A person mustacceptance, love and worth met. A person must
experience identity before they can perform a task.experience identity before they can perform a task.Wednesday, February 7, 2018Wednesday, February 7, 2018
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REALITY THERAPYREALITY THERAPY
Dr. William GlasserDr. William Glasser
(May 11, 1925 – August 23, 2013)(May 11, 1925 – August 23, 2013) 1414
45

Two critical periods of development inTwo critical periods of development in
children –children –
 Children ages 2 to 5 first learnChildren ages 2 to 5 first learn
socializationsocialization
and learn to deal with frustrations andand learn to deal with frustrations and
disappointments. Children not gettingdisappointments. Children not getting
supportsupport
and love from their parents during thisand love from their parents during this
critical time begin to establish a failurecritical time begin to establish a failure
identity.identity.
 Second critical period is between 5 and 10Second critical period is between 5 and 10
years or the early school years. Childrenyears or the early school years. Children
whowho
have socialization or academic problemshave socialization or academic problems
maymay
establish a failure identity.establish a failure identity. Wednesday, February 7, 2018Wednesday, February 7, 2018
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 Human learning is a lifelong process; one canHuman learning is a lifelong process; one can
change one’s identity at any time in one’schange one’s identity at any time in one’s
personalpersonal
history by learning what needs to be learned.history by learning what needs to be learned.
 Humans are self determined. Each person hasHumans are self determined. Each person has
within themselves a picture or perception ofwithin themselves a picture or perception of
themselves. Self image can be maintained bythemselves. Self image can be maintained by
control theory, which has three parts –control theory, which has three parts –
• BB is the behavioris the behavior
• CC is the control, where a comparison is madeis the control, where a comparison is made
between the desired image and the imagebetween the desired image and the image
thethe
behavior is producing.behavior is producing.
• PP is the perception or the development ofis the perception or the development of
thethe
image.image.
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978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Based on choice theory, this approachBased on choice theory, this approach
assumes that we are by nature socialassumes that we are by nature social
creatures and we need quality relationshipscreatures and we need quality relationships
to be happy.to be happy.
 Psychological problems are the result ofPsychological problems are the result of
our resisting the control by others or ofour resisting the control by others or of
our attempt to control others.our attempt to control others.
 Choice theory is an explanation of humanChoice theory is an explanation of human
nature and how to best achieve goodnature and how to best achieve good
relationships.relationships.
Basic PhilosophyBasic PhilosophyREALITYTHERAPYREALITYTHERAPY 1414
48

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Basic focus is on what clients are doingBasic focus is on what clients are doing
and how to get them to evaluateand how to get them to evaluate
whether their present actions arewhether their present actions are
working for them.working for them.
 People create their feelings by thePeople create their feelings by the
choices they make and by what theychoices they make and by what they
do.do.
 This approach rejects the medicalThis approach rejects the medical
model, the notion of transference, themodel, the notion of transference, the
unconscious, and dwelling on one’s past.unconscious, and dwelling on one’s past.
Key ConceptsKey ConceptsREALITYTHERAPYREALITYTHERAPY 1414
49

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Help client to become psychologically strong andHelp client to become psychologically strong and
rational.rational.
 Help clients to determine what they want in life.Help clients to determine what they want in life.
 Help client to develop a practical plan toHelp client to develop a practical plan to
accomplish their personal needs and desires.accomplish their personal needs and desires.
 Establishing an involved and meaningfulEstablishing an involved and meaningful
relationship.relationship.
 Help client put the past behind and focus on theHelp client put the past behind and focus on the
present and the outcome of present behaviors.present and the outcome of present behaviors.
 Accept no excuses and to eliminate punishmentAccept no excuses and to eliminate punishment
from client’s life.from client’s life.
 Help people become more effective in meetingHelp people become more effective in meeting
their needs.their needs.
Goals of TherapyGoals of Therapy 1414
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50

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Counselor is a teacher and a model to client.Counselor is a teacher and a model to client.
 Counselor creates an atmosphere of acceptanceCounselor creates an atmosphere of acceptance
and warmth helping client focus on the controland warmth helping client focus on the control
of displayed thoughts and actions.of displayed thoughts and actions.
 Reality counselor used “ing” verbs to help theReality counselor used “ing” verbs to help the
clients describing their thoughts and actions,clients describing their thoughts and actions,
i.e. angering, bullying, intimidating, excusing.i.e. angering, bullying, intimidating, excusing.
 Focus of therapy is on the behavior that theFocus of therapy is on the behavior that the
client needs or wants to change and how toclient needs or wants to change and how to
change that behavior in a positive manner.change that behavior in a positive manner.
 This therapy does not generally use formalThis therapy does not generally use formal
assessment techniques or diagnostic categories.assessment techniques or diagnostic categories.
Role of CounselorRole of Counselor 1414
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978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Main function is to create a good relationshipMain function is to create a good relationship
with the client.with the client.
 Therapists are then able to engage clients toTherapists are then able to engage clients to
what they want and how effective they are inwhat they want and how effective they are in
getting this.getting this.
 Therapists find out what clients want, ask whatTherapists find out what clients want, ask what
they are choosing to do, invite them tothey are choosing to do, invite them to
evaluate present behavior, help them makeevaluate present behavior, help them make
plans for change, and get them to make aplans for change, and get them to make a
commitment.commitment.
 Therapist is client’s advocate, as long as theTherapist is client’s advocate, as long as the
client is willing to attempt to behaveclient is willing to attempt to behave
responsibly.responsibly.
Therapeutic RelationshipTherapeutic Relationship 1414
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978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 An active, directive, and didactic therapy. MainAn active, directive, and didactic therapy. Main
technique has three basic steps -technique has three basic steps -
1.1.Through involvement with the client, counselor helpsThrough involvement with the client, counselor helps
the client to see the reality and understand how athe client to see the reality and understand how a
behavior is unrealistic.behavior is unrealistic.
2.2.Counselor separates the client from the behavior andCounselor separates the client from the behavior and
rejects the behavior without rejecting the client.rejects the behavior without rejecting the client.
3.3.To teach the client how to fulfill their needsTo teach the client how to fulfill their needs
realistically and positively.realistically and positively.
 Uses humor to point out absurdity without beingUses humor to point out absurdity without being
sarcastic.sarcastic.
 uses confrontation to help the client acceptuses confrontation to help the client accept
responsibility for behavior.responsibility for behavior.
 Final technique is NEVER GIVE UP.Final technique is NEVER GIVE UP.
Therapeutic TechniquesTherapeutic Techniques 1414
53

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
Eight steps that reality therapy uses toEight steps that reality therapy uses to
accomplish its goals and techniques -accomplish its goals and techniques -
1.1. Establishing a relationship.Establishing a relationship.
2.2. Focusing on present behavior.Focusing on present behavior.
3.3. Client evaluation of his or her behavior.Client evaluation of his or her behavior.
4.4. Developing a contract or plan of action.Developing a contract or plan of action.
5.5. Getting a commitment from the client.Getting a commitment from the client.
6.6. Not accepting excuses.Not accepting excuses.
7.7. Allowing reasonable consequences but refusingAllowing reasonable consequences but refusing
to use punishment.to use punishment.
8.8. Refusing to give up on the client.Refusing to give up on the client.
Therapeutic TechniquesTherapeutic Techniques 1414
54

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Geared to teaching people ways ofGeared to teaching people ways of
using choice in everyday living tousing choice in everyday living to
increase effective behaviors.increase effective behaviors.
 It has been applied to individualIt has been applied to individual
counseling, group counseling,counseling, group counseling,
working with youthful law offenders,working with youthful law offenders,
and marital and family therapy.and marital and family therapy.
 In some instances it is well suited toIn some instances it is well suited to
brief therapy and crisis intervention.brief therapy and crisis intervention.
ApplicationsApplications 1414REALITYTHERAPYREALITYTHERAPY
55

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Focus is on members, making ownFocus is on members, making own
evaluation of behavior.evaluation of behavior.
 Clients can find a balance betweenClients can find a balance between
retaining their own ethnic identity andretaining their own ethnic identity and
integrating some of the values andintegrating some of the values and
practices of the dominant society.practices of the dominant society.
 Counselor needs to appreciate the roleCounselor needs to appreciate the role
of discrimination and racism and helpof discrimination and racism and help
clients deal with social and politicalclients deal with social and political
realities.realities.
MulticulturalismMulticulturalism 1414REALITYTHERAPYREALITYTHERAPY
56

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Consists of simple and clear concepts thatConsists of simple and clear concepts that
are easily grasped; thus, it can be used byare easily grasped; thus, it can be used by
teachers, nurses, ministers, educators,teachers, nurses, ministers, educators,
social workers, and counselors.social workers, and counselors.
 It is a positive approach, with an actionIt is a positive approach, with an action
orientation.orientation.
 Due to the direct methods, it appeals toDue to the direct methods, it appeals to
many clients who are often seen asmany clients who are often seen as
resistant to therapy.resistant to therapy.
 It is a short-term approach that can beIt is a short-term approach that can be
applied to a diverse population.applied to a diverse population.
ContributionsContributions 1414REALITYTHERAPYREALITYTHERAPY
57

978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
 Discounts the therapeutic value ofDiscounts the therapeutic value of
exploring the client’s past, dreams, theexploring the client’s past, dreams, the
unconscious, early childhoodunconscious, early childhood
experiences, and transference.experiences, and transference.
 The approach is limited to less complexThe approach is limited to less complex
problems.problems.
 It is a problem-solving therapy thatIt is a problem-solving therapy that
tends to discourage exploration oftends to discourage exploration of
deeper emotional issues.deeper emotional issues.
LimitationsLimitations 1414REALITYTHERAPYREALITYTHERAPY
58

FAMILY SYSTEMS THERAPYFAMILY SYSTEMS THERAPY
Basic PhilosophyBasic Philosophy
 Family is viewed from an interactive andFamily is viewed from an interactive and
systemic perspective.systemic perspective.
 Clients are connected to a living system; aClients are connected to a living system; a
change in one part of the system will result inchange in one part of the system will result in
a change in other parts.a change in other parts.
 Family provides the context for understandingFamily provides the context for understanding
how individuals function in relationship tohow individuals function in relationship to
others and how they behave.others and how they behave.
 Treatment is best focused on the family unit.Treatment is best focused on the family unit.
 An individual’s dysfunctional behavior grows outAn individual’s dysfunctional behavior grows out
of the interactional unit of the family and outof the interactional unit of the family and out
of larger systems as well.of larger systems as well.
Basic PhilosophyBasic Philosophy
 Family is viewed from an interactive andFamily is viewed from an interactive and
systemic perspective.systemic perspective.
 Clients are connected to a living system; aClients are connected to a living system; a
change in one part of the system will result inchange in one part of the system will result in
a change in other parts.a change in other parts.
 Family provides the context for understandingFamily provides the context for understanding
how individuals function in relationship tohow individuals function in relationship to
others and how they behave.others and how they behave.
 Treatment is best focused on the family unit.Treatment is best focused on the family unit.
 An individual’s dysfunctional behavior grows outAn individual’s dysfunctional behavior grows out
of the interactional unit of the family and outof the interactional unit of the family and out
of larger systems as well.of larger systems as well.
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
1515
59

Key ConceptsKey Concepts
 Focus is on communication patterns within a family,Focus is on communication patterns within a family,
both verbal and nonverbal.both verbal and nonverbal.
 Problems in relationships are likely to be passed onProblems in relationships are likely to be passed on
from generation to generation.from generation to generation.
 Symptoms are viewed as ways of communicatingSymptoms are viewed as ways of communicating
with the aim of controlling other family members.with the aim of controlling other family members.
 Key concepts vary depending on specific orientationKey concepts vary depending on specific orientation
but include differentiation, triangles, powerbut include differentiation, triangles, power
coalitions, family-of-origin dynamics, functionalcoalitions, family-of-origin dynamics, functional
versus dysfunctional interaction patterns, familyversus dysfunctional interaction patterns, family
rules governing communication, and dealing withrules governing communication, and dealing with
here-and-now interactions.here-and-now interactions.
 Present is more important than exploring pastPresent is more important than exploring past
experiences.experiences.
 Focus is on communication patterns within a family,Focus is on communication patterns within a family,
both verbal and nonverbal.both verbal and nonverbal.
 Problems in relationships are likely to be passed onProblems in relationships are likely to be passed on
from generation to generation.from generation to generation.
 Symptoms are viewed as ways of communicatingSymptoms are viewed as ways of communicating
with the aim of controlling other family members.with the aim of controlling other family members.
 Key concepts vary depending on specific orientationKey concepts vary depending on specific orientation
but include differentiation, triangles, powerbut include differentiation, triangles, power
coalitions, family-of-origin dynamics, functionalcoalitions, family-of-origin dynamics, functional
versus dysfunctional interaction patterns, familyversus dysfunctional interaction patterns, family
rules governing communication, and dealing withrules governing communication, and dealing with
here-and-now interactions.here-and-now interactions.
 Present is more important than exploring pastPresent is more important than exploring past
experiences.experiences.
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
1515FAMILYSYSTEMSTHERAPYFAMILYSYSTEMSTHERAPY
60

Goals of TherapyGoals of Therapy
 Helping family members gainHelping family members gain
awareness of patterns ofawareness of patterns of
relationships that are notrelationships that are not
working well and create new waysworking well and create new ways
of interacting to relieve theirof interacting to relieve their
distress.distress.
 Focus on resolving the specificFocus on resolving the specific
problem that brings the family.problem that brings the family.
 Helping family members gainHelping family members gain
awareness of patterns ofawareness of patterns of
relationships that are notrelationships that are not
working well and create new waysworking well and create new ways
of interacting to relieve theirof interacting to relieve their
distress.distress.
 Focus on resolving the specificFocus on resolving the specific
problem that brings the family.problem that brings the family.
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
1515
FAMILYSYSTEMSTHERAPYFAMILYSYSTEMSTHERAPY
61

Therapeutic RelationshipTherapeutic Relationship
 Family therapist functions as a teacher, coach,Family therapist functions as a teacher, coach,
model, and consultant.model, and consultant.
 Family learns ways to detect and solve problemsFamily learns ways to detect and solve problems
that are keeping members stuck, and it learnsthat are keeping members stuck, and it learns
about patterns that have been transmitted fromabout patterns that have been transmitted from
generation to generation.generation to generation.
 Some approaches focus on the role of therapist asSome approaches focus on the role of therapist as
expert; others concentrate on intensifying what isexpert; others concentrate on intensifying what is
going on in the here and now of the family session.going on in the here and now of the family session.
 All family therapists are concerned with theAll family therapists are concerned with the
process of family interaction and teaching patternsprocess of family interaction and teaching patterns
of communication.of communication.
 Family therapist functions as a teacher, coach,Family therapist functions as a teacher, coach,
model, and consultant.model, and consultant.
 Family learns ways to detect and solve problemsFamily learns ways to detect and solve problems
that are keeping members stuck, and it learnsthat are keeping members stuck, and it learns
about patterns that have been transmitted fromabout patterns that have been transmitted from
generation to generation.generation to generation.
 Some approaches focus on the role of therapist asSome approaches focus on the role of therapist as
expert; others concentrate on intensifying what isexpert; others concentrate on intensifying what is
going on in the here and now of the family session.going on in the here and now of the family session.
 All family therapists are concerned with theAll family therapists are concerned with the
process of family interaction and teaching patternsprocess of family interaction and teaching patterns
of communication.of communication.
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
62

Techniques of TherapyTechniques of Therapy
 There is a diversity of techniques, dependingThere is a diversity of techniques, depending
on the particular theoretic orientation.on the particular theoretic orientation.
 Interventions may target behavior change,Interventions may target behavior change,
perceptual change, or both.perceptual change, or both.
 Techniques include using genograms, teaching,Techniques include using genograms, teaching,
asking questions, family sculpting, joining theasking questions, family sculpting, joining the
family, tracking sequences, issuing directives,family, tracking sequences, issuing directives,
anchoring, use of counter-transference, familyanchoring, use of counter-transference, family
mapping, refraining, paradoxical interventions,mapping, refraining, paradoxical interventions,
restructuring, enactments, and settingrestructuring, enactments, and setting
boundaries.boundaries.
 Techniques may be experiential, cognitive, orTechniques may be experiential, cognitive, or
behavioral in nature.behavioral in nature.
 There is a diversity of techniques, dependingThere is a diversity of techniques, depending
on the particular theoretic orientation.on the particular theoretic orientation.
 Interventions may target behavior change,Interventions may target behavior change,
perceptual change, or both.perceptual change, or both.
 Techniques include using genograms, teaching,Techniques include using genograms, teaching,
asking questions, family sculpting, joining theasking questions, family sculpting, joining the
family, tracking sequences, issuing directives,family, tracking sequences, issuing directives,
anchoring, use of counter-transference, familyanchoring, use of counter-transference, family
mapping, refraining, paradoxical interventions,mapping, refraining, paradoxical interventions,
restructuring, enactments, and settingrestructuring, enactments, and setting
boundaries.boundaries.
 Techniques may be experiential, cognitive, orTechniques may be experiential, cognitive, or
behavioral in nature.behavioral in nature.
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
63

ApplicationsApplications
 Applications vary depending on theApplications vary depending on the
particular approach to family therapy.particular approach to family therapy.
 Useful for dealing with maritalUseful for dealing with marital
distress, problems of communicatingdistress, problems of communicating
among family members, poweramong family members, power
struggles, crisis situations in thestruggles, crisis situations in the
family, helping individuals attain theirfamily, helping individuals attain their
potential, and enhancing the overallpotential, and enhancing the overall
functioning of the family.functioning of the family.
 Applications vary depending on theApplications vary depending on the
particular approach to family therapy.particular approach to family therapy.
 Useful for dealing with maritalUseful for dealing with marital
distress, problems of communicatingdistress, problems of communicating
among family members, poweramong family members, power
struggles, crisis situations in thestruggles, crisis situations in the
family, helping individuals attain theirfamily, helping individuals attain their
potential, and enhancing the overallpotential, and enhancing the overall
functioning of the family.functioning of the family.
978-984-8798-22-5, Dkaka - 1100;978-984-8798-22-5, Dkaka - 1100;
1515
FAMILYSYSTEMSTHERAPYFAMILYSYSTEMSTHERAPY
64

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