The document explains various methods of assessment used in the process of guidance and counselling. The methods discussed in detail are: Intake interview, case study, mental status examination, psychological assessment tools; such as, cognitive and personality assessment. The document further elaborates some intervention techniques; such as, relaxation training, assertion training, bio-feedback, systematic desensitisation, A-B-C model of cognitive behaviour approach, rational-emotive therapy, etc. employed in guidance and counselling.

1. Guidance and Counselling:
Assessment and Intervention
Ari Sudan Tiwari, Ph. D.

2. Guidance and counselling
Enables the individual to understand his/her abilities,
interests, thought content and process, emotions,
motives, conflicts, etc.
A process that brings about sequential changes over a
period of time leading to a set goal
Relationship between counsellor and counsellee is
characterised by trust, warmth and understanding
Difference among guidance, counselling and
psychotherapy

3. Process of guidance and counselling
Initial assessment and establishing rapport
Intake interview
Problem identification and exploration
Case history
Mental status examination
Psychological assessment
Planning for problem solving
Choosing appropriate intervention
Solution application and termination
Executing intervention

4. Intake interview
A method for gathering basic data or information about
the client in order to arrive at a provisional diagnosis
Structured interview
Semi-structured interview
Unstructured interview

5. Attitude of interviewer and interviewee
Proper atmosphere: Physical and psychological
Interviewer’s effective response
Measuring understanding
Recording responses
Interview is different from general communication or
conversation
Basic issues in intake interview

6. Case history
Method for gathering in depth information about the
client
Focused on getting the details of the client’s life
Compulsorily a structured interview
Recording responses
Important for testing, diagnostic and therapeutic
choice

7. Modal format for case history
Identification data: Name, age, sex, marital status, education,
occupation, etc.
Informants: Include all informants, their relationship to the client
and estimated reliability
Chief complaints:
Must be a quotation of the client's own complaint and not the
relative's statement or the doctor's paraphrase.
If desired, an additional chief complaint, that of an informant
other than the patient, may be added provided the source is
made clear.

8. Modal format for case history
Present illness:
Cardinal symptoms including pertinent positives and
negatives, organized by diagnostic category
Onset and duration of symptoms and treatments
received
Evidence of functional impairment
Exclusion criteria, psychiatric and organic
Include all the diagnostic possibilities
The concluding sentence of the present illness should be a
statement of the event precipitating admission at this time, and of
the means whereby the patient was brought to the hospital

9. Modal format for case history
Personal history:
Family history
Birth and development
School history
Medical history
Social history
Sexual history
Occupational history
Emotional development
Premorbid personality
Client’s fantasy life

10. Modal format for case history
Physical examination: Vital signs and complete
neurological investigation
Mental status examination
General appearance and behaviour
Form of thought
Content of thought
Affect
Sensorium and intellectual resources
Insight and judgment

11. Modal format for case history
Impression: Diagnostic choice using DSM Multiaxial
System
Differential diagnosis: Including impression as first
choice. Be inclusive, not exclusive; use precise
terminology.
Discussion: Supporting diagnostic choice
Recommendations:
Diagnosis
Therapy

12. Mental status examination (MSE)
Part 1: General appearance and behaviour
Does the client appear his stated age?
General condition and dress (well-nourished, unshaven,
tousled, etc.)
Is he responsive, alert, cooperative?
Facial expression: sad, happy, smiling, weeping, dull or
expressionless, stiff, ecstatic
Unusual motor activities: Overly active, underactive,
stereotypes, mannerisms, forced grasping, stupor, posturing,
waxy flexibility, restlessness, picking motions, etc.

13. Mental status examination (MSE)
Part 2: Form of thought
Rate and rhythms of thought patterns/speech: Rapid and
difficult to interrupt (push of speech), speech easily distracted by
surroundings, spontaneous speech, excessive speech, few
words, slow speech, speech in answer to questions only,
monosyllabic answers, increased, decreased or variable latency
of response in answer to questions, sudden stoppage of speech
interrupting a thought sequence (thought blocking), and no
speech at all (mute)

14. Mental status examination (MSE)
Associated patterns of speech:
Sentence and phrase patterns:
Echolalia: Repeating what is said by other people as
if echoing them
Circumstantial speech: Going from one idea to
another with the inclusion of many trivial details
Flight of ideas: Rapid digression from one idea to
another.
Tangential, disconnected, incoherent, irrelevant and
loose associations
Perseveration: Repeating the same word, phrase,
sentence or idea over and over again

15. Mental status examination (MSE)
Word patterns:
Clang association: Connecting together words that
have the same sound
Word salad: Series of disconnected or unrelated
words
Alliteration : Words that follow one another that begin
with the same sound
Syllable patterns:
Neologisms: Inventing new words by connecting
together syllables

16. Mental status examination (MSE)
Part 3: Content of thought
Phobias
Obsessions
Compulsions
Depersonalization
Derealization
Illusion
Hallucination
Delusion

17. Mental status examination (MSE)
Part 4: Affect
Type: Depressed, normal or elevated, anxious, fearful, irritable,
euphoric, hostile
Lability: Susceptibility to mood swing, complete loss of control
of emotion, emotional blunting, flattening of affect, etc.
Appropriateness of emotions

18. Mental status examination (MSE)
Part 5: Sensorium and intellectual resources
Attention
Concentration
Perception
Memory
Intelligence
Part 6: Insight and judgement
Insight
Judgement

19. Psychological Assessment in
Counselling

20. Relevance of psychological assessment in counselling
Assessing the client’s problem(s)
Conceptualizing and defining the client problem(s)
Intensity and frequency of the client’s problem(s)
Selecting and implementing effective counselling
Evaluating counselling process
Assessment may have therapeutic value

21. Types of assessment tools
Standardized vs. non-standardized
Objective vs. subjective
Speed vs. power
Individual vs. group
Verbal vs. non-verbal/performance
Cognitive vs. Affective
Developmental vs. staged

22. Issues in psychological assessment
Scale
Instructions
Reliability
Validity
Norms
Response biases

23. Assessment of Cognitive Abilities

24. Issues in cognitive assessment
Theory structure of the test being used
Test of content or appraisal of process
Fairness dimensions
Functional vs. organic interpretations

25. Stanford-Binet Scale (SB 5)
Assessment range: 2-89 years
Number of items: 129
Content of assessment: Fluid Reasoning, Knowledge,
Quantitative Reasoning, Visual-Spatial Processing,
and Working Memory
Process of assessment: Verbal and non-verbal

26. Stanford-Binet Scale (SB 5)
Factor
Indices
Domains
Non-verbal Verbal
Fluid
Reasoning
Activity: Object-Series/Matrices
Requires the ability to solve novel
figural problems and identify
sequences of pictured objects or
matrix-type figural and geometric
patterns
Activities: Early Reasoning, Verbal
Absurdities, Verbal Analogies
Requires the ability to analyze and
explain, using deductive and
inductive reasoning, problems
involving cause effect connections
in pictures, classification of objects,
absurd statements, and
interrelationships among words

27. Stanford-Binet Scale (SB 5)
Factor
Indices
Domains
Non-verbal Verbal
Knowledge
Activity: Procedural Knowledge,
Picture Absurdities
Requires knowledge about common
signals, actions, and objects and the
ability to identify absurd or missing
details in pictorial material
Activity: Vocabulary
Requires the ability to apply
accumulated knowledge of
concepts and language and to
identify and define increasingly
difficult words

28. Stanford-Binet Scale (SB 5)
Factor
Indices
Domains
Non-verbal Verbal
Quantitative
Reasoning
Activity: Nonverbal Quantitative
Reasoning
Requires the ability to solve
increasingly difficult pre-
mathematic, arithmetic, algebraic,
or functional concepts and
relationships depicted in
illustrations
Activity: Verbal Quantitative
Reasoning
Requires the ability to solve
increasingly difficult mathematical
tasks involving basic numerical
concepts, counting, and word
problems

29. Stanford-Binet Scale (SB 5)
Factor
Indices
Domains
Non-verbal Verbal
Visual-Spatial
Processing
Activity: Form Board, Form
Patterns
Requires the ability to visualize
and solve spatial and figural
problems presented as “puzzles”
or complete patterns by moving
plastic pieces into place
Activity: Position & Direction
Requires the ability to identify
common objects and pictures
using common visual-spatial terms
such as “behind” and “farthest
left,” explain spatial directions for
reaching a pictured destination, or
indicate direction and position in
relation to a reference point

30. Stanford-Binet Scale (SB 5)
Factor
Indices
Domains
Non-verbal Verbal
Working
Memory
Activity: Delayed Response, Block
Span
Requires the ability to sort visual
information in short-term memory
and to demonstrate short-term and
working memory skills for tapping
sequences of blocks
Activity: Memory for Sentences,
Last Word
Requires the ability to demonstrate
short-term and working memory for
words and sentences and to store,
sort, and recall verbal information
in short-term memory

31. Stanford-Binet Scale (SB 5): Scoring and interpretation
Sub-testlet scores (10), Factor indices (5), Domain
sores (2), Full Scale IQ and Change-Sensitive Scores
Norms:
Sub-testlet scores: Mean = 10, SD = 3
Composite scores: Mean = 100, SD = 15

32. Wechsler Intelligence Scales
Wechsler Adult
Intelligence Scale
(Age range: 16-90 years)
Wechsler Intelligence
Scale for Children
(Age range: 6-16 years)
Wechsler Preschool and
Primary Scale of
Intelligence
(Age range: 2 1/2-7 years)
Wechsler-Bellevue-I: 1939 Wechsler-Bellevue-II: 1946 WPPSI: 1967
WAIS: 1955 WISC: 1949 WPPSI-R: 1989
WAIS-R: 1981 WISC-R: 1974 WPPSI-III: 2002
WAIS-III: 1997 WISC-III: 1991
WAIS-IV: 2008 WISC-IV: 2003

33. WAIS: Structure
Four factors measured by 10 core subtests and five
supplemental subtests
Verbal Comprehension:
Similarities: Abstract verbal reasoning
Vocabulary: The degree to which one has learned, been able
to comprehend and verbally express vocabulary
Information: Degree of general information acquired from
culture
Comprehension (Supplemental): Ability to deal with abstract
social conventions, rules and expressions

34. WAIS: Structure
Perceptual Reasoning :
Block design: Spatial perception, visual abstract processing
and problem solving
Matrix reasoning: Nonverbal abstract problem solving,
inductive reasoning, spatial reasoning
Visual puzzles: non-verbal reasoning
Picture completion (Supplemental): Ability to quickly perceive
visual details
Figure weights (Supplemental): Quantitative and analogical
reasoning

35. WAIS: Structure
Working Memory :
Digit span: Attention, concentration, mental control
Arithmetic: Concentration while manipulating mental
mathematical problems
Letter-number sequencing (Supplemental): Attention and
working memory
Processing Speed:
Symbol search: Visual perception, speed
Coding: Visual-motor coordination, motor and mental speed
Cancellation (Supplemental): Visual-perceptual speed

36. WAIS: Scoring and interpretation
Factor indices:
Verbal Comprehension Index (VCI)
Perceptual Reasoning Index (PRI)
Working Memory Index (WMI)
Processing Speed Index (PSI)
General Ability Index (GAI): Combined score on the six
core subtests that comprise the VCI and PRI
Full Scale IQ (FSIQ): Total combined performance of the
VCI, PRI, WMI, and PSI (Mean = 100, SD = 15)

37. Assessment of Personality

38. Issues in personality assessment
Theoretical framework
Assessment of structure or appraisal of process
Fairness dimensions
Functional/psychological vs. organic/biological
interpretations

39. 16 Personality Factor (16 PF)
Factor analytic approach
185 items/questions asking about actual behavioural
situations
Responses in categories of True/False
Translated into more than 20 languages and dialects

40. Primary factors and descriptors of 16 PF
Descriptors of low range Primary factors Descriptors of high range
Impersonal, distant, cool,
reserved, detached, formal, aloof
Warmth
(A)
Warm, outgoing, attentive to
others, kindly, easy-going,
participating, likes people
Concrete thinking, lower general
mental capacity, less intelligent,
unable to handle abstract
problems
Reasoning
(B)
Abstract-thinking, more
intelligent, bright, higher general
mental capacity, fast learner
Reactive emotionally,
changeable, affected by feelings,
emotionally less stable, easily
upset
Emotional stability
(C)
Emotionally stable, adaptive,
mature, faces reality calmly
Deferential, cooperative, avoids
conflict, submissive, humble,
obedient, easily led, docile,
accommodating
Dominance
(E)
Dominant, forceful, assertive,
aggressive, competitive,
stubborn, bossy

41. Primary factors and descriptors of 16 PF
Descriptors of low range Primary factors Descriptors of high range
Serious, restrained, prudent,
taciturn, introspective, silent
Liveliness
(F)
Lively, animated, spontaneous,
enthusiastic, happy go lucky,
cheerful, expressive, impulsive
Expedient, nonconforming,
disregards rules, self-indulgent
Rule consciousness
(G)
Rule-conscious, dutiful,
conscientious, conforming,
moralistic, staid, rule bound
Shy, threat-sensitive, timid,
hesitant, intimidated
Social boldness
(H)
Socially bold, venturesome, thick
skinned, uninhibited
Utilitarian, objective,
unsentimental, tough minded,
self-reliant, no-nonsense, rough
Sensitivity
(I)
Sensitive, aesthetic, sentimental,
tender minded, intuitive, refined
Trusting, unsuspecting,
accepting, unconditional, easy
Vigilance
(L)
Vigilant, suspicious, skeptical,
distrustful, oppositional

42. Primary factors and descriptors of 16 PF
Descriptors of low range Primary factors Descriptors of high range
Grounded, practical, prosaic,
solution oriented, steady,
conventional
Abstractedness
(M)
Abstract, imaginative, absent
minded, impractical, absorbed in
ideas
Forthright, genuine, artless,
open, guileless, naive,
unpretentious, involved
Privateness
(N)
Private, discreet, non-disclosing,
shrewd, polished, worldly, astute,
diplomatic
Self-Assured, unworried,
complacent, secure, free of guilt,
confident, self-satisfied
Apprehension
(O)
Apprehensive, self doubting,
worried, guilt prone, insecure,
worrying, self blaming
Traditional, attached to familiar,
conservative, respecting
traditional ideas
Openness to change
(Q1)
Open to change, experimental,
liberal, analytical, critical, free
thinking, flexibility

43. Primary factors and descriptors of 16 PF
Descriptors of low range Primary factors Descriptors of high range
Group-oriented, affiliative, a
joiner and follower dependent
Self reliance
(Q2)
Self-reliant, solitary, resourceful,
individualistic, self-sufficient
Tolerates disorder, unexacting,
flexible, undisciplined, lax, self-
conflict, impulsive, careless of
social rules, uncontrolled
Perfectionism
(Q3)
Perfectionist, organized,
compulsive, self-disciplined,
socially precise, exacting will
power, control, self-sentimental
Relaxed, placid, tranquil, torpid,
patient, composed low drive
Tension
(Q4)
Tense, high energy, impatient,
driven, frustrated, over wrought,
time driven

44. Global factors and descriptors of 16 PF
Descriptors of low range Global factors Descriptors of high range
Introverted, socially inhibited Extraversion
Extraverted, socially
Participating
Low Anxiety, emotional
stability
Anxiety/Neuroticism
High Anxiety, emotional
instability
Receptive, open-minded,
intuitive
Tough-mindedness
Tough-minded, resolute, un-
empathic
Accommodating, agreeable,
selfless
Independence
Independent, persuasive,
wilful
Unrestrained, follows urges Self-control Self-controlled, inhibits urges

45. 16 PF: Scoring and interpretation
Raw scores converted into Sten Scores
Sten Scores on 16 primary factors and 5 global factors
are presented as a profile
Three validity indices are presented in percentiles,
scores between p40 to p60 are supposed to be within
expected range:
Impression Management
Infrequency
Acquiescence
Combinations of various primary and global factors are
used for interpretation on various dimensions

46. MMPI-II
Developed by McKinley & Hathaway (1940) at
University of Minnesota Hospital
Presently available in two forms: MMPI-II (567 items)
and MMPI-A (478 items)
Responses in two categories: True/False
10 validity scales, 10 clinical scales and 15 content
scales
Interpretation:
Raw scores of each scale are converted into T
Score
Above 65 T Score: Elevated
60-65 T Score: Moderately elevated

47. MMPI-II & A: Validity scales
Cannot Say Score (?): The total number of items that the
individual did not answer.
VRIN Scale: The Variable Response Inconsistency scale
examines consistency of response and can be helpful in
determining if the person randomly marked answers or had
difficulty understanding the items. VRIN consists of paired
items in which the content is very similar or opposite.
TRIN Scale: The True Response Inconsistency scale is
designed to measure “yea-saying” or “nay-saying.” These are
paired items with consistency indicated by answering true
one time and false the other time.

48. MMPI-II & A: Validity scales
F Scale: The Infrequency (F) scale concerns whether the
individual is faking or attempting to exaggerate symptoms.
Endorsing a large number of these items indicates the test
taker is presenting an extremely symptomatic picture not
found in the general population.
FB Scale: The Infrequency Back (FB) scale, an extension
of the F scale, measures items that are infrequently endorsed
by the general population.
FP Scale: The Psychopathology Infrequency (FP) scale
indicates the veracity of the client’s negative symptoms.
Designed to indicate rare or extreme responses in a
psychiatric setting as compared with the other F scales,
which indicate rare responses in a normal setting.

49. MMPI-II & A: Validity scales
FBS Scale: The Symptom Validity (FBS) Scale, informally
labeled as fake bad scale, useful in measuring potentially
exaggerated claims of disability.
L Scale: The Lie (L) scale provides an indication of the
degree to which the individual is trying to look good.
K Scale: The Correction (K) scale measures defensiveness
or guardedness. More subtle than the L scale but measures
the same dimension of trying to present oneself in an overly
positive manner.
S Scale: The Superlative Self-Presentation (S) scale is an
additional measure of defensiveness to provide information
on the possible reasons underlying the defensive attitude.

50. MMPI-II & A: Clinical scales
Clinical scales Descriptors/symptoms of high scorers
Hypochondriasis (Hs)
Cynical, defeatist, preoccupied with self, complaining, hostile
and presenting numerous physical problems
Depression (D) Moody, shy, despondent, pessimistic and distressed
Conversion Hysteria
(Hy)
Repressed, dependent, naive, outgoing and having multiple
physical complaints
Psychopathic Deviate
(Pd)
Rebellious, impulsive, hedonistic and antisocial
Masculinity-
Femininity (FM)
Males: Sensitive, aesthetic, passive and feminine
Females: Aggressive, rebellious and unrealistic

51. MMPI-II & A: Clinical scales
Clinical scales Descriptors/symptoms of high scorers
Paranoia (Pa)
Suspicious, aloof, shrewd, guarded, worrisome, overly
sensitive and project or externalize blame
Psychasthenia (Pt)
Tense, anxious, ruminative, preoccupied, obsessional, phobic,
rigid, self-condemning and feeling inferior and inadequate
Schizophrenia (Sc)
Withdrawn, shy, unusual, peculiar thoughts and ideas,
delusions and hallucinations
Hypomania (Ma)
Sociable outgoing, impulsive, overly energetic, optimistic, and
in some cases amoral, fighty, confused and disoriented
Social Introversion-
Extraversion (Si)
Modest, shy, withdrawn and inhibiting.

52. MMPI-II & A: Content scales
Content scales Descriptors/symptoms of high scorers
Anxiety (ANX)
Tension, somatic problems, sleep difficulties, excessive worry,
and concentration problems
Fear (FRS) Specific fears or phobias (excluding general anxiety)
Obsessiveness
(OBS)
Rumination and obsessive thinking, difficulties with decisions,
and distressed with change
Depression (DEP)
Depression, feeling blue, uninterested in life, brooding,
unhappiness, hopelessness, frequent crying, and feeling
distant from others
Health Concerns
(HEA)
Many physical complaints across body systems, worry about
health, and reports of being ill

53. MMPI-II & A: Content scales
Content scales Descriptors/symptoms of high scorers
Bizarre Mentation
(BIZ)
Thought disorder that may include hallucinations, paranoid
ideation, and delusions
Anger (ANG)
Anger control problems, irritability, being hotheaded, and
having been physically abusive
Cynicism (CYN)
Misanthropic beliefs, suspicion of others’ motives, and
distrustful of others
Antisocial Practices
(ASP)
Misanthropic attitudes, problem behaviors in school, antisocial
practices, and enjoyment of criminals’ antics
Type A Personality
(TPA)
Hard-driven and competitive personality, work-oriented, often
irritable and annoyed, overbearing in relationships

54. MMPI-II & A: Content scales
Content scales Descriptors/symptoms of high scorers
Low Self-Esteem
(LSE)
Negative view of self that does not include depression and
anxiety, feeling unimportant and disliked
Social Discomfort
(SOD)
Uneasiness in social situations and preference to be alone
Family Problems
(FAM)
Family discord, families seen as unloving, quarrelsome, and
unpleasant
Work Interference
(WRK)
Problems with and negative attitudes toward work or
achievement
Negative Treatment
Indicators (TRT)
Negative attitude toward physicians and mental health
professionals

55. What do counselors need to know about assessment?
Theory relevant to the testing context and type of counselling
specialty
Testing theory, techniques of test construction, reliability and validity
Sampling techniques, norms, and descriptive, correlational and
predictive statistics
Ability to review, select and administer tests appropriate for clients
Administration of tests and interpretation of test scores
Impact of diversity on testing accuracy, including age, gender,
ethnicity, race, disability and linguistic differences
Professionally responsible use of assessment and evaluation
practice

56. Intervention Techniques in
Counselling

57. Goals of counselling
Developmental goals
Preventive goals
Enhancement goals
Remedial goals
Exploratory goals
Reinforcement goals
Cognitive goals
Physiological goals
Psychological goals

58. Basic assumptions of behaviour modification techniques
All behaviour, normal and abnormal, is acquired and maintained in
identical ways (that is, according to the principles of learning)
Behaviour disorders represent learned maladaptive patterns that
need not presume some inferred underlying cause or unseen motive
Maladaptive behaviour, such as symptoms, is itself the disorder,
rather than a manifestation of a more basic underlying disorder or
disease process
It is not essential to discover the exact situation or set of
circumstances in which the disorder was learned; these
circumstances are usually irretrievable anyway. Rather, the focus
should be on assessing the current determinants that support and
maintain the undesired behaviour

59. Basic assumptions of behaviour modification techniques
Maladaptive behaviour, having been learned, can be extinguished
(that is, unlearned) and replaced by new learned behaviour patterns
Treatment involves the application of the experimental findings of
scientific psychology, with an emphasis on developing a
methodology that is precisely specified, objectively evaluated and
easily replicated
Assessment is all ongoing part of treatment, as the effectiveness of
treatment is continuously evaluated and specific intervention
techniques are individually tailored to specific problems

60. Basic assumptions of behaviour modification techniques
Behaviour therapy concentrates all "here and now" problems, rather
than uncovering or attempting to reconstruct the past. The therapist
is interested in helping the client identify and change current
environmental stimuli that reinforce the undesired behaviour, in order
to alter the client’s behaviour
Treatment outcomes arc evaluated in terms of measurable
behavioural changes.
Research and scientific validation for specific therapeutic techniques
have continuously been carried out by behaviour therapists

61. Theory of classical conditioning: Ivan P. Pavlov
When a neutral stimulus (conditioned stimulus, CS) is
paired with a natural stimulus (unconditioned stimulus,
UCS), neutral stimulus alone acquires the ability to elicit
the response (conditioned response, CR) which naturally
occurs (unconditioned response, UCR) after natural
stimulus

62. Paradigm of classical conditioning
Stimulus Response
Neutral/Conditioned Stimulus No response
Natural/Unconditioned Stimulus Unconditioned response
Continuous pairing of the two stimuli
Neutral/Conditioned Stimulus (alone) Conditioned response

63. Experimental phenomena of classical conditioning
Extinction
Spontaneous recovery
Reconditioning
Stimulus generalization and discrimination

64. Theory of instrumental conditioning: B. F. Skinner
Behaviour
Change in the
environment
Desirable
Undesirable
Increases the likelihood of
behaviour
Decreases the likelihood of
behaviour

65. Paradigm of instrumental conditioning
Nature of the event following a response
Appetitive Aversive
Consequenceofa
response
Onset of
event
Positive reinforcement
(Increases the likelihood
of behaviour)
Punishment
(Decreases the
likelihood of behaviour)
Termination
of event
Omission of
reinforcement
(Decreases the
likelihood of behaviour)
Negative reinforcement
(Increases the likelihood
of behaviour)

66. Behaviour modification techniques
Relaxation training
Assertion training
Bio-feedback
Systematic desensitisation

67. Relaxation training
A method, process, procedure, or activity that helps a person
to relax, to attain a state of increased calmness and to reduce
levels of pain, anxiety, stress or anger
Biofeedback
Deep breathing
Meditation
Mind-body relaxation
Zen Yoga
Progressive
Muscle Relaxation
Pranayama
Visualization
Yoga Nidra
Self-hypnosis
Autogenic training

68. Assertion training: Social skill training
Can be useful for those:
Who cannot express anger or irritation
Who have difficulty saying no
Who are overly polite and allow others to take advantage of them
Who find it difficult to express affection & other positive responses
Who feel they do not have a right to express their thoughts,
beliefs and feelings
Who have social phobia

69. Assertion training: Social skill training
Basic assumption: People have the right (not the obligation) to
express themselves
Process: Model presentation, Behaviour rehearsal, Feedback,
Promting, Programming of change and Homework assignments
Goals:
To increase people’s behavioural repertoire so that they can make
the choice of whether to behave assertively in certain situations
To teach people to express themselves in ways that reflect
sensitivity to the feelings and rights of others

70. Biofeedback
A process that enables an individual to learn how to change
physiological activity for the purposes of improving health and
performance
Precise instruments measure physiological activity such as
brainwaves, heart function, breathing, muscle activity, and skin
temperature
These instruments rapidly and accurately 'feed back' information to
the user which in conjunction with changes in thinking, emotions,
and behaviour supports desired physiological changes.

71. Systematic desensitisation
Systematic Desensitization (Wolpe, 1958; 1961) gradually
exposes person to the feared object by moving through an
anxiety hierarchy while delivering stimuli that are incompatible
with anxiety, like relaxation
Often starts with in-vitro (imagined) stimuli, and moves to in-
vivo (real) ones

72. Steps of systematic desensitisation
Establish anxiety stimulus hierarchy. The individual must first
identify the items that are causing anxiety. Each item that
causes anxiety is given a subjective ranking on the severity of
induced anxiety.
Learn coping mechanism or incompatible response.
Relaxation training, such as meditation, is one type of coping
strategy. Wolpe taught his patients relaxation responses
because it is not possible to be both relaxed and anxious at
the same time.

73. Steps of systematic desensitisation
Connect the stimulus to the incompatible response or coping
method through counter conditioning. In this step the client
completely relaxes and is then presented with the lowest item
that was placed on their hierarchy of severity of anxiety. When
the client has reached a state of serenity again after being
presented with the first stimuli, the second stimuli of higher
level of anxiety is presented. Again, the individual practices the
coping strategies learned. This activity is completed until all
items of the hierarchy of severity of anxiety is completed
without inducing anxiety in the client.

74. Cognitive learning
Learning without being involved in any active process
 Selection of information from the environment
 Making alterations in the selected information
 Associating the items of information with each other
 Elaborating information in thought
 Storage of information
 Retrieval of information when needed

75. Cognitive behaviour approach
Situations Automatic thoughts
Emotional/behavioural
reactions
Assumptions/rules
Core beliefs

76. A-B-C model of cognitive behaviour approach
‘A’
Activating event
What happened:
Friend passed me
in the street without
acknowledging me.
Inferences about
what happened:
He’s ignoring me.
He doesn’t like me.
‘B’
Belief about ‘A’
Evaluation: I am
unacceptable as a
friend, so I must be
worthless as a
person.
‘C’
Consequence
Emotions: Depressed.
Behaviours: Avoiding
people generally.

77. Cognitive distortions
Mind reading: You assume that you know what people think
without having sufficient evidence of their thoughts. "He thinks I'm
a loser."
Fortune telling: You predict the future--that things will get worse
or that there is danger ahead. "I'll fail that exam" and "I won't get
the job."
Catastrophizing: You believe that what has happened or will
happen will be so awful and unbearable that you won't be able to
stand it. "It would be terrible if I failed."
Labeling: You assign global negative traits to yourself and
others. "I'm undesirable" or "He's a rotten person.”

78. Cognitive distortions
Discounting positives: You claim that the positives that you or others
attain are trivial."That's what wives are supposed to do, so it doesn't
count when she's nice to me." "Those successes were easy, so they
don't matter."
Negative filter: You focus almost exclusively on the negatives and
seldom notice the positives. "Look at all of the people who don't like
me."
Overgeneralizing: You perceive a global pattern of negatives on the
basis of a single incident. "This generally happens to me. I seem to fail
at a lot of things."
Dichotomous thinking: You view events, or people, in all-or-nothing
terms. "I get rejected by everyone" or "It was a waste of time."

79. Cognitive distortions
Shoulds: You interpret events in terms of how things should be
rather than simply focusing on what is. "I should do well. If I don't,
then I'm a failure."
Personalizing: You attribute a disproportionate amount of the blame
to yourself for negative events and fail to see that certain events are
also caused by others. "The marriage ended because I failed."
Blaming: You focus on the other person as the source of your
negative feelings and refuse to take responsibility for changing
yourself. "She's to blame for the way I feel now" or "My parents
caused all my problems.”

80. Cognitive distortions
Unfair comparisons: You interpret events in terms of standards that
are unrealistic, for example, you focus primarily on others who do
better than you and find yourself inferior in the comparison. "She's
more successful than I am" or "Others did better than I did on the
test."
Regret orientation: You focus on the idea that you could have done
better in the past, rather on what you can do better now. "I could
have had a better job if I had tried" or "I shouldn't have said that".
What if? You keep asking a series of questions about "What if"
something happens and fail to be satisfied with any of the answers.
"Yeah, but what if I get anxious? Or what if I can't catch my breath?"

81. Cognitive distortions
Emotional reasoning: You let your feelings guide your interpretation
of reality, "I feel depressed, therefore my marriage is not working out."
Inability to disconfirm: You reject any evidence or arguments that
might contradict your negative thoughts. For example, when you have
the thought "I'm unlovable", you reject as irrelevant any evidence that
people like you. Consequently, your thought cannot be refuted.
Judgment Focus: You view yourself, others and events in terms of
evaluations of good-bad or superior-inferior, rather than simply
describing, accepting, or understanding. "I didn't perform well in
college" or "If I take up tennis, I won't do well" or "Look how successful
she is. I'm not successful".

82. Rational-emotive therapy
Developed by Albert Ellis (1950s)
Name changed to Rational-Emotive Behaviour Therapy in 1990s
Goal:
To facilitate clients to think rationally in order to feel and
behave rationally
Therapeutic changes brought on feeling and behavioural
levels are superficial; fundamental and lasting change
involves modifying the underlying core beliefs

83. Rational-emotive therapy
Help the client understand that emotions and behaviours are
caused by beliefs and thinking.
Show how the relevant beliefs may be uncovered. The ABC
format is invaluable here with being focused on ‘B’
component.
Teach the client how to dispute and change the irrational
beliefs, replacing them with more rational alternatives.
Help the client get into action. Acting against irrational beliefs,
disputing the belief. Emphasis on both rethinking and action
brings about desired change.

84. Steps in cognitive restructuring
Step 1: Identify the upsetting situation
Describe the event or problem that’s upsetting you. Who (or
what) are you feeling unhappy about?
Step 2: Record your negative feelings
How do you feel about the upsetting situation? Identify the
feeling in precise word like sad, irritated, annoyed, angry,
enraged, anxious, guilty, ashamed, humiliated, regretful,
bewildered, confused, flustered, swamped, frustrated,
hopeless, despairing, scared, frightened, horrified, intimidated,
vulnerable, uneasy, worried, unsure. Rate each negative
feeling for intensity on a scale from F-1 (for the least) to F-10
(for the most).

85. Steps in cognitive restructuring
Step 3: Record your automatic thoughts
Tune in to the negative thoughts that are associated with these
feelings. Pay attention to what are you saying to yourself about
the problem. Write these thoughts and record how much you
believe each one between B-0 (not at all) and B-10
(completely).
Step 4: Analyze these thoughts
Analyze your thoughts using the “Checklist of Cognitive
Distortions”. The analysis should point out how your automatic
thoughts are unfair, unrealistic or irrational. Rate your belief in
the automatic thoughts again using a different colour ink. If they
are less believable, proceed to step five. If not, continue the
analysis using another method.

86. Steps in cognitive restructuring
Step 5: Construct realistic and balanced thoughts
Construct more realistic, objective and balanced thoughts. You
may wish to construct a 2-part response beginning with an honest
acknowledgement of a realistic negative aspect of the situation,
followed by the word, “BUT” and then a realistic positive
consideration of the situation. The formula looks like this: Realistic
Thinking = Negative (-) side, BUT Positive (+) side.
Step 6: Evaluate this restructuring process
Rate the degree to which you believe the reconstructed thoughts
(B-0 to B-10). Is it higher than your belief in the distorted
automatic thoughts? Rate again the intensity of the feelings (F-1
to F-10). Are they less intense than originally? If you are still not
satisfied, return to step four.

87. You largely constructed your depression.
It was not given to you. Therefore, you
can deconstruct it and reconstruct your
happiness.
Thank You