The document outlines the principles and practices of psychotherapy, emphasizing the collaborative nature of the therapeutic process between counselors and clients. It highlights the importance of personal characteristics, values, and ethical considerations for effective counseling, and discusses various therapeutic techniques including psychoanalysis. Additionally, it addresses the challenges faced by beginning therapists and the role of values in multicultural counseling.

1. September-2010

2. What is Psychotherapy
 Psychotherapy is a process of engagement between two
persons, both of whom are bound to change through the
therapeutic venture.
 It is a collaborative process that involves both the therapist
and the client in co-constructing solutions to concerns
 (theory and practice of counselling and psychotherapy-
Gerald Corey)
 As a counsellor, you need to remain open to your growth
and to address your personal problems if your clients are to
believe in you and the therapeutic process .
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3.  Your personal characteristics are of primary
importance in becoming a counselor, but it is not
sufficient to be merely a good person with good
intentions. To be effective you must have supervised
experience in counseling and sound knowledge of
counseling theory and techniques
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4. Counselor as a therapeutic person
 Counseling is an intimate form of learning, it demands
a practitioner who is willing to shed stereotypes and be
an authentic person in the therapeutic relationship.
 Therapists serve as models for our clients. If we model
incongruent behaviour, low risk activity, and remain
distant, we can expect our clients to imitate this
behaviour. If we model realness by engaging in
appropriate self disclosure, our client will tend to be
honest with us in the therapeutic relationship
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5. Basic counseling/psychotherapy skills
ACTIVE
LISTENING
PROCESSING
RESPONDING
TEACHING
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6. Personal characteristics of effective counselors
 Effective therapists have an identity
 Effective therapists respect and appreciate themselves
 Effective therapists are open to change
 Effective therapists make choices that are life oriented
 Effective therapists are authentic, sincere, and honest
 Effective therapists have a sense of humor
 Effective therapists make mistakes and are willing to
admit them.
 Effective therapists generally live in the present
 Effective therapists appreciate the influence of culture
 Effective therapists have a sincere interest in the
welfare of others.
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7.  effective therapists possess effective interpersonal
skills
 Effective therapists become deeply involved in their
work and derive meaning from it.
 Effective therapists are passionate
 Effective therapist are able to maintain healthy
boundaries.
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8. Counselor’s values and the
therapeutic process
 The role of values in counseling
Counselors need to guard against the tendency to assume
either of the two extreme positions.
At one extreme are counselors who hold definite and
absolute beliefs and see it as their job to exert influence
on clients to adopt their values- these counselor tend to
direct their clients towards the attitudes and values they
judge to be “right”.
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9. At the other extreme are counselors who maintain that
they should keep their values out of their work and that
ideal is to strive for value-free counseling
Because such counselors are so intent on not influencing
their clients, they run the risk of immobilizing
themselves.
Research has shown that counselor’ values influence all
aspects of the therapeutic process, including assessment
strategies, therapy goals, identifying what client
problems will be the focus of treatment, choice of
techniques and evaluation of therapeutic outcomes
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10. Becoming an effective multicultural
counselor
 A major part of becoming a diversity-competent
counselor involves challenging the idea that the values
we hold are automatically true for others, we also need
to understand how our values likely to influence our
practice with diverse clients who embrace different
values
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11.  Sue, Arredondo, and McDavis (1992) and Arredondo
and her colleagues(1996) have developed a conceptual
framework for competencies and standards in
multicultural counseling, their dimensions of
competency involve three areas:
 Beliefs and attitudes
 Knowledge
 Skill and intervention strategies
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12. Issues faced by beginning
therapists
 Dealing with our anxieties
 Being ourselves and disclosing our experiences
 Avoiding perfectionism
 Being honest about our limitations
 Understanding silence
 Dealing with demands from clients
 Dealing with clients who lack commitment
 Tolerating ambiguity
 Avoiding losing ourselves in our clients
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13. Cont.
 Developing a sense of humor
 Sharing responsibility with the client
 Declining to give advice
 Defining your role as a counselor
 Learning to use techniques appropriately
 Developing your own counseling style
 Staying vital as a person and as a professional
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14. 6/13/2023 14

15. Ethical issues in psychotherapy
practice
 Discussion of these issues is aimed at stimulating you
to think further about these issues so that you can
form a sound basis for making ethical decisions.
 Topics addressed include:
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16.  Putting the clients needs before you own
 The right of informed consent
 Dimensions of confidentiality
 Ethical issues in the assessment process
 Considering ethical and cultural factors in assessment
and diagnosis
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17.  Dual and multiple relationships in counseling
 [sexual/nonsexual]
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18. Theories & techniques of
psychotherapy
 Psychoanalytic therapy
 Adlerian therapy
 Existential therapy
 Person-centered therapy
 Gestalt therapy
 Behavioural therapy
 Cognitive behavioral therapy
 Reality therapy
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19. Common factors in psychotherapy
 Listening and talking
 Release of emotions
 Giving information
 Providing rationale
 Restoration of morale
 Suggestion
 Guidance and advice
 The therapeutic relationship
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20. QUESTIONS ?
COMMENTS ?
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22. overview
 System of psychology originating from work of
Sigmund Freud
 Originally used to treat psycho-neurotic disorders
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23.  According to Ernst Kris(1950)-psychoanalysis may be
defined as Human nature seen from a vantage point of
conflict
 Psychoanalysis views the mind as the expression of
conflicting forces. some of these forces are conscious;
other perhaps the majors ones are unconscious.
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24.  Conflict is an inexorable dimension of the human
condition. It reflects the humans as biological animals
and social beings
 The functioning of the mind is related to events in the
body. The boy is the substrate of all psychology,
including psychoanalysis. Basic responses to stimuli
are part of man’s biological inheritance
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25.  A fundamental principle of psychoanalytic theory is
that human psychology is governed by a tendency to
seek pleasure and to avoid pain
 The earliest experiences of pleasure and pain play a
crucial role in shaping each individual’s psychological
structure
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26.  Psychoanalysis is the most extensive, inclusive, and
comprehensive system of psychology. It encompasses
humans’ inner experiences and outer behavior. Their
biological nature and social roles, how they function
individually and how they function in groups..
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27.  As far as the individual is concerned, the sources of his
neurotic suffering are by their very nature “unknowable”
they reside outside the realm of consciousness, barred from
awareness by virtue of their painful, unacceptable quality.
 By enabling the patient to understand how his neurotic
symptoms and behavior represent derivatives of
unconscious conflict, psychoanalysis permits the patient to
make rational choices instead of responding automatically
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28. History
 Psychoanalysis originates from freud’s works
 1 Studies on hysteria (1895)
 2 The interpretation of dreams
 3 On narcissism
 4 papers of metapsychology
 5 dual instinct theory
 6 Structural theory
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29. Current status
 Under the leadership of Melanie Klein(1932)the
English school of psychoanalysis emerged
 It emphasizes the importance of primitive fantasies of
loss (the depressive position) and persecution(the
paranoid position) in the pathogenesis of mental illness.
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30. View of human nature
 According to Freud,our behaviour is determined by
irrational forces, unconscious motivations and
biological and instinctual drives as these evolve
through key psychosexual stages in the first six years of
life
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31. Onset of neurosis
 In children:
 Neurotic disorders in children stem from conflicts
resulting from wishes of the oedipal phase
 Usually childhood neurosis assumes the form of general
apprehensiveness, nightmares, phobias, tics,
mannerisms or ritualistic practices
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32.  In adults:
 Neurosis in adults may develop anew when the balance
between the pressures of the id drives and the defensive
forces of the ego is upset
 There are 3 typical situation in which this can occur
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33. 1
 An individual may be unable to cope with the
additional psychological burden of normal
development
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34. 2
 Disappointment, defeat, loss of love, physical illness,
or some other consequence of the human condition
may lead an individual to turn away from current
reality and unconsciously seek gratification in the
world of fantasy
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35. 3
 By a combination of circumstances, an individual may
find himself in adult life in a situation that
corresponds in its essential features to some childhood
trauma or conflict-laden fantasy. Current reality is
then misperceived in terms of the childhood conflict
and the individual responds as he did in childhood, by
forming symptoms eg crying in cases of problems
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36. ANXIETY
 Reality anxiety
 Neurotic anxiety
 Moral anxiety
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37. Ego-defense mechanism
 Repression
 Denial
 Reaction formation
 Projection
 Displacement
 Rationalizations
 Sublimation
 Regression
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38.  Introjections
 Identification
 Compensation
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39. Theory of Personality
 The psychoanalytic theory of personality is based on a
number of fundamental principles:
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40. 1. Determinism
 Psychoanalytic theory assumes that mental events are
not random, haphazard, accidental, unrelated
phenomena.
 Thoughts, feelings, and impulses are events in a chain of
causally related phenomena. They result from
antecedent experience in the life of the individual.
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41. 2. Topographic viewpoint
 Every mental element is judged according to its
accessibility to consciousness.
 The process by which certain mental contents are barred from
consciousness is called repression- it is an active effort to keep
certain thoughts out of awareness to avoid pain or unpleasure.
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42. 3. Dynamic viewpoint
 This pertains to the interaction of libidinal and
aggressive impulses.
 Instinct vs. drive
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43. 4. Genetic viewpoint
 Tracing the origins of later conflicts, character traits,
neurotic symptoms, and psychological structure to the
crucial events and wishes of childhood and the
fantasies they generated. The genetic approach is not a
theory; it is an empirical finding confirmed in every
psychoanalysis.
 It states that in many ways, we never get over our
childhood.
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44.  Personality evolves out of the interaction between
inherent biological factors and the vicissitudes of
experience. For any individual, given an average
expectable environment, one may anticipate a more or
less predictable sequence of events constituting the
steps in the maturation of the drives and the other
components of the psychic apparatus.
 Whatever happens to the individual—illness,
accidents, deprivation, abuse, seduction,
abandonment—in someway will alter the native
endowment and will contribute towards determining
the ultimate personality structure.
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45. Structure of personality
 ID
 EGO
 SUPER-EGO
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46. Psychosexual stages of
development
Stage Period
Oral phase Birth to
2yrs
Libidinal Gratification centres around feeding and
the organs connected with that function
Gratification of oral needs in the form of satiety
brings about a state of freedom from tension and
induces sleep.
Many disturbances of sleep seem to be connected
with unconscious fantasies of an oral libidinal
Nature(Lewin, 1946, 1949).
People whose early oral needs have been excessively
frustrated turn out to be pessimists.
On the other hand, individuals whose oral needs
have been gratified tend to have a more optimistic
view of the world.
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47. Anal phase 2yrs-4yrs Libidinal gratification comes from retraining and
passing feces-during this phase interest in bodily
processes, in smelling, touching, and playing with
feces are paramount.
The disgust that those who train the child evince and
the shame the child is made to feel may contribute
towards a lowered sense of self esteem.
In reaction, the child may respond by stubborn
assertiveness, contrary rebelliousness, and the
determination to be in control of whatever happens to
him
Through reaction formation the child may overcome
the impulse to soil by becoming meticulously clean,
excessively punctual, and quite parsimonious in
handling possesions [Freud 1917]
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48. Phallic phase 4yrs-6yrs At this stage libidinal gratification shifts to the
genitals. Both boys and girls, the penis becomes the
principal object of interest in the phallic phase. At
this time the clitoris,embryologically an analogue of
the penis, begin to be appreciated for pleasure
During this time, children may entertain intensely
hostile wishes with the penis serving as an
instrument for aggression.
Also prominent at this stage are exhibitionistic and
voyeuristic wishes.
Latency period
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49. Genital phase 12yrs +
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50. Psychotherapy
 The principles and techniques of psychoanalytic
therapy are based upon the psychoanalytic theory of
neurosis:[the theory of neurosis changed so did the
techniques]
 Originally Freud felt that neurotic symptoms were a
result of pent up, undischarged emotional tension
connected with the repressed memory of a traumatic
childhood sexual experience.
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51. Techniques
 At first he used hypnosis to bring about emotional
catharsis and abreaction of the trauma
 Forced suggestion- a technique of recollection
fostered by the insistent demanding pressure of the
therapist
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52.  Free association: in this technique he asked his
patients to report freely and without criticism
whatever came into their mind
 To Freud the principal goal was to make the contents
of the unconscious conscious
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53. Changes in psychoanalytic theory
of pathology and treatment
 Regulation of self-esteem and the vicissitudes of what
is called the “self state” are perhaps the primary factors
in pathology and dictate the analysts approach
 Very early dissonance in a mother/child interaction
creates the basis for narcissistic vulnerability.
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54.  Object relations Theory[Kernberg]- he emphasizes
how the relations with the earliest significant objects
in the individual’s life leave a residue of internalized
relationship concepts that may continue throughout
the individual’s life.
 Later trauma may evoke latent object relations and
lead the individual to respond in an unrealistic way to
present-day situations.
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55. Therapeutic techniques and
procedures
 Modern psychoanalysis has these features
 Therapy is geared more to limited objectives than to
restructuring ones personality
 Therapist is less likely to use the couch
 There are probably fewer sessions
 There is more frequent use of supportive
interventions—such as reassurance, expression of
empathy, and support, and suggestions and more self
disclosure by the therapist
 The focus is more on pressing practical issues than on
working with fantasy
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56.  Maintaining the analytic framework
 Free Association
 Interpretation
 Dream analysis
 Analysis and interpretation of resistance
 Analysis and interpretation of transference
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57. Maintaining the analytic
framework
 Psychoanalytic process stresses maintaining a
particular framework aimed at accomplishing the goals
of this type of therapy.
 analyst’s relative anonymity, the regularity and
consistency of meetings, and starting and ending the
sessions on time. ,
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58. Free Association
 Clients are encouraged to say whatever comes to mind,
regardless of how painful, silly, trivial, illogical, or
irrelevant it may be.
 In essence, clients flow with any feelings or thoughts
by reporting them immediately without censorship.
 As the therapy progresses, most clients will
occasionally depart from this basic rule, and these
resistances will be interpreted by the therapist when
its is timely to do so.
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59. interpretation
 Interpretation consists of the analyst’s pointing out,
explaining, and even teaching the client the meanings
of behavior that is manifested in dreams, free
association, resistances and the therapeutic
relationship itself.
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60. Dream analysis
 This is used to uncover unconscious material and
giving the client insight into some areas of unresolved
problems. During sleep, defenses are lowered and
repressed feelings surface.
 Dreams have two levels of content
 Latent content
 Manifest content
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61. Analysis and interpretation of
transference
 TRANSFERENCE – Core of psychoanalytical therapy
 Unconsciously projecting old, unresolved feelings and
attitudes onto the therapist
 EX: stern father
old lover
mother
excellent father
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62. Goal of therapy is to work through transferences
 Explore unconscious, defenses, and repressed material
 Interpret client behavior
 Help client make new choices
 Help client see how past experiences are effecting their
current behaviors
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63.  Help clients see how problems are effecting client in
their daily lives
 Reveals childhood motivations
Counselor: all powerful
Client/child: please, angry, acceptance
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64. COUNTERTRANSFERENCE
 Therapist projects unconscious material onto client
 Therapist responds irrationally and subjectively to
client
 Therapists own conflicts are triggered
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65. EX:
 Unresolved issues with father>when counseling an old
man
 Dislike of adolescents, ethnic group
 Client example/house
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66.  Therapist loses objectivity, and becomes emotional
 Serious detriment to therapeutic relationship
 Refer client, get supervision
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67. 6/13/2023 67

68. 6/13/2023 68

69. Brief biography
 1870-1937
 Vienna family of six boys two girls
 Early child hood experience had an impact on
formation of theory
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69

70. Historical context
 Freud and Adler met in 1902, Freud invited
Adler after he made strong defense to his
paper “interpretation of dreams”
 Adler[a president of PS] was expelled from
psychoanalytic society in 1911, after
presenting a paper “masculine protest” this
was a controversial paper to Freud’s earlier
works. Instead of focusing on biological and
psychological factors on masculine behaviors
in males and female- Adler emphasized the
power of culture and socialization
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70

71. Cont.
 Adler together with five other people[former
members of psychoanalytic society] formed
the society for individual psychology
 Later a number of psychoanalysts deviated
from Freud’s orthodox position. These
included: Karen Horney, Erich Fromm, and
Harry Stack Sullivan. They believed that social
and cultural factors were of great significance
in shaping personality
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71

72. Cont.
 Although they are referred to as neo
Freudians, the three psychoanalysts who
crossed from Freud would best be called neo
Adlerian. Because they moved away from
Freud's biological and deterministic point of
view and towards the Adler's social-
psychological and teleological(or goal
oriented) view of human nature
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72

73. Cont.
 Adler saw human as both the creators and
creations of their own lives
 People develop a unique style of living that is
both a movement toward and an expression of
their selected goals. In this sense we create
ourselves rather than being merely shaped by
our childhood experiences
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73

74. Overview
 Individual psychology views the person holistically
as a creative, responsible, “becoming” individual
moving toward fictional goals within his or her
phenomenal field. It holds that one’s lifestyle is
sometimes self defeating because of inferiority
feelings.
 The individual with psychopathology is
discouraged rather than sick, and the therapeutic
task is to encourage the person, to activate
his/her social interest and develop a new lifestyle
through relationship, analysis and action methods
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74

75. Key concepts
 View of human nature
 Subjective perception of reality
 Unity & patterns of human personality
 Behaviour as purposeful and goal oriented
 Striving for significance and superiority
 lifestyle
 Social interest &Community feeling
 Birth order and sibling relationship
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76. Viewofhumannature
 Humans are motivated primarily by social
relatedness rather than by sexual urges;
behaviour is purposeful and goal-directed and
consciousness, more than unconsciousness,
is the focus of therapy.
 From the Adlerian perspective, human
behaviour is not determined solely by heredity
and environment. Instead we have the
capacity to interpret, influence, and create
events.
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76

77. Subjectiveperceptionofreality
 Adlerians attempt to view the world from the
client's subjective frame of reference. An
orientation described as phenomenological.
 This “subjective reality” includes the
individual’s perceptions, thoughts, feelings,
values, beliefs, convictions, and conclusions.
 Behavior is understood from a vantage point of
this subjective perspective.
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77

78. Unity&patternsofhumanpersonality
 A basic premise of Adlerian individual
psychology is that personality can only be
understood holistically and systematically
 The individual is seen as an indivisible whole,
born, reared, and living in specific familial,
social and cultural contexts
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78

79.  An individual’s thoughts, feelings, beliefs,
convictions, attitudes, character, and actions
are expressions of his or her uniqueness, and
all reflect a plan of life that allows for
movement toward a self-selected life goal.
 An implication of the holistic view of
personality is that the client is an integral part
of a social system.
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79

80. Behaviouraspurposefulandgoaloriented
 Individual psychology assumes that all human
behaviour has a purpose.
 Adler referred to the endpoint of our future
purposeful striving as fictional finalism
because the endpoint is each individual’s
subjective fiction.
 Ex.
 If I become depressed, I can communicate my anger and
dissatisfaction indirectly. I will be taken care of and thereby in
control of the household. 6/13/2023
80

81.  Strivingforsignificanceandsuperiority
 Adler stresses that striving for perfection and
coping with inferiority by seeking mastery are
innate. Inferiority is not a negative factor in life.
 The moment we experience inferiority we are
pulled by striving for superiority. He maintained
that the goal of success pulls people forward
toward mastery and enables them to
overcome obstacles.
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82.  It is important to understand that superiority as
used by Adler does not mean one being
superior to others. Rather it means moving
from a perceived lower position to a perceived
higher position, from a felt minus to a felt plus.
 People cope with feelings of helplessness by striving for
competence, mastery, and perfection. They seek to change the
weakness into strength. For example one strives to excel in one
area of concentration to compensate for defects in other areas.
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82

83.  Lifestyle
 An individual’s core beliefs and assumptions
through which the person organizes his/her reality
and finds meaning in life events constitutes the
individual’s lifestyle.
 [readcurrentpsychotherapies pg 77-78]
 These styles of life consist of people’s views
about themselves and the world and their
distinctive behaviors and habits as they pursue
personal goals. Everything we do is influenced by
these unique lifestyles
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83

84. Socialinterest&Communityfeeling
 Social interest & Community feeling: one of the basic
assumption is that individual psychology is an
interpersonal psychology-how individuals interact with
others sharing “this crust earth” is paramount. These
concepts refer to an individual’s awareness of being
part of the human community and to individual’s
attitudes in dealing with the social world. Social
interest includes striving for a better future for
humanity.
 Social interest is the central indicator of mental health.
those with social interest tend to direct the striving
toward the healthy and socially useful side of life.
Individual psychology rests on the a central belief that
our happiness and success are largely related to this
social connectedness.
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84

85. Birthorder&siblingrelationship
 Adler identified five psychological positions:
 Oldest child
 Second of only two
 Middle child
 Youngest child
 Only child
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86. Tasks of life
 Work or occupation
 Social relationships
 Love and marriage
 Self
 Spirituality
 Parenting and family
(Dreikurs & Mosak, 1966,1967)
(Dinkmeyer, 1987)
(Adlers ,) 1956
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87.  When clients come to therapy, they almost
always come because they have had difficulty
with one or more basic life tasks. The
difficulties arise from inaccuracies, mistakes,
and maladaptive perceptions associated with
their lifestyles. Therefore, the overarching goal
of therapy is to help clients adjust or modify
their lifestyles in ways that help them more
effectively complete their life tasks.
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87

88. Workoroccupation
 Adler believed the best way to solve the life
task of work or occupation was by solving the
second life task, social relationships, through
“friendship, social feeling, and
cooperation”(Adler, 1958, p. 239). If a person
is unable to work cooperatively, divide labor
responsibilities, and maintain friendly relations,
he or she is likely to struggle in the area of
work.
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88

89. Socialrelationship
 Adler was a strong proponent of positive social
relationships. As has been noted, he felt that
establishing healthy social relationships was
the key to solving the work or occupational
problem. In essence, humans are
interdependent.
 from the Adlerian perspective, clients’ social
problems stem from inappropriate
expectations, beliefs, and interpersonal habits
imbedded in their individual lifestyles.
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89

90. Loveandmarriage
 Some theorists refer to this life task as love
and others refer to it as sex (Mosak, 1999).
 Many clients come to therapy with intimacy
problems, both sexual and nonsexual. For
Adlerians, the road to recovery for these
clients is the same as we have suggested
previously: Modify the lifestyle, develop
empathy for others (community feeling), and
take decisive action by thinking and acting
differently in everyday life.
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91. Self
 Essentially, this task emphasizes that
everyone has a relationship with himself or
herself. The nature of your relationship with
yourself is established during childhood.
 Mosak and Maniacci (1999) describe four
dimensions of the self life task:
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92.  Survival of self: Am I taking good care of my physical self ? Am I taking good
care of my psychological self ? Am I taking good care of my social self ?
 Body image: Is my perception of my body reasonable and congruent with my
actual body?
 Opinion: What is my opinion of me? To evaluate this in an interview, Adlerians
often ask clients to complete the incomplete sentence, “I me” (Mosak &
Maniacci, 1999, p. 107).
 Evaluation: Some clients have various extreme perspectives of the self. From
the object relations perspective, the question would be “Am I good or am I
bad?”
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93.  The optimal resolution of the self task is
characterized by good self-care, an accurate
perception and expectations of one’s body, a
reasonably accurate and positive opinion of
oneself, and a balanced view of oneself as not
overly good or overly bad.
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94. Spirituality
 Mosak and Maniacci (1999) describe five
specific issues related to the spirituality task.
As individuals grow up and face life, they must
approach and deal with each of these issues:
 Relationship to God
 Religion
 Relationship to the universe
 Metaphysical issues
 Meaning of life
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95. 6/13/2023
95

96. Parentingandfamily
 Giving birth to and raising children, and
functioning as a family, are extensions of the
love and marriage task discussed previously.
However, these things also constitute a task in
and of themselves. Some individuals function
as single parents and raise children outside
marriage. Individual parents also develop
strong feelings and beliefs about how children
should be raised. How individuals face the
parenting and family task is both a function of
and a challenge to the lifestyle.
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97. Psychopathology and human
change
 Adlerians define psychopathology as
“discouragement,” but of course there’s much
more to it than that.
 The discouraged individual is one who is
unable or unwilling to approach and deal with
essential life tasks.
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98.  With regard to psychopathology and life tasks,
Adler stated:
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99.  In the case of mental dysfunction, one or more
of the life tasks have become overwhelming.
This is where the concept of discouragement
fits in. The person struggling to adequately
face a life task becomes discouraged. He or
she feels inferior or unable to successfully
manage the life task demands, and therefore
symptoms arise.
 Symptomatic patients are suffering from the
effects of their inaccurate or mistaken
lifestyles. 6/13/2023
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100.  Mosak (1989) also makes a clear statement
about psychopathology from the Adlerian
perspective when he says, “poor interpersonal
relationships are products of misperceptions,
inaccurate conclusions, and unwarranted
anticipations incorporated in the life-style” (p.
86).
 The maladaptive lifestyle and its associated
interpersonal dysfunctions cause the client to
experience disappointments, feelings of
inferiority, and eventually discouragement.
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101. Therapy process
Therapeutic techniques and
procedures
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102. Therapeuticgoals
 The main aim of therapy is to develop the
client’s sense of belonging and to assist in the
adoption of behaviors and processes
characterized by community feeling and social
interest.
 Adlerian do not see clients as sick- they are
just discouraged. Symptoms are attempted
solutions.
 The goal is to re-educate clients so that they
can live in society as equals, both giving
society and receiving from others.
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103.  Mosak (2000) lists these goals for the educational
process of therapy
 Fostering social interest
 Helping clients overcome feelings of discouragement
and inferiority
 Modifying clients’ views and goals—that is changing
their lifestyle
 Changing faulty motivation
 Assisting clients to feel a sense of equality with others
 Helping people to become contributing members of
society
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104. Therapist’s function and role
 Therapists tend to look for major mistakes in
thinking and valuing such as mistrust,
selfishness, unrealistic ambitions, and lack of
confidence.
 A major function of the therapist is to make
comprehensive assessment of the client’s
functioning.
 They assist clients in better understanding,
challenging, and changing their life story
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105.  Client’s experience in therapy
 Relationship between therapist and client
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106. General Therapeutic Strategy
 Therapeutic strategy from an Adlerian perspective
can be boiled down to a few simple components.
Use these as a general guide:
 • Be a friendly, supportive model for your clients.
 • Use encouragement to help clients have more
success potential and faith in themselves.
 • Help clients have insight into their style of life
and fictional finalism.
 • Help clients modify their basic mistakes using a
broad range of educational procedures
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107. Counseling or psychotherapy is a friendly and
collaborative process consisting of four phases
(Dreikurs, 1969). These phases include:
 Forming the therapeutic relationship
 Lifestyle assessment and analysis
 Interpretation and insight
 Reorientation
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108. Phase1:Establishing therelationship
 Work in a collaborative way with clients- this
relationship is based on a sense of deep
caring, involvement, and friendship.
 Progress is possible only when there are
clearly defined goals between therapist and
client.
 Adlerian therapists seek to make person-to-
person contact with clients rather than starting
with the problem.
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109.  Pay more attention to the subjective
experience of the client than you do to using
techniques.
 Adlerian attempt to grasp both the verbal and
nonverbal messages of the client
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109

110. Phase2:Exploringtheindividual’sdynamics
 Exploring the psychological dynamics
operating in the client
 This second phase of Adlerian counseling
proceeds from two interview forms:
 Subjective interview
 Objective interview
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111.  In the subjective interview—the counselor helps
the client to tell his/her story as completely as
possible
 Process facilitated generous use of empathetic
listening and responding
 Throughout the interview the therapist is listening for
clues to purposive aspects of the client’s coping and
approaches to life
 Adlerians often end the subjective interview with
this question “how would your life be different, and
what would you do differently, if you did not have
this symptom or problem?
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112.  The objective interview seeks to discover
information about:
a) How problems in the client’s life began
b) Any precipitating events
c) A medical history-including current and past
medications
d) A Social history
e) The reasons the client chose therapy at this
time
f) The person’s coping with life tasks
g) A lifestyle assessment
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113.  Family constellation
 Early recollection
 Personality priorities
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114. Phase3:Interpretationandinsight
 Based on the belief that everything in human
life is purposeful- self understanding is only
possible when hidden purposes and goals of
behavior are made conscious
 Disclosure and interpretations are techniques
that facilitate the process of gaining insight.
They are focused on here and now behavior
and on the expectations and anticipations that
arise from one’s intentions
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115. Reorientation
 The encouragement process
 Change and the search for new possibilities
 Making a difference
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116. 6/13/2023 116

117. Introduction
 Existential therapy can best be described as a
philosophical approach that influences a
counselors therapeutic practice. Therefore
existential psychotherapy is neither an
independent nor a separate school of therapy,
nor is it a neatly defined model with specific
techniques
 The existential approach rejects the
deterministic view of human nature espoused
by orthodox psychoanalysis and radical
behaviourism. 6/13/2023
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118.  Psychoanalysis sees freedom as restricted by
unconscious forces, irrational drives, and past
events; behaviorists see freedom as restricted
by sociocultural conditioning.
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118

119. “we are authors of our lives, and we
design the signposts to follow”
 Existential therapists acknowledge some of
these facts about human situation but
emphasize our freedom to choose what to
make of our circumstances.
 This is based on the assumption that we are
free and therefore responsible for our choices
and actions
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120. Major aim in therapy
 Is to encourage people/clients to reflect on life,
to recognize their range of alternatives and to
decide among them.
 Once clients begin on the process of recognizing
the ways in which they have passively accepted
circumstances and surrendered control, they can
start on a path of consciously shaping their own
lives.
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121.  Yalom (2003) emphasizes that the 1st step in
the therapeutic journey is for the client to
accept responsibility;
 “once the individual recognize their role in
creating their own life predicament, they also
realize that they, and only they have the power
to change that situation”
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122.  Key figures in contemporary existential
psychotherapy
 Viktor Frankl,
 Rollo May
 James Bugental
 Irvin Yalom
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123. View of human nature
 The existential view of human nature is captured, in
part, by the notion that the significance our existence
is never fixed once and for all; rather, we continually
re-create ourselves through our projects. Human are in
a constant state of transition, emerging, evolving, and
becoming.
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124.  The basic dimensions of the human condition,
according to the existential approach, include:
1. The capacity for self-awareness
2. Freedom and responsibility
3. Creating one’s identity and establishing
meaningful relationships with others
4. The search for meaning, purpose, values, and
goals
5. Anxiety as a condition of living, and
6. Awareness of death and non-being.
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125. Proposition1: the capacity for self
awareness
 As human beings, we can reflect and make
choices because we are capable of self-
awareness. The greater our awareness, the
greater our possibility for freedom. Thus we
increase our capacity to live fully as we
expand our awareness in the following areas:
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126.  We are finite and do not have unlimited time to do
what w want in life.
 We have the potential to take action or not to act;
inaction is a decision
 W choose our actions, and therefore we can
partially create our own destiny.
 Meaning is the product of discovering how we are
thrown or situated in the world and then, through
commitment, living creatively.
 Existential anxiety, which is basically a
consciousness of our own freedom, is an
essential part of living; as we increase our
awareness of the choices available to us, we
increase our sense of responsibility for
consequences of these choices.
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127.  We are subject to loneliness, meaningfulness,
emptiness, guilt, and isolation.
 We are basically alone, yet we have an
opportunity to relate to other beings.
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127

128. Proposition 2: Freedom and
Responsibility
 A characteristic existential theme is that
people are free to choose among alternatives
and therefore have a large role of shaping their
destinies.
 “Freedom is existence, and in its
existence precedes essence” and “Man’s
essence is his existence” (Sartre, 1953, p.
5).
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129. Proposition 3: Striving for identity
and relationship to others
 People are concerned about preserving their
uniqueness and centeredness, yet at the same
time they have an interest in going outside of
themselves to relate to other beings and to
nature.
 Many existential writers discuss loneliness,
uprootedness, and alienation, which can be
seen as the failure to develop ties with others
and with nature
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130.  The courage to be
 The experience of aloneness
 The experience of relatedness
 Struggling with our identity
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130

131. Proposition 4: The Search for
Meaning
 A distinctly human characteristic is the struggle
for a sense of significance and purpose in life.
 Existential therapy can provide the conceptual
framework for helping clients challenge the
meaning in their lives
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132. Commonchallengesinprocessofstrivingforidentity
 The problem of discarding old values
 Meaninglessness
 Creating new meaning
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132

133. Proposition 5: Anxiety as a
Condition of Living
 Anxiety arises from ones personal striving to
survive and to maintain and assert one's
being, and the feelings anxiety generates are
an inevitable aspect of the human condition.
 Existential anxiety is conceptualized as the
unavoidable result of being confronted with the
“givens of existence” –death, freedom,
existential isolation, and meaninglessness
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134.  Existential therapists see anxiety as a potential
source of growth. Normal anxiety is an
appropriate response to an event being faced,
neurotic anxiety in contrast is out of proportion
to the situation. It is typically out of awareness,
and it tends to immobilize the person.
 Because Humans could not survive without
some anxiety, it is not a therapeutic goal to
eliminate normal anxiety
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134

135.  Freedom and anxiety are two sides of the
same coin- we experience anxiety when we
use our freedom to move out of the known into
the realm of the unknown. Out fear, many of us
try to avoid taking such a leap into the
unknown.
 Existential therapy helps clients come to terms
with the paradoxes of existence—life and
death, success and failure, freedom and
limitations, and certainty and doubt.
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136.  Existential therapist does not aim at
eliminating anxiety, --to do that would be to cut
off a source of vitality.
 Counselors have the task of encouraging
clients to develop the courage to face life
squarely, largely, by taking a stance,
performing an action, or making a decision.
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136

137. Proposition 6: Awareness of death
and nonbeing
 The existentialist does not view death
negatively but holds that awareness of death
as a basic human condition gives significance
to living.
 It is necessary to think about death if we are to
think significantly about life.
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137

138. 1. Read about the therapeutic process under existential
therapy
2. Watch “the secret” and compare the principle of
existentialism to “the secret”.
6/13/2023 138

139. THERAPEUTIC TECHNIQUES AND
PROCEDURES
APPLICATION
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139

140. APPLICATION
 EXISTENTIAL THERAPY is a collaborative
adventure in which both the therapist and
client will be transformed if they allow
themselves to be touched by life.
 When the deepest self of the therapist meets
the deepest part of the client, the counseling
process is at its best. Therapy is a creative,
evolving process of discovery that can be
conceptualized in three general phases
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141.  Initial phase:
 counselor assists client in identifying and
clarifying their assumptions about the world.
Client are invited to define and question the ways
in which they perceive and make sense of their
experience.
 They examine their values, beliefs and
assumptions to determine their validity
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142.  Middle phase:
 Clients are encouraged to more fully examine the
source and authority of their present value
system.
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142

143.  Final phase:
 Counseling focuses on helping client take what
they are learning about themselves and put it into
action.
 The aim of therapy is to enable clients to find ways of
implementing their examined and internalized values
in a concrete way. Clients typically discover their
strengths and find ways to put them to the service of
living a purposeful existence.
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144. Areas of application
 For clients who are struggling with developmental
crises, doing grief work, confronting death, or
facing a significant decision, existential therapy is
especially appropriate.
 Duerzen-smith (1990) suggests that this form of
therapy is best suited for clients who are
committed to dealing with their problems about
living, for people who feel alienated from the
current expectations of society, or for those who
are searching for meaning in their lives.
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145.  It tends to work well for people who are on the
crossroads and who question the state of
affairs in the world and a re willing to challenge
the status quo. It can be useful for people who
are on the edge of existence, such as those
who are dying, who are working through a
developmental or situational crisis, or who are
starting a new phase of life
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146. Carl Rogers
1902-1987

147. Introduction
 The person centered approached is based on
concepts from humanistic psychology.
 Roger’s basic assumptions:
 People are essentially trustworthy
 People have a vast potential for understanding
themselves and resolving their own problems
without direct intervention on the side of the
therapist.
 People are capable of self-directed growth
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148. Determinants of therapy outcome
 Rogers emphasized
 Attitudes
 Personal characteristics of the therapist
 Quality of the client-therapist relationship
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148

149. Existentialism and Humanism
 In 1960s and 1970s- saw the development of a
“third force” an alternative to psychoanalytic
and behavioral approaches.
 Person-centered therapy is an experiential and
relationship oriented treatment.
 Both humanism and existentialism share a
respect for the client’s subjective experience
and a trust in the capacity of the client to make
positive and constructive conscious choices.
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149

150.  Emphasize concepts like
 Freedom
 Choice
 Values
 Personal responsibility
 Autonomy
 Purpose and
 Meaning
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150

151. Differences btn humanistic and
existentialists
 Existentialists take the position that we are
faced with the anxiety of choosing to create an
identity in a world that lacks intrinsic meaning
 Humanists, in contrast, take the somewhat
less anxiety invoking position that each of us
has a natural potential that we can actualize
and through which we can find meaning
 Refer to metaphor of an acorn
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151

152.  The underlying vision of humanistic philosophy
is captured in the metaphor of an acorn, if
provided with the appropriate conditions,
will automatically grow in positive ways,
pushed naturally towards its actualization
as an oak.
 The humanistic philosophy on which the
person-centered approach rests is expressed
in attitudes and behaviors that create a growth-
producing climate 6/13/2023
152

153. Key concepts
View of Human Nature
 Rogers maintains that people are trustworthy,
resourceful, capable of self –understanding
and self-direction, able to make constructive
changes, and able to live effective and
productive lives.
 When therapists are able to experience and
communicate their realness, caring and
nonjudgmental understanding, significant
changes in the client are most likely to occur.
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153

154.  Roger expresses little sympathy for
approaches based on the assumption that
the individual cannot be trusted and
instead needs to be directed, motivated,
instructed, punished, rewarded, controlled,
and managed by others who are in a
superior and expert position.
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154

155.  Therapist attributes that create a growth-
promoting climate
1. Congruence(genuineness, or realness)
2. Unconditional positive regard(acceptance and
caring)
3. Accurate empathetic understanding(an ability to
deeply grasp the subjective world of another
person)
 If therapist communicates these attitudes the
client will become less defensive and more
open to themselves and their world and they
will behave in more prosocial and constructive
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155

156.  The person centered therapist focuses on the
constructive side of human nature, on what is
right with the person, and on the assets the
individual brings to therapy
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156

157. Therapeutic Process
 Goals – person centered approach aims towards a
greater degree of independence and integration of
the individual.
 Its focus is on the person not the person’s
presenting problem.
 People who enter psychotherapy often ask:
 How can I discover my real self?
 How can I become what I deeply wish to become?
 How can I get behind my facades and become
myself? 6/13/2023
157

158.  Therapy aims to provide a conducive
climate to help the individual become a
more fully functioning person.
 The client must first get behind the masks
they wear, which they develop through the
process of socialization.
 Clients come to recognize that they have
lost contact with themselves by using
facades. 6/13/2023
158

159.  Rogers describes people who are
becoming increasingly actualized as
having:
1. An openness to experience
2. A trust in themselves
3. An internal source of evaluation
4. A willingness to continue growing
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159

160. Therapist’s Function and Role
 The role of the therapist is rooted in their ways of
being and attitudes.
 Research indicate that the attitude of therapists
rather than their knowledge, theories, or
techniques, facilitate personality change in the
client.
 Therapists do not aim to manage, conduct,
regulate or control the client.
 Therapist does not intend to diagnose, create
treatment plans, strategize, employ treatment
techniques or take responsibility of the client in
any way 6/13/2023
160

161.  Person centered theory holds that the
therapists function is to be present and
accessible to clients and to focus on their
immediate experience.
6/13/2023
161

162. Application: Therapeutic Techniques and
Procedures
 Early emphasis on reflection of feelings
Yes!
When I get home in the
evening, my house is a mess.
The kids are dirty… My
husband does not care about
dinner...I do not feel like
going home at all.
You are not satisfied
with the way the house
chores are organized.
That irritates you.
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162

163. Person centered therapy from
multicultural perspective
 Discussion
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163

164. BEHAVIOUR THERAPY
B.F. Skinner (1904-1990)

165. Introduction
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165

166. Key concepts
View of Human Nature
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166

167. Key concepts 2
Basic characteristics and assumptions
1. Behaviour therapy is based on the principle
and procedures of the scientific method.
 Devotion to Empiricism
 Adherence to precision and empirical evaluation
 Behavior therapists state treatment goals in
concrete objective terms to make replication of
their interventions possible.
 Behavioural concepts and procedures are
stated explicitly, tested empirically, and revised
continually. 6/13/2023
167

168. 2. Behaviour therapy deals with the clients
current problems and the factors influencing
them--as opposed to an analysis of the possible historical
determinants.
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168

169. 3. Clients involved in behaviour therapy are
expected to assume an active role by
engaging in specific actions to deal with their
problem.
 They are required to do something to bring about
change.
 Client monitor their behaviour both during and
outside the therapy session , learn and practice
coping skills and role play new behaviors.
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170. 4. The behavioral approach emphasizes
teaching clients skills of self
management.
 Behaviour therapy is largely carried out in the
clients natural environment.
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170

171. 5. The focus is on assessing overt and covert
behaviour directly, identifying the problem
and evaluating change.
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171

172. 6. Behaviour therapy emphasizes a self-
control approach in which clients learn self-
management strategies.
 Therapists train clients to initiate, conduct, and
evaluate their own therapy. Clients are
empowered through this process of being
responsible for their changes
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172

173. 7. Behavioural treatment
interventions are
individually tailored to
specific problems
experienced by clients
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173

174. 8. The practice of behaviour therapy is based
on a collaborative partnership between client
and therapist and every attempt is made to
inform clients about the nature and course of
treatment.
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174

175. 9. The emphasis is on practical applications.
Interventions are applied to all facets of daily
life in which maladaptive behaviour are to be
decreased and adaptive behaviour are to be
increased
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175

176. 10. Therapists strive to develop culture-specific
procedures and obtain their clients
adherence and cooperation
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176

177. The therapeutic process
Therapeutic goals
 The general goals of behaviour therapy are to
increase personal choice and to create new
conditions for learning.
 The client with the help of the therapist,
defines specific goals at the outset of the
therapeutic process.
 Although assessment and treatment occur
together, a formal assessment takes place
prior to treatment to determine behaviours that
are target for change
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178. Therapist’s Function and Role
 Behaviour therapists tend to be active and
directive and to function as consultants and
problem solvers.
 Behavioural clinicians perform these other
functions
 Conduct a thorough functional assessment.
 Formulate initial treatment goals, design and
implement a treatment plan.
 Use strategies to promote generalization and
maintenance of behaviour change
 Evaluate the success of the change plan by
measuring progress towards the goals.
 Conduct follow up assessments 6/13/2023
178

179. APPLICATIONS
THERAPEUTIC TECHNIQUES AND PROCEDURES
 Positive
reinforcement
 Negative
reinforcement
 Extinction
Applied behaviour analysis: Operant conditioning techniques
 Positive punishment
 Negative punishment

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179

180. Operant conditioning: Addiction (1)
Drug use is a behaviour that is reinforced by the
positive reinforcement that occurs from the
pharmacologic properties of the drug.
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180

181. Operant conditioning: Addiction (2)
Once a person is addicted, drug use is
reinforced by the negative reinforcement of
removing or avoiding painful withdrawal
symptoms.
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181

182. Operant conditions (1)
Positive reinforcement strengthens a
particular behaviour (e.g., pleasurable
effects from the pharmacology of the
drug; peer acceptance)
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182

183. Operant conditions (2)
Punishment is a negative condition that
decreases the occurrence of a particular
behaviour (e.g., If you sell drugs, you will go to
jail. If you take too large a dose of drugs, you
can overdose.)
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184. Operant conditions (3)
Negative reinforcement occurs when a particular
behaviour gets stronger by avoiding or stopping a
negative condition (e.g., If you are having unpleasant
withdrawal symptoms, you can reduce them by taking
drugs.).
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185. 6/13/2023
185

186. Functional assessment model
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186

187. The 5 Ws (functional analysis)
The 5 Ws of a person’s drug use (also called a
functional analysis)
 When?
 Where?
 Why?
 With / from whom?
 What happened?
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188. The 5 Ws
Behavioural problems do not happen at random. It
is important to know:
 The time periods when the client engages in the
behaviour
 The places where the behaviour happens
 The external cues and internal emotional states that
can trigger behaviour(why)
 The people with whom the client engages in the
behaviour
 The effects the client receives from the behaviours ─
the psychological and physical benefits (what
happened) 6/13/2023
188

189. Questions clinicians can use to learn the 5 Ws
 What was going on before you used?
 How were you feeling before you used?
 How / where did you obtain and use drugs?
 With whom did you use drugs?
 What happened after you used?
 Where were you when you began to think about
using?
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189

190. Functional Analysis or High-Risk Situations Record
Antecedent
Situation
Thoughts Feelings and
Sensations
Behaviour Consequences
Where was I?
Who was with
me?
What was
happening?
What was I
thinking?
How was I
feeling?
What signals
did I get from
my body?
What did I do?
What did I use?
How much did I
use?
What
paraphernalia
did I use?
What did other
people around
me do at the
time?
What
happened
after?
How did I feel
right after?
How did other
people react to
my behaviour?
Any other
consequences
?
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191. Steps in doing functional
assessment
Step 1 Gather data about the antecedents and consequences that are
functionally related to the occurrence of problematic behavior.
The therapist uses the 5Ws to direct the client about the
information to be gathered. Both indirect [behavioural interview,
questionnaires, diaries] and direct methods[observation] are
used to gather information
Step 2 From the functional assessment- Therapist and client
collectively develop hypotheses about the nature of the problem
behavior and the conditions contributing to this behavior.
Step 3 Once the different functions of problem behavior are identified,
functional treatments are devised to address the antecedents
and consequences hypothesized to be maintaining the problem
behavior.
Operant techniques can be used to deal with the factors
•Differential reinforcement
•Extinction
•Antecedent control procedures 6/13/2023
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192. Note
 Negative punishment procedures can be used
to decrease problem behavior but only after
functional approaches have been exhausted.
 After treatment methods have been used, it is
very important to develop strategies for to
promote the generalization and maintenance
of behavioral change that have occurred.
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193. Other techniques
 Relaxation training
 Systematic desensitization
 Exposure therapies
 EMDR
 Assertion training
 Self management programs
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