SOCW 740:Week 2
Gehart Ch. 1, Prochaska Ch. 1
(Williams Ch. 1, Patterson Ch. 1)
Philosophical Schools of Theory
1. Modernist: CBT,
... [Show More] Psychodynamic
2. Humanistic: Gestalt, Person Centered (Rogerian), Emotionally Focused, (Satir, Whitaker).
• Philosophical Schools of Theory
3. Systemic: Systems theories, Strategic, MRI Problem-Focused Approach, Cybernetics system theory, Structural Theory
4. Postmodern: Constructivism, Social Constructionism, Feminist Theory, Narrative Therapy (Societal, Political).
Chapter 1: Counseling Theory, Competency, Research and You: Connecting the Dots
• Competencies:
– Diversity and multicultural competence
– Research and the evidence base
– Ethics (and Law)
– Person-of-the-counselor/Person-of-the-therapist
• Research and the Evidence Base: Reframing and Redesigning Theory
– Two main Research Approaches:
• Common factors (across theories) research
• Most concensual common factors:
• (1) clients positive expectations
• (2) therapeutic relationship (12%+)
• Rogers’ Facilitative Conditions
• Therapist is congruent or genuine.
• Therapist relates with (unconditional) positive regard.
• Therapist expresses accurate empathy.
• Lambert’s Common Factors Model
• Client Factors = Client motivation and resources (40%).
• Two types:
• Client characteristics: Client motivation to change, attitude about counseling/change, commitment to change, personal strengths and resources (e.g., cognitive, emotional, social, financial, spiritual), duration of complaints, and so on.
• Extratherapeutic factors: Social support, community involvement, fortuitous life events, and so on.
• Therapeutic Relationship = How the client views the relationship (30%).
• Therapeutic Model/Techniques = The theory or model used (15%).
• Hope and the Placebo Effect (Positive Expectancy) = Does the client believe it will help?(15%).
• Other Common Factors
• Hawthorne EffectThe tendency to perform or perceive differently when one knows they are being observed
• Catharsis (Emotional discharge)
• Choosing (New Alternatives, self-liberation)
• Contingency Control (Reinforcement increases response)
• Evidence-based practice and treatments
• empirically supported treatments (ESTs) meet the following criteria:
• Subjects are randomly assigned to treatment groups.
• In addition to a group receiving the treatment being studied, there must also be
• a no-treatment control (usually subjects are on a waiting list) or
• an alternative treatment (for comparison; may be an unspecified approach: “treatment as usual”) or
• placebo treatment.
• Advantages of ESTs and Efficacious Treatments
• Greater scientific support
• Written manuals to guide treatment; highly structured
• Target a specific population with a specific problem
• Disadvantages of ESTs and Efficacious Treatments
• Limited applicability: targets a specific and therefore limited population
• Expensive: counselors need highly specific training in the model and need to be trained in a number of models to function effectively in most work environments
• evidence-based practice (EBP) refers to using research findings to inform clinical decisions for the care of individual clients.
• practical and practice-friendly approach for using research to enhance the practice of counseling
• Law, Ethics, and Competency
– Confidentiality
• Secret unless written releases or state law permit
– Diversity
– Scopes of competence and practice
• practice only within their scope of competence, areas in which they have been adequately trained, or they obtain supervision in areas of growth
• The scope of practice refers to what one’s specific license allows one to do
– Dual relationships
– Defining the client
– Children’s rights to confidentially
– Personal concerns
– Mandated reporting
• Person-of-the-Counselor and Competency
– Personal characteristics:
– Identify and manage countertransference
– Therapeutic presence
– a quality of self considered to have intrapersonal, interpersonal, and transpersonal elements, including elements of empathy, compassion, charisma, spirituality, transpersonal communication, patient responsiveness, optimism, and expectancies
THE ROLE OF THEORY and PYSCHOTHERAPY POWERPOINT
• Psychotherapythe informed and intentional application of clinical methods and interpersonal stances, derived from established psychological principles, for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable
• Theory Is Used To:
– Develop a specific form of helping relationship
– Articulate more useful understanding of clients’ situation
– Identify effective means to resolve clients’ presenting problems
• Theories describe clinical phenomena, delimit and organize mass of information, and integrate knowledge that directs psychotherapy.
– Provides Direction
– Provides a system of understanding information
– Conceptualizes health, pathology, reality and the therapeutic process
SOCW 740: Introduction
The Beginning Family Therapist
• Common Issues:
– Anxiety
– Academics versus competence
– Difficulties with integration
– Necessary Skills
– Interventions???
What do I do?
• Managing Anxiety Includes:
1. Normalizing it
2. Share with others
3. Identify faulty cognitions
1. Client-Therapist Relationship
2. Realize learning curve takes time Therapist Development
• Learning Essential Skills
• Case Conceptualization
• Therapist as Self Six Domains:
Admission to Treatment
Clinical Assessment and Diagnosis Treatment Planning/Case Management Therapeutic Interventions
Legal Issues, Ethics and Standards Research and Program Evaluation
Competencies in Family Therapy (Gehart, Ch. 1) Five Subdomains of MFT Core Competencies:
1) Conceptual - Knowledge, facts
2) Perceptual - “What's going on?”
3) Executive - “Skills”
4) Evaluative - Assess own abilities (Accurately)
5) Professional – Ethics, standards, policies Who should come to therapy?
• Individuals? 54%
• Couples and Family? 35-42%
– Marital and Family problems most common
– Relations trumps individual
• Need to emphasize power of relationship in the influence of others thoughts, feelings and actions.
Gehart Ch. 2 (Skim 15 and 16) Chapter 2: Treatment Planning
Treatment Planning and Creative Planning
◦ Treatment Plans
▪ Help counselors think through which dynamics need to be changed and how
▪ provide counselors with a clear understanding of the client situation
▪ give counselors a sense of confidence and an increased clarity
▪ ground counselors in their theory
Brief History of Mental Health Treatment Planning
◦ Treatment planning needed to receive third-party payment
▪ Derived from a medical model
◦ Symptom-based treatment plansmost extensive treatment plan models focused solely on clients’ medical symptoms
▪ Focus on “presenting problem” symptoms
▪ Danger: the counselor will underutilize counseling theories to conceptualize and over focus on symptoms
◦ Theory-based treatment planningUses theory to generate clinically relevant treatment plans Types of Treatment Plans
◦ Clinical Treatment Plans
▪ separate out treatment tasks, the treatment elements the counselor is responsible for, from client goals, the specific aspects of the client’s life to be changed
▪ Clinical Treatment Plans Include:
• Introduction—include planned modalities (i.e. individual, couple), frequency, and expected length of treatment
• Treatment Tasks—informed by theory, as well as ethical and legal requirements
• Diversity
• Client Goals—describe what behaviors, thoughts, feelings, or interactions will be either increased or decreased as a result of treatment
• Interventions—include two to three
• Client Perspectives—describe areas of client agreement and concern with the outlined plan
◦ Theory-Specific Case Conceptualization
▪ Using One Theory to Understand/View a Client and His or Her Situation
▪ Most Important Step in Treatment Planning Process
• Not formulaic
◦ Writing Useful Treatment Tasks
▪ Initial Phase Treatment Tasks
• Two initial counselor tasks:
o Establishing foundation for counseling
o Assess individual, family, and social dynamics
▪ Working Phase Treatment Tasks
• Primary task: Keep the ball rolling
• Monitor relationship via observation and checking in
▪ Closing Phase Treatment Task
• Primary task: counselors to make themselves unnecessary in client’s life
• Develop aftercare plans and maintain progress
◦ Diversity and Treatment Tasks
▪ Examples of How to address counselor-client differences
• Use of humor with teens and men
• Use of present-focused, problem-focused approaches with clients who do not value exploring the past.
• Accounting [Show Less]