ALBELAR, LENNARD, J.

BS PSYCH 301P

COUNSELLING AND PSYCHOTHERAPY

Existential Therapy

Umwelt – Physical

Mitwelt – Social

Eigenwelt – Psychological or self-knowing

Uberwelt – Spiritual

Levels of Being the World:

 Umwelt (Biological/Physical World): living cycles of organisms such as sleep patterns,

drives, instincts
 Milwelt (Social World): refers to existence as influenced by our social relationships
 Eigenwelt (Self-Knowing/Psychological experience): refers to our own individual
world, represents an attempt to understand ourselves; consists of our awareness,
introspection and self-knowing
 Uberwelt (Spiritual World): refers to the spiritual world of being; people relate to the
unknown and create a sense of an ideal world, as well as philosophical outlook on that
world. It often leads to people finding something for which they are willing to live or die.

Goals of Therapy:

 Finding personal meaning: the client is encouraged to find his or her own personal
meanings and truths about life.
 Taking responsibility for one’s decisions about living.
 Living in the present so that the client experience life more fully each moment
 Increasing self-awareness and authentic living

Role of Therapist
  Facilitate client’s encounters with themselves
 Focus on the issue of client responsibility
 Assist clients in learning how to embrace responsibility rather than avoid it
 Assists clients in making choices, removing the obstacles that block their decision-making
ability, and understanding the methods they use in arriving at decisions.

Therapy Techniques
 Free to use techniques across the broad schools of thought, including diverse techniques
such as desensitization and free association
 Primary guideline: address the uniqueness of each person
 Initial Phase: help clients identify and clarify their beliefs about their worlds. Clients are
encouraged to explore the ways in which they make sense of their being
 Middle Phase: examines clients’ values and their sources
 Final Phase: focuses on helping clients take action regarding
the kind of life they want.

Logotherapy
 Life has meaning under all circumstances
 People have a will to meaning
 People have the freedom under all circumstances to activate the will to meaning and to
find meaning in life

Techniques:

 Socratic Dialogue: Conversational method used to raise clients’ consciousness about

their possibilities. Therapist asks specific questions to raise into consciousness the

possibility to find, and the freedom to fulfill, meaning in one’s life

 Paradoxical Intention: Directs a client to do something contrary one’s actual intentions

 Labeled Dereflection: People encounter problems because they put too much emphasis

on themselves. When people shift their attention to others, their own personal

problems seem to lessen

Behavior Therapy

Classical Conditioning (Pavlov)

Operant Conditioning (Skinner and Thorndike)

 Consequences that follow behavior help learning

 Behavior is changed by systematically changing the consequences
 It occurs when a behavior is followed by a consequence, and the nature of the
consequence changes a person’s or an organism’s tendency to repeat the behavior in
the future.
 We are more likely to increase behavior that is rewarded and to decrease behavior that is
either punished or not reinforced.

Reinforcement

 To strengthen some behavior. It refers to any stimulus that strengthens or increases the
likelihood of a specific response from a person.
 Positive Reinforcement: adding something to increase a response
 Negative Reinforcement: when a certain stimulus is removed after a specific behavior is
exhibited. It involves taking something away to increase a response
 Punishment: adding something aversive for the purpose of decreasing a behavior; helps
decrease a behavior

Extinction

 Takes place when reinforcers are withdrawn or unavailable, and people stop
demonstrating a behavior
 A process of removing an unwanted response by not reinforcing it.

Generalization

 When behavior is reinforced on a consistent basis, it may become generalized to other

situations
Discrimination

 Learning how to respond differently to stimuli, depending on the situation with which we
are presented

Shaping

 Behavior that is learned gradually in steps by successive approximation

 Shaping takes place when a person actually practices a behavior.

Counterconditioning

 E.g., desensitization
 Because anxiety can be learned through conditioning, it can be unlearned by a process of
counterconditioning

Token Economies

 To shape client behavior when approval and other reinforcers do not work
 Provide a concrete measure of a person’s motivation to change specific behaviors
 Individuals can decide how to use their tokens, thereby giving them a sense of control
over their lives

The Therapeutic Process (Perspectives)

 Should focus on client’s observable behavior and their life responses, not on their
unresolved, unconscious conflicts.
 Learning is a central principle for understanding and changing a client’s behavior.
 Clients’ changes in behavior are governed by the law of effect
 Learning is also governed by contingencies. Clients change their behaviors as they
discover relationships between sequences of events and their behaviors—associate
learning
 Behavior therapy is an individual-focused approach.
 It takes a non-pathological approach to what other schools of thoughts label as mental
illness.
 Most abnormal behavior is assumed to be acquired through learning and maintained in
the same manner as normal behavior
 Instead of focusing on the past, behavioral assessment examines the current
determinants of behavior.
 The therapist conducts a prior analysis of the problem into its components or subparts
 Therapist develops treatment strategies that are individually tailored for each client,
depending on the issue for which they request assistance
 It is not essential for a behavior therapist to understand the origins of a psychological
problem in order to produce positive client behavioral change.
 Behavior therapists must commit to the scientific method in their work with clients
 Behaviorists establish a warm and empathic relationship with clients
 It is central in behavior therapy because the therapists must be able to get clients to trust
them in such sensitive issues as dealing with their deepest fears.

Goals of Therapy

 The counselor informs the client about the need for goals, the role that they play in
therapy, and the client’s involvement in the goal-setting process.
 The client indicates the positive changes he or she desires from therapy. Emphasis is
placed on what the client wants rather than what he or she does not want.
 The therapist highlights that change can only come from the client and the fact that the
client must accept responsibility for the desired change in behavior.
 Throughout the therapy process, the client and therapist work on identified goals, revising
them as the need arises. A plan of action is developed to achieve the identified goals.

Role of Therapist

 Function as consultants in producing behavioral change

 Active and directive during counseling
 Conduct a complete functional assessment to identify the variables that maintain the
conditions about which the client complains
 Generate initial treatment goals and construct a treatment plan to achieve these goals
 Teach concrete skills to the client by instruction, modeling, and performance feedback
 Use therapy techniques to promote maintenance of behavior change
 Measure the effectiveness of treatment procedures
 Complete follow-up assessments

Role of the Client

 Agreeing to perform homework assignments and by engaging in behavioral rehearsal

until skills are
 learned.

 Clients who come to therapy are motivated to change

Behavior Therapy Techniques

Relaxation Training Techniques: should be individualized for each client

Reciprocal Inhibition and Systematic Desensitization

Reciprocal inhibition: based on the inhibition of responses by the occurrence of another

response that is incompatible with it.

 E.g. relaxation training

 Systematic desensitization
 Training in deep muscle relaxation
 Construction of anxiety hierarchies
 Matching specific anxiety situations from the hierarchies with relaxation training

Stress Inoculation Training

 Designed to help inoculate people against collapse as they experienced stress.

 Goal: to change individual’s beliefs about the behaviors and statements they make to
themselves regarding how they deal with stress
 Helps clients to induce a relaxation response, engage in cognitive restructuring, and perform
effective problem-solving skills

Exposure Therapies

Flooding: constitutes either an in vivo or imaginal exposure to anxiety-evoking stimuli for a

prolonged period of time. The therapist exposes the client to a safe version of the fearsome
stimulus at maximum intensity.

In Vivo: refers to procedures that takes place in the client’s actual environment

Implosive Therapy:

 Client imagines all anxiety situations

 The imagined anxiety scene is exaggerated to elicit as much anxiety as possible
  The imagined scenes are based on hypothesized sources of anxiety, which are
psychodynamic in nature

REBT

ABC Model of Personality

A: activating event or experiences, such as family problems or early childhood trauma, that
trigger stress or worry

B: belief system—the cognitive component in our reaction to events. Especially important are
irrational, self-defeating beliefs that form the source of our unhappiness

C: consequences (the neurotic symptoms and negative emotions,

such as depression, anger, and rage) that come from our beliefs

D: Disputing Irrational Thoughts and beliefs

 Detecting
 Debating
 discriminating

E: Cognitive and Emotional effects of revised beliefs

The Therapeutic Process

 Designed to help clients gain a more realistic, rational philosophy of life

 Therapist does not devote much time to examining the morbid details of the client’s life
 Challenges clients’ irrational beliefs in the first few sessions
 Intended to be a brief therapy (1-10 sessions)
 Clients with sever disturbances are encouraged to come to individual and/or group session
for at least 6 months
2 techniques:
 Tape the entire session. Clients then listen to the recording several times so they can
ascertain their problems and the REBT way of handling them
  To give REBT Self-Help Form to teach clients how to use the method when they
experience emotional problems between therapeutic sessions

The Therapeutic Relationship

General REBT: similar to CBT

 Preferential REBT, which stresses a deep philosophical change in the client’s life
and way of relating to people

3 powerful insights:
 Person’s self-defeating behavior usually stems from the interaction of A and B; such
that A+B=C
 People have made themselves emotionally disturbed because they keep
indoctrinating themselves with similar irrational beliefs
 Clients recognize that only hard work and practice will correct irrational beliefs.
Clients must commit themselves to repeated challenging of irrational thoughts until
they are fully extinguished.

Role of REBT Therapist

 Must understand belief systems and how to distinguish rational and irrational
beliefs.
 Primary role: focus on the main irrational ideas that lie behind the feelings clients
have expressed in therapy, especially their ideas that is awful the way in which
people have treated them
3 phases:
Cognitive Phase: therapist presents the cognitive rationale for REBT to the client. It is
devoted to clients writing down their troublesome thoughts.
Emotive Phase; clients are instructed that they can learn to
control their emotions by becoming fully aware of the thoughts that support such
emotions and by learning to substitute alternative thoughts
Behavioristic Phase: clients are taught to change their behavior

Role of the Client

  Individuals who are out of contact with reality, in a highly manic state, seriously autistic or
brain injured, and in lower ranges of mental deficiency are not good candidates for
REBT
 More effective clients who have a single major symptom such as depression.
 Clients are instructed to focus on the present and not on the past
 Expected to participate actively in the therapeutic process and to complete assignments.

Counseling Techniques

 Uses a variety of therapeutic techniques: didactic discussion, bibliotherapy, role

playing, assertion training, operant conditioning, activity-oriented homework assignments
 Changing one’s language
 Imprecise language contributes to distorted thinking
 Clients learn how to change their “musts” to “preferences”
 Humor: emotional disturbance comes from taking oneself too seriously
 Shame-attacking exercises: to help clients reduce shame over how they behaved. Such
exercises are designed for increasing client self-acceptance.
 Disputing: Detailed examination sentence by sentence of any irrational belief that the
client states during therapy

Using three forms of disputation:

 Cognitive: attempts to persuade the client by asking direct questions; e.g. “Can u prove
it?”; “How do u know”?
 Imaginal: ask client to imagine themselves in the situation about which they feel
uncomfortable
 Behavioral: if clients continue practicing rational emotive imagery, they can reach the
point where they no longer feel upset over negative events

Emotional Control Card

 Wallet sized and contains four emotionally debilitating categories: anger, self-criticism,
anxiety and depression; a list of inappropriate feelings, and a parallel list of
appropriate feelings
 The goal is to get clients to become aware of the feelings that they are using and to
encourage them to rationally choose the emotions they display.