PSYC3082

Psychotherapies &
Counselling

Dr Cassandra Tellegen (She/Her)

School of Psychology
University of Queensland

Introduction to Course 1
Acknowledgement of Country
The University of Queensland (UQ) acknowledges
the Traditional Owners and their custodianship of
the lands on which we meet.

We pay our respects to their Ancestors and their

descendants, who continue cultural and spiritual
connections to Country.

We recognise their valuable contributions to

Australian and global society.

2
Course Staff
Coordinator and Lecturer
• Cassie Tellegen – [email protected]

Lead Tutor
• Ciara Hambridge-Chambers

Course Tutors:
• Lydia Chan
• Jeff Adina
• Amina Khalid

Course Administration:
• py‐[email protected]

Introduction to Course 3
Where to direct your queries?
• Requests for extensions, tutorial changes &
general course administration should be directed
to the Course Administrations:
[email protected]

• All queries re tutorials, general course content,

and assessments (quizzes, assignment &
portfolio)  Tutor

• If not resolved  Lead Tutor: Ciara

• If still not resolved, contact the Course

Coordinator – [email protected]

Introduction to Course 4
What is PSYC3082 all about?
• To provide you with a personalised, practical, theoretical, and research‐based introduction to
major aspects of psychotherapy and counselling psychology.

­ To teach you the fundamental building blocks of psychotherapy practice.

­ To introduce you to a broad range of relevant psychotherapies used widely by clinicians

in private practice and hospital settings.
­ To talk about various clinical frameworks for use with various populations/disorders and
the evidence for these approaches.
­ To allow you opportunities to practise various psychotherapy tools on yourself to develop
a deeper understanding of yourself and working with clients (Bennett-Levy & Finlay-
Jones, 2018 and Pakenham & Viskovich, 2019).

Introduction to Course 5
Course Structure
Weekly lectures:
• In person and recorded
• 10am – 12pm Thursdays
• Breaks

Tutorials:
• Mon/Tues/Wed as per timetable
• Not recorded

Introduction to Course 6
Weekly Lectures
• Psychotherapy Introduction & Micro‐counselling
skills (Week 1)

9 Psychotherapies: longstanding and recent

• History
• Theory
• Techniques
• Empirical support
• Personal Application

• Slides will be available in PDF format in

Learning Resources on Blackboard prior to each
lecture

Introduction to Course 7
Week Tutorials (Mon-Wed) Lectures (Thurs)
1 Introduction and counselling skills
2 Micro-counselling skills Behaviour therapy
3 Behaviour therapy Cognitive therapy
4 NO CLASSES
5 Cognitive therapy ACT part 1
6 ACT part 1 ACT part 2
7 ACT part 2 Compassion Focused Therapy (James Kirby)
8 CFT Psychodynamic therapy (Giac Giacomantonio)
9 Psychodynamic therapy Person centred therapy
10 NO TUTORIALS Existential therapy (Paul McQuillan)
11 Existential therapy Schema therapy (Julieta Castellini)
12 Schema therapy Positive psychology (James Fowler)
13 Positive psychology Panel discussion: Pathways for therapists
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Tutorials
• Tutorials start Week 2

• Assessment details
• Practising micro-counselling
• Experiential therapy exercises
• Reviewing your personal application of
psychotherapy strategies (Portfolio)
• Reviewing lecture content
• Asking questions about lectures, content,
assessments etc.

Introduction to Course 9
Practice Component of Course
• Observation of audio‐visual demonstrations of
psychotherapy in action.
• Participation in experiential exercises and role‐plays in
lectures and tutorials.
• Practice in developing treatment formulations for various
cases using varied frameworks.
• Personal practice of psychotherapy strategies via Portfolio
exercises.

Introduction to Course 10
Personal Application Component of Course
Application of psychotherapy strategies in your own
life via Portfolio:
▪ Self‐practice tasks
▪ Self‐reflections
▪ Self‐care prompts

• Participation in experiential exercises in class.

• Personal reflections on role‐play and case
studies.
• Participation in tutorial discussion groups.
• If you want to get the most out of the course,
you need to fully ENGAGE in it.

Introduction to Course 11
Assessment Overview
Component Due Date Weight
Quiz I 7-8 September 23%

Case Study 22 September 37%

Assignment

Quiz II 26-27 October 27%

Portfolio 27 October 13%

Introduction to Course 12
Rationale for Assessments
Portfolio:

• Experiential mastery of course content

• Personal application and mastery of
psychotherapy techniques
• Identification of techniques from specific
schools of psychotherapy
• Deep learning of psychotherapy
approaches
• Reflective learning
• Self‐awareness
• Personal growth and wellbeing
• Self‐care skills

Introduction to Course 13
Rationale for Assessments
Case Study Assignment
• Basic case formulation skills
• Fundamental clinical reasoning and
decision making skills
• Development of a psychotherapy
intervention plan
• Application of a psychotherapy theoretical
framework to a case
• Understanding of how psychotherapy
theory and techniques are linked and, in
turn, apply to a case
• Understanding of psychotherapy research

Introduction to Course 14
Rationale for Assessments
Quizzes

• Mastery of the curriculum content

• History of the main psychotherapies
• Psychotherapy theories and techniques
• Processes and Phases of Psychotherapy
• Micro‐counselling skills
• Methodologies for evaluating
psychotherapies
• Psychotherapy research

Introduction to Course 15
Documents Related to Assessments
Information on assessments:
• ECP
• “Assessment” section of Blackboard

Portfolio
• Information sheet
• Portfolio template
Quizzes:
• Information sheet
Case study assignment:
• Information sheet including marking criteria

Introduction to Course 16
Resources: Textbook and Readings
Textbook: Corey, G. (2017) Theory & Practice of Counseling &
Psychotherapy (10th edition)
• Print copy
• MindTap: eBook + videos, revision quizzes, homework exercises

HAVE QUESTIONS?
▪ Contact customer support: Monday to Friday: 8am – 5pm AEST
▪ Ph: (AU) 1300 790 853
▪ Email: [email protected];
[email protected]
• FAQs: cengagebrain.com.au/shop/faqpage;

• Required readings are listed in the ECP

• Psychological Support Services – Course Help on Blackboard
• Notes on counselling others – Course Help

Introduction to Course 17
 Why am I teaching this course?

Introduction to Course 18
 • What motivated you to
enrol in this course?

• What do you hope to

learn in the course?

Introduction to Course 19
20
Why pay for a
psychotherapist
when you could
have your palm
read over a nice
cup of tea?

21
What is Psychotherapy?
Some definitions...
• The treatment of mental disorders by psychological means.
• Specialised formal interaction between a mental health practitioner and
a client in which a therapeutic relationship is established to help to
resolve symptoms of mental disorder, psychosocial stress, relationship
problems and difficulties in coping in the social environment.
OR
• Psychotherapy is a psychological approach to relieving human
suffering

• Approximately 1 in 5 people 16-85 will experience a mental illness in

any year (ABS, 2018).
• Almost half (45%) of Australians will experience a mental health illness
in their lifetime (ABS, 2018).
Introduction to Course 22
What is Psychotherapy?
Psychotherapy is Theory Driven and Evidence Based

• “Counsellors who don’t have a theory are likely to get lost in

their efforts to help their clients” – Nancy Murdock

• According to Murdock (2009) a good theory has:

• Precision and testability
• Parsimony – the simplest explanation for the data
• Practicality – readily applied
• Stimulation – it gets people excited!
• Empirical validity – case study; RCT; meta‐analysis; etc.

Introduction to Course 23
Who provides Psychotherapy?
Registered Health Professionals:
• Psychologists
• Psychiatrists
• Other registered allied health profession (e.g., mental health
nurses)

Non‐registered Health Professionals:

• Counsellors (various)
• Psychotherapists
• Coaches

Anyone can claim to be a counsellor, psychotherapist or coach

even without adequate training. Registration is important.

Introduction to Course 24
How is Psychotherapy Delivered
• Individual
• Face to face
• Online via Zoom
• Family
• All family members
• Sections of family members
• Couple
• Centered around relationship issues with both
individuals present
• Therapeutic communities
• Common in substance abuse
• Live in with individual and group therapy
• E-Therapy
• Web-based programs
Introduction to Course 25
Does Psychotherapy Work?

Psychotherapy is evaluated via:

• Single case study designs
• Efficacy studies
• Effectiveness studies
• Systematic reviews and meta-analyses of research

All play a role in determining if treatment works.

Introduction to Course 26
So, is Psychotherapy Efficacious?
• 100s of studies show that the average
client in psychotherapy improved more
than about 80% of clients who were not
treated (Lambert & Ogles, 2004).

• Psychotherapy > placebo > control (do‐

nothing or wait).

Introduction to Course 27
So, is Psychotherapy Effective?
Most likely yes‐ the vast majority of clients report
improvements from psychotherapy as it is practiced
in the real world.

Differences in outcome between various forms of

therapy are not as pronounced as might be
expected (this might be as research finds up to 50%
of the change in outcomes to come from rapport!).

An important aspect of evaluating if therapy is

working is using valid, reliable and USEFUL
treatment outcome measures to track changes.

Introduction to Course 28
Psychotherapy vs Pharmacology
Psychotherapies are as effective as pharmacotherapy in
treatment of depression and anxiety disorders.

• Yet psychotherapy is less available or accessible (e.g.,

wait times, cost).

• But 75% of patients prefer psychotherapy over

medication.

• For some clients, a combination of psychotherapy and

medication is the most effective treatment.

Introduction to Course 29
Why Does Psychotherapy Work?
• One of the most often cited common factors is
the therapeutic relationship or therapeutic
alliance.

• Meta‐analysis (k = 295) with >30,000 clients

confirmed the moderately strong correlation
between alliance & intervention outcomes
(Fluckiger et al, 2018).

• Many researchers maintain that the therapeutic

alliance accounts for dramatically more of the
variability in outcomes than any specific factors
based on theoretical approaches (Wampold,
2001).
Introduction to Course 30
Overview of the Stages of Psychotherapy
Assessment and
observation

Case formulation

Intervention Implementation

Evaluation
Micro-Counselling Skills
Definition: Specific skills a therapist uses to enhance
communication with a client. Helps build a working alliance
and creates helpful and meaningful discussions.

Exercise
Q. When you’re feeling upset about something, what sort of
person do you share it with?

Q. What specific things does that person do (or NOT do) to put
you at ease and make you feel like talking?

Q. Would you expect a therapist to do anything differently from 32

a close friend?
Attending Micro-Behaviours
Definition: Non-verbal behaviours displayed by the Four dimensions to attending micro-
therapist that let the client know they are listening. behaviours:

Visual: Maintain good eye contact

Attending micro-behaviours:
• Communicate that you are interested in what they Vocal qualities: Tone & speech rate
are saying. appropriate
• Increase your awareness of a client’s pattern of Verbal tracking: Stick with the client’s story
focusing on certain topics.
• Helps you modify your behaviour to establish Body language:
rapport. Face client squarely
Open relaxed posture
Lean slightly toward client
Attention is a powerful reinforcer. Mirror body language to develop trust 33
Specific Micro-Counselling Skills
• Encouragers
• Reflection of Content
• Reflection of Feeling
• Paraphrasing
• Summarising
• Open Questions
• Closed Questions

34
Encouragers
Encouragers: nodding, “uh ha”, “go on” or “tell me more”
etc.

Maintain the flow of the interview with minimum

interference from the interviewer.

Are less intrusive than questions, but give less control

over the duration of the interview.

Aim is to find out more about the current topic/issue as an

35

alternative to questions.
Reflection of content
Reflection of Content: The therapist aims to tell the client, in a clear brief way, and in the
therapist’s or client’s own words, the most important things the client has just told the therapist.

Benefits:
• Client feels heard
• Very validating
• Opportunity to hear what they are saying from
another point of view
Example:
“When my husband was away in Canada the worst thing
36
was that I couldn’t easily just go for a run as I had no one to watch the kids”
Reflection of feelings
Reflection of Feelings: Involves expressing in fresh words the client’s
essential feelings, stated or implied. Captures emotional tones & phrases.

Benefits:
• Help clients become aware of their feelings.
• Help client accept and explore feelings.
• Demonstrate therapist’s understanding.
• Develops the therapeutic relationship.

For example:
• “You sound …”
37

• “It seems as though …”

• “In other words, you feel …”
Reflection of feelings
Be sure to distinguish feelings from thoughts/physical sensations:
• “I had the feeling that I wanted to run away” (which is really a thought) vs
feeling of fear.
• “I feel tired” (again thought tied in with body sensations linked to fatigue).

It’s ok to be uncertain with feelings:

• “I’m wondering how this makes you feel?”
• “If that happened to me I’d feel really hurt”.
• “I imagine that could be a bit scary for you?”

• It’s not about getting it right – sometimes getting it wrong allows the client to 38

correct you, leading to further understanding and clarity.

Paraphrasing
Rephrasing in your own words a specific issue the client has raised or alluded
to. It is not a direct repetition (“parroting”) nor does it alter the actual meaning.

Benefits:
• Indicates that you are attending to the client.
• Check that you understand what the client has said.
• Helps the client clarify their thoughts (by hearing the key elements of what
they have just said).

Can reflect back:

• Content (“and then you lost your job”) and/or
• Feeling (“and you just feel completely overwhelmed”)
• Each will lead in a different direction.

Example: the client says: “I was feeling depressed last week, but I’ve been 39
feeling better the past two days”.
The interviewer could paraphrase the “you were feeling depressed” or the “you
are feeling better now” depending on what they wanted to focus on.
Paraphrasing: Common errors
• Poor timing (e.g. reflecting anger, shame, that the client hasn’t
acknowledged yet).
• Stereotyping your client (e.g., “You must be really sad not to have
any children”).
• Poor word choice (e.g., powerless vs weak vs tired; terrified vs
afraid vs worried; betrayed vs cheated vs misled).
• Overshooting with too much feeling:
Client: “I don’t know if I could stay overseas for a year without my
boyfriend”
Therapist: “You feel like you’d be so lonely that you just couldn’t
function without him”
40
Summarising
Reflecting back the whole, or in large part, what the client has been discussing
over the course (or significant part) of the interview.

Used to:
• Begin or end a session (e.g., a session recap at the beginning of a session).
• Transition to a new topic (e.g., So to summarise, you have said ….. and I
now want to talk about how it connects to ….).
• Provide clarity (e.g., client’s get a lot out of hearing back what they have
said, it can help them organise their thoughts and how to tackle and issue).

• Like paraphrasing, summarising clarifies that the interviewer has accurately

understood what the client has been saying.
• It is different in that the summary is of all or at least several
41
ideas/issues/feelings raised by the client.
Open vs closed questions
Open questions
• Result in a detailed response and open the dialogue.
• Often start with words like ‘How’, ‘Tell me’, or ‘Why’.
• E.g., “Tell me about what it’s like at your work?”

Closed Questions
• Result in a simple response (yes; no) and close down the dialogue.
• Often start with words like ‘What’, ‘Who’, ‘Do’ or ‘So’.
• You use them to clarify a particular issue.
• E.g., “Do you work fulltime or part-time?”

Caution: some clients (or my husband) answer closed questions

with open responses and open questions with closed responses. 42
Questioning

• Ask one Q at a time. • Ask intrusive questions without adequate rapport.

• ‘Rapid fire’ questioning (like an interrogation).
• Use simple & clear Qs (don’t
• Ask leading questions; E.g., “I imagine you ate some
take forever to explain the Q).
healthy food as well?”
• Wait for an answer • Loaded questions - questions with a clear emotional
or social-judgemental bias; E.g., “Last week you
mentioned you went to McDonalds, you didn’t do
that again this week I hope?”
• Use “why” questions if “what” or “how” questions 43

would work.
• Answer your own question
Open and closed questions

44
Empathy

• Stepping into the shoes of the client.

• Seeing from the client’s perspective.
• Micro-counselling skills are used to communicate
empathy and validate the client’s experience.
• Useful for all phases of therapy.

45
Silence
• Don’t be afraid of silence.

• Use silence strategically.

• Gives client a chance to reflect on his/her

external or internal experience.

• Gives space in the interaction.

• Can bring emphasis to what has just been said

or what is being experienced.

46
Reading & Self Practice
Tutorial:
• Counselling skills practice

Reading for next lecture:

• Chapter 9 in Corey

Portfolio:
• Your Self-practice Task in your Portfolio for
the next week is to practice micro-counselling
skills in your day-to-day interactions and then
to write a reflection on how it went and note 47

how it could be helpful for self-care.

 Questions
or
Comments?

Introduction to Course 48