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Theoretical Approaches to Human Service Work

Chapter Four

Learning Objectives (slide 1 of 2)

LO 1: Understand the differences between a person who conducts counseling versus one who conducts psychotherapy

LO 2: Learn the important place that theory plays in the development of a manner in which to practice counseling

LO 3: Understand how one’s view of human nature is the floor plan to the development of and use of one’s theory

LO 4: Gain knowledge about four major conceptual orientations, the theories that accompany them, and how they impact the work of the human service professional

LO 5: Learn the stages that a person goes through in developing an integrative or eclectic approach to helping

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Learning Objectives (slide 2 of 2)

LO 6: Examine how the ethical and professional issues of confidentiality, dual and multiple relationships, and supervision are critical to the helping relationship

LO 7:Embrace the importance of adhering to a counseling theory yet being flexible enough to adapt and change that theory over one’s career

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Counseling or Psychotherapy?

Counseling	Psychotherapy
Short term Surface Issues Here and now Conscious Focused Issues	Long term Deep-seated issues There and then Unconscious Life stories

In truth, texts do not draw a stark distinction between “counseling” and “psychotherapy.”

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Why Have a Theory?

It is heuristic - researchable and testable

Provides a comprehensive system of doing counseling

Helps us to understand our clients and decide which techniques to apply

Help us to predict change

Theories undergo continuous revision as research allows us better understanding

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Views of Human Nature

Views of human nature drive one’s theory. Most theories can be placed into 4 conceptual orientations: psychodynamic, cognitive-behavioral, existential-humanistic, and postmodern. Each orientation has a different view of human nature.

Everyone develops a view of human nature based on personal beliefs.

Developing a view of human nature is understanding why people do the things they do.

What is the impact of early child-rearing on personality development?

What is the impact of instincts, genetics, and social forces on personality development?

Is a person born good, bad, or neutral?

What are your own religious beliefs about the nature of a person?

Do you believe people can change? Can a person choose their circumstances?

Do you belief that life is predetermined?

Do you believe in the unconscious?

Do Activity 4.1 to determine your view of human nature

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Conceptual Orientation 1 — The Psychodynamic Approach (slide 1 of 2)

Common themes in the View of Human Nature of Psychodynamic Approaches

A person is affected by both his or her conscious and unconscious.

Early child rearing is important in developing personality.

Interacting with the past is an important part of the therapeutic process.

Three popular approaches:

Psychoanalysis: Freud, instincts are strong motivators. Early child-rearing practices are applied through the oral, anal, and phallic psychosexual stages. We develop defense mechanisms to manage our instincts.

Analytical psychology: Jung. The major goal is to help a person become whole. We have psychological types: sensation-intuition; thinking-feeling; extroverted introverted. Is the foundational theory of the Myers-Briggs Type Indicator. We have a conscious, personal unconscious, and collective unconscious that stores our archetypes.

Do Activity 4.2 to determine your “psychological type”

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Conceptual Orientation 1 — The Psychodynamic Approach (slide 2 of 2)

Three popular approaches (Cont’d) :

Individual psychology: Adler, early childhood experiences and memories build personality. We all experience feelings of inferiority. How we deal with those feelings lead us to adaptive of or maladaptive behaviors. More optimistic than other psychodynamic theories.

More recent theories are based on the same basic premises—(e.g., Neo-Freudians such as Object Relations theorists and Erik Erikson)

Human services professional’s use the psychodynamic approach?

Although HS students don’t do psychoanalysis, it can offer them a conceptual framework for understanding deep-seated problems

This knowledge helps the HS professional have empathy for individuals who, in the past, may have seen “evil,” misguided, or “bad.”

Also helps us understand “transference,” and “countertransference”

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Conceptual Orientation 2 — The Existential-Humanistic Approach (slide 1 of 2)

Common themes in the View of Human Nature of Existential-Humanistic Approaches

Antideterministic and more focused on conscious behavior

Phenomenological perspective : stresses the subjective reality of the client

Optimistic—people can change

Inborn tendency to self-actualize

Maslow’s hierarchy of needs

Existential Therapy (Frankl, May)

The world has no inherent meaning or purpose; each person creates it for themselves

All have the ability to live authentically and experience fully

Anxiety, feeling dread, and struggles in life are a natural part of living

We can choose to find meaningfulness in our lives

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Conceptual Orientation 2 — The Existential-Humanistic Approach (slide 2 of 2)

Person-Centered Counseling (Rogers)

Born with inborn tendency to actualize

However, tendency is sometimes thwarted by significant others who want us to be something other than what we are but conditions of worth lead to anxiety

Empathy, unconditional positive regard, and congruence by helper helps client understand real self

Gestalt theory (Perls)

Born with capacity to embrace infinite number of personality dimensions

Mind, body, and soul operate in unison

Parental dictates, social mores, and peer norms can prevent a person from attaining a need and result in resistances or blockages of experience

Goal: to understand our blacked experiences: experience = awareness = reality

Human services professional’s use the existential-humanistic approach

Gives us key relationship skills to work with clients (UPR, Empathy, Congruence)

Gives us a model for what to work on (e.g., Maslow)

Normalizes many problems—struggles are part of life

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Conceptual Orientation 3 — The Cognitive-Behavioral Approach (slide 1 of 2)

Common themes in the View of Human Nature of Cognitive-Behavioral Approaches

Conditioning:

Classical conditioning (Pavlov)

Operant conditioning (Skinner)

Social learning (Modeling—Bandura)

More recently—cognitive perspective has been included

Assumptions that underlie this approach—Read 9 assumptions on pp. 81-82

Behavior Therapy

Classical conditioning, operant conditioning, and modeling can change person

Hundreds of techniques: e.g., positive reinforcement, token economies, relaxation exercises, many more!

Rational Emotive Behavior Therapy (REBT) (Ellis)

Born with potential for rational or irrational thinking

Belief about activating event yields consequence

Irrational beliefs yields negative consequences

Change irrational beliefs to rational beliefs through cognitions and behaviors

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Conceptual Orientation 3 — The Cognitive-Behavioral Approach (slide 2 of 2)

Cognitive Therapy (Beck)

Born with predisposition to certain ways of living (genetics, environment, interaction)

Core beliefs (embedded) yield automatic thoughts

Change automatic thoughts then core beliefs, and you change person

Reality Therapy (Glasser)

Five needs: survival, love and belonging, power, freedom, and fun

Quality world contains pictures in our mind of people, things, and beliefs most important to meeting our needs

Choices we make based on these pictures can be bad or good

Caring, nonblaming language reflects positive choices, negative blaming language reflects poor choices

Can reevaluate behaviors, thoughts, feelings and physiology and make new choices

Human services professional’s use the existential-humanistic approach

Many behavioral techniques used in wide range of setting by HS professionals

Cognitive techniques help us understand how our clients react…but we don’t tend to do “cognitive therapy”

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Conceptual Orientation 4 — The Postmodern Approach (slide 1 of 2)

Common themes in the View of Human Nature of Postmodern helpers

Question scientific methods and belief that there is one correct answer

Belief in social constructionism (we construct our reality)

Language passed down through culture and society deeply impacts the person

Oppressed people particularly impacted through the language used in society

Narrative therapy (White)

Reality socially constructed through the power of language

We develop problem-saturated stories or narratives

Be humble, listen, and deconstruct stories and construct new positive stories

Solution-focused brief therapy (de Shazer & Berg)

Pathology, not inherent within people

No objective reality (don’t look “inside” person to find problem)

Focus on finding solutions to quickly (less than 6 sessions)

Miracle question: Suppose that one night while you were asleep, there was a miracle and the problem was solved. How would you know? What would be different?

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Conceptual Orientation 4 — The Postmodern Approach (slide 2 of 2)

Gender Aware Approaches

Feminist therapy and men’s issues therapy

Gender central to the helping relationships

Problems viewed as related to societal context

Collaborative and equal relationship and at one’s sex-role identity and perceptions of self

Human services professional’s use a postmodern approach?

HSP tend to be collaborative with clients and do not use their “power” to oppress clients

Focus on advocacy and social justice (HSP believe that societal issues negatively impact many of their clients)

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Other Conceptual Approaches

Other approaches include:

EMDR (Eye Movement Desensitization Therapy)

Complementary and alternative approaches

Motivational interviewing

Positive psychology www.positivityratio.com/single.php

Brief approaches to counseling (see Comparison of Brief and Long-term, Fact sheet 4.2, p. 86)

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Eclecticism or Integrative Approaches to Counseling

Drawing on a number of different orientations to develop your own theory

First, develop your own view of human nature

Then, develop your personal technique

Chaos stage: haphazard combination of different approaches

Coalescence stage: drift toward one particular approach that attracts you

Multiplicity: thorough knowledge of one approach and learning others to work out what works for a particular client

Development of metatheory: what beliefs underlie everything you do

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Ethical, Professional, and Legal Issues

The Importance of Supervision

What is it?

Characteristics of a good supervisor?

Supervision should be ongoing

Good supervision helps us evaluate ourselves and our skills

Confidentiality and the Helping Relationship

Read vignette, bottom of p. 88

When to break confidentiality and when to not break confidentiality (read p. 89)

Confidentiality—an ethical guideline, not a legal one

Difference between privileged communication and confidentially?

Dual or Multiple Relationships

When is it all right to have a client who is a friend, relative, lover?

Read from NOHS ethics standards, p. 90

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Are You an Effective Human Services Professional?

Yes, if you

Have reflected on a variety of approaches and made a commitment to one approach.

Never stop exploring and adapting.

Are dedicated to personal and professional growth.

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Summary

Contrast between counseling and psychotherapy

Creating a view of human nature

Four conceptual orientations

Psychodynamic approach

Existential-humanistic approach

Cognitive-behavioral approach

Postmodern approach

Other popular approaches

Integrating and developing your own approach

Ethical issues

Confidentiality

Supervision

Dual relationships

Personal commitment

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