Disorders and Treatments Paper

Unit 6

1. Demonstrate therapeutic communication skills in a given clinical situation.

· LEARNING ACTIVITIES

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[u06s1] Unit 6 Study 1

Existential and Gestalt Therapy

Readings

Use your Current Psychotherapies text to read:

. Chapter 8, "Existential Psychotherapy," pages 273–308.

. Chapter 9, "Gestalt Therapy," pages 309–348.

Media

Use the Capella Library to watch the following videos:

. " Counseling Therapies, Session 2: Gestalt Therapy " [12 min].

· [music]

· AIPC Presents Counselling Therapies Session 2: Gestalt Therapy

· 00:20UNKNOWN All right, hi, Sandra. Um, well, uh, we have about half an hour together this time and, uh, how are you feeling right now? What's your awareness? See there's a bit of a, kinda, the situation's different from last time?

· 00:35SANDRA Um, no, I, I'm still feeling the same.

· 00:40UNKNOWN Right.

· SANDRA Just, yeah, I think it's...

· UNKNOWN (crosstalk)The same meaning what?

· SANDRA Uh, just, just, a little frustrated at the moment. That's all.

· 00:50UNKNOWN Mm-hmm. And what is the frustration like? For you?

· 00:55SANDRA It, it's just a, a tight feeling that I have. I, I just, um, yeah, it, it's very, it's, it's difficult to put into words, but just a . . .

· 01:10UNKNOWN Yeah.

· SANDRA . . .it just doesn't feel, feel good.

· UNKNOWN (crosstalk) Okay. So, let's shift it to your body. Where in your body do you feel this tight feeling?

· 01:15SANDRA I think it's, it's in my chest.

· 01:20UNKNOWN So that's a hard area. You feel it around the heart.

· 01:25SANDRA (crosstalk) Okay.

· UNKNOWN Yeah, right, right, yeah. And what is there in that heart? If you pay attention to that, that area in your heart, what, what do you find there?

· 01:30SANDRA (crosstalk) Mm-hmm.

· UNKNOWN What sort of thing do you find there?

· 01:35focusing on the here and now

· SANDRA Yes, it, it, it's just a, a really, just a compressing feeling, just...

· 01:40being directive and confrontational

· UNKNOWN Uh, I notice that you have been saying "it" when you talked about your feelings, and, uh, I'd like to suggest if you can say "I" instead of "it" . . .

· 01:50SANDRA (crosstalk) Mm-hmm.

· 01:55UNKNOWN . . . and see what happens in your body.

· SANDRA (crosstalk) Mm-hmm.

· UNKNOWN So go ahead.

· 02:00SANDRA You, you actually want me to, to say.

· UNKNOWN (crosstalk) Yes. Yes, please.

· SANDRA Okay, yes. Um, my chest feels very tight. I feel very frustrated, angry.

· 02:10UNKNOWN Mm-hmm. Angry.

· SANDRA Mm-hmm.

· 02:15UNKNOWN So that's what's coming up, frustration, anger.

· SANDRA Mm-hmm.

· UNKNOWN Right. So what are you doing this moment with your anger as you're sensing it right here in your chest? This moment.

· 02:25SANDRA I'm just, just accepting it. Just, it's just there, it's...

· 02:30UNKNOWN (crosstalk) So you're accepting it. And once you accept that anger inside you, what else do you do with that anger, having accepted it?

· 02:45[sil.]

· 02:50SANDRA Um, it's, it's just a part, it's just a part of me, you know.

· 02:55UNKNOWN I'm noticing you're saying "it" again.

· SANDRA Yes.

· 03:00UNKNOWN "I am". "I make". Use the word "I".

· SANDRA "I".

· 03:05UNKNOWN It's a thing that, to acknowledge this is you, not something out there. You do that a lot.

· SANDRA (crosstalk) Mm-hmm. Okay.

· UNKNOWN When you think of something very strong, you put it out there.

· 03:10SANDRA Okay.

· UNKNOWN So, it's a safe way to put it, but if you say "I feel angry".

· 03:15SANDRA Mm-hmm. I feel angry.

· 03:20UNKNOWN And who do you feel angry at?

· SANDRA My ex-husband. Yes.

· 03:25UNKNOWN Mm-hmm. Your ex-husband.

· SANDRA Mm.

· UNKNOWN Sandra, having just explored some of your feelings around this situation you have, uh, I'm gonna suggest that you, um, speak to Jeff on an empty chair. This may be a little uncomfortable, but it helped me to facilitate a process where I become an observer, and you'll be in, dialoging with a, the, the party, that you are actually having to deal with. And I'll be facilitating for you that process. And then pointing out some of the things we could do to change that process, okay?

· 03:55SANDRA (crosstalk) Okay. Mm-hmm.

· UNKNOWN Yeah. Let's bring Jeff, in your imagination, as if Jeff were here.

· 04:00SANDRA Mm-hmm.

· 04:05UNKNOWN That's all right? Okay, I'll bring a chair.

· SANDRA Okay.

· empty chair technique

· UNKNOWN So welcome, Jeff. I mean, I welcome Jeff, you don't have to welcome him. And, uh, and there's Jeff. (laughing) So imagine his face, what he looks like, how you remember him.

· 04:15SANDRA Mm-hmm.

· UNKNOWN How, uh, and bring him in in your fantasy, and then when you're ready, you just say whatever comes to your, er, um, to you, at that moment, at this moment spontaneously, okay?

· 04:25SANDRA (crosstalk) Mm-hmm. Okay. Jeff, I feel very frustrated about the situation, that you have left me and the children in. I don't think you understand how hard it is at times and the, the things that I have to explain to them about, about the situation. Uh, it bothers me that you don't go out of your way to spend extra time with the children, and I really believe that in the future they, they will come to, uh, to really resent that and, and not look at you as, as their father. Uh, I, I, I honestly can't understand why you don't want to spend more time with them and irrespective of what's happened between, between us, and, and you moving on and so forth, I, I just don't think that, um, that your children and my children should really suffer in that way. I, I would like them to have as, as normal a life as possible and, and be able to, to be with both of their parents. A-, and, why, you know, what is so important rather than them wanting to be with them. It, It's, it's just veryhard.

· 06:00UNKNOWN Okay. Mm-hmm. Okay, so there's a, kinda a question. You understand why this happened, etc., right?

· 06:05SANDRA Mm-hmm.

· UNKNOWN So what, in the next thing we'll do you'll, you'll sit over there, and you will be Jeff.

· 06:10SANDRA Mm-hmm.

· UNKNOWN And see what Jeff can answer...

· SANDRA Mm-hmm.

· 06:15UNKNOWN . . . to you as to where he is at. That may be a little bit, uh,difficult, but let's do a dialog as if he were here. He's not here anyway.

· 06:25SANDRA Yeah.

· UNKNOWN So, we'll be having a dialog between Jeff, the imaginate Jeff that you have...

· 06:30SANDRA Mm-hmm.

· UNKNOWN . . . and you in the present, here and now. Okay?

· SANDRA A-, and what is, what is he saying?

· 06:35UNKNOWN Well go ahead as I'm suggesting.

· SANDRA Okay.

· UNKNOWN Sit over there.

· 06:40SANDRA Okay.

· UNKNOWN The moment you sit over there, you become Jeff.

· SANDRA Okay.

· 06:45UNKNOWN And whatever Jeff says to the statement of, you made...

· SANDRA Mm-hmm.

· UNKNOWN Go ahead, Jeff.

· empty chair technique

· 06:50SANDRA Sandra, I know that it must have been hard on you and the kids with me leaving, and it's not that I, I don't want to spend more time with them, but I am very busy with, with work and, and a few other things that,that are going on in, in my life. And Sandra, my children do mean a lot to me, and you know, if, if I was to spend more time with them, though, when I contact you about it, I, I don't want you to be, to be short and rude and, and, and I want you to be open to, to the opportunity.

· 07:30UNKNOWN Okay, I'll stop you, Jeff, and say, "Sandra, but the children really mean a lot to me." Just say that to her again, a statement.

· 07:40SANDRA Sandra, the children really do mean a lot to me.

· UNKNOWN Okay. So go back over there. So check your frustration over there. How is, do you feel different about him now? That he really cares for the children?

· 07:50SANDRA Mm-hmm.

· 07:55UNKNOWN And there is a future maybe with him and them?

· SANDRA Mm-hmm.

· UNKNOWN Do you feel that?

· SANDRA Yeah.

· 08:00UNKNOWN Yeah. So have you any appreciations to Jeff? I know there are the hurts and the frustration, anger, but any appreciation that he still cares for these children. He's their father.

· 08:10SANDRA Mm-hmm. I really don't have any appreciation for that because the reason that he's...

· 08:20UNKNOWN Tell him that.

· SANDRA The reason that you've given . . .

· UNKNOWN Okay.

· SANDRA . . .that you're busy, like, I'm busy in my life, and, and I still give our children priority. They still take precedence in my life.

· 08:30UNKNOWN Okay.

· SANDRA And I just don't think that that, that that's right.

· 08:35UNKNOWN Okay, okay. Then tell him what sort of a father he should be.

· SANDRA Mm-hmm.

· 08:40UNKNOWN For the children.

· SANDRA You should be proactive in wanting to see them, and I, I wouldn't mind if you wanted to see them more than, than what we have agreed. Uh, if there are times when, when you want to do something spontaneous and, and see them then, then feel free to, to contact us and, and see if it's okay.

· 09:05UNKNOWN Good.

· SANDRA Um.

· 09:10UNKNOWN Good, good, good. Go over there. That sounded like a, a very good idea.

· 09:15SANDRA Mm-hmm

· UNKNOWN A good offer.

· SANDRA Mm-hmm.

· UNKNOWN As you, Jeff, are you prepared to take that offer on?

· 09:20SANDRA Mm-hmm.

· UNKNOWN For the kids' sake?

· SANDRA Well, Sandra, I, I'm glad that you said that, and uh . . .

· 09:30UNKNOWN Mm-hmm.

· SANDRA I think that's something that I could look at, but when I contact you, I don't want you to be, to be short with me or rude.

· 09:45UNKNOWN Right.

· SANDRA I, I want you to consider it and, and to be honest.

· 09:50UNKNOWN Yeah, great. Go over there. So are you aware of, of what's going on here? A contract's happening.

· 09:55SANDRA Okay.

· UNKNOWN You're aware of that?

· SANDRA Mm-hmm.

· UNKNOWN It seems the two parties, seem to be agreeing, beginning to agree to something important. That's the children.

· 10:05UNKNOWN So the children will not suffer. They will actually benefit from that agreement if you two can really, really, uh, come to a, a mutual agreement to what, how you're going to take care of the children.

· 10:15SANDRA Mm-hmm.

· UNKNOWN 'Cuz this thing, no matter how in my view, no matter howpeople live together, as a couple, separated, together, the, the contract, life ... I'm still my father to my children. You're still a mother to my children. If we could only get that anger out, frustration out, we can come to an agreement as to how we're gonna work together, even if we don't live together, we will live for the, with the kids and they'll be happy.

· 10:40SANDRA Mm-hmm.

· UNKNOWN Does that make sense to you?

· SANDRA Yes, uh . . .

· 10:45UNKNOWN There's a "but".

· SANDRA (crosstalk)But how . . .

· UNKNOWN There's a "but".

· SANDRA How do I... It's a question.

· 10:50UNKNOWN Good. Good. Good.

· SANDRA This is in a counseling session.

· 10:55UNKNOWN Yeah.

· SANDRA And he hasn't really participated in, in forming this contract.

· 11:00UNKNOWN Yes, but you hear that this happened here for you?

· 11:05SANDRA Yes.

· UNKNOWN And you've done it.

· SANDRA Mm-hmm.

· UNKNOWN So is there something that, that now you have that you can begin to negotiate with him? No matter how he is?

· 11:10SANDRA Mm-hmm.

· 11:15UNKNOWN Good. There's a, now in you, a realization that the children need that, that father and mother.

· 11:20SANDRA Mm-hmm.

· UNKNOWN How's that for you?

· SANDRA Yeah. M-, Maybe I just need to let him know that, um, and, andjust extend the invitation of, of having more time.

· 11:30UNKNOWN Without that ...

· SANDRA Yeah. Yeah.

· UNKNOWN Remember?

· 11:35SANDRA Yeah.

· UNKNOWN And you're good at that.

· SANDRA Mm-hmm.

· UNKNOWN You're very good. Watching you working here, you're very good at creating contracts, and very clear about what you want.

· 11:40SANDRA Mm-hmm.

· UNKNOWN It's a question of how you can, the two parties can get to that, uh, agreement together. What do you think?

· 11:50SANDRA Mm.

· UNKNOWN Great. 'Cuz that's, this is a rehearsal for what's gonna happen.

· 11:55SANDRA Okay.

. " Gestalt Integration " [16 min].

· [sil.]

· These demonstrations are for professional training and for use in skill, theories, multicultural, and practicum/internship courses. The demonstrations present situations that viewers may encounter in real life. All demonstrations are role-played with volunteers who gave their informed consent and willingness to be videotaped.

· Influencing Skills: Strategies For Change Carlos Zalaquett, Ph.D., Lic. Seriashia Chatters, Doctoral student

· Gestalt Integration: Internal parts, polarities, and dichotomies produce stress and interfere with decision making. Establishing communication between these parts help clients integrate even unwanted parts of self and facilitate growth and progress.

· 00:45CARLOS ZALAQUETT Good to see you again, Seriashia, um, welcome back.

· 00:50SERIASHIA CHATTERS Thank you, um, thank you. It's good to see you too.

· CARLOS ZALAQUETT We, um, decided last time that we wanted to focus on a particular aspect of your experience growing up

· 01:00SERIASHIA CHATTERS Yeah.

· CARLOS ZALAQUETT And, uh, um, you wanted to see if there was a way to, um, create an impact effect positively that situation. Please describe the situation again, so we can start from there.

· 01:15SERIASHIA CHATTERS Well, um, I've just been having some issues lately with, um, being legally blind and not being able to transport myself from place to place, and sometimes it makes me feel a little bit inadequate and want to give up because it's really difficult, um, to try to do all the things that I do, um, and I feel as if I'm a burden to other people. And so I just wanted some help with that, because I've just been having some difficulty with those feelings, and it's making me feel as if I just want to give up at times.

· 01:45CARLOS ZALAQUETT Just give up.

· SERIASHIA CHATTERS Mm-hmm.

· Interview starts with strengths

· CARLOS ZALAQUETT Now, for what I've learned from you on the previous sessions, is that you have been very successful in what you do.

· 01:50SERIASHIA CHATTERS Yes.

· CARLOS ZALAQUETT You are a educated woman.

· 01:55SERIASHIA CHATTERS Mm-hmm.

· CARLOS ZALAQUETT You know, from a diverse background.

· 02:00SERIASHIA CHATTERS Mm-hmm.

· CARLOS ZALAQUETT Who can accomplish, or has accomplished, a number of different academic degrees, and is at the brink of another one.

· 02:05SERIASHIA CHATTERS Right.

· Counselor introduces Gestalt therapy

· CARLOS ZALAQUETT So as we spoke, my impression is that, is like there are like two different dimensions here, two different, what gestaltist, uh,therapists call parts.

· 02:20SERIASHIA CHATTERS Yes.

· CARLOS ZALAQUETT And they are in some sort of a, of a polarity type of position.

· 02:25SERIASHIA CHATTERS Yes.

· CARLOS ZALAQUETT So being as it is, I will, uh, ask you permission to work with an experiential technique, a Gestalt-based technique, although modified as you will see at the end.

· 02:35SERIASHIA CHATTERS Mm-hmm.

· Obtaining permission for a new strategy

· CARLOS ZALAQUETT But, um, would you like to, to try a different technique today?

· 02:40SERIASHIA CHATTERS Sure, I, I definitely would like to try something.

· 02:45CARLOS ZALAQUETT Very good. This is what I'm going to ask you to do.

· SERIASHIA CHATTERS Okay.

· Relaxation helps bring client to here and now

· Imagery Directive

· CARLOS ZALAQUETT I'm going to ask you to take a deep breath in and out. Very good. To relax your shoulders and your body. And I'm going to ask you to, uh, put your hands on your lap, in this way. Very good. Let your feet rest on the floor, comfortably. Make sure your back is comfortable, also.And now, I'm going to ask you to close your eyes, turn your hands upsidedown. Very good. And I'm going to ask you to use your imagination, to picture in one of those hands, an image of yourself, an image of Seriashia concerned about her visual limitation. And whenever you picture this image of yourself, just take a moment to share with me, how does you look like, what is her, her attitude, and what is your sense of her?

· 03:50SERIASHIA CHATTERS Well, she is crouched in a corner, and she is scared, and wants to give up, and she looks very tired.

· 04:05[sil.]

· Next, Carlos introduces a dialogue of parts. We have already seen a strong capable woman who is also scared and tired. Note the use of hands.

· CARLOS ZALAQUETT Very tired. Thank you very much. This was a very, very good representation and I could sense that I have like a, an understand to some extent of what is going on. Now, uh, on your left hand there.

· 04:25SERIASHIA CHATTERS Mm-hmm.

· Guiding a dialogue of internal parts

· CARLOS ZALAQUETT You know, picture an image of yourself as a womanwho has accomplished all these different academic achievements and other achievements in life.

· 04:40SERIASHIA CHATTERS Mm-hmm.

· CARLOS ZALAQUETT How does you look like? You know, what is your position in that image? And what's your sense about her?

· 04:50SERIASHIA CHATTERS Well she is standing very tall, and she's got her arms crossed, and she's looking like she's very upset with the other part of myself. And, um, she is, definitely seems very distinguished and just irritated.

· 05:10CARLOS ZALAQUETT Irritated. So allow me to invite you to continueexploring this conversation by letting the person, the Seriashia on your left hand to look at the Seriashia on the right hand and to let the Seriashia on the right hand to look on the one on the left hand . How do they feel about one another? What would they like to say about one another? And once you notice that , let one of them tell the other one how does she see her, how does she likes her, and what would she like for her to do?

· 06:00Here and now awareness of experience

· SERIASHIA CHATTERS Well, the Seriashia on this hand, looks at this Seriashia, and says that she would like her to get up and stop feeling sorry for herself. And she doesn't like it when she sits and feels sorry for herself, because there are too many things to do , and there's no time for her to be feeling that way.

· 06:20[sil.]

· In the following, note the flow between hands as Seria moves to a Gestalt integration. The Gestalt "empty chair" strategy could achieve the same objective.

· 06:35CARLOS ZALAQUETT Very good. Now, let's repeat that (inaudible ) in, in, in, in first person, as if the Seriashia on that hand, you know, is verbally addressing the other one. "I don't like the way you," "I would like for you to," using a first person communication and direct communication between the Seriashias.

· 06:55SERIASHIA CHATTERS I don't like the way that you are sitting in the corner feeling sorry for yourself. There is no time for this. You need to get up, and you need to get going, because we have too many things to do, and there is no time for you to feel sorry for yourself.

· 07:10CARLOS ZALAQUETT How does the, the, the, the Seriashia on the right hand, you know, reacts to that? How does she feels, and what would you like to say to respond to that?

· 07:20SERIASHIA CHATTERS I'm tired of you bullying me, and I'm tired. I'm just tired of always having to ask everyone to do things for me. And there's so many things I can't do for myself and I wish that you would just leave me alone.

· 07:35CARLOS ZALAQUETT How does the other one react to that? And what would you like to say in reply?

· 07:40SERIASHIA CHATTERS I can't leave you alone because if I leave you alone, you would be left to do nothing. And you have a lot of support around you and yes, you can't do a lot of things yourself, but you're lucky enough to have other people to do them for you. And you need to get up because there is no time for this.

· 08:05CARLOS ZALAQUETT How does the other Seriashia respond to that?

· SERIASHIA CHATTERS Every once in a while, I would like to feel sorry for myself. And I would like some time to sit back, and to be who I am, and I don't need you bullying me.

· 08:15Notice the counselor's frequent use of encouragers.

· 08:20CARLOS ZALAQUETT Mm-hmm. Allow the dialog to continue. What would the other Seriashia respond to that?

· 08:30SERIASHIA CHATTERS That, I understand that you need that time, but the thing about it is that, while you have people around, while you have the ability to get to and from where you need to go, you need to take advantage of it, and you need to stop the wallowing.

· 08:45CARLOS ZALAQUETT Uh-huh.

· 08:50SERIASHIA CHATTERS And this Seriashia would say that I, I understand that, and every once in a while though, I do feel that way, when things get really difficult.

· 09:00CARLOS ZALAQUETT Mm-hmm.

· SERIASHIA CHATTERS But I do understand that I do need to get up, and I do need to do what it is that I need to do. But sometimes it's just really hard and I need help.

· 09:10Note counselor's use of "I" as he tunes in with client experience.

· 09:15CARLOS ZALAQUETT Let's hear you repeat that last part.

· SERIASHIA CHATTERS I need help!

· CARLOS ZALAQUETT (crosstalk) Sometimes it's really hard and- I need help, yes?

· 09:20SERIASHIA CHATTERS I need help.

· CARLOS ZALAQUETT Uh-huh. What, what, what is the other Seriashia's reaction to that?

· SERIASHIA CHATTERS Well, I don't think that she's angry anymore, but she would say that I understand that you need help, and I can help you, that's what I'm trying to do.

· 09:30CARLOS ZALAQUETT Very good. Now let me ask you to, uh, open your eyes for a second, uh, and and, look at your hands as if you were looking at them from your mind's eye. And, uh, what did you notice? What did you notice about this conversation so far?

· 09:50SERIASHIA CHATTERS I noticed that the two, the two parts of me seem to be getting closer together.

· 09:55CARLOS ZALAQUETT Uh-huh. Very good.

· Client starts a Gestalt integration

· SERIASHIA CHATTERS And that, um, even though there are two different parts of me that it just seems as if, uh, it's easier to handle things but right now they're separated, but it would be easier to handle things if they were to support one another.

. " The Human Dilemma " [1hr, 25 min].

· [music]

· THINKING ALLOWED

· NARRATOR Thinking allowed. Conversations on the leading edge of knowledge and discovery with psychologist Jeffrey Mishlove.

· 00:15[music]

· THINKING ALLOWED with Jeffrey Mishlove

· JEFFREY MISHLOVE Hello and welcome. I'm Jeffrey Mishlove. Our topictoday is existential psychology. And with me, is Dr. Rollo. May. Dr. May is one of the founding sponsors of the Association for Humanistic Psychology,and a genuine pioneer in the field of existential psychology and clinicalpsychology. He was recently awarded the distinguished career in psychology award by the American Psychological Association. He's the author of numerous classic books, including "The Courage to Create", "Love and Will", "The Meaning of Anxiety", "Freedom and Destiny", and "Psychology and the Human Dilemma". Welcom, Dr. May.

· 01:10DR. ROLLO MAY Thank you.

· JEFFREY MISHLOVE It's a pleasure to have you here. You, you're really, I think, most known these days as a pioneer in establishing existential psychology as an independent discipline in the, in the clinical area. And, that's a discipline which, unlike most forms of clinical psychology that rely on a medical model or a behavioral model, relies on a philosophical model, and you draw heavily on the works, I think, of philosophers, uh, such as Sartre, Heidegger, Kierkegaard, who , who deal with basic notions, such as anxiety in a different way than, than most medical clinicians do.

· 01:50ROLLO MAY, PhD Existential Psychologist

· DR. ROLLO MAY Yes. Well, when I was in my , in the year, I think, '56 or '57, the publishers called me up and asked if I would edit a book onEuropean existential psychotherapy, and I was delighted to hear there was such a book. I hadn't known a th ing about the existential movement. But, I knew that in this country, I believed in it very firmly, cuz they are the ones who emphasize anxiety. They emphasize the, the individual, courage. They emphasize skill feeling, that has to be taken into consideration at least. And they see human beings s struggling, sometimes successful, sometimes not successful. And this was exactly the model that we needed for psychotherapy. Uh, the medical model had turned out to be a dead end. And I welcomed the chance to edit this book of, uh, existential, uh,chapters from Europe. And it was, uh, it, it met my own needs in my own heart.

· 03:05JEFFREY MISHLOVE Would I be correct in, in assuming that when you speak of anxiety, you don't think of it as a symptom to be removed, but rather as a gateway for exploration into the meaning of life?

· 03:20DR. ROLLO MAY Yes. Well, you got that exactly right. Now I think anxiety is associated with creativity. When you're ina situation of anxiety, you can of course run away from it, and that's certainly not constructive. Or, you can take a few pills to get you over it or cocaine or whatever else you may take.

· 03:40JEFFREY MISHLOVE You could meditate.

· DR. ROLLO MAY Well, you could meditate, but I think none of those things, including meditation, which I happen to believe in, none of those paths, uh, lead you to creative activity. What anxiety means is it's as though the world is knocking at your door, and you need to create. You need to make something. You need to do something. And I think anxiety, thus, is, uh, well for people who are, uh, they've found their own heart and their own souls. For them it is a stimulus toward, toward creativity, toward courage. It's what makes us human beings.

· 04:20JEFFREY MISHLOVE I suppose of much our anxiety comes form the basic human dilemma of being mortal, of ultimately having to confront our own demise.

· 04:35DR. ROLLO MAY Yes. We are conscious of our own selves, our own tasks. And also we know we're going to die. Man is the only creature, men, women and children sometimes even, are the only creatures who can be aware of their death. Uh, and out of that comes normal anxiety. When I let myself feelt hat, then I, uh, apply myself to new ideas. I write books. I communicate with my fellows. Uh, and in other words, the creative interchange of human personality rests upon the fact that we know we're going to die. That the animals and the grasses knows nothing. Uh, but our knowledge of our death is what gives us a normal anxiety, that says to us make the most of these, uh, these years. You are alive. And, that's what I've tried to do.

· 05:35DR. ROLLO MAY Another source of anxiety that you described in your writing is, is our very freedom, our ability to make choices and to have to confront the consequences of those choices

· 05:45DR. ROLLO MAY Yes, that's right. Freedom is the, uh, also the mother ofanxiety. If you had no freedom, you'd have no anxiety. That's why the sleight(ph) is in the films. Or people without any expression on their faces. They have no freedom, but those of us who do have are alert, alive. We're aware that what we do matters. Uh, and, that we only have about 70 or 80 or 90 years in which to do it. So, why not do it and get joy out of it rather than running away from it. But, I think that's a little capsule of the meaning of anxiety.

· 06:30JEFFREY MISHLOVE But, isn't there a little bit of a , a conflict between feeling anxiety and allowing oneself to be open vulnerable to that feeling of anxiety, and then also seeking joy?

· 06:40DR. ROLLO MAY Oh, no. Uh, there's a conflict betweent hat, uh, and what's generally called happiness or the, the flat. I would speak of , of the meaningless forms of feeling good. I'm not against anybody feeling good or having happy hours, but joy is something different from that. Joy is the zestthat you get out of, uh, using your talents, your understanding, uh, your totality of your being for great aims. The musicians, men who, uh, wrote music, Mozart and Beethoven and the rest of them. They always showed considerable anxiety because they were in the process of loving beauty, of feeling joy when they heard a beautiful, uh, combination of notes. Now, that's the kind of feeling that goes with, uh, creativity. That's why I say the courage to create. Creation does not come out of, uh, simply what you're born with. That must be united with your courage, uh, which both of whichcause anxiety, but also great joy.

· 08:05JEFFREY MISHLOVE It seems that, uh, much of our modern culture, though, is an attempt to cope with this fundamental anxiety by diversions and, what you would have called banal pleasures.

· 08:15DR. ROLLO MAY Yeah, well you just put your finger on the most significant aspect of modern society. We try to avoid anxiety by getting rich, by making a hundred thousand dollars when we're 21 years of age, by becoming millionaires. Now, none of those things, uh, lead to the joy of creativity that I'm talking about. One can own the world, uh, and still be without the inner sense of , of pleasure, of joy, of courage, of creation. Uh, and I think our society is in the midst of a vast change. The society that began at the Renaissance, uh, now is ending. Uh, and we are seeing the results of this ending of a, a social period. Uh, and the fact that psychotherapy has grown with such great zest, almost every other person in California is a psycotherapist.

· 09:25JEFFREY MISHLOVE It seems that way.

· 09:30DR. ROLLO MAY Yes, it does. And, this always happens when an age is dying. You see, the Greeks began their great, uh, age in the seventh, sixth centuries B.C. Uh, and then they taught that beauty and goodness andtruth, all these great things that philosophers talked about. Uh, but by the third, uh, second century B.C., or first century B.C., that had all been forgotten. The philosophers now talked about security. And they, uh, tried to help people, uh, get along with as little pain as possible. And they made mottos for human beings. Beauty and truth and goodness had been lost. Now, our Renaissance began the modern age, uh, and at the beginning of an age, there are no psychotherapists. This is taken care of by religion and by art, uh, and by beauty, by music. But the end of an age, every age down through history has been the same. Uh, every other person becomes a therapist because there are no, uh, no ways of ministering to people in need. Uh, and they form long lines at the psychotherapists' office. I think it's a sign of the decadence of our age, rather than a sign of our, uh, greatintelligence.

· 11:05JEFFREY MISHLOVE I know in your book, "Love and Will", you refer to the,uh, great poem by T.S. Elliot, "The Wasteland". And, the way so many people that when it wasw first written at the early part of this century, seemed to relate to it, not understanding its prophetic nature. It, it seemed to characterize the, the emptiness of modern society.

· 11:25DR. ROLLO MAY Yes. There's a king in the wasteland, remember, was impotent. And the wheat and the grass did not grow. It therefore was a wasteland. And he goes on in marvelous detail. When just about that time, in the 1920's, in the jazz age, there was written another book that is prophetic, and that is "The Great Gatsby". The movie was terrible. Forget the movie, and take, take the book.

· 11:55JEFFREY MISHLOVE F. Scott Fitzgerald.

· DR. ROLLO MAY F. Scott Fitzgerald. It's a small book. It's a marvelous picture of how our age has disintegrated. He ultimately dies, and dies a completely lonely man. Uh, there is nobody at the funeral, and it's a tragedy.Uh, but Fitzgerald saw that this was happening, not in the jazz age. Then everybody was earning lots of money, and, uh, trying new styles, just like nowadays. Uh, and, uh, but he knew what was going to happen, and therefore "The Great Gatsby". Now, we are now in the age when those things, "Wasteland" and "The Great Gatsby" are coming to fruition. And that's why I, uh, believe that if our world survives, I believe it will, a nuclear threat. If it survives, that we will move into a new age when the emphasis will not be on making piles and piles of money and being scared to death the stock market is gonna drop tomorrow. But, rather the emphasis will be on, on, uh, truth and joy, on understanding, uh, and these, uh, beauty, these things that to my mind, make life really worth living.

· 13:25JEFFREY MISHLOVE You've also characterized our present age as, as one in which modern man seems to be robbed of his own free will, that through Freudian psychology, and other scientific movements we see the human being as, as being influenced by deterministic forces, and threats of great social movements, nuclear war, and so on. That there's nothing that we can do. There's a feeling of helplessness, alienation. And yet you suggest, I think, that through philosophical and existential exploration, we can enter into a, in effect, another state of consciousness where, where we reconnect at our will at a deeper level.

· 14:05DR. ROLLO MAY Yes, this is why I wrote "Love and Will". Cuz, you cannot love unless you also can will. Uh, and, uh, I, uh, thought, I think and thought when I wrote that book that a new way of love, uh, would come about. People would learn to be intimate again. They would write letters. There would be a feeling of friendship among people. Now, this is the new age that is coming. And, I don't think it's a matter chiefly of philosophy. See,nowadays there are no philosophers. The last philosopher in this country was Paul Tillich. Uh, and, uh, people now have given up, and they now call philosophy the kibitzing of science, a way of simply looking over the scientist's shoulder and seeing how they can help science put things together. And, that's not philosophy. Philosophy is a deep search for a truth by which I can fulfill myself, by which I can create. Uh, Philosophy is the basis of freedom. It's the basis of goodness, too. It seems to not trouble many modern people, but I think it's a great mistake, cuz of all of our lack of ethics, our lack of morality. We need goodness, and we need beauty. All of those are philosophical terms, but beyond that, you see I'm really apsychotherapist. After saying all these nasty things about psychotherapy, it is the way we have in our end of the 20th century of helping many people to find their, themselves and their way of life that will be satisfying and will give them the joy that, uh, that human beings have certainly a right to have. And I'm not ashamed at all that I'm a psychotherapist. I became a therapist because I saw that's where people unburden themselves. That's where people will show what they have in their hearts. Uh, and they don't show that in philosophy. They don't show it in, uh, well in most religions these days, they also don't show it. This is why so many people in California join the cults. Now, I happen to believe in meditation, and I do it myself. And, we've learned a lot of things from India and Japan. But, we cannot be Indians or Japanese. Uh, and we must find a form of religious observation,religious experience that will fit us as pioneers of the 21st century.

· 17:05JEFFREY MISHLOVE You, a couple of moments ago, you referred to the term, "A New Age", and of course the new age is kind of a popular term, these days, for, for many different, a wide scope of activities. And I would gather from my familiarity with your work that you're critical of, of a good deal of this as, as glossing over, you know, basic human pain and attempting to make nice, and, I suppose these are some of the same criticisms, perhaps that, that Freud had of religion.

· 17:35DR. ROLLO MAY Oh, exactly. It's very good to talk with you, because you've read all of what I've written, and you know exactly which way to turn. No, I don't like the new age movement. I think it's over simplified, makes everybody feel temporarily happy. But, they avoid the real problems.Uh, and the new age can come only as we face anxiety, as we face guilt feeling for our, our, uh, misapprehension of what's the purpose of life, as the way we face death, uh, as a new adventure. Uh, now none of these things does the new age talk about. It talks about only being gleeful. And, uh, everybody singing songs.

· 18:25JEFFREY MISHLOVE But, you know, I've sensed another paradox here. I noticed in your book, "Freedom and Destiny" that you, you have a section on mysticism, and you refer to the great Western mystics, Jacob Boehme and Meister Eckhart and their search for, for the divine fire within themselves.

· 18:40DR. ROLLO MAY Yes.

· JEFFREY MISHLOVE And, you, you seem to see that almost as, well, I, I don't know uite what to say, but almost as a model deep existential trolling.

· 18:50DR. ROLLO MAY Well, it is. I'm very much a believer and follower of these mystics in our tradition. I'm not a believer and follower of, uh, Rajneesh, uh, or the other.

· 19:05JEFFREY MISHLOVE Maharishi or...

· DR. ROLLO MAY No, Maharishi. Muktananda, I called the most , uh, companionable, uh, of these leaders. But, most of them that come from India, uh, build up cults and get into all kinds of trouble, and are sued for billions of dollars. Uh, and the, uh, cult then collapses. Or, like Jim Jones, who took this 800 and 900 people to an island, and there they were going to set up the perfect community. And they all committed suicide, 919.

· 19:45JEFFREY MISHLOVE My sense is that your criticism goes much deeper than just the scandals themselves. My sense is that what you're saying is that in this sort of retreat to a mystical lotus land, that, uh, or, or perhapsbeliefs such as spiritualism and reincarnation, that people are losing touchwith the basic issues of their very existence.

· 20:10DR. ROLLO MAY Oh, absolutely. You said it beautifully. I, uh, I'm very critical of these movements that soft pedal our problems. Uh, and that indicate that we, uh, should forget them. I think it's the mystics that you andI were talking about. Jacob Boehme was burned at the stake. Uh, and, uh, the other Christian mystics or mystics of Mohammedism and so on, back in our tradition, are very important. And though the church at that time opposed them, uh, they never the less left great, uh, books full of knowledge that we can read, and we can understand, we can learn from.

· 21:05JEFFREY MISHLOVE Well, I know that some of the existentialist philosophers, such as, uh, Camus and, and Sartre, and perhaps even Jenez(ph) made quite a bit about out of the idea of rebelling against the, the, conventional mores of, of society. And I sense that what you're saying that genuine mysticism has to also involve this, this kind of cutting edge rebellion against the, the, the herd instincts.

· 21:35ROLLO MAY, PhD Existential Psychologist

· DR. ROLLO MAY Yes, it does. It's, it's rebellion against the herd instinct. Sartre was very important, uh, in this movement of the rebel. Camus wrote the book, "The Rebel". Uh, and, Paul Tillich, who was my dear and very close friend for some 30 years, uh, he and, and the others of the existentialists understood that joy and freedom come only from, uh, thefacing of life, the confronting of the difficulties. Sartre, when France was overrun by the Nazis, Sartre wrote a drama called, "The Flies". This is a retelling of the ancient Greek story of Orestes and the, a little bit of it that I want to quote as that Zeus tries to get Orestes not to go back, uh, to, uh, his hometown, and, uh, kill his mother, which he was ordered to do to revenge his father. Uh, and Zeus says, "I made you, so you must obey me." And, Orestes says, "You made me, but you blundered. You made me free."And then Zeus gets quite angry, and he has the stars and the planets zooming around to show how powerful he is. And, uh, he says,"But do you realize how much despair lies ahead of you if you follow your course?" And Orestes says, "Human life begins on the far side of despair." Now, I happen to believe that, that human joy begins, like the alcoholics, they cannot get over the alcohol except as they get into despair. And then, the AA can take them, and, uh, and free them from alcoholism. That's why I think despairhas a constructive side as well as anxiety having constructive effect.

· 23:45JEFFREY MISHLOVE, PhD

· JEFFREY MISHLOVE And, and you've mentioned earlier the great artistic achievements of Mozart and, and Beethoven. And, one has a sense, well we even have this term, tears of joy, that when one experiences deep joy,it's because it somehow incorporates the wholeness of human life, and, and we see the joy bubbling up, emerging through the despair itself. And, and that's real joy.

· 24:10DR. ROLLO MAY Yeah, yeah. That's, uh, you have understood it very well.

· JEFFREY MISHLOVE And yet, there's something in, almost intimidating. It's, it's as if, in many of us, as we live our lives and, and, and go through our routines that we're afraid to really drink deeply of, of the fullness of that.

· 24:30DR. ROLLO MAY Yes, I know. Well, if it were easy, it wouldn't be effective.It's not easy. Life is difficult, and, uh, has many conflicts in it, many challenges. Uh, but, it seems to me that without those, life wouldn't be interesting. The interest, the joy, the creativity that comes from these is, say in Beethoven's symphonies. A joy, joyful , we adore Thee. That's the end of the Ninth Symphony. And that joyful, joyful comes only after the agony of, it is shown in the first part of that, uh, symphony. Now, I believe in life , and I believe in the joy of human existence, but these things cannot be experienced except as we also face the, the despair, uh, also face theanxiety, uh, that every human being, uh, has to face if he lives, uh, with any creativity at all.

· 25:40JEFFREY MISHLOVE Rollo May, it's been a pleasure being with you, and sort of looking at this very deep issue of agony and ecstasy . I must admit that when I was reading your, your book, "Love and Will" in preparation for this interview, I, I felt after reading the final chapter, almost waves of, of energy pulsing through my body. I almost...

· 26:15DR. ROLLO MAY How marvelous.

· JEFFREY MISHLOVE ...almost what the yogis would have described as, as kundalini. I mean, it was a very strange feeling of, of ecstasy and agony. It, itseemed as if your willingness to look so directly at life itself is almost a willingness to stare God in the face.

· 26:30DR. ROLLO MAY Well, that's marvelous. I'm very happy that you had this experience.

· 26:35JEFFREY MISHLOVE Thank you so much for, for...

· 26:40DR. ROLLO MAY It's been a pleasure to be here

· JEFFREY MISHLOVE ...with me. It, it, it sort of is just, a, a anotherconcluding note. It makes me feel like I, in appreciating your work, I have a sense of why tragedy was considered the very highest art form...

· 26:55DR. ROLLO MAY Ah, by all means.

· JEFFREY MISHLOVE ...in Shakespeare, for example.

· DR. ROLLO MAY By all means, yes. The great plays were the tragedies. And in our day too, "The Death of a Salesman" is one of the great plays of the 20th century.

· 27:05JEFFREY MISHLOVE Rollo May, thank you very much for being with me.

· 27:10DR. ROLLO MAY Well, I enjoyed it myself.

· JEFFREY MISHLOVE And thank you very much for being with us.

· 27:20[music]

· HOSTED BY JEFFREY MISHLOVE PRODUCED & DIRECTED BY ARTHUR BLOCH

· DVD Version © 2007 Thinking Allowed Productions

· THINKING ALLOWED

· NARRATOR Thinking allowed. Conversations on the leading edge of knowledge and discovery with psychologist Jeffrey Mishlove.

· 27:45[music]

· THINKING ALLOWED with Jeffrey Mishlove

· JEFFREY MISHLOVE Hello and welcome. I'm Jeffrey Mishlove, and our topic today is existential psychotherapy. With me is Dr. Rollo May, psychotherapist, existential philosopher and psychologist, recipient of the "Distinguished Career in Psychology" Award by the American Psychological Association, a found sponsor of the Association for Humanistic Psychology, and author of many classic books, including "Love and Will","Freedom and Destiny", "The Courage to Create", "Psychology and the Human Dilemma". Welcome, Rollo.

· 28:30DR. ROLLO MAY Thank you.

· 28:35JEFFREY MISHLOVE It's a pleasure to be with you. You know, it's interesting, the, the parallel that there may be between the television interview, this one on one situation and the therapy situation, especially, I think, as seen from the existential perspective of, uh, direct encounter between two people. You don't, in, in, in therapy, so much see yourself as a doctor/patient type of relationship that many other therapists will view.

· 29:00ROLLO MAY, PhD Existential Psychologist

· DR. ROLLO MAY No, I don't, uh, think that patient/doctor, uh, symbol is very fitting for psychotherapy. I think it's two human beings. One of them is there for the purpose of getting help, and the other is there for the purpose of giving help. Uh, and the second one assumedly is trained, has had a lot of experience. Now, existential psychotherapy means that we deal with the other person as an existing creature. We don't deal with him as somebodywho has only problems, but he is existentially real. And that means that he has anxiety, uh, that he has some guilt feelings that come from unexpressedcapacities that are within him. He has a need for love, need for other people, for friendship, uh, and he has also a, a presence of anger. All these things, uh, are present in the active human being, and I as the therapist have to and love to understand this person as a total human being, with all of these emotions that I've already mentioned.

· Toggle Drawer

[u06a1] Unit 6 Assignment 1

Disorders and Treatments Paper

This assignment will require you to select a psychological disorder and pair it with a form of psychotherapy that has demonstrable success. You will also create a therapy session transcript that shows successful application of therapeutic communication skills. In your work as a mental health provider, you will be called upon to identify, interpret, and successfully apply evidence-based therapies. The transcript exercise provides you the opportunity to demonstrate competence in applying basic therapeutic communication skills you learned and practiced in Units 3 and 4, and at least one technique of the approach you selected to assist your fictional client. This assignment also provides practice in matching therapies to client concerns—which will you will do again in Unit 10—while at the same time incorporating theories of multicultural therapies.

Instructions

For this 9–12 page assignment, you will choose a psychological disorder from the following DSM-5 categories:

. Depressive disorders, anxiety disorders, trauma and stress related disorders, OR

. Substance-related and addictive disorders.

You will then choose an approach to psychotherapy that has a proven track record. You will also create a therapy session transcript. In that imaginary session, you will explain to the client the type of therapy you would like to use (See 10.1 Informed Consent to Therapy, and 4.02, Discussing the Limits of Confidentiality in the Ethical Principles of Psychologists and Code of Conduct. Link in the Resources) as well as demonstrating the therapeutic communication skills of reflection (thoughts and affect), empathic statements, and open-ended questions.

The first 5–6 pages of the paper should describe the client's demography and presenting concern; it should then provide an academically-based reason for your choice of therapeutic approach to use with the client. The final 3–4 pages will be the transcript of a fictional client.

EXAMPLE OF IDENTIFICATION OF SKILL SET WITHIN TRANSCRIPT [Excerpt of middle of a session]

Therapist: Hi, how are things going today? [open-ended question]

Client: Everyone hates me.

Therapist: Can you tell me more....who is "everyone"? [open-ended question]

Client: My dad is always on my butt to mow the yard, my mom yells at me about my bedroom. She wants it to look like no one sleeps there, and none of my friends are talking to me at school.

Therapist: I want to make sure I understand correctly, right now your friends are not being so friendly, and your mom and dad are mostly interested in their house and yard. [paraphrase]

Client: EXACTLY! Did they have me just so I could provide free labor?

Therapist: Feeling used can weaken the best of relationships. [empathic statement] Can you tell me when you noticed that your friends stopped talking to you? [open ended question, clarifying question]

To successfully complete this assignment, you must meet the following requirements:

. Written communication: Written communication is grammatically correct and free of errors that detract from the overall message. Writing should be consistent with graduate level scholarship.

. APA formatting: Title page, main body, references should be formatted according to APA (6th Edition) style and formatting.

. Number of resources: Minimum of 6–7 resources.

. Length of paper: 9–12 typed double-spaced pages to include 3–4 page session transcript, title page, and references. No abstract or table of contents is required. Do not exceed 12 pages for the entire project, title page through reference page.

. Font: Times New Roman, 12 pt

Resources

. Disorders and Treatments Paper Scoring Guide .

Information

Section:

Innovative Methods

The article applies Bloom's (B. S. Bloom, M. D. Engelhart, F. J. Furst, W. H. Hill, & D. R. Krathwohl, 1956) Taxonomy of Educational Objectives, Handbook I: Cognitive Domain to the process of graduate-level writing in counselor education. Bloom's Taxonomy is provided as a mechanism to help students develop and demonstrate cognitive complexity when writing comprehensive literature reviews. The article outlines common assumptions held by students operating at each level of the Taxonomy, typical organizational structure and content of papers at each level of the Taxonomy, and tips to move writing to more cognitively advanced levels.

Graduate students in counselor education write numerous papers. One of the more common types of papers assigned is the comprehensive review of the existing literature. Both master's- and doctoral-level students are expected to write literature reviews for courses, and doctoral students eventually use their writing skills for literature reviews in their dissertations.

Little literature exists, however, to support curricular or pedagogical methods for improving writing in graduate programs. There is some evidence that three types of training are typically available: conducting a library search (Bem, 1995; Peper, 1971), learning to read and understand research (Jackson, 1980), and writing in American Psychological Association (APA, 1994) format. In other words, students may attend classes or workshops to learn how to conduct computerized database searches and collect information to be included in their papers. In addition, students are typically required to take a research methods course to help them read, understand, and summarize research (Council for Accreditation of Counseling and Related Educational Programs [CACREP], 1994). Finally, they may attend workshops or use the APA (1994) Publication Manual to learn the specifics of how to cite references in APA style. Although the APA manual advocates cognitively advanced writing, it does not offer a mechanism on how to improve the complexity in writing. Rather, it focuses only on the specifics of written presentation. Thus, although specific faculty certainly engage in individualized instruction to improve writing, what seems to be missing in the counselor education literature is a formalized, intentional, and well-grounded mechanism designed to teach students how to critically evaluate and synthesize the material they have collected into cognitively advanced reviews of the literature.

Comprehensive literature reviews involve more than simply a recitation of information gleaned from other sources. Cognitively advanced reviews organize, integrate, and evaluate previously published material (Bem, 1995). As such, they clearly define and clarify the problem; summarize previous work in the area; identify relationships, contradictions, gaps, and inconsistencies in the literature; and suggest the next step or steps in solving the problem (APA, 1994). Through the process, writers enhance their own learning and, it has been argued, advance their capacity for critical thought (Rivard, 1994). A review of the empirical research found consistent results showing that writers who use a specific cognitive strategy in their work demonstrate higher levels of cognitive complexity than those who do not (Klein, 1999).

University faculty in graduate programs often express concerns about students' inability to analyze, evaluate, and critically synthesize the existing research and literature (Anisfeld, 1987; Chamberlain & Burrough, 1985; Froese, Gantz, & Henry, 1998; Makosky, 1985). Jackson (1980) noted that there is a surprising lack of attention to the topic of reviewing and integrating the literature, particularly given the importance that various types of literature reviews have for the science of behavioral health. More recently, this same sentiment has been echoed in the field of marriage and family counseling, with indications that many faculty consider this lack of training for students to be a relevant problem (Piercy, Sprenkle, & McDaniel, 1996).

In the field of psychology, Froese et al. (1998) noted that "this mismatch between expectation and performance may arise from instructional deficiencies" (p. 103). They argued that instructors may make faulty assumptions about students' ability to transfer critical thinking skills learned in other facets of their graduate programs to the writing of comprehensive literature reviews. Because of these assumptions, the essential writing skills necessary to engage in cognitively complex writing assignments are not explicitly taught to graduate students. These writing skills both allow students' current level of cognitive complexity to be expressed and, in turn, force students to higher levels of complexity in their thinking and writing (Klein, 1999). Boice (1982) and Nodine (1990) suggested that faculty must make the effort to teach these writing skills to students, but both lamented the absence of relevant models to guide this instruction.

In the field of counselor education, there also is a lack of information on how to teach critical writing skills to graduate students. Articles related to writing literature reviews explain the process of publishing (e.g., Forman, 1988), suggest methods for improving publication success (e.g., Gladding, 1989; McGowan, 1996; Smaby & Crews, 1998), and give tips on publishing in particular journals (e.g., Brown, 1989; Hazler, 1992). No article could be located, however, that provides a model to teach students how to engage in the higher order thinking and writing skills necessary to write advanced quality literature reviews.

There is, however, a framework available to guide counselor educators in their efforts to help graduate students write more cognitively complex literature reviews. The Taxonomy of Educational Objectives, Handbook I: Cognitive Domain (Bloom, Engelhart, Furst, Hill, & Krathwohl, 1956), more commonly referred to as Bloom's Taxonomy, is a specification of six hierarchically ordered levels of instructional outcomes that are intended to move students toward higher levels of cognitive complexity. Bloom's Taxonomy could be a useful learning schema if applied to writing graduate-level papers in counselor education.

This article outlines the basic premises of Bloom's Taxonomy, applies these premises to writing comprehensive literature reviews in counselor education, and suggests methods for moving students to higher levels of cognitive complexity in their papers. Faculty may use this model to give their students a specific cognitive map for their writing that includes a goal and a method to move toward that goal. Thus, rather than simply telling a student that his or her work "lacks critical thinking," the model is intended to help the student recognize where his or her thinking has broken down and what method can be used to get back on track.

Bloom's Taxonomy

Bloom's Taxonomy (Bloom et al., 1956) was one of the first models developed to provide educators with a systematic classification of cognitive operations. The Taxonomy outlines six hierarchical positions of cognitive complexity, ordered from the least to the most complex: Knowledge, Comprehension, Application, Analysis, Synthesis, and Evaluation. The levels are assumed to be cumulative, with each level of the system building on the successful completion of the previous levels. Much research has been conducted on the model, and it has been found to transcend age, type of instruction, and subject matter (Hill & McGaw, 1981; Kottke & Schuster, 1990; Kunen, Cohen, & Solomon, 1981). Since its inception, the model has influenced curricular development, educational research, and the construction of tests in education and professional organizations (Kunen et al., 1981). It is one of the most widely accepted models of cognitive abilities and educational objectives used in education, and even its severest critics agree that the model has enormous influence and is an important step toward understanding the structure of learning outcomes (Kottke & Schuster, 1990).

Bloom's Taxonomy in Graduate-Level Writing  Skills Used and Assumptions Made at Each Level of the Taxonomy

Each of the six levels in the hierarchy provides an essential skill for students who would like to write cognitively advanced literature reviews. Applied to the process of writing, each level provides a critical component of the process. The levels are articulated in the following sections, with descriptions based on those included in the Learning Skills Program (1999) and with appropriate applications made to the writing process. Of course, it should be recognized that an individual paper may not fit neatly into only one category on the Taxonomy. Nevertheless, the paper can be classified generally into a Taxonomy level based on the overarching principle used to organize and write it, and a precise categorization of the entire paper is not necessary for this method to be successful in promoting cognitive advancement.

Knowledge. In this lowest level, the student recalls or recognizes information, ideas, and principles in the approximate form in which they were learned. The material may vary from specific facts to complete theories, but all that is required is remembering the information. Students who use only this cognitive level in their writing will simply repeat information from other sources without demonstrating an understanding of the material or making distinctions between the quality of the different sources. Common assumptions made by writers at the knowledge level include the following: If it has been published, it is worthy of inclusion; all published articles are equally valid; no true distinctions can be drawn between research and nonresearch articles; and main ideas from source material cannot be distinguished from less important ideas presented.

Comprehension. This level is defined as the ability to grasp the meaning of material and may be demonstrated by translating material from one form to another or by interpreting material. Students using comprehension present a basic understanding of material. Whereas a student at the knowledge level can recall information in a rote fashion, students at the comprehension level are able to manipulate that information in a manner that demonstrates more than simple memorization. In written work, students demonstrating comprehension are able to summarize the main points of articles they have read and can manipulate that information into their own words. However, they continue to make many of the same assumptions that students in the knowledge level make. They are still unable to make distinctions between the quality of the sources they are using, believing all publications to be equally valid and relevant. They continue to have difficulty understanding which information is particularly relevant to the topic at hand, and they may include extraneous information simply because it is interesting or is assumed to be related because it appears in an article with other related information.

Application. Application is defined as the ability to use learned material in new and concrete situations and includes applying rules, methods, concepts, principles, and theories. In their writing, students at the application level are able to select the main ideas and research findings from other sources that relate directly or indirectly to their selected topic. They make explicit connections between the writings of others and the topic at hand. They are able to make decisions about the relevance of a particular piece of information. However, like those students at the first two levels, students at the application level are unable to make distinctions about the quality of information read. In addition, like students at lower levels, they often focus their attention solely on the introduction and discussion sections of other articles (Anisfeld, 1987). Without a meaningful schema for analysis, they are unable to break down source information to the component research principles or conceptual ideas. Therefore, they must rely on the source authors' analysis of their own work, which is typically in the discussion section of the source articles.

Analysis. Analysis refers to the ability to break down material into its component parts and may include the identification of the parts, analysis of the relationship between the parts, and recognition of the organizational principles involved. Students are able to identify the component parts of a research or literature review article and can identify the main patterns or themes in each article reviewed. They no longer need to rely on the source author's own conclusions; they can reach conclusions of their own, based on an analysis of the research or ideas presented. However, they have yet to articulate a method for evaluating the information and therefore have difficulty reconciling contradictory findings in research. In addition, like students at lower levels of the Taxonomy, they do not demonstrate an ability to link source material across articles. Each item is presented as a stand-alone piece of information.

Synthesis. Synthesis refers to the ability to put parts together to form a new whole. The student originates, integrates, and combines ideas into a product, plan, or proposal that is new to him or her. In their writing, students at this level are able to draw together ideas and research findings from source material into thematically outlined literature reviews. They are able to gather all relevant information, taken from an analysis of the components of the source articles, and combine it into broader themes and principles. However, their writing still lacks an organized and articulated schema for evaluation. Thus, like students at lower levels of the Taxonomy, students at the synthesis level tend to give more merit to source articles that support their premise, ideas, and values and to downplay the results of studies or opinions if they do not match the student's position or if they contradict other sources.

Evaluation. This level is concerned with the ability to judge the value of material for a given purpose. The judgments are based on defined criteria that are either developed by the student or given to the student by an outside source. This is considered to be the highest level in the cognitive hierarchy because it contains elements of all the other categories and involves conscious value judgments based on clearly defined criteria. Whereas students at earlier levels of the hierarchy may evaluate what they have read, they typically do so in a subjective manner. Students who master the evaluative level recognize that there are certain preestablished criteria that are used to evaluate source writings. They make distinctions between research and conceptual articles and between conclusions drawn from research, from experience, or from opinion. In addition, using skills gleaned from research courses, they are able to critically evaluate the quality of different research studies and make evaluative comparisons between them. Thus, they can understand and evaluate contradictory research results when differing methodologies caused those contradictions, and they are more likely to accept the ambiguities of contradictory results when they recognize that the field does not always yield clear-cut answers.

Format of Papers at Each Level of the Taxonomy

When instructors read students' papers, it is often apparent at which level of the Taxonomy a particular student is operating. Both the format and the content of the paper provide clues. These same clues are useful to assist students in evaluating their own work.

Knowledge. Papers at the knowledge level are typically organized by articles read rather than by topic or theme. Each paragraph outlines a particular article or study, with a description of what the source authors investigated and their results. The paper may seem to be simply a listing of these articles, with little or no integration and few summative comments. A key indicator of papers at the knowledge level is overreliance on quotations. Students are unable to translate the ideas of the source authors into their own words and, thus, overuse quotes.

Comprehension. Like papers at the knowledge level, papers at the comprehension level lack integration and analysis and have an organizational style in which paragraphs are laid out by articles read, rather than by main ideas. However, unlike knowledge level papers, papers at the comprehension level present the main ideas of the source articles, demonstrating a student's ability to distinguish main ideas from less important ideas in the articles read. In addition, comprehension level papers do not rely on quotations but use them sparingly and appropriately.

Application. Papers written at the application level are still organized by source articles rather than by topics or themes. However, with each source article being reviewed, there is a direct and explicit link from that article to the topic of the current paper. The student summarizes the source article and then applies the findings from that article to the topic of their own paper. These links are neither integrative nor summative, and there are few or no connections drawn between source articles.

Analysis. Writing at the analysis level typically includes more detailed descriptions of source article information. Students discuss the specifications of the studies they are including and can identify patterns that emerge. Like students at the application level, they link the source articles back to the main idea of their paper, but they add a layer of complexity by identifying the component parts of the source article that directly support their argument.

Synthesis. When students' writing reaches the synthesis stage, the papers have a qualitatively different look to them. The most notable change is organization based on themes rather than on source articles. Froese et al. (1998) noted that students often summarize articles sequentially rather than comprehensively integrating the various findings. Sequential organization represents a failure to accomplish synthesis. Using synthesis, the students are able to determine the main points not just of source articles (a comprehension task) but of the paper they are composing. Source articles are spread throughout the paper and applied to the arguments and ideas presented, using the students' own organizational schema to direct the flow of information. Ideas from various sources that support a theme are brought together, compared, and contrasted.

Evaluation. Papers at the evaluation level are organized thematically and present convincing and well-thought-out arguments that are well grounded in the literature. They analyze the source articles for strengths and limitations and include objective critiques of the quality of the source information. They present both sides of an argument with a minimum of researcher bias. They draw synthesized conclusions logically based on objective evaluations; therefore, readers of these papers can feel secure in the quality of the conclusions reached.

Moving Papers to Higher Levels of the Taxonomy

Recognizing a student's current level of functioning in writing comprehensive literature reviews is only important if this recognition can be used to move the student to a higher level of cognitive complexity. A paper might not fit completely into only one level of the Taxonomy because, as with all developmental models, the levels of the Taxonomy are not absolutes, and some overlapping is inevitable (Barrow, 1987). Nevertheless, papers can be generally categorized into a Taxonomy level based on the predominant skills and assumptions demonstrated.

Once a paper is placed at a certain level of the Taxonomy, the next step is to use the information collected to teach the student how to move to the next level. There is considerable support for the idea that the steps toward higher cognitive complexity should be incremental (Bloom et al., 1956; Kottke & Schuster, 1990; Kunen et al., 1981). Thus, if a student presents at the Knowledge level, the next step is to move the student to the Comprehension level. Care must be taken not to bypass that level in an effort to move the student to higher levels of complexity; each level must be understood and competency demonstrated before the next level is attempted.

Of course there are as many writing strategies as there are writers, and no universal strategy will work for everyone. Nevertheless, what follows are some ideas that may be useful to help push students to higher levels of cognitive complexity. Faculty are encouraged to add their own ideas and strategies to the discussion when presenting this material in class.

From knowledge to comprehension. To move from knowledge to comprehension, students need to learn to put the ideas they are reading into their own words. Many students admit that when they are writing papers, they sit down at their computers with the source articles before them, read a source article (or parts of a source article), and type what they are reading into the computer. This strategy encourages low levels of complexity as students merely repeat information directly gleaned from the source articles without any effort to comprehend the source material. Thus, students benefit from a strategy that forces them to restate or summarize source material in their own words before they include the material in their papers. One such strategy is to read a source article and summarize the main points or themes on a "sticky note" or 3 x 5 card stapled to the article, then enter material into the paper based on the summaries rather than on the actual source articles.

From comprehension to application. To move from comprehension to application, students must take their comprehension summaries and add a direct link from the source material to the paper being written. By asking themselves, "How does this information directly link or apply to my topic?" students force themselves into the application process. If they cannot make direct links, or if the links are strained and difficult to support, then the student is probably including extraneous or irrelevant information.

From application to analysis. Analysis is a necessary and often neglected precursor to synthesis. Unless the source articles are understood and analyzed in detail, synthesis will be based on inaccurate or incomplete information. Whereas a written summary for the purposes of comprehension will focus on more global themes and main points, analysis requires an in-depth review of the source articles. If analyzing an empirical study, what was the methodology used? Are there alternative explanations for the findings? Are causal relationships inferred from correlational data? Are effect sizes reported and are they meaningfully large? Is there justification for the generalizations drawn from the sample that has been studied? In nonempirical articles, how did the authors come to their conclusions? What evidence is provided for these conclusions? The student may develop a list of questions that he or she would use to analyze the source articles.

From analysis to synthesis. Writing from a detailed outline is an important component of producing quality literature reviews, and this becomes particularly true at the synthesis stage. Students often have vague outlines with only three or four general categories when they begin a paper. A change in the process is necessary. Cognitively advanced writers typically start with a very detailed outline that emerges from the themes of the source articles (Jackson, 1980). This is done before the writing begins. An outline detailed enough to include subtopics and both sides of specific arguments will not be conducive to a sequential listing of articles. Students will be forced to use a more integrated approach. However, this outline can be developed only after the source material is read, understood, and analyzed, so that the themes to be included in the outline emerge from the existing literature. Faculty can encourage the use of a detailed outline by working on an outline with the student or, alternatively, requiring an outline to be turned in and evaluated before the final paper is written and submitted.

From synthesis to evaluation. Moving to evaluation requires students to develop an objective rating system for their source articles. Often, students at lower levels of the complexity will struggle with whether to include their own opinions in a literature review (Froese et al., 1998). At the evaluation level, students understand that opinion is not the primary method of evaluation, but reasoned and articulated assessment of the source articles is essential to making evaluative comparisons. To complete this task, students must use the information gleaned at the analysis level to analyze the quality of the research or other types of source articles. They should have clearly defined criteria developed beforehand that will help them make these judgments.

Conclusion

Writing a cognitively advanced literature review is a difficult but important skill for counseling students. Cognitive complexity in writing has been linked to enhanced learner-directed learning, an important component of adult and graduate education (Brookfield, 1989). It also is consistent with developing advanced capacity for critical thought (Rivard, 1994).

Faculty cannot assume that students who are cognitively advanced in other areas of their lives or in other areas of their academic programs will necessarily transfer those skills to their writing. Simpson, Dalgaard, and O'Brien (1986) and Granello (1999) studied the cognitive complexity of graduate students and found that students regressed in their cognitive development when they were faced with new and unfamiliar tasks. These findings can be applied to the process of graduate level writing. Students without a conceptual understanding of the goals and process of cognitively complex writing may easily resort to lower levels of complexity. Certainly, without a model or a goal for writing, it would be difficult for them to use the experience to push their thinking to higher levels of complexity through the process of writing.

The use of Bloom's Taxonomy to increase the cognitive complexity of students' writing is just one attempt to provide a methodology for students in their learning. Clearly, other models could be applied and be equally, or even more, useful. In addition, the Taxonomy is not intended to be an all-encompassing model of writing. The use of the model does not preclude the importance of other components of writing (e.g., selecting appropriate topics, conducting a comprehensive review of the literature, setting aside time to write, using concise language).

In presenting this model to counselor education students over the past several years, I have found that students benefit from having a clear understanding of the goals of writing literature reviews. Prior to implementing this model in our program, students complained that they were given assignments to write literature reviews without a full intellectual understanding of the desired outcome. They expressed frustration with the faculty's evaluation of their writing as lacking complexity. Discussions with faculty from programs around the country confirm a frustration on the part of many faculty members as well. They want to help their students advance in their writing but lack models or teaching methods to do so. With a model to follow, students more easily understand the desired goals. Furthermore, because most students have achieved higher levels of cognitive complexity in other domains of their lives, they readily understand and identify with the levels of Bloom's Taxonomy. With very little explanation and effort, most students can begin to apply this model to their own writing. Clearly, this model works best when students have opportunities to receive feedback on rough drafts of their writing and have the opportunity to resubmit a paper. A rough draft could be analyzed, using this model, and placed at the appropriate Taxonomy level, with input and discussion between the student and the faculty member on how to reach the next level in the subsequent draft. Faculty who would like to teach this model can photocopy the summary presented in Table 1 and use it with students to stimulate discussion. Students and faculty should be encouraged to add their own ideas in the "tips to move to the next level" category.

Although this article represents a first attempt at applying a model to graduate writing in counselor education, the ideas presented here could benefit from research to determine whether students who have been taught this model actually produce more cognitively complex papers. The symbiotic relationship between cognitive complexity in writing and complexity in thinking could also be the focus of more research. In the meantime, the empirical grounding of Bloom's Taxonomy and research on its use to promote cognitive complexity provide a solid initial foundation for its application to graduate-level writing in counselor education.

TABLE 1

Application of Bloom's Taxonomy to Graduate-Level Writing

Legend for Chart:

A - Areas of Analysis
B - Knowledge
C - Comprehension
D - Application
E - Analysis
F - Synthesis
G - Evaluation
A
     B
     C
     D
     E
     F
     G
Skills used
     Repeat information from other sources.
     Summarize main points of articles reviewed.
     Select main ideas and research findings from others that
       relate directly or indirectly to the topic.
     Make explicit links between source articles and current
       paper.
     Identify the component parts of a research or literature
       article.
     Identify patterns or themes in the articles reviewed.
     Use data and information from others to support current
       paper's ideas.
     Integrate and combine ideas from source articles into a
       new whole.
     Draw together ideas into a thematically written research
       review.
     Able to make distinctions about the quality of source
       articles based on objectively defined criteria.
Assumptions made by the writer
     If it has been published, it is worthy of inclusion.
     All published articles are equally valid.
     No true distinctions between research and nonresearch
       articles.
     Main ideas are not distinguished from less important
       ideas. Therefore, the information included from authors
       is not necessarily the main points from their writings.
     Make many of the same assumptions as a student using the
       knowledge domain, e.g., if it has been published, it is
       worthy of inclusion; all published articles are equally
       valid; no true distinctions between research and
       nonresearch articles.
     Make many of the same assumptions as a student using the
       knowledge domain, particularly regarding the lack of
       evaluation of the relative merit of publications.
     Believe that selecting main ideas from articles related to
       the topic and making explicit connections to the current
       paper is sufficient.
     Have same lack of evaluation as students at lower levels.
     Focus on the details and component parts, rather than the
       bigger picture ideas of how these findings are
       interrelated.
     Lack evaluative schema for source articles. Tend to
       include information that supports premise of current
       paper and exclude that which does not.
     Have difficulty developing overarching themes when data
       are in conflict.
     Unable to make objective determination of what to do when
       source articles are in conflict.
     Not applicable.
Main organization and content of papers at each level
     Organized by articles read, rather than topic.
     Simply give a listing of what others have found with no
       summative comments, no integration.
     Information contained is not necessarily based on main
       ideas of source articles.
     There is an overuse of quotations from others; unable to
       capture main ideas in own words.
     Able to distinguish main ideas of the articles reviewed.
       Therefore, although the organization of the paper may be
       similar to a student at the "knowledge" domain, the
       content will be based on main ideas from source
       articles, not just recitation of all they have read.
     The paper is still organized by source articles, rather
       than topics or themes.
     With each article reviewed, there is a direct and explicit
       link from the source article to the current paper (e.g.,
       "Therefore, the findings of Smith and Jones support the
       premise that differences in age between the counselor and
       client can affect the counseling relationship.")
     Each article is directly and explicitly linked to the topic
       of the current paper by identification of the specific
       components of the source article that are relevant. The
       findings from the source articles are not linked to each
       other.
     The paper is organized thematically, rather than by source
       articles.
     Main ideas are presented, and source material that supports
       and questions those ideas is discussed.
     At the end of each major theme, a discussion of the results
       from the source articles is included, but this discussion
       still does not include a systematic objective evaluation.
     Paper is thematically organized.
     Source articles are analyzed and critiques based on
       strengths and limitations.
     When findings are in conflict, this conflict is
       acknowledged. Whenever possible, the quality of the
       source articles is discussed, particularly when research
       of differing merit produces contradictory results.
     Both sides of an argument are presented, with minimal
       researcher bias.
Tips to move to next level
     As each article is read, before beginning to write,
       summarize main ideas from each article in own words on
       note cards.
     At end of each summary, develop an explicit and direct link
       from the source article to the paper being written.
     For each summary, ask "How does this relate to my topic?"
       If it doesn't, or the relationship is strained, then
       exclude it from the paper.
     Add to the summaries all the details that are necessary to
       make decisions about the merit of the source article.
     Develop a list of questions that can be asked of every
       source article to determine essential components.
     Assess internal and external validity and whether
       conclusions are based on findings.
     Review all source materials thoroughly, develop summaries
       with detailed information. From these summaries, develop
       a comprehensive and detailed, thematically based outline
       before beginning to write the paper.
     Determine beforehand what constitutes a strong versus weak
       source article.
     Use information gleaned from research methods courses to
       determine methodological soundness of research and
       results of source articles.