Chapter 2
1. Most important instrument tis YOU
Your example of your own struggles is self exposure to the client
Boundaries are essential
Key elements to being an effective clinical mental health counselor (group discussion):
- Set good boundaries
- Leave things at work/staying professional
- Listen well without judgment/ objectivity
- Be selfaware
- Taking care of your own mental health
- Be personalable to have a relationship, adaptable, professional
- Be a good communicator
- Being present in the moment but engaged
- Care about people and be empathetic, but still realistic
- Welcoming space to make clients comfortable, safe space
Personal Characteristic of Effective Counselors (Ch2.3):
- Have an identity
No one approach is the best way, be authentic tto yourself,
temperament, and personality
- Be open to change
- Makee choices that are life eoriented
- Be authentis, sincere, honest
- Have a sene of humor
Sense of humor should beegin after client and ciubselor havee
formed a relationship and rapport.
- Make mistakes and be willing to admit them
Take ownership and appologize immediately, without the power struggle
imediecy: in the moment, evaluate something that was said or happened
- Live in the present
- Appreciated thet influence of culture
- Have a sincere interest in the welfare of others
Listen to them, listetn to listen not to answer or find a solution
- Possess effective interpersonal skills
Listen to them, validate, communicate, empathize
- Become deeply involved in work and derive emeaning form it
- Be passionate
- Maintain healthy boundaries
You should get joy and personal meaning form each session because you know youre
contributing to your clieenets life and society.
Personal Therapy for the Counselor
Personal therapy contributee to the therapists professional work in 3 ways”:
1. As part of teh therapists training, offers a model of therapeutic practice in
hwihc the trainee observes a more eexpeereienced therapist at work and
learns experimentally what is is helpful or not
2. A beneficial experience in personal therapy can firther enhance a
therapists interpersonal skills, which are essential to skillfully practicing
therapy
3. Successful therapy can contribute to a therapists ability to deal with the
ongoing stresses associated with clinical work
The Role of Values in COunsleing
1. Assists clints in finding answers that are most congruent with their own values. Avoid
imposing personal values, beliefs, attitudes, and behaviors
ie. covid vaccine, prayer, medication, public/private school
2. Seek supervision to learn to effectively manage value differences with your clients
Issues faced by Beginning Therapist (Novice)
1. Dealing with anxiety
2. Being yourself and self-disclosure
3. Avoiding perfectionism
Being professional and relatable is the goal
4. Being honest about your limitations
5. Understanding silenc
6. Dealing with the demains of clients
7. Dealing with clients who lack commitment
8. Tolerating ambiguity
9. Becoming aware of countertransference
10. Developing a sense of humor
11. Sharing responsibility with the client
12. Dont give advice
13. Defining your role as a counselor
Maintaining Your Vitaloty as a Person and as A Professional
Therapeutic lifestyle changes that promote wellness:
1. Physical activity
2. Diet and nutrition
3. Being in nature
4. Relationships
5. Recreation
6. religious/spiritual involvemeent
7. Providing service to others
The COunselor as a Theruputic Person
1. Be authentic and resis hiding behind your role.
Leaving your reactions (responses) and self outt of your work may result in
ineffective counseling
2. Be a therapeutic person
Be willoing to groe, risk, care, and be involved
3. Abundant research indicates the centrality of the person of the therapist and therapeutic
relationship are key factors in successful therapy
Chapter 3
Ethical issues in Counseling Practice
Types of Ethics
- Mandatory Ethics
Deals with the minimum level of professional practice
- Aspirational Ethics
Involves the highest standards of thinking and conduct
- Positive Ethics
An approach taken by practitioners who want to do their best for clients rather
than simply meet minimum standards to stay out of trouble
Putting Clients’ Needs Before Your Own
- Aware of our own nbeeds, areas of unfinished business, potential personal problems, and
especially out sources of countertransference
- Professional relationships with clients exist for their benefit
- Examine your personal needs that can potentially impede growth-producing relationships
(need for control, nurturing, being appreciated, etc.)
Ethical Decision Making
- Ethics codes are fundamental component of effective counseling
- They are guidelines that outline professional standards of behavior and responsible
practice
- Counselors must interpret and apply ethical principles to thiere decision making
- Codes do not make decisions for counselors
The principles that underline professional codes: benefit others, do not harm, respect
others autonomy, and be just, fair, and faithfulk
The role eof our ethical codes:
1. Educate is about responsiblities
2. Provide accountability
3. Improve eprofessional practice
4. Protect lcients and counselors
Where do we get codes?
The American COunseling Associarion - Code of Ethics
Nouthetic Counseling
Its defined by three elements:
1. Confrontation - to teach
2. Concern - person tot person with words. Focuses on the “what” no the “why”.
3. Change - changing hurtful behavior into a Biblical standard
The goal of nourthetic counselinf is to love - per scripture
Who is competent to counsel?
1. Qualities of “goodness and knowledge”
2. A person who is “rich” in knowledge of God’s Word skillfully applied in
“wisdom”
Potential questions
1. Why do bad things happen to good people?
2. I have beene praying for years and it still hasn’t gone away. Do I keep praying?
3. Is it wrong for a Christian to take medication?
Chapter 04: Psychoanalytic Theory
Gives attention to psychodynamic factor that motivate behavior - internal forces,
unconcious, biological instinctual drives
Structure of Personality
The ID - the demanding child
Ruled by pleasure principle
The EGO - the traffic cop
Ruled by the reality principle
The SUPEREGO - the Judge
Ruled by thee moral principle
Anxiety
Feeling of dread resulting form repressed feelings, memories, and desires
Develops out of conflict among the id, ego, and superego to control psychic energy
Three types:
1. Neurotic Anxiety - fear that causes a person to do something for which they will
be punished (id impulses materializing)
2. Reality Anxiety - fear of danger from the external world (reality). Ie. public
speaking
3. Moral Anxiety - fear of one’s conciounce (violating one’s own moral
beleifs/codes)
Ego Defense Mechanisms
- Helps the individual cope with anxiety and prevenets the ego from beeing overwhelmed
- Are normal behaviors that have adaptive value IF they do no become a style of life to
avoid facing reality
Two characteristics common:
1. They either deny or distort reality
2. They operate on an unconscious level
Ego Defense Mechanisms (pg 62-63)
- Repression
- Denial
- Reaciton formation (react the opposite of true feelings to overcompensate)
- Projection
- Displacemnt
- Rationalization
- Sublimation
- Regression
- Introjection
- Identification
- Compensation
-
Comcious and Unconcious
Consciousness is a thin slice of the total mind
Like the iceberg that lies below the surface of teh water, the larger part of the mind exists
below the
surface of awareness
Unconscious store all experiences, memories, and repressed material
The unconcious is the root tof all forms of neurotic symptoms and behaviors.
How do you make the unconscious, conscious?
Free association: lay down and say whatever comes to mind
The following are proposed clinical evidence for postulating the eunconcious:
- Dreams
- Slips of the tongue
- Posthypnotic suggestions
- Material derived from free association techniques
- Material derinved from projective techniques (ink blot)
- Symbolic content of psychotic symptoms
Develeopment of Presonality
Freuds Psychosexual Stages (probleems arise via fixation)
- First year: Oral stage (nurtursnce/oral fixation/mistrust of opthers/inability to form
intimate relationships)
- Ages 1-3: Anal stage (learning independence/ personal power/expression of negative
feeeleing/parental discipline patterens influence personality development.) Relationships
(control/lack of autonomy/express anger)
- Ages 3-6: Phallic stage (unconcious sexual desires for the opposite sex parent is
repressed/Oedipus complex and Electra complex
- Age 6-12: Latency stage (sexual interest are replaced with social interest)
- Ages 12-18: Geneital stage (themes from the phallic stage are revived. This stage
continues throughout the rest of adult development
Erickson’s Psuchosocial Stages (master each stage/crisis)
- First year: Infancy - Trust vs. Mistrust
- Ages 1-3: Early childhood - Autonomy vs. Shame and DOubt
- Ages 3-6: Preschool Age - Initiative vs. Guilt
- Ages 6-12: School Age - Industry vs. Inferiority
- Ages 12-18: Adolescence - Identity vs. Role Confusion/Diffusion
- Ages 18-35: Young Adulthood - Intimacy vs. Isolation
- Ages 35-60: MIddle Age - Generativity vs. Stagnation
- Ages 60+: Later life - Integrity vs. Despair
Therapist’s Function and Role
Blank screen approach, also known as anonymous nonjudgmental stance, fosters
transference
Transference relationship refers tto te clients tendency to vieewe the therapist in terms
thatt are shaped by his or her experienced with important caregivers and other significant figures
who played impotant roles during the developmental process.
Working through process consists of repetitive and elaborate explorations of
imcomciouc
material, originated in early childhood.
Countertransference occurs when therapists lose their objectivity because their
own
conflicts are triggered
Maintaining the Analytic Framework therapist uses a range of procedural and
stylistic
factors (ie. analysts relative anonymity, consistency of meeting, therapists
objectticity, structure)
Free Association clients are encourage to say whatever come to mind
Interpretation analysts pointing out, explaining, and even teaching the client the
meanings
of beehavior
Jung’s Perspecttive on the Development of Personalty
An elaborate explanation os human nature that combines ideas from hsitory, mythology,
anthropology, and religion
Places central importance on psychological changes associated with midlife
Achieving individuation - the harmonious integration of the conscious and unconscious
aspects of personality (is an innate and primary goal)
To become integrates, it is essential to accept our dark side, or shadow
Dreams are aimed at integration and resolution; they contain messages from the
collective unconscious, our source of creativity’ used to express not repress
Images of universal experiences contains in the collective unconscious are called
archetypes (the persona - public mask, the anima and animus - biological and psychological
aspects of masculinity/femininity that coexists in both sexes, and the shadow - darkest and most
dangerous/powerful of the archetypes)
Chapter 05: Adlerian Theory
View of Human Natire
Focused on the person’s past as perceived in the present and how an individual interprets
early events
Inferiority Feelings
- Are normal and a source oof all human striving
- Are the welspring of creativity
- Sevelop when we are young/ characterized bynealry feelings of hopelessness
Superiority Feelings
- Promote mastery and enable us to overcome obstacles
Subjective Percepetion of Reality
The world is seen from teh client’s subjective frame of reference and is described as
phenomenological
Subjective reality - paying attention to the individual the way in which people perceive
their world
Strive tto understand the world from the clients perspective (glasses)
Unity and Patterns of Human Personality
For adler, Individual Psychology
Takes a holistic approach. We mist understand ourselves in socially embedded contexts
(family, culture, school, work), rather than in parts.
Assumes that all human behavuior has a purpose in relation to achieving our goals - the
guiding self-ideal.
A life movement that organizees our reality, giving meaning to life (“fictional finalism”
or “guiding self ideal”
The goal of implies strivcing for greater competence, for teh common good ofsuperiority
others. Moving from a felt minus to a felt plus. UNifies the personality, core beliefs, and
assumptions
Lifestyle (plain of life, Strategy of living, Road Map of life), described as our perceptions
regarding self, other, and the world (Private Logic)
The Life Tasks
We must successfully master three universal life tasks:
1. Building friendships (social tasks
2. Esttablishing intimacy (love-marriage tasks)
3. Contributing to society (occupational task)
Each of these tasks requires the development of psychological capacities for friendship
and belonging, for contribution and self-worth, and for cooperation
Aneed for therapy is likeely die to a problem in one of these areas
Therapeutic Goals
1. Create collaborative arrangement between the client and the counseleor
2. Complete a general psycho;ogical investigiation or lifestyle assessment, disclogin
mistaken goals and faulty assumptions
3. To Emphasize the importance of health, well-being, and prevention of problems - “the
useful side of life”
4. Create a new cognitive map (awareness - modify faulty assumptions - reframe childhood
experiences - concioucly create a new style of living/lifeestyle)
5. Take a proactive instead of reactive approach to their social environment
Encouragment
To build courage
Encouragementisthemostdistinctiveinterventionandiscentraltoallphasesof
Adleeriantherapy
Itt is a fundamental attitude more than a ttechniqe
Expectinf clients to assume responsibility for their lives builds their self-confidenceand
courage
Discouragmentis the basic condition that preveents people from functioning
Change old familiar patterns and trust a new “blueprint” for living
Application: Therapeutic Techniques and Procedures
Phase 1: Establishing the Relationship
- Supportive, collaborative, educational, encouraging process
- Person-to-person contact with the client without identifying the problem
- Help client build awareness of their srtangths
- Provide a “wide -angle perspective”
Phase 2: Assessing teh Individuals Psychological Dynamics
- Lifestyle assessment (early life expeerinces influencing private logic)
- Subjective interview (wonder, fascination, interest - experts intheir own
lives ) This process helps identify patters
- Objective interview
- Family constekattion - see page 110
- Early recollectioins - influence the story of our life/metaphors
Chapter 07: Person Centered Therapy
Karl Rogers - main theorist
This approach emphasizes:
1. Personal characteristics of the therapists
2. Quality of the therapeutic relationships
3. Person’s capacity for selfdirectted growth IF involved in a therapeuttic relationship
Primary relationship for growth/change belongs to the client. The primary responsibility fo teh
therapist is providing the conditions for change.
View of Human Nature
- At the core, humans are trustworthy and positive
- Humans are capable of making changes and living productive and effective lives
- Humans innately gravitate towards self-actualization
- Given the right growth-fostering conditions, individuals strive to move forward and fulfil
their creative nature
- Counselors create a growth-promoting environment
The Environment
Three counselor attributed that create a growth-promoting climate:
1. Congruence - genuoness or realness
2. Unconditional positive regar - accepting and caring
3. Accurate empathetic understanding - the ability to deeply grasp the subjective world of
another person
Relationship Between Therapist and Client
The following six conditions are necessary and sufficient for changes to occur:
1. Two people are in psychological contact
2. The client is experiencing incongruence (Ideal self/Reality)
3. The therapist/counselor is congruent or integrated in the relationship
4. The therapist experiences/communicated unconditional positive regard or real caring for
the client
5. The therapist experiences empathy for the client's interal frame of reference and
endeavors to communicate this to the client
6. The communication to teh client is to a minimal degree, achieved (client feels
understood)
The client is responsible for making change, the therapist is rrepsinsible for the environment.
Application of the Person-Centered Approach
Emphasizes stating with clients as opposed to getting ahead of them with interpretations
Straightforwad and easy to comprehend
Encourages locating power in the person
TRUST thee Organismic Valuing Process (OVP)
Demands a great deal of the therapist (presence)
Without a person-centered way of being, mere rapplication of skills is likely to be empty
Client’s Experience in Therapy
Clients have teh opportunity to explore their feelings, beliefs, behaviors, and worldview
CLients may hope to find thier way through the guidance of the therapist
OrganismicValuingProcess
Therapy relationship provides a supportive structure within which clients self-healing
capacities are activated
One of the fathers of humanisttic thought
Application To Crisis Intervention
When people are in crisis, one of the first steps is tto give them an opportunity to fully
express themselves
Genuibe support, caring, and non-posseesive warmth can motivate people to do
something to work through and resolve crisis (Walk in the Solution)
Communicating a deep sense of understanding should always precede othe
problem-solving interventions, per this approach
Creativity and Offering Stimulating Experiences
Individuals who have experienced unsafe creative environments feel “held back” and
may disengage from the creative process
Some cliebnts can use art to facilitate self-expression and personal growth
Conditions that foster creativity (counselor’s” responsibility:)
- Acceptance of the individual
- A nonjudgmental setting
- Empathy
- Psychological freedom
- Stitmulating and challenging experiences
Principles of Expressive Arts Therapy
All people have an innate ability to be creative
Creative process is transformative and healing
Conciousness can be achieved through self-discovery, self awareness, and insight via
artistic expression
Types of creative expression can include:
- Mediations
- Poetry
- Painting
- Journal writing
- Music
- drawing
The Now
Our “power is in the present”
Nothing exists except the “now”
The past is gone, and the future has not yet arrived
For many people, the power of the present is lost. They may focus on their past
mistakes or engage in endless resolutions and plans for the future
Unfinished Buisness
Unexpressed feelings about the past
Associated with distinct memories and fantasies
Feelings are not fully experienced
Linger in the background and interfere with effective contact (emotional debris)
Resutls
Preoccipatiton, compulsive behavior, oppressive energy, self-defeating behaviors
` all preventing contact witht another persin
Can manifest in physical symptoms
When awareness is powerful enough, change can occur
Impasse can occur if external support is not available
Gestalt Theraputic Intterventions
- The Internal Dialogue exercise (top dog/underdog
- The Empty Chair Technique
- Making thet Rounds
- The Reversal Exercise (too sweet)
- The Rehersal Exercise
- The Exaggeration Exercise
- Staying with the Feeling
- The Gestalt Approach to Dream Work
Chapter 09: Behavioral Therapy
Introduction
Directly observable behavior, current determinants of behavior, and learning experiences
Treatment for anxiety disorders, depression, posttramatic stress disorder, substance
abuses, eating/wieght disorders, sexual dysfuntion, pain managment,
schizophrenia, and hypertension
Used in the fields of developmental disabilities, education, community psychology,
sports, business, self-managment, sport psychology, gerontology and medicine
Four Areas of Development
Classical Conditions: What happens prior to learning that creates a response through
pairing the stimuli
Operant Conditioning: Behaviors are influenced mainly by consequences that follow
them
Social Learning: Interaction between an individual’s behavior, personal factors, and the
Environemet
Basic Characteristics and Assumptions
Clinical procedures relying on experimental findings of psychological research
Action oriented and educational
Clintes are taught skills and that they should be pro-acttive
Behavior can be operationally defined
Over actions and internal processes
Change can take place without insight
Interventions are:
Individually tailored to specific problems
Empirically supported with evidence
Therapist’s Function and ROle
Behavior therapists conduct a thorough functitonal assesmenet/behavioral analysis
A-B-C Mode:
Antecedent(s) - identify situations that precede the behavior
Behavior(s) - identify the problem behavior
Consequence(s) - maintain the bahavior
Goals:
Set measurable goals following a thorough assessment
Treatment Plan:
Therapist and client are involved in a proactive treatment plan. Measurable goals
and measurable behavior
Techniques and Approaches
Applied behavioral Analysis
Progressice muscle relaxation
Systematic desensitization
In Vivo exposure
Flooding
Eye movement deseensitizatiion and reprocessing (EMDR)
- Asseesmeeent and preparation
- Imaginal flooding
- Cognitive restructuring
Additional Approaches
Social Skills Training (schizophrenia)
Self-Managmenet Programs and Seefl-Directed Behavior
Multimodal Therapy: Holistic approach, Basic ID
Mindfulness and Accepetance-Based Approaches
“Third Generation” behavioral therapies that center around five core themes:
1. An expanded viewe of psychological health
2. A broad view of acceptable outcomes in therapy
3. Acceptancee
4. Mindfulness
5. Creating a life worth living
Mindfulness and Acceptance-Based APproaches
Dialectical Behavior Therapy (DBT)
Mindfulness to accepet currentt state/emotitonal regulation; managing opposing
forces tot accomplish a desired outcome
Mindfulness-Based Stress Reduction
Stress comes from wantitng things different from reality
Mindfulness-Based Cognitive Therapy
Kindness, self-compasion, self0care
Acceptance and Commitment Therapy (ACT)
Accept thoughts, not change them. Recognize their relationships with their
Thoughts
