Richardson Counseling Services, PC

1. Practical Treatment Strategies forImproving Self-EsteemKirleen Neely PhD, LPC-S Richardson Counseling Services, PC

2. Agenda • Introduction of the topic • Defining and understanding the construct of Self-Esteem • Employee Assistance Counseling and Self-Esteem • Compassion Therapy Strategies • Cognitive Therapy Strategies • Shame and Perfectionism strategies • Interactive case scenario • Questions/Answers

3. What is Self-Esteem? • Self-esteem is defined as an attitude toward self that can be either favorable or unfavorable; it includes a sense of value or worth person has for him or herself (Rosenberg, 1965). • Global Self-Esteem – A person’s overall emotional evaluation of his or her own worth. • Domain Specific Self-Esteem- A person’s emotional evaluation of his or her worth in one particular area.

4. Self-Esteem: Fluid Construct McLeod, 2010

5. Clients with Self-Esteem Issues • Are more troubled by failure than others and tend to exaggerate events as being negative. • They are more likely to experience social anxiety and low levels of interpersonal confidence. • Operate out of a fear of rejection and look for approval from friends, family, and co-workers. • Blame themselves and often think everything is their fault. • Are anxious about the future and are often depressed. • Can be perfectionists, constantly seeking to improve themselves and their environment. They are never satisfied.

6. What Our Clients Feel

7. Employee Assistance CounselingTypical Issues Presented

8. Gender and Cultural Differences • In elementary school years, girls and boys have equal levels of self-esteem. • Around age 9, girls take a nose dive in self-esteem as it relates to body image. • Girls rate themselves higher than boys in academic self-concept, personal character, and being more responsible. • Do not discount the fact that men and boys do experience self-esteem issues. • Ethnic minority score higher on self-esteem assessment scales than other races. Current assessments may not ask questions that truly assess cultural differences.

9. Compassion Therapy

10. Compassion Therapy • Self Compassion- Involves acting kind to yourself when you are having a difficult time, fail, or notice something you do not like about yourself. • Three Core Components of Compassion Therapy • Self-Kindness-being warm and understanding towards ourselves when we suffer, fail or feel inadequate, rather that ignoring our pain. • Common Humanity-common humanity recognizes that suffering and feelings of personal inadequacy are part of the shared human experience. • Mindfulness- Taking a balanced approach to negative emotions so they feel neither suppressed nor exaggerated.

11. Practical Strategies Using Compassion Therapy • Externalizing the voice exercise using self compassion. • The client uses their own distorted thoughts as a tool to learn compassion skills. • Self-Compassion Journal • The client notes any surprising moments of equanimity or self-compassion—times when they would have ordinarily have criticized themselves, stressed out, or overreacted. A record of such events will inspire then to continue your practice. • Love & Kindness Meditation

12. Love & Kindness Meditation

13. Cognitive Therapy

14. Practical Strategies Related To Cognitive Therapy • Feared Fantasy Role Play • Role play activity where the therapist and the client act out the client’s worst case scenario. • Distorted Thought List • Use distorted thinking list to assist clients to identify distorted thought patterns. • The Self-Esteem Check Up • Quick client self assessment tool that can be administered pre- and post-treatment.

15. Distorted Thinking List • All-Or-Nothing Thinking – You see things in black-and-white categories. • Overgeneralization – You see a single negative event as a never-ending pattern of defeat. • Mental Filter – You pick out a single negative defeat and dwell on it exclusively so that your vision of reality becomes darkened. • Disqualifying the positive – You dismiss positive experiences by insisting they “do not count”. • Jumping to conclusions – You make a negative interpretation even though there are no definite facts that support your conclusion. • Mind reading -- You arbitrarily conclude that someone is reacting negatively to you and do not follow-up. • Personalization – You see yourself as the cause of a negative external event when you were not primarily responsible.

16. Self-Esteem Assessment Tool (Schiraldi, 2001)

17. Shame-Vulnerability-Perfectionism

18. Practical Strategies Shame-Vulnerability-Perfectionism The “Not even my best friend knows” Exercise. • Therapist works with the client to learn how to relinquish shame through imitating connection. Reasonable Expectations List • Therapist works with the client to create a list of tasks that usually leads them to being self-critical. The client then writes reasonable expectations by each task. • Photo Exercise • The client is asked to bring in a photo that they find unflattering. The client is then asked to describe the photo with love, kindness, and free of disparaging remarks. This exercise taps into vulnerability and perfectionism.

19. Case Example Lauren is a 25 year old single female presenting for counseling due to feelings of unworthiness and depression. She repots that all of her friends have gotten married and are living very happy lives. She feels unattractive and doubts her ability to attract a loving partner. She has attempted to finish her college degree several times but always drops classes because she feels that she is not smart enough to do the work. Lauren wants to work on improving her self-worth.

20. RESOURCES • Brown, B. (2010). The Gifts of Imperfection. Center City, MN: Hazelden. • Brown, B. (2012). Daring Greatly. New York, NY: Penguin Book. • Burns, D. ( 1993 ). Ten Days to Self-Esteem. New York, NY: Harper Collins Books. • Neff, K. (2000). Self Compassion the Proven Power of Being Kind to Yourself. New York, NY: Harper Collins Books. • Schiraldi, G. (2001). The Self-Esteem Workbook. Oakland, CA: New Harbinger Publications.