Chapter 1

1. Chapter 1 Theories and Therapies

2. What is a theory? • A group of related laws or relationships that are used to provide explanations within a discipline (Sharf, 2004) • No one theory fits all situations or persons.

3. Characteristics of Sound TheoriesHansen, Stevic, & Warner (1986) • Clear, easily understood, and communicable • Comprehensive • Explicit and heuristic • Specific in relating means to desired outcomes • Useful to its intended practitioners

4. Pragmatic Value of Theories • Helps explain what happens in a counseling relationship • Assists the counselor in predicting, evaluating, and improving results • Provides a framework for making scientific observations about counseling • Encourages the coherence of ideas about counseling and the production of new ideas

5. Functions of TheoryBoy & Pine (1983) • Find unity and relatedness within the diversity of existence. • Examine relationships they would otherwise overlook. • Provide operational guidelines by which to work and helps them evaluate their development as professionals. • Focus on relevant data and tells them what to look for. • Assist clients in the effective modification of behavior. • Evaluate approaches to the process of counseling.

6. Antiquated Theories • Trephining • Exorcism • Flogging, Starving, Chains, Immersion in Hot Water • Institutions and “Lock-up”

7. Talk Therapies • Proposed the unchaining of patients and better treatment such as time outdoors, feeding them a more nutritious diet, and talking with them. • Two Early Examples: • Paul Dubois (1848-1918) – a Swiss physician • Pierre Janet (1859-1947) – a French physician

8. Examples of Modern Theories • Psychoanalysis • Behaviorism • Existentialism • Adlerian theory • Person-Centered theory • Reality therapy

9. Present Trend • Helping professionals seem to be pragmatically flexible in adapting techniques and interventions from different theoretical approaches into their work without actually accepting the premises of some theoretical points of view. • Can be seen in the development and use of microskills.

10. Eclecticism • Most modern professionals consider themselves as eclectic • Combine theories or techniques from a wide variety of therapeutic approaches. • Modern counselors use an average of 4.4 theories making up their therapeutic work with clients. (Cheston, 2000)

11. Style-shift counseling • As needs change, counselors depart from a theory they are using to another approach.

12. Strength of Eclecticism • The ability to draw on various theories, techniques, and practices to meet client needs.

13. Drawback of Eclecticism • Can be hazardous to the counseling process if counselors are not thoroughly familiar with all aspects of the theories involved. • Can do more harm than good because the counselor may have little or no understanding about what is helping the client.

14. Levels of EclecticismMcBride and Martin (1990) • Syncretism • Lowest or first level • Sloppy, unsystematic process of combining clinical concepts

15. Levels of EclecticismMcBride and Martin (1990) (cont.) • Traditional • Second level • An orderly combination of compatible features from diverse sources into a harmonious whole • More thought out and theories are examined in greater depth.

16. Levels of EclecticismMcBride and Martin (1990) (cont.) • Theoretical Integrationism • Third level • Requires that counselors master at least two theories before trying to make any combinations. • Assumes two things: • A degree of equality between theories (which may not be true) • The existence of criteria to determine what pieces of each theory to include or exclude.

17. Levels of EclecticismMcBride and Martin (1990) (cont.) • Technical Eclecticism • Fourth level • Procedures from different theories are selected and used “without necessarily subscribing to the theories that spawned them” (Lazarus & Beutler, 1993) • Critical variables are a mastery of theory and an acute sensitivity to knowing what approach to use when, where, and how.

18. Transtheoretical Model (TTM) of change • Model is developmentally based and has been empirically derived over time. • An alternative to technical eclectic approaches.

19. TTM Five (5) Stages Model of Change • Precontemplation • Contemplation • Preparation • Action • Maintenance

20. TTM’s Underlying Stages of Change • Consciousness-raising • Dramatic Relief • Environmental Reevaluation • Self-evaluation • Self-liberation • Contingency Management, Counterconditioning, and Stimulus Control

21. TTM’s Levels of Change • Symptom/Situation problems • Maladaptive Cognitions • Current Interpersonal Conflicts • Family System Conflicts • Intrapersonal Conflicts

22. Drawbacks of TTM • Comprehensiveness of approach • Complexity of approach • Has only been tested among limited groups

23. The Case of Linda • Linda is a recently divorced, 32-year-old Caucasian woman. • Comes seeking counseling because of “relationship problems.” • Was married for 7 years but ended her relationship because she no longer found her husband exciting and thought he was verbally abusive. • Had an abortion in the marriage two years earlier because her husband insisted and she did not feel ready for parenting responsibilities.

24. Family Background • Father was a construction worker with just a 7th grade education. • Drank heavily on weekends. • Good work ethic and positive attitude toward work. • Definite and vocal opinions about politics, religion, and the subservient place of women in society.

25. Family Background • Mother was a high school graduate. • Did not work outside the home • Quiet and introverted woman

26. Family Background • Older Brother (two years). • Two younger sisters (13 months and 3 years). • Linda reports she is not emotionally close to her family at all.

27. Historical Context • Grew up in a lower class neighborhood in a mid-size Midwest city. • As a teenager, she reports being mildly rebellious. • Dated older boys and was flirtatious, but never engaged in more than heavy petting. • States her brother was her protector.

28. Educational Background • Good enough grades to be admitted to a 4-yr college but did not feel confident enough to apply since it would go against family norms. • Father discouraged her from furthering her education. • Enrolled in a local community college and completed a program in business administration.

29. Employment History • Since graduation she has drifted from job to job as an administrative assistant or secretary. • No job has challenged her. • Admits to getting “fed up” with the treatment she gets from her bosses, who are sexist, she thinks.

30. Hobbies • Likes to read romance novels. • Watches the home and garden TV channel. • Goes to see action movies. • All make her feel better by taking her away from her mundane existence.

31. Social Factors • Has felt “aimless, anxious, and depressed” since the divorce. • Has not found a group of singles to associate with and her former friends have all “married or moved away.” • Considers her family boring and sees them only once a week.

32. Take-In Session • Reveals she has had daydreams about ending her life by stepping out in front of a truck, though she doubts she would ever do thing. • Has recently contemplated finding a new job and has given two weeks notice. • Thinks life is passing her by and her voice is desperate as she relates this to you.