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CHAPTER 3

CHAPTER 3. THEORETICAL APPROACHES TO HUMAN SERVICE WORK. Counseling or Psychotherapy?. Both Counseling and Psychotherapy Rely on the Same Theoretical Underpinnings How Practitioners Implement Them May Vary With More Education and Training You Can Do Counseling and Eventually Psychotherapy.

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CHAPTER 3

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  1. CHAPTER 3 THEORETICAL APPROACHES TO HUMAN SERVICE WORK

  2. Counseling or Psychotherapy? • Both Counseling and Psychotherapy Rely on the Same Theoretical Underpinnings • How Practitioners Implement Them May Vary • With More Education and Training You Can Do Counseling and Eventually Psychotherapy

  3. Individual Versus Systems Approach to Clients • Individual Approach: Person Can Change (e.g., Viktor Frankl, William Glasser) • Systems Approach: Lives Are Seen Contextually: (e.g., Social and Family Systems) • See Box 3.1, p. 65: “Joshua”

  4. Why Have a Theory? • Offers Us a Comprehensive System of Doing Counseling • Helps Us Understand Clients, Offers Techniques, and Predicts Change • Are Heuristic: They Are Researchable and Testable

  5. Views of Human Nature • Basis for Our Understanding of Theory • Major Orientations: Psychodynamic, Behavioral, Humanistic, & Cognitive • Offers Explanations for Why People Are Motivated to Do the Things They Do

  6. Deterministic Versus Antideterministic View of Human Nature • The Deterministic View Asserts That There is Little Ability for the Person to Change • Determinism: Early Childhood, Biology, Genetics Determine Later Psychological Makeup • Often Adheres to Medical Model • Antideterministic View Has Belief in the Ability of the Individual to Change

  7. Directive Versus Nondirective Approaches to Clients • Directive View Believes Clients Need Guidance in the Change Process • Nondirective View Has Trust in the Client's Own Ability to Make Change

  8. Integrative Approach • Few Are Strictly Deterministic, Antideterministic, Directive, or Nondirective • Most People Today Take On an Integrative Approach Which Reflects Their Own Views of Human Nature

  9. Major Theoretical Orientations • Four Orientations Have Dominated • Psychodynamic • Behavioral • Humanistic • Cognitive • Let’s Examine Each of Them

  10. Psychodynamic Approach • Originated by the Psychoanalytic Approach of Sigmund Freud • Freud Started Using Hypnosis: E.g., Conversion Reaction in Patients • Freud Developed a Complex Theory of Development (See Chapter 5)

  11. The Psychodynamic View of Human Nature • More Deterministic than Other Approaches: Freud, Others (e.g., Kohut, Erikson, Adler, Jung) • Believes That Drives Motivate Behavior and are Somewhat Unconscious • Believes Perceptions of our Childhood and Actual Events in Combination with Our Drives Affects Our Psyche and our Later Adult Development • Purpose: To Help the Person Understand Childhood Experiences, and How, in Combination with the Individual's Drives, They Motivate the Person

  12. Key Concepts of the Psychodynamic Approach • Developmental Stages (Especially Freud) • One May Become Fixated in a Stage • Early Patterns of Behaviors Are Repeated with our Significant Others • Transference

  13. The Human Service Professional's Use of the Psychodynamic Approach • Offers a Developmental Model to Understand the Individual • Helps Us Particularly to Understand Deviant Behavior • Gives Us an Understanding of the Importance of “Countertransference”

  14. Behavioral Approach • Three Main Orientations • Classical Conditioning • Pavlov • CS Paired with UCS yields UCR • Operant Conditioning • Skinner (Skinner Box) (see Box 3.2, p. 72) • Positive Reinforcement • Negative Reinforcement • Punishment • Social‑learning, or Modeling • Bandura • Bobo Dolls

  15. The Behavioral View of Human Nature • All Behavior is Learned • We are Conditioned by Reinforcers in our Environment • Antideterministic: What was Learned Can Be Relearned • Some Applications of the Behavioral Approach • Token Economy • Treatment of Phobias • Systematic Desensitization • Spontaneous Recovery • Learning of Assertive Behavior • Role-Playing • See Box 3.3, p. 74

  16. The Human Service Professional's Use of the Behavioral Approach • One of the Most Commonly Used Approaches • E.g., Token Economies with the Mentally Retarded • E.g., Use of Reinforcement (e.g., Weight Loss, Behavior Change, Stop Smoking) • E.g., Modeling via Role‑playing • See Box 3.4, p. 75

  17. Humanistic Approach • Some Key People • Carl Rogers • Rollo May • Abraham Maslow • Highlights the Strengths and Positive Aspects of the Individual

  18. The Humanistic View of Human Nature • Origins in: • Existential Philosophy • Phenomenology • Antideterministic: We Have Choices and We Constantly Create Our Existence • Born with Actualizing Tendency

  19. Key Concepts of the Humanistic Approach • Person‑centered Approach of Carl Rogers • Necessary and Sufficient Conditions: • Empathy • Unconditional Positive Regard • Genuineness • Maslow: Hierarchical Approach of Needs • See Figure 3.1, p. 76

  20. The Human Service Professional's Use of the Humanistic Approach • Maslow's Hierarchy: A way of understanding the development of the person • Empathy, Being Nonjudgmental, & Being Genuine: Essential Qualities & Skills • Importance of the Helper/Client Relationship has Become Key

  21. Cognitive Approach • Two Key Theorists • Albert Ellis • Aaron Beck • Stresses How Cognitions Affect our Behaviors and How we Feel

  22. The Cognitive View of Human Nature • Not Born with Innate Goodness or Evil, Rational or Irrational Beings • Thinking Can Be Changed Through Counterconditioning • Antideterministic: We can Change Thinking, and Ultimately Behaviors and Feelings • Understanding “Why” We Behave Is Not as Important as Making Changes in How We Think

  23. Key Concepts of the Cognitive Approach • Less Emphasis on Qualities of the Helper/Client Relationship • Stresses Importance of Extinguishing Past Destructive Ways of Thinking • Stresses Importance of Practicing New, Positive Ways of Thinking • Recent Addition: Constructivism • Stresses understanding how the client makes meaning and finding ways to change meaning-making system.

  24. The Human Service Professional's Use of the Cognitive Approach • Have Not Been Widely Adopted, but Could Be Beneficial For Clients • Helping Clients Understand the Connection Between Thinking, Behaving, and Feeling Can Dramatically Impact How They Interact in the World

  25. Cross Theoretical Approaches • Eclecticism or Integrative Approaches • Draws from a Number of Different Orientations • Not “Shooting from the Hip”: Must Carefully Reflect on View of Human Nature

  26. Formation of an Eclectic Approach Is a Developmental Process: • Evolving One’s Eclectic Approach is a Developmental Process • Stages: • 1- Chaos • 2-Coalescent • 3-Theoretical Integration • 4-Metatheory Stage

  27. Brief and Solution‑focused Counseling • Defined as Anywhere from a 2 to 50 Sessions • Garfield Suggests Four Stages: • Building the Relationship and Assessing the Problem • Developing a Plan for the Client and Working on the Problem • Reformulating Plan Based on New Info & Client Feedback • Termination • Comparing Long-Term and Short-Term Approaches (See Table 3.1, p. 82) • Read Box 3.5, p. 82

  28. Solution-Focused Therapy: One Type of Brief Treatment Approach • Helps Clients Focus on What they Want in Their Future • Counselor May Ask “Miracle Question” • Helps Client Focus on Creating Future Based Partly on Responses to Miracle Question

  29. Gender Aware Approaches (Feminist Therapy and Men’s Issues Therapy) • Considers Gender Central to the Helping Relationship • Views Problems Within Social Context & Examines Gender Injustices • Encourages Collaborative and Equal Relationship with Client • Client’s Choose Gender Roles Regardless of Political Correctness

  30. Ethical, Professional, and Legal Issues • Supervision for the Human Service Professional • Helps You Review: • View of Human Nature • Theoretical Approach • Effectiveness • Should Continue as Long as One Is Working with Clients

  31. Ethical, Professional, and Legal Issues • Supervisor Roles: • Assuring the Welfare of the Client • Assuring That Ethical, Legal, and Professional Standards are Upheld • Overseeing Development of and Evaluating the Supervisee • Confidentiality and the Helping Relationship

  32. Ethical, Professional, and Legal Issues • When to Keep Confidentiality and When to Break it • Tarasoff Case and Breaking Confidentiality • Refer to NOHS Ethical Guidelines • Difference Between Confidentiality and Privileged Communication

  33. Ethical, Professional, and Legal Issues • When to Break Confidentiality • If client is in danger of harming self or someone else • Minor client and law states parents have a right to info • If client asks you to break confidentiality (for example, your testimony is needed in court) • If you are bound by law to break confidentiality (e.g., a local law requires professionals to report the selling of drugs) • To reveal info about client to your supervisor to benefit the client • A written agreement from your client to reveal information to specified sources (e.g., other social service agencies)

  34. Ethical, Professional, and Legal Issues • When You Cannot Break Confidentiality • You’re frustrated with client and talk to a friend or colleague to “let off steam.” • Helping professional requests info about your client and you haven’t received written permission to disclose • When a friend asks you to tell him or her something interesting about a client with whom you are working • When breaking confidentiality will clearly cause harm to your client and does not fall into one of the categories previously listed

  35. Ethical, Professional, and Legal Issues • Dual Relationships and the Human Service Professional • Refers to things like: Social, Work, Sexual Relationships with Clients • Unethical and May Be Illegal (See NOHS Ethical Guidelines)

  36. The Developmentally Mature Human Service Professional: Committed to a Counseling Approach and Willing to Change • Commitment with Relativism: Reflecting on Different Approaches, Choosing an Approach, Being Willing to Change as You Receive New Info

  37. Experiential Exercises and Ethical and Professional Vignettes • See Pages 87-93

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