The Three Theoretical Approaches

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Theoretical Essay The Three Theoretical Approaches 22. 04. 08 Introduction In this essay I have looked at the three theoretical approaches, The Person Centred, The Psychodynamic and The Cognitive Behaviourist approaches. I have done this through the theoretical knowledge gained in class and through my own personal research, triad/diad practice and my personal life and experiences and how they relate to the theory. I have taken each theory, and the knowledge I have gained, and how this relates to me in my own life. I have looked at the triad/diad practice I have undertaken for each and given examples of how I have demonstrated theory through the use of skill, also how this contributed to the process of the counsellor/client relationship. The Person-centred Approach The Person-Centred Approach was developed by the psychologist Dr Carl Rogers. It’s a humanistic, non-directive model of therapy, in which the therapist facilitates the client in the here and now working through their issues by walking with them. In Roger’s theory he believed that there were six conditions that are necessary for therapeutic change to take place. This includes The Three Core Conditions: • Congruence is being a genuine whole person who is comfortable with their own personal experiences, positive and negative. • Empathy, to sense the client’s private world and walk along side them through their issues, without over identifying and making the session about the counsellor. • Unconditional Positive Regard, no conditions of acceptance, being as open to the negative aspect of the client as the positive. There is also the contract, developed between the client and the counsellor. The client should be incongruent and the counsellor should be congruent. The core conditions are said to be a way of being and can be demonstrated by the counsellor through the use of skills such as: • Paraphrasing is when the counsellor relays spoken content back to the client in their own words, or the counsellors to give a different or better perspective. • Reflecting is when the counsellor senses the emotions behind spoken content and relays them back to the client. • Summarising is when the counsellor takes all the threads of the session at any point and puts them all together; it is used to assist the client in making connections. Silence is used to assist reflection on content and that may have been experienced during the session. Giving the client time to think, process feelings and compose themselves and find the words to go on. It can be uncomfortable, but being able to sit with it will benefit the process. • Minimal encouragers are used when the client is identifying their concerns, they can be as simple as a nod of the head to show that the counsellor is following what has been said, or simple yes, and, then, or even repeating a simple phrase. • Open questions are used to help the client open up and explore there issues. These are question that can not be answered with a simple yes or no. by the way that the question is worded the counsellor can facilitate the client in exploring aspects of there issues from a deeper or new prospective, in the hope of bringing clarity. • Focusing is a very important part of the counselling process. Where in most settings there are limitations on time and duration the counsellor need to structure the sessions into a beginning where the introductions/greeting are done and when the contract can be set and can be amended, also the client will be able to identify their concerns. The middle of the session is where the issues are explored with demonstration of theory by the use of skills. The ending is when the counsellor will whine down the session by informing the client that time is coming to an end and give them enough time to prepare for this and if there is anything that they need to say they will have the time to do so, therefore the client is not left hanging or in a bad place. With the limitations the counsellor need to be able to identify and focus on specific concerns and facilitate the client in working on this before moving on, but also giving the client the control of the session. There are also the five theoretical strands that go with the person centred approach. The Self concept, how we feel about ourselves. Conditions of Worth, the external influences/forces that strengthen our own self concepts. If you have low self esteem and you do things to place and get the approval of others. The Organismic Self, the true you, to reach your potential and be all you can be. The Locus of Evaluation, there is external, incongruent and doing to please others rather than to please themselves, and internal, pleasing yourself, Self-actualization: reaching your full potential. When you do what pleases you it brings you closer to your Organismic self, the true and congruent you. You extend and demonstrate the core conditions when it comes to the consequences brought on by pleasing yourself; you need to extend the 3 core conditions to the consequences and to yourself according to Carl Rogers. The Conditions of Growth, which are the 3 Core Conditions, Congruence, Empathy and Unconditional Positive Regard. During triad/diad sessions I was given the opportunity to demonstrate theory with the use of skills, here is an example: I gave a short contract covering time, confidentiality and its limits, qualifications, complaints and supervision. Claire was happy to continue and began to talk about bereavement. She told me that an old friend that she had not seen for some time had passed away and she had attended her funeral last Tuesday. I got the feeling that this is what I had sensed earlier when she had said it was fine about me not being there last week and I felt that I had really let her down. I tried to block out these feelings so that could try and facilitate her for this session. She talked of her feelings at the funeral and not understanding why she had been so upset. I tried to follow her and see where it was going and we managed to go a bit deeper into her own feelings about her own life and where it was going. With the short amount of time we had I could not help my feeling of guilt coming back and as my client was talking about it also it was hard for me to get away from it. I felt that we made a little progress, the client came to a realisation in regards to some of the emotions that she was feeling and I think that is why she told me after that things had gone better than she thought would. I was happy to hear this, but still carried the feeling I had earlier. The Psychodynamic Approach We looked at Psychodynamics briefly during the course. The first week we watched a person centred video and had to identify the psychodynamic aspect in it. In this model of counselling the counsellor works with the clients past and relates it to the present issues or behaviour. We looked at Sigmund Freud’s free association the tutors gave us a demonstration. The client was stood with their back to the counsellor and was able to talk about anything that came into their head. It happened to be a cold dark night and it brought them back to their childhood and walking home from school on their own and the emotions that brought up for them and now how protective they are of their own children. The theory looked at in the Psychodynamic Approach and some of its theory: • Transference, where the client sees behaviour of another in someone and then begins to treat them as they would the other person e. g. the counsellor talks to the client as their mother had, so they then begin to treat and talk to the counsellor as they would their mother. • Counter-Transference, this is when the counsellor or person takes on the role that has been transferred to them. • Defense Mechanism, the ways in which we protect ourselves. The mind will find a way of protecting us from thoughts and feeling that we can’t deal with. The conscious mind, includes everything that we are awareness of and comfortable processing and we are able to think and talk about in a rationally. • The Unconscious, this is where all the negative thoughts and feelings are stored. It is said that even though they are repressed they can still have an influence on behaviour. During the weeks we looked at psychodynamics we were then asked to think of a time age and use that for our dyads. My client was age 14, thinking of family Christmases with her father, who had recently past away for a heart attack. She was the youngest child and had been really close to her father and missed him so much. I did not feel the need to ask questions, but I used lots of minimal encouragers and summarized that at this time of the year she was feeling quite overwhelmed by sadness. Personally I found this way of practicing psychodynamics very uncomfortable. I had always thought that this model of therapy would work best for me as I am a believer that my past has shaped me into the woman that I am today. When I was put into the client’s chair I felt really uncomfortable. I have never been the type of person that was comfortable with anyone being behind me and even though I have known my peer counselor for some time now I really felt like I was not safe. The Cognitive Behaviourist Approach We looked at CBT for three weeks and focused on Ellis and Beck. Albert Ellis first introduced behavioural therapy in the 1950’s, his theory Rational Emotive Behavioral Therapy, known as REBT. Later in the 1960’s Aaron T. Beck introduced Cognitive Therapy. In our first session we observed a video of Ellis in a CBT counselling session. This new approach was very different to The Person Centred Approach, directive and in the clients face. The focus in the session was on behaviour rather that emotion, and challenging these behaviours. The concepts behind the theory are: • Negative Automatic Thoughts (NATS), developed by Beck, this is the thought just pop into our heads when we are in certain situations and have a big influence our behaviour. These it is believed can be challenged. • Core Beliefs, the beliefs that we have about ourselves that come to us in early life from the information that we get from others. If your told to shut up all the time as a child you may grow up to believe that you are not important and become shy and not want to talk to other, because you believe that they will not want to hear what you have to say. • Underlying Assumptions, lie between the NATS and the core beliefs and are deeply related to acceptance, competence and control. The way that we feel about ourselves, and needing to be loved, to accomplish, and cannot ask for help. In a counselling session these are challenged with the use of lots of Socratic questions, these challenge the client, who said that? Where is the proof? Why can’t you? There is also the setting of goals and homework so the client can feel they are actively doing something and place less focus on their negative behaviour. We did a case study and we had to chose for 8 cases an then use the ABC technique developed by Albert Ellis to identify which processes developed the irrational beliefs, by putting the information into three column table. • A – Activating Event or objective situation. The first column records the objective situation, that is, an event that ultimately leads to some type of high emotional response or negative dysfunctional thinking. B – Beliefs. In the second column, the client writes down the negative thoughts that occurred to him or her. • C – Consequence. The third column is for the negative disturbed feelings and dysfunctional behaviors that ensued. The negative thoughts of the second column are seen as a connecting bridge between the situation and the distressing feelings. The third column C is next explained by describing emotions or negative thoughts that the client believes are caused by A. These could be anger, anxiety or sorrow etc. A |B |C | |The activating event |The beliefs about the event |The consequences of the event | |As a child Jesse would have closed question|Jesse felt that he was not trying hard |Jesse was left with low self esteem and | |sessions over the dinner table from his |enough and that he deserved the questioning|lack of ambition, in his mind it was clear | |father about what he had learned that day |and remarks that followed. He felt that he |to him that he was not good enough and | |at school and he would freeze and forget |was letting his father down (fear factor). |would never make it. | |everything and not be able to answer. His | | | |father would tell him over and over that if| | | |he could not do better he will never amount| | | |to anything or get anywhere in life. This | | | |lead to him dreading seeing his father’s | | | |car in the drive. | | | |The event, this can not be changed. NATs, core beliefs, assumptions |Consequences | | |Ellis believes that by challenging the core|Show they can change their behaviour | | |beliefs and Negative Automatic Thought the | | | |attitude of the client can be changed | | Dyads were practiced here is an example: My client was a female how was experiencing some problems within her relationship. She had noticed that her partner of late had been talking about his brother’s girlfriend a lot of the time. This had had a serious effect on her confidence and lead to her feeling a little jealousy. She acknowledged that she had an ongoing issue with her weight. Q & A Are you jealous? No I really like her, but envious of her style Is it just her style or is it her personality etc? She is very happy with her life; she just thinks that it is the way she looks. Do you think that your partner likes her? She was positive that he does not like her in that way. Are you comfortable with the way you look? No. Well you look very comfortable to me. Would you like to change your style, maybe dressing a little more glamorous? Yes Ok we will try that for homework and tell me how it works out next week. Supervision Supervision is a British Association of Counselling & Psychotherapy ethical requirement, at all levels of counselling and psychotherapy. The BACP is the overseeing body for the practice in this country and are there to assist in many areas, not only for counsellors, but for the client also. As well as supervision for counsellors they also deal with personal development, complaints etc. Supervision is time to sit and talk over any concerns that you may have from sessions, with consideration for confidentiality. There is also the case of referrals and harm to self or others, in this case supervisors are needed to advise the counsellor the next step, but all this should be explained to the client during the contract. Supervisors can also help the counsellor with issues that may arise during sessions, not dissimilar to a counselling session the supervisor is there to assist the counsellor work through their process, positive and negative. Summary I feel that all three of the approaches are very different, but work well with various clients. I think it is a matter of finding the theory that is right for the client. Just being introduced to CBT and Psychodynamics, there is defiantly something there and I believe that a combination of the three could go far, using what is appropriate for the client. References Books: Milne. Aileen. , (2003), Teach Yourself Counselling, London, Hodder Education Websites: https://www. bapca. org. uk/ 19. 04. 08 https://www. personcentered. com/pcch1. html 19. 04. 08 https://psychology. about. com/od/historyofpsychology/a/psychodynamic. htm 19/04/08 https://en. wikipedia. org/wiki/Cognitive_behavioral_therapy 19/04/08

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