Tag Archives: Psychotherapy

Clinical Interviewing, Cool Counseling, Counseling and Psychotherapy Theory and Practice, Parenting, Therapy with Adolescents, Tough Kids, Tough Kids Cool Counseling

Upcoming Workshops!

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John II

Coming up in March and April, I’ve got two, two-day professional workshops scheduled at the University of Montana. Together, these workshops can earn you 2-credits through the U of M . . . or you can enroll for continuing education credit (one workshop = 2 days = 13 CE hours). Whatever you decide, coming to Missoula in early March and early April is pretty fabulous. We’ve scheduled these workshops for the first Friday and Saturday in Missoula to coincide with the First Friday Art Walk. That way you can workshop during the day and walk around downtown Missoula and check out fantastic Montana art Friday evening.

The workshops and their descriptions are below:

March 2 and 3, 8:30am to 4:30pm: Working with Challenging Youth and Parents . . .  and Loving It

Counseling difficult youth and challenging parents can be immensely frustrating or splendidly gratifying. The truth of this statement is so obvious that the supportive reference, at least according to many teenagers is, “Duh!” Using storytelling, video clips, live demonstrations, group discussion, and skill-building break-out sessions, John will present essential evidence-based principles and over 20 specific techniques for influencing “tough” clients or students. Techniques for working with youth will include, but are not limited to: (a) the affect bridge, (b) what’s good about you?, (c) empowered storytelling, (d) generating behavioral alternatives, (e) the three-step emotional change technique, and many more. Dr. Sara Polanchek will join John for the parenting portion of the workshop. They will describe essential principles for working effectively with parents, how to conduct brief parenting consultations using a positive, solution-focused model, and strategies for providing parents with specific suggestions and advice to parents. Issues related to ethics and culture will be highlighted and discussed throughout this two-day workshop.

Here’s a link to the registration form for both workshops. Registration Form for JSF Workshops 2018

If you want to call for more information: Call 406-243-5252 and leave a message if our administrative person is away. Or you can always email me: john.sf@mso.umt.edu

April 6 and 7, 8:30am to 4:30pm: Variations on the Clinical Interview: Collaborative Approaches to Mental Status Examinations, Suicide Assessment, and Suicide Interventions

The clinical interview is the headwaters from which all mental health assessment and interventions flow. In this workshop, following an overview of clinical interviewing principles and practice, skills training for conducting the mental status examination (MSE) and suicide assessment interviews will be provided. Participants will learn MSE terminology, common symptom clusters and presentations, and strategies through which the MSE can be more collaborative and user-friendly. Additionally, participants will learn a flexible model for conducting suicide assessments. This model features eight core suicide dimensions and techniques for directly and collaboratively questioning clients about suicide ideations, previous attempts, hopelessness, and more. Five suicide interventions will be featured: alternatives to suicide; separating suicide intent from the self; interpersonal re-connection; neodissociation; and safety-planning.

One last note: On Wednesday, February 14, I’ll be doing my annual 1/2 day workshop on Tough Kids, Cool Counseling in the Schools at the annual meeting of the National Association of School Psychologists (NASP). We’re in Chicago this year. So if you happen to be in Chicago, check out the NASP conference. https://www.nasponline.org/professional-development/nasp-2018-annual-convention

 

 

 

Counseling and Psychotherapy Theory and Practice

Choice Theory/Reality Therapy and Spirituality

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John and Bob Wubbolding 2017 B

Counseling and psychotherapy theories are wildly variable and surprisingly convergent. What do I mean by this? Well, despite the fact that Sigmund Freud and Francine Shapiro and Steven Hayes and Marsha Linehan have very different ideas about what helps people change for the better, there’s also a boatload of commonality.

Based on my narrow range of experience and knowledge, nowhere is there more commonality than the theoretical outposts of Adlerian theory (i.e., Individual Psychology) and Choice Theory/Reality Therapy. Both of these approaches include a broad theoretical concept related to an individual’s personal and cultural construction of how they view themselves, others, and the world (i.e., Adlerians say “Lifestyle” while Reality Therapists say “Quality World”); both perspectives view individuals as pulled forward by internal values (and not driven by Freudian conflicts); both perspectives view behavior as purposeful, and perhaps not coincidently, they also view psychopathology as purposeful.

All this theory-speak is way for me to introduce this post as a continuation of my spirituality and counseling/psychotherapy theories series. What’s especially interesting about this post (IMHO) is that I’m writing about spirituality and Reality Therapy. I mean, how can a form of therapy that explicitly emphasizes “reality,” accommodate “spirituality?” We’ll see about that . . . maybe.

Chapter 9 of Counseling and Psychotherapy Theories in Context and Practice focuses on choice theory and reality therapy. Many people may not perfectly understand the definitions of choice theory and reality therapy. As a quick refresher, here’s an excerpt from the beginning of Chapter 9, followed by the brief spirituality section.

*************

Reality therapy is often oversimplified and confused with confrontational therapeutic approaches. In this chapter we describe and explain the nuances and clarify the confusion.

What is Choice Theory and Reality Therapy?

Glasser developed reality therapy in the 1960s. Later, recognizing that he needed a theoretical foundation for his therapeutic approach, he began exploring cybernetics and control system theory (Powers, 1973; Wiener, 1948). Initially, Glasser used control theory to explain reality therapy. Later, he adapted the theoretical model and shifted to using choice theory (Glasser, 1998).

Choice theory is based on the idea that conscious behaviors are chosen in an effort to satisfy one of five internal basic human needs (Wubbolding & Brickel, 2017). The human mind or brain acts as a “negative input control system,” providing feedback to individuals so that they can correct behaviors and continue getting what they need and want (Wubbolding, 2012, p. 13).

Reality therapy is a present-focused, directive therapeutic approach designed to help individuals identify and satisfy their needs and wants more consistently and adaptively. As Wubbolding (2012) has written, “If choice theory is the track, reality therapy is the train that delivers the product” (p. 5).

Choice Theory, Reality Therapy, and Spirituality

In the 1989 Spring issue of the Journal of Reality Therapy, Brent Dennis, a certified reality therapist, wrote an article titled, “Faith: The fifth psychological need.” Glasser (1989) responded later that year. Glasser noted that he found the discussion interesting, but that there is “no possible way to resolve an argument about belief” (p. 29). He concluded with a statement embracing inclusiveness toward whatever anyone might place in their quality world. Consistent with this perspective, contemporary reality therapists have published book chapters on how to help interfaith and multicultural couples succeed in their partnerships and marriages (Minatrea & Duba, 2012; Olver, 2012). It’s interesting however, that Glasser described faith as residing in an individual’s quality world; he did not embrace it as a new psychological human need.

In an article on integrating reality therapy into Malaysian Islamic culture, Jusoh and Ahmad (2009) described many ways in which choice theory is consistent with Islam and can be practiced in Asian cultures. Specifically, they focused on the WDEP and SAMI2C3 systems and emphasized their compatibility with Islamic concepts. They concluded that “choice theory and reality therapy have universal attributes, and these can be interpreted in any religion or culture” (2009, p. 7). This statement seems consistent with Glasser’s (1989) inclusive statement on spirituality as a potential human need.

Overall, aside from the content briefly summarized here, little information exists on the integration of spirituality into reality therapy. However, given the growing international flavor of CT/RT, progress in this area seems inevitable.

 

Counseling and Psychotherapy Theory and Practice

Behavior Therapy and Spirituality

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1974 Football Cropped II

The whole idea of integrating behavior therapy with religion and spirituality might seem odd or off or impossible. But here in Theories Land, we don’t believe in the impossible. In fact, many religious folks do just fine with behavior therapy and many behavior therapists do just fine with religious folks. If you think about it, for behaviorists, the focus is purely on problematic behaviors. In some ways, this naturally leads to an acceptance of all people . . . .

Put another way, for behaviorists, there’s no room or need for discrimination based on race, sexuality, or religion. Behaviorists work with all people to help them with their problem behaviors.

Rather than digressing into the political, let’s refocus on behavior therapy and spirituality. Here’s the short section from the 3rd edition of Counseling and Psychotherapy Theories in Context and Practice. If you feel moved (by the spirit, or anything else), please let me know what you think.

************

Strict behaviorists don’t believe in the utility of cognition. The clients’ problems are behaviors. Behavioral treatments involve new learning to facilitate behavior change. If you stick with the perspective that cognition is irrelevant—which is the perspective we’re sticking with in this chapter—then client religious or spiritual beliefs are also not relevant.

Considering religious and spiritual beliefs as irrelevant doesn’t imply disrespect for religious and spiritual beliefs. Behaviorists are respectful of beliefs, but the focus of therapy would be on behaviors—these behaviors could include religious or spiritual behaviors. If you’re following the logic here, then you can see that behavior therapy is 100% compatible with religion and spirituality.

The focus of behavior therapy with religious and spiritual clients would be on behaviors that are related to religion and spirituality. From a behavioral model, the question is, “Are your religious/spiritual behaviors causing you distress or contributing to your well-being?” The good news about this is that behavior therapy is an evidence-based approach for modifying behavior, including the development of positive and healthy habits (and behaviors commonly thought of as representing self-control and self-discipline). The focus on enhancing self-control and self-discipline is a good fit for clients with religious or spiritual orientations (Shapiro, 1978).

Researchers have explored the relationship between behavioral activation and client values. In one study, it was found that when individuals with high intrinsic religious values engaged in a greater frequency of religious behaviors, they reported reduced depressive symptoms (Agishtein et al., 2013). Conversely, for individuals with low intrinsic religious values, increasing religious behaviors were associated with more depressive symptoms. In conclusion, despite disregard for religious/spiritual beliefs, a strict behavioral approach can be used to increase or decrease specific religious and spiritual behaviors. . . and increasing or decreasing specific religious and spiritual behaviors may be therapeutic—depending on the individual client and his/her/their situation.

 

Counseling and Psychotherapy Theory and Practice

Person-Centered Spirituality

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Rogerian Spirituality

Most of the distinct figures who developed major theories of psychotherapy also had distinct views about religion and spirituality. As you may recall, Freud was antagonistic toward religion. One of the interesting parts of exploring how each theoretical orientation deals with spirituality has involved learning a bit more about the religious and spiritual perspectives of people like Freud, Adler, and others.

In chapter 5 of Counseling and Psychotherapy Theories in Context and Practice, the focus is on Carl Rogers. Other than knowing that he was raised in a conservative Christian family, I didn’t know much about Rogers and his personal spirituality. Here’s a sampling of what I discovered.

Person-Centered Spirituality

On his journey to developing person-centered theory and therapy, Carl Rogers renounced traditional Christianity. Given that all religions, including Christianity, can be viewed as directly imposing judgmental conditions of worth, Rogers’s renouncing Christianity as antithetical to his beliefs is not surprising. In particular, Rogers may have been especially reactive to religious dogma because of his childhood experiences in an extremely conservative Christian family. Thorne (1990) proposed that Rogers broke from Christianity, at least in part, over the doctrine of original sin.

Although he died an agnostic, toward the end of his life, Rogers began speaking about transcendental or mystical experiences (Thorne, 1992). These spiritual statements were mostly made in the context of interpersonal mutuality and human connection, derived from person-centered or I-Thou experiences. Within the person-centered world, his statements about spirituality have been viewed as controversial (Fruehwirth, 2013). In an interview with Elizabeth Sheerer, one of Rogers’s early colleagues at the University of Chicago Counseling Center, Sheerer was asked about why Rogers never formally addressed spirituality. Her response included:

That’s Carl. This was an area of difficulty for Carl. We learned early in the game not to talk about religion with Carl … it was uncomfortable for him …. But, of course, his work is so profoundly influenced by his background in Christianity. I don’t think he could have developed without that background. (Barrineau, 1990, pp. 423–424)

There have been contemporary efforts to build a bridge between spirituality and PCT. One example is Fruehwirth’s (2013) work connecting PCT and Christian contemplation. He proposed that if wordless contemplation can be regarded as “the heart of the Christian spiritual tradition” (p. 370), then parallels can be drawn to wordless contemplation and the PCT experience. Similarly, a case can be made connecting the acceptance doctrine of Christian, Buddhist, and other religious viewpoints with the PCT process.

Overall, it seems reasonable that, for some therapists and clients, the deep interpersonal acceptance inherent in the PCT experience might have religious, spiritual, or mystical components. Spiritual-based acceptance is probably the main place where an integration of PCT and religion/spirituality can occur. In contrast, wherever and whenever judgment flows from religious doctrine, religion and PCT are incompatible.

 

Counseling and Psychotherapy Theory and Practice, Writing

Existential Spirituality

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Bikes Snow 2

An impromtu word search of the existential theory chapter for the 3rd edition of Counseling and Psychotherapy Theories in Context and Practice revealed 17 appearances of the word “spirituality.” That’s nice. Seventeen is a prime number. Seventeen is also one of my favorite spiritual numbers. Back in 2nd grade in Sunday school in a synagogue in Portland, my teacher asked us to guess a number from 1 to 20. The winner had the honor of taking a special Bible story book home for the week. My guess was a perfect 17. I got the book for the week. Obviously, the number 17 is a spiritual force in my life.

More important is the sublime integration of spirituality into existential theory. Or not. It seems to go one way or another. Either existential theorists are deeply spiritual/religious or they’re atheist/agnostic. There is no middle ground. Or maybe there is? [More on this conundrum below]

What follows are several short excerpts from the Existential Theory chapter. These excerpts culminate with the short section on Existential Spirituality.

Soren Kierkegaard

The Danish philosopher Soren Kierkegaard (1813–1855) lived nearly his entire life in Copenhagen. Kierkegaard was devoutly religious. He was shaken when he discovered, at age 22, that his father had not only cursed God, but also seduced his mother prior to marriage. Subsequently, Kierkegaard’s writings focused primarily on religious faith and the meaning of Christianity. Eventually he concluded that religious faith was irrational and attainable only via a subjective experiential “leap of faith.” For Kierkegaard, virtuous traits such as responsibility, honesty, and commitment are subjective choices—often in response to a subjective religious conversion. Kierkegaard did not describe himself as an existentialist, but his work is a precursor to the existential philosophical movement, which formally began some 70 years following his death.

Friedrich Nietzsche

In contrast to Kierkegaard who began from a position of religious faith, the German philosopher Friedrich Nietzsche (1844–1900) had negative feelings about Christianity. It was he who, in his book Thus Spake Zarathustra, wrote, “God is dead.” Although he may have been referring to societal emptiness, he also claimed that religion used fear and resentment to pressure individuals into moral behavior. Instead of following a religion, he believed, individuals should channel their passions into creative, joyful activities. Irvin Yalom offers a fascinating view of Nietzsche’s psychological suffering in a historical fiction piece titled When Nietzsche Wept. In this novel, Yalom (1992) weaves existential principles into a fictional therapeutic encounter between Breuer, Freud, and Nietzsche.

Kierkegaard and Nietzsche represent an interesting paradox or dialectic in existential thinking. A dialectic is a process where learning is stimulated from the integration of opposites. On the one hand, some existentialists embrace deep religious faith, whereas others are staunchly atheistic. Still others claim an agnostic middle ground. These differences in fundamental beliefs represent a wide sweep of human intellectual diversity and provide for fascinating philosophical exploration. You will glimpse existential dialectics intermittently in this chapter.

Four Existential Ways of Being

There are four primary existential ways of being-in-the-world. They include:

  1. Umwelt: Being-with-nature or the physical world.
  2. Mitwelt: Being-with-others or the social world.
  3. Eigenwelt: Being-with-oneself or the world of the self.
  4. Uberwelt: Being-with-the-spiritual or over world.

Boss (1963), Binswanger (1963), and May et al. (1958) described the first three of these existential ways of being. van Deurzen (1988) added the fourth.

These dimensions of existence are ubiquitous and simultaneous. Some people focus more on one dimension than others or shift from one to another depending on particular intentions or situations. For example, while on a hike up the Stillwater gorge in Montana, it’s easy to experience being-with-nature as water powerfully cascades around you. However, depending on other factors, this experience can take people inward toward eigenwelt, toward an uberwelt spiritual experience, or stimulate a deep mitwelt (albeit a nonverbal one). In most cases, the direction your being-ness moves within a given situation is likely a combination of several factors, such as: awareness, anxiety, previous experiences, intention, and/or your spiritual predisposition.

The Daimonic

According to Rollo May, “The daimonic is any natural function which has the power to take over the whole person” (1969, p. 123). Historically, Daimon possession was used to explain psychotic episodes and is popularly referred to as demonic possession. However, May repeatedly emphasized that daimonic and demonic are not the same concept: “I never use the word demonic, except to say that this is not what I mean” (May, 1982, p. 11).

The daimonic is an elemental force, energy, or urge residing within all persons that functions as the source of constructive and destructive impulses. May wrote, “The daimonic is the urge in every being to affirm itself, assert itself, perpetuate and increase itself .… [The reverse side] of the same affirmation is what empowers our creativity” (May, 1969, p. 123).

Similar to C. G. Jung, May considered harnessing and integrating the daimonic as a central psychotherapy task. He viewed psychotherapy as an activity that plumbs the depths of an individual’s most basic impulses … the purpose of which is to acknowledge, embrace, and integrate every bit of being and energy into the whole person. May commented specifically about the danger of leaving the daimonic unintegrated:

If the daimonic urge is integrated into the personality (which is, to my mind, the purpose of psychotherapy) it results in creativity, that is, it is constructive. If the daimonic is not integrated, it can take over the total personality, as it does in violent rage or collective paranoia in time of war or compulsive sex or oppressive behavior. Destructive activity is then the result. (May, 1982, p. 11)

The goal is to integrate natural daimonic urges and energies in ways that maximize constructive and creative behavior.

Existential Spirituality

A spiritual-oriented client was engaging in guided imagery with an existential therapist. The client “discovered” a locked door in the basement of his “self.”

“What’s behind the door?” the therapist asked.

“It’s darkness,” he said. With shivers of fear, he added, “There’s dread. It’s the dread of being unacceptable. . . of being unacceptable to God. Even worse, it’s my dread of being unforgiveable.”

“Shall we go in?” asked the therapist.

Silence followed.

The therapist noticed his client’s reluctance and said, “Let’s wait a moment and breathe. I’m wondering if you can even get in the door. I’m wondering if you want to get in. There’s no rush. We know where the door is. We can wait. Or we can create a key and try to get in. Or we can leave the door shut. But first let’s wait here and breathe before deciding anything.”

For two minutes, client and therapist sat breathing together. The paralyzing fear diminished and the client said, “I have a key. Let’s look inside.”

“Yes. Let’s look inside.”

The key opened the lock. The door creaked open. In the dreaded darkness, there was light. A dialogue with the dread and unforgiveable ensued and the client found a broad sense of love and acceptance. There were tears of relief. His spiritual load was lightened. His basement demons were exorcised.

In this chapter we’ve discussed the deep and profound quality of existential psychotherapy. Schneider (2010) called it the “Rediscovery of Awe.” Frankl and Wong referred to it as the pursuit of meaning. In existential therapy, meaning and awe are individualized, as is spirituality. There’s great potential in combining the existential and the spiritual in psychotherapy, but clients should be forewarned and informed: combining the spiritual and existential isn’t about formulaic or surface explanations; it requires a commitment to go deep and explore doubts, uncertainties, and core vulnerabilities.

Here’s a link to the new Theories 3rd edition cover: https://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/1119279127/ref=dp_ob_title_bk

 

 

Cool Counseling, Tough Kids Cool Counseling

What’s Good About West Virginia?

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The easy and short answer to the “What’s Good About West Virginia?” question is: Chris Schimmel, Ed Jacobs, and Sherry Cormier. The harder and longer answer is harder and longer and consequently won’t be answered here.

This post includes two educational content-pieces related to my presentation today at the Morgantown Art Museum, but that we don’t have time to cover.

What’s Good About You?

            [This excerpt is adapted from our Tough Kids, Cool Counseling book]

About 25 years ago, in collaboration with a colleague of ours, Dudley Dana, Ph.D., we began using a relationship-building assessment procedure that can provide a rich interpersonal interaction between young clients and counselors.  The procedure is called “What’s good about you?” It’s designed primarily as an informal assessment of self-esteem. Depending on the age of the child with whom you’re working, you can introduce it as a game with specific rules:

I want to play a game with you. Here’s how it works. I’m going to ask you the same question 10 times. The only rule is that you can’t use the same answer twice. So, I’ll ask you the same question 10 times, but you have to give me 10 different answers.

When playing this game all you need to do is get out a tablet or clipboard with paper and then ask your client, “What’s good about you?” Your client may moan and complain about this game.  You can empathize, but encourage full participation.  This assessment activity should be done at a point in counseling when you know your clients well enough to provide a few genuine positive statements in case they can’t come up with anything good to say about themselves.

After your client responds to the question say, “Thank you” and smile and write down whatever was said, while repeating the statement out loud. If your client says, “I don’t know” write that response down too, but add with a smile, “I’ll write that down, but you can only use that answer once.”

The “What’s good about you?” game will provide you (and perhaps your clients) with interesting insights into client self-perceptions and self-esteem. For example, some youth have difficulty clearly staking claim to a positive talent, skill, or personal attribute. They sometimes identify possessions like, “I have a nice computer” or “I have some good friends” instead of taking personal ownership of an attribute such as, “I’m a great skate-boarder,” or “My friendly personality helps me make friends.” Similarly, they may describe a role they have (e.g., “I’m a good son”), rather than identifying personal attributes that make them good at the particular role (e.g., “I’m thoughtful and very responsible and so I am a good son”). Obviously, the ability to clearly state one’s positive personal attributes may be evidence of higher or more intact self-esteem.

You can also gather interpersonal assessment data also through the “What’s good about you?” procedure. For example, we’ve had some assertive or aggressive children request or even insist that they be allowed to switch roles and ask us the “What’s good about you?” questions. We always happily comply with these requests because they:

  • provide us with a modeling opportunity,
  • provide clients with an empowerment experience, and
  • are a sign of engagement.

Additionally, the way young clients respond to this interpersonal request can be revealing.  For instance, youth who meet the diagnostic criteria for conduct disorder (or who are angry with adults) sometimes ridicule or mock the procedure, while most other children and adolescents cooperate and seem to enjoy the process. See Box 2.1 for an interesting example of using this procedure with a multicultural client.

The What’s Good About You Activity in a Multicultural Context

While implementing the What’s Good About You activity with an Japanese American teen, I (John) recently had the opportunity to directly experience multiple and contextual levels of identity in a Japanese American teenage client. Specifically, when asked to respond with 10 different answers to the question, “What’s good about you?” the 15-year-old boy responded with a direct and assertive refusal. He said, “I’m not comfortable with that. We don’t talk like that in our family?” Upon hearing his refusal, I immediately accepted his position and fortunately, he was willing to share his perspective with me. He made it clear that making positive statements about oneself was inappropriate, not only in his family, but also within his Japanese culture. Interestingly, he noted that his Japanese mother and White father were both especially encouraging of him to raise his self-esteem and wanted him to be able to say positive things about himself. However, he tended to find their efforts demeaning in the sense that he felt they were worried about him and his self-esteem—which just made him even less willing to say positive things about himself (after all, if they really thought he was so wonderful, why then, did they need to keep telling him that as if he needed it). At the same time, he also expressed an interest in being able to display more confidence in social situations—similar to his White American friends. This situation illustrates how tensions can arise between cultural identity, familial context, social context, and personal or individual distress and how it is the counselor’s responsibility to negotiate these various tensions, without judgment, in partnership with the client or student.

Here’s a link to the video of me doing “What’s good about you?” with  a 16-year-old girl. The audio isn’t great, but the process is very interesting: https://www.youtube.com/edit?o=U&video_id=4GtfO-rBIIg

The Three-Step Emotional Change Trick

For a description and video demo of the Three-Step Emotional Change Trick, go here: https://johnsommersflanagan.com/2017/03/12/revisiting-the-3-step-emotional-change-trick-including-a-video-example/

Cool Counseling, Therapy with Adolescents, Tough Kids, Tough Kids Cool Counseling

Upcoming Workshops: L.A., Chicago, Morgantown, and Greensburg (outside Pittsburg)

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Rainbow 2017

October is almost always a big month for counseling and psychology conferences and workshops. This October is no exception. I’m posting my October workshop presentation schedule here, just in case you want to say hello and possible collect some continuing education credit.

On Thursday, October 5, I’ll be in Orange County for the California Association for School Psychologists conference. Here’s a link: https://event.casponline.org/#intro

On Sunday, October 8, I’ll be in Chicago for the Association of Counselor Educators and Supervisors to present on the Mental Status Examination with Thom Field of the City University of Seattle.

On Thursday, October 12, I’ll be in Morgantown, WV for an afternoon workshop with counseling and psychology students from West Virginia University.

On Friday, October 13, I’ll be in Greensburg, PA (just outside Pittsburgh) for an all-day workshop sponsored by Indiana University of Pennsylvania. The link: https://www.iup.edu/counseling/centers/upcoming-workshops-and-events/

Today is the first day of Autumn . . . I hope this signals the end of hurricanes, floods, fires, and other challenges so many people are facing.

 

Counseling and Psychotherapy Theory and Practice

Evidence-Based Relationship Factors in Counseling and Psychotherapy

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The medical model of psychotherapy . . . has led us to accept a view of clients as inert and passive objects on whom we operate and whom we medicate. Gene V. Glass, in The Great Psychotherapy Debate, 2001, p. ix

John and Max Seattle

In a 1957 publication in the Journal of Consulting Psychology, Carl Rogers boldly declared:

  1. No psychotherapy techniques or methods are needed to achieve psychotherapeutic change.
  2. Diagnostic knowledge is “for the most part, a colossal waste of time” (1957, p. 102).

Let’s pause for a moment and reflect on what Rogers was saying.

**PAUSE HERE FOR SERIOUS REFLECTION**

If diagnosis is a waste of time and therapy techniques are unnecessary, then what can counselors or therapists do to produce positive outcomes? Here’s what Rogers said:

All that is necessary and sufficient for change to occur in psychotherapy is a certain type of relationship between psychotherapist and client.

Rogers’s revolutionary statements refocused counseling and psychotherapy. Until Rogers, therapy was primarily about theoretically based methods, techniques, and interventions. After Rogers, writers and practitioners began debating whether the relationship between client and therapist—not the methods and techniques employed—might be producing positive therapy outcomes.

This debate continues today. Wampold (2001) has called it “the great psychotherapy debate.” This debate has been boiled down to a dichotomy captured by the question: “Do treatments cure disorders or do relationships heal people?” (Norcross & Lambert, p. 3).

Keep in mind that like lots of things on planet Earth, the techniques vs. relationship debate promotes a false dichotomy. IMHO, most “rational” professionals understand that therapy relationships and techniques are BOTH important to positive outcomes. Seriously, how could it be otherwise?

But there is a positive outcome from this debate. Various researchers around the world started focusing on how to define specific relationship factors that contribute to counseling outcomes. Previously, these relationship factors were lumped into a category called “common factors.” Common factors were viewed as the main reason why all therapy approaches tend to produce approximately equal positive outcomes.

Flowing from research on common factors, one of the most fascinating and important movements in counseling and psychotherapy is now called, “Evidence-based relationships” (Norcross, 2011). As it turns out, there’s a large body of existing and accumulating research to help us clearly identify what’s relationally therapeutic.

In the attached link, you’ll find the powerpoint slides that Kim Parrow and I developed for a supervisor training yesterday, at the University of Montana. Our goal was to describe, demonstrate, and discuss 10 specific and observable relationship factors that contribute to positive counseling outcomes. We call them Evidence-Based Relationship Factors (EBRFs). They include:

  1. Congruence
  2. Unconditional positive regard
  3. Empathic understanding
  4. WA1: Emotional bond
  5. WA2: Goal consensus – Focus on strengths
  6. WA3: Task collaboration
  7. Rupture and repair
  8. Countertransference (management)
  9. Progress monitoring (feedback)
  10. Culture and Cultural Humility

The link at the bottom of this post will take you to our powerpoint slides. Also, for more information, you can always check out various theories textbooks, including Counseling and Psychotherapy Theories in Context and Practice (from which this blog was adapted). https://www.amazon.com/Counseling-Psychotherapy-Theories-Practice-Resource/dp/1119084202/ref=sr_1_1?ie=UTF8&qid=1504292029&sr=8-1&keywords=counseling+and+psychotherapy+theories+in+context+and+practice

EBRFs for Supervisors 2017 FIN

Counseling and Psychotherapy Theory and Practice, Uncategorized

Counseling Theories Lab Activities

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With Wubbolding

Hi All.

Below I’m pasting links to a variety of lab activities that I’ve used in teaching Counseling and Psychotherapy Theories. Although I’ve got a textbook that I’d love you to use: http://www.wiley.com/WileyCDA/WileyTitle/productCd-1119084202.html, this post is about free stuff that I’m happy to share to help make your theories teaching experiences more practical and more fun.

Here are the activities:

This is a short guide to conducting an Adlerian Family Constellation Interview: Chapter 3 Family Constellation Interview and Earliest Memories

This is a short guide for doing and debriefing a person-centered interview: Chapter 5 Person Centered Activity

Dreamwork can be enlightening. This guide helps students explore each other’s dreams: Chapter 6 Jungian and Gestalt Dream Work

This handout helps your students practice conducting a behavioral or cognitively oriented symptom interview. Chapter 7 Analyzing Symptoms Interview

This isn’t really an activity, just a sample Ellis ABCDE form. Chapter 8 Ellis ABCDE

These two handouts provide tips for doing a CBT Six Column intervention, as well as a sample Six Column form, filled out using an angry teen example. Chapter 8 Six Column CBT Tips  and Chapter 8 Six Columns Youth Anger Example

Here’s a video clip (just a snippet) of me doing a CBT example:https://www.youtube.com/watch?v=LQ8hNDHoyDU

This is an interview activity to give students and role-play clients a taste of solution-focused interviewing: Chapter 11 Solution-Focused Activity

I hope these materials are helpful for you. As always, if you have feedback to share, you can share it on this blogsite or via email: johnsf@mso.umt.edu

 

 

 

 

 

 

 

 

Counseling and Psychotherapy Theory and Practice, Personal Reflections

When the Yellow Grows into Gold and Happy Breaks Out

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Lower Grove Creek 7 14 17This morning the clock said 3:51am. My lungs felt refreshed. Then a memory from last night bubbled up. You know how they do.

Rita and I discovered mold in our garden. It was yellow and green and it shared its spores with my lungs before we recognized or best option: retreat inside to formulate our battle plan in response  to the attack of the multicolored mold.

Google was waiting. All the postings were about White mold or Black mold, or even yellow dog-vomit mold. Nothing fit our mold. I read with great and trepidiacal interest of a U.K. man who died from inhaling compost mold; my lungs were burning. Not good.

But sleep came.

Then 3:51am came.

And then the thoughts came.

At 3:52am it seemed odd that I could hear my pulse in my ear on the pillow. It seemed fast. That U.K. man had a rapid pulse. I could either choose to lift my head and take my pulse and while waiting for the digital clock to move to the next minute, or I could look at my fit bit. But my fit bit is charging. But I decide, anyway, to roll over and grab it and attach it to my wrist and look at the pulse rate. It flashes, 113. Not good. I check again, 112. Not good. Not normal. I compulsively check again, 111. The fit bit is probably still adjusting, now it’s 109. Stop checking, the voice in my head says. Let it be. Let it settle. Thirty seconds later, it’s 55. I am normal again.

At 3:54am, I find another troubling thought. Today is July 14, 2017. My Theories text revision is due in 31 days. I have five more chapters to revise. That’s six days per chapter. Plus references. Plus table of contents and preface and . . . . Not good. I’m a bad author.

At 4:12am, I’m up, turning on the computer. I’m a bad author and a bad husband and a bad father and a bad friend. All I do is write meaningless drivel that maybe 12 people a year will read and then immediately forget. Forgettable, I am. Even my own students can’t answer my pop theories quiz questions when they drop by my office. I wonder why they don’t stop in so much anymore.

Good thing I’m revising CBT today. God and Albert Ellis know, I sure as Hell need it.

One of today’s content areas is called, Thinking in Shades of Gray. It’s a description of a cognitive technique to help people get out of destructive, irrational, and maladaptive black-white (aka polarized) thinking. It’s boring. Of course it’s boring. Shades of gray? It’s a technique to help with depressive thoughts. I can hear the Albert Ellis voice in my head. WTF? You work with depressed people and you teach them how to think in shades of gray. What the Holy Hell are YOU thinking?

Later this morning, as I ride through Lower Grove Creek with yellow flowers and the Beartooth Mountains looming, I stop for a photo. There are no cars, no deer, and not even a trace of fungal spores. Just me and my breath and my bike and the yellow flowers and shades of gray, black, and white rising above. Why are there no colors in the shades of gray activity? There’s more to our thinking (and our client’s) thinking than black, white, and gray. Today, with the wind in my face and Tippet Rise to my starboard, I want to be an art therapist. “Let’s put a little yellow there,” I say. And the yellow grows into gold and happy breaks out.

But sooner or later, you and I know. We. Know. The yellow will catch dust and lose its sparkle and turn to mold, until a future morning at 3:51am, when a red seed of awareness gets planted among the anxiety bushes and purple flowers bloom, replacing the moldy browned-up yellow, and then we will remember. We have been here before. And it was wondrous and terrible and everything in between.

At that point, it’s not a bad idea to find your fit bit, take your pulse, and embrace the ever disintegrating now that is morning. You have your next 31 days and I have mine. Let’s meet somewhere in the middle and celebrate the next disintegrating now with all the passion and monotony we can muster. You know we can. We’ve done it before.