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Defining features of counseling psychology: |
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3 central roles 1. remedial 2. preventative 3. developmental/educative 4. social justice/advocacy |
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1) Focus on intact or ÒwellÓ people. 2) Focus on strengths and positive mental health 3) Brief interventions 4) Person environmental interactions 5)Vocational development |
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Training and characteristics of CP training programs |
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1) Training 2)Scientist practitioner model 3) Licensure |
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Professional distinctiveness and overlap with other professions |
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1)Clinical psychology abnormal bx, troubled people in hospitals, medical model 2) Community psychology view threats to mental health at social environment 3) School psychology help kids learn more effectively, adjustment/emotional 4) Industrial/organizational psychology maximize effectiveness of organization 5) Clinical social workers (MSW) less research/vocational concerns, more field 6) Psychiatrists MD 7) Counselors practitioners, less research |
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Rules and laws of a profession, Protect the public/counselors, Provide quality services, Training mandated by APA, Clarify the role, Consistency of care, Ethical code. |
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Ethics code applies to ALL professional roles, ONLY applies to professional roles, Lack of awareness/misunderstanding is not a defense of unethical conduct, If ethical code is more strict than law, follow code, If law vs code is tangled, follow law such as confidentiality |
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Like a mission statement, Aspirational, Nonenforceable, Highlights the spirit of Ethics Code, Òcommitted to increasing scientific and professional knowledge of behavior and peopleÕs understanding of themselves and others, use knowledge to improve conditions of individuals, organizations, and societyÓ |
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General principles of Intro and Preamble |
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Benefice and nonmaleficence= Do good; do no harm, Fidelity and responsibility Establish relationships of trust, Be a responsible professional, Integrity= Accuracy, honesty, and truthfulness, Justice= Promote fairness, Respect for peopleÕs rights and dignity= Right to confidentiality, privacy, and autonomy Ethical standards= enforceable, broad not exhaustive |
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Ethical Standard 1: Resolving ethical issues |
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Mandated to attempt to resolve ethical issues, No reckless allegations, If conflict with the law, follow more strict rule, CanÕt discriminate against another psychologist in hiring/promotion because of prior ethics complaint |
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Ethical Standard 2: Competence |
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Know boundaries, Be aware of own unresolved issues |
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Ethical Standard 3: Human relations |
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Avoid harmful dual relationships, exploitative (power) rlx |
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Ethical Standard 4: Privacy and confidentiality |
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Maintain, given limits by law, Discuss limits with individuals prior |
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Ethical Standard 5: Advertisements and public statement |
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No false statements, No testimonials from former clients permitted |
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Ethical Standard 6: Record keeping and fees |
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Must discuss fee structure with clients, donÕt misrepresent fees, Keep records stored in safe place |
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Ethical Standard 7: Education and training |
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Comprehensive current training, Treat students ethically, No sex with students or supervisors |
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Ethical Standard 8: Research and publications |
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Consent, Do not offer excessive incentives |
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Ethical Standard 9: Assessment |
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Ensure assessments have good evidence to support their use and are appropriate for client issue and culture |
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Ethical Standard 10: Therapy |
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Informed consent, If client is in treatment elsewhere, discuss with client, work to minimize confusion, If you need to interrupt therapy, make efforts for continuation, Terminate when therapy has reached natural conclusion, Prior to termination, provide pre-termination counseling, referral if needed, No sex with clients, former clients (2 years following and then only in unusual circumstances), relative/friends of clients |
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ABCDE Ethical Decision Making Model |
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Assessment- what is problem Client, therapist, relationship or other stakeholderÕs needs, Benefit- what would benefit the stakeholders and minimize harm, Consequences and consultation- you should consider the therapeutic, legal and ethical consequences of your action in your response to an ethical dilemma, Duty and documentation- your main responsibility is to the client and not to anyone else, Education- Review education |
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3) Therapy Relationship: Prochaska & Norcross (1999): 3 ways counselor-client relationship is thought to contribute to client change. |
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Pre-condition for therapy to proceed basic agreement on goals, commitment to the work. Primary source of content-to be talked about and processed in therapy. Essential process-the relationship itself is the agent |
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joining of clientÕs observing side with counselorÕs working side (which is also therapistÕs observing side) for the purpose of facilitating the work of therapy. Client= I'm depressed. Therapist= here's your problems and my opinion and here is what you have to do. |
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Agreement between counselor and client on the goals of counseling. Agreement about the tasks of the work. The emotional bond that forms between the participants. Strength of alliance positive therapy outcomes. |
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Transference/countertransference |
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Transference- clients distorted perceptions of the therapist. Countertransference-the therapistÕs distorted reactions to the client. Always an error. Can be positive or negative. Unconscious. Usually represents areas of most unresolved conflicts |
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Developmental sequence of the relationship |
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Working alliance should be established early. Transference can develop at any point. Real relationship is there from beginning but it grows and deepens overtime. Figure and ground. Facilitative conditions of the relationship. Tripartite model-Each of these factors affect the relationship. |
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Theory of the person vs theory of the treatment process Theory of the person: belief about how people develop. Theory of the treatment process: belief about how to treat people |
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The terms drive theory and drive reduction theory refer to a diverse set of motivational theories in psychology. Drive Reduction Theory, developed by Clark Hull in 1943, was the first theory for motivation (Dewey, 2007). Drive is an Òexcitatory state produced by a homeostatic disturbanceÓ |
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ego is your current state, superego is the state you want to be at, the id is what is stopping you from reaching your id, it is your basic pleasures and desires. Defense is part of yourself that tries to prevent anxiety, depression or any other disorder. |
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psyche grows in relation to environment. Object relations theory within psychoanalytic psychology describes the process of developing a psyche as one is growing up, in relation to others in the environment. Based on psychodynamic theory, the theory object relations suggests that people relate to others and situations in their adult lives as shaped by family experiences during infancy. Attachment theory and interpersonal theory |
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behavior is motivated by unconscious. Everything a client says/does has meaning. Unconscious is developed in your childhood. |
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PT- Genetic development hypothesis |
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personality is shaped by past: experiences in childhood |
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PT-Repetition and transference |
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repeat life patterns. If your parents always say you are a bad child, may make you feel like a worthless person. Or if you were abandoned as a child you will also be abandoned as an adult. |
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transference and counter are central |
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key technique. how the counselor is interpreting the client is very important in this field. |
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key internal mechanism for change |
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something you are aware of. for instance "i like this because it makes me happy because itÉ" |
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forces outside our awareness motivate behavior "motivated for no reason" |
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part of our mind that is underneath the conscious "this makes me feel good, i don't know whyÉ" |
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not allowing painful material into consciousness |
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behaving in ways consistent with earlier happier stage |
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PT Defense: Identification |
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copying anotherÕs characteristics |
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thinking that other people have same thought or feeling |
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PT Defense: Reaction formation |
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acting opposite to how one really feels |
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changing unacceptable impulses to socially appropriate ones |
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PT Defense: Rationalization |
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come up with justifications |
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Talking cure, Developmental explanations (how childhood can impact adulthood),Understanding of mental disorders, unconscious/concious |
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Cross cultural limitations not taken into considerationsNot evidence based practices, length |
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Democratic ideal, belief in the worth and dignity of all people/ Fundamental predominance of the subjective- emotional, internal world is dominant in healthy functioning. Tendency toward growth and actualization- people have the innate tendency toward growth and actualization. Essential trustworthiness of persons- people are inherently good, rational, trustworthy, and constructive. Value of an authentic human encounter in the present- being real is very important, here and now. Necessity of scientific methods accommodating the human experience- research and a variety of methodologies should be used to capture richness of human behavior |
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RogerÕs theory of personality development. Actualizing tendency the nature of all things is to fulfill their potential. Organismic valuing process (OVP) innate internal process that tells us what is good/bad. Helps us actualize. Healthy people have highly functioning OVP |
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Gap between real/ideal selves is threatening. Incongruent person uses defenses to reduce the perceived gap and minimize anxiety. Denial (Freudian denial + repression= you will deny the feelings and try to act the way you felt before the feelings arose). Perceptual distortion (Freudian rationalization + intellectualization= you will come up with ideas to rationalize certain feelings) |
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Characteristics of fully functioning people- |
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Accurate perceptions of reality (nondefensive). Live in here and now. Trust themselves. Take responsibility for actions/life. In touch with organismic experience. Use OVP to seek out what is best for them. Congruent. Naturally actualizing and growing |
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Characteristics of nonfully functioning people |
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To actualize and reach potential, people need unconditional positive regard. In reality, people tend to receive conditions of worth (COW)Imposition of cow, OVP becomes weakened or even disabled. Overreliance on others. Creation of ideal self. Incongruence= distance between oneÕs real and ideal self. Deny and repress organismic experience. Compelled by COW to seek out what other say is best for them. Split between real and ideal selves. Uses defenses to avoid awareness of incongruence |
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How therapy is supposed to work |
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Person has to become aware of their distorted and denied experiences. To become healthy a person has to Reduce conditions of worth and Increase positive self regard by obtaining unconditional positive regard from another and internalize it |
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Necessary and sufficient conditions |
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Client and therapist must be in psychological contact. Client must be in state of incongruence. Therapist must be congruent (genuine) in the relationship with the client. Therapist must feel unconditional positive regard for the client. Therapist must have empathy. Client must experience therapists empathy, unconditional positive regard, and congruence |
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Strengths and limitations of Humanistic Approach |
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Theory include the focus on both the positive nature of humankind and the free will associated with change. The biggest criticism of humanistic thought appears to center around its lack of concrete treatment approaches aimed at specific issues. With the basic concept behind the theory being free will, it is difficult to both develop a treatment technique and study the effectiveness of this technique. |
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Beliefs of Gestalt therapists (assumptions) |
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Self actualizing tendency- humans have a natural tendency to self actualize. Humans function as wholes not parts. Personality consists of many polarities: everything needs to work together to work in harmony.Ecological interdependence- differentiating self from other, connecting self and other. Human regulation is based on acknowledgement of what is vs what should be. Maturation: the process of moving from environmental support to self support. All people are responseable for themselves. Healthy live in here and now. People need to be open to self- discovery and happens through experience |
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What happens to interfere with the actualizing tendency |
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Maturation: transcendence from environmental support to self support. Parents can impede: Undersupport, Critical imposing. Oversupport- Can lead to phoniness and game playing |
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Role of counselor- Create an atmosphere that promotes a clientÕs exploration of what they need in order to grow. Therapist must be intensely and personally involved with the client and be fully honest. Process that is occurring between therapist and client and on clientÕs nonverbal behavior. Any slip out of here and now is an indication of resistance to something in the present. Now=experience=awareness=reality Increase awareness: not only self knowledge, but a direct knowing of the current situation and how the self is in the situation. Focus on responsibility. Help client become whole and integrated |
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Confrontation= very honest, Exaggerated movements, Two chair technique. Empty chair technique. Concentrate on non-verbal level |
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Holistic and optimistic approach to mental illness. Focuses on aspects of human existence. Tries to integrate humanism and empiricism |
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Sometimes frustrates clients because it doesnÕt directly provide tools, client must find themselves.May exclude certain phenomena. Lacks objective measure of behavior beyond self report. Sometimes impossible to be totally understanding |
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Nine basic assumptions of behavioral and cognitive approaches- |
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Focus on overt (outside, obvious) behavior, behavior is learned and can thus be unlearned and relearned, Most effective treatment integrates cognitive and behavior approaches, Focus on present, Focus on symptoms and presenting problem, Importance of clear and specific goals for treatment, Counselor plays active, directive, and prescriptive role, Client counselor relationship is important to counseling and therapists aspire to be warm and empathetic but it is not sufficient for constructive change. Research |
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Common techniques (Three CÕs) |
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Counterconditioning= Systematic desensitization , Assertiveness and social skills training, Stimulus control. This replaces and changes behavior. Contingency management/ contracting- Cognitive-behavior modification |
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Assumption: clientÕs self talk shapes their problems. So, need to change what messages clients give themselves. Concepts= Cognitive structures: our assumptions and beliefs about ourselves Òim no goodÓ. Cognitive processes: automatic and we are not always aware of them. How we appraise events, selectively attend to or not attend to information Òselectively attend to failureÓ. Cognitive events: the messages we give ourselves Òsee, you screwed up again, like you always doÓ Evaluating the validity of clientÕs thoughts and beliefs. Assessing what clients expect and how they interpret their own behavior and that of others. Exploring what might be a range of causes for clientÕs behavior and otherÕs reactions. Training clients to make more effective attributions about these causes. Altering absolutistic, catastrophic thinking styles |
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Beck's Maladaptive cognitions/thoughts: Overgeneralizing |
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if its true in one situation its true in any |
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Beck's Maladaptive cognitions/thoughts:Selective abstraction |
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only events that matter are failures |
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Beck's Maladaptive cognitions/thoughts:Excessive responsibility |
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I am responsible for all bad things |
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Beck's Maladaptive cognitions/thoughts: Self-references |
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I am at the center of everyoneÕs attention especially when I fail |
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Beck's Maladaptive cognitions/thoughts: Dichotomous thinking |
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everything is either black or white |
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Albert Ellis's ABC Theory |
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Activating event --> Belief --> Consequence. Changing beliefs that lead to maladaptive consequences is done by Disputing peoples irrational beliefs. This process leads to an Effective new philosophy. Examples of very common irrational beliefs in western culture: I canÕt tolerate certain events e.g. facing criticism, waiting in traffic, being rejected (when in fact we can stand them even though they are unpleasant). and My worth is determined by success or failure (e.g. income) and traits such as income, World should treat me fairly |
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Albert Ellis' 3 types of irrational thinking |
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musterbating, "such and such MUST happen", catastrophizing, " If this happens or doesnÔt happen, it would be terrible and a catastrophe" and absolutist thinking "It will never be right again, this always happens to me, etc." |
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Generated by research, strong tie with biology, Relatively fast treatment, Provides clients with tools and hw to improve |
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Oversimplifies and overemphasizes role of behavior and Can neglect more existential elements of mental illness and history |
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