Page 1
1
1
INTERVENTION SYSTEMS
EMPHASIZING BACKGROUND - I
Unit Structure
1.1 Sigmund Freud - Classic Psychoanalysis
1.1.1 Process of Therapy
1.1.2 Therapeutic Techniques
1.1.3 Strengths and Weaknesses
1.3 References
1.1 SIGMUND FREUD - CLASSIC PSYCHOANALYSIS Sigmund Freud, an Austrian psychologist, is regarded as father of
psychotherapy. He developed a traditional psychotherapy, which is also
called as id Psychoanalysis, in early 1900. In this technique, the client
would lie on a couch, and the therapist would seat o n a chair, where the
client could not see him. Client would say whatever that came to his mind
and the therapy would continue. The term psychoanalysis was first used
by Freud in 1896 paper. Classical psychoanalysis is grounded on id
psychology; it believes that instincts and intrapsychic conflicts are the
basic factors that shape development of personality.
a) Structure of Personality :
According to Freud, Personality has three systems: the id, the ego, and the
superego. These separate structures of the p ersonality work together as the
internal forces that form one’s personality.
i) The id:
Id is present at birth and it is largely unconscious, that is, out of
awareness. The id is the biological component. It can be described as
amoral, illogical, blind and demanding. It works on pleasure principle,
avoiding pain and gaining pleasure. Id cannot stand tension, thus it aims at
relieving the tension immediately. For gaining pleasure, Id uses two
strategies - reflex actions and primary processes. Reflex actions c onsist of
automatic processes that reduce tensions, such as tickle in throat.
Sometimes, people form a mental image of something which is a solution
to their problem - it is called as wish fulfillment. According to Freud, our
dreams work on this function by providing a wish -fulfillment image.
Id includes inherited systems, called as Instincts. Drive theory or instinct
theory is Freud’s dynamic approach to human psychology. Sigmund Freud
believed that humans are filled with a psychic/ mental energy. This ener gy
comes from two sources - Life instinct (Eros) and death or destructive munotes.in
Page 2
2 Intervention Systems Emphasizing Background - I instinct (Thanatos). Like good and evil, Thanatos and Eros are in
opposition to each other.
Life instincts seek to avoid pain and gain pleasure. One important aspect
of life instinct s or Eros is Libido. Libido is present at birth. Initially, it
was defined by Freud as sexual desire, but now it is also considered as a
zest for life, energy, vitality. Wish for sexual fulfillment is still one of the
important facets of life instinct. Th e death instinct (Thanatos) has its roots
in aggression and other destructive forces. Freud wanted to explain about
the human tendency toward destruction that overrides the pleasure
principle through death instinct. According to Freud, both sexual and
aggressive drives are powerful factors determining one’s behaviour.
ii) The Ego:
The ego is not present at birth like Id, but it evolves later when a child
realizes that it is separate, different from its mother. This ego works on
reality principle. It regula tes and organizes our personality by acting as a
mediator within its structure. It tries to maintain a balance between Id and
Superego, while still considering their needs. Ego takes decisions in a
realistic and logical way.
iii) The superego:
It is an exa ct opposite of Id. The learning from our parents, teachers,
society, traditions, and culture contribute to the development of superego.
Superego is a strict conscience that internalizes standards, rules,
guidelines, moral values etc. It strives for perfect ion and differentiates
between good and bad, right or wrong choices, actions. Superego
functions to control drives and impulses of id, but it is very controlling and
represents ideal, and not real. When a child is growing up, self -control
takes place of pa rental control when superego is forming. When one
follows moral code of superego, it can make one feel proud; when one
ignores directions of superego, it can lead to guilt, anxiety and shame.
There are two parts of the superego: Conscience and Ego -ideal. T he
conscience develops as a result of prohibitions of parents. The ego -ideal is
a positive desire to imitate adult standards of behaviour.
b) Stages of Development:
According to Freud, psychosexual stages are chronological phases of
development. Stages in the first five years of life are very important as
they determine development of personality in later life. Following are the
five psychosexual stages:
i) The oral stage (Birth to about one year of age):
Oral stage is the first stage, which mouth is the m ost important zone for
the baby to seek pleasure. It is because eating, sucking are important
actions to sustain in life. In this period, biting is a way to show aggression.
Mouth becomes child’s first erotic zone. Problems in this stage could later munotes.in
Page 3
3 Intervention Systems In Psychology result in symptoms such as overeating, oral aggressiveness. It also deals
with inability to trust oneself and others.
ii) The anal stage (between the age of 18 to 36 months):
This is the second stage, where the zone for gratification shifts from
mouth. Child get s social pleasure by impressing the parents and the
physical pleasure by emptying the bowels. In this stage, parents who try to
do toilet training using punishment and restrictions are likely to promote
compulsive, controlling characteristics in their chil dren. Parents who use
praise and rewards after appropriate behaviour are likely to promote
creativity. This stage deals with the inability to recognize, express anger.
iii) The phallic stage (between the age of 3 to 5 years):
This is the third stage, of w hich Freud believed that it is complex and
highly related to adult sexual relationship. Genitals become one’s source
of gratification and masturbation; sexual fantasies are developed. It deals
with an inability to completely accept one’s sexual feelings, s exuality and
accept oneself as a man or woman. Self -esteem, self -image, need for love
and approval, feelings toward authority figures and sense of initiative are
evolved during this stage. At this stage, children develop unconscious
sexual desires for a pa rent of the other gender. Children also have an
unconscious wish to remove the parent of the same gender as it is seen as
an obstacle in a child’s first desire. For example, a boy having
unconscious sexual desire about his mother, and wishing elimination o f
his own father. In boys, this is called as Oedipus complex. This name has
come from Greek literature, where a boy unknowingly married his own
mother.
The parallel situation in girls is called as Electra complex. This too has
come from Greek literature where a woman had feelings of love towards
her father. Freud believed that fear of retaliation or punishment from the
father leads to boys developing castration anxiety. Castration anxiety lets a
male child repress his feelings for his mother and identify with his father,
which is an appropriate resolving of the feelings. Instead of castration
anxiety, girls have penis envy; in which girls become resentful or jealous
cause of not having a penis. Girls too, resolve this problem by identifying
with their mot her.
iv) The latency stage (between the ages 5 to 11 years):
This is fourth stage, which is considered as a comparatively quiet period in
child’s sexual development. Social interest increases and sexual drive
becomes less important. Children engage in ac tivities such as making
friends, developing hobbies etc.
v) The Genital stage:
This is the final stage, which continues after latency stage through the life
span from adolescence. One’s personal identity is strengthened, feelings of munotes.in
Page 4
4 Intervention Systems Emphasizing Background - I altruism, care are dev eloped towards each other, positive and loving
sexual relationships are developed.
During these developmental stages, if a child’s needs are not sufficiently
met, later in life that person may become fixated at that particular stage,
and behave in psychol ogically immature ways. A fixation or complex can
be defined as an unresolved unconscious conflict.
c) Levels of Consciousness:
Levels of consciousness and the concept of unconscious are considered as
Freud’s greatest contributions, which help us to unders tand human
behaviour and personality. There are the following three levels of
consciousness, according to Freud:
i) The Conscious is material in awareness, which is available to us all
the time. The preconscious contains the information which may not be
part of current awareness but which can be readily obtained. This
information can be aversive (for example, the memory of painful
treatment and hospitalization, after hearing siren of ambulance) or
benign.
ii) The unconscious level contains memories that are highly charged.
They include impulses, repressed drives. When these experiences are
recalled, they may be so unacceptable, unpleasant that they are not
allowed in preconscious or conscious level. Psychoanalysis can bring
memories from unconscious to c onsciousness. According to Freud,
unconscious contained a lot more memories than the preconscious or
the conscious. There are certain ways in which we can access material
from unconscious mind. First way is our dreams. Dreams are
considered as symbolic re presentations of our unconscious needs,
conflicts and desires. All dreams are considered important - the dreams
try to satisfy impulses, desires that are not fulfilled while being aware.
Second process where unconscious is revealed includes slips of
tongue, errors, omissions, poorly performed tasks & forgetting, which
have latent meaning. A misstatement that tells an unconscious desire
or feeling is called as Freudian slip. There are some other ways too,
such as information obtained from free association, p rojective
techniques, posthypnotic suggestions & the symbolic information
obtained from psychotic symptoms.
iii) The preconscious level refers to something that one is not currently
aware of but could be brought into consciousness at any given
moment.
d) Anxiety and Defense Mechanisms:
According to Freud, humans try to reduce tension and anxiety. Anxiety is
important concept in the psychoanalytic approach. According to Freud,
there are three kinds of anxiety that are as follows: munotes.in
Page 5
5 Intervention Systems In Psychology i) Reality Anxiety , whi ch is a fear of danger from the external world
around us is reality anxiety. The amount of reality anxiety is
proportionate to the level of real threat.
ii) Neurotic Anxiety, which is a fear that instincts will be difficult to
control and lead to punishme nt due to unacceptable behaviour.
iii) Moral Anxiety is a fear of one’s own conscience.
Freud also gave the concept of signal anxiety, which can be defined as the
anxiety resulting from a battle between internal wishes and limitations that
stem from inte rnalized prohibitions or external reality. Among the
defenses used by humans, some are healthy, some are distorting.
Freud believed that signal anxiety would lead to automatic triggering of
ego defense mechanisms. These ego defense mechanisms are develope d to
deal with anxiety, internal conflict, negative emotions etc. & to stop the
ego from being overwhelmed. They work to repel unacceptable id
impulses which are against superego or lead to problems in real life. The
defenses used by an individual depend on his/her level of development
and degree of anxiety.
There are some characteristics of defense mechanisms:
They are automatic, i.e. Individual learns to spontaneously use a
specific defense mechanism.
They either deny reality or distort reality and op erate on an
unconscious level.
They are categorized in several ways. For example, Primary vs.
Secondary defense mechanisms, psychotic vs. neurotic defenses,
immature vs. healthy defenses.
Here are some defense mechanisms along with their examples:
Denial : It refers to not accepting threatening aspect of reality that is
evident to others. For example, a person who has addiction of alcohol
denying that drinking is not good for their health.
Reaction formation: It refers to replacing unacceptable, threatenin g
thoughts, emotions with active expression of their opposite, in order
to overcompensate. For example, a person hates his boss, but behaves
in an excessively nice, friendly manner with him.
Repression: According to Freud, it is involuntary removal of
some thing from consciousness. Thoughts and feelings that are painful,
threatening are relegated to the unconscious, excluding them from
awareness. For example, a person is sexually molested when she was
5 years old. There is behavioural evidence that it exists , but she
genuinely cannot recall this event. munotes.in
Page 6
6 Intervention Systems Emphasizing Background - I Projection : It is projecting unacceptable thoughts, feelings, or
impulses on another person. For example, a person hates his mother,
but instead says that his mother is the one who hates him.
Displacement : It i s directing strong feelings from a threatening
person/ object toward other person/object which is less threatening
than the previous one. For example, a child is very angry with his
mother, so he displaces these angry feelings toward his dog, by
kicking it .
Rationalization refers to using excessive explanations, to justify
behaviour in self -serving but invalid ways. A person who is rejected
by his date might say that he was not anyways attracted towards her.
Sublimation is diverting potentially harmful emo tions or impulses
(sexual or aggressive energy) into other socially acceptable ways. For
example, a person sublimating her aggressive impulses into athletic
activities (playing football) where she finds a way to express these
feelings.
Regression refers to reverting to an earlier phase of development in
thoughts, emotions, and behaviour when there were fewer demands.
For example, a child who is traumatized may regress to earlier
developmental stage and start thumb sucking behaviour.
1.1.1 Process of Therapy :
Therapeutic Goals:
Goals of Freudian psychoanalytic therapy include making the unconscious
conscious and strengthening the ego.
i) Making unconscious motives conscious
It is one of the goals of psychoanalytic therapy because only then can
person exerci se choice. To bring out the unconscious material, therapeutic
methods are used. Later, childhood experiences are discussed,
reconstructed, interpreted and analyzed. This can result in behaviour
which is based more on reality and less on instincts, irration al guilt;
important modification in one’s personality and character structure is also
expected. Unconscious processes are considered as the root of all forms of
neurotic behaviours, symptoms. According to this view, a “cure” for such
symptoms & behaviours is built on revealing the meaning of symptoms,
the causes of behaviour along with the repressed information which
interferes with healthy functioning; intellectual insight alone cannot fix
symptoms. The therapeutic process is not limited to problem solving and
modification of behaviour, but it also considers exploring an individual’s
past to arrive at a self -understanding level which is needed for changes in
character. It is important that the feelings and memories connected with
this self -understanding are experienced.
munotes.in
Page 7
7 Intervention Systems In Psychology ii) Strengthening the ego
It is the second goal. Achieving equilibrium between id and superego is
considered as a comprehensive goal of psychoanalysis. Individual must
have a strong ego manage the demands of living, and to not get
overwhelme d by guilt, shame, or nervous anxiety. Examples of certain
treatment objectives are as follows - Reducing punitiveness, rigidity and
perfectionism of the superego, promoting accurate assessment of reality,
improving nature of defense mechanisms etc.
One of the main functions of analysis is to help clients gain the liberty to
love, work, and play. Other functions involve helping clients to achieve
self-awareness, honesty, and more effective personal relationship, to face
anxiety in a realistic way; and to g et control over impulsive, irrational
behaviour.
Therapeutic Alliance:
Generally, psychoanalysis is a long term and intensive process. Treatment
continues for 3 to 5 years, where people are seen for 2 to 5 times a week.
Freud recommended having the patie nt lying on the couch, whereas the
therapist seating (behind the patients head) on the chair where he could not
be seen. This was thought to relax the patient, reduce distractions for the
patient and promote anonymity of the therapist. After lying on the c ouch,
clients say whatever that comes to their mind; this content should not be
censored by them. This is called free association. Generally, clients are the
ones who talk the most in psychoanalysis. When clients are lying down on
the couch, their ability to read facial reactions of the therapist is reduced
and therapist also does not need to carefully observe client’s facial
expression. Therapist’s role is to actively give direction to the sessions and
encourage uncovering of the repressed information. The classical
psychoanalyst stays outside of the relationship and comments on it taking
an anonymous stance. This is called the “blank -screen” approach. Paying
attention to underlying meanings, symbols, and omissions is done by the
therapist.
Establishing a working relationship with a client, listening, interpreting is
important. Specific attention is given to the client’s resistance as well.
Resistance is a fundamental concept in the practice of psychoanalysis. It is
anything which works against the progres s of therapy. It prevents the
client from bringing the unconscious, repressed material to conscious.
Resistance blocks the threatening material from entering awareness.
Therapist then points it out and clients shall confront it, if they want to
deal with c onflicts realistically. Resistance can be a valuable tool in
understanding the client if resistance is handled properly.
Transference and countertransference:
Relationship between client and therapist is very important in
psychoanalytic therapy. Client u nconsciously shifting his feelings and
fantasies which are reactions to important figures in his past, toward
psychoanalyst is called as transference. It is characterized by its munotes.in
Page 8
8 Intervention Systems Emphasizing Background - I inappropriateness. It involves (unconscious) repetition of past in the
present and misperception of the therapist. Freud believed that the
formation of transference is a key component for successful treatment.
According to relational model of psychoanalysis, transference is an
interactive process between the therapist and the client .
A client can have variety of feelings to a therapist, such as mixture of
positive and negative. Transference can be positive, negative, or mixed. A
client projecting feelings of anger and hostility on to a therapist which he
originally had towards his f ather is an example of negative transference.
For example, someone who had loving and caring mother may transfer the
similar feelings toward the therapist, is an example of positive
transference. A client who grew up with his seductive but caring
grandmoth er may project those feelings on the therapist, is an example of
mixed transference.
Psychoanalyst who is not observed by the client and who is neutral is
more likely to elicit transference than one who is engaging in self -
disclosure, is interactive. Work ing through transference is a lengthy
process and it involves three stages. After the transference is developed, it
is established and explored. This is done in order to evoke repressed
material. Step by step, the original dysfunctional pattern is emerged again
as transference towards the therapist. When positive and negative feelings
toward the therapist become conscious, clients can recognize and resolve
their unfinished business (unresolved issues) from these past relationships.
At the end, the root of transference is understood, resolved and the client
can relate with others in a healthier way.
Originally, Countertransference was called as the therapist’s tendency to
see the client in terms of his own relationships in the past. In classical
psychoanaly sis, countertransference is avoided. Countertransference is
therapist’s feelings about the client. Therapists are instructed not to
respond to client’s feelings about them. Clients can experience both
positive and negative transference as a result of thera peutic process. The
therapist shall understand the difference between client’s transference and
our own reactions to the client (which stem from therapist’s unresolved
issues). Therapists should carefully monitor all the strong reactions they
have for the clients to check for the possibility of counter transference.
1.1.2 Therapeutic Techniques:
Some interventions that psychoanalysts use are questions, dream analysis,
interpretations and free association.
i) Free Association:
It is a primary technique in psychoanalytic therapy. It is used as an
approach to get access to repressed material. Its process shows the most
important rule of psychoanalysis. It is that the people should say whatever
that comes into their mind, without judging or censoring the info rmation
no matter how painful, illogical, silly or irrelevant it may be. It is
considered as a basic tool to get access to unconscious fantasies, wishes, munotes.in
Page 9
9 Intervention Systems In Psychology conflicts etc. Free association, in simple words, is automatic connecting of
one thought to another. T his was encouraged by Freud to facilitate patients
recall of the information in past and release the intense emotions and
feelings (catharsis). Blocks in the chain of free association can be viewed
as a source to obtain repressed material. Free association plays an
important role to maintain the analytic framework. Therapist’s role during
free association process is to acknowledge repressed material. Therapist
then interprets the material to the client and helps them in increasing
insight into the underlyin g problem. Hidden meaning underlying the
surface content is understood. A slip of tongue, areas the client does not
talk about are also significant.
ii) Abreaction:
Freud recognized the significance of emotions and believed that affect
needs to go hand i n hand with the recall of past material. The reason
behind this is to fully understand and work through the importance that
repressed material has for clients. Freud encouraged abreaction in his
patients to promote the connection between recall of past mat erial and
emotions. Abreaction involves recalling a repressed painful experience,
working through that painful experience and the conflicts created by it.
For this process, one needs to relive the experience in memory, along with
its associated emotions an d analyze that experience. Finally, emotional
release is achieved as the climax of this process.
iii) Interpretation and Analysis:
They are the most fundamental techniques in Freudian psychotherapy
which promote awareness and insight. The tools of analys is and
interpretation allowed Freud to bring unconscious material into
consciousness.
Ø The process of thoroughly exploring, understanding the
unconscious representations in the material presented by people in
treatment, is called as analysis. For example , in the process if
analyzing a dream, Freud would examine the meaning of every item
in the dream with the client. The person then would be motivated to
free-associate to the dream and talk about the emotions reflected in
the dream and emotions experienced after waking up and recalling the
dream along with events which might have triggered the dream would
be discussed. Suggestions of repressed, unacceptable urges and wish
fulfillment acted by the dream would be emphasized.
Ø The process of explaining the unconscious meaning of the
symbols in presented material and of connecting these new insights to
client’s present concerns, blocks is called as Interpretation. Analysts
point out, explain, and teach the meanings of behaviour to the client.
Working through the material from unconscious on cognitive and
emotional level allows people to understand the effect the past has
had on them. It also allows people to use the mature defenses and
strategies of ego for making better choices that are free from the
negative effect of unconscious material. Interpretation is done to munotes.in
Page 10
10 Intervention Systems Emphasizing Background - I accelerate the process of uncovering material which is unconscious.
Any gaps, inconsistencies in client’s story, inferring the meaning of
reported dreams and free associations are paid attention to . Client is
taught the meaning of these processes, through interpretation. This
can result in clients achieving insight into their problems, increase
awareness about ways to change, and gain more control over their
lives.
iv) Dream Analysis:
According to Freud, dreams are “royal road to the unconscious”. When we
sleep, our defenses are lowered; repressed feelings come up to surface.
There are some wishes, motivations that are not at all acceptable to the
person, and thus they are expressed in symbolic for m instead of being
revealed directly. There are two levels of content in our dreams: latent
content and manifest content. Latent content includes symbolic,
unconscious and hidden motives, wishes, and fears. As they are painful
and threatening for the clien t, the unconscious sexual, aggressive impulses
that create latent content are transformed into the more acceptable
manifest content, which is the dream that actually appears to the dreamer.
There is a process by which the latent content is transformed into the more
acceptable, less threatening manifest content. It is called as dream work.
Therapist tries to study the symbols in manifest content of the dream to
reveal the disguised meanings. Along with serving as a way to repressed
material, dreams provide a n understanding of clients’ functioning in the
present.
1.1.3 Strengths and Weaknesses:
One of the significant contributions of Freud is the great impact his
thoughts had on our understanding of personality development. Even if
some of us do not agree wit h the psychoanalytic model of treatment or an
emphasis on infantile sexuality, Freud’s contributions to our
understanding of psychological development and knowledge of
psychotherapy are undeniable. His views still influence contemporary
practice.
Many bas ic concepts given by Freud are part of foundation on which
other theorists built and developed their theories. Psychotherapy was
given a new horizon, new look & he developed the first therapeutic
procedures to understand, modify the structure of one’s basi c
character. Freud’s Psychoanalytic theory is a benchmark theory
against which many other theories are measured.
Classical Freudian psychoanalysis has received much criticism from
empirical researchers from years. In the practical application of
classical psychoanalysis, one of the limitations is that many highly
disturbed clients lack the level of ego strength which is needed for this
treatment.
munotes.in
Page 11
11 Intervention Systems In Psychology A potential drawback of the psychoanalytic approach is the
anonymous role of the psychotherapist. This approach by the therapist
can be justified on theoretical grounds, but in therapies other than
classical psychoanalysis, this approach is excessively restrictive. This
classical approach of nondisclosure can be put to wrong use in short -
term therapy and assessment . If applied in such situations, a therapist
may actually be keeping himself hidden as an individual by “being
professional.”
Classical psychoanalytic approach is costly. It is generally considered
as being based on upper - and middle -class values. There ca n be some
clients who do not share these values and cannot afford this treatment.
It is a lengthy procedure as this approach is not designed to help
people with urgent concern. Psychoanalytic therapy focuses on long -
term personality reconstruction more th an short -term problem solving.
Because of the lengthy, intense nature of the treatment, each therapist
can work only with limited number of people and each treatment is
unique. Thus, research proving the value of classic psychoanalysis is
limited.
Multicu ltural dimensions may not be attended adequately and it talks
a little about developing a healthy adult. It fails to adequately address
the social, cultural, and political factors leading to person’s problems.
Clients may be held responsible for their situ ation, if there is no
balance between the external and internal outlook.
Freud had some incorrect and harmful ideas about women. He blamed
mothers as they are children’s primary caregivers. Freud seemed to
look at men as emotionally healthier than women, as he viewed
women as suffering from greater levels of narcissism, masochism,
envy & shame. According to Freud’s theory on female sexuality,
women are considered as “essentially castrated men”.
1.3 REFERENCES 1. Corey, G. (2009). Theory and practice of c ounseling and
psychotherapy (8th ed.). CA: Thomson Brooks.
2. Seligman, L. & Reichenberg, L. W. (2014). Theories of counseling
and psychotherapy: Systems, strategies, and skills (4th ed.). Pearson
education.
3. Flanagan, J.S. & Flanagan, R.S. (2004). Co unseling and
psychotherapy theories in context and practice: Skills strategies and
techniques. Hoboken, NJ: John Wiley & Sons, Inc.
*****
munotes.in
Page 12
16
2
INTERVENTION SYSTEMS
EMPHASIZING BACKGROUND - II
Unit Structure
2.1 Alfred Adler - Individual Psychology
2.1.1 Basic Concepts of Individual Psychology
2.1.2 Treatment Using Individual Psychology
2.1.3 Evaluation of Individual Psychology
2.2 Carl Jung - Analytical Psychology: Basic Theoretical Concepts
2.2.1 Treatment Using Jungian Analytical Psychology
2.2.2 Evaluation of Jung’s Analytical Psychology
2.3 References
2.2 References
2.1 ALFRED ADLER -INDIVIDUAL PSYCHOLOGY Alfred Adler was a settler of a h olistic, social, systemic approach. He was
also the first systemic therapist. He believed that it is necessary to
understand individuals within the systems in which they live. Adler’s
theory of human development is called as individual psychology. It
reflects the unique beliefs and skills that every individual advances from
early childhood, which acts as a reference for their attitudes, behaviours,
along with the private view of self, others, society.
Adler initially worked with Freud, but later he moved f orward with his
own ideas. Adler believed that Freud’s focus on biological and instinctual
determination was very narrow. The concept of the sexual drive and the
libido was replaced with the drive to gain power, superiority, becoming a
fully functioning ad ult. Adler looked at humans as the creators of their life
and also as the creations of their own lives. This means that individuals
create a unique style for living that is a way toward and an expression of
their selected goals. Here, the focus is more on interpersonal relationships
instead of individual’s internal psychodynamics.
2.1.1 Basic Concepts of Individual Psychology
a) The Whole Person and Patterns of Human Personality :
Adler focused on the unity and indivisibility of the person. According to
him, human behaviour is not merely decided by heredity and environment.
Individual has the capacity to interpret, influence, and create events. The
whole person makes the decisions for which he or she is totally
responsible. Adler highlighted unity of thinki ng, feeling, acting, attitudes,
values, the conscious mind, the unconscious mind etc. instead of breaking
the individual into different functional parts. Adler emphasized the munotes.in
Page 13
17 Intervention Systems In Psychology understanding the whole person – how all the aspects of an individual are
interco nnected and unified by his/ her movement toward a life goal. Adler
did not believe in id -ego-superego approach given by Freud.
Comprehending and helping the unique individual is the goal of Adler’s
Individual Psychology. Client is considered as an integral part of a social
system as an implication of this holistic view of personality.
According to individual Psychology, all human behaviours have a
purpose. Human beings set goals for themselves, and behaviour becomes
unified to achieve their goals. Humans c an be fully understood
considering their purposes and goals toward which we are striving.
Adler’s theory focuses on future without minimizing the significance of
past influences.
According to individual psychology, human behaviour is considered as a
functi on of a combination of many influences or contributing factors.
Generally, no single, direct causal factor leads to a single behaviour. Adler
believed that each person is responsible for his/her behaviour as they have
the freedom to select from a variety o f behavioural options. It shall be
noted that though this approach says that an individual is responsible for
his/her behaviour, it does not blame them for their wrong deeds.
b) Private Logic :
Being one of the major construct given by Adler, private lo gic means our
beliefs about ourselves, our place in the world which is subjective and
based on lifestyle. Private logic provides a life pattern and it begins in
childhood, providing a compass by which to live. Individuals develop their
own set of rules to overcome feelings of inferiority as they must learn to
interact with that system. This Private logic is unique to every individual
but it is not always logical. Feelings of superiority, fear of inferiority are
meaningful only to the individual.
c) Concept of Inferiority and Striving For Superiority :
Adler looked at inferiority feelings as a normal condition of all individuals
and as a source of all human striving. Instead of looking at inferiority
feelings as a sign of weakness or abnormality, inferiority f eelings can be
thought of as the wellspring of creativity, as they inspire us to strive for
mastery, completion, success or superiority. Individuals are driven to
overcome their sense of inferiority and to strive for increasingly higher
levels of developme nt. Adler believed that the moment one experiences
inferiority he/she is pulled by the striving for superiority. The goal of
success pushes people toward mastery and enables them to deal with
hurdles. Superiority does not necessarily mean being superior to others but
it means moving from a perceived lower place to a perceived higher place.
Human beings produce their own internalized goals and then they strive to
achieve success. An individual deals with feelings of helplessness by
trying hard for competence , mastery, and perfection.
The feelings of inferiority during the early childhood years have a
significant impact on development. Most children experience these munotes.in
Page 14
18 Intervention Systems Emphasizing Background - II feelings and they perceive themselves as small, powerless as compared to
their parents, older siblings. Treatment given to young children and how
they manage their feelings of inferiority play important role in shaping
them. One achieves a sense of accomplishment by mastering an issue.
According to Adler, pampered children generally grow up expecti ng
others to care for them and thus they do not develop their own resources.
Neglected children may become discouraged and hopeless if their attempts
to manage an inferior role are ignored or rejected.
d) Striving With Purpose :
Humans actively shape them selves and their environment is one of the
main concepts of individual psychology. Individual is not solely passive
recipients of his/her biological traits or reactor to his/her external
environment. Beyond biology and the environment there is a third elem ent
which influences and governs human behaviour. Adler called this third
force as “attitude toward life”. Attitude toward life consists of individual
human choice, individual sense of purpose.
e) Goals :
According to Adler, a healthy & well -functioning adu lt is an individual
who is independent, emotionally as well as physically self -reliant, useful,
productive, and one who is able to cooperate with others for personal and
social benefit. By using psychotherapy and education, Adler wanted to
help people real ize that feelings of pain, inadequacy are caused due to
their own faulty logic and not by others. Therapist can help people deal
their feelings of inferiority, dependency, and fears of failure by enabling
them to become aware about their faulty logic & to establish healthy,
realistic, rewarding goals, to align their lifestyles, thinking, and behavior
with these goals.
f) Social Interest :
Social interest and community feeling are important and distinctive
concepts given by Adler. An action line of one’s co mmunity feeling,
which involves his/ her positive attitude toward other people in the world
is called as social interest. The capacity to cooperate and contribute is
social interest, which requires sufficient contact with the present to take a
step toward a meaningful future, that one is willing to give and take, and
that one develops his/her capacity for donation to the welfare of others.
As human beings are born into an interpersonal context, their personality
development is shaped by interpersonal factor s. The interpersonal nature
of humans leads to community feeling. When a person experiences a
strong sense of connection to others, an awareness of being a member of
the human community then he or she is experiencing community feeling.
Social interest is a community feeling in action. The development of social
interest, sense of social responsibility is a goal of therapy for many clients.
Adler thought of social interest as innate but he also believed that it must
be taught, learned, and used. People with s ocial interest guide the striving
toward the healthy, socially useful side of life. As social interest develops, munotes.in
Page 15
19 Intervention Systems In Psychology feelings of inferiority and alienation reduce. Social interest is expressed by
shared activity and mutual respect. Individual Psychology believ es that
that our happiness and success are greatly related to this social
connectedness; Humans are primarily motivated by a desire to belong.
Community feeling incorporates the feeling of being connected to all of
humanity and to being engaged in making the world a better place. People
who lack community feeling get discouraged and end up on the useless
side of their life. If one’s sense of belonging is not fulfilled, it leads to
anxiety. When one feels united with others, only then he is able to act with
courage in dealing with problems. Adler maintained that we must
successfully adept three universal life tasks. They are building friendships
(social task), establishing intimacy (love –marriage task), and contributing
to society (occupational task). Regard less of their age, gender, time in
history, culture, or nationality, all people need to address these three tasks.
Each of these tasks needs the development of psychological capacities for
friendship and belonging, for contribution and self -worth, and for
cooperation. These basic life tasks are fundamental to human living.
Dysfunction in any one of them is generally an indicator of a
psychological disorder.
g) Phenomenology :
The concept of phenomenology is main assumption of individual
psychology. Viewin g the world from the client’s subjective frame of
reference is described as phenomenological orientation. Adler emphasized
on an individual’s perception of reality and not what actually is or what
others perceive. The internal and subjective were more sign ificant than the
external and objective for Adler. He paid attention on the way an
individual perceived the world, his/her inner reality. Adler looked at each
person as a unique individual. He believed that only by understanding that
individual’s perceptio ns of the world, private logic, lifestyle, and goals
one can understand and know that person. This can be called as an essence
of Adler’s Individual Psychology.
Lifestyle is one of the important concepts in Adler’s theory. The
individual map everyone uses to navigate through life is created in
childhood. This map is called as lifestyle. This is also called as “plan of
life,” “style of life,” “strategy for living,” or “road map of life.” It gives us
an idea about ourselves, others, and the working of the wo rld. When we
acknowledge the patterns, continuity of our lives, we can modify our
faulty assumptions and make basic changes needed. Childhood
experiences can be reframed and new style of life can be consciously
created using therapeutic, educational exper iences. Lifestyle comprises of
four elements. They are 1) the person’s subjective worldview (beliefs
about the self and others, values, inner narratives, expectations, and
attitudes), 2) goals, 3) behavioural strategies that an individual uses to
achieve g oals and negotiate the journey of life and 4) the outcomes of
those behaviours. munotes.in
Page 16
20 Intervention Systems Emphasizing Background - II Everybody has an image, often unconscious, of what life will be like when
goals are met. Adler called this as fictional finalism. He believed that this
aim is strongly establi shed between the ages of 6 and 8. It remains
constant throughout our life. Some people have beliefs about the self,
world, and others that lead to emotional pain and distress. These beliefs
are called as basic mistakes. Adler was hopeful, optimistic about helping
people to change their cognitive maps as change is also possible.
h) Birth Order and Family Constellation :
Adler pointed out that it is not correct to assume that children born in the
same family are formed in the same environment. Siblings do sh are some
aspects in the family constellation but the psychological position of each
child is different from other children because of birth order. Birth order is
an aspect of families which has a profound impact on development of a
child.
Adler identified five psychological positions (vantage points) from which
children are likely to view life. The five positions are as follows - oldest,
second of only two, middle, youngest, and only. Birth order increases an
individual’s likelihood of having a specific set of experiences. A persons
interpretation of his/her place in the family is important than the actual
birth order. Individuals learn a specific style of relating to others during
their childhood, forming a picture of themselves which they carry into
their adult relationships.
Adler believed that we can understand people’s lifestyle by examination of
the family constellation. An individual’s family constellation involves the
composition of the family, role of every person, along with the reciprocal
transacti ons that a person has during his/her the early formative years,
with his/her siblings, parents. Children do influence how their parents and
siblings respond to them. Children are influenced by both their similarities
and differences from their families. Ex ploring birth order and its influence
on the development of an individual’s personality can help understand that
person.
1. The oldest child:
It is likely to be the most intelligent and achieving among the five groups.
The firstborns are generally depend able, well organized, and responsible,
and having strong verbal skills. Often, they are well behaved, cooperative,
fairly traditional conforming to societal expectations. Due to their
strengths they often attend leadership positions. Till the time firstbor ns are
only child in the family, they are the centre of attention and often spoiled.
After birth of their sibling, they might feel dethroned, threatened, angry,
fearful, and jealous as a reaction to not being only child. If firstborns deal
successfully wit h the birth of their sibling, it can help them to be self -
confident and affiliative.
2. The second child : munotes.in
Page 17
21 Intervention Systems In Psychology The second child of the only two children is in a different position. The
second child tends to feel pressurized to catch up, compete with the olde st
child. As second -born child often realizes that he/she cannot outdo the
successes the firstborn child has already obtained, they are inclined toward
things in which their older sibling is unskilled or uninterested. A common
pattern for a firstborn is to excel in a traditional area (English or
mathematics) and for the second -born to excel in more creative area
(singing or drawing). Second -born children are likely to be caring,
friendly, and expressive than their older siblings. The second -born is
generall y opposite to the firstborn.
3. The middle child:
The middle child generally feels squeezed between older children and
younger children, cheated and may get convinced of the unfairness of life.
They sometimes have a problem searching a way to become speci al. They
can also view themselves as unloved and neglected, accepting “poor me”
attitude. This child may become a problem child. But in some families
characterized by conflict, this middle child can become the peacemaker
and an individual who holds things together. In case there are four
children in a family, the second child will generally feel like a middle
child. The third will be more easy going, social, aligning with the third
born. Middle children generally become well adjusted, friendly, creative,
and ambitious, value their individual strengths due to encouragement and
positive parenting.
4. The youngest child:
The youngest child is generally the most pampered one and spoiled. It is
the baby of the family. They often tend to go their own way where no
others in their family have thought about. They may feel the need to keep
up with their older siblings, and then may get discouraged about
competition. Other pitfall is that others may take decisions for them, lack
of taking responsibility for themselves or others may exist. These children
may experience strong feelings of inferiority. These children can also get
power and thrive on the attention received by their family. They generally
become adventurous, sociable, innovative, and pursue their own interes ts
in order to avoid competition with their siblings.
5. The only child:
These children have some things common with firstborn and last born
children. i.e. achievement like the initial and attention like the later one.
The only child may not learn to coo perate with other children and has
problem of their own. As the only child is pampered, he/she may become
dependent on one or both parents. Although as the other family members
are adults, they deal with adults well and mature early. If parents are
insecur e, the children often adopt worries and insecurities of their parents.
2.1.2 Treatment Using Individual Psychology :
a) Therapeutic Alliance: munotes.in
Page 18
22 Intervention Systems Emphasizing Background - II Adler’s ideas about client -clinician relationship are different than Freud.
Adler highlighted cooperative interact ion which includes establishment of
shared goals, mutual trust and respect. Therapists play role of role models,
educators, teaching people how to modify their lifestyles, behaviours, and
goals, fostering social interest. They recognize faulty logic and
assumptions, explore & interpret the meaning and impact of clients’ birth
order, dreams, early recollections, and drives.
b) Techniques :
Adler’s Individual Psychology has a lot of creative and useful
interventions. They are as follows:
Spitting in the Cl ient’s Soup: Clients often try to avoid demands and
responsibilities considering the basic life tasks. Spitting in the client’s
soup is used as a metaphor for spoiling the client’s use of a specific
strategy for avoidance or a neurotic strategy.
Catching Oneself: This technique is designed to help clients become
aware about their maladaptive goals and behaviour patterns. The
therapist teaches the client about how to catch himself/herself when
he or she slips back into old and unhelpful behaviours. It enco urages
people to be more conscious of their repetitive faulty goals and
thoughts. This approach lets the client monitor themselves without
being critical toward themselves.
Pushing the Button: Rather than allowing their emotions to control
them, this techn ique makes clients aware about the control they can
have over their emotions. Clients are encouraged to imagine pleasant
and unpleasant experiences one by one, observing emotions
accompanying each image. Then they realize that they can decide
which button to push.
c) Phases of Treatment :
There are four treatment phases in Adler’s model which generally merge
and overlap. They are as follows:
Phase 1) Establishment of the therapeutic relationship and setting
goals
Therapist and clients build a collaborat ive, democratic, and trusting
relationship where they can work together to create a clear statement of
the problem and meaningful, realistic goals. They can discuss about the
structure of the treatment. Initial questions are asked to explore clients’
expe ctations from treatment and their views about problems etc.
Encouragement is necessary in this initial phase of treatment as it is used
throughout treatment to deal with clients’ discouragement. There are some
appropriate ways to form partnerships with cli ents, which provide
encouragement and support. For example, writing a note to the client who
is in hospital, making a telephone call to them when they are in crisis etc. munotes.in
Page 19
23 Intervention Systems In Psychology Phase 2) Assessment, analysis, understanding of the person and the
problem :
Adlerian therapy focuses on in -depth assessment. Initial interview and the
lifestyle interview are taken. They provide thorough information about the
client’s current level of functioning and background which leads to current
distress. The Life Style Interview is a semi structured process. It consists
of 10 sections. The first 9 sections are called as the family constellation
interview, which gives details from early childhood till adolescence. The
10th section collects early childhood recollections. Adler called i nitial
interview as “the general diagnosis”. Here the therapist conducts a general
assessment of six main domains. They are identifying information,
background, current level of functioning, presenting problem, expectations
for treatment, and summary.
Phase 3) Re-education, insight, and interpretation :
As therapists need to be both encouraging and challenging, this phase can
be difficult. Therapists provide support, as well as use interpretation and
confrontation. They help clients to gain awareness of th eir lifestyles,
acknowledge the covert reasons leading to their behaviours, realize the
negative impact of such behaviours, and move toward positive change.
Clinicians focus on present rather than the past. They are more concerned
with results rather than with unconscious motivation. Their interpretations
are introduced in ways that are acceptable by the client. Through these
gentle interpretations, therapists try to educate clients, promote self -
awareness, insight, and discussion. They try to help people w eigh their
options and take decisions. Beliefs, attitudes, and perceptions are
emphasized because behavioural change will take place only by cognitive
means and social interest.
Phase 4) Reorientation, reinforcement, termination and follow -up:
After the clients have gained some insight and modified their distorted
beliefs, they become ready for reorientation and initiation of new ideas,
patterns of behaviors. Clients can make more rewarding choices and look
at their lives from different perspective. Clini cians help people to become
full participants in their social system, shift their roles and interactions;
take on rewarding challenges. In this phase, clinicians model and support
optimism and flexibility. This final phase of treatment enables client to
consolidate the gains they have made, and move ahead with their life.
Primary role of therapists here is to reinforce positive changes. Together,
client and therapist decide when the client is ready to complete treatment,
agree on follow -up procedures. This is to make sure that clients continue
their positive growth and move forward.
2.1.3 Evaluation of Individual Psychology :
Adler’s theory is considered as an optimistic, growth oriented, and
educational theory. According to Adler, people can change their go als and
lifestyles to live happier, fulfilled lives. Adler’s model of Individual
Psychology is used for treatment of various groups such as children, munotes.in
Page 20
24 Intervention Systems Emphasizing Background - II individuals, couples, families for various reasons such as career
development, education, training, superv ision, consultation etc. Adler’s
ideas have influenced many other approaches of treatment such as
cognitive therapy, reality therapy. Individual Psychology can be
effectively combined with other treatment approaches as well. But there
are some limitations as well. Some of the Adler’s concepts like fictional
finalism and superiority are not well defined. Adlerian therapy fails to
account for biological, genetic influences. Adler is also called as overly
optimistic because of his statement that social interes t is innate.
2.2 CARL JUNG - ANALYTICAL PSYCHOLOGY: BASIC THEORETICAL CONCEPTS Carl Jung’s theory is known as analytical psychology. He called his theory
as well as therapy “analytical psychotherapy” to differentiate it from
Freud’s psychoanalysis. Accordi ng to Jung, unconscious shall be
approached with respect, hope and listening attitude. Jung’s concept of
psychotherapy helps people to make conscious and integrate aspects of
psyche.
a) Components of the Psyche :
Jung’s concept of the psyche is more comp lex than Freud’s concept of
psyche. The conscious mind, the collective unconscious, and the personal
unconscious are three levels in psychic functioning. They are described
below:
i) The Conscious Mind :
Conscious mind is only a small part of the psyche. I t includes the ego, the
persona, two attitudes, and four functions.
The Ego:
It is formed of perceptions, memories, thoughts, and feelings which are
within one’s awareness. Being the centre of the conscious mind, ego offers
us our sense of world and reali ty. It affects our transactions with our
environment, giving us a sense of identity. The development of ego lets us
differentiate ourselves from others. Comparatively, ego is weaker than
other parts of the psyche. Ego protects itself using process of repre ssion,
by assigning threatening material into personal unconscious. Like this,
conscious and unconscious levels of personality are connected by ego.
The Persona :
It is the idealized side of ourselves which we present to the external world.
It is the face of collective psyche. Although it is a mask or protective
façade which hides our problems, sorrows, it allows us to function
properly in society, deal with other individuals and continue with our daily
activities. Our persona is affected by people around u s and it can change in
order to adapt with the social situations. Generally, our original thoughts munotes.in
Page 21
25 Intervention Systems In Psychology and emotions which are not socially acceptable, are not reflected in our
persona.
Attitudes and Functions:
Extraversion and introversion are two attitudes, and thinking, feeling,
sensation and intuition are four functions. Thinking is opposite to feeling
and sensation is opposite to intuition. People interact with the world
through one of these four functions. This function is called as primary or
superior f unction. The opposite function of the primary function is least
developed, inferior and it’s the problematic. Opposites are in balance in
the well -functioning person and they provide psychic energy. We will
later look at each of the functions and attitudes in detail.
ii) The Unconscious Mind :
Jung’s view of unconscious mind is complex and positive. It is considered
as source of creativity, spiritual and emotional growth, along with
confusion, symptoms. It contains forces, predispositions, motives and
energ y in our psyche which is unavailable to conscious mind. There are
two levels of the unconscious mind – the personal unconscious and the
collective unconscious.
The Personal Unconscious:
The personal unconscious is unique to every person reflecting his/ he r
history and it is material which was once conscious. It forms over one’s
lifetime and includes memories which are forgotten or repressed but which
might be made conscious again. Memories from the personal unconscious
can be triggered by daily stimuli a nd then they are recalled. Repressed
material generally emerges from the personal unconscious via dreams or
symbols. Dreams and fantasies represent the personal unconscious when
they are of a personal nature. Archetypes and the shadow are also found in
personal unconscious.
Complexes:
They are located in the personal unconscious, having an archetype at their
core, containing related and emotional collection of one’s feelings,
thoughts, perceptions, memories. These dynamic structures of the
personality can b e thought of as challenging obstacles. They are not
necessarily negative, but their impact might be. They might affect our
daily life but as they are located in the unconscious, generally we are not
aware about them. Jung thought of complexes as a pool whe re energy
whirls and circles, due to unresolved areas in an individual’s life.
Complexes can be as diverse as human experiences.
The Collective Unconscious:
The collective unconscious can be described as storehouse of motives,
urges, fears, and potentia lities which we inherit by being human. It is
shared by all humans in the world and contains myths, images and
symbols. According to Jung, collective unconscious is far larger than munotes.in
Page 22
26 Intervention Systems Emphasizing Background - II personal unconscious. When dreams and fantasies include impersonal
material which is not related to our personal experiences, they come from
the collective unconscious. Some examples of reactions originating from
collective unconscious are fear of the dark, fear of snakes.
Archetypes :
The collective unconscious has patterns that are important elements of the
common human experience. These patterns are called as archetypes.
Archetypes are innate, unconscious energies which are universal and they
predispose people to look at the world and organize their perceptions in
specific ways. Archetypes are transmitted through cultures, generations,
appearing in dreams and fantasies. They affect how people think, feel, and
behave in their lives. There are some archetypes such as the warrior, the
hero, the great mother, the innocent, and the tr ickster. Here are some of
the archetypes described below:
(i) The self: It is a central, organizing archetype, which is regulating
centre of the personality. It integrates and balances the needs,
messages of the conscious, the personal unconscious, and the
collective unconscious. It is primarily located in the collective
unconscious, emerging from dreams, symbols, perceptions, and
images. It generally emerges after the second half of our lives,
reflecting from our spiritual, philosophical perspective. The s elf
gives our personality unity, equilibrium, and stability. When the self
within us is fully realized, it helps us to connect with the larger
spiritual truth.
(ii) Anima/animus: These concepts have similarity with Chinese
concept of yin and yang, which a re the feminine and masculine
principles that exist in every human. The anima is the psychological
feminine element in a man and the animus is the psychological
masculine element in a woman. These archetypes are evolved from
generations of experience. Thei r functions are to be a part of self and
project on others. Anima and animus affect how we feel, present our
masculine and feminine sides, along with our relationships with the
other gender. In men’s dreams, the archetype of anima manifests as
a female and in women’s dreams, the animus manifests as a male.
(iii) The shadow: The archetype of shadow can be manifested in
collective and the personal unconscious. It can be described as a
dark side of an individual which he/ she does not wish to admit, and
thus t ries to hide it from self as well as others. This archetype
consists of traits, instincts that are morally objectionable. It is in
direct and reciprocal relationship with our persona. As nature of the
shadow is not restrained but primitive, it is a wellspr ing of energy,
creativity, vitality. In a way it is opposite to persona as persona tries
to get social acceptance, while shadow contains the socially
undesirable. People project their archetype of shadow on other
individuals and then over react to that ove rblown projection. Some
similarities are observed between Freud’s concept of id and shadow. munotes.in
Page 23
27 Intervention Systems In Psychology b) Concept of Human Development :
According to Jung, people’s lives are divided into two periods. In the first
half of their life, they find our place and develop interests, values, find a
partner, make career choice. In the second half, with established
foundation, they move towards individuation. In search of individuation
an individual becomes a psychological individual i.e. a whole. This is a
lifelong process wh ere the whole personality develops. Greater access is
obtained to unconscious and latent abilities; movement is made towards a
state of greater balance, harmony, equilibrium along with clarification of
who we are in relation to others. In this second half of life, one’s self
evolves, persona is weakened, shadow becomes integrated and is better
understood, empowering archetypes emerge. An individual’s values are
shifted from materialism, sexuality, procreation towards spiritual, social,
and cultural values. Vision of purpose and meaning of life becomes clear.
Jung’s theory of human development is optimistic, focusing on growth.
Balance and Polarities:
Life has opposites or polarities. Their balance determines our
psychological health and development. Extreme s are harmful as they
prevent the realization of the opposite construct, gaining satisfactory
expression. The result of imbalance is the likelihood of an extreme
emotion to turn into its opposite over time. There are inborn self -
regulating systems within p eople which regulate energy flow and help to
maintain balance. This self -regulation is facilitated by transcendent
functions, allowing people to make the transition from one dimension of
their personality to another. The self -regulating systems include the
principle of equivalence and the principle of entropy. The principle of
equivalence states that energy lost in one system reappears in another
system, with the sum total of energy being constant. The principle of
entropy states that the libido flows from a more intense to a less intense
element in order to prevent the overload of energy in one area. Jung
defined libido as total psychic energy.
c) Dimensions of Personality:
Individual differences in personality are assigned to two dimensions. First
dimen sion is the typical ways in which people take in and understand
internal and external stimuli (the four functions). Second dimension is the
characteristic directions of people’s libidos (the two attitudes).
i) The Two Attitudes: The direction of movement o f libido or energy is
the second determinant of personality. Energy of every person moves
primarily in one of the two ways - Extraversion and introversion.
Extraversion : Those who have dominant extraversion attitude, direct
their energy towards the world o utside. They are likely to be outgoing and
adapt smoothly to the external change. These people are energized by
social, interpersonal situations than by solitude. munotes.in
Page 24
28 Intervention Systems Emphasizing Background - II Introversion - Introversion is an opposite attitude of extraversion. Those
who have dominant introversion attitude, are comfortable in directing their
libido inward. They may have good social skills, but they prefer to be
introspective and recharge themselves by being alone.
ii) The Four Functions: Thinking, feeling, sensation and intuition are t he
four functions which determine how we process internal and external
stimuli. Thinking and feeling are known as rational functions and
sensation and intuition are known as irrational functions. They are as
follows:
Thinking : Those who have dominant think ing function reacts cognitively
and intellectually, trying to interpret and understand a stimulus.
Feeling : This function is opposite to the feeling function. Those with
dominant feeling function react emotionally and focus on pleasure,
dislike, anger, et c. emotions raised by a stimulus.
Sensation : Sensation includes receiving, identifying physical stimuli
through our senses and passing them on to the consciousness. Those
who have dominant sensation function look at substance of a
stimulus, facts and seek evidence of its meaning, value.
Intuition : This function is opposite to the sensation function. Those
with dominant intuition function depend on feelings about where a
stimulus has come from, its direction and possibilities to determine
their decisions a nd reactions about the stimulus.
Every individual has a dominant/ superior function. This superior function
organizes experiences, perceptions and an inferior function that is closer to
the unconscious. We have minimum control on our inferior function and it
causes us discomfort. If one has balance or access to all four functions,
then it allows him/ her to operate fully in various situations. Unconscious
compensates for the dominance of an individual’s superior function by
encouraging the opposite tendenc ies.
The four functions can be paired with each of the two attitudes and makes
eight possible personality types. They are thinking and introversion,
thinking and extraversion, feeling and introversion, feeling and
extraversion, sensation and introversion, sensation and extraversion,
intuition and introversion, intuition and extraversion. The functions and
attitudes form the basis for the Myers -Briggs Type Indicator (MBTI).
2.2.1 Treatment Using Jungian Analytical Psychology
According to Jungian analysts, treatment is a lengthy, intensive process
where clients are generally seen at least twice a week.
a) Goals of Psychotherapy:
This approach focuses on emergence and understanding of material from
personal and the collective unconscious. Painful, unaccepta ble aspects of
the unconscious are made conscious, acceptable, and meaningful which munotes.in
Page 25
29 Intervention Systems In Psychology leads to resolution of inner conflicts, greater balance, integration in the
person, individuation, growth in creativity, energy and spiritual feelings.
The goal is not to b ring people happiness but make clients able to cope
with the inevitable pain and suffering of life. The ultimate goal of Jungian
analysis is individuation (transcendence or self -actualization).
Jungian treatment typically has four stages -
First stage is catharsis, and emotional cleansing, where strong
emotions are discharged.
Second stage is elucidation, where meaning of clients difficulties in
life, symptoms, archetypes (anima and animus, shadow) and current
situation is understood, clarified. Transfere nce and
countertransference are explored, analyzed which can inform and
direct the treatment. People also work through their immature and
unrealistic thoughts, fantasies.
Third stage is education, where analyst is encouraging, supportive
and helps people to take risks in order to improve their life. Many
clients stop taking treatment at this point.
Fourth stage is transformation, which takes place when clients
achieve thorough access to the collective unconscious and the
archetypes. After facilitation of an ego - self dialogue, balance is
emerged which in turn promotes individuation and self -realization.
b) Therapeutic Alliance:
Jung’s psychotherapy has a more relational view. He looked at
psychotherapy as providing healing, guidance and comfort. Jungian
analysts’ play role of educators, collaborators and take active part in the
process of treatment. They try to create awareness through interventions.
Jung believed that both client and analyst have an unconscious impact on
each other which can facilitate tre atment. Jung considered therapy as a
reciprocal process as each participant (client and analyst) experience
healing, growth and benefit from the positive changes in the other
participant.
c) Interventions:
In the beginning, Jungian psychotherapy focuses o n the conscious, builds
a therapeutic alliance, and provides foundation for safe, productive
exploration of the unconscious. After this, various techniques are used to
obtain access to the contents of the unconscious. When this content of the
unconscious i s brought into consciousness, it is explored, clarified,
interpreted, and understood. This content can be later integrated into the
overall psyche of the person.
i) Use of Symbols: Jung’s work highlights the capacity to think
symbolically and look at the underlying dynamics, patterns which
drive clients’ thoughts, feelings, and actions. These patterns may
appear in symbolic, indirect way in client’s dreams, symptoms, munotes.in
Page 26
30 Intervention Systems Emphasizing Background - II fantasies etc. Analysts ability to understand this psychological subtext
can be improved by knowing the symbols which seen in myths, fairy
tales, art, literature, religions etc.
ii) Dream Interpretation: According to Jung, dreams provide easiest
access to the unconscious, reflecting people’s inner lives and their
unconscious responses. Dreams represent wishes, fears, fantasies,
memories, experiences, visions, truths, etc. Dream interpretation of
this approach includes retelling the recalled dream, describing its
effect on consciousness; searching for events that may have triggered
that dream. After this, investigation of the dream’s objective and
subjective content is done for archetypal images and symbols of the
unconscious. After understanding the dream, it is assimilated into
consciousness.
iii) Word Association Tests: In these tests, the a nalyst reads single
words one at a time to the client. Client’s task is to reply with the first
word that comes into his/her mind. Responses which are unusual,
repeated and hesitations, flushing, visible tensions give clue to the
presence of unconscious ma terial and complexes. Associations are
used for exploring the meaning of the dreams.
iv) Rituals: Jung occasionally incorporated rites, rituals into therapy
which can enhance its process and strengthen its individual, cultural
relevance and impact.
2.2.2 Evaluation of Jung’s Analytical Psychology :
Jung’s concepts are complex, ill -defined and the treatment is lengthy. His
work is not empirically validated. Little attention is paid to immediate
crisis and to practice Jungian analysis, extensive training an d supervision
is needed. There are some strengths as well. For example, Jung’s ideas are
later reflected in many theories in various fields. The Myers -Briggs Type
Indicator, a personality inventory is based on his theory.
2.3 REFERENCES 1. Corey, G. (2009 ). Theory and practice of counseling and
psychotherapy (8th ed.). CA: Thomson Brooks.
2. Seligman, L. & Reichenberg, L. W. (2014). Theories of counseling
and psychotherapy: Systems, strategies, and skills (4th ed.) . Pearson
education.
3. Flanagan, J.S. & Flanagan, R.S. (2004). Counseling and
psychotherapy theories in context and practice: Skills strategies and
techniques. Hoboken, NJ: John Wiley & Sons, Inc.
***** munotes.in
Page 27
31
3
INTERVENTION SYSTEMS
EMPHASIZING HUMANISTIC,
COGNITIVE, BEHAVIOURAL
APPROACHES
Unit Structure
3.1 Introduction
3.2 Carl Rogers – Person Centred Therapy
3.2.1 The Therapeutic Process
3.2.2 Application: Therapeutic Techniques And Procedures
3.2.3 Evaluat ion of Person -Centred Therapy:
3.3 Behaviour Therapy
3.3.1 Historical Background
3.3.2 Key Concepts
3.3.3 The Therapeutic Process
3.3.4. Application: Therapeutic Techniques and Procedures
3.4 Aaron Beck – Cognitive Therapy
3.4.1 Basic Principles of Cogni tive Therapy:
3.4.2 Applications of Cognitive Therapy
3.4.3 Evaluation
3.5 Reference
3.1 INTRODUCTION This chapter describes another set of three major therapies in counselling
and psychotherapy. They are Person Centred Therapy by Carl Rogers,
Behaviour Therapy, and Cognitive Therapy by Aaron T. Beck.
3.2 CARL ROGERS – PERSON CENTRED THERAPY Carl Rogers (1902 -1987) was a major spokesperson for humanistic
psychology and is considered as the “father of psychotherapy research”.
He introduced many phenomena in the field of counselling and
psychotherapy for the first time, including analysis of the transcripts of
actual therapy session to study the counselling process in depth, use of
quantitative methods to conduct major studies on psychotherapy, and
formulat ion of a comprehensive theory of personality and psychotherapy
grounded in empirical research. He also contributed to developing a theory
of psychotherapy that de -emphasized pathology and focused on the
strengths and resources of individuals. munotes.in
Page 28
32 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches The Person -Centred Therapy by Carl Rogers shares many concepts and
values with another psychotherapy called “Existential Therapy”. The basic
assumptions of the Person -Centred Therapy about people are as follows:
People are essentially trustworthy and resourceful
They are able to make constructive changes and live effective and
productive lives
They have a vast potential for understanding themselves and resolving
their own problems without direct intervention on the therapist’s part
They are capable of self -directed gro wth if they are involved in a
specific kind of therapeutic relationship.
According to Rogers, the attitudes and personal characteristics of the
therapist and the quality of the client -therapist relationship are the major
determinants of the outcome of the therapeutic process. Since Rogers did
not present person -centred theory as a fixed and completed approach to
therapy, his person -centred therapy is considered as the result of an
evolutionary process as it continues to remain open to change and
refinement (Cain, 2010; Cain & Seeman, 2002).
Rogers’ approach developed in four periods with major turning points that
finally led the development of person -centred therapy. These identified
four periods with milestones/turning points are mentioned below in brief:
1940s: During this first period, Rogers developed a counselling
approach called “nondirective counselling”. This approach provided a
powerful and revolutionary alternative to the directive and interpretive
approaches to therapy being practiced during that p eriod. He also
challenged the validity of commonly accepted therapeutic procedures,
such as advice, suggestion, direction, persuasion, teaching, diagnosis,
and interpretation in this period.
1950s: In this second period, Rogers renamed his approach as clie nt-
centred therapy to reflect its emphasis on the client, rather than on
nondirective methods. This period was mainly characterized by a shift
from clarification of feelings to a focus on the phenomenological
world of the client. Rogers assumed that how pe ople behave can be
understood best from their own internal frame of reference. He also
focused on the actualizing tendency more explicitly as the basic
motivational force that leads to client change.
Late 1950s to 1970s: This period mainly addressed the ne cessary and
sufficient conditions of therapy. Rogers’ interest in how people best
progress in psychotherapy led him to study the qualities of the client -
therapist relationship as a catalyst leading to personality change. He
also conducted extensive researc h with his associates on both the
process and outcomes of psychotherapy. munotes.in
Page 29
33 Intervention Systems In Psychology During 1980s and the 1990s: This period was marked by
considerable expansion of counselling approach to education, couples
and families, industry, groups, conflict resolutions, politi cs, and the
search for world peace. Thus, Rogers’ theory came to be known as
person -centred approach due to his ever -widening scope of influence,
including his interest in how people obtain, possess, share, or
surrender power and control over others and th emselves. Being
mainly applied to individual and group counselling, person -centred
approach was further applied to important areas including education,
family life, leadership and administration, organizational
development, health care, cross -cultural and interracial activity, and
international relations.
Many of Carl Rogers’ ideas, especially on the positive aspects of being
human and the fully functioning person, are based on Abraham Maslow’s
(a pioneer in the development of humanistic psychology) basic
philosophy. According to Rogers, there are three therapist attributes that
create a growth -promoting climate. They are i) congruence (genuineness
or realness), ii) unconditional positive regard (acceptance and caring), and
iii) accurate empathic understand ing (an ability to deeply grasp the
subjective world of another person).
Rogers believed that in such a climate, individuals can move forward and
become what they are capable of becoming. Also, such a therapeutic
climate with this attitude of the therapi sts makes the one being helped to
become less defensive and more open to themselves and their world. They
will also behave in prosocial and constructive ways. Thus, the person -
centred approach rejects the role of the therapists as the authority and of
the passive clients merely following the beliefs of the therapists. Overall,
person -centred therapy is rooted in the clients’ capacity for awareness and
self-directed change in attitudes and behaviour.
The emphasis in the person -centred approach is mainly on t hree things:
how clients act in their world with others,
how they can move forward in constructive directions, and
how they can successfully deal with obstacles (both from within
themselves and outside of themselves) that are blocking their growth.
3.2.1 The Therapeutic Process :
Therapeutic Goals:
The aim of the person -centred approach is to make the client achieve a
greater degree of independence and integration. Hence, the focus in the
therapy is on the person, and not on the person’s presenting problem.
Thus, the main goal of the therapy is to assist clients in their growth
process, so that clients can better cope with problems as they identify
them. People entering psychotherapy often ask such questions (Rogers,
1961) as follows: munotes.in
Page 30
34 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches “How can I discover my real self?”
“How can I become what I deeply wish to become?”
“How can I get behind my facades and become myself?”
In line with this set of questions, the underlying aim of person -centred
therapy is to provide a climate conducive to helping the individual s trive
toward self -actualization. According to Rogers (1961), people who
become increasingly actualized have the following characteristics:
An openness to experience,
A trust in themselves
An internal source of evaluation, and
A willingness to continue gro wing.
The basic goal of person -centred therapy is to encourage these
characteristics.
Therapist’s Function and Role:
The role of person -centred therapists is rooted in their ways of being and
attitudes. It is the attitude of therapists that facilitate pers onality change in
the clients, rather than therapists’ knowledge, theories, or techniques
(Rogers, 1961). Thus, basically therapists use themselves as an instrument
of change. In short, their “role” is to be without roles, when they encounter
the client on a person -to-person level. In other words, they do not get lost
in their professional role. Thus, it is the therapist’s attitude and belief in
the inner resources of the client that creates the therapeutic climate for
growth (Bozarth et al., 2002).
The th erapist’s function is to be present and accessible to clients and to
focus on their immediate experience. First and foremost, the therapist must
be willing to be real in the relationship with clients. Thus, the therapist is a
catalyst for change by being c ongruent, accepting, and empathic. These
attitudes of the therapists lead the clients to have the necessary freedom to
explore areas of their life that were either denied to awareness or distorted.
Client’s Experience in Therapy:
Clients have the opportuni ty to explore the full range of their experience,
including their feelings, beliefs, behaviour, and worldview as result of a
climate created by the counselor which is conducive to self -exploration.
Thus, the therapeutic change depends on clients’ perceptio ns both of their
own experience in therapy and of the counselor’s basic attitudes.
Clients basically seek therapy because they have a feeling of basic
helplessness, powerlessness, and an inability to make decisions or
effectively direct their own lives. H owever, in person -centred therapy,
clients soon learn that they can be responsible for themselves in the munotes.in
Page 31
35 Intervention Systems In Psychology relationship and that they can learn to be more free by using the
relationship to gain greater self -understanding.
The person -centred therapy relation ship provides a supportive structure
within which clients’ self -healing capacities are activated, since it is
grounded on the assumption that it is clients i) who heal themselves, ii)
who create their own self -growth, and iii) who are active self -healers
(Bohart & Tallman, 1999, 2010; Bohart & Watson, 2011). Clients value
most, especially the following things:
being understood and accepted which results in creating a safe place
to explore feelings, thoughts, behaviours, and experiences;
support for trying o ut new behaviours (Bohart & Tallman, 2010).
As a result of the progress in counselling, clients also have the following
valuable experiences:
They are able to explore a wider range of beliefs and feelings.
They can express their fears, anxiety, guilt, sha me, hatred, anger, and
other emotions that they had deemed too negative to accept and
incorporate into their self -structure.
They distort less and move to a greater acceptance and integration of
conflicting and confusing feelings.
They increasingly disco ver aspects within themselves that had been
kept hidden.
They become less defensive and become more open to their
experience, when they feel understood and accepted,
they become more realistic, perceive others with greater accuracy, and
become better able to understand and accept others, because they feel
safer and are less vulnerable,
They come to appreciate themselves more as they are, and their
behaviour shows more flexibility and creativity
They become less concerned about meeting others’ expectations, and
thus begin to behave in ways that are truer to themselves.
They direct their own lives instead of looking outside of themselves
for answers.
They move in the direction of being more in contact with what they
are experiencing at the present moment, le ss bound by the past, less
determined, freer to make decisions, and increasingly trusting in
themselves to manage their own lives.
Relationship between Therapist and Client: munotes.in
Page 32
36 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches Rogers’ (1957) hypothesis of the “necessary and sufficient conditions for
therape utic personality change” was based on the quality of the
relationship. His hypothesis stated, “If I can provide a certain type of
relationship, the other person will discover within himself or herself the
capacity to use that relationship for growth and ch ange, and personal
development will occur” (Rogers, 1961, p. 33). Rogers (1967) further
hypothesized that “significant positive personality change does not occur
except in a relationship” (p. 73). This hypothesis was formulated on the
basis of many years o f Rogers’ professional experience, which remains
basically unchanged to this day. For Rogers’s, the client –therapist
relationship is characterized by equality and the process of change in the
client depends to a large degree on the quality of this equal re lationship.
Following are the core conditions, that are an integral part of the
therapeutic relationship:
1. Congruence, or genuineness:
It implies that therapists are real; genuine, integrated, and authentic during
the therapy hour. Their inner experienc e and outer expression of that
experience match, and they can openly express feelings, thoughts,
reactions, and attitudes that are present in the relationship with the client.
2. Unconditional positive regard and acceptance:
Deep and genuine caring for th e client as a person, or a condition of
unconditional positive regard can best be achieved through empathic
identification with the clients (Farber & Doolin, 2011). Therapists should
communicate through their behaviour that they value their clients as they
are and that clients are free to have feelings and experiences. Thus,
acceptance is the recognition of clients’ rights to have their own beliefs
and feelings. However, it is not the approval of all behaviour, and all overt
behaviour need not be approved o f or accepted.
3. Accurate empathic understanding:
Understanding clients’ experience and feelings sensitively and accurately
is one of the main tasks of the therapist because they are revealed in the
moment -to-moment interaction during the therapy session . The therapist
strives to sense clients’ subjective experience, particularly in the here and
now. The aim of this accurate empathic understanding is to encourage
clients to get closer to themselves to feel more deeply and intensely, and to
recognize and r esolve the incongruity that exists within them. Thus, it is
the cornerstone of the person -centred approach, and a necessary ingredient
of any effective therapy (Cain, 2010). Accurate empathic understanding
implies that the therapists will sense clients’ fe elings as if they were his or
her own without becoming lost in those feelings.
3.2.2 Application: Therapeutic Techniques And Procedures
Early Emphasis on Reflection of Feelings : Rogers’s original
emphasis was on grasping the world of the client and reflect ing this
understanding. Many followers of Rogers simply imitated his munotes.in
Page 33
37 Intervention Systems In Psychology reflective style. client -centred therapy has often been identified
primarily with the technique of reflection.
Evolution of Person -Centred Methods: Contemporary person -
centred therapy is the result of an evolutionary process of more than
70 years, and it continues to remain open to change and refinement.
The Role of Assessment: Assessment is frequently viewed as a
prerequisite to the treatment process. In person -centred therapy, the
client ’s self-assessment, not how the counselor assesses the client.
Assessment seems to be gaining in importance in short -term
treatments in most counselling agencies, and it is imperative that
clients be involved in a collaborative process in making decisions that
are central to their therapy.
Application of the Philosophy of the Person -Centred Approach:
The person -centred approach has been applied to working with
individuals, groups, and families. It has been found effective in many such
following cases:
With a wide range of client problems including anxiety disorders,
alcoholism, psychosomatic problems, agoraphobia, interpersonal
difficulties, depression, cancer, and personality disorders (Bozrath,
Zimring, and Tausch, 2002).
In training both professionals an d paraprofessionals who work with
people in a variety of settings.
In crisis intervention such as an unwanted pregnancy, an illness, a
disastrous event, or the loss of a loved one. People in the helping
professions (nursing, medicine, education, the minist ry) are often first
on the scene in a variety of crises, and they can do much if the basic
attitudes
In the group counselling, where the unique role of the group counselor
as a facilitator rather than a leader. The primary function of the
facilitator is to create a safe and healing climate —a place where the
group members can interact in honest and meaningful ways.
Several writers consider person -centred therapy as being ideally
suited to clients in a diverse world.
Motivational interviewing, which is based on the philosophy of
person -centred therapy, is a culturally sensitive approach that can be
effective across population domains, including gender, age, ethnicity,
and sexual orientation (Levensky et al., 2008).
3.2.3 Evaluation of Person -Centred Therapy:
Criticism/evaluation:
Person -centred therapy is based on a philosophy of human nature that
postulates an innate striving for self -actualization. munotes.in
Page 34
38 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches Rogers’s view of human nature is phenomenological; that is, we
structure ourselves according to our perceptions of reality. We are
motivated to actualize ourselves in the reality that we perceive.
Rogers’s theory rests on the assumption that clients can understand
the factorsin their lives that are causing them to be unhappy. They
also have the capacity for self -direction and constructive personal
change. Change will occur if a congruent therapist makes
psychological contact with a client in a state of anxiety or
incongruence. It is essential for the therapist to establish a relationship
the client perceives as genui ne, accepting, and understanding.
The person -centred approach emphasizes personal relationship
between client and therapist; the therapist’s attitudes are more critical
than are knowledge, theory, or techniques employed. In the context of
this relationship , clients unleash their growth potential and become
more of the person they are capable of becoming.
This approach places primary responsibility for the direction of
therapy on the client. In the therapeutic context, individuals have the
opportunity to dec ide for themselves and come to terms with their
own personal power. The underlying assumption is that no one knows
the client better than the client.
Contributions:
Rogers had, and his theory continues to have, a major impact on the
field of counselling an d psychotherapy.
One of Rogers’s contributions to the field of psychotherapy was his
willingness to state his concepts as testable hypotheses and to submit
them to research.
His theories of therapy and personality change have had a tremendous
heuristic eff ect, and though much controversy surrounds this
approach, his work has challenged practitioners and theoreticians to
examine their own therapeutic styles and beliefs.
Among the major contributions of person -centred therapy are the
implications of empathy f or the practice of counselling.
One of the strengths of the person -centred approach is “the
development of innovative and sophisticated methods to work with an
increasingly difficult, diverse, and complex range of individuals,
couples, families, and groups ” (Cain, 2002b, p. xxii).
One of the developments associated with the person -centred approach
is the emergence of emotion -focused therapy (EFT).
Limitations:
This therapeutic modality emphasizes the role of techniques aimed at
bringing about change in clie nts’ behaviour. munotes.in
Page 35
39 Intervention Systems In Psychology A potential limitation of the person -centred approach is that some
students -in-training and practitioners with this orientation may have a
tendency to be very supportive of clients without being challenging.
3.3 BEHAVIOUR THERAPY Introducti on:
Behaviour therapy is rooted mainly in the work of three pioneers in B. F.
Skinner (1904 -1990), Albert Bandura (b. 1925), and Arnold A. Lazarus (b.
1932). Behaviour therapy practitioners focus on directly observable
behaviour, current determinants of be haviour, learning experiences that
promote change, tailoring treatment strategies to individual clients, and
rigorous assessment and evaluation. Behaviour therapy has been used to
treat a wide range of psychological disorders with different client
populati ons.
Anxiety disorders, depression, posttraumatic stress disorder, substance
abuse, eating and weight disorders, sexual problems, pain management,
and hypertension have all been successfully treated using this approach
(Wilson, 2011). Behavioural procedur es are used in the fields of
developmental disabilities, mental illness, education and special education,
community psychology, clinical psychology, rehabilitation, business, self -
management, sports psychology, health -related behaviours, medicine, and
gerontology (Miltenberger, 2012; Wilson, 2011).
3.3.1 Historical Background :
The behavioural approach had its origin in the 1950s and early 1960s, and
it was a radical departure from the dominant psychoanalytic perspective.
The behaviour therapy movement diffe red from other therapeutic
approaches in its application of principles of classical and operant
conditioning to the treatment of a variety of problem behaviours. As
behaviour therapy has evolved and developed, it has increasingly
overlapped in some ways wi th other psychotherapeutic approaches
(Wilson, 2011).
Traditional behaviour therapy arose simultaneously in the United States,
South Africa, and Great Britain in the 1950s. In spite of harsh criticism
and resistance from psychoanalytic psychotherapists, th e approach has
survived. Its focus was on demonstrating that behavioural conditioning
techniques were effective and were a viable alternative to psychoanalytic
therapy. In the 1960s Albert Bandura developed social learning theory,
which combined classical and operant conditioning with observational
learning. Bandura made cognition a legitimate focus for behaviour
therapy.
During the 1960s a number of cognitive behavioural approaches sprang
up, which focus on cognitive representations of the environment rat her
than on characteristics of the objective environment. Contemporary
behaviour therapy emerged as a major force in psychology during the
1970s, and it had a significant impact on education, psychology, munotes.in
Page 36
40 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches psychotherapy, psychiatry, and social work. Behaviou ral techniques were
expanded to provide solutions for business, industry, and child -rearing
problems as well. Behaviour therapy techniques were viewed as the
treatment of choice for many psychological problems.
Two of the most significant developments in t he field were (1) the
continued emergence of cognitive behaviour therapy as a major force and
(2) the application of behavioural techniques to the prevention and
treatment of health -related disorders.
Four Areas of Development:
Contemporary behaviour ther apy can be understood by considering four
major areas of development: (1) classical conditioning, (2) operant
conditioning, (3) social cognitive theory, and (4) cognitive behaviour
therapy.
Classical conditioning (respondent conditioning) refers to what ha ppens
prior to learning that creates a response through pairing. A key figure in
this area is Ivan Pavlov who illustrated classical conditioning through
experiments with dogs. Placing food in a dog’s mouth leads to salivation,
which is respondent behaviour . When food is repeatedly presented with
some originally neutral stimulus (something that does not elicit a
particular response), such as the sound of a bell, the dog will eventually
salivate to the sound of the bell alone. However, if a bell is sounded
repeatedly but not paired again with food, the salivation response will
eventually diminish and become extinct.
Operant conditioning involves a type of learning in which behaviours are
influenced mainly by the consequences that follow them. If the
environme ntal changes brought about by the behaviour are reinforcing —
that is, if they provide some reward to the organism or eliminate aversive
stimuli —the chances are increased that the behaviour will occur again. If
the environmental changes produce no reinforcem ent or produce aversive
stimuli, the chances are lessened that the behaviour will recur. Positive
and negative reinforcement, punishment, and extinction techniques.
illustrate how operant conditioning in applied settings can be instrumental
in developing p rosocial and adaptive behaviours. Operant techniques are
used by behavioural practitioners in parent education programs and with
weight management programs.
The social learning approach (or the social cognitive approach)
developed by Albert Bandura and Ri chard Walters (1963) is interactional,
interdisciplinary, and multimodal (Bandura, 1977, 1982). Social cognitive
theory involves a triadic reciprocal interaction among the environment,
personal factors (beliefs, preferences, expectations, self -perceptions, and
interpretations), and individual behaviour. In the social -cognitive approach
the environmental events on behaviour are mainly determined by
cognitive processes governing how environmental influences are
perceived by an individual and how these events are interpreted (Wilson,
2011). A basic assumption is that people are capable of self directed munotes.in
Page 37
41 Intervention Systems In Psychology behaviour change and that the person is the agent of change. For Bandura
(1982, 1997), self -efficacy is the individual’s belief or expectation that he
or she can master a situation and bring about desired change.
Cognitive behaviour therapy (CBT) represents the mainstream of
contemporary behaviour therapy and is a popular theoretical orientation
among psychologists. Cognitive behavioural therapy operates on the
assumption that what people believe influences how they act and feel.
Since the early 1970s, the behavioural movement has conceded a
legitimate place to thinking, even to the extent of giving cognitive factors
a central role in understanding and treating em otional and behavioural
problems. By the mid -1970s cognitive behaviour therapy had replaced
behaviour therapy as the accepted designation, and the field began
emphasizing the interaction among affective, behavioural, and cognitive
dimensions (Lazarus, 2008 a; Wilson, 2011).
Contemporary behaviour therapy has much in common with cognitive
behaviour therapy in which the mechanism of change is both cognitive
(modifying thoughts to change behaviours) and behavioural (altering
external factors that lead to behavi ourchange) (Follette & Callaghan,
2011). Considered broadly, the term “behaviour therapy” refers to
practices based primarily on social -cognitive theory and encompasses a
range of cognitive principles and procedures (Wilson, 2011).
3.3.2 Key Concepts :
View of Human Nature :
Modern behaviour therapy is grounded on a scientific view of human
behaviour that accommodates a systematic and structured approach to
counselling. The current view is that the person is the producer and the
product of his or her environm ent. Behaviour therapy aims to increase
people’s skills so that they have more options for responding. By
overcoming debilitating behaviours that restrict choices, people are freer
to select from possibilities that were not available to them earlier, which
increases individual freedom. People have the capacity to choose how they
will respond to external events in their environment, which makes it
possible for therapists to use behavioural methods to attain humanistic
ends (Kazdin, 1978, 2001).
Basic Charact eristics and Assumptions:
Seven key characteristics of behaviour therapy are described below.
1. Behavior therapy is based on the principles and procedures of the
scientific method.
2. Behaviour is not limited to overt actions a person engages in that w e
can observe; behaviour also includes internal processes such as
cognitions, images, beliefs, and emotions. The key characteristic of a
behaviour is that it is something that can be operationally defined. munotes.in
Page 38
42 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches 3. Behaviour therapy deals with the client’s curr ent problems and the
factors influencing them, as opposed to an analysis of possible
historical determinants.
4. Clients involved in behaviour therapy are expected to assume an
active role by engaging in specific actions to deal with their problems.
5. This approach assumes that change can take place without insight into
underlying dynamics and without understanding the origins of a
psychological problem.
6. Assessment is an ongoing process of observation and self -monitoring
that focuses on the current d eterminants of behaviour, including
identifying the problem and evaluating the change; assessment
informs the treatment process.
7. Behavioural treatment interventions are individually tailored to
specific problems experienced by the client.
3.3.3 The The rapeutic Process :
Therapeutic Goals:
Goals occupy a place of central importance in behaviour therapy. The
general goals of behaviour therapy are to increase personal choice and to
create new conditions for learning. The client, with the help of the
therapi st, defines specific treatment goals at the outset of the therapeutic
process. Continual assessment throughout therapy determines the degree
to which identified goals are being met. It is important to devise a way to
measure progress toward goals based on empirical validation.
The therapist assists clients in formulating specific measurable goals.
Goals must be clear, concrete, understood, and agreed on by the client and
the counselor. The process of determining therapeutic goals entails a
negotiation betw een client and counselor that results in a contract that
guides the course of therapy. Behaviour therapists and clients alter goals
throughout the therapeutic process as needed.
Therapist’s Function and Role:
Behaviour therapists conduct a thorough functio nal assessment (or
behavioural analysis) to identify the maintaining conditions by
systematically gathering information about:
Situational antecedents (A),
The dimensions of the problem behaviour (B), and
The consequences (C) of the problem.
This is kn own as the ABC model, and the goal of a functional assessment
of a client’s behaviour is to understand the ABC sequence. This model of
behaviour suggests that behaviour (B) is influenced by some particular
events that precede it, called antecedents (A), an d by certain events that munotes.in
Page 39
43 Intervention Systems In Psychology follow it, called consequences (C). Antecedent events cue or elicit a
certain behaviour. Consequences are events that maintain a behaviour in
some way, either by increasing or decreasing it.
In doing a behavioural assessment inter view, the therapist’s task is to
identify the particular antecedent and consequent events that influence, or
are functionally related to, an individual’s behaviour (Cormier, Nurius, &
Osborn, 2013). Here are some of the functions of behaviourally oriented
practitioners:
They tend to be active and directive and to function as consultants and
problem solvers.
They rely heavily on empirical evidence about the efficacy of the
techniques they apply to particular problems.
They must possess intuitive skills an d clinical judgment in selecting
appropriate treatment methods and in determining when to implement
specific techniques (Wilson, 2011).
They pay close attention to the clues given by clients, and
They are willing to follow their clinical hunches.
They u se some techniques common to other approaches, such as
summarizing, reflection, clarification, and open -ended questioning.
Behavioural clinicians perform other functions as well (Miltenberger,
2012; Spiegler & Guevremont, 2010):
The therapist formulates in itial treatment goals and designs and
implements a treatment plan to accomplish these goals.
The behavioural clinician uses strategies that have research support
for use with a particular kind of problem.
The clinician evaluates the success of the change p lan by measuring
progress toward the goals throughout the duration of treatment.
A key task of the therapist is to conduct follow -up assessments to see
whether the changes are durable over time.
Client’s Experience in Therapy :
Both therapist and client hav e clearly defined roles, and the importance of
client awareness and participation in the therapeutic process is stressed.
The client engages in behavioural rehearsal with feedback until skills are
well learned and generally receives active homework assignm ents (such as
self-monitoring of problem behaviours) to complete between therapy
sessions. Behaviour clinicians emphasize that changes clients make in
therapy need to be translated into their daily lives.
It is important for clients to be motivated to cha nge, and they are expected
to cooperate in carrying out therapeutic activities, both during therapy munotes.in
Page 40
44 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches sessions and in everyday life. If clients are not involved in this way, the
chances are slim that therapy will be successful. Clients are encouraged to
expe riment for the purpose of enlarging their repertoire of adaptive
behaviours. Clients are as aware as the therapist is regarding when the
goals have been accomplished and when it is appropriate to terminate
treatment. It is clear that clients are expected t o do more than merely
gather insights; they need to be willing to make changes and to continue
implementing new behaviour once formal treatment has ended.
Relationship between Therapist and Client:
Behavioural practitioners have increasingly recognized the role of the
therapeutic relationship and therapist behaviour as critical factors related
to the process and outcome of treatment. Today, most behavioural
practitioners stress behavioural practitioners have increasingly recognized
the role of the therapeut ic relationship and therapist behaviour as critical
factors related to the process and outcome of treatment. Today, most
behavioural practitioners stress the value of establishing a collaborative
working relationship with their clients. The skilled behavio ur therapist
conceptualizes problems behaviourally and makes use of the client –
therapist relationship in facilitating change.
3.3.4. Application: Therapeutic Techniques And Procedures :
A hallmark of the behavioural approaches is that the therapeutic
techni ques are empirically supported and evidence -based practice is highly
valued. According to Lazarus (1989, 1992b, 1996b, 1997a, 2005, 2008a,
2008b), behavioural practitioners can incorporate into their treatment
plans any technique that can be demonstrated t o effectively change
behaviour. Lazarus advocates the use of diverse techniques, regardless of
their theoretical origin. It is clear that behaviour therapists do not have to
restrict themselves only to methods derived from learning theory.
Likewise, behavi oural techniques can be incorporated into other
approaches. Therapists are often quite creative in their interventions. A
range of behavioural techniques available to the practitioner include
applied behavioural analysis, relaxation training, systematic
desensitization, exposure therapies, eye movement desensitization and
reprocessing, social skills training, self -management programs and self -
directed behaviour, multimodal therapy, and mindfulness and acceptance -
based approaches.
Applied Behavioural Analysi s: Operant Conditioning Techniques:
In applied behaviour analysis, operant conditioning techniques and
methods of assessment and evaluation are applied to a wide range of
problems in many different settings (Kazdin, 2001). The goal of
reinforcement, whethe r positive or negative, is to increase the target
behaviour. Positive reinforcement involves the addition of something of
value to the individual (such as praise, attention, money, or food) as a
consequence of certain behaviour. The stimulus that follows t he behaviour
is the positive reinforcer. Negative reinforcement involves the escape munotes.in
Page 41
45 Intervention Systems In Psychology from or the avoidance of aversive (unpleasant) stimuli. The individual is
motivated to exhibit a desired behaviour to avoid the unpleasant condition.
Another operant method of changing behaviour is extinction, which refers
to withholding reinforcement from a previously reinforced response. In
applied settings, extinction can be used for behaviours that have been
maintained by positive reinforcement or negative reinforcement.
Another way behaviour is controlled is through punishment , sometimes
referred to as aversive control, in which the consequences of a certain
behaviour result in a decrease of that behaviour. The goal of reinforcement
is to increase target behaviour, but the goal of punishment is to decrease
target behaviour. Miltenberger (2012) describes two kinds of punishment
that may occur as a consequence of behaviour: positive punishment and
negative punishment. In positive punishment an aversive stimulus is added
after the behaviour to decrease the frequency of a behaviour. In negative
punishment a reinforcing stimulus is removed following the behaviour to
decrease the frequency of a target behaviour (such as deducting money
from a worker’s salary for missing time at work, or taking television time
away from a child for misbehaviour). In both kinds of punishment, the
behaviour is less likely to occur in the future.
Some other important influential techniques in behaviour therapy are as
follows in brief:
Progressive mu scle relaxation initially developed by Jacobson (1938)
which is a method of teaching people to cope with the stresses produced
by daily living. It is aimed at achieving muscle and mental relaxation and
is easily learned.
Systematic desensitization , which i s based on the principle of classical
conditioning, is a basic behavioural procedure developed by Joseph
Wolpe, one of the pioneers of behaviour therapy. Clients imagine
successively more anxiety -arousing situations at the same time that they
engage in a b ehaviour that competes with anxiety. Gradually, or
systematically, clients become less sensitive (desensitized) to the anxiety -
arousing situation.
Exposure therapies are designed to treat fears and other negative
emotional responses by introducing clients, under carefully controlled
conditions, to the situations that contributed to such problems.
Eye movement desensitization and reprocessing (EMDR) is a form of
exposure therapy that entails assessment and preparation, imaginal
flooding, and cognitive restr ucturing in the treatment of individuals with
traumatic memories.
Social skills training is a broad category that deals with an individual’s
ability to interact effectively with others in various social situations; it is
used to help clients develop and ac hieve skills in interpersonal
competence. munotes.in
Page 42
46 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches Self-management programs enable people to make decisions concerning
specific behaviours they want to control or change.
Multimodal therapy is a comprehensive, systematic, holistic approach to
behaviour therapy de veloped by Arnold Lazarus (1989, 1997a, 2005,
2008a). It is grounded in social -cognitive theory and applies diverse
behavioural techniques to a wide range of problems.
Mindfulness involves being aware of our experiencing in a receptive way
and engaging in activity based on this nonjudgmental awareness (Robins
& Rosenthal, 2011). In mindfulness practice, clients train themselves to
intentionally focus on their present experience while at the same time
achieving a distance from it.
Acceptance is a process inv olving receiving one’s present experience
without judgment or preference, but with curiosity and kindness, and
striving for full awareness of the present moment (Germer, 2005b).
Dialectical Behaviour Therapy (DBT) formulated by Linehan (1993a,
1993b), is a promising blend of behavioural and psychoanalytic techniques
for treating borderline personality disorders.
Mindfulness -Based Stress Reduction (MBSR) aims to assist people in
learning how to live more fully in the present rather than ruminating about
the past or being overly concerned about the future. The essence of MBSR
consists of the notion that much of our distress and suffering results from
continually wanting things to be different from how they actually are
(Salmon, Sephton, & Dreeben, 2011).
Mindfulness -Based Cognitive Therapy (MBCT) program is a
comprehensive integration of the principles and skills of mindfulness
applied to the treatment of depression (Segal, Williams, & Teasdale,
2002).
Acceptance and Commitment Therapy (Hayes et al., 2005, 2 011),
which involves fully accepting present experience and mindfully letting go
of obstacles.
Applications:
Group -based behavioural approaches emphasize teaching clients self -
management skills and a range of new coping behaviours, as well as
how to restru cture their thoughts. Clients can learn to use these
techniques to control their lives, deal effectively with present and
future problems, and function well after they complete their group
experience.
Behaviour therapy has some clear advantages over many o ther
theories in counselling culturally diverse clients.
Shortcomings: munotes.in
Page 43
47 Intervention Systems In Psychology Behaviour therapy is sensitive to differences among clients in a broad
sense.
Race, gender, ethnicity, and sexual orientation are critical variables
that influence the process and outco me of therapy.
Instead of viewing clients in the context of their sociocultural
environment, these practitioners concentrate too much on problems
within the individual.
Evaluation:
Contributions of Behaviour Therapy:
Behaviour therapy challenges us to rec onsider our global approach to
counselling.
The specificity of the behavioural approaches helps clients translate
unclear goals into concrete plans of action, and it helps both the
counselor and the client to keep these plans clearly in focus.
Techniques s uch as role playing, relaxation procedures, behavioural
rehearsal, coaching, guided practice, modelling, feedback, learning by
successive approximations, mindfulness skills, and homework
assignments can be included in any therapist’s repertoire, regardless
of theoretical orientation.
A major contribution of behaviour therapy is its emphasis on research
into and assessment of treatment outcomes.
A strength of the behavioural approaches is the emphasis on ethical
accountability.
Limitations and Criticisms of Behaviour Therapy:
Behaviour therapy has been criticized for a variety of reasons. Here are
four common criticisms and misconceptions about behaviour therapy:
1. Behaviour therapy may change behaviours, but it does not change
feelings.
2. Behaviour therapy does not provide insight.
3. Behaviour therapy treats symptoms rather than causes.
4. Behaviour therapy involves control and social influence by the
therapist.
3.4 AARON BECK – COGNITIVE THERAPY INTRODUCTION :
Aaron Temkin Beck (b. 1921) found the cognitio ns of depressed
individuals to be characterized by errors in interpretation that he called
“cognitive distortions.” For Beck, negative thoughts reflect underlying munotes.in
Page 44
48 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches dysfunctional beliefs and assumptions. When these beliefs are triggered by
situational events , a depressive pattern is put in motion. Beck believes
clients can assume an active role in modifying their dysfunctional thinking
and thereby gain relief from a range of psychiatric conditions. His
continuous research in the areas of psychopathology and t he utility of
cognitive therapy has earned him a place of prominence in the scientific
community in the United States.
Beck is the pioneering figure in cognitive therapy, one of the most
influential and empirically validated approaches to psychotherapy. H e has
successfully applied cognitive therapy to depression, generalized anxiety
and panic disorders, suicide, alcoholism and drug abuse, eating disorders,
marital and relationship problems, psychotic disorders, and personality
disorders. He has developed a ssessment scales for depression, suicide risk,
anxiety, self -concept, and personality.
All of the cognitive behavioural approaches share the same basic
characteristics and assumptions as traditional behaviour therapy. Although
the approaches are quite dive rse, they do share these attributes: (1) a
collaborative relationship between client and therapist, (2) the premise that
psychological distress is largely a function of disturbances in cognitive
processes, (3) a focus on changing cognitions to produce desi red changes
in affect and behaviour, (4) a present -centred, time -limited focus, (5) an
active and directive stance by the therapist, and (6) an educational
treatment focusing on specific and structured target problems (Beck &
Weishaar, 2011).
Both, cogniti ve therapy and the cognitive behavioural therapies -
Are based on a structured psychoeducational model,
Emphasize the role of homework,
Place responsibility on the client to assume an active role both during
and outside therapy sessions,
Emphasize deve loping a strong therapeutic alliance, and
Draw from a variety of cognitive and behavioural strategies to bring
about change.
To a large degree, are based on the assumption that a reorganization
of one’s self -statements will result in a corresponding reorg anization
of one’s behaviour.
Include a variety of behavioural strategies as a part of their integrative
repertoire.
Beck developed an approach known as cognitive therapy (CT) as a result
of his research on depression (Beck 1963, 1967). Beck’s observations of
depressed clients revealed that they had a negative bias in their
interpretation of certain life events, which contributed to their cognitive
distortions (Beck, 1967). munotes.in
Page 45
49 Intervention Systems In Psychology Cognitive therapy has a number of similarities to both rational emotive
behaviour t herapy and behaviour therapy. All of these therapies are active,
directive, time -limited, present centred, problem -oriented, collaborative,
structured, and empirical. They make use of homework and require
explicit identification of problems and the situati ons in which they occur
(Beck & Weishaar, 2011). Some of the important features of cognitive
therapy are as follows:
It perceives psychological problems as stemming from commonplace
processes such as faulty thinking, making incorrect inferences on the
basis of inadequate or incorrect information, and failing to distinguish
between fantasy and reality.
Like REBT, it is an insight -focused therapy with a strong
psychoeducational component that emphasizes recognizing and
changing unrealistic negative thoughts and maladaptive beliefs.
It is highly collaborative and involves designing specific learning
experiences to help clients (Dobson & Dozois, 2010; Dozois & Beck,
2011))
• monitor their automatic thoughts
• examine the validity of their automatic thoughts
• underst and the relationship among cognition, feelings, and
behaviour
• develop more accurate and realistic cognitions; and
• change underlying beliefs and assumptions
It is based on the theoretical rationale that the way people feel and
behave is influenced by how t hey perceive and structure their
experience.
Its theoretical assumptions (Weishaar, 1993) are:
(1) that people’s internal communication is accessible to introspection,
(2) that clients’ beliefs have highly personal meanings, and
(3) that these meaning s can be discovered by the client rather than being
taught or interpreted by the therapist.
3.4.1 Basic Principles of Cognitive Therapy:
Beck, formerly a practicing psychoanalytic therapist for many years, grew
interested in his clients’ automatic thoughts (personalized notions that are
triggered by particular stimuli that lead to emotional responses). As a part
of a psychoanalytic research study, he was examining the dream content of
depressed clients for anger that they were turning back on themselves. He
began to notice that rather than retroflected anger, as Freud theorized with munotes.in
Page 46
50 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches depression, clients exhibited a negative bias in their interpretation or
thinking.
Individuals tend to maintain their core beliefs about themselves, their
world, and their future . A primary focus of cognitive therapy is to assist
clients in examining and restructuring their core beliefs (or core schema)
(Dozois & Beck, 2011). By encouraging clients to gather and weigh the
evidence in support of their beliefs, therapists help clien ts bring about
enduring changes in their mood and their behaviour.
Beck contends that people with emotional difficulties tend to commit
characteristic “logical errors”, called Arbitrary inferences, Selective
abstraction, Overgeneralization, Magnification a nd minimization,
Personalization, Labeling and mislabelling, and Dichotomous thinking
that distort objective reality, and lead to faulty assumptions and
misconceptions, which are termed cognitive distortions (J. Beck, 2011;
Beck & Weishaar, 2011). In cogni tive therapy, clients learn to engage in
more realistic thinking, especially if they consistently notice times when
they tend to get caught up in catastrophic thinking.
The Client –Therapist Relationship:
Beck (1987) emphasizes that the quality of the thera peutic relationship is
basic to the application of cognitive therapy. A therapeutic alliance is a
necessary first step in cognitive therapy, especially in counselling
difficult -to-reach clients. In cognitive therapy, the aim is to identify
specific, measur able goals and to move directly into the areas that are
causing the most difficulty for clients (Dienes et al. 2011).
Some of the essential characteristics of cognitive therapists are as follows:
must have a cognitive conceptualization of cases,
be creat ive and active,
be able to engage clients through a process of Socratic questioning,
and
be knowledgeable and skilled in the use of cognitive and behavioral
strategies aimed at guiding clients in significant self -discoveries that
will lead to change (Bec k & Weishaar, 2011).
strive to create “warm, empathic relationship with clients while at the
same time effectively using cognitive therapy techniques that will
enable clients to create change in their thinking, feeling, and
behaving” (Macy, 2007).
function as catalysts and a guide who helps clients understand how
their beliefs and attitudes influence the way they feel and act
emphasize the client’s role in self -discovery aim to teach clients how
to be their own therapist. munotes.in
Page 47
51 Intervention Systems In Psychology educate clients about the nature an d course of their problem, about the
process of cognitive therapy, and how thoughts influence their
emotions and behaviours
realize that clients are more likely to complete homework if it is
tailored to their needs, if they participate in designing the hom ework,
if they begin the homework in the therapy session, and if they talk
about potential problems in implementing the homework (J. Beck,
2005).
Clients, on the other hand, are expected to:
identify the distortions in their thinking,
summarize important points in the session, and
collaboratively devise homework assignments that they agree to carry
out.
Homework is often used as a part of cognitive therapy because practicing
cognitive behavioural skills outside of the office facilitates more rapid
gains (Dieneset al., 2011). A few characteristics of homework are:
it is tailored to the client’s specific problem and arises out of the
collaborative therapeutic relationship
its purpose is to teach clients new skills, and to enable them to test
their beliefs a nd experiment with different behaviours in daily -life
situations
it is generally presented to clients as an experiment, which increases
the openness of clients to get involved in an assignment
its emphasis is placed on self -help assignments that serve as a
continuation of issues addressed in a therapy session (Dattilio,
2002b).
One indicator of a good therapeutic alliance is whether homework is done
and done well.
3.4.2 Applications of Cognitive Therapy :
Cognitive therapy initially gained recognition as an approach to treating
depression, but extensive research has also been devoted to the study and
treatment of many other psychiatric disorders. One of the reasons for the
popularity of cognitive therapy is due to “strong empirical support for its
theoretical framework and to the large number of outcome studies with
clinical populations” (Beck & Weishaar, 2011, p. 305).
Cognitive therapy has been successfully used to treat -
phobias, psychosomatic disorders, eating disorders, anger, panic
disorders, and genera lized anxiety disorders (Chambless & Peterman,
2006; Dattilio & Kendall, 2007; Riskind, 2006); munotes.in
Page 48
52 Intervention Systems Emphasizing Humanistic, Cognitive, Behavioural Approaches posttraumatic stress disorder, suicidal behavior, borderline personality
disorders, narcissistic personality disorders, and schizophrenic
disorders (Dattilio & Freeman, 2007);
personality disorders (Pretzer & Beck, 2006);
substance abuse (Newman,2006);
chronic pain (Beck, 1987);
medical illness (Dattilio & Castaldo, 2001);
crisis intervention (Dattilio & Freeman, 2007);
couples and families therapy (Dattili o, 1993, 1998, 2001, 2005, 2010;
Dattilio & Padesky, 1990; Epstein, 2006);
child abusers, divorce counseling, skills training, and stress
management (Dattilio, 1998; Granvold, 1994; Reinecke, Dattilio, &
Freeman, 2002).
There are several strengths of cog nitive behavioral approaches in
working with individuals from diverse cultural, ethnic, and racial
backgrounds.
Clearly, cognitive therapy programs have been designed for all ages and
for a variety of client populations.
3.4.3 EVALUATION :
Contributions of the Cognitive Therapy:
Research has demonstrated the efficacy of cognitive therapy for a variety
of problems (Leahy, 2002; Scher, Segal, & Ingram, 2006). Cognitive
therapy has been applied to a wide range of clinical populations. Beck
demonstrated that a s tructured therapy that is present centred and problem
oriented can be very effective in treating depression and anxiety in a
relatively short time. One of Beck’s major theoretical contributions has
been bringing private experience back into the realm of le gitimate
scientific inquiry (Weishaar, 1993). A strength of cognitive therapy is its
focus on developing a detailed case conceptualization as a way to
understand how clients view their world.
Limitations and Criticisms of the Cognitive:
Cognitive therapy h as been criticized for (Freeman & Dattilio, 1992;
Weishaar, 1993) -
Focusing too much on the power of positive thinking; being too
superficial and simplistic;
denying the importance of the client’s past
being too technique oriented; munotes.in
Page 49
53 Intervention Systems In Psychology failing to use the the rapeutic relationship;
working only on eliminating symptoms,
failing to explore the underlying causes of difficulties;
ignoring the role of unconscious factors; and
neglecting the role of feelings
Although the cognitive therapist is straightforward and looks for simple
rather than complex solutions, this does not imply that the practice of
cognitive therapy is simple. However, they do recognize that clients’
current problems are often a product of earlier life experiences, and thus,
they may explore wit h clients, especially those with Axis II disorders, the
ways their past is presently influencing them.
3.5 REFERENCE 1. Corey, G. (2013). Theory and Practice of Counseling and
Psychotherapy (9th ed.). CA: Thomson Brooks.
*****
munotes.in
Page 50
54
4
TECHNIQUES IN GROUP
Unit Structure
4.1 Introduction
4.2 Fundamentals of Group Therapy
4.2.1 Influences
4.2.2 Advantages
4.2.3 Organizing Group
4.2.4 Opening and Later Sessions
4.2.5 Technical Functions of Group Therapists
4.3 Special Problems during Group Therapy
4.4 Group Therapy Approaches
4.4.1 Pre -intake and Post -intake
4.4.2 Special Age Groups
4.4.3 Behaviour Therapy
4.4.4 Experiential Therapy
4.4.5 Psychodrama and Role Play
4.5 References
4.1 INTRODUCTION Groups are a promising framework to de liver services to the largest
number of people sharing the common qualities, whether demographic,
cognitive, emotional, personality, values etc. Thus, many people can be
addressed based on their common need at a time forming a group that
allows to save tim e. For this reason, having several clients meet as a group
for a common purpose can save considerable time and effort. Many people
have feelings they believe to be unique. Being a member of a group allows
them to discover that they are not the only ones to have those particular
thoughts, concerns and feelings.
Group therapy/ psychotherapy means more than one individual are being
treated at the same time by at least one therapist. Some groups may have
more than one therapist. Group sizes vary depending on t he type of
therapy. Group psychotherapy is a valuable and, in some cases,
indispensable treatment method. It may be utilized (1) independently,
during which both intrapsychic and interpersonal operations are
considered; (2) in combination with individual t herapy conducted by the
same therapist (“combined therapy”) —individual sessions deal with the
patient’s resistances, transferential responses to the therapist, and primary
separation anxiety, while group sessions focus chiefly on interpersonal
phenomena; ( 3) in conjunction with individual therapy conducted by munotes.in
Page 51
55 Intervention Systems In Psychology another therapist (“conjoint therapy”); and (4) as leaderless groups
particularly after formal group therapy has ended (Kline, 1975).
4.2 FUNDAMENTALS OF GROUP THERAPY 4.2.1 Influences:
Phenomena are m obilized that may have an influence on each individual,
when people gather together in a group. This encourages one to express
oneself openly. The person soon discovers that the group fosters free
expression of feelings or attitudes on any subject. There a re no social
taboos on content usually avoided in everyday interactions. The
recognition that fellow members harbour the same fears and doubts, can
be reassuring in a group. Hence, the individual finds that problems can be
shared with others without reject ion or ridicule, apart from the emotional
catharsis that is experienced. This enhances self -esteem and self -
confidence.
People in a group may reinforce each other’s rational reactions, as they
collectively make up the norm from which they individually dev iate. The
fluctuating group interaction is influenced by levels of tension that affect
participation, the sharing of ideas, and decision making. Feelings that are
controlled and verbalizations related to them suppressed or repressed in
the usual group sett ing, are encouraged and even rewarded in the
therapeutic group by approval from the therapist. The individual gradually
learns to accept criticism and aggression without falling apart. The fear of
becoming violent and in turn being subject to physical atta ck and
humiliation lessen. The group judgment is a moving force that cannot be
resisted. Where a number of members share an opinion about an
individual or behaviour, the effect may be more intense than an
interpretation by the therapist.
The group strength ens the individual’s ability to express feelings toward
the therapist, whether rational or irrational; one may be unable to do this
during individual therapy. One of the most important consequences of
being in a group geared toward reconstructive goals is learning how
emotional processes operate by observing how other members talk about
and solve their problems. Dynamic thinking soon becomes a dominant
mode in the group. Awareness of inner psychological operations is also
sharpened through emotional involve ments with other group members,
through one’s own spontaneous discoveries, and through interpretations
from fellow members and the therapist. Instead of withdrawing, as in a
usual life situation, the patient is encouraged to hold his or her ground and
to express and analyze feelings and defenses.
4.2.2 Advantages:
Diversified intrapsychic defenses come out toward members of the group
with whom the patient plays varying roles. Multiple transferences, both
sequential and simultaneous, are readily established. The opportunity to
relate in different ways to fellow members enables the individual to work munotes.in
Page 52
56 Techniques In Group through insights in the direction of change. Within the group the patient
feels more protected, both by the therapist and by members with whom
alliances have been formed, and he or she may be able to practice new
attitudes more propitiously. Some of the major advantages of group
therapy are the opportunities to:
see that one is not alone in one’s suffering and that problems felt to be
unique are shared by others;
break down one’s detachment and tendencies to isolate oneself
correct misconceptions in ideas about human behaviour by listening
to others and by exposing oneself to the group judgment
observe dynamic processes in other people and to study one’s own
defen ses in clear perspective in relation to a variety of critical
situations that develop in the group;
modify personal destructive values and deviancies by conforming
with the group norm
relieve oneself of tension by expressing feelings and ideas to others
openly;
gain insight into intrapsychic mechanisms and interpersonal
processes,
observe one’s reactions to competition and rivalry that are mobilized
in the group
learn and to accept constructive criticism
express hostility and to absorb the reactions of oth ers to one’s
hostility
consume hostility from others and to gauge the reasonableness of
one’s reactions
translate understanding into direct action and to receive help in
resolving resistances to action
gain support and reassurance from the other members wh en one’s
adaptive resources are at a breaking point
help others which can be a rewarding experience in itself
work through problems as they precipitate in relationship with others
share difficulties with fellow members;
break down social fears and barrier s
learn to respect the rights and feelings of others, as well as to stand up
to others when necessary munotes.in
Page 53
57 Intervention Systems In Psychology develop new interests and make new friends;
perceive one’s self -image by seeing a reflection of oneself in other
people;
develop an affinity with others, with the group supplying
identification -models
relate unambivalently and to give as well as to receive
enter into productive social relationships, the group acting as a bridge
to the world
Thus, in a group therapy, the group is acting as a unit that repli cates the
family setting and sponsors reenactment of parental and sibling
relationships.
4.2.3 Organizing Group:
Group participants should be those who are sufficiently advanced in their
understanding of themselves to be able to perceive their patterns as they
will appear in the group setting. Though clinical diagnosis is not too
important in psychotherapy, the conditions and patients with - i)
Psychopathic personalities and those with poor impulse control, ii) Acute
depressions and suicidal risks, iii) Stu tterers, iv) True alcoholics, v)
Hallucinating patients and those out of contact with reality, vi) Patients
with marked paranoidal tendencies, vii) Hypomanics, and viii) Patients
with a low intelligence – perform poorly in a group, except perhaps when
implemented by an experienced group therapist in a homogeneous group
within an inpatient setup through supportive or reeducative group
methods.
Some other essential characteristics that should be taken care of while
organizing or forming a group are as follows :
The age difference should preferably not exceed 20 years
Homogeneity in educational background and intelligence is desirable,
but not imperative
A well -balanced group often contains an “oral -dependent,” a
“schizoid -withdrawn,” a “rigid -compulsive,” and p erhaps a
“provocative” patient, such as one who is in a chronic anxiety state
The number of group members may range optimally from 6 to 10;
which can be reduced in case a therapist feels uncomfortable with a
large group.
Marital status is relatively unimpo rtant
A balance of males and females, that allows for an opportunity to
project and to experience feelings in relation to both sexes. munotes.in
Page 54
58 Techniques In Group A heterogeneous group in terms of age, sex, and syndrome is most
effective for reconstructive goals
A homogeneous group co mposed of patients with the same problem,
is best for alcoholism, substance abuse, obesity, smoking, sexual
problems, insomnia, phobias, depression, delinquency, stuttering,
criminality, marital problems, divorce, and geriatric problems,
although an occasi onal person with such problems may do well with
and stimulate activity in a heterogeneous group.
Adolescents seem to be more responsive in same -sex, same -age
groups.
The length of a group therapy session is approximately H to 2 hours.
The frequency of mee tings is one to two sessions weekly, with
alternate sessions once weekly if desired
The best seating arrangement is in a circle
4.2.4 Opening and Later Sessions:
a) Opening Sessions: At the first session the members are introduced by
their first names, and the purpose of group discussions is clarified. This
will vary with different therapists and different groups. The more passive -
dependent the patient, the more leadership will be demanded of the
therapist. The technique employed during the opening session will be
determined by the therapist’s orientation and level of anxiety.
Some therapists begin by simply stating that the group offers members an
opportunity to talk about their feelings and eventually to understand their
individual patterns. It is not nec essary for the members to feel compelled
to reveal something that they want to keep to themselves. However,
communicating freely will help them to get a better grip on their problems.
Before the close of the first session, some therapists find it advisable to
stress the confidential nature of the meetings and to caution that each
member is expected not to reveal to others the identity of the members and
the subject matter discussed in the group.
Therapists who strongly believe that acting out is harmful wil l discourage
any contact outside of the group, in all probability. Sexual involvements
may be forestalled by fostering verbalization of the patients’ feelings and
impulses toward each other. Usually the anxiety level drops markedly at
the end of the first session, but rises temporarily at the outset of the second
session. During the early stages of treatment, some therapists who are
anxious to prevent acting -out at any cost will, at first, assume a dictatorial
role that contrasts sharply with their role in individual sessions.
Parenthetically, this may lead to more acting -out. They may try to keep
patients from exposing painful revelations before the group is ready to
support them. munotes.in
Page 55
59 Intervention Systems In Psychology Free verbal interaction may be encouraged in the group in order to bring
out each member’s customary facades and defenses. Often individual
members in their temporary authority posts may initiate ways of eliciting
meaningful material. This may take the form of giving each person an
opportunity to express him or herself at each sess ion, or there may be a
much more informal arrangement with the members spontaneously
expressing what is on their minds at the moment. There is no need for
procedural structuring; and it should not be rigidly controlled at any time.
Thus in the opening sess ion, the content of discussions will vary greatly,
covering current incidents of importance in the lives of each member,
dreams, attitudes toward others in the group or toward the therapist, and
general areas, such as family relations, sex, dependency, and competition.
b) Later Sessions: In later sessions, the therapists must be constantly on
the alert for covert transference manifestations that relate directly to them
but are being diluted by references to others. The therapist can
advantageously analyze t he structure of the group as it displays itself in a
particular session and designate the roles played by the different members,
thus delineating the defense mechanisms displayed by the individual
members. As the group becomes integrated, the patient gains more insight
into personal difficulties recognizing that many troubles previously
believed unique have a common base.
Hence, the therapist should direct energies toward stimulating thinking
around universally shared problems, getting responses from other group
members even though the subject under consideration is out of the
ordinary. The patients may be asked to talk about personal impressions of
the role the therapist is playing in the group. There are three trends in
transference, that may take place ( Grotjahn, 1973) in later sessions: (1)
transference to the therapist and central figure (e.g., paternal figure), (2)
transference to peers (e.g., sibling), and (3) transference to the group itself
(e.g., pregenital mother symbol). These different transfere nce relationships
are always present simultaneously, patients treating the group as if it were
their own family. The basic rule in a group setting is for members
individually to express themselves as freely and without restraint as
possible. This encourage s the disclosure of forbidden or fearsome ideas
and impulses without threat of rejection or punishment.
In later sessions, The interactional processes virtually do put the various
group members in the role of cotherapists. Under the guidance of the
therapi st this role can be enhanced. The specific effect of member
“cotherapists” may be analytic or it may be more supportive, encouraging,
accepting, and empathic, thus providing an important dimension to
supplement the work of the therapist. Among the therapis t’s activities
during these sessions, are clarifying, structuring, focusing, timing,
interpreting individual and group resistances, encouraging group
interaction, and clarifying group interrelations. Reactions of the patient
occur in complex clusters as a release of feeling within the group is
accelerated. Lack of restraint in one group member often results in a
similar lack of restraint in the others. munotes.in
Page 56
60 Techniques In Group 4.2.5 Technical Functions of Group Therapists:
Therapist’s roles, as a group leader, include many technica l functions.
They are listed down below:
to catalyze participation of the various members,
to maintain an adequate level of tension,
to promote decision making and problem solving,
to encourage identifications, to foster an interest in the goals to be
achieved, and
to resolve competitiveness, resentments, and other defenses that block
activity
to deal with overt obstructions in the form of resistances from group
members, like coming late, socializing too much, getting frozen into
interlocking roles
to constantly remind the members that they are not there to act as
professional psychoanalysts, attempting to figure out dynamics and to
expound on theory
to focus on the conversational theme around pertinent subjects when
topics become irrelevant
to creating tension by asking questions and pointing out interactions
when there is a slackening of activity in the group
to pose pointed questions to facilitate participation
to deal with individual and group resistances
to support upset members
to encourage withdra wn members to talk.
to interfere with hostile pairings who upset the group with their
quarrelling
to reminding the group that communication about and understanding
of mutual relationships is more important than interpreting dynamics
to manage silence, whic h tends to mobilize tension in the group
to gauge and regulate group tension and anxiety
to detect resistances of the group as a whole as well as of the
individual members.
4.3 SPECIAL PROBLEMS DURING GROUP THERAPY munotes.in
Page 57
61 Intervention Systems In Psychology The management by the therapist of specia l problems among patients will
be essential where they obstruct group interaction. Some of the examples
of such special problems are as follows:
The Salient Patient:
Since the response will be hesitant and unsure, more aggressive patients
may attempt to in terrupt to take the floor over for themselves. The
therapist may block this subterfuge and continue to encourage the
reluctant patient to articulate. The patient may also be asked directly to
report on any dreams.
The Monopolizer :
The aggressive, narcissi stic patient, often called monopolizer, who insists
on dominating the session will usually be interrupted by one or more
members who resent this takeover. Where this does not occur, the
therapist may halt the patient by asking another member what he or she is
thinking about or by directing a question at the group as to whether they
want the monopolizing patient to carry on all the discussion.
The Quarreling Dyad:
The best way to deal with this phenomenon is by working toward each
participant’s tracing of t he transferential roots of the enmity in order to
recognize how both are projecting unconscious aspects of themselves on
each other.
Acting -out Patients :
acting -out can be a disturbing phenomenon in groups. The therapist may
caution the members to talk ou t rather than to act out. The group members
may be required to report at a regular session the activities engaged in
between members outside the group. The therapist may try to reduce the
anxiety level of the group.
The Private Session in the Group:
Some patients will attempt to utilize the group time to get a private session
with the therapist. They will look at and direct their conversation to the
therapist, ignoring the presence of the group. The therapist may ask the
patient to focus remarks on the gro up, may question the group as to how
they feel about the patient’s carrying on an intimate discussion with the
therapist, may ask other members to associate to the patient’s
verbalizations, and finally, may suggest that the patient come in for a
private se ssion.
The Habitual Latecomer:
The latecomer ultimately may be threatened with removal from the group
if he or she does not come on time. The group members should be
encouraged to deal with this problem, not just the therapist.
The Patient Who Insists tha t He or She Is Getting Worse not Better : munotes.in
Page 58
62 Techniques In Group Such patients can influence the group morale and may be disturbing,
especially to new members. The therapist may handle such a reaction by
nondefensively citing examples from the progress made by various
members of the group to disprove the thesis that therapy does not help
and, where applicable, may point out the aim of the complainant to drive
certain members (especially new members) out of the group.
The Accessory Therapist:
It may be a way of seeking favour wit h the therapist. It may be a gesture to
compete with and replace the therapist. Irrespective of its basis, the patient
may soon gather about him a group of followers as well as adversaries.
The best way to handle this maneuver is to ask the other members w hat
they think is happening, until the therapeutic pretender quiets down. The
therapist may also ask the competing patient why he or she feels obliged
to “play psychoanalyst.”
Mobilizing Activity:
Where progress has bogged down and members seem to be in a stalemate,
one may stir up activity by (1) asking the group why this is so, (2)
introducing psychodrama or role playing, (3) asking a member to talk
about the role assumed in the group, then going around the group
requesting the other members to comment, (4) asking each member to talk
about feelings concerning the two people on either side of him or her, (5)
utilizing one or more techniques of encounter or Gestalt therapy, (6)
extending the length of a session up to the extent of a marathon session,
(7) in troducing several new members into the group, (8) determining the
nature of the resistance and interpreting it, (9) shifting some old members
to a new group, (10) introducing a borderline patient into the group whose
anxiety level is high, (11) taking and playing back video tapes of the group
in action, (12) pointing out which stimuli in the group release repetitive
patterns in each patient and interpreting their ramifications in outside
relationships.
4.4 GROUP THERAPY APPROACHES: 4.4.1 Pre-Intake and Pos t-Intake Groups:
Pre-Intake Groups:
These groups act as a forum for discussion and orientation, and are a
valuable aspect of clinic functioning where a delay is unavoidable before
formal intake. Up to 20 people may attend, and sessions may be given at
weekly, bimonthly, and even monthly intervals. Example, Parents of
children awaiting intake may be organized into such type of group, which
may meet for 3 to 6 monthly sessions.
Post-Intake Groups:
They may take place before permanent assignment, and meeting s may be
spaced weekly or up to 1 month apart. Here some therapeutic changes are munotes.in
Page 59
63 Intervention Systems In Psychology possible as disturbing problems are introduced and elaborated. These
preliminary groups serve as useful means of selecting patients for ongoing
group therapy. They are worthy orientation and psychoeducation devices
and help prepare and motivate patients for therapy.
4.4.2 Special Age Groups:
Group therapy with children is usually of an activity nature. The
size of children’s groups must be kept below that of adult groups
(Gelle r, 1962). Single -sex groups are (1) from 6 to 8 years, which
optimally consist of three to five members; (2) from 8 to 12 years,
which may have four to six members; (3) from 12 to 14 years, which
may contain six to eight youngsters; and (4) from 14 to 16 y ears,
which have the same number. Mixed -sex groups at the oldest age
level are sometimes possible. Play therapy is the communicative
medium up to 12 years of age, the focus being on feelings and
conflicts. Beyond 12 years discussions rather than play const itute the
best activity medium. Techniques include analysis of behaviour in the
group, confrontation, and dream and transference interpretation.
Techniques include analysis of behaviour in the group, confrontation,
and dream and transference interpretation . discussion take place at
various intervals. Interventions of the therapist should be such so as
not to hamper spontaneity. Discussion is stimulated by the therapist,
and silences are always interrupted. individual therapy is carried on
conjointly with gr oup therapy, particularly at the beginning of
treatment.
Group psychotherapy with older people has met with considerable
success in maintaining interest and alertness, managing depression,
promoting social integration, and enhancing the concept of self in
both affective and organic disorders (Goldfarb & Wolk, 1966). Here,
the goal is reconstructive, and old individuals may be mixed with
younger people.
4.4.3 Behaviour Therapy:
Behavioral techniques (Lazarus 1968; Meacham & Wiesen, 1974; Wolpe,
1969; Liberma n, 1970; Fensterheim, 1971) are largely used in groups.
behavioural change may be achieved by the employment of methods such
as behavioural rehearsal, modelling, discrimination learning, and social
reinforcement. Homogeneous groups seem to do best, the sel ection of
members being restricted to those who may benefit from the retraining of
specific target behaviours. Individually oriented behavioural interventions
may be employed alone in a group setting, or in combination with
psychodrama, role playing, Gesta lt tactics, encounter maneuvers, or
formal group therapy procedures (inspirational, educational, or analytic)
depending on the training and flexibility of the therapist.
The size of the group varies from 5 to 10 individuals. A cotherapist is
valuable and s ometimes indispensable as in the treatment of sexual
problems. The initial few sessions may be relatively unstructured to help
facilitate the group process. The time of sessions varies from 1½ to 3 or 4 munotes.in
Page 60
64 Techniques In Group hours. During the starting sessions members are encou raged to voice their
problems and to define what they would like to achieve in the sessions, the
therapist helping to clarify the goals.
Feedback is provided with confrontation of the reactions of the other
members to the patient’s own verbalizations and responses. This gives the
patient an opportunity to alter these if it is desired. Modelling oneself after
how others approach and master the desired behaviour is an important
learning modality. The therapists may engage in role playing or
psychodrama to fa cilitate modelling. Behaviour rehearsal similarly
employs role playing involving the patient directly. Repetition of the
process with different members helps solidify appropriate reactions, the
patient engaging in role reversal when necessary. Countercondi tioning and
extinction methods (systematic desensitization, role playing with the
introduction of the anxiety provoking stimulus, encouraging expression of
forbidden emotions in the group like anger) eventually lead to
desensitization. The therapist provid es direction and guidelines for
appropriate behaviour, which with the pressure of the group, helps create
motivation and social reinforcement. Support is provided the patient when
necessary. Specific assignments outside the group may be given the
patient.
Relaxation methods may be employed in a group for the relief of tension
and such symptoms as insomnia. Behavioural tactics are ideally suited for
habit disorders related to eating, such as obesity, smoking, gambling,
alcoholic over -indulgence, and substanc e abuse. Where problems are
centred around lack of assertiveness, assertiveness training can be highly
effective. Special exercises are employed with role playing depending on
problems of individual members, such as talking in a loud voice, behaving
unplea santly, telling an interesting story, expressing a warm feeling
toward other group members, practicing progressive expressions of anger.
Phobias respond remarkably well to group behavioural methods. Here, the
patient selection must also be homogeneous as i n assertive training. Other
phobias may be treated in a group setting introducing whatever
modifications are essential considering the nature of the target symptom.
Videotaping and playback may be employed in the sessions.
4.4.4 Experiential Therapy:
The t raditional model, which focused on inspiration, education, and
insight acquisition, has been supplemented by groups whose objective is
experiential with a wide variety of techniques. Many names have been
given to these new arrangements including Gestalt, h uman relations
training, human awareness, leadership training, T -groups, sensitivity
therapy, and encounter therapy. The time element (traditionally 90
minutes) has been stretched sometimes to several hours, 12 hours, 24
hours, or several days with time of f for sleep (marathon groups).
Encounter therapy may be an ongoing process like any other form of
group therapy, or it may be brief, from one to a dozen sessions. A
constructive group experience with a small group of people who are
educationally on a relat ively equal level and who permit themselves to munotes.in
Page 61
65 Intervention Systems In Psychology disclose their self -doubts and personal weaknesses can be most liberating
to the participants. Interpersonal confrontations, while temporarily
upsetting, may even ultimately bring the individual into contact w ith
repudiated aspects of himself or herself in such therapy sessions.
Under the guidance of a skilled group leader the encounter group becomes
a means through which the members become aware of how they are
creating many of their own troubles. By talking t hings out they are able to
correct some of their misperceptions. The effects of the encounter group
can be psychotherapeutic, particularly in persons who are ready for change
and who already have, perhaps in previous psychotherapeutic experiences,
worked t hrough their resistances to change.
The usual marathon group exposes group members to constant association
of approximately 30 hours, generally in the course of which a 5 -hour
break is taken. During the first 15 hours of interaction there is a gradual
sloughing off of defenses, and, in the last hours, a “feedback” is
encouraged in which the therapist enjoins the patients to utilize the
understanding of themselves to verbalize or execute certain constructive
attitudes or patterns. Experiential therapies are sometimes resorted to by
psychotherapists when their patients have reached a stalemate in
individual or group therapy. Generally, the individual entering an
experiential or marathon group is instructed in the responsibility that he or
she has in the group, the need for physical restraint and abstinence from
drugs and alcohol, and the fact that while one’s behaviour in the group is
related to one’s life style, that there may be new and better ways of
relating that one can learn. Negative outcomes with experi ential groups
are to be expected in view of the superficial screening of the participants
and the large number of untrained leaders who contact these groups with
few or no limits on the selection of techniques.
4.4.5 Psychodrama and Role Play:
Moreno (193 4, 1946, 1966b) created a useful group therapy method,
“psychodrama,” which he first introduced in 1925 and that has evolved
into a number of clinical methods, including sociodrama, the axiodrama,
role playing, and the analytic psychodrama. Many of these h ave been
incorporated into modern Gestalt, encounter, and marathon therapy. In the
hands of a skilled therapist psychodrama is a valuable adjunct in helping
patients work through resistances toward translating their insights into
action.
The initial tacti c in the group is the “warm -up” process to facilitate
movement. This may take the form of the director (the therapist) insisting
that the group remain silent (“cluster warm up”) for a.period. As tension
mounts, it will finally be broken by some member expo stulating about a
problem, the verbalizations drawing a “cluster” of persons around the
member. Other members may similarly come forth with feelings and
stimulate “clusters” interested in what they are saying. Soon the whole
group is brought together aroun d a common theme. munotes.in
Page 62
66 Techniques In Group Another warm -up method is the “chain of association.” Here the group
spontaneously brings up fears and associations until an engrossing theme
evolves.
A third warm -up is initiated by the director (“directed warm -up”) who,
knowing the pro blems of the constituent members, announces the theme.
A “patient -directed warm -up” is one in which a patient announces to the
group the subject with which he or she would like to deal.
The director facilitates the working together of the group on their
problems, while focusing on one person (the “protagonist”). Among the
techniques are (1) “role reversal,” during which a protagonist and
auxiliary reverse positions; (2) “the double,” another member seconding
for and supporting the protagonist; (3) “the sol iloquy,” characterized by a
recitation by the protagonist of self -insights and projections; and (4) “the
mirror,” auxiliary egos portraying what the protagonist must feel. Role
reversal is a useful technique in psychodrama, two related individuals, for
example, taking the role of one another expostulating how they imagine
the other feels or portraying the behaviour of the other. Where a
protagonist is involved emotionally with an absent person, the latter may
be portrayed by an auxiliary ego. The psychodram atic technique has given
rise to a number of role -playing methods that are being applied to
education, industry, and other fields.
4.5 REFERENCE 1. Wolberg, L. R. (2005). The Technique of Psychotherapy Part I and II:
NJ: Jason Aronson, Inc.
*****
munotes.in
Page 63
67
5
INTERVENTIONS EMPHASIZING
INTEGRATION, ECLECTIC SYSTEMS,
MULTICULTURAL PERSPECTIVES
Unit Structure
5.1 Introduction
5.2 Integrated and Eclectic Interventions
5.2.1 Reasons for the Growth of Integrated and Eclectic Apporach
5.2.2 Nature of Integrated an d Eclectic Approaches
5.2.3 Integrating Treatment Systems
5.2.4 Formulating an Integrated and Eclectic Treatment System
5.2.5 Skill Development: Treatment Planning
5.2.6 Benefits of Integrated and Eclectic Approaches
5.2.7 Challenges of Eclectic and Integr ated Approaches
5.3 Effective Multicultural Counselling
5.3.1 Historical Context and Important Contributors
5.3.2 Theoretical Principles
5.3.3 The Practice of Multicultural Counselling
5.3.4 Non -Western Theories and Techniques
5.4 Psychoanalytical, Adler ian, Person -Centered, Behaviour Therapy
from Multicultural Perspective
5.4.1 Psychoanalytic Therapy from Multicultural Perspective
5.4.2 Adlerian Therapy from Multicultural Perspective
5.4.3 Person -Centred Therapy from Multicultural Perspective
5.4.4 Behav iour Therapy from Multicultural Perspective
5.5 References
5.1 INTRODUCTION In this chapter, we will learn other important counselling approaches,
known as integrated and eclectic interventions, multicultural counselling,
and some influential approaches to multicultural counselling. Let us have
a detailed look at each of them.
5.2 INTEGRATED AND ECLECTIC INTERVENTIONS Many factors account for this trend toward integrative and eclectic
treatment. Chief among them is the fact that no single theory has yet bee n
found that can clearly capture the entire range of human experiences
across the life span. Instead of viewing clients in the context of their
sociocultural environment, these practitioners concentrate too much on munotes.in
Page 64
68 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives problems within the individual. A large n umber of therapists identify
themselves as “eclectic,” and this category covers a broad range of
practice. The integrative approach is characterized by openness to various
ways of integrating diverse theories and techniques.
5.2.1 Reasons for the Growth of Eclectic and Integrated Apporach :
The following 12 factors have combined during the past 30 years to move
clinicians in the direction of preferring integrative and eclectic approaches
over adherence to one specific treatment system (Prochaska & Norcross,
2007):
1. The large and growing number of approaches to treatment; more than
400 treatment systems have been identified
2. The increasing diversity and complexity of clients and their concerns
3. The inability of any one treatment system to successfully address all
clients and all problems
4. The growing importance of solution -focused brief approaches that
encourage clinicians to draw on and combine interventions from
various systems of therapy to find the most effective and efficient
strategy for each treatment situation
5. The availability of training opportunities, as well as case studies and
other informative literature, that give clinicians the opportunity to
study, observe, and gain experience in a wide variety of treatment
approaches
6. The requ irement of some state and national credentialing bodies that
clinicians obtain post graduate continuing education units; this
encourages continued professional growth and development of new
skills and ideas
7. Increasing pressure from managed care organiz ations, governmental
agencies, consumers, and others for clinicians to determine the most
effective and efficient treatment approach for each client, to plan and
document their work, and to maintain accountability
8. The growing body of compelling researc h demonstrating which
treatment approaches are most likely to be successful in the treatment
of particular people, disorders, or problems (Seligman &
Reichenberg, 2007).
9. The increasing availability of manuals, providing detailed and
empirically validate d treatment plans for specific mental disorders
10. The development of organizations such as the Society for the
Exploration of Psychotherapy Integration that focus on studying and
promoting treatment integration munotes.in
Page 65
69 Intervention Systems In Psychology 11. The emergence of models providing bluep rints or guidelines for
logical and therapeutically sound integration of treatment approaches
12. Clinicians’ increasing awareness that common factors among
treatment approaches, such as the nature of the therapeutic alliance,
are at least as important in determining treatment success as are
specific strategies.
5.2.2 Nature of Integrated and Eclectic Approaches :
When clinicians first began to describe their theoretical orientations as
eclectic, the term lacked a clear meaning; it simply suggested that
clinicians drew on more than one approach to treatment. While some
clinicians who characterized their work as eclectic were gifted therapists
and astute theoreticians with a clear rationale for combining interventions
in their work, some clinicians who charact erized their work as eclectic
were gifted therapists and astute theoreticians with a clear rationale for
combining interventions in their work, others lacked a thoughtful and
systematic approach to treatment. Without a logic or structure, eclecticism
can l ead to treatment that is haphazard and inconsistent, lacking in
direction and coherence.
Eysenck (1970) denounced what he referred to as “lazy eclecticism” (p.
140) the use of a grab bag of interventions, combined without an
overriding logic. Such an appro ach reflects a lack of knowledge and
professionalism and is incompatible with current emphases on
accountability and treatment planning in counselling and psychotherapy.
Following are the four identified types of eclecticism listed below with the
brief des cription of each approach:
1. Atheoretical eclecticism is characterized by combining interventions
without an overriding theory of change or development.
2. Common factors eclecticism hypothesizes that certain elements of
treatment, notably a therapeutic a lliance that communicates support,
empathy, and unconditional positive regard, are primarily responsible
for promoting client growth and change (Hansen, 2002).
3. Technical eclecticism provides a framework for combining
interventions from different treatme nt systems without necessarily
subscribing to the theories or philosophies associated with those
interventions.
4. Theoretical integration offers conceptual guidelines for combining
two or more treatment approaches to provide a clearer understanding
of cli ents and more effective ways to help them.
5.2.3 Integrating Treatment Systems:
Although most clinicians do not adhere to a systematic approach to
theoretical integration, they probably have formulated their own logic for
combining compatible theories. The most common combinations of
theories, in descending order of frequency, include (1) cognitive and munotes.in
Page 66
70 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives behavioural treatment systems, (2) humanistic and cognitive approaches,
and (3) psychoanalytic and cognitive approaches (Prochaska & Norcross,
2007).
Charact eristics of Sound Integrated and Eclectic Approaches:
Sound eclecticism has the following characteristics: i) Evidence of
building on the strengths of existing theories, ii) A coherent combination
of theories that creates a unified whole, iii) An underlyin g theory of
human behaviour and development, iv) A philosophy or theory of change,
v) Logic, guidelines, and procedures for adapting the approach to a
particular person or problem, vi) Strategies and interventions, related to
the underlying theories, that facilitate change, vii) Inclusion of the
commonalities of effective treatment, such as support, positive regard,
empathy, and client –clinician collaboration.
5.2.4 Formulating An Integrated Eclectic/Treatment System :
When clinicians formulate an integrated or eclectic treatment system, they
must address many questions, including the following:
1. What model of human development underlies the theory?
2. How does this treatment approach suggest that change is best
facilitated?
3. What information should be obtained in an intake interview?
4. What conception does this approach have of the influence of the past
on the present, and how should past experiences and difficulties be
addressed in treatment?
5. How important is insight in promoting change, and how much
attention should be paid in treatment to improving insight?
6. How important is exploration of emotions in promoting change, and
how much attention should be paid in treatment to helping people
identify, express, and modify their emotions?
7. How imp ortant is identification and modification of dysfunctional
cognitions in promoting change, and how much attention should be
paid in treatment to helping people alter their cognitions?
8. How important is identification and modification of self -destructive
and unhelpful behaviours in promoting change, and how much
attention should be paid in treatment to helping people alter their
behaviours?
9. What sorts of people and problems are likely to respond well to this
approach?
10. In what treatment settings an d contexts is this approach likely to be
successful? munotes.in
Page 67
71 Intervention Systems In Psychology 5.2.5 Skill Development: Treatment Planning :
Treatment planning serves the following four purposes (Seligman, 2004a):
i) A carefully developed plan, grounded in research on treatment
effectiveness, provi des assurance that counselling or psychotherapy is
likely to succeed, ii) A treatment plan specifying goals and strategies helps
clinicians and clients to track progress, determine whether goals are being
met, and, if not, revise and improve the plan, iii) Treatment plans provide
structure and direction to the therapeutic process. They help clinicians and
clients to develop shared and realistic expectations for treatment and
promote optimism that treatment will be helpful, and iv) Treatment plans,
in conjun ction with post -treatment evaluations, allow clinicians to
determine and demonstrate their effectiveness. Treatment planning is
particularly important for clinicians who follow integrated or eclectic
approaches to treatment. A treatment plan can organize t he disparate
elementsof various theories into a cohesive whole, clarify the sequence of
interventions, and help ensure that treatment strategies address the entire
range of clients’ concerns.
Clinicians should explore clients’ difficulties and symptoms; ga in some
understanding of their strengths, weaknesses, and context; and develop at
least a preliminary connection with clients before moving into treatment
planning. In addition, the treatment plan should be viewed as a work in
progress; as clients develop hope that treatment can help them, as
theyshare more of themselves in their sessions, and as they make progress,
the treatment plan may need to be changed. Adhering doggedly to an
outdated and inappropriate treatment plan can lead to ineffective treatment
and can damage the therapeutic alliance. The purpose of the plan is, of
course, to map out the treatment process for a given client. The 12 steps in
this comprehensive treatment process include:
i) Diagnosis: The first step in treatment planning is making an accurate
diagnosis of a person’s difficulties using the multiaxial assessment
format and diagnostic terminology of the Diagnostic and Statistical
Manual of Mental Disorders (American Psychiatric Association,
2000).
ii) Objective of treatment : Once prob lems and symptoms have been
explored and a diagnosis formulated, client and clinician collaborate
in establishing written objectives for treatment that address the
diagnoses and problems presented by the client.
iii) Assessments: Clinicians often use asses sment tools to enhance their
efforts to make accurate diagnoses, establish worthwhile and viable
objectives, and measure progress.
iv) Clinician: Variables that characterize the sort of clinician likely to
work well with a given client are specified in thi s section of the
treatment plan. munotes.in
Page 68
72 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives v) Location of treatment . This item specifies whether treatment should
be inpatient, outpatient, or an alternative such as a day treatment
program and might suggest a specific agency or treatment facility,
vi) Interventions . This part of the plan provides two important pieces of
information. First, the treatment approach is specified (e.g., cognitive
therapy, solution -focused brief therapy, Gestalt therapy).
vii) Emphasis. Although many clinicians share a particular theoreti cal
orientation, no clinician ever does exactly the same thing as another
clinician, nor does a given clinician practice in exactly the same way
with each client.
viii) Number of people seen in treatment. This section of the treatment
plan specifies whethe r individual, family, or group therapy will be the
primary mode of intervention.
ix) Timing. This part of the plan encompasses four scheduling aspects of
the therapeutic process: the length of each session, the frequency of
sessions, the duration of treatm ent, and the pacing of the treatment
process.
x) Medication. Psychologists, counselors, and social workers often
collaborate with psychiatrists in treating clients who require
medication.
xi) Adjunct services. Most clients benefit from adjunct services
xii) Prognosis. This last step specifies the likelihood of clients achieving
the specified objectives according to the treatment plan.
5.2.6 Benefits of and Integrated Eclectic Approaches :
Some of the benefits of integrated and Eclectic interventions are as
follows:
They bring flexibility to the treatment process
Enable clinicians to tailor their work to specific clients and concerns
in an effort to find a good fit between treatment and client
Enable clinicians to demonstrate multicultural competence by creat ing
integrated treatment plans that reflect sensitivity to clients’ culture
and context.
Allow clinicians to adapt standard treatment approaches to their own
beliefs about human growth and development as well as to their
natural style and personality.
Clinicians can expand on that foundation by incorporating into their
work ideas that have face validity as well as strategies that they have
used successfully with other clients. munotes.in
Page 69
73 Intervention Systems In Psychology 5.2.7 Challenges of Integrated and Eclectic Approaches :
Clinicians who view their primary theoretical orientation as eclectic or
integrated need expertise in a range of treatment systems so they can draw
on those approaches in creating effective treatment plans. Clinicians who
have an eclectic or integrated orientation also set limits on the scope of
their practice; no clinician could have sufficient knowledge and expertise
in the entire range of therapeutic approaches to treat all clients and all
problems. They must carefully think through their treatment of each client
to ensure that the disparate parts of treatment comprise a seamless whole
in which each intervention is chosen deliberately to accomplish a purpose.
Their treatment must not just be an amalgam of “tricks of the trade” but,
rather, should reflect coherence, relevance, and planning and be solidly
grounded in both theory and empirical research. Thus, clinicians who
prefer eclectic or integrated treatment approaches still have a professional
role that is more comprehensive and challenging than that of clinicians
with a specif ic theoretical orientation.
5.3 EFFECTIVE MULTICULTURAL COUNSELLING Theories of multiculturalism are considered the fourth force in the family
of theories. Multiculturalism argues that people are a product of their
culture and deserve to be understood fore most as such. Considering
counselling and psychotherapy from a multicultural view is challenging in
that these are professional endeavors conceived of and developed within a
very Western cultural frame. As is true with the definition of multicultural,
there is controversy within the domain of multicultural counselling about
what groups to include when one considers diversity (D. W. Sue & Sue,
2003). Most multicultural thinkers acknowledge these differences but
believe that to call all counseling multicultur al misses the point of the
power of culture in our lives.
5.3.1 Historical Context And Important Contributors to
Multiculturalism:
Many writers, practitioners, and researchers have contributed to current
multicultural theories. Few of them are mentioned he re. Second -
generation Chinese brothers (all of whom are trained in psychology)
Derald Wing Sue, Stanley Sue, and David Sue have been strong voices in
general multicultural theory for well over 30 years. Apart from them,
Allen and Mary Bradford -Ivey, along with many coauthors and
researchers, namely, Paul Pederson, Joseph Trimble, Pat Arredondo, and
Teresa LaFromboise have also contributed to multiculturalism. Also,
Freddy Paniagua has worked steadily on the issues of diagnosis and
assessment in a multicultu ral society.
It came into existence —or, more accurately, was driven into being —by
the painful recognition that the worldview of the privileged White male
was not the only viable worldview on the face of the planet. There are
many appalling historic example s of the misapplication of Western
psychological theory and technique to non -White and non -male munotes.in
Page 70
74 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives populations. In the worst scenarios, White, upper -class males made
sweeping statements about what was good or bad for individuals from
other cultures.
For one g roup to claim that another group is benefiting from systematic
oppression is a foundation for stereotyping, prejudice, and all forms of
racism, classism, ageism, and sexism. From the multicultural perspective,
the dominant culture’s tendency to identify wh at’s good for nondominant
groups includes a series of amazing oversights. That is, the dominant
culture forgot to (and still forgets to):
Try systematically to understand the perspective of the nondominant
group by simply asking them for their opinion on t he subject —and
listening to their answers!
Step into the alternative culture in an effort to deepen mutual
understanding and respect.
Consider that the nondominant group might not speak up on its own
behalf for fear of reprisal.
Before understanding multic ulturalism, it is imperative to understand
culture. While describing culture, Christopher (1996) states:
Culture permeates our lives much more thoroughly or pervasively than we
tend to consider. Because of Western culture’s individualistic orientation,
we tend to think of the individual first and of culture second. . . . What this
tendency to give primacy to the self overlooks is the manner in which
culture precedes us. (p. 17).
Christopher helps us understand that cultural development often precedes
individual development. He further states, “Our social practices,
institutions, family structures, and daily life make sense and ‘hang
together’ because of these webs of significance” (p. 17). Further, he points
out that culture shapes us, gives us views of hu man nature, and provides
our moral frame work. Thus, culture tells us both what should be
considered a good life and what should be considered deviant. Humans are
group -seeking creatures. Even as scholars have tried to understand the
irrational social forc es behind the rise of racism, fascism, or other
fundamentalist movements, they recognize that “the striving for self -worth
by belonging to a strong and glorious ‘we’ is an important force even in
the development of ‘normal’ ethnic, religious, and national movements”
(Suleiman, 2002, p. 33). Thus, Culture plays a central role in defining
what it means to be human. Culture is understood as a set of learnings one
obtains from the environment into which one has been born or the
environment in which one is funct ioning (Axelson, 1999). There are many
dimensions to culture, and specific definitions of culture are often based
on whether or not certain of these dimensions are included.
Counselors working with young people can find the application of
multicultural cou nselling principles most helpful. The term multicultural
is relatively new and is not without political baggage. Webster’s munotes.in
Page 71
75 Intervention Systems In Psychology Dictionary offers this definition: “Of, relating to, or designed for a
combination of several distinct cultures.” Terms like cross -cultural and
intercultural tend to insinuate the same set of values and concerns, but
most writers have settled on a preference for the term multicultural.
Transculturalists are more focused on the commonalities between cultures
and are more oriented toward universals that might be applicable to all
humankind (Rouchy, 2002).
At the core, the term multicultural acknowledges the idea of culture, and
by acknowledging that there is more than one viable culture, it might be
said to insinuate value in the existenc e of more than one. The mere act of
attempting to accommodate more than one culture is a political act.
Gender, disability, sexual orientation, and class also represent cultures
within the meaning of multicultural. It is believed that the term
multicultura l should indeed include class, as well as the other categories
named, and perhaps others as well. Although there are problems with the
term and struggles within the dominant culture for both definition and
sincere expression, the idea of multiculturalism i s profound and will be
pivotal in the coming decades.
D.W. Sue et al. (1999) write, “ Multiculturalism is not only about
understanding different perspectives and worldviews but also about social
justice. As such it is not value neutral. Multiculturalism sta nds against
beliefs and behaviours that oppress other groups and deny them equal
access and opportunity”. (p. 1064).
What Is Multicultural Counselling? :
Derald Wing Sue offers the following definition of multicultural
counselling, “Multicultural counselli ng and therapy can be defined as both
a helping role and a process that uses modalities and defines goals
consistent with the life experiences and cultural values of clients,
recognizes client identities to include individual, group, and universal
dimensio ns, advocates the use of universal and culture -specific strategies
and roles in the healing process, and balances the importance of
individualism and collectivism in the assessment, diagnosis, and treatment
of client and client systems. (Sue, in press). A multicultural worldview and
multicultural practices are essential to development on both individual and
global levels.
5.3.2 Theoretical Principles :
At the theoretical level, multiculturalism as applied to mental health
elevates and centralizes the role of culture in defining psychological
functioning, psychological distress, and psychological well -being (D. W.
Sue, Bingham, Porche -Burke, & Vasquez, 1999). There is no definitive
agreed -upon set of principles for multicultural theories because of
diversity o f opinion in the finer points of what it means to be
multiculturally oriented. However, there is significant common ground as
well. Here are some principles guiding to understanding general
multicultural theory, as follows: munotes.in
Page 72
76 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives Principle 1 :.We were born and ra ised in a culture (or set of cultures) that
influence our ways of being (or cosmologies; Duran & Duran, 1995).
Politically, these memberships can either enhance or limit our life
opportunities.
Principle 2 : We make distinctions between groups of people bas ed on
race, religion, sex, sexual orientation, ethnicity, physical and mental
disabilities, and socioeconomic status.
Principle 3 : A multiculturalist stance is intended to foster greater
understanding between members of different cultural groups and to str ive
toward egalitarian treatment of all humans, inclusive of their cultural
identities.
a) Theory of Personality:
From a multicultural perspective, individual personality is heavily
influenced by cultural experience. In fact, multicultural counselors note
that even the idea of personality is an essentialist way of approaching
human beings and is therefore a culture -bound concept (Markus &
Kitayama, 1998). There are many dimensions of intra - and interpersonal
functioning that vary by culture.
Individualisti c versus Collectivist Orientation:
One of the most common dialectical discussions in the multicultural
literature is that of individualistic versus collectivist cultures.
Individualistic cultures, like the dominant culture in the United States,
place enor mous value on the personal liberty of the individual and the
supremacy of self -interests over those of the group. Autonomy is a highly
regarded goal and virtue, and personality is often viewed as separate from
family and culture.
On the other hand, In coll ectivist cultures, values and norms are more
shared. The self and the personality are defined in terms of group
memberships, and the group needs and values are more central than those
of the individual. Collectivists tend to evaluate themselves based on th e
attainment of commonly held group goals, whereas individualists are more
likely to orient toward individual responsibility and to establish personal
goals (Earley & Gibson, 1998; Triandis, 1994 #654).
Although this individualistic orientation is still pr edominant, theorists
within Western culture point to problems with this value orientation.
Collectivist cultural values and personality traits are difficult for a
counselor raised in an individualistic culture to understand and honour in
the counselling pr ocess.
Acculturation and the Infamous Melting Pot:
On an individual level, acculturation (or ethnocultural orientation) refers
to “a process of giving up one’s traditional cultural values and behaviours
while taking on the values and behaviours of the dom inant social munotes.in
Page 73
77 Intervention Systems In Psychology structure” (Atkinson, Lowe, & Mathews, 1995, p. 131). Garrett and
Pichette (2000) identified five cultural orientation types within American
Indian populations that were previously discussed in the literature
(Herring, 1996; LaFromboise, Trimb le, & Mohatt, 1990):
1. Traditional. The individual thinks in the native tongue and practices
traditional tribal customs and tribal worship methods.
2. Marginal. The individual is not fully connected with traditional
Indian culture or mainstream society. Both languages may be spoken.
3. Bicultural. The individual is relatively comfortable and conversant in
both sets of cultural values.
4. Assimilated. The individual is oriented toward the mainstream social
culture and has little interest in traditional tribal practices.
5. Pantraditional. The individual has been exposed to and perhaps
adopted mainstream values but has made an intentional effort to
return to traditional values.
Cultural identity and even racial identity, at the individual level, can be
unique mixtures and expressions. Multicultural counselors realize that
cultural identity is not static and that racial identity and affiliation cannot
be assumed by glancing at the colour of one’s skin or the shape of one’s
eyes. However, culturally sensiti ve counselors also realize that a client’s
personality can be greatly influenced by the experience of being a
minority within a dominant culture. Family functioning and identity also
can be challenged and severely stressed by second -generation members
assuming the values and practices of the dominant culture (McGoldrick,
1998).
Swartz -Kulstad and Martin (1999) identified five separate contextual
factors serving as building blocks for human behavior: 1.Ethnocultural
orientation or acculturation, 2. Family e nvironment, 3. Community
environment, 4. Communication style, and 5. Language usage (see also J.
Sommers -Flanagan & Sommers -Flanagan, 2003).
b) Theory of Psychopathology:
Multicultural theory acknowledges the role of social forces in the
understanding and causation of suffering and pathology. Multicultural
practitioners are extremely cautious in using standardized assessment
instruments and diagnoses and take care to explore any concerns within
the beliefs and practices of the client’s culture (Paniagua, 20 01).
Multicultural counselors do not quickly impose pathological labels on
troubling behaviours but instead seek to understand the meaning of the
behaviours from within the cultural context of each individual or family.
5.3.3 The Practice of Multicultural Counselling :
Practicing multicultural counselling means including client’s cultures and
their culturalvalues and experiences centrally and directly in the munotes.in
Page 74
78 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives counselling process. However, this requires sensitivity and flexibility in
application. Das (1995) of fers the following reminders for practitioners:
• Culture shapes the behaviour, values, and beliefs of all humans. Both
client and counselor are products of their cultures.
• Problems that minority cultures face in accessing mental health
services stem b oth from different worldviews and cultural values and
from narrow attitudes and ignorance on the part of service providers.
• All counselling can be regarded as multicultural when culture is
defined as including not only race, ethnicity, and nationality b ut also
gender, age, social class, sexualorientation, and disability.
• People in minority groups experience life stress due to sociocultural
pressures and stressors and often seek counselling due to these
difficulties
• Traditional counselling still mir rors the overdeveloped Western value
of individualism.
Even when clients insist that their particular cultural background isn’t
relevant to the counselling process, multiculturally aware mental health
counselors realize the power of one’s cultural backgrou nd and
membership. It is not necessary to work directly with cultural material or
conflicts, but this awareness informs the counselor’s understanding
nonetheless.
Preparing Yourself to Do Therapy from a Multicultural Perspective:
The American Counselling Association has established a set of
multicultural competencies, based on an article by D. W. Sue, Arredondo,
and McDavis (1992):
Awareness and Acceptance: Culturally competent mental health
professionals are aware of their own cultural background and expe riences.
They can articulate what it means to be a member of their culture.
Knowledge: Culturally competent mental health professionals realize that
they must seek specific knowledge about the cultures they are most likely
to encounter in their work.
Skills: Culturally competent mental health professionals realize that
techniques and strategies for change must be tailored to meet the needs of
clients from diverse cultures.
Preparing Your Client for Multicultural Therapy:
If you are a member of a minority culture and are training to be a mental
health professional in the dominant culture, you face unique challenges in
preparing your clients from a multicultural perspective.
munotes.in
Page 75
79 Intervention Systems In Psychology Assessment Issues and Procedures:
Any assessment done with culturally different cl ients must be done with
extreme caution to avoid being unethical and inaccurate. Multicultural
therapists look first to their clients’ cultures for clues about how best to
assess the nature of the presenting problems. Further, they look to culture
to defin e appropriate treatment goals. Historically, psychological and
intellectual assessment has been used in biased and prejudicial ways with
ethnic minorities and women. Multicultural assessment requires
significant training and experience. conducting skilled assessments of
people from other cultures requires a great deal of training, supervision,
and experience. Overdiagnosing, underdiagnosing, and misdiagnosing
psychopathology in clients from diverse cultures has been a critical
problem for many years (Paniag ua, 2001).
To provide culturally competent assessment, therapists should use a
culture -specifi service delivery, possibly including test administration in
the client’s native language; evaluate the client as a cultural being prior to
testing; observe for c ulture -specific syndromes; select culture -specific
tests; and critically examine the standardization procedures and norms
used in testing procedures (Dana, 1996).
Specific Therapy Techniques:
Multicultural counselling is not an approach that emphasizes tec hniques.
multicultural counselling emphasizes a relationship that respects the
client’s cultural identity and affiliation. It is also inappropriate to outline
specific techniques for multicultural counselling because clients with
different ethnocultural ba ckgrounds will prefer different therapy
approaches. S. Sue (1998) identified three specific skills that he considers
indicative of cross -cultural therapeutic competency. These skills include:
Scientific mindedness : Therapists who use scientific mindedness form
hypotheses about their clients rather than coming to firm and premature
conclusions.
Dynamic sizing :Therapists with this skill know when to generalize and be
inclusive and when to individualize and be exclusive.
Culture -specific expertise : This involv es acquiring knowledge about
one’s own cultureand about the client’s culture.
Thus, S. Sue (1998) emphasizes that effective multicultural therapy
requires more than just familiarity with the client’s culture and
intercultural sensitivity.
5.3.4 Non -Western Theories and Techniques :
It has been noted that Western cultural view is biased toward masculinist,
individualistic, essentialist, and rationalist worldviews. Diverse cultural
approaches to human psychological distress include viewing both the
concept of mind and ideas about human functioning through different
lenses. Far more than in Western theories, these lenses include munotes.in
Page 76
80 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives philosophical -ethical, religious -spiritual, ancestral -familial, and even
political considerations.
Buddhism :
Buddhism and one of Buddhi sm’s central tenets, mindfulness, have
become part of some Western treatment modalities. Buddhism has been
said to be the most psychological of the world’s religions and the most
spiritual of the world’s psychologies (Epstein, 1998, p. 16). However,
attemp ting to classify Buddhism is controversial. Buddhists do not believe
in a creator, higher power, or godlike entity, so Buddhism can therefore
perhaps more accurately be called an applied philosophy.
Four Noble Truths taught by Buddha, are: 1. All is suffe ring (or
suffering is everywhere), 2. The cause of suffering is craving, desiring, or
having greed, 3. Suffering can be stopped or eliminated, 4. To eliminate
suffering, one must follow the Eightfold path. Morgan (1996, pp. 57 –58)
explains the Eightfold pa th as containing guidance for attaining wisdom,
for being moral, and for meditation. She names these as follows: Wisdom Right understanding is the perception of the world as it really is, without delusions. This involves particularly understanding suffering, the law of cause and effect, and impermanence. Right thought involves the purification of the mind and heart and the growth of thoughts of unselfishness and compassion, which will then be the roots of action. Morality: Right speech means the discipline of not lying and not gossiping or talking in any way that will encourage malice or hatred.Ø Right action is usually expanded into the five precepts: avoid taking life, stealing, committing sexual misconduct, and taking stimulants and intoxicants. Right livelihood is a worthwhile job or way of life that avoids causing harm or injustice to other beings. Meditation: Right effort is the mental discipline that prevents evil arising, tries to stop evil that has arisen, and encourages what is good. Right mindfulness involves total attention to the activities of the body, speech, and mind. Right concentration is the training of the mind in meditation stages. munotes.in
Page 77
81 Intervention Systems In Psychology Some mental health professionals have integrated Buddhist perspectives
into their work with clients. Meditation, or seeking mindfulness through
emptying one’s mind, is a core value of Buddhism, and meditation
practices have been increasingly used in various combinations with other
treatment modalities and mixed in with other theoretical orientations.
Medi tation: G. Alan Marlatt (2002) explores the important
contributions that meditation and mindfulness can make to
understanding and treating addictions.
Mindfulness : Along with in understanding and treating addictions, it
has also been used in treating pain (Kabat -Zinn,1990), in promoting
holistic health in persons with HIV and AIDS (Logsdon -Conradsen,
2002), and perhaps most notably, in Marsha Linehan’s (1993)
dialectical behavior therapy for persons diagnosed with borderline
personality disorder.
If spiritu ality and psychology are to be reunited, serious implications for
therapists and therapy follow. Karasu (1999) contends that counseling and
psychotherapy stemming from the traditional -psychoanalytic, behavioural,
and humanistic -approaches leave clients spi ritually bereft. Some criticisms
are as follows:
There has been no systematic effort to empirically evaluate spiritual
approaches to counseling and psychotherapy.
Karasu (1999) clearly states that the effectiveness of spiritual
psychotherapy is immeasurabl e:
5.4 PSYCHOANALYTICAL, ADLERIAN, PERSON -CENTERED, BEHAVIOUR THERAPY FROM
MULTICULTURAL PERSPECTIVE This section introduces strengths and shortcomings of some influential
therapies, namely Psychoanalytic therapy, Adlerian Therapy, Person -
Centred Therapy, and Behaviour Therapy in counselling practice from
multicultural perspective:
5.4.1 Psychoanalytic Therapy from Multicultural Perspective
Strength:
Psychoanalytically oriented therapy can be made appropriate for
culturally diverse populations if techniques are modified to fit the
settings in which a therapist practices.
Erikson’s psychosocial approach, with its emphasis on critical issues
in stages of development, has particular application to people of
colour. munotes.in
Page 78
82 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives It helps therapists become aware of their own sources of
countertransference, including their biases, prejudices, and racial or
ethnic stereotypes.
Shortcomings:
Traditional psychoanalytic approaches are costly, and psychoanalytic
therapy is generally perceived as being based on upper - and middle -
class values. For many, the cost of treatment is prohibitive.
Ambiguity inherent in most psychoanalytic approaches can be
problematic for clients from cultures who expect direction from a
professional.
The psychoanalytic approach can be criticied for failing t o adequately
address the social, cultural, and political factors that result in an
individual’s problem.
There are likely to be some difficulties in applying a psychoanalytic
approach with low -income clients.
5.4.2 Adlerian Therapy from Multicultural Pers pective
Strength:
Adlerian theory addressed social equality issues and social
embeddedness of humans long before multiculturalism assumed
central importance in the profession (Watts & Pietrzak, 2000).
Adler introduced notions with implications toward multi culturalism
that have as much or more relevance today as they did during Adler’s
time (Pedersen, as cited in Nystul, 1999b).
Although, the Adlerian approach is called Individual Psychology, its
focus is on the person in a social context.
Adlerians allow b road concepts of age, ethnicity, lifestyle, sexual/
affectional orientations, and gender differences to emerge in therapy.
Shortcomings:
Because other cultures have different conceptions, this primary
emphasis on changing the autonomous self may be proble matic for
many clients.
For people brought up in extended family contexts, some of its ideas
may be less relevant or at least may need to reconfigured.
Adlerian therapy has some potential drawbacks for clients from those
cultures who are not interested in exploring past childhood
experiences, early memories, family experiences, and dreams.
5.4.3 Person -Centered Therapy from Multicultural Perspective munotes.in
Page 79
83 Intervention Systems In Psychology Strength:
Person -centred approach has its impact on the field of human relations
with diverse cultural groups .
Empathy, being present, and respecting the values of clients are
essential attitudes and skills in counselling culturally diverse clients.
It is ideally suited to clients in a diverse world.
Motivational interviewing which is based on the philosophy of
person -centred therapy is a culturally sensitive approach that can be
effective across population domains, including age, ethnicity, and
sexual orientation (Levensky et. Al., 2008).
Shortcomings:
Many clients who come to community mental health clinics or w ho
are involved in outpatient treatment want more structure than this
approach provides.
It is difficult to translate the core therapeutic conditions into actual
practice in certain cultures.
It is difficult to apply this approach with the person -centred a pproach
with clients from diverse cultures pertains to the fact that this
approach extols the value of an internal locus of evaluation.
5.4.4 Behaviour Therapy from Multicultural Perspective :
Strength:
Behaviour therapy has some clear advantages over many other
theories in counselling culturally diverse clients.
Behaviour therapy focuses on environmental conditions that
contribute to a client’s problems. Social and political influences can
play a significant role in the lives of people of colour through
discriminatory practices and economic problems, and the behavioural
approach takes into consideration the social and cultural dimensions
of the client’s life.
The foundation of ethical practice involves a therapist’s familiarity
with the client’s culture, as well as the competent application of this
knowledge in formulating assessment, diagnostic, and treatment
strategies.
In designing a change program for clients from diverse backgrounds,
effective behavioural practitioners conduct a functional analysis of th e
problem situation. This assessment includes the cultural context in
which the problem behaviour occurs, the consequences both to the
client and to the client’s sociocultural environment, the resources munotes.in
Page 80
84 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives within the environment that can promote change, and t he impact that
change is likely to have on others in the client’s social surroundings.
Shortcomings:
Behaviour therapy is sensitive to differences among clients in a broad
sense.
Instead of viewing clients in the context of their sociocultural
environment, these practitioners concentrate too much on problems
within the individual.
5.5 REFERENCE 1. Flanagan, J. S. & Flanagan, R. S. (2004). Counselling and
psychotherapy theories in context and practice: Skills strategies and
techniques. Hoboken, NJ: John Wi ley & Sons, Inc.
2. Corey, G. (2013).Theory and Practic of Counselling Psychotherapy:
Systems, strategies, and skills (3rd Ed.) Pearson Education.
3. Seligman, L., & Reichenberg, L. W. (2010). Theories of counselling
and psychotherapy: Systems, strategies, and skills (3rd Ed.). Pearson
Education.
*****
munotes.in