MA-Psychology-SEM-II-Intervention-System-munotes

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INTERVENTION SYSTEMS
EMPHASIZING BACKGROUND - I
Unit Structure
1.0 Objectives
1.1 Introduction: Sigmund Freud - Classic Psychoanalysis
1.1.1 Structure of personality
1.1.2 Stages of development
1.1.3 Levels of consciousness
1.1.4 Anxiety and defense me chanisms
1.2 Process of therapy
1.2.1. Therapeutic goals
1.2.2. Therapeutic alliance
1.3Therapeutic techniques
1.4 Strengths and weaknesses
1.5 Summary
1.6 Questions
1.7 References
1.0 OBJECTIVES After studying this unit you should be able to:
 Under stand the structure of personality
 Know the stages of development
 Study the levels of consciousness
 Study anxiety and defense mechanisms
 To know the process of psychoanalysis and Understand its therapeutic
techniques
 To understand strength and limitations of Psychoanalysis
1.1 INTRODUCTION: SIGMUND FREUD - CLASSIC PSYCHOANALYSIS You must have learned about the psychotherapy, where the client would
lie on a couch, and the therapist would seat on a chair, where the client
could not see him. Client would say wh atever that came to his mind and
the therapy would continue. Sigmund Freud developed this traditional
psychotherapy, which is also called as id Psychoanalysis, in early 1900.
Freud is also regarded as father of psychotherapy. The term munotes.in

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2 psychoanalysis was f irst 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.
1.1.1 Structure of Personality:
According to Freud, Personality has three systems - the id, the ego, and the
superego. Now, we will look at each system in detail. Though these
structures of the personality are separated, in reality, they work together as
the internal forces that form one’s personality.
The id- Id is present at birth and it is largely unconscious i.e. 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
cann ot stand tension, thus it aims at relieving the tension immediately. For
gaining pleasure, Id uses two strategies - reflex actions and primary
processes. Reflex actions consist 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 energy
comes from two sources - Life instinct (Eros) and death or destructive
instinct (Than atos). 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 instincts 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.
The 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 behavior.
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 regulates 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
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3 Intervention Systems Emphasizing Background - I The superego:
You can think of superego, as an exact opposite of Id. Learning’s from
our parents, teachers, society, tra ditions, and culture contribute to the
development of superego. Superego is a strict conscience that internalizes
standards, rules, guidelines, moral values etc. It strives for perfection and
differentiates between good and bad, right or wrong choices, act ions.
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 parental 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. The
conscience develops as a result of prohibitions of parents. The ego -ideal is
a positive desire to imitate adult standards of behavior.
1.1.2. 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 d evelopment of personality in later life. Now, we will take
a look at these stages in detail.
The oral stage :
Oral stage is the first stage, and it makes up till about a first year of a
child’s life. In this stage, mouth is the most important zone of the b ody for
the baby. 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 result in
symptoms such as overeating , oral aggressiveness. It also deals with
inability to trust oneself and others.
The anal stage :
This is the second stage, between the age of 18 to 36 months (1.5 to 3
years). The zone for gratification shifts from mouth. Child gets social
pleasure by impr essing the parents and the physical pleasure by emptying
the bowels. In this stage, parents who try to do potty training using
punishment and restrictions are likely to promote compulsive, controlling
characteristics in their children. Parents who use prai se and rewards after
appropriate behavior are likely to promote creativity. This stage deals with
the inability to recognize, express anger.
The phallic stage :
This is the third stage, between the age of 3 to 5 years. Freud believed that
this stage is com plex and it is 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
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4 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 parent of
the other gender. C hildren 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 of 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 o f 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 mother.
The latency stage - This is fourth stage, between the ages 5 to 11 years. It’s
considered as a comparatively quiet period in child’s sexual development.
Social interest increases and sexual drive becomes less important.
Children engage in activities such as making friends, deve loping hobbies
etc.
The Genital stage - This is the final stage, after latency stage, which
continues through the life span from adolescence. One’s personal identity
is strengthened, feelings of altruism, care are developed 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 psychologically immature ways. A fixation or c omplex can
be defined as an unresolved unconscious conflict.
Table 1.1 Psychosexual stages of development, age group and their
characteristics Sr.no Name of the stage Age Charecteristics 1 The oral stage 0-1 year Mouth is an important zone in the body for pleasure. 2 The anal stage 1.5- 3 years Obtaining social pleasure by impressing the parents and physical pleasure by emptying the bowels. 3 The phallic stage 3- 5 years Genitals become one’s source of gratification. Sexual fantasies are developed. 4 The latency stage 5-11 years Increase in the level of social interest, engaging in social munotes.in

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5 Intervention Systems Emphasizing Background - I activities. 5 The genital stage 11- till death Final stage where positive and loving sexual relationships are developed. 1.1.3 Levels of Consciousness :
Levels of co nsciousness and the concept of unconscious are considered as
Freud’s greatest contributions, which help us to understand human
behavior and personality. We will look at each level in detail.
There are three levels of consciousness, according to Freud: the conscious,
the preconscious, and the unconscious. 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 in formation can be aversive (for example, the
memory of painful treatment and hospitalization, after hearing siren of
ambulance) or benign.
The unconscious level contains memories that are highly charged. They
include impulses, repressed drives (A boy’s sexu al feelings for his
mother). 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
consciousness.
Levels of consciou s are compared with iceberg. Consciousness is
considered as thin slice of the total mind. Conscious mind is considered
only as the tip of an iceberg. Just like an iceberg has its larger part below
the surface of water, greater part of mind is found below t he surface of
awareness (unconscious). 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
representations 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, projective techniques, posthypnotic suggestions & the
symbolic information obtained from psychotic symptoms.
1.1.4. Anxiety and Defense Mechanisms :
According to Freud, humans try to reduce tension and anxiety. Anxiety is
importa nt concept in the psychoanalytic approach. According to Freud,
there are three kinds of anxiety: reality, neurotic, and moral. 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. Second type is munotes.in

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6 neurotic anxiety. It is the fear that instincts will be difficult to control and
lead to punishment due to unacceptable behavior. Third one is moral
anxiety. It is 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 internalized
prohibitions or external reality.
Among the defenses used by humans, some are healthy, some are
distorting. Freu d believed that signal anxiety would lead to automatic
triggering of ego defense mechanisms. These ego defense mechanisms are
developed 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 defense mechanisms. Defense mechan isms
are automatic i.e. Individual learns to spontaneously use a specific defense
mechanism. Defense mechanisms either deny reality or distort reality; they
operate on an unconscious level. Defense mechanisms are categorized in
several ways. For example, P rimary vs. Secondary defense mechanisms,
psychotic vs. neurotic defenses, immature vs. healthy defenses.
We will now look at some defense mechanisms along with their examples.
Table 1.2 Defense mechanisms along with their depression and
examples Sr.no Defense mechanisms Description Example 1 Denial Not accepting threatening aspect of reality that is evident to others. A person who has addiction of alcohol denying that drinking is not good for their health. 2 Reaction formation Replacing unacceptable, threatening thoughts, emotions with active expression of their opposite, in order to overcompensate. A person hates his boss, but behaves in an excessively nice, friendly manner with him. 3 Repression According to Freud, it is involuntary removal of something from consciousness. Thoughts and feelings that are painful, threatening are relegated to the unconscious, A person is sexually molested when she was 5 years old. There is behavioral evidence that it exists, but she genuinely cannot recall this event. munotes.in

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7 Intervention Systems Emphasizing Background - I excluding them from awareness. 4 Projection Projecting unacceptable thoughts, feelings, or impulses on another person. A person hates his mother, but instead says that his mother is the one who hates him. 5 Displacement Directing strong feelings from a threatening person/ object toward other person/object which is less threatening than the previous one. A child is very angry with his mother, so he displaces these angry feelings toward his dog, by kicking it. 6 Rationalization Using excessive explanations, to justify behavior in self-serving but invalid ways. A person who is rejected by his date might say that he was not anyways attracted towards her. 7 Sublimation Diverting potentially harmful emotions or impulses (sexual or aggressive energy) into other socially acceptable ways. A person sublimating her aggressive impulses into athletic activities (playing football) where she finds a way to express these feelings. 8 Regression Reverting to an earlier phase of development in thoughts, emotions, and behavior when there were fewer demands. A child who is traumatized may regress to earlier developmental stage and start thumb sucking behavior.
1.2 PROCESS OF THERAPY 1.2.1 Therapeutic Goals :
Goals of Freudian psychoanalytic therapy include making the unconscious
conscious and strengthening the ego. Making unconscious motives
conscious is one of the goals of psychoanalytic therapy because; only then
can person exercise choice. To bring out the unconscious material,
therapeutic methods are used. Later, c hildhood experiences are discussed,
reconstructed, interpreted and analyzed. This can result in behavior which
is based more on reality and less on instincts, irrational guilt; important
modification in one’s personality and character structure is also exp ected.
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8 behaviors, symptoms. According to this view, a “cure” for such
symptoms & behaviors is built on revealing the meaning of symptoms, the
causes of behavior along with the repre ssed information which interferes
with healthy functioning; intellectual insight alone cannot fix symptoms.
The therapeutic process is not limited to problem solving and modification
of behavior, but it also considers exploring an individual’s past to arri ve 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.
Now we will talk about the second goal - strengthening the ego. Achieving
equil ibrium 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 overwhelmed 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, wo rk, 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 get control over impulsive, irrational
behavior.
1.2.2. 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 patient 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 couch,
clients say whatever that comes to their mind; this content should n ot be
censored by them. This is called as 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
importa nt. 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 progress of therapy. It prevents the
client from bringing the unconscious, rep ressed material to conscious.
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9 Intervention Systems Emphasizing Background - I Therapist then points it out and clients shall confront it, if they want to
deal with conflicts realistically. Resistance can be a valuable tool in
understand ing the client if resistance is handled properly.
Transference and countertransference :
Relationship between client and therapist is very important in
psychoanalytic therapy. Client unconsciously 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
inappropriateness. It involves (unconscious) repetition of past in the
present and misperception of the therapist. Freud believed that the
formation o f 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 father is an example of negative transference.
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 grandmother 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. Working through transference is a lengthy
process and it involves three stages. After th e 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 heal thier way.
Now we will understand countertransference. Originally,
Countertransference was called as the therapist’s tendency to see the client
in terms of his own relationships in the past. In classical psychoanalysis,
countertransference is avoided. Cou ntertransference 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 therapeutic process. The therapist shall
unde rstand 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 countertransference.

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10 1.3 THERAPEUTIC TECHNIQUES Some interventions that psychoanalysts use are questions, dream analysis,
interpretations and free association.
Free Association :
Free association is a primary technique in psychoanalytic therapy. Free
association is used as an approach to get access to repressed material. It’s
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 information 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, conflicts etc. We all experience automatic
connecting of one thought to another, i.e. free association. This was
encoura ged 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 impo rtant 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 underlying
problem. Hid den meaning underlying the surface content is understood. A
slip of tongue, areas the client does not talk about are also significant.
Abreaction :
Freud recognized the significance of emotions and believed that affect
needs to go hand in hand with the re call 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 material 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 and analyze that exp erience. Finally, emotional
release is achieved as the climax of this process.
Interpretation and Analysis :
Interpretation and Analysis are the most fundamental techniques in
Freudian psychotherapy which promote awareness and insight. The tools
of analy sis and interpretation allowed Freud to bring unconscious material
into consciousness. We will now look at analysis and interpretation in
detail.
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 munotes.in

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11 Intervention Systems Emphasizing Background - I person then would be motivated to free -associate to the dream and talk
about th e 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 dr eam would be
emphasized.
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 t he meanings of behavior 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 fo r making better choices
that are free from the negative effect of unconscious material.
Interpretation is done to accelerate the process of uncovering material
which is unconscious. Any gaps, inconsistencies in client’s story, inferring
the meaning of repo rted 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 contr ol over their lives.
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 form 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 client, 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 proces s 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 an
understanding of clients’ functioning in the present.
1.4 STRENGTHS AND WEAKNESSES One of the significant contributions of Freud is the great impact his
thoughts had on our understanding of personality de velopment. Even if
some of us do not agree with 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 st ill influence contemporary practice. Many basic
concepts given by Freud are part of foundation on which other theorists munotes.in

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12 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 basic character. Freud’s
Psychoanalytic theory is a benchmark theory against which many other
theories are measured.
Now, we will look at some limitations of classical psychoanalysis.
Classical Freudian psychoanalys is 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.
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 res trictive. 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 psychoan alytic approach is costly. It is generally considered as
being based on upper - and middle -class values. There can 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 than short -term problem solving. Because of the
lengthy, intense nature of the treatment, each therapist can work only with
limited number of peop le and each treatment is unique. Thus, research
proving the value of classic psychoanalysis is limited.
Multicultural 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 situation, if there is no balance between
the external and internal outlook.
Freud had some incorrect and harmful ideas about women. He blamed
moth ers 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, wom en are considered as
"essentially castrated men".
1.5 SUMMARY In this chapter, we learned about classic psychoanalysis. According to
Freud, structure of personality has three systems – Id, Ego and Superego.
We talked about Drive theory and two instincts - Eros (life instinct) and
Thanatos (Death instinct). These two are in opposition to each other.
Humans are filled with psychic energy which comes from these two
sources. There are five stages of development - the oral stage, anal stage,
phallic stage, late ncy stage and genital stage. If a child’s needs are not munotes.in

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13 Intervention Systems Emphasizing Background - I sufficiently met at each of these stages, later in life that child may become
fixated at that particular stage, and behave in ways that are
psychologically immature.
There are three levels of conscio usness, according to Freud: the conscious,
the preconscious, and the unconscious which are compared with iceberg.
Each of these levels has specific characteristics. Anxiety is important
concept in psychoanalysis and there are three types – Neurotic anxiety ,
Moral anxiety and Reality anxiety. To deal with anxiety, humans have
defense mechanisms. They are automatic and they operate on unconscious
level etc. Denial, Displacement, Repression, Projection, Rationalization,
Sublimation, Regression are some example s of defense mechanisms. We
also discussed about psychoanalytic therapy. Goals of psychoanalytic
therapy include making the unconscious conscious and strengthening the
ego. Therapeutic alliance has many factors such as approach of therapist
(blank screen a pproach). Relationship between client and therapist is very
important in psychoanalytic therapy. Client unconsciously shifting his
feelings and fantasies which are reactions to important figures in his past,
toward psychoanalyst is called as transference. Countertransference is
therapist’s feelings about the client. Understanding resistance and its role,
pointing it out and its confrontation are significant in the process of
therapy.
There are therapeutic techniques such as free association, abreaction,
dream analysis, interpretation and analysis. Freud’s theory of
psychoanalysis had significant impact on understanding of psychological
concepts and became a foundation for other theories. There are some
limitations of psychoanalysis, such as it being a long term, costly and
intense treatment, which may not solve problems immediately.
Anonymous role of therapist, lack of empirical research, Freud’s ideas
about women have received criticism.
1.6 QUESTIONS A) Write long answers:
a) Write about developmental s tages in detail.
b) Discuss about anxiety and defense mechanisms in detail.
c) Explain in detail about therapeutic goals and therapeutic alliance.
d) Explain in detail: Therapeutic techniques.
B) Write short notes:
a) The Structure of personality.
b) Levels of consciousness.
c) Strength and weakness of psychoanalysis.
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14 1.7 REFERENCES  Corey, G. (2009). Theory and practice of counseling and
psychotherapy (8th ed.). CA: Thomson Brooks.
 Seligman, L. & Reichenberg, L. W. (2014). Theories of counseling
and psy chotherapy: Systems, strategies, and skills (4th ed.). Pearson
education.
 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.


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15 2
INTERVENTION SYSTEMS
EMPHASIZING BACKGROUND - II
Unit Structure
2.0 Objectives
2.1 Introduction: Alfred Adler -Individual psychology
2.2 Basic concepts of individual psychology
2.2.1The whole person and patterns of human personality
2.2.2 Private logi c
2.2.3 Concept of inferiority and striving for superiority
2.2.4 Striving with purpose
2.2.5 Goals
2.2.6 Social interest
2.2.7 Phenomenology
2.2.8 Birth order and family constellation
2.3 Treatment using individual psychology
2.3.1 Therapeutic alliance
2.3.2 Techniques
2.3.3 Phases of treatment
2.4 Evaluation of individual psychology
2.5 Carl Jung - Analytical psychology : Basic theoretical concepts
2.5.1. Components of the psyche
2.5.2 Concept of human development
2.5.3 Dimensions of personality
2.6 Treatment using Jungian analytical psychology
2.6.1 Goals of psychotherapy
2.6.2 Therapeutic alliance
2.6.3 Interventions
2.7 Evaluation of Jung’s analytical psychology
2.8 Summary
2.9 Questions
2.10 References
2.0 OBJECTIVES After studying this unit yo u should be able to:
 To understand the basic concepts of individual psychology
 To understand the basic concepts of analytical psychology munotes.in

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16  To know about treatment using individual psychology
 To know about treatment using analytical psychology
 To understand strengths and limitations of individual and analytical
psychology
2.1 INTRODUCTION: ALFRED ADLER -INDIVIDUAL PSYCHOLOGY Alfred Adler was a settler of a holistic, social, systemic approach. He was
also the first systemic therapist. He believed that it is n ecessary 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, behaviors,
along with the private view of self, others, society.
Adler initially worked with Freud, but later he moved forward with his
own ideas. Adler believed that Freud’s focus on biological and instinctual
determinatio n 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 adult. 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.
2.2 BASIC CONCEPTS OF IN DIVIDUAL PSYCHOLOGY 2.2.1 The Whole Person and Patterns of Human Personality :
Adler focused on the unity and indivisibility of the person. According to
Adler, human behavior 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 thinking, feeling, acting,
attitudes, values, the conscious mind, the unconscious mind etc. instead of
breaking the individual into different functional parts. Adler emphasized
the understanding the whole person —how all the aspects of an individual
are interconnected 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 individ ual Psychology, all human behavior has a purpose.
Human beings set goals for themselves, and behavior becomes unified to
achieve their goals. Humans can be fully understood considering their
purposes and goals toward which we are striving. Adler’s theory f ocuses
on future without minimizing the significance of past influences. munotes.in

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17 Intervention Systems Emphasizing Background - II According to individual psychology, human behavior is considered as a
function of a combination of many influences or contributing factors.
Generally, no single, direct causal factor leads to a single behavior. Adler
believed that each person is responsible for his/her behavior as they have
the freedom to select from a variety of behavioral options. It shall be noted
that though this approach says that an individual is responsible for his/her
behavior, it doesn’t blame them for their wrong deeds.
2.2.2 Private Logic :
Being one of the major construct given by Adler, private logic means our
beliefs about ourselves, our place in the world which is subjective and
based on lifestyle. Pr ivate 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 uniq ue to every individual
but it is not always logical. Feelings of superiority, fear of inferiority are
meaningful only to the individual.
2.2.3 Concept of Inferiority and Striving For Superiority :
Adler looked at inferiority feelings as a normal condition o f all individuals
and as a source of all human striving. Instead of looking at inferiority
feelings as a sign of weakness or abnormality, inferiority feelings can be
thought of as the wellspring of creativity, as they inspire us to strive for
mastery, comp letion, success or superiority. Individuals are driven to
overcome their sense of inferiority and to strive for increasingly higher
levels of development. Adler believed that the moment one experiences
inferiority he/she is pulled by the striving for super iority. 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 produc e 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. For example,
working hard in one area to compensate for flaw in other area.
From our earliest years, one recognizes that he or she is helpless is many
ways which is characterized by feelings of inferiority. These feelings of
inferiority during the early childhood years have a significant impact on
development. Most children experie nce these 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 expecting 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.
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18 2.2.4 Striving with Purpose :
Humans actively shape themselves 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 element
which influences and governs human behavior. Adler called this third
force as “attitude toward life”. Attitude toward life consists of individual
human choice, individual sense of purpose.
2.2.5 Goals :
According to Adler, a healthy & well -functioning adult is an individual
who is independent, emotionally as well as physically self -reliant, useful,
productive, and one who is able to cooperate with o thers for personal and
social benefit. By using psychotherapy and education, Adler wanted to
help people realize 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.
2.2.6 Social Interest :
Social interest and community feeling are important and distinctive
concepts given by Adler. An action line of one’s community feeling,
which involves his/ her positive attitude toward other people in the world
is called as social interest. The capacity to cooper ate 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 huma n beings are born into an interpersonal context, their personality
development is shaped by interpersonal factors. 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 th ought of social interest as innate but he also believed that it must
be taught, learned, and used. People with social interest guide the striving
toward the healthy, socially useful side of life. As social interest develops,
feelings of inferiority and ali enation reduce. Social interest is expressed by
shared activity and mutual respect. Individual Psychology believes 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
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19 Intervention Systems Emphasizing Background - II 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). Regardless 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
psychologica l disorder.
2.2.7 Phenomenology :
The concept of phenomenology is main assumption of individual
psychology. Viewing 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 significant than the
external and objective for Adler. He paid attention on the way an
individual perceived the world, his/her inner reality. Adl er looked at each
person as a unique individual. He believed that only by understanding that
individual’s perceptions 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 Ind ividual 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 world. When we acknowledge
the patterns, continuity of our lives, we can modify our faulty assumptions
and make basic changes needed. Childhoo d experiences can be reframed
and new style of life can be consciously created using therapeutic,
educational experiences. 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)
behavioral strategies that an individual uses to achieve goals and negotiate
the journey of life and 4) the outcomes of those behaviors.
Everybody has an image, often unconscious, of what life will b e like when
goals are met. Adler called this as fictional finalism. He believed that this
aim is strongly established 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.
2.2.8 Birth Order and Family Constellation :
Adler pointed out that it is not correct to assume that children born in the
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20 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,
secon d 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 speci fic 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 fa mily constellation involves the
composition of the family, role of every person, along with the reciprocal
transactions 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. It shall be noted that one shall not
stereotype people according to birth order, but remember that exploring
birth order and its influence on the development of an individual's
personality can help us to understand that person.
Table 2.1. Five psychological positions given by Adler Sr. no. Psychological Positions Characteristics 1 The oldest child The oldest child is likely to be the most intelligent and achieving among the five groups. Firstborn’s are generally dependable, 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 firstborns are only child in the family, they are the center 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 with the birth of their sibling, it can help them to be self- confident and affiliative. 2 The second child 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 munotes.in

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21 Intervention Systems Emphasizing Background - II oldest 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, fr iendly, and expressive than their
older siblings. The second -born is
generally 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 special. 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 munotes.in

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22 adventurous, sociable, innovative and pursue their own interests 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 init ial and attention
like the later one. The only child may not
learn to cooperate 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 insecure, the
children often adopt worries and
insecurities of their parents.

2.3 TREATMENT USING INDIVIDUAL PSYCHOLOGY 2.3.1 Therapeutic Alliance :
Adler’s ideas about client -clinician relationship are different than Freud.
Adler highlighted cooperative interaction which includes establishment of
shared goals, mutual trust and respect. Therapists play role of role models,
educators, teaching people how to modify their lifestyles, behavi ors, 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.
2.3.2 Techniques :
Adler's Individual Psychology has a lot of creative and useful
interventions. We will look at few interventions in detail.
Spitting in the Client’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 metaph or 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 behavior patterns. The therapist teaches the client
about how to catch himself/herself when he or she slips back into old and
unhelpful behaviors. It encourages people to be more conscious of their
repetitive faulty goals and thoughts. This approach lets the client monitor
themselves without being critical toward themselves.
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23 Intervention Systems Emphasizing Background - II Pushing the Button :
Rather than allowing their emotions to control them, this technique 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.
2.3.3 Phases of Treatment :
There are four treatment phases in Adler's model which generally merge
and overlap.
Phase 1) Establishment of t he therapeutic relationship and setting
goals
Therapist and clients build a collaborative, democratic, and trusting
relationship where they can work together to create a clear statement of
the problem and meaningful, realistic goals. They can discuss abou t the
structure of the treatment. Initial questions are asked to explore clients'
expectations 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 clients, 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.
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 fun ctioning 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 til l adolescence. The
10th section collects early childhood recollections. Adler called initial
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 their lifestyles,
acknowledge the covert reasons leading to their behaviors, realize the
negative impact of such behaviors, and move toward positive change.
Clinicians f ocus on present rather than the past. They are more concerned
with results rather than with unconscious motivation. Their interpretations
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24 gentle interpretations, therapists try to edu cate clients, promote self -
awareness, insight, and discussion. They try to help people weigh their
options and take decisions. Beliefs, attitudes, and perceptions are
emphasized because behavioral change will take place only by cognitive
means and social i nterest.
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. Clinicians help people to become
full participants in their social system, shift their roles and interactions;
take on rewarding challenges. In this phase, clinicians model an d 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 decid e 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.
2.4 EVALUATION OF INDIVIDUAL PSYCHOLOGY Adler's theory is considered as an optimistic, grow th oriented, and
educational theory. According to Adler, people can change their goals and
lifestyles to live happier, fulfilled lives. Adler's model of Individual
Psychology is used for treatment of various groups such as children,
individuals, couples, f amilies for various reasons such as career
development, education, training, supervision, consultation etc. Adler’s
ideas have influenced many other approaches of treatment such as
cognitive therapy, reality therapy. Individual Psychology can be
effectivel y 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. Adl er is also called as overly
optimistic because of his statement that social interest is innate.
2.5 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. According 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 o f
psyche.
2.5.1 Components of the Psyche :
Jung's concept of the psyche is more complex than Freud’s concept of
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25 Intervention Systems Emphasizing Background - II unconscious are three levels in psychic functioning. We will look at each
level in detail.
The Conscious Mind :
Conscious mind is only a small part of the psyche. It includes the ego, the
persona, two attitudes, and four functions.
The Ego :
Ego is formed of perceptions, memories, thoughts, and feelings which are
within one’ s awareness. Being the center of the conscious mind, ego offers
us our sense of world and reality. It affects our transactions with our
environment, giving us a sense of identity. The development of ego lets us
differentiate ourselves from others. Comparat ively, ego is weaker than
other parts of the psyche. Ego protects itself using process of repression,
by assigning threatening material into personal unconscious. Like this,
conscious and unconscious levels of personality are connected by ego.
The Persona :
This 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 othe r individuals and continue with
our daily activities. Our persona is affected by people around us and it can
change in order to adapt with the social situations. Generally, our original
thoughts and emotions which are not socially acceptable, are not refle cted
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 t he world
through one of these four functions. This function is called as primary or
superior function. The opposite function of the primary function is least
developed, inferior and it’s the problematic. Opposites are in balance in
the well -functioning per son and they provide psychic energy. We will
later look at each of the functions and attitudes in detail.
The Unconscious Mind :
Jung 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
energy in our psyche which is unavailable to conscious mind. There are
two levels of the unconscious mind - the personal unconscious and the
collective unconscious.

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26 The Pers onal Unconscious :
The personal unconscious is unique to every person reflecting his/ her
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 consc ious again. Memories from the personal
unconscious, can be triggered by daily stimuli and then they are recalled.
Repressed material generally emerges from the personal unconscious via
dreams or symbols. Dreams and fantasies represent the personal
uncons cious when they are of a personal nature. Archetypes and the
shadow are also found in personal unconscious. We will later look at both
in detail.
Complexes :
Complexes 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 be thought of as challenging obstacles. They are not
necessarily negative, but their impact might be. They might affect ou r
daily life but as they are located in the unconscious, generally we are not
aware about them. Jung thought of complexes as a pool where energy
whirls and circles, due to unresolved areas in an individual’s life.
Complexes can be as diverse as human expe riences.
The Collective Unconscious :
The collective unconscious can be described as storehouse of motives,
urges, fears, and potentialities which we inherit by being human. It is
shared by all humans in the world and contains myths, images and
symbols. Ac cording to Jung, collective unconscious is far larger than
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 o riginating 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, unc onscious 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 trickster. We will look at
some archetypes in detail.
The self :
It is a central, organizing archetype, which is regulating c enter of the
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27 Intervention Systems Emphasizing Background - II conscious, the personal unconscious, and the collective unconscious. It is
primarily located in the collective unconscious, emerging from dreams,
symbols, perceptions, and imag es. It generally emerges after the second
half of our lives, reflecting from our spiritual, philosophical perspective.
The self 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.
Anima/animus :
These concepts have similarity with Chinese concept of yin and yang,
which are the feminine and masculine principles that exist in every human.
The anima is the psychological feminine element in a man and the animu s
is the psychological masculine element in a woman. These archetypes are
evolved from generations of experience. Their 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.
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 tries to hide it from self as well as
others. This archetype consists of traits, instincts that are morally
objectionable. It is in direct and rec iprocal relationship with our persona.
As nature of the shadow is not restrained but primitive, it is a wellspring
of energy, creativity, vitality. In a way it is opposite to persona as persona
tries to get social acceptance, while shadow contains the soci ally
undesirable. We project our archetype of shadow on other individuals and
then over react to that overblown projection. Some similarities are
observed between Freud’s concept of id and shadow.
2.5.2 Concept of Human Development :
According to Jung, pe ople's lives are divided into two periods. In the first
half of our life, we find our place and develop interests, values, find a
partner, make career choice. In the second half, with established
foundation, we move towards individuation. In search of indi viduation an
individual becomes a psychological individual i.e. a whole. This is a
lifelong process where the whole personality develops. Greater access is
obtained to unconscious and latent abilities; movement is made towards a
state of greater balance, h armony, 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.
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28 Balance and Polarities
Life ha s opposites or polarities. Their balance determines our
psychological health and development. Extremes are harmful as they
prevent the realization of the opposite construct, gaining satisfactory
expression. The result of imbalance is the likelihood of an e xtreme
emotion to turn into its opposite over time.
There are inborn self -regulating systems within people 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, wi th 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.
2.5.3 Dime nsions of Personality :
Individual differences in personality are assigned to two dimensions. First
dimension is the typical ways in which people take in and understand
internal and external stimuli (the four functions). Second dimension is the
characteris tic directions of people’s libidos (the two attitudes).
The Two Attitudes :
The direction of movement of 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 outside. They are likely to be outgoing and
adapt smoothly to the external change. These people are energized by
social, interpersonal situations than by sol itude.
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 t hemselves by being alone.
The Four Functions :
Thinking, feeling, sensation and intuition are the four functions which
determine how we process internal and external stimuli. Thinking and
feeling are known as rational functions and sensation and intuition a re
known as irrational functions. We will know about each function in detail.
Thinking :Those who have dominant thinking function reacts cognitively
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29 Intervention Systems Emphasizing Background - II Feeling - This function is opposite to the feeling function. Those with
dominant feeling function react emotionally and focus on pleasure, dislike,
anger, etc. emotions raised by a stimulus.
Sensation : Sensation includes receiving, identifying physical stimuli
through our senses and passing th em 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 d epend on feelings about where a stimulus has
come from, its direction and possibilities to determine their decisions and
reactions about the stimulus.
Every individual has a dominant/ superior function. This superior function
organizes experiences, percep tions 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 situatio ns. Unconscious
compensates for the dominance of an individual’s superior function by
encouraging the opposite tendencies.
The four functions can be paired with each of the two attitudes and makes
eight possible personality types. They are thinking and int roversion,
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 Mye rs-Briggs Type Indicator (MBTI).
2.6 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.
2.6.1 Goals of Psychotherapy :
This approa ch focuses on emergence and understanding of material from
personal and the collective unconscious. Painful, unacceptable aspects of
the unconscious are made conscious, acceptable, and meaningful which
leads to resolution of inner conflicts, greater balanc e, integration in the
person, individuation, growth in creativity, energy and spiritual feelings.
The goal is not to bring 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. Transference and countertransference are explored,
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30 through their immature and unre alistic thoughts, fantasies. The 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. Transformation is the fourth stage. Transfor mation 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.
2.6.2 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 awarenes s through interventions.
Jung believed that both client and analyst have an unconscious impact on
each other which can facilitate treatment. Jung considered therapy as a
reciprocal process as each participant ( client and analyst) experience
healing, gro wth and benefit from the positive changes in the other
participant.
2.6.3 Interventions :
In the beginning, Jungian psychotherapy focuses on the conscious, builds
a therapeutic alliance, and provides foundation for safe, productive
exploration of the uncon scious. After this, various techniques are used to
obtain access to the contents of the unconscious. When this content of the
unconscious is brought into consciousness, it is explored, clarified,
interpreted, and understood. This content can be later integ rated into the
overall psyche of the person.
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, 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.
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 include s 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 un conscious. After understanding the dream, it is
assimilated into consciousness.
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31 Intervention Systems Emphasizing Background - II Word Association Tests :
In these tests, the analyst 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 material and complexes.
Associations are used for exploring the meaning of the dreams.
Rituals :
Jung occasionally incorporated rite s, rituals into therapy which can
enhance its process and strengthen its individual, cultural relevance and
impact.
2.7 EVALUATION OF JUNG’S ANALYTICAL PSYCHOLOGY Jung’s concepts are complex, ill -defined and the treatment is lengthy. His
work is not empir ically validated. Little attention is paid to immediate
crisis and to practice Jungian analysis, extensive training and supervision
is needed. There are some strengths as well. For example, Jung’s ideas are
later reflected in many theories in various field s. The Myers -Briggs Type
Indicator, a personality inventory is based on his theory.
2.8 SUMMARY Alfred Adler developed the theory of Individual Psychology which
assumes that people are responsible for their own thoughts, feelings,
behavior; they are the creators and creations of their own lives. Every
individual has a unique private logic and people actively shape themselves
and their lives. Human beings experience feelings of inferiority and strive
for superiority. Adler gave five psychological positions and their
characteristics. Among the four phases of treatment, therapist helps client
by cooperative interaction, support; encouragement is important in the
therapeutic relationship.
Jung’s theory is known as analytical psychology. According to Jung,
psychic functioning has three levels - The conscious mind, the collective
unconscious, and the personal unconscious. The conscious mind includes
the ego, the persona, two attitudes, and four functions. The collective
unconscious and the personal unconscious ar e two levels of unconscious
mind. Personal unconscious is unique to every person and contains
repressed and forgotten memories, complexes, archetypes, shadow. The
collective unconscious includes archetypes, such as the shadow, anima
and animus, self, etc. The balance of polarities in our life determines our
psychological health and development. There are two dimensions of
personality - the two attitudes ( introversion and extraversion) and four
functions (thinking, feeling, sensation, intuition). The four f unctions can
be paired with each of the two attitudes and we get eight possible
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32 goal is individuation. There are various techniques such as use of symbols,
dream interpretation, word association test and rituals.
2.9 QUESTIONS A) Write long answers:
a) Discuss in detail about social interest and phenomenology
b) Explain about birth order and family constellation.
c) Explain in detail about treatment using individual psychology.
d) Explain: Jung’s concept of unconscious mind.
e) Write in detail about dimensions of personality.
f) Treatment using Jungian analytical psychology.
B) Write short notes:
a) Write about the whole person, patters of human personality and
private logic.
b) Discuss about concept of inferiority and striving for superiority,
striving with purpose and goals.
c) Write in detail about evaluation of individual and analytical
psychology.
d) Explain about Jung’s concept of human development along with
balance and polarities.
e) Explain in detail: Jung’s concept of conscious mind.
2.10 REFERENCES  Corey, G. (2009). Theory and practice of counseling and
psychotherapy (8th ed.). CA: Thomson Brooks.
 Seligman, L. & Reichenberg, L. W. (2014). Theories of counseling
and ps ychotherapy: Systems, strategies, and skills (4th ed.). Pearson
education.
 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.

*****
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33 3
INTERVENTION SYSTEMS
EMPHASIZING HUMANISTIC,
COGNITIVE AND BEHAVIORAL
APPROACHES - I
Unit Structure
3.0 Objectives
3.1 Introduction
3.2 Carl Rogers Person Centered Therapy
3.2.1 Four Periods of Development of the Approach
3.2.2 Existentialism and H umanism
3.2.3 View of Person Centered Therapy
3.2.4 The Process Of Therapy
3.2.5 Application of Therapeutic Techniques and Processes
3.2.6. Person -Centered Therapy from a Multicultural Perspective
3.3 Summary
3.4 Questions
3.5 References
3.0 OBJECTI VES After studying this unit students should be able to:
 Understand the importance of studying different therapeutic
approaches.
 Know the nature of Carl Rogers Person Centered Approach.
 Study the the process of therapy
 To know application of therapeutic t echniques and processes
 Understand Person -Centered Therapy from a multicultural perspective
3.1 INTRODUCTION It is really important to understand different therapeutic approaches, their
views and techniques. The information given in this chapter will hel p
students to develop a balanced view of the major ideas of various
therapists, theorists, and the practical techniques commonly used by
counselors. Each therapeutic approach has useful dimensions.
Interventions provided by each approach has a significant role in the
therapy. It is not a matter of a theory being “right” or “wrong,” as each
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34 unique practical implications. Accepting the validity of one approach does
not necessarily imply r ejecting another approach .Each intervention
technique is based on what clients are thinking, feeling, and doing, and a
complete therapy must address all three of these aspects. Combining all
therapeutic dimensions gives the basis for a strong and complet e therapy.
In a developing diverse society theoretical pluralism has its own
significant place. In this chapter we are going to study Carl Rogers -
Person Centered Therapy in detail.
3.2 CARL ROGERS - PERSON CENTERED THERAPY The person -centered approach is o ne of the important approaches in the
study of Psychology. It is mostly based on the concepts of humanistic
psychology, in which many concepts were articulated by Carl Rogers in
the early 1940s.Carl Rogers is one of the pioneers of a therapeutic
approach, and Rogers stands out as one of the most influential figures in
revolutionizing the direction of counseling theory and practice. A survey
conducted by Psychotherapy Networker (“The Top 10,” 2007), Identified
Carl Rogers as the single most influential psych otherapist of the past
quarter century. Rogers has become known as a “quiet revolutionary”. He
contributed to theory development .His influence continues to shape
counseling practice even today ( Rogers & Russell, 2002).
The person -centered approach share s many values and concepts with the
existential approach.According to Rogers people are essentially
trustworthy and they have a great potential of understanding themself and
they can resolve their own problems without direct intervention on the
therapist’ s part, If they are involved in a specific kind of therapeutic
relationship they are capable of self -directed growth. According to Rogers
the attitudes and personal characteristics of the therapist and the quality of
the client –therapist relationship are t he prime determinants of the outcome
of the therapeutic process. Person -centered therapy is the result of an
evolutionary process that continues to remain open to change and
refinement ( Cain & Seeman, 2002). Actually Rogers did not present the
person -centered theory as a fixed and completed approach of therapy. He
hoped that others would view his theory as a set of tentative principles
which are relating to how the therapy process develops. Rogers expected
his model to evolve and was open and receptive to change.
3.2.1 Four Periods of Development of the Approach :
To search for major turning points in Rogers’s approach, Zimring and
Raskin (1992) and Bozarth and colleagues (2002) identified four periods
of development. During the first period, in the 1940s, Rogers evolved
nondirective counseling, which provided a powerful and revolutionary
alternative to the directive and interpretive approaches to therapy then
being practiced. Rogers (1942) published Counseling and Psychotherapy:
Newer Concepts in Practice, which elaborates the philosophy and practice
of non -directive counseling, while he was a professor at Ohio State
University. Rogers challenged the validity of most commonly accepted
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35 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I teaching, diagnosis, and interpretation. Rogers omitted diagnostic concepts
and procedures from his approach.
During the second period, in the 1950s, Rogers (1951) wrote Client -
Centered Therapy and renamed his approach as client -centered therapy,
which shows its focus on the client rather than on non -directive methods.
Then he opened the Counseling Center at the University of Chicago. This
period was emphasized by a shift from clarification of feelings to a focus
on the phenomenological world of the client. R ogers stated that the best
view for understanding how people behave was from their own internal
frame of reference.
The third period showed the necessary and sufficient conditions of
therapy.This period began in the late 1950s and extended into the 1970s.
Rogers (1957) set a hypothesis which resulted into three decades of
research. An important publication was On Becoming a Person (Rogers,
1961), it showed the nature of “becoming the self that one truly is.” In this
book he explained the process of “becomi ng one’s experience,” which is
emphasized by an openness to experience, an internal locus of evaluation,a
trust in own experience, and the willingness to be present in the process.
During the 1960s, Rogers and his associates continued to test the process
and the outcomes of psychotherapy. He was interested in how people best
progress in psychotherapy, and he studied the qualities of the client –
therapist relationship. After this research, the approach was further refined
and expanded (Rogers, 1961).
The four th phase was about considerable expansion to education, industry,
groups, conflict resolution, and the search for world peace during the
1980s and the 1990s. It was during the 1980s that Rogers directed his
efforts toward applying the person -centered appro ach to politics,
especially to the achievement of world peace.
In a comprehensive review of the research on person -centered therapy
over a period of 60 years, Bozarth and colleagues (2002) concluded the
following:
• In the earliest years of the approach, the client rather than the therapist
was in charge. This style of nondirective therapy was associated with
increased understanding, greater self -exploration, and improved self -
concepts.
• Later a shift from clarification of feelings to a focus on the cl ient’s
frame of reference developed. There was strong evidence for the
value of the therapeutic relationship and the client’s resources as the
essence of successful therapy.
• As person -centered therapy developed further, research centered on
the core con ditions assumed to be both necessary and sufficient for
successful therapy.
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36 3.2.2 Existentialism and Humanism :
Both approaches place little value on the role of techniques in the
therapeutic process, and emphasize the significance of genuine encounter.
They differ in that existentialists take the position that we are faced with
the anxiety of choosing to create an identity in a world that lacks intrinsic
meaning.
The humanists, in contrast, take the somewhat less anxiety -evoking
position that each of us h as a natural potential that we can actualize and
through which we can find meaning.
According to Rogers (1986b), when this philosophy is lived, it helps
people develop their capacities and stimulates constructive change in
others. Individuals are empowere d, and they can use this power for
personal and social transformation.
Both approaches focus on the client’s perceptions and call for the
therapist to enter the client’s subjective world, and both approaches
emphasize the client’s capacity for self -awaren ess and self -healing.
3.2.3. View of Person Centered Therapy :
Rogers firmly believed that people are resourceful, trustworthy, capable of
self understanding and self -direction, they can make Positive changes,
and are able to live powerful and productive lives. Rogers shows little
sympathy for approaches based on the assumption that the individual
cannot be trusted and instead needs to be instructed, punished, controlled,
and managed by others who are in an “expert” position. According to him
three therap ist attributes helps to create a growth -encouraging atmosphere
in which individuals can grow forward and become what they are capable
of becoming: (1) congruence (genuineness, or realness), (2) unconditional
positive regard (acceptance and caring), and (3 ) accurate empathic
understanding (an ability to deeply grasp the subjective world of another
person). Rogers stated that , if therapists express these attitudes, clients
will behave in prosocial and encouraging ways.
Rogers mentioned that “human beings ar e essentially forward -moving
organisms drawn to the fulfillment of their own creative natures and to the
pursuit of truth and social responsiveness” (Thorne, 1992, p. 21). It
implies that people will move toward health if the way seems open for
them to do so.This positive view of human nature has important
implications for the practice of the therapy.
As the individual has an innate capacity to move away from
maladjustment and toward psychological health, the therapist holds the
primary responsibility on t he client.
The person -centered approach rejects the role of the therapist as the
superior who knows best and of the passive client who merely follows the
instructions of the therapist.
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37 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I The root of therapy is in the client’s capability to be aware and mak e self
directed change in attitudes and behavior. Therapists with a humanistic
orientation encourage their clients to make changes which will lead to
living authentically and fully, with the realization that this demands a
continuing struggle. The emphasis is on how clients act in their world with
others, how they can move forward in constructive directions, and how
they can successfully encounter obstacles that are blocking their growth.
People never come to a last stage of being self -actualized; in fact they are
continually involved in the process of actualizing themselves.
3.2.4 The Process of Therapy :
Therapeutic Goals :
The goals of person -centered therapy are different from other traditional
approaches. The main focus of a person -centered approach is t hat the
client achieves a greater degree of independence. Its main focus is on the
person, not on the person's existing issues.
Rogers (1961) wrote that people who enter psychotherapy often ask:
“How can I discover my real self? How can I become what I d eeply wish
to become?”
Rogers (1977) believed that the goal of therapy was to assist clients in
their growth process which encourages them to cope with their current and
future problems rather than solving their problems. The underlying goal of
the ther apy is to bring an encouraging atmosphere to helping the
individual become a fully functioning person.
Before clients move toward that goal, they must first get behind the masks
they wear, which they intentionally or unintentionally develop through the
process of socialization.
Encouraging (1) an openness to experience, (2) a trust in themselves, (3)
an internal source of evaluation, and (4) a willingness to continue growing
these characteristics is the basic goal of person -centered therapy. These
four c haracteristics help to provide a kind of framework for understanding
the exact direction of therapeutic movement. The therapist does not
choose particular goals for the client. The foundation of person -centered
theory is the view that clients in a relation ship with an assisting therapist
have the capacity to define and clarify their own goals.
Person -centered therapists believe that they are not setting goals for what
clients need to change, yet they encourage them on how to best help
clients to achieve th eir own goals (Bohart, 2003).
Therapist’s Function and Role :
The role of person -centered therapists is based on their ways of being and
their attitudes. Research based on person -centered therapy shows that the
attitude of therapists encourages personality changes in the client (Rogers,
1961). Actually, therapists should see themselves as an instrument of
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38 helps to create the therapeutic atmosphere for growth (Bozarth et al.,
2002) . Thorne (2002a) highlighted the significance of therapists
communicating with clients in a person -to-person way. He suggested that
this overemphasis on professionalism is directed towards protecting
therapists from overinvolvement with clients, which most ly results in
under involvement with them.
Person -centered theory states that the therapist’s role is to be present and
accessible for clients and to focus on their immediate experience. First of
all, the therapist must be real in the relationship with cl ients. The therapist
meets clients on a moment -to-moment experiential basis then enters their
world. With the help of a therapist's attitude of genuine respect, caring,
support, acceptance, and understanding, clients can loosen their defenses
and rigid per spectives and can shift to a higher level of personal
functioning.
With this positive attitude of therapist clients get necessary freedom to
explore dimensions of their life which were either distorted or denied to
awareness.
Person -centered therapists als o avoid these functions: They generally do
not take a history, and avoid asking probing and leading questions, they
do not create interpretations of the client’s behavior, they do not evaluate
the client’s plans, and they do not decide the frequency or le ngth of their
therapeutic venture (Broadley, 1997). Broadley (1997) states that “In more
specific terms the client -centered therapist does not intend to diagnose,
create treatment plans, strategize, employ treatment techniques, or take
responsibility for t he client in any way” (p. 25).
Client’s Experience about Therapy :
Progress and changes occurring in therapy depends on clients’ perspective
both of their self -experience and the counselor’s basic attitudes in therapy.
If the therapist creates an atmosphere encouraging self -exploration, clients
can explore their experience fully, including their beliefs, behavior,
feelings and worldview. Clients come to the counselor in a state of a
discrepancy between their self -perception and their experience in reality.
clients come for therapy when they are feeling a little helpless, powerless,
and are unable to make effective decisions in their lives. They might be
hoping that they can find “the way” through the guidance of the therapist.
In Person Centered Therapy ,cl ients soon learn that they are responsible
for themselves in the relationship and that they can learn to gain self -
understanding. In this process, clients can explore a vast range of feelings
and beliefs (Rogers, 1987c).They can express all their negative emotions
like anxiety, fears, shame, hatred, guilt,anger that are hard to accept and
incorporate into their self -image. With this therapy, clients can move to a
greater acceptance and integration of conflicting and confusing feelings.
As clients feel under stood and accepted, they feel less vulnerable, they
become more realistic, perceive others more accurately and are able to
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39 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I They begin to behave truer to themselves. Clients can start to direct their
own lives.
Clients become psychologic ally mature and more actualized :
According to Tallman and Bohart (1999), the framework of person -
centered therapy is based on the assumption that clients heal themselves,
can create their self -growth, and they are the primary agents of change.
The therapy relationship gives a supportive Atmosphere within which
clients’ self -healing capacities are positively activated.
Therapist and Client Relationship :
Rogers hypothesized that If the therapeutic core conditions exist over
some period of time, c onstructive personality change will occur. From
Rogers’s perspective the client –therapist relationship is characterized by
equality. As clients experience the therapist listening in an accepting way
to them, they slowly learn to accept themselves.
As they experience the realness of the therapist, they drop defenses and
get real with both themselves and the therapist. The therapist can be a
guide on this journey as he or she is usually more experienced and more
psychologically mature than the client.
Mearns and Cooper (2005) states: “When two people come together in a
wholly genuine, open and engaged way, we can say that they are both
fully present” (p. 37). Being congruent might involve the expression of
anger, liking, frustration, attraction, boredom,concer n, annoyance, and a
range of other feelings in the relationship.
Person -centered therapy stresses that counseling will be inhibited if the
counselor feels one way about the client but acts in a different way.
Rogers’s concept of congruence does not state that only a fully self -
actualized therapist can be effective in counseling, because therapists are
human, they cannot be expected to be fully authentic.If therapists are
congruent in their relationships with clients, trust will be formed and the
process of therapy will get under way.
Unconditional Positive Regard And Acceptance :
Therapists express through their behavior that they value their clients as
they are and that clients are free to have feelings and experiences without
risking the loss of their ther apists’ acceptance. It is not an attitude of “I’ll
accept you when . . .”; rather, it is one of “I’ll accept you as you are.”
Therapists value and warmly accept clients without placing stipulations on
their acceptance.
Acceptance is understanding of clien ts’ rights to have their own beliefs
and feelings;
it does not mean the approval of all behavior.Rogers’s (1977) states that
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40 non possessive way, the greater the chance that therapy will be
successful.He also mentioned that it is not possible for therapists to
genuinely feel acceptance and unconditional caring at all times. Still , if
the therapists have little respect for their clients then it is not likely that the
therapeutic work will be fruitful.
Accurate Empathic Understanding :
One of the important tasks of the therapist is to understand clients’
experience and feelings accurately and sensitively. The goal is to motivate
clients to get closer to themselves, to understand and re solve the
incongruity that exists within them. Empathy is a deep and subjective
recognition of the client with the client. Empathy is not sympathy, or
feeling sorry for a client.
Rogers states that when therapists can grasp the client’s private world as
the client sees and feels it without losing the separateness of their own
identity —constructive change starts to occur. Empathy helps clients to pay
attention and value their experiences; to see earlier experiences in
completely new ways; modify their persp ectives of themselves, others,
and the world; and to increase their confidence while making choices and
actions.
It is important to understand that accurate empathy goes beyond
recognition of obvious feelings to a sense of the less clearly experienced
feelings of clients. This empathy results in clients’ self -understanding and
clarification of their self beliefs and worldviews. Watson (2002)
mentioned that full empathy entails understanding the meaning and
feeling of a client’s experience. According to Wat son, 60 years of research
has consistently shown that empathy is the most strong factor of a client's
progress in therapy.
3.2.5 Application of Therapeutic Techniques and Processes :
According to Rogers and other contributors the person -centered approach
is basically a simple restatement of what the client just said. One of
Rogers’s main contributions to this field is the notion that the quality of
the therapeutic relationship is the primary agent of growth in the client.
Natalie Rogers mentioned the terms “techniques,” “strategies,” and
“procedures” are seldom used in the person -centered approach (N. Rogers,
Personal communication, February 9, 2006).She told students to use
phrases such as “person centered philosophy” or “person -centered values.”
It is imp ortant for therapists to react in a therapeutically spontaneous
manner to what is happening between themselves and their clients.
The person -centered philosophy is based on the assumption that clients
have the resourcefulness for positive movement without the counselor
assuming an active, directive role. The therapist is emphatically interested
in the client, in order to understand the individual’s inner world (Broadley,
2000).
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41 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I This existence is far more strong than any other technique a therapist
might u se to bring about change. There has been increased latitude for
therapists to share their reactions, to confront clients in a caring way, and
to participate actively and fully in the therapeutic process (Bozarth et al.,
2002).
This approach encourages the use of a wider variety of methods and
allows for considerable diversity in personal style among person -centered
therapists (Thorne, 2002b). Tursi and Cochran (2006) propose that
cognitive behavioral techniques can be carefully applied within a person -
centered relational framework, and that a high level of therapist self -
development is not required to integrate these skills and techniques.
Cain (2002a, 2008) states it is important for therapists to modify their
therapeutic style to accommodate the specific needs of each client. Person
centered therapists have the freedom to use a variety of responses and
methods to assist their clients.
Therapist congruence is basic to establishing trust and safety with clients,
and the therapy process is likely to be adver sely affected if the therapist is
not fully authentic.
The Role of Assessment :
Many mental health agencies use a variety of assessment procedures.
From a person -centered perspective, the best source of knowledge about
the client is the individual client. F or example, some clients may request
certain psychological tests as a part of the counseling process. It is
important for the counselor to follow the client’s lead in the therapeutic
engagement (Ward, 1994).
Rogers (1942) recommended caution in using psych ometric measures or
in taking a complete case history at the outset of counseling. If a
counseling relationship began with a battery of psychological tests and a
detailed case history, he believed clients could get the impression that the
counselor would b e giving the solutions to their problems. Assessment
seems to be gaining in importance in short -term treatments in most
counseling agencies, and it is imperative that clients be involved in a
collaborative process in making decisions that are central to th eir therapy.
Application of the Philosophy of the Person -Centered Approach :
Bozrath, Zimring, and Tausch (2002) cite studies done in the 1990s which
revealed the effectiveness of person -centered therapy with a wide range of
client problems including alcoho lism, anxiety disorders, psychosomatic
problems, depression, interpersonal difficulties, cancer, and personality
disorders.
The basic philosophy of the person -centered approach has applications to
education from elementary school to graduate school. Rogers and Freiberg
(1994) describe journeys taken by different teachers who have moved
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42 have explored their own pathways to freedom. According to Rogers and
Freiberg, both research and e xperience indicates that more learning, more
problem solving, and more creativity can be found in classrooms that
operate within a person -centered climate. In such an atmosphere learners
are able to become increasingly self -directing, able to assume more
responsibility for the consequences of their choices, and can learn more
than in traditional classrooms.
The person -centered approach is especially applicable in crisis
intervention such as an unwanted pregnancy, an illness, a disastrous event,
or the loss of a loved one. When people are in crisis, one of the first steps
is to give them an opportunity to fully express themselves. Sensitive
listening, hearing, and understanding are essential at this point.
Being heard and understood helps people in crises, it helps them to calm
down in the midst of turmoil, and enables them to think more clearly and
make better decisions. If the person in crisis does not feel understood and
accepted, he or she may lose hope of “returning to normal” and may not
seek help in t he future. Genuine support, caring, and non -possessive
warmth can go a long way in building bridges that can encourage people
to do something to work through and resolve a crisis.
Communicating a deep sense of understanding should always be
significant pro blem -solving interventions.
The person -centered approach puts the therapist in the directive position of
making interpretations, probing the unconscious, analyzing dreams, and
working toward personality changes. If counselors are lacking in these
relation ship and communication skills, they will not be effective in
carrying out a treatment program for their clients. The person -centered
approach demands a great deal of the therapist. An effective person -
centered therapist must be grounded, centered, genuine, present, focused,
patient, and accepting in a way that involves maturity.
Application to Group Counseling :
The person -centered approach implies 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 atmosphere —a place where the
group members can interact in honest and meaningful ways. Members
become more appreciative and start to trust in themselves as they are and
are able to move toward self -direction and emp owerment. so, group
members started to make their own choices and bring about change in
themselves.
Yet with the presence of the facilitator and the support of other members,
participants realize that they do not have to experience the struggles of
change alone and that groups as a collective whole have their own source
of transformation.
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43 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I Rogers (1970) clearly believed that groups tend to move forward if the
facilitator exhibits a deep sense of trust in the members and refrains from
using techniques or e xercises to get a group moving. Group process
observations should come from members. According to Raskin, Rogers,
and Witty (2008), groups are fully capable of articulating and pursuing
their own goals.
Person -Centered Expressive Arts Therapy :
Natalie Roge rs (1993) expanded on her father, Carl Rogers’s (1961),
theory of creativity using the expressive arts to enhance personal growth
for individuals and groups.
3.2.6. Person -Centered Therapy from a Multicultural Perspective :
Strengths from a Diversity Persp ective :
One of the strengths of the person -centered approach is its impact on the
field of human relations with diverse cultural groups. Carl Rogers has had
a global impact. His work has reached more than 30 countries, and his
writings have been translated into 12 languages. Person -centered
philosophy and practice can now be studied in several European countries,
South America, and Japan.
• In several European countries, person -centered concepts have had a
significant impact on the practice of counseling a s well as on
education, cross -cultural communication, and reduction of racial and
political tensions. In the 1980s Rogers (1987b) elaborated on a theory
of reducing tension among antagonistic groups that he began
developing in 1948.
• In the 1970s Rogers and his associates began conducting workshops
promoting cross -cultural communication. Well into the 1980s he led
large workshops in many parts of the world. International encounter
groups have provided participants with multicultural experiences.
Japan, A ustralia, South America, Mexico, and the United Kingdom
have all been receptive to person -centered concepts and have adapted
these practices to fit their cultures.
• Before his death, Rogers conducted intensive workshops with
professionals in the former Soviet Union.
The underlying philosophy of person -centered therapy is grounded on the
importance of hearing the deeper messages of a client. Empathy, being
present, and respecting the values of clients are essential attitudes and
skills in counseling cult urally diverse clients.
This empathy may be expressed and communicated either directly or
indirectly.
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44 Bohart (2003) claims that the person -centered philosophy makes this
approach particularly appropriate for working with diverse client
populations becaus e the counselor does not assume the role of expert who
is going to impose a “right way of being” on the client. Instead, the
therapist is a “fellow explorer” who assists to understand the client’s
phenomenological world in an interesting, accepting, and op en way and
checks with the client to confirm that the therapist’s perceptions are
accurate. Glauser and Bozarth mentioned that counseling in a multicultural
context must embody the core conditions associated with all effective
counseling.
Shortcomings From a Diversity Perspective :
Although the person -centered approach has made important contributions
to counseling people with diverse social, political, and cultural
backgrounds, there are some shortcomings to practicing it within this
framework. Many clients who come to community mental health clinics or
who are involved in outpatient treatment want more structure than this
approach provides. Some clients seek professional help to deal with a
crisis or to learn coping skills in dealing with everyday problems. Because
of certain cultural messages, when these clients do seek professional help,
it may be as a last resort. They expect a directive counselor and can be put
off by one who does not provide sufficient structure.
Another shortcoming of the person -center ed approach is that it is difficult
to translate the core therapeutic conditions into actual practice in certain
cultures. Communication of these core conditions must be consistent with
the client’s cultural framework
There is a shortcoming in applying the person -centered approach with
clients from diverse cultures pertains to the fact that this approach praises
the value of an internal locus of evaluation. In collectivist cultures, clients
are likely to be highly influenced by societal expectations and not simply
motivated by their own personal preferences. The focus on development
of individual autonomy and personal growth may be viewed as being
selfish in a culture that stresses the common good.
Cain (2008) contends that “many individuals from both the ma jority
individualistic culture and from collectivistic cultures are oriented less
toward self -actualization and more toward intimacy and connection with
others and toward what is best for the community and the common good”
(p. 217).
Although there may be particular shortcomings in practicing exclusively
within a person -centered perspective, it should not be concluded that this
approach is unsuitable for working with clients from diverse cultures.
There is great diversity among any group of people, and ther efore, there is
room for a variety of therapeutic styles.
Counseling the culturally different client may need more activity and
structuring than is usually the case in a person -centered framework, but
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45 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I a culturally different client cannot be overestimated. Often, the client has
never met someone like the counselor who is able to truly listen and
understand. Counselors will certainly find it challenging to empathize with
clients who ha ve had vastly different life experiences.
Contributions of the Person -Centered Approach :
Rogers was a pioneer in shifting the therapeutic focus from an emphasis
on technique and reliance on therapist authority to that of the therapeutic
relationship. Farber (1996) stated that Rogers's notions regarding empathy,
the primacy of the therapeutic relationship, and the value of research are
commonly accepted by many practitioners and have been incorporated
into other theoretical orientations with little acknowledg ment of their
origin.
Person -centered therapy is strongly represented in Europe, and there is
continuing interest in this approach in both South America and the Far
East. The person -centered approach has established a firm foothold in
British universities. Some of the most in -depth training of person -centered
counselors is in the United Kingdom (Natalie Rogers, personal
communication, February 9, 2006). In addition, British scholars including
Fairhurst (1999), Keys (2003), Lago and Smith (2003), Mearns and
Cooper (2005), Mearns and Thorne (1999, 2000), Merry (1999), Natiello
(2001), Thorne (2002a, 2002b), and Watson (2003) continue to expand
this approach.
Natalie Rogers has been instrumental in the evolution of the person -
centered approach by using nonverba l methods to enable individuals to
heal and to develop. Many individuals who have difficulty expressing
themselves verbally can find new possibilities for self -expression through
nonverbal channels (Thorne, 1992).
Limitations and Criticisms of the Person -Centered Approach :
There are some criticisms of this approach. Some researchers have been
critical of the methodological errors contained in some of these studies.
therapeutic modalities fail to emphasize the role of techniques aimed at
bringing about chan ge in clients’ behavior.
A potential limitation of this approach is that some students -in-training
and practitioners with a person -centered orientation may have a tendency
to be very supportive of clients without being challenging.
These basic attitudes ar e the foundation on which counselors must then
build the skills of therapeutic intervention. A related challenge for
counselors using this approach is to truly support clients in finding their
own way. Counselors sometimes experience difficulty in allowing clients
to decide their own specific goals in therapy. Perhaps the main limitations
of the approaches are a reflection of the personal limitations of the
therapist (Thorne, 2002b). Because the therapeutic relationship is so
central to the outcomes of the therapeutic venture, a great deal is expected
of the therapist as a person. From Bohart’s (2003) perspective, the munotes.in

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46 majority of errors that person -centered or experiential therapists can
commit are the result of “failing to be warm, empathic, and genuine;
imposing an agenda upon the client; or failing to be in touch with the
moment by -moment process” (p. 126). These are not limitations of the
theory as much as they are limitations of the practitioner.
3.3 SUMMARY In this unit we began by explaining the Diff erent approaches and then we
focused on Person Centered therapy by Carl Rogers. Person -centered
therapy is based on a philosophy of human nature which encourages self -
actualization. Further, Rogers’s view of human nature is
phenomenological; Rogers’s theor y is based on the assumption that clients
can understand the factors in 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
psych ological contact with a client in a state of anxiety or incongruence.
The person -centered approach emphasizes this personal relationship
between client and therapist; the therapist’s attitudes are more critical than
are knowledge, theory, or techniques. C lients are encouraged to use this
relationship to unleash their growth potential and become more of the
person they choose to become. This approach places primary
responsibility for the direction of therapy on the client. In the therapeutic
context, indivi duals have the opportunity to decide for themselves and
come to terms with their own personal power.
The general goals of therapy are becoming more open to experience,
achieving self trust, developing an internal source of evaluation, and being
willing to continue growing. Current applications of the theory emphasize
more active participation by the therapist than was the case earlier.
3.4 QUESTIONS A) Write long answers:
a) Discuss in detail about View of Person Centered Therapy
b) Discuss about Perso n-Centered Therapy From a Multicultural
Perspective
c) Explain the Process Of Therapy.
B) Write short notes:
a) Therapist’s Function and Role
b) UNCONDITIONAL POSITIVE REGARD AND ACCEPTANCE
c) Therapeutic Goals
d) The Role of Assessment munotes.in

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47 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - I 3. 5 REFERENCES  *COREY, G. (2009). Theory and practice of counseling and
Psychotherapy (8th ed.)., CA: Thomson Brooks.
 *BOHART, A. C., & GREENBERG, L. S. (Eds.). (1997). Empathy
reconsidered: New directions in psychotherapy. Washington, DC:
American Psychological Associati on.
 *BOHART, A. C., & TALLMAN, K. (1999). How clients make
therapy work: The process of active self -healing. Washington, DC:
American Psychological Association.
 *CAIN, D. J. (2002a). Defining characteristics, history, and evolution
of humanistic psychothe rapies. In D. J. Cain & J. Seeman (Eds.),
Humanistic psychotherapies: Handbook of research and practice (pp.
3–54). Washington, DC: American Psychological Association.
 CAIN, D. J. (2002b). Preface. In D. J. Cain & J. Seeman (Eds.),
Humanistic psychotherap ies: Handbook of research and practice (pp.
xix–xxvi). Washington, DC: American Psychological Association.
 *CAIN, D. J. (2008). Person -centered therapy. In J. Frew & M. D.
Spiegler (Eds.), Contemporary psychotherapies for a diverse world
(pp. 177 –227). Bo ston: Lahaska Press

*****

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48 4
INTERVENTION SYSTEMS
EMPHASIZING HUMANISTIC,
COGNITIVE AND BEHAVIORAL
APPROACHES - II
Unit Structure
4.0 Objectives
4.1 Behaviour Therapy: Introduction
4.1.1 Nature of Behaviour Therapy
4.1.2 The Therapeutic Process
4.1.3 Applied Behavioral Analysis:
4.1.4. Behavior Therapy from a Multicultural Perspective
4.2 Aaron Beck’s Cognitive Therapy : Introduction
4.3 Applications of Cognitive Therapy
4.4 Summary
4.5 Questions
4.6 References
4.0 OBJECTIVES After studying this unit students should be ab le to:
 Understand nature of Behaviour Therapy
 Know the process of therapy
 Study nature of Beck's Cognitive Therapy
 To know application of therapeutic techniques and processes
 Understand Both therapies from a multicultural perspective
4.1 BEHAVIOR THERAPY : INTRODUCTION Behavior therapy practitioners focus on observable behavior, current
determinants of behavior, learning experiences that promote change,
tailoring treatment strategies to individual clients, and rigorous assessment
and evaluation (Kazdin, 20 01; Wilson, 2008).Its focus was on
demonstrating that behavioral conditioning techniques were effective and
were a viable alternative to psychoanalytic therapy. Behavior therapy has
been used to treat a wide range of psychological disorders with different
client populations (Wilson, 2008). Anxiety disorders, depression,
substance abuse, eating disorders, domestic violence, sexual problems,
pain management, and hypertension have all been successfully treated
using this approach. Behavioral procedures are use d in the fields of munotes.in

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49 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II developmental disabilities, mental illness, education and special education,
community psychology, clinical psychology, rehabilitation, business, self -
management, sports psychology, health -related behaviors, and
gerontology (Miltenberger , 2008). Historical Background The behavioral
approach had its origin in the 1950s and early 1960s, and it was a radical
departure from the dominant psychoanalytic perspective. In spite of harsh
criticism and resistance from psychoanalytic psychotherapists , the
approach survived.
In the 1960s Albert Bandura developed social learning theory, which
combined classical and operant conditioning with observational learning.
Bandura made cognition an authorized focus for behavior therapy. During
the 1960s a numbe r of cognitive behavioral approaches sprang up, and
they still have a significant impact on therapeutic practice. Contemporary
behavior therapy emerged as a major force in psychology during the
1970s, and it had a significant impact on education, psycholog y,
psychotherapy, psychiatry, and social work. Behavioral techniques were
expanded to provide solutions for business, industry, and child -rearing
problems as well.
The 1980s were characterized by a search for new horizons in concepts
and methods that went beyond traditional learning theory.Two of the most
significant developments in the field were
(1) the continued emergence of cognitive behavior therapy as a major
force and
(2) the application of behavioral techniques to the prevention and
treatment of h ealth related disorders.Cognitive therapy is considered
to be the “second wave” of the behavioral tradition.
By the early 2000s, the “third wave” of the behavioral tradition emerged,
enlarging the scope of research and practice. This newest development
includes dialectical behavior therapy, mindfulness -based stress reduction,
mindfulness based cognitive therapy, and acceptance and commitment
therapy.
Four Areas of Development :
Contemporary behavior therapy can be understood by considering four
major areas of development:
(1) classical conditioning,
(2) operant conditioning,
(3) social learning theory, and
(4) cognitive behavior therapy.
Classical conditioning (respondent conditioning) refers to what happens
prior to learning that creates a response through pairing. A key figure in
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50 experiments with dogs. Placing food in a dog’s mouth leads to salivation,
which is respondent behavior. When food is repeatedly presented with
some ori ginally 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 sali vation response will
eventually diminish and become extinct. This technique illustrates how
principles of learning derived from the experimental laboratory can be
applied clinically. Desensitization can be applied to people who, through
classical condition ing, developed an intense fear of flying after having a
frightening experience while flying. Most of the significant responses we
make in everyday life are examples of operant behaviors, such as reading,
writing, driving a car, and eating with utensils.
Operant conditioning involves a type of learning in which behaviors are
influenced mainly by the consequences that follow them. Positive and
negative reinforcement, punishment, and extinction techniques illustrate
how operant conditioning in applied setting s can be instrumental in
developing prosocial and adaptive behaviors. The behaviorists of both the
classical and operant conditioning models excluded any reference to
mediational concepts, such as the role of thinking processes, attitudes, and
values. The social learning approach (or the social -cognitive approach),
developed by Albert Bandura and Richard Walters (1963), is interactional,
interdisciplinary, and multimodal (Bandura, 1977, 1982). Social learning
and cognitive theory involves a triadic reciproc al interaction among the
environment, personal factors (beliefs, preferences, expectations, self -
perceptions, and interpretations), and individual behavior.
In the social cognitive approach the environmental events on behavior are
mainly determined by cog nitive processes governing how environmental
influences are perceived by an individual and how these events are
interpreted (Wilson, 2008). A basic assumption is that people are capable
of self -directed behavior 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 behavior therapy and social learning theory now represent the
mainstream of contemporary behavior therapy. Since the early 1970s, the
behavioral movement has conceded a legitimate place to thinking, even to
the extent of giving cognitive factors a central role in understanding and
treating emotional and behavioral problems.
By the mid -1970s cognitive behavior therapy had replaced be havior
therapy as the accepted designation and the field began emphasizing the
interaction among affective, behavioral, and cognitive dimensions
(Lazarus, 2003; Wilson, 2008).
4.1.1 Nature of Behaviour Therapy :
Behavior therapy aims to increase people’s s kills so that they have more
options for responding. The current trend in behavior therapy is toward
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51 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II increase their range of freedom. By overcoming debilitating behaviors that
restrict ch oices, people are freer to select from possibilities that were not
available earlier, increasing individual freedom (Kazdin, 1978, 2001). It is
possible to make a case for using behavioral methods to attain humanistic
ends (Kazdin, 2001; Watson & Tharp, 20 07).
4.1.2 The Therapeutic Process :
Therapeutic Goals :
The general goals of behavior therapy are to increase personal choice and
to create new conditions for learning. The client, with the help of the
therapist, defines specific treatment goals at the o utset of the therapeutic
process. Although assessment and treatment occur together, a formal
assessment takes place prior to treatment to determine behaviors that are
targets of change. 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.
Contemporary behavior therapy stresses clients’ active role in deciding
about their treatment. 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 counselor and client discuss the behaviors associated
with the goals, the circumstances required for change, the nature of
subgoals, and a plan of action to work toward these goals. This process of
determining therapeutic goals entails a negotiation between client and
counselor that results in a contract that guides the course of therapy.
Behavior therapists and clients alter goals throughout the therapeutic
process as needed
Therapist’s Function and Role Behavior therapists conduct a thorough
functional assessment (or behavioral analysis) to identify the maintaining
conditions by systematically gathering information about sit uational
antecedents, the dimensions of the problem behavior, and the
consequences of the problem. This is known as the ABC mod el, which
addresses antecedents , behaviors, and consequences. This model of
behavior suggests that behavior (B) is influenced by some particular
events that precede it, called antecedents (A), and by certain events that
follow it called consequences (C). Antecedent events are ones that cue or
elicit a certain behavior. For example, with a client who has trouble going
to sleep, list ening to a relaxation tape may serve as a cue for sleep
induction. Turning off the lights and removing the television from the
bedroom may elicit sleep behaviors as well. Consequences are events that
maintain a behavior in some way either by increasing or decreasing it. For
example, a client may be more likely to return to counseling after the
counselor offers verbal praise or encouragement for having come in or
having completed some homework. A client may be less likely to return
after the counselor is con sistently late to sessions. In doing an assessment
interview, the therapist’s task is to identify the particular antecedent and munotes.in

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52 consequent events that influence or are functionally related to an
individual’s behavior (Cormier, Nurius, & Osborn, 2009).
Beha viorally oriented practitioners tend to be active and directive and to
function as consultants and problem solvers. They pay close attention to
the clues given by clients, and they are willing to follow their clinical
hunches. Behavioral practitioners must possess skills, sensitivity, and
clinical acumen (Wilson, 2008). They use some techniques common to
other approaches, such as summarizing, reflection, clarification, and open -
ended questioning. However, behavioral clinicians perform other
functions as wel l (Miltenberger, 2008; Spiegler & Guevremont, 2003):
• Based on a comprehensive functional assessment, the therapist
formulates initial treatment goals and designs and implements a
treatment plan to accomplish these goals.
• The clinician evaluates the success of the change plan 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. Clients learn how to
identify and c ope with potential setbacks. The emphasis is on helping
clients maintain changes over time and acquire behavioral and
cognitive coping skills to prevent relapses.
A large part of the therapist’s role is to teach concrete skills through the
provision of in structions, modeling, and performance feedback. The client
engages in behavioral rehearsal with feedback until skills are well learned
and generally receives active homework assignments (such as self -
monitoring of problem behaviors) to complete between the rapy sessions.
Clients must be motivated to change and are expected to cooperate in
carrying out therapeutic activities, both during therapy sessions and in
everyday life.
Relationship Between Therapist and Client :
Clinical and research evidence suggests t hat a therapeutic relationship,
even in the context of a behavioral orientation, can contribute significantly
to the process of behavior change (Granvold & Wodarski, 1994). Most
behavioral practitioners stress the value of establishing a collaborative
work ing relationship (J. Beck, 2005). The skilled behavior therapist
conceptualizes problems behaviorally and makes use of the client –
therapist relationship in facilitating change. In contrast, most behavioral
practitioners contend that factors such as warmth, empathy, authenticity,
permissiveness, and acceptance are necessary, but not sufficient, for
behavior change to occur. The client –therapist relationship is a foundation
on which therapeutic strategies are built to help clients change in the
direction they wish. However, behavior therapists assume that clients
make progress primarily because of the specific behavioral techniques
used rather than because of the relationship with the therapist.
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53 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II Application:
Therapeutic Techniques and Procedures A strength of the behavioral
approaches is the development of specific therapeutic procedures that
must be shown to be effective through objective means. The results of
behavioral interventions become clear because therapists receive continual
direct feedback from thei r clients. According to Arnold Lazarus (1989,
1992b, 1996b, 1997a, 2005, 2008), a pioneer in contemporary clinical
behavior therapy, behavioral practitioners can incorporate into their
treatment plans any technique that can be demonstrated to effectively
change behavior. Lazarus advocates the use of diverse techniques,
regardless of their theoretical origin. It is clear that behavior therapists do
not have to restrict themselves only to methods derived from learning
theory. Likewise, behavioral techniques c an be incorporated into other
approaches. This is illustrated later in this chapter in the sections on the
integration of behavioral and psychoanalytic techniques and, as well, by
the incorporation of mindfulness and acceptance -based approaches into
the pr actice of behavior therapy. The therapeutic procedures used by
behavior therapists are specifically designed for a particular client rather
than being randomly selected from a “bag of techniques.” Therapists are
often quite creative in their interventions. These techniques do not
encompass the full spectrum of behavioral procedures, but they do
represent a sample of the approaches used in contemporary behavior
therapy.
4.1.3 Applied Behavioral Analysis:
Operant Conditioning Techniques: In applied behavior 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 most important contribution of applied behavior analysis is
that it offers a function al approach to understanding clients’ problems and
addresses these problems by changing antecedents and consequences (the
ABC model). Behaviorists believe we respond in predictable ways
because of the gains we experience (positive reinforcement) or because of
the need to escape or avoid unpleasant consequences (negative
reinforcement). Once clients’ goals have been assessed, specific behaviors
are targeted. The goal of reinforcement, whether positive or negative, is to
increase the target behavior. Positive reinforcement involves the addition
of something of value to the individual (such as praise, attention, money,
or food) as a consequence of certain behavior. The stimulus that follows
the behavior is the positive reinforcer. Another operant method of
chan ging behavior is extinction, which refers to withholding
reinforcement from a previously reinforced response. In applied settings,
extinction can be used for behaviors that have been maintained by positive
reinforcement or negative reinforcement. Extinctio n can reduce or
eliminate certain behaviors, but extinction does not replace those
responses that have been extinguished. The goal of reinforcement is to
increase target behavior, but the goal of punishment is to decrease target
behavior. Miltenberger (200 8) describes two kinds of punishment that may
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54 punishment. In positive punishment an aversive stimulus is added after the
behavior to decrease the frequency of a behavior (such as withhold ing a
threat from a child for misbehavior or reprimanding a student for acting
out in class). In negative punishment a reinforcing stimulus is removed
following the behavior to decrease the frequency of a target behavior
(such as deducting money from a wor ker’s salary for missing time at
work, or taking television time away from a child for misbehavior). In
both kinds of punishment, the behavior is less likely to occur in the future.
These four operant procedures form the basis of behavior therapy
programs for parent skills training and are also used in the self -
management procedures.
Skinner (1948) believed punishment had limited value in changing
behavior and was often an undesirable way to modify behavior. He
opposed using aversive control or punishment, and recommended
substituting positive reinforcement. The key principle in the applied
behavior analysis approach is to use the least aversive means possible to
change behavior, and positive reinforcement is known to be the most
powerful change agent. Skinn er believed in the value of analyzing
environmental factors for both the causes and remedies for behavior
problems and contended that the greatest benefits to the individual and to
society occur by using systematic positive reinforcement as a route to
beha vior control (Nye, 2000). In everyday life, punishment is often used
as a means of getting revenge or expressing frustration.
However, as Kazdin (2001) has noted, “punishment in everyday life is not
likely to teach lessons or suppress intolerable behavior because of the
specific punishments that are used and how they are applied” (p. 231).
Even in those cases when punishment suppresses undesirable responses,
punishment does not result in teaching desirable behaviors. Punishment
should be used only after non aversive approaches have been implemented
and found to be ineffective in changing problematic behavior (Kazdin,
2001; Miltenberger, 2008). It is essential that reinforcement be used as a
way to develop appropriate behaviors that replace the behaviors that are
suppressed.
Relaxation Training and Related Methods :
Jacobson (1938) is credited with initially developing the progressive
muscle relaxation procedure. Relaxation training involves several
components that typically require from 4 to 8 hours of instruct ion. Clients
are given a set of instructions that teaches them to relax. They assume a
passive and relaxed position in a quiet environment while alternately
contracting and relaxing muscles. This progressive muscle relaxation is
explicitly taught to the cl ient by the therapist. Deep and regular breathing
is also associated with producing relaxation. At the same time clients learn
to mentally “let go,” perhaps by focusing on pleasant thoughts or images.
Clients are instructed to actually feel and experience the tension building
up, to notice their muscles getting tighter and study this tension, and to
hold and fully experience the tension. Also, it is useful for clients to
experience the difference between a tense and a relaxed state. The client is munotes.in

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55 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II then taugh t how to relax all the muscles while visualizing the various parts
of the body, with emphasis on the facial muscles. The arm muscles are
relaxed first, followed by the head, the neck and shoulders, the back,
abdomen, and thorax, and then the lower limbs. R elaxation becomes a
well-learned response, which can become a habitual pattern if practiced
daily for about 25 minutes each day.Dattilio (2006) Relaxation procedures
have been applied to a variety of clinical problems, either as a separate
technique or in conjunction with related methods. The most common use
has been with problems related to stress and anxiety, which are often
manifested in psychosomatic symptoms. Some other ailments for which
relaxation training is helpful include asthma, headache, hyperte nsion,
insomnia, irritable bowel syndrome, and panic disorder (Cormier et al.,
2009). Systematic Desensitization Systematic desensitization, which is
based on the principle of classical conditioning, is a basic behavioral
procedure developed by Joseph Wolp e, one of the pioneers of behavior
therapy. Clients imagine successively more anxiety -arousing situations at
the same time that they engage in a behavior that competes with anxiety.
Gradually, or systematically, clients become less sensitive (desensitized)
to the anxiety -arousing situation. This procedure can be considered a form
of exposure therapy because clients are required to expose themselves to
anxiety -arousing images as a way to reduce anxiety. Systematic
desensitization is an empirically researched behavior therapy procedure
that is time consuming, yet it is clearly an effective and efficient treatment
of anxiety -related disorders, particularly in the area of specific phobias
(Cormier et al., 2009; McNeil & Kyle, 2009; Spiegler & Guevremont,
2003). Before implementing the desensitization procedure, the therapist
conducts an initial interview to identify specific information about the
anxiety and to gather relevant background information about the client.
This interview, which may last several session s, gives the therapist a good
understanding of who the client is. The therapist questions the client about
the particular circumstances that elicit the conditioned fears. Some
therapists also administer a questionnaire to gather additional data about
situa tions leading to anxiety. If the decision is made to use the
desensitization procedure, the therapist gives the client a rationale for the
procedure and briefly describes what is involved.
McNeil and Kyle (2009) describe several steps in the use of system atic
desensitization: (1) relaxation training, (2) development of the anxiety
hierarchy, and (3) systematic desensitization proper.
The steps in relaxation training, which were described earlier, are
presented to the client. The therapist uses a very quiet , soft, and pleasant
voice to teach progressive muscular relaxation. The client is asked to
create imagery of previously relaxing situations, such as sitting by a lake
or wandering through a beautiful field. It is important that the client reach
a state of calm and peacefulness. The client is instructed to practice
relaxation both as a part of the desensitization procedure and also outside
the session on a daily basis. The therapist then works with the client to
develop an anxiety hierarchy for each of the identified areas. Stimuli that
elicit anxiety in a particular area, such as rejection, criticism, jealousy,
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56 list of situations that elicit increasing degrees of anxiety or avoidanc e. The
hierarchy then arranged in order from the worst situation the client can
imagine down to the situation that evokes the least anxiety. If it has been
determined that the client has anxiety related to fear of rejection, for
example, the highest anxiet y-producing situation might be rejection by the
spouse, next, rejection by a close friend, and then rejection by a coworker.
The least disturbing situation might be a stranger’s indifference toward the
client at a party.
Desensitization does not begin unti l several sessions after the initial
interview has been completed. Enough time is allowed for clients to learn
relaxation in therapy sessions, to practice it at home, and to construct their
anxiety hierarchy. The desensitization process begins with the cli ent
reaching complete relaxation with eyes closed. A neutral scene is
presented, and the client is asked to imagine it. If the client remains
relaxed, he or she is asked to imagine the least anxiety -arousing scene on
the hierarchy of situations that has be en developed. The therapist moves
progressively up the hierarchy until the client signals that he or she is
experiencing anxiety, at which time the scene is terminated. Relaxation is
then induced again, and the scene is reintroduced again until little anxi ety
is experienced.
Then Treatment will end when the client is able to remain in a relaxed
state while imagining the scene that was formerly the most disturbing and
anxiety -producing. The core of systematic desensitization is repeated
exposure in the imagi nation to anxiety -evoking situations without
experiencing any negative consequences. In this process homework and
follow -up are essential components. Clients can practice selected
relaxation procedures daily, at which time they visualize scenes completed
in the previous session. Gradually, they also expose themselves to daily -
life situations as a further way to manage their anxieties.
Systematic desensitization is an appropriate technique for treating phobias,
but it is a misconception that it can be appli ed only to the treatment of
anxiety. It has also been used to treat anger, asthmatic attacks, insomnia,
motion sickness, nightmares, and sleepwalking (Spiegler, 2008). A
safeguard is that clients are in control of the process by going at their own
pace and terminating exposure when they begin to experience more
anxiety than they want to tolerate (Spiegler & Guevremont, 2003).
In Vivo Exposure and Flooding :
Exposure is a key process in treating a wide range of problems associated
with fear and anxiety. Exp osure therapies treat fears and other negative
emotional responses by introducing clients, under carefully controlled
conditions, to the situations that contributed to such problems. Exposure
therapy involves systematic confrontation with a feared stimulus , either
through imagination or in vivo (live). Whatever the route used, exposure
involves contact by clients and what they find fearful (McNeil & Kyle,
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57 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II Desensitization is one type of exposure therapy, but there are others. Two
variations of tradit ional systematic desensitization are in vivo exposure
and flooding.
IN VIVO EXPOSURE - In vivo exposure involves client exposure to the
actual anxiety -evoking events rather than simply imagining these
situations. Live exposure has been a cornerstone of beh avior therapy for
decades (Hazlett -Stevens & Craske, 2003). Together, the therapist and the
client generate a hierarchy of situations for the client to encounter in
ascending order of difficulty. Clients engage in brief and graduated series
of exposures to feared events. Clients can terminate exposure if they
experience a high level of anxiety. In some cases the therapist may
accompany clients as they encounter feared situations. People who have
extreme fears of certain animals could be exposed to these ani mals in real
life in a safe setting with a therapist.
Self-managed in vivo exposure is a procedure in which clients expose
themselves to anxiety -evoking events on their own. It is an alternative
when it is not practical for a therapist to be with clients in real -life
situations.
FLOODING - Another form of exposure therapy is flooding. It refers to
either in vivo or imaginal exposure to anxiety -evoking stimuli for a
prolonged period of time. In vivo flooding consists of intense and
prolonged exposure to th e actual anxiety -producing stimuli. In flooding,
clients are prevented from engaging in their usual maladaptive responses
to anxiety arousing situations. In vivo flooding tends to reduce anxiety
rapidly. An advantage of using imaginary flooding over in viv o flooding is
that there are no restrictions on the nature of the anxiety -arousing
situations that can be treated. In vivo exposure to actual traumatic events
(airplane crash, rape, fire, flood) is often not possible nor is it appropriate
for both ethical and practical reasons. Imaginal flooding can re -create the
circumstances of the trauma in a way that does not bring about adverse
consequences to the client. Survivors of an airplane crash, for example,
may suffer from a range of debilitating symptoms. The y are likely to have
nightmares and flashbacks to the disaster, they may avoid travel by air or
have anxiety about travel by any means, and they probably have a variety
of distressing symptoms such as guilt, anxiety, and depression. Flooding is
frequently used in the behavioral treatment for anxiety -related disorders,
posttraumatic stress disorder, phobias, obsessive -compulsive disorder and
agoraphobia. Prolonged and intense exposure can be both an effective and
efficient way to reduce clients’ anxiety. It is important for the behavior
therapist to work with the client to create motivation and readiness for
exposure. Clients need to make informed decisions after considering the
pros and cons of subjecting themselves to temporarily stressful aspects of
treatm ent. Research consistently indicates that exposure therapy can
reduce the client’s degree of fear and anxiety (Tryon, 2005). The repeated
success of exposure therapy in treating various disorders has resulted in
exposure being used as a part of most behavi oral and cognitive behavioral
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58
Spiegler and Guevremont (2003) conclude that exposure therapies are the
single most potent behavioral procedures available for anxiety -related
disorders, and they can h ave long -lasting effects. However, using exposure
as a sole treatment procedure is not always sufficient.
Eye Movement Desensitization and Reprocessing :
Eye movement desensitization and reprocessing (EMDR) is a form of
exposure therapy which involves imagi nal flooding, cognitive
restructuring, and the use of rapid, rhythmic eye movements and other
bilateral stimulation to treat clients who have experienced traumatic
stress.It is developed by Francine Shapiro (2001).It draws from a wide
range of behavioral interventions. Designed to assist clients in dealing
with posttraumatic stress disorders, Shapiro (2001) emphasized the
importance of the safety and welfare of the client when using this
approach.
Social Skills Training :
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 correct deficits clients have in interpersonal competencies
(Spiegler, 2008). Social skills involve being able to communicate with
others in a way that is both appropriate and effective. Social skills training
includes psychoeducation, modeling, reinforcement, behavioral rehearsal,
role playing, and feedback (Antony & Roemer, 2003).
Assertion Training :
One specialized form of so cial skills training that has gained increasing
popularity is teaching people how to be assertive in a variety of social
situations. Many people have difficulty feeling that it is appropriate or
right to assert themselves. People who lack social skills fre quently
experience interpersonal difficulties at home, at work, at school, and
during leisure time.
Assertion training can be useful for those
(1) who have difficulty expressing anger or irritation,
(2) who have difficulty saying no,
(3) who are overl y polite and allow others to take advantage of them,
(4) who find it difficult to express affection and other positive responses,
(5) who feel they do not have a right to express their thoughts, beliefs,
and feelings, or
(6) who have social phobias.
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59 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II The basic assumption underlying assertion training is that people have the
right (but not the obligation) to express themselves. One goal of assertion
training is to increase people’s behavioral repertoire so that they can make
the choice of whether to be have assertively in certain situations.
Self-Modification Programs and Self -Directed Behavior :
An advantage of self -modification (or self -management) techniques is that
treatment can be extended to the public in ways that cannot be done with
traditional ap proaches to therapy. Another advantage is that costs are
minimal. Because clients have a direct role in their own treatment,
techniques aimed at self -change tend to increase involvement and
commitment to their treatment. Self -modification strategies includ e self -
monitoring, self -reward, self contracting, stimulus control, and self -as-
model.
In self -modification programs people make decisions concerning specific
behaviors they want to control or change. People frequently discover that a
major reason that the y do not attain their goals is the lack of certain skills
or unrealistic expectations of change. Hope can be a therapeutic factor that
leads to change, but unrealistic hope can pave the way for a pattern of
failures in a self -change program. A self -directe d approach can provide
the guidelines for change and a plan that will lead to change.
Self-modification strategies have been successfully applied to many
populations and problems, a few of which include coping with panic
attacks, helping children to cope w ith fear of the dark, increasing creative
productivity, managing anxiety in social situations, encouraging speaking
in front of a class, increasing exercise, control of smoking, and dealing
with depression (Watson & Tharp, 2007).
Integrating Behavioral Tec hniques With Contemporary Psychoanalytic
Approaches
Certain aspects of behavior therapy can be combined with a number of
other therapeutic approaches. Morgan and MacMillan (1999) developed a
three -phase integrated counseling model based on theoretical con structs of
object -relations and attachment theory that incorporates behavioral
techniques. In the first phase, object -relations theory serves as the
conceptual basis for the assessment and relationship -building process.
What children learn from early inter actions with parents clearly affects
personality development and may result in problematic adult relationships.
During this phase, therapists provide a supportive holding environment
that offers a safe place for clients to recall and explore painful earlie r
memories. At this phase counseling includes an exploration of clients’
feelings regarding past and present circumstances and thought patterns
that influence the clients’ interpretation of the world.
In the second phase, the goal is to link insights glean ed from the initial
assessment phase to the present to create an understanding of how early
relational patterns are related to present difficulties. This insight often
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60 and thoughts. As clients are able to process previously repressed and
dissociated memories and feelings in counseling, cognitive changes in
perception of self and others often occur. Both experiential and cognitive
techniques are utilized in the second phase.
In the third and final phase of treatment, behavioral techniques with goal
setting and homework assignments are emphasized to maximize change.
This is the action phase, a time for clients to attempt new behaviors based
on the insight, understanding, and cognitive restr ucturing achieved in the
prior phases of counseling. Clients take action, which leads to
empowerment.
The counseling interventions :
Morgan and MacMillan claim that if these treatment goals are well
defined it is possible to work through all three phases in a reasonable
amount of time. Adapting the conceptual foundation of psychoanalytic
thinking to relatively brief therapy makes this approach useful in time
limited therapy.
Application to Group Counseling :
Clients can learn to use these techniques to con trol their lives, deal
effectively with present and future problems, and function well after they
complete their group experience. Many groups are designed primarily to
increase the client’s degree of control and freedom in specific aspects of
daily life.
4.1.4 Behavior Therapy from a Multicultural Perspective :
Strengths from a Diversity Perspective :
Behavior therapy has some clear advantages over many other theories in
counseling culturally diverse clients. Behavioral counseling does not
generally place e mphasis on experiencing catharsis. Rather, it stresses
changing specific behaviors and developing problem -solving skills. Some
potential strengths of the behavioral approaches in working with diverse
client populations include its specificity, task orienta tion, focus on
objectivity, focus on cognition and behavior, action orientation, dealing
with the present more than the past, emphasis on brief interventions,
teaching coping strategies, and problem -solving orientation.
Behavior therapy focuses on environ mental conditions that contribute to a
client’s problems. Social and political influences can play a significant
role in the lives of people of color through discriminatory practices and
economic problems, and the behavioral approach takes into considerati on
the social and cultural dimensions of the client’s life. Assessment methods
should be chosen with the client’s cultural background in mind (Spiegler
& Guevremont, 2003; Tanaka -Matsumi et al., 2002).

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61 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II Shortcomings From a Diversity Perspective :
According t o Spiegler and Guevremont (2003), a future challenge for
behavior therapists is to develop empirically based recommendations for
how behavior therapy can optimally serve culturally diverse clients.
Although behavior therapy is sensitive to differences amon g clients in a
broad sense, behavior therapists need to become more responsive to
specific issues pertaining to all forms of diversity. Because race, gender,
ethnicity, and sexual orientation are critical variables which influence the
process and outcome o f therapy, it is essential that behavior therapists pay
greater attention to these factors than they often do. The fact that
behavioral interventions often work well raises an interesting issue in
multicultural counseling. When clients make significant per sonal changes,
it is very likely that others in their environment will react to them
differently. Before deciding too quickly on goals for therapy, the
counselor and client need to discuss the challenges inherent in change. It is
essential for therapists t o conduct a thorough assessment of the
interpersonal and cultural dimensions of the problem. Clients should be
helped in assessing the possible consequences of some of their newly
acquired social skills.
Contributions of Behavior Therapy :
Behavior therapy challenges us to reconsider our global approach to
counseling.Ledley and colleagues (2005) state that therapists can help
clients to learn about the contingencies that maintain their problematic
thoughts and behaviors and then teach them ways to make the changes
they want. Techniques such as role playing, behavioral rehearsal,
coaching, guided practice, modeling, feedback, learning by successive
approximations, mindfulness skills, and homework assignments can be
included in any therapist’s repertoire, rega rdless of theoretical orientation.
An advantage behavior therapists have is the wide variety of specific
behavioral techniques at their disposal. The basic therapeutic conditions
stressed by person -centered therapists —active listening, accurate empathy,
positive regard, genuineness, respect, and immediacy —need to be
integrated in a behavioral framework. Behavioral techniques have been
extended to more areas of human functioning than have any of the other
therapeutic approaches Behavior therapy is deeply enm eshed in medicine,
geriatrics, pediatrics, rehabilitation programs, and stress management.
This approach has made significant contributions to health psychology,
especially in helping people maintain a healthy lifestyle. A major
contribution of behavior th erapy is its emphasis on research into and
assessment of treatment outcomes. It is up to practitioners to demonstrate
that therapy is working. If progress is not being made, therapists look
carefully at the original analysis and treatment plan. Another str ength of
the behavioral approaches is the emphasis on ethical accountability.


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62 Limitations and Criticisms of Behavior Therapy :
Behavior therapy has been criticized for a variety of reasons. There are
five common criticisms and misconceptions people often have about
behavior therapy,
1. Behavior therapy may change behaviors, but it does not change
feelings. Some critics argue that feelings must change before behavior
can change. Behavioral practitioners hold that empirical evidence has
not shown that feel ings must be changed first, and behavioral
clinicians do in actual practice deal with feelings as an overall part of
the treatment process. A general criticism of both the behavioral and
the cognitive approaches is that clients are not encouraged to
experi ence their emotions. In concentrating on how clients are
behaving or thinking, some behavior therapists tend to play down the
working through of emotional issues.
2. Behavior therapy ignores the important relational factors in therapy.
The charge is often made that the importance of the relationship
between client and therapist is discounted in behavior therapy.
3. Behavior therapy does not provide insight. If this assertion is indeed
true, behavior therapists would probably respond that insight is not a
necessary requisite for behavior change. A change in behavior often
leads to a change in understanding or to insight, and often it leads to
emotional changes
4. Behavior therapy treats symptoms rather than causes. The
psychoanalytic assumption is that earl y traumatic events are at the
root of present dysfunction. Behavior therapists may acknowledge
that deviant responses have historical origins, but they contend that
history is seldom important in the maintenance of current problems.
However, behavior thera pists emphasize changing current
environmental circumstances to change behavior.
5. Behavior therapy involves control and manipulation by the therapist.
All therapists have a powerful relationship with the client and thus
have control. Behavior therapists are just clearer with their clients
about this role (Miltenberger, 2008).
4.2 AARON BECK’S COGNITIVE THERAPY: INTRODUCTION Aaron Beck’s Cognitive Therapy :
Aaron T. 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
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63 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II Cognitive therapy has a numbe r of similarities to both rational emotive
behavior therapy and behavior therapy. All of these therapies are active,
directive, time -limited, present -centered, collaborative, problem -oriented,
empirical, structured, make use of homework, and require explic it
identification of problems and the situations in which they occur (Beck &
Weishaar, 2008).
The basic theory of Cognitive Therapy states that to understand the nature
of an emotional episode it is essential to focus on the cognitive content of
an indivi dual’s reaction to the upsetting event or stream of thoughts
(DeRubeis & Beck, 1988). The goal is to change the way clients think by
using their automatic thoughts to reach the core schemata and begin to
introduce the idea of schema restructuring. This can be done by
encouraging clients to collect and weigh the evidence in support of their
beliefs.
Cognitive therapy is based on the theoretical rationale that the way people
feel and behave is determined by how they perceive and structure their
experience. Th e theoretical assumptions of cognitive therapy are
(1) people’s internal communication is accessible to introspection,
(2) clients’ beliefs have highly personal meanings, and
(3) these meanings can be discovered by the client rather than being
interpr eted by the therapist (Weishaar, 1993).
Basic Principles of Cognitive Therapy :
Beck was practicing psychoanalytic therapy for many years. As a part of
his psychoanalytic study, he was examining the dream content of
depressed clients for anger that they wer e turning back on themselves. He
then noticed that clients exhibited a negative bias in their interpretation or
thinking. Beck asked clients to observe negative automatic thoughts that
persisted even though they were contrary to objective evidence, and the n
he developed a comprehensive theory of depression.
Beck mentioned that people with emotional difficulties tend to commit
characteristic “logical errors” that tilt objective reality in the direction of
self deprecation. some of the systematic errors are
Arbitrary Inferences :
Arbitrary inferences refer to making conclusions without supporting and
relevant evidence. it includes “catastrophizing,” or thinking of the absolute
worst scenario and outcomes for most situations. For example ,You are
convinced that you fooled your professors and somehow just managed to
get your degree, but now people will certainly see through you!
Selective abstraction :
Selective abstraction consists of forming conclusions based on an isolated
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64 significance of the total context is missed. The assumption is that the
events that matter are those dealing with failure and deprivation.
Overgeneralization :
Overgeneralization is a process of holding extreme belie fs on the basis of
a single incident and applying them inappropriately to dissimilar events or
settings, for example If you have difficulty working with one colleague at
work, you might conclude that you will not be effective in communication
at the workpl ace. You might also conclude that you will not be effective
working with any Colleagues!
Magnification :
Magnification and minimization consist of perceiving a case or situation in
a greater or lesser light than it truly deserves. Person might make this
cognitive error by assuming that even minor mistakes in work could
easily create a crisis for the individual and might result in damage.
Personalization ;
Personalization is a tendency for individuals to relate external events to
themselves, even when there is no basis for making this connection.
Labeling and mislabeling :
Labeling and mislabeling involve portraying one’s identity on the basis of
imperfections and mistakes made in the past and allowing them to define
one’s true identity.
Dichotomous thinkin g:
Dichotomous thinking involves categorizing experiences in either -or
extremes. With such polarized thinking, events are labeled in black or
white terms. You might give yourself no latitude for being an imperfect
person.
The cognitive therapist operates on the assumption that the most direct
way to change dysfunctional emotions and behaviors is to modify
inaccurate and dysfunctional thinking. The cognitive therapist guides
clients how to identify these distorted and dysfunctional cognitions
through a proc ess of evaluation.
In this therapy, clients learn to be involved in more realistic thinking,
especially if they consistently notice times when they are caught up in
catastrophic thinking. After they have understood how their unrealistically
negative though ts are affecting them, clients are trained to test these
automatic thoughts against reality by examining the evidence for and
against them. They can begin to monitor the frequency with which these
beliefs intrude in situations in everyday life. The frequen tly asked question
is, “Where is the evidence for _____?” If this question is raised often
enough, clients are likely to make it a practice to ask themselves this
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65 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II empirically testin g them by actively engaging in a Socratic dialogue with
the therapist, carrying out homework assignments, gathering data on
assumptions they make, keeping a record of activities, and forming
alternative interpretations (Dattilio, 2000a; Freeman & Dattilio, 1994;
Tompkins, 2004, 2006).
Clients form hypotheses about their behavior and slowly learn to employ
specific problem -solving and coping skills. Through a process, clients
acquire insight about the connection between their thinking and the ways
they act and feel.
Cognitive therapy is focused on present problems.The past may be
brought into therapy when the therapist feels it essential to understand
how and when certain core dysfunctional beliefs originated and how these
ideas have a current impact on the client’s specific schema (Dattilio,
2002a).
The Client –Therapist Relationship :
Beck (1987) emphasizes that the quality of the therapeutic relationship is
basic to the application of cognitive therapy. Beck believes that effective
therapists are able to com bine empathy and sensitivity, along with
technical competence. The core therapeutic conditions described by
Rogers in his person -centered approach are viewed by cognitive therapists
as being necessary, but not sufficient, to produce optimum therapeutic
effect. therapists must also have a cognitive conceptualization of cases, be
creative 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 focused a t guiding clients in significant self -
discoveries that will lead to change (Weishaar, 1993).
Cognitive therapists are continuously active and deliberately interactive
with clients, to help clients frame their conclusions in the form of testable
hypotheses . Therapists engage clients’ active participation and
collaboration throughout all phases of therapy, including deciding how
often to meet, how long therapy should last, what problems to explore, and
setting an agenda for each therapy session (J. Beck & Bu tler, 2005).
Clients 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 (J. Beck, 1995, 2005;
J. Beck & Butler, 2005; Beck & We ishaar, 2008).
Cognitive therapists emphasize the client’s role in self -discovery.
Cognitive therapists aim to teach clients how to be their own therapist.
Typically, a therapist will educate clients about the nature and course of
their problem, about the process of cognitive therapy, and how thoughts
influence their emotions and behaviors. Cognitive therapy has been known
to the general public through self -help books.
Homework is often used as a part of cognitive therapy. The homework is
focused on the cl ient’s specific problem and arises out of the collaborative
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66 clients new skills but also to enable them to test their beliefs in daily -life
situations.
Emphasis is placed on self -help assignments that serve as a continuation
of issues addressed in a therapy session (Dattilio, 2002b). Cognitive
therapists realize that clients are more likely to complete homework if it is
tailored to their needs, if they participate in designing the homew ork, if
they begin the homework in the therapy session, and if they talk about
potential problems in implementing the homework (J. Beck & Butler,
2005). Tompkins (2006) points out that there are clear advantages to the
therapist and the client working in a collaborative manner in negotiating
mutually agreeable homework tasks. He believes that one of the best
indicators of a working alliance is whether homework is done and done
well.
4.3 APPLICATIONS OF COGNITIVE THERAPY Applying Cognitive Techniques :
The g oal of Techniques are correcting errors in information processing
and modifying core beliefs which result in faulty conclusions. Cognitive
techniques focus on identifying and examining a client’s beliefs, exploring
the origins of these beliefs, and modifyi ng them if the client cannot
support these beliefs. For Example, skills training, role playing, behavioral
rehearsal, and exposure therapy. Regardless of the nature of the specific
problem, the cognitive therapist is mainly interested in applying
procedure s that will assist individuals in making alternative interpretations
of events in their daily lives.
Treatment of Depression :
Beck Focuses on the content of the depressive negative thinking and
biased interpretation of events (DeRubeis & Beck, 1988). In a n earlier
study that provided much of the backbone of his theory, Beck (1963) even
found cognitive errors in the dream content of depressed clients.
Beck (1987) writes about the cognitive triad as a pattern that triggers
depression. In the first component of the triad, clients hold a negative view
of themselves and blame their setbacks on personal inadequacies without
considering circumstantial explanations. They are convinced that they lack
the qualities essential to bring them happiness. The second compo nent of
the triad consists of the tendency to interpret experiences in a negative
manner. It almost seems as if depressed people select certain facts that
conform to their negative conclusions, a process referred to as selective
abstraction by Beck. Select ive abstraction is used to support the
individual’s negative schema, giving further acceptance to core beliefs.
The third component of the triad pertains to depressed clients’ gloomy
vision and projections about the future. They expect their present
diffic ulties to continue, and they anticipate only failure in the future.
Depression -prone people often set perfectionist goals for themselves that
are impossible to attain. Their negative expectations are so strong that
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67 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II next time. They screen out successful experiences that are not consistent
with their negative self -concept. The thought content of depressed
individuals centers on a sense of irreversible loss that results in emotional
states of sadness and disappointment.
Beck’s therapeutic approach to treating depressed clients focuses on
specific problem areas and the reasons clients give for their symptoms.
Some of the behavioral symptoms of depression are inactivity,
withdrawal, an d avoidance. To assess the depth of depression, Beck
(1967) designed a standardized device known as the Beck Depression
Inventory (BDI).Clients are asked to complete easy tasks first, so that they
will meet with some success and become slightly more optimi stic. The
point is to enlist the client’s cooperation with the therapist on the
assumption that doing something is more likely to lead to feeling better
than doing nothing.
Cognitive therapy techniques may include exposing the client’s
ambivalence, generat ing alternatives, and reducing problems to
manageable proportions. Further, if the client can develop alternative
views of a problem, alternative courses of action can be developed. This
can result not only in a client feeling better but also behaving in m ore
effective ways (Freeman & Reinecke, 1993).
A central characteristic of most depressive people is self -criticism.
Underneath the person’s self -hate are attitudes of weakness, inadequacy,
and lack of responsibility.Many techniques can help in this situat ion.
Clients can be asked to identify and provide reasons for their excessively
self-critical behavior. The therapist may ask the client, “If I were to make
a mistake the way you do, would you despise me as much as you do
yourself?” A skillful therapist ma y play the role of the depressed client,
portraying the client as inadequate and weak. This technique can be
effective in demonstrating the client’s cognitive distortions and
unpredictable inferences. The therapist can then discuss with the client
how the “tyranny of shoulds” can lead to self -hate and depression.
Depressed clients typically experience painful emotions. One procedure to
counteract painful effects is humor. A therapist can demonstrate the ironic
aspects of a situation. If clients can even bri efly experience some
lightheartedness, it can serve as an antidote to their sadness. Such a shift in
their cognitive set is simply not compatible with their self -critical attitude.
Another specific characteristic of depressed people is an exaggeration of
external demands, problems, and pressures. Such people often exclaim
that they feel overwhelmed and that there is so much to accomplish that
they can never do it. A cognitive therapist might ask clients to list things
that need to be done, set priorities, c heck off tasks that have been
accomplished, and break down an external problem into manageable units.
When problems are discussed, clients often become aware of how they are
magnifying the importance of these difficulties. Through rational
exploration, cli ents are able to regain a perspective on defining and
accomplishing tasks. The therapist typically has to take the lead in helping
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68 realistic plan of action. Because carrying out s uch a plan is often inhibited
by self -defeating thoughts, it is well for therapists to use cognitive
rehearsal techniques in both identifying and changing negative thoughts. If
clients can learn to combat their self -doubts in the therapy session, they
may be able to apply their newly acquired cognitive and behavioral skills
in real -life situations.
The cognitive behavioral approach Concentrates on family interaction
patterns, and family relationships, cognitions, emotions, and behavior are
viewed as exertin g a mutual influence on one another. Cognitive therapy,
as set forth by Beck (1976), places a heavy emphasis on schema, or what
have elsewhere been defined as core beliefs. A key aspect of the
therapeutic process involves restructuring distorted beliefs (o r schema),
which has a crucial impact on changing dysfunctional behaviors.
Strengths From a Diversity Perspective :
There are several strengths of cognitive behavioral approaches from a
diversity perspective. If therapists understand the core values of thei r
culturally diverse clients, they can help clients to explore these values and
gain a full awareness of their conflicting feelings. Then client and therapist
can work together to modify selected beliefs and practices.
Shortcomings From a Diversity Perspec tive:
Exploring values and core beliefs plays an important role in all of the
cognitive behavioral approaches, and it is crucial for therapists to have
some understanding of the cultural background of clients and to be
sensitive to their struggles. Therapi sts would do well to use caution in
challenging clients about their beliefs and behaviors until they clearly
understand their cultural context.
One of the shortcomings of applying cognitive behavior therapy to diverse
cultures pertains to the hesitation of some clients to question their basic
cultural values. Dattilio (1995) notes that some Mediterranean and Middle
Eastern cultures have strict rules with regard to religion, marriage and
family, and child -rearing practices. These rules are often in conflict with
the cognitive behavioral suggestions of disputation.
4.4 SUMMARY Behavior therapy is diverse with respect not only to basic concepts but
also to techniques that can be applied in coping with specific problems
with a diverse range of clients. The behav ioral movement includes four
major areas of development: classical conditioning, operant conditioning,
social learning theory, and increasing attention to the cognitive factors
influencing behavior In helping clients achieve their goals, behavior
therapist s typically assume an active and directive role. Although the
client generally determines what behavior will be changed, the therapist
typically determines how this behavior can best be modified. In designing
a treatment plan, behavior therapists employ te chniques and procedures
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69 Intervention Systems Emphasizing Humanistic, Cognitive And Behavioral Approaches - II needs of each client. Behavioral strategies can be used to attain both
individual goals and societal goals. Because cognitive factors have a place
in the practi ce of behavior therapy, techniques from this approach can be
used to attain humanistic ends. It is clear that bridges can connect
humanistic and behavioral therapies, especially with the current focus of
attention on self -directed approaches and also with the incorporation of
mindfulness and acceptance -based approaches into behavioral practice
In cognitive therapy, it is presumed that clients are helped by the skillful
use of a range of cognitive and behavioral interventions and by their
willingness to perf orm homework assignments between sessions. All of
the cognitive behavioral approaches stress the importance of cognitive
processes as determinants of behavior. It is assumed that how people feel
and what they actually do is largely influenced by their subj ective
assessment of situations. Because this appraisal of life situations is
influenced by beliefs, attitudes, assumptions, and internal dialogue, such
cognitions become the major focus of therapy.
4.5 QUESTIONS A) Write long answers:
a) Discuss in detai l about nature of Behaviour Therapy
b) Discuss about Behaviour Therapy from a Multicultural Perspective
c) Explain the Application Of Cognitive Therapy.
B) Write short notes:
a) Relaxation training and related methods
b) Client Therapist Relationship in Behaviour Therapy
c) Basic Principles of Cognitive Therapy
d) Client Therapist Relationship in Cognitive Therapy
4.6 REFERENCES  COREY, G. (2009). Theory and practice of counseling and
Psychotherapy (8th ed.)., CA: Thomson Brooks.
 ALBERTI, R. E., & EMM ONS, M. L. (2008). Your perfect right: A
guide to assertive behavior (9th ed.). Atascadero, CA: Impact.
 ANTONY, M. M., & ROEMER, L. (2003). Behavior therapy. In A.
S. Gurman & S. B. Messer (Eds.), Essential psychotherapies: Theory
and practice (2nd ed., p p. 182 –223). New York: Guilford Press.
 BANDURA, A. (1969). Principles of behavior modification. New
York: Holt, Rinehart & Winston. munotes.in

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70  ALFORD, B. A., & BECK, A. T. (1997). The integrative power of
cognitive therapy. New York: Guilford Press.
 ARNKOFF, D. B., & GLASS, C. R. (1992). Cognitive therapy and
psychotherapy integration. In D. K. Freedheim (Ed.), History of
psychotherapy: A century of change (pp. 657 –694). Washington, DC:
American Psychological Association.
 BECK, A. T. (1963). Thinking and depression: Idiosyncratic content
and cognitive distortions. Archives of General Psychiatry, 9, 324 –333.
 BECK, A. T. (1967). Depression: Clinical, experimental, and
theoretical aspects. New York: Harper & Row. (Republished as
Depression: Causes and treatment. Philade lphia: University of
Pennsylvania Press, 1972)

*****

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71 5
TECHNIQUES IN GROUP - I
Unit Structure
5.0 Objectives
5.1 Introduction
5.2 Fundamentals of Group Therapy
5.2.1 Influences of Group Therapy
5.2.2 Advantages of Group Therapy
5.2.3 Organizing Group
5.2.4 Opening and Later Sessions
5.2.5 Technical Funct ions of Group Therapists
5.3 Summary
5.4 Questions
5.5 References
5.0 OBJECTIVES After reading this unit, you would be able to understand:
 The fundamentals of group therapy
 The influences and advantages of group therapy
 The basics of organizing a group for therapy
 The nature of opening and later sessions of group therapy
 The technical functions of group therapists
5.1 INTRODUCTION Groups enable professionals from the various fields to deliver services to
the largest number of people, who share the common qualities, whether
demographic, cognitive, emotional, personality, values etc. Forming
groups helps them save time and effort, where several clients can be
addressed based on their common needs at a time. Therefore it is
imperative for professionals, such as counselors, psychologists, social
workers, ministers, teachers, and others who work with people that they
should learn to lead groups. Here, we will be learning about various group
dynamics, leadership qualities and techniques used in group
therapy/psy chotherapy. Many people believe that they have unique
feelings. However, when they become a member of a group, it allows
them to discover that they are not the only ones to have those particular
thoughts, concerns and feelings. Thus, working in groups is o ften effective
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72 In the counselling service, groups have a long and distinguished history. A
Boston physician, Joseph Hersey Pratt is generally credited for starting the
first group -psychotherapy in 1905 – with tubercular outpatients at
Massachusetts General Hospital. Other pioneers to contribute to group
therapy are Jacob L. Moreno (who introduced the term group
psychotherapy and psychodrama in a group setting), Kurt Lewin (who
formed the basis for the T -group movement), Fritz Perls (Gestalt approach
in groups), W. Edwards Deming (conceptualized and implemented the
idea of quality work groups), William Schutz and Jack Gibb (who
emphasized a humanistic aspect to T -groups), and Carl Roger s (who
devised the basic encounter group, i.e. the model for growth -oriented
group approaches). Among many valid reasons for using a group
approach, two are common to all groups (Jacobs et al., 2016):
i) groups are more efficient and offer more resources and viewpoints,
and
ii) groups have the feeling of commonality, the experience of belonging,
the chance to practice new behaviours, the opportunity for feedback
and vicarious learning by listening and observing others, the
approximation to real -life enc ounters, and the pressure to uphold
commitments.
Groups can be categorized into seven categories, based on their different
goals (Jacobs, et al., 2016). They are:
i) education groups, in which helping professionals, that is, group
leaders provide inform ation and then elicit reactions and comments
from members. Thus, they play the role of educators in such groups
(e.g., students learning study skills, women learning how to protect
themselves from being raped, etc.).
ii) discussion groups, in which the f ocus is usually on topics or issues
rather than any member’s personal concerns. The purpose of such
groups is to give participants the opportunity to share ideas and
exchange information.
iii) task groups, in which a specific task is to be accomplished, s uch as
discussing a client, deciding policies for a school, etc.
iv) growth and experiential groups, in which the group activities are
focused on group members’ relevant self -exploration and personal
growth.
v) counselling and therapy group, in which cer tain problems in group
participants’ lives are dealt with, with the help of therapist/s and other
group members.
vi) support groups, in which group members learn about something in
common that they share. They also learn that other people struggle
with the same problems, feel similar emotions, and think similar
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73 Techniques In Group - I vii) self-help groups, in which group members mainly learn to develop
and enhance their decision -making capacity.
5.1.2 Nature of Group Therapy/Psychotherapy :
In group therapy/ psychoth erapy, there is at least one therapist to treat
more than one individual at the same time. Some groups may have more
than one therapist. Group sizes vary depending on the type of therapy.
Group therapy is a valuable and, in some cases, essential treatment
method. Developing group cohesiveness and mutual assistance are among
the most important processes that evolve during group psychotherapy.
Other important processes that evolve are i)manifestations of empathy,
support, challenge, confrontation, and interpr etation; ii) availability of
identification models; iii) opportunities for introducing projective
identifications; iv) investigative explorations, and v) a joint sharing of
problems. It may be utilized in the following four different ways:
(1) Independentl y: Here, both intrapsychic and interpersonal operations
are considered;
(2) As a “combined therapy”: It can be utilized in a combination with
individual therapy conducted by the same therapist. individual
sessions deal with the patient’s resistances, tran sferential responses to
the therapist, and primary separation anxiety, while group sessions
focus chiefly on interpersonal phenomena;
(3) As a “conjoint therapy”: in conjunction with individual therapy
conducted by another therapist; and
(4) As leaderles s groups: It is particularly after formal group therapy has
ended (Kline, 1975).
Meetings in independent, combined, conjoint therapy may take place once
or twice weekly or even daily in institutional settings. At times, there may
be regularly scheduled mee tings that are not attended by the therapist/s,
called “coordinated meetings”.
Coordinated Meetings:
In coordinated meetings, the members may assemble -
• before a regular session (i.e., “pre -meetings”),
• after a regular session (i.e., post -meetings), o r
• at other times at specially selected places (i.e., “alternate meetings”).
Such coordinated meetings enable clients to discuss their feelings about
the therapist more freely. Meetings are generally less formal and more
spontaneous than regular meetings .

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74 There are two types of groups:
i) closed groups that maintain a constant membership, although new
members may be added to it for special reasons. They can be time -
limited and goal -oriented.
ii) open groups that operate continuously with new member s being
added as regular members operate therapy and leave the group.
Treatment in group therapy may be “therapist -centred”, “group -centred”,
and “authority -denying” at times. When it is therapist -centred, therapists
have a range of diverse roles to play, which will be discussed in Section
5.2.5 in detail.
5.2 FUNDAMENTALS OF GROUP THERAPY Group, as we have come to know up to this point, is the essential and
leading factor in group psychotherapy which has the potential to make the
therapy effective and suc cessful. When the treatment in group therapy is
“group-centred”, the group operates as the primary authority, while
therapists function in a consultative role. Thus, peer and authority
relationships are considered equally important. Here, two types of
comm unication take place:
i) Circular communication, where rotating leadership is encouraged,
with no interference with the relationships between clients (i.e., group
participants) that are constantly broken, restored, and reorganized.
Here, the therapists co ntrol their anxiety about neurotic alliances.
ii) Horizontal communication, which is also known to be authority -
denying, may occur in which the therapists are on an equal plane with
the clients. Here, emotional interactions are considered most
important, and direct experience in the group is encouraged. Also,
therapists present their own problems to the group
Let us now discuss some fundamental aspects of the group that makes the
therapy work in an effective manner.
5.2.1 Influences of Group Therapy:
Group may have an influence on each individual, when people gather
together in a group. This encourages one to express oneself openly. The
person soon realizes that the group fosters free expression of feelings or
attitudes on any subject, without any social taboos on content usually
avoided in everyday interactions. Recognizing that fellow members have
the same fears and doubts, can be supportive in a group. Hence, the
individual finds that problems can be shared with others without rejection
or ridicule, apa rt 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 deviate. The
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75 Techniques In Group - I participation, the sharing of ideas, and decision -making. Feelings that are
controlled and verbalizations related to them suppressed or repressed in
the usual group setting, are encouraged and even rewarded in the
therapeutic group by approval from the therapists. Thus, individual
gradually learns to accept criticism and aggression without falling apart.
The fear of becoming violent and in turn being subject to physical attack
and humiliatio n lessens. Group judgment is a moving force that cannot be
resisted. As compared to an interpretation by the therapist, an opinion
Where shared by many members about an individual or behaviour brings a
more intense effect.
During individual therapy, one ma y be unable to express feelings toward
the therapist. However, the group strengthens the individual’s ability to
express feelings toward the therapist, whether rational or irrational.
Learning how emotional processes operate by observing how other
members talk about and solve their problems is one of the most important
consequences of being in a group geared toward reconstructive goals. This
soon turns the dynamic thinking into a dominant mode in the group. Also,
awareness of inner psychological operations is sharpened through
emotional involvement with other group members, through one’s own
spontaneous discoveries and interpretations from fellow members and the
therapist. In group therapy, thus, the client is encouraged to hold his or
her ground and to e xpress and analyze feelings and defences, instead of
withdrawing as in a usual life situation.
5.2.2 Advantages of Group Therapy:
In group therapy, diversified intrapsychic defences come out toward
members of the group with whom the client plays varying ro les. Multiple
transferences, both sequential and simultaneous, are readily established.
The opportunity to relate in different ways to fellow members enables the
individual to work through insights in the direction of change. Within the
group, the clients feel more protected, both by the therapist and by
members with whom alliances have been formed, and they may be able to
practice new attitudes more favourably.
Yalom and Leszcz (2005) noted down some positive forces of groups in
group therapy, in terms of their general advantages as therapeutic factors,
which include:  Installation of hope (i.e., assurance that treatment will work)  Universality (i.e., the realization that one is not alone, unique, or abnormal)  Imparting of information (i.e., instruction about mental health, mental illness, and how to deal with life problems)  Altruism (i.e., sharing experiences and thoughts with others, helping them by giving of oneself, working for the common good)  Corrective recapitulation of the primary family group munotes.in

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76 (i.e., reliving early family conflicts and resolving them)  Development of socializing techniques (i.e., interacting with others and learning social skills as well as more about oneself in social situations)  Imitative behaviour (i.e., modelling positive actions of other group members)  Interpersonal learning (i.e., gaining insight and correctively working through past experience)  Group cohesiveness (i.e. bonding with other members of the group)  Catharsis
(i.e., experiencing and expressing feelings)  Existential factors
(i.e., accepting responsibility for one’s life in basic isolation from
others, recognizing one’s own mortality and the capriciousness of
existence) Source: Gladding, S. T. (2018). Counseling: A Comprehensive Profession
(8th Ed.) Pearson Education}.
Here are some of the major advantages in terms of a number of
opportunities that group therapy provides: An opportunity 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 study one’s own defences 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 accept constructive criticism  express hostility and absorb the reactions of others to one’s hostility  consume hostility from others and determine the reasonableness of one’s reactions  translate understanding into direct action and receive help in munotes.in

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77 Techniques In Group - I resolving resistance to actions  gain support and reassurance from the other members when 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 the relationship with others  share difficulties with fellow members;  break down social fears and barriers  learn to respect the rights and feelings of others, as well as to stand up to others when necessary  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, wit h 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 group therapy, the group is acting as a unit that replica tes the
family setting and sponsors the re -enactment of parental and sibling
relationships. Thus, Group therapy is effective for clients experiencing
isolation and social disengagement, especially those with posttraumatic
stress disorder (PTSD), and comple x traumatic stress disorders following
childhood sexual abuse in women (Ford et al., 2009). It assures being in a
group that offers safety, respect, honesty, privacy, and dedication to
recovery for people who struggle with anxiety, fear, shame, guilt,
alienation, loneliness, and a sense of powerlessness and of being
permanently damaged which is profoundly demoralizing and isolating for
trauma survivors (Courtois, 1988; Mendelsohn, Zachary, & Harney,
2007). Overall, group therapy helps one find his or her au thentic voice and
reclaim one’s memories and sense of self.
Although group therapy assures several above -listed advantages, it is
found that the integration of the therapist’s guidance and peer support in
group therapy may be especially challenging when pa rticipants with a
deep distrust for people in the role of authority and caregivers (Courtois,
1988) and whose attachment styles are insecure and/or dysregulated (Ford
et al., 2009).
5.2.3 Organizing Group:
Before conducting a group for a therapy purpose, t herapists need to
consider the following factors that will determine how to form a group:
1. Goals that are set by the therapists, whether supportive, reeducative,
or reconstructive.
2. Constituent members of the group, whether alcoholics, drug addicts,
psychotics, stutterers, delinquents, psychoneurotics, character
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78 3. Therapist’s training, whether related to group dynamics,
rehabilitation, behaviour therapy, cognitive therapy, existential
therapy, psychodr ama, psychoanalytically oriented psychotherapy, or
psychoanalysis.
4. Therapists’ personal ambitions and needs, whether characterologic or
countertransferential.
Group participants should be those who are sufficiently advanced in their
understanding of the mselves 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 clients with the following
conditions are likely to perform poorly in a group. They are:
i) Psychopathic personalities and those with poor impulse control,
ii) Acute depression and suicidal risks,
iii) Stutterers,
iv) True alcoholics,
v) Hallucinating patients and those out of contact with reality,
vi) Patients with marked paran oic tendencies,
vii) Hypomanics, and
viii) Clients with low intelligence.
Such clients 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 intellig ence is desirable,
but not imperative
• A well -balanced group often contains an “oral -dependent,” a
“schizoid -withdrawn,” a “rigid -compulsive,” and perhaps 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 unimportant
• A balance of males and females that allows for an opportunity to
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79 Techniques In Group - I • A heterogeneous group in terms of age, sex, and the syndrome is most
effective for reconstructive goals
• A homogeneous group composed of patients with the same problem is
best for alcoholism, substance abuse, obesity, smokin g, sexual
problems, insomnia, phobias, depression, delinquency, stuttering,
criminality, marital problems, divorce, and geriatric problems,
although an occasional 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 1 to 2 hours.
• The frequency of meetings is one to two sessions weekly, with
alternate sessions once weekly if desired
• The be st seating arrangement is in a circle
5.2.4 Opening and Later Sessions:
Let us now understand, in this section, how the opening and later sessions
should be conducted and the precautions that need to be taken by the
therapists while conducting the opening and later sessions.
a) Opening Sessions:
Opening sessions include the entire first session, the last part of the first
session, or even the first couple of sessions. In the first session, the
members are introduced by their first names, and the purpose of group
discussions, what to expect, fears, group rules, comfort levels, and the
content of the group are clarified. This will vary with different therapists
and different groups. Thus, members check out other members and their
own level of comfort with shar ing in the group during opening sessions. In
the case of groups with a culturally diverse membership, the opening
sessions may get extended longer based on the level of discomfort of
group members. On the other hand, for some groups, the opening sessions
may last only a few minutes since the purpose is clear and the trust and
comfort levels are already high. Thus, the more passive -dependent the
clients are, the therapist should exercise the more demanded leadership.
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 to understand their individual
patterns eventually. Tho ugh, it is not necessary for the members to feel
compelled to reveal something that they want to keep to themselves,
communicating freely will help them to get a better grip on their problems.
Before the close of the first session, some therapists may stre ss the
confidential nature of the meetings and caution that each member is
expected not to reveal to others the identity of the members and the
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80 Therapists who strongly believe that acting out is harmful will discourag e
any contact outside of the group, in all probability. Sexual involvement
may be prevented 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 se ssions. This may
lead to more acting -out. They may try to keep clients from exposing
painful revelations before the group is ready to support them.
In a group, free verbal interaction may be encouraged in order to bring out
each member’s habitual disguises and defences. 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 session, or there may be a
much mor e informal arrangement with the members spontaneously
expressing what is on their minds at the moment. There is no need for
procedural structuring; it should not be rigidly controlled at any time.
Thus in the opening session, the content of discussions wil l 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. Interpretation of transference with the
therapists brings the clients closer to behaviour patterns that the clients
have been disclaiming. It also permits reality testing. The therapists can
advantageously analyze the structure of the group as it displays itself in a
particular session. They also define the defence mechanisms disp layed by
the individual members by designating the roles played by the different
members. As the group becomes integrated, the clients gain more insight
into personal difficulties. Clients recognize that many troubles that they
previously believed to be un ique, have a common base.
For this reason, the therapists 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., siblings), and
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81 Techniques In Group - I These different transference relationships are always present
simultaneously, where clients treat t he group as if it were their own
family. During this transference phase, defences dreams are also utilized
advantageously in a different manner than in individual therapy. Thus,
systematic analysis of intragroup transferences may be helpful in
successful t ransference interpretations. This further can lead to
reconstructive personality changes of a deep and enduring nature.
The basic rule in a group setting is for members to express themselves
individually and as freely and without restraint as possible. Th is
encourages the disclosure of prohibited or fearsome ideas and impulses
without the threat of rejection or punishment.
In later sessions, the interactional processes virtually do put the various
group members in the role of co -therapists. Under the guida nce of the
therapist, this role can be enhanced. The specific effect of member “co -
therapists” 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 therapist’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 co mplex clusters as a release of feeling within the group is
accelerated. Here, a lack of control in one group member often results in a
similar lack of control in others.
Alternate sessions: Alternate sessions are those apart from opening and
later sessions as they suggest. These sessions can provide opportunities for
free interaction, testing, and exploring. They enable some patients to speak
more freely about their feelings about the therapist and thereby consolidate
their separation from parental authorit y. However, it is essential that
activities at alternate sessions or elsewhere involving group members with
each other be reported at the regular group sessions.
5.2.5 Technical Functions of Group Therapists:
As discussed before, some sessions of the grou p therapy may take place
without the presence of the therapist/s may be in informal way, allowing
some degree of freedom to group participants, where they may discuss
their feelings about the therapist/s more openly and freely.
However, treatment in gro up therapy may be ”therapist -centred” at times,
where therapists take a directive and more authoritarian role. The leader’s
feelings about leading a group affect how the group will work. Four
leadership qualities of a group leader, when not used excessivel y, have a
positive effect on the outcome of groups (Yalom & Leszcz, 2005). They
are as follows:
1. Caring – the more caring nature, the better the outcome.
2. Meaning attribution, which includes clarifying, explaining, and
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82 3. Emotional stimulation, which involves activity, challenging, risk -
taking, self -disclosure; and
4. Executive function, which entails developing norms structuring, and
suggesting procedures.
Hence, the group therapist must be a good leader a nd beyond those of a
therapist, with these four positive and essential leadership qualities.
The therapist’s roles, as a group leader, include many technical 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,
• to resolve competitiveness, resentments, and other defences that block
the act ivity
• to deal with overt obstructions in the form of resistance 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 psychoana lysts, attempting to figure out dynamics and
explain the theory.
• to resolve resistance to talking about feelings regarding one another
• to try to break up fixed role behaviour patterns
• to focus on the conversational theme around pertinent subjects whe n
topics become irrelevant
• to create tension by asking questions and pointing out interactions
when there is a reduction of activity in the group
• to pose pointed questions to facilitate participation
• to deal with individual and group resistance
• to support upset members
• to encourage withdrawn members to talk.
• to interfere with hostile pairings who upset the group with their
quarrelling
• to remind the group that communication about and understanding of
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83 Techniques In Group - I • to manage silence, which tends to mobilize tension in the group
• to gauge and regulate group tension and anxiety. Here, the therapist
can step in and deal with excessive tension and maintain an optimal
level of tension.
• to detect resistances of the group as a whole as well as of the
individual members.
• to bring out one’s serious neurotic problems that may destroy the
confidence of some group members in the therapist’s capacity for
objectivity and ability to help them and the imp air effectiveness of the
therapeutic process.
• to share feelings and reactions that will reveal the therapist as more
human and less omniscient and give the patients confidence to talk
more openly about their own anxieties.
This way, therapists’ efforts to expedite group therapy and catalyze
movement result in their own evolving techniques.
Ethical Considerations in the context of Group Therapy (Jacobs et al.,
2016):
An effective therapist as a group leader must be aware of ethical
considerations. Unethi cal behaviour on therapists’ part usually consists of
therapists being incompetent to lead the groups they are leading, and/or
not caring properly for the group members. Here are noted down ethical
considerations to be taken care of by the couselors/therap ists as leaders
regarding a few aspects:
Training:
The fundamental ethical principle for leading groups is that the group
counselors should be thoroughly trained in using any technique or should
use it under supervision by a counselor familiar with the i ntervention
(Association of Specialists in Group Work [ASGW], 2008).
Knowledge:
Counselors/therapists should have a good grasp of the material being
discussed in the group and they should know how to deal with such
material. Also, they should have an unde rstanding of crucial aspects, like
cultural and gender issues of the group members.
Personal Growth:
Couselors should not use groups for their own personal growth.
Dual Relationships:
Dual relationship, in the group context, is a relationship that exis ts in
addition to the therapeutic relationship established between the leader and
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84 relationship is not being put at risk. For this purpose, they should not enter
into any dual relationship withou t caution. They should avoid any
exploitative dual relationship since doing so is unethical.
Role in Making Referrals:
Counselors as group leaders should make sure, as an ethical responsibility,
that the group members are made aware of proper follow -up tr eatment
possibilities. It is because follow -up becomes important since very often,
members in the therapy groups need additional individual, group, or
family counselling.
In the next chapter, we will be learning about other aspects of group
therapy, that i s, about managing special problems in group therapy and
other group approaches.
5.3 SUMMARY Groups enable professionals from different fields to deliver services to the
largest number of people, who share the common qualities, whether
demographic, cognitiv e, emotional, personality, values etc. There are
seven categories of groups, namely, educations groups, discussion groups,
task groups, growth and experiential groups, counselling and therapy
groups, support groups, and self -help groups. We have learned ma ny
aspects of groups in the context of group therapy. During group therapy,
becoming a member of the therapeutic group allows people to discover
that they are not the only ones to have particular thoughts, concerns and
feelings. In group therapy/ psychothe rapy, there is at least one therapist to
treat more than one individual at the same time, while some groups may
have more than one therapist. Group sizes vary depending on the type of
therapy.
Developing group cohesiveness and mutual assistance are among t he most
important processes that evolve during group psychotherapy. Other
important processes are i) manifestations of empathy, support, challenge,
confrontation, and interpretation; ii) availability of identification models;
iii) opportunities for introdu cing projective identifications; iv)
investigative explorations, and v) a joint sharing of problems. Group
therapy may be utilized in four ways, as independently, combined therapy,
conjoint therapy and leaderless groups. At times, there may be regularly
scheduled meetings may be arranged called “coordinated meetings” that
are not attended by the therapist/s, for which members may assemble
either before a regular session (i.e., “pre -meetings”), after a regular session
(i.e., post -meetings), or at other times at specially selected places. There
are either open groups or closed groups for group therapy.
Communication in group therapy takes place in two ways, that is, circular
and/or horizontal. Group and group therapy have many influences on
individuals, such a s encouraging the persons to express themselves openly
and enhancing persons’ self -esteem and self -confidence as being two
major influences. Some of the major advantages of group therapy include
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85 Techniques In Group - I oneself, observe dynamic processes in other people and study one’s own
defences in a clear perspective in relation to a variety of critical situations
that develop in the group, modify personal destructive values and
deviancies by conforming wi th the group norm, relieve oneself of tension
by expressing feelings and ideas to others openly, etc. Group therapy has
been found effective for clients experiencing isolation and social
disengagement, especially those with posttraumatic stress disorder
(PTSD), and complex traumatic stress disorders following childhood
sexual abuse in women. On the other hand, it is challenging for clients
with a deep distrust for people in the role of authority and caregivers, and
with insecure and/or dysregulated attachme nt styles.
Before conducting a group for a therapy purpose, therapists need to
consider the goals set by them, constituent members of the group,
therapists’ training, and their personal ambitions and needs. Clients with
certain conditions, that is, psychop athic personalities and those with poor
impulse control, acute depression and suicidal risks, stutterers, true
alcoholics, hallucinating patients and those out of contact with reality,
patients with marked paranoic tendencies, hypomanics, and clients with
low intelligence, are likely to perform poorly in a group. Also, some other
essential characteristics should be taken care of while organizing or
forming a group considering age difference, homogeneity in educational
background and intelligence (which may be desirable, but not imperative),
number of group members, a balance of male and female participants, and
heterogeneity of group in terms of age, sex, and the syndrome.
Group therapy proceeds through opening sessions, later sessions and also
alternate ses sions and these sessions are dependent on the therapists’
skills, preferences, anxiety level etc. Transference is likely to take place in
three types during later sessions - to the therapist and central figure, to
peers, to the group itself (Grotjahn, 1973 ). The therapist as a good leader
should possess the four leadership qualities (i.e., caring, meaning
attribution, emotional stimulation, and executive function) that have a
positive effect on the outcome of groups. The therapist’s roles, as a group
leader , include many technical functions. Some of them are: to catalyze
participation of the various members, to maintain an adequate level of
tension, to promote decision -making and problem -solving, to try to break
up fixed role behaviour patterns, etc. Lastly, we also learned about ethical
considerations in brief on part of the therapists considering their training,
knowledge, personal growth, dual relationships, and role in making
referrals. The next chapter will throw light on managing special problems
in gro up therapy and other group approaches.
5.4 QUESTIONS 1. Write a note on the nature of group therapy/psychotherapy.
2. Discuss the influences and advantages of group therapy as its
fundamentals.
3. Write a note on organizing a group. munotes.in

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86 4. Discuss the opening sessions, later sessions, and alternate sessions in
group therapy.
5. Discuss the technical functions of group therapists.
6. Write short notes on:
a) Influences of group therapy
b) Advantages of group therapy
c) Opening sessions
d) Later sessions
5.5 REF ERENCES  Wolberg, L. R. (2005). The Technique of Psychotherapy Part I and II:
NJ: Jason Aronson, Inc.
 Ford, J. D., Fallot, R. D., & Harris, M. (2009). Group therapy. In
Christine, A. Courtois & Julian, D. Ford (Eds.). Treating complex
traumatic stress disor der: An evidence -based guide. New York, NY:
The Guilford Press.
 Jacobs, E. E., Schimmel, C. J., Masson, R. L., & Harvill, R. L. (2016).
Group Counselling: Strategies and Skills (8th Ed.). Australia:
Cengage Learning.
 Gladding, S. T. (2018). Counseling: A C omprehensive Profession (8th
Ed.). New York: Pearson Education}.

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87 6
TECHNIQUES IN GROUP - II
Unit Structure
6.0 Objectives
6.1 Introduction
6.1.1 Special Problems during Group Therapy
6.2 Group Therapy Approaches
6.2.1 Pre -intake and Post -intake Groups
6.2.2 Special Age Groups
6.2.3 Behaviour Therapy
6.2.4 Experienti al Therapy
6.2.5 Psychodrama and Role Play
6.3 Summary
6.4 Questions
6.5 References
6.0 OBJECTIVES After reading this unit, you would be able to understand:
 Special problems during group therapy
 Different group therapy approaches
 Pre-intake and Post -intake groups
 Special age groups for group therapy
 Behaviour therapy, experiential therapy, and psychodrama and role
play
6.1 INTRODUCTION Previously, we discussed the various aspects of group therapy, its
fundamentals in terms of its influences and advantage s in dealing with
problems in groups that are experienced by its members in common. We
gained knowledge about how the groups are organized based on the
problems to be treated, and how opening and later sessions are conducted
considering the needs of the cl ients in the groups. Besides, we also had a
glance at the various technical functions of the group therapists including
ethical considerations pertaining to their roles as group leaders. Extended
to this, the present chapter will impart knowledge about the various special
problems or situations that should be dealt with during group therapy and
various group therapy approaches.
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88 6.1.1 Special Problems During Group Therapy :
The management by the therapists of special problems among clients will
be essential where they obstruct group interaction. Problematic behaviours
and situations illustrate the need for learning effective leadership skills.
Some of the examples of such special problems or problematic behaviours
are as follows:
The Silent Patients/Clients:
Since the response will be hesitant and unsure, more aggressive clients
may attempt to interrupt to take the floor over for themselves. The
therapist may block this subterfuge and continue to encourage the
reluctant clients to articulate. The clients may also be asked directly to
report on any dreams.
The Monopolizer:
The aggressive, narcissistic clients – often called the monopolizers – who
insist on dominating the session will usually be interrupted by one or more
members who resent this takeover. Wher e this does not occur, the
therapist may halt the clients 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 clients 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 the transferential roots of the enmity in order to
recognize how both are projecting unconscious aspects of themselves on
each other.
Acting -out Clients/Client:
acting -out can be a disturbing phenomenon in groups. The therapist may
caution the members to talk out rather than act out. The group members
may be required to report at a regular session on the activities engaged in
between members outside the group. T he therapist may try to reduce the
anxiety level of the group.
The Private Session in the Group:
Some clients 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
therap ist, ignoring the presence of the group. The therapist may ask the
clients to focus remarks on the group, may question the group as to how
they feel about the clients’ carrying on an intimate discussion with the
therapist, may ask other members to associat e with the clients’
verbalizations, and finally, may suggest that the clients come in for a
private session.

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89 Techniques In Group - II 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 mem bers should be
encouraged to deal with this problem, not just the therapist.
The Clients/Client Who Insists that He or She Is Getting Worse, not
Better:
Such clients can influence the group morale and may be disturbing,
especially to new members. The ther apist 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 mem bers (especially new members) out of the group.
The Accessory Therapist:
It may be a way of seeking favour with the therapist. It may be a gesture to
compete with and replace the therapist. Irrespective of its basis, the clients
may soon gather about him a group of followers as well as adversaries.
The best way to handle this manoeuver is to ask the other members what
they think is happening, until the therapeutic pretender quiets down. The
therapist may also ask the competing clients why he or she feels o bliged 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 en counter or Gestalt therapy, (6)
extending the length of a session up to the extent of a marathon session,
(7) introducing 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 clients 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 clients and in terpreting their ramifications in outside
relationships.
When a Therapist Becomes Bored with a Session:
At some point in time, therapists also may experience boredom, while
treating the problems of the group. In this situation, the therapists are
likely t o ask whether anyone else besides him or her is bored with the
ongoing conversation. Such a reaction (and its basis) from the therapists
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90 Added to this list, some other problematic behaviours and situations are
also present in certain or all kinds of groups. They are:
i) skipping from topic to topic,
ii) dominating the discussion,
iii) being “chit -chatty” rather than personal and focused,
iv) attending infrequently,
iv) being shy and withdrawn,
v) getting angry at th e leader,
vi) getting angry at one another,
vii) pressurizing (forcing) others to speak,
viii) preaching their personal morality,
ix) being resistant because forced to attend,
x) disliking other members, and
xi) stopping attending the group.
Such behaviours of the group or group members further illustrate the need
for therapists/counselors to learn effective leadership skills.
6.2 GROUP THERAPY APPROACHES 6.2.1 Pre -Intake and Post -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 this group. Sessions of this
group may take place weekly, bimonthly, and even monthly intervals. For
example, parents of children awaiting intake may be organized into a pre -
intake group, which may meet for 3 to 6 monthly sessions.
Post-Intake Groups:
These groups may take place before permanent assignment. Meetings for
post-take groups may be spaced week ly or up to 1 month apart. Some
therapeutic changes are possible here as disturbing problems are
introduced and elaborated. These preliminary groups serve as useful
means of selecting clients for ongoing group therapy. They are worthy
orientation and psych oeducation devices and help prepare and motivate
clients for therapy.
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91 Techniques In Group - II 6.2.2 Special Age Groups :
Group therapy with children :
It is usually activity -based in nature. The size of children’s groups must be
kept below that of adult groups (Geller, 1962). Sin gle-sex groups are in
the following age groups:
(1) 6 to 8 years: This group optimally consists of three to five members;
(2) 8 to 12 years: This group may have four to six members;
(3) 12 to 14 years: This group may contain six to eight youngsters; and
(4) 14 to 16 years: This group has 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, in which the
focus is on feelings and conflicts. Rather than play, d iscussions constitute
the best activity medium beyond 12 years.
Techniques in group therapy with children include i) analysis of behaviour
in the group, ii) confrontation, and iii) dream and transference
interpretation. Both - activity and discussion take place at various
intervals. Interventions of the therapist should be such that do not hamper
spontaneity. Therapists should stimulate the discussion and should always
interrupt the silence in appropriate way. individual therapy is ideally
carried on conjo intly with group therapy, particularly at the beginning of
treatment.
Group psychotherapy with older people :
Group psychotherapy has been considerably successful 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). The goal of group psychotherapy with older
people is reconstructive, in which old individuals may be mixed with
younger people.
6.2.3 Behaviour Therapy in Groups :
Behavioural techniques (Lazarus 1968; Meacham & Wiesen, 1974;
Wolpe, 1969; Liberman, 1970; Fensterheim, 1971) are largely used in
groups. Employment of methods such as behavioural rehearsal, modelling,
discrimination learning, and social reinforcement en ables us to achieve
behavioural change, while the group process tends to accelerate such
behavioural strategies to facilitate the change. In this context,
homogeneous groups seem to do best, where the selection of members is
restricted to those who may ben efit from the retraining of specific target
behaviours.
Examples of some problems are obesity, shyness, speaking anxiety,
insomnia, and phobias that can be best dealt with by achieving control
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92 on the abolition of similar undesirable behaviour. Group decision -making
strategies may be practised in institutional settings, particularly with
psychotic clients, where they will be offered reinforcement through token
economies. On the othe r hand, short hospitalization can be provided to
severe clients or clients with obsessive -compulsive disorder, and perhaps
alcoholics and drug addicts too. If such clients are treated in special
groups of populations with similar maladaptive behaviours, it can often be
a rewarding course of action (Rachman et al., 1971).
Individually oriented behavioural interventions may be employed alone in
a group setting or a combination with psychodrama, role -playing, Gestalt
tactics, encounter manoeuvers, or formal g roup therapy procedures
(inspirational, educational, or analytic) depending on the training and
flexibility of the therapist. However, if group therapy is planned to apply,
it is best to introduce the individual into a newly formed group with
persons suffe ring from the same difficulties and having approximately the
same level of intelligence and knowledge of psychological processes.
The size of the group varies from 5 to 10 individuals. The role of the co -
therapist is valuable and sometimes crucial, especia lly 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 hours. During these initial sessions, members are encouraged to voice
their problems and define what they would like to achieve in the sessions,
and the therapist helps them clarify the goals.
Here are some important operations in group behavioural treatment,
outlined by Goldstein and Wolpe (1971):
Feedback :
It is provided wit h the confrontation of the reactions of the other members
to the clients’ own verbalizations and responses. Clients get an
opportunity through feedback to alter these if it is desired.
Modelling:
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 facilitate modelling.
Behaviour Rehearsal:
Behavioural rehearsal similarly employs role -playing and involves the
clients directly. Repetition of the process with different members helps
solidify appropriate reactions, and the clients engage in role reversal when
necessary.
Desensitization:
Counterconditioning and extinction methods (systematic desensitization,
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93 Techniques In Group - II encouraging expression of forbidden emotions in the group like anger)
eventually lead to desensitization.
Motivational Stimulation and Social Reinforcement:
The therapists provide direction and guidelines for appropria te behaviour
with which the pressure of the group helps create motivational stimulation
and social reinforcement.
Apart from this, support is provided to the clients when necessary. Clients
also may be given specific assignments outside the group.
Conditi ons for Behaviour Therapy in Treating Various Problems in
Groups:
Habit disorders:
Behavioural tactics are ideally suited for habit disorders related to eating,
such as obesity, smoking, gambling, alcoholic over -indulgence, and
substance abuse. Here, the members of each group must be chosen who
suffer from the same problem and possess the adequate motivation to
cooperate with the interventions.
Lack of Assertiveness:
Assertiveness training can be highly effective in problems that are centred
around a lac k of assertiveness. As Fensterheim (1971) describes the
method to deal with this problem, groups can be formed that consist of 9
or 10 men or women in approximately the same number, and are roughly
homogeneous considering their age, marital status, achieve ment,
education, and socio -economic status to enhance modelling. These groups
can meet 2½ hours once a week. For these sessions, seats are arranged in a
horseshoe configuration in which the opening serves as a stage for role -
playing and behaviour rehearsal .
Being very intense, the sessions begin with each member reporting on the
assignment proposed the previous week. Following this, successes are
rewarded with approval by the therapists and members, while failures are
discussed. The assignment for the foll owing week may be formulated
based on the report. Special problems will evoke discussion in the group.
Group members are asked to keep their own records of assertive incidents
that they indulged in during the past week.
Special exercises are employed with role-playing depending on the
problems of individual members, such as talking in a loud voice, behaving
unpleasantly, telling an interesting story, expressing a warm feeling
toward other group members, and practising progressive expressions of
anger. Thes e exercises include reading dialogues and portraying an angry
role, improvising one’s own dialogue, and role -playing scenes from one’s
life and experience. Thus, about 5 to 10 minutes of each session is spent
doing these exercises over a period of 4 -months . Thus, roughly 10 to 15
minutes may be used for systematic group desensitization from a common
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94 members formulate their own next assignment or if they are blocked, this
is suggested.
Tens ion and Symptoms like Insomnia:
Relaxation methods may be employed in a group for the relief of tension
and symptoms like insomnia. In this case, any of the hypnotic or
meditational methods explained by Wolberg (2005) may be utilized which
will have the b est impact in a group atmosphere.
Phobia:
Group behavioural methods are remarkably successful in treating phobias
to which persons with phobias respond well. Here, the clients’ selection
must also be homogeneous as in assertive training. Aronson (1974)
describes a program designed for fear of flying that has been successful in
treating 90% of his clients completing it. In this program, initial individual
consultations are geared toward establishing a working relationship with
the clients and essentially fo r doing a behavioural analysis. A high degree
of motivation for the clients is desirable in this program in which they may
be asked how much they want to get over that particular fear. For this
purpose, the therapist structures the program in the first ses sion as follows:
 First five sessions – for a discussion of fear of flying.
 Next one or two sessions – for educational briefings with safety
experts, pilots, and other air personnel to answer questions.
 Next seven to eight sessions – for discussion and meth ods of
overcoming the fears.
The optional size of the group is 8 to 12 persons and the meetings are
conducted for 1½ hours once a week. Also, pre -session and post -session
meetings of ½ hour each without the therapists may be recommended, in
which reading m aterials on air travel and development should be made
available. Besides, the following rules are defined for the group members
suffering a phobia:
In the first session - each member will be permitted to talk freely about their
existing fears within the ti me limitation
In the second session - each member is asked to bring in a drawing depicting
the most pleasurable aspect that he or she can imagine about a commercial air
flight and a second drawing depicting the most unpleasant consequences.
The individuals are also invited to talk about any personal dreams about
travel. However, neither any associations nor interpretations regarding
defences are encouraged in recounting such dreams.
Some exercises aimed at anxiety control, offered by some researchers, are
also introduced in these sessions. They are described (in Wolberg, 2005)
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95 Techniques In Group - II Exercise 1 - based on Wolpe (1969): While lying down or seated comfortably on a chair, visualize all the sensations and anxieties you experience while on a plane. Simply visualizing yourself on a plane may make you anxious at first. You may find yourself wanting to avoid thinking about it. If so, let your mind dwell on pleasant thoughts for a while. As soon as you feel somewhat more relaxed, reenter the fantasy of being anxious on a plane. Focus initially on the least frightening aspects of flight. Gradually allow yourself to visualize more frightening fears. Each time you practice this exercise, you will be able to get closer to the dangerous situation and stay with it longer. Do this exercise twice a day for a week. Exercise 2 - based on Perls (1969): Picture yourself in the most pleasant situation you can imagine. Let your mind dwell on this situation as long as possible. Then imagine yourself on a plane. Some of the positive feelings you experienced in your fantasy will come back with you and help calm your anxiety when you next imagine yourself on a plane on the ground or actually flying. Exercise 3 - based on Perls (1969): Visualize the most unpleasant situation you can possibly think of a situation even more unpleasant to you than being on a plane. You will find that when you leave this fantasy and imagine yourself flying or actually on a flight, you will experience less anxiety.
{Source for the exercises: Wolberg, L. R. ( 2005). The Technique of
Psychotherapy Part I and II: NJ: Jason Aronson, Inc.}
 In case, any of these exercises stir up anxiety, the members must
indicate in order to prevent it from getting too deep.
 In case, group members start feeling strongly hostile to each other, the
therapists encourage verbalization and explain that strong, positive
feelings among all group members will be necessary for success.
 Talking about personal matters other than those related to fears of
flying should be discouraged.
 After the fourth or fifth session – one or two educational sessions are
held with local airline representatives to answer technical questions
about flying and safety measures.
 After the eighth session – the entire group visits an airport, and if
possible, meets in a stationary airliner for about 1 hour. Here, group
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96  Around the tenth and twelfth session – the group leader suggests a
target date for a short flight. This date can be temporarily postponed if
too much anxiety prevails and until it recedes. During this period, the
leader must set the time with the airline representatives and
accompany the group. After the flight, the group reconvenes to
discuss the reactions.
 Finally, group members are encouraged to arra nge their own flights
and to continue in group therapy for a few sessions thereafter.
The ideas of this program can also be adapted to other phobias, such as
fear of cars, ships, elevators, tunnels, bridges, high places, etc., in a group
setting following this format, considering the nature of the target symptom
and introducing essential modifications accordingly. Videotaping and
playback also may be employed in the sessions.
6.2.4 Experiential Therapy in Groups:
Experiential therapy is of two types: Encou nter therapy or Marathon
therapy. Its traditional model focused on inspiration, education, and
insight acquisition. Later it is supplemented by groups whose objective is
experiential with a wide variety of techniques. Many names have been
given to these ne w arrangements including Gestalt, human 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 off for sleep (marathon groups).
Encounter Group Therapy:
Like any other form of group therapy, encounter therapy may be an
ongoing process or it may be brief, from one to a dozen sessions. A
constructive group experience with a small group of people can be most
healing to the participants, when group members are educationally on a
relatively equal level and permit themselves to disclose their self -doubts
and personal weaknesses. In such therapy sessions, interpersonal
confrontations may even ultimately bring the individual into contact with
denied aspects of himself or herself, which may be temporarily upsetting.
In a group, a person can expose himself to others and reveal fears and
desires of which he or she is ashamed, wi thout being rejected or ridiculed.
This leads person’s acceptance of himself or herself with all of the flaws,
rather than for the pose presented to the world. Thus, as communication
between the members broadens, they share more and more their hidden
secre ts and anxieties. They begin to trust and accept themselves as they
learn to trust and accept the other participants.
Such frequent “encounters” in the group further will probably sooner or
later release underlying patterns of conflict, such as hostility toward
certain members, excessive tendencies to defy and obstruct, inferiority
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97 Techniques In Group - II that have little to do with the immediate group situation. However, they
are manifestations of funda mental characterologic flaws.
Encounter groups are organized on a long -term basis and focused on
neurotic symptoms and intrapsychic processes. Under the guidance of a
skilled group leader, the encounter group becomes a means through which
the members becom e aware of how they are creating many of their own
troubles. Thus, people become able to correct some of their
misperceptions by talking things out and they accomplish an educational
realignment that challenges certain attitudes and teaches the person how to
function better in certain situations. Thus, 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, and worked through their resistances to change.
There is some evidence that shows that the encounter group experiences
may have a therapeutic effect on neurotic personality structure. However,
in the Postgraduate Centre for Mental Health, Wolberg (2005) observed
that personality c hanges are temporary when they occur during encounter
group therapy sessions. However, they disappear rapidly in case of some
participants once they leave the encounter group and return to their
habitual life setting. In many instances, the encounter group makes
individuals alert regarding many neurotic shortcomings and motivates
them to seek psychotherapy on a more intensive level. Many of the
apparently cured clients are likely to ask for thorough psychotherapeutic
help, once they have the hints of their problems.
Marathon Group Therapy:
In the usual marathon group, members are exposed to a 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 s loughing off of defences. In the last hours, “feedback” is
encouraged in which the therapist directs the clients to utilize the
understanding of themselves to verbalize or execute certain constructive
attitudes or patterns. In such groups, highly emotional outbursts are
encountered with this intensity of exposure, where corrective emotional
experiences seem to occur. The therapists participate actively with the
group, and express their own reactions to the members. However, they
avoid interrupting personal needs and problems. A variety of techniques
with a combination of theories and methods, such as Perls’ Gestalt
therapy, Freud’s unconscious motivational ideas, Rolf’s structural
integration and body balance, Lowen’s bioenergetic theory, Moreno’s
psychodram a, Shutz’s encounter tactics, and other sensitivity training
methods (Quaytman, 1969) may be employed in the sessions,
Experiential therapies are sometimes resorted to by psychotherapists when
their clients have reached a deadlock in individual or group th erapy. There
are circumstances, where some clients seem unable to move ahead,
productivity reduces, boredom develops and motivation to continue
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98 or a weekend marathon therapy have be en found suddenly to open them
up, produce more and more fresh material to work on and offer more
enthusiasm for continued treatment. In experiential group therapy, the
emotional stability of the therapist, control of countertransference, and the
presence of a trained co -therapist are vital.
The individual entering an experiential or marathon group is generally
instructed about his or her responsibilities 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 lifestyle, that there
may be new and better ways of relating that one can learn. Sometimes a
contract also may be drawn up with the clients in an experiential group
therapy based on the changes persons desire to achieve. Also, emphasis is
on the “here -and-now” rather than on the past.
Techniques in Experiential Group Therapy:
Encounter techniques vary with the inventiveness of the leader. Some of
the techniques used are as follows:
 Members in a small g roup may be asked to “go around” and give their
impressions of all the members – both, positive and negative.
 Members may be asked to draw anything that represents how they
feel and also how they would like to feel by utilizing art materials
(crayons, chal k, pastels, etc.). Later, the group associates with or
discusses these productions.
 Two members may be asked to approach each other in front of the
group and to communicate in nonverbal terms (i.e., touching,
gestures, facial expressions, etc.). The group discusses the nature of
communication.
 “warm-up” and other techniques described by Schutz (1967): i)
Encourage the client to stand with the back to the therapist and to shut
the eyes and fall straight back with trust that the therapist will surely
prevent falling. This will help the person give up rigid controls and
distrust of others. ii) Invite the clients to stretch out on a couch and to
have them lifted by many hands and passed along, their bodies being
stroked in the process.
Negative outcomes with ex periential groups are also to be expected in two
circumstances: i) when the superficial screening of the participants takes
place, and ii) when a large number of untrained leaders contacting these
groups have a few or no limits on the selection of techniqu es.
In experiential group therapy, factors such as close contact, the extended
time period of interaction, the developing fatigue, and actual and implied
pressure for change; all lead to the uniqueness of the experience.
Motivation for change may be incre ased as the individual realizes the
consequence of one’s acts on the reactions of others.
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99 Techniques In Group - II 6.2.5 Psychodrama and Role Play in Groups:
In 1925, Moreno (1934, 1946, 1966b) first introduced a useful group
therapy method, called “psychodrama,” created by him a nd it has later
evolved into several clinical methods, including sociodrama, the
axiodrama, role -playing, and the analytic psychodrama. Many of these
have been incorporated into modern Gestalt and experiential therapy (i.e.,
encounter, and marathon therapy ). Psychodrama is a valuable addition in
the hands of a skilled therapist for helping clients work through resistance
and translating their insights into action.
The initial tactic called the “warm -up” process in the group facilitates
movement. Psychodram a is thus characterized by the three warm -up
methods or processes as described below in brief:
1. “Cluster warm -up”:
In this process, the director (the therapist) insists that the group remains
silent) for a period. As tension increases, it will finally b e broken by some
member who complains about a problem, that is, 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 around a
common theme. Then a “star” is chosen in a group, who is the person
whose personality reflects the problem area most clearly.
2. “Chain of association warm -up”:
In this warm -up method, an engrossing theme evolves w hen the group
spontaneously brings up fears and associations. Here, the star chosen
person is the one who is most concerned with the theme; and
3. “Directed warm -up”:
This warm -up, as the term suggests, is initiated by the director. It is of two
types. In the first directed warm -up method, the therapist, who knows the
problems of the constituent members, announces the theme. On the other
hand, in the second method called the “patient(client) -directed warm -up”,
the client announces to the group the subject/ theme with which he or she
would like to deal.
Thus through these three warm -up processes, the star is groomed for the
roles to play with representatives of important people in the client’s past
and current life, selected from other group members (“auxili aries”) whose
needs for insight preferably fit in with the parts they assume.
The director, on the other hand, facilitates the working together of the
group on their problems while focusing on one person (the “protagonist”).
Among the techniques used in th is group therapy are:
• “Role Reversal”: A protagonist and auxiliary reverse positions. munotes.in

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100 • “The Double”: Another member seconds for and supports the
protagonist;
• “The Soliloquy”: It is characterized by a recitation by the protagonist
of self -insights a nd projections; and
• “The Mirror”: Auxiliary egos portray what the protagonist must feel.
In Psychodrama group therapy, the members are helped to break through
blocks in their perceiving, feeling, and acting by forcing themselves to
verbalize and act pa rts. Sometimes the therapist, as a director, decides
which life situations from the clients’ history are to be re -enacted in order
to work at important conflictual foci.
Often, a technique is followed that is assumed by the “auxiliary egos”.
Auxiliary ego s are the trained workers or former clients “standing in” for
the client and spontaneously uttering ideas and thoughts that they believe
the client may not yet be able to verbalize. They are best recruited from
those persons present in the group who come f rom a sociocultural
environment similar to that of the clients and portray the client’s own
internal figures, forcing the patient to face them in reality. This helps the
client to bring his or her personal and collective drama to life and correct it
(Moren o, 1966).
During psychodrama, the therapist as a director may remain silent or add
questions and suggestions, when the clients re -enact the situation – the self
role as well as other significant persons in their life, such as parents and
siblings. Materia l elicited during psychodrama is utilized immediately in
the presence of the “actor” client and the group “audience”. An
emotionally cathartic value of this technique also may help the clients
understand problems revealed by their personal actions and thou ghts as
well as those reflected by other group members. The clients often get
desensitized to inner fears, achieve hidden wishes, prepare for future
contingencies, and otherwise help to resolve many deeper problems and
conflicts as a result of venting feel ings and fantasies in the role of the
actor.
Different props, called “auxiliary chair” and “magic shop” are sometimes
used in psychodrama group therapy. An auxiliary chair may represent an
absentee personage. By using this prop, living or dead family memb ers
may be portrayed by several empty chairs around a table, where each chair
in fantasy is being occupied by a different relative. On the other hand, in a
magic shop, the shopkeeper distributes imaginary items to all group
members, cherished by each in ex change for values and attitudes that are
to be identified and surrendered by each member.
Role reversal is a useful technique in psychodrama. In this technique, two
related individuals, for example, take the role of one another arguing how
they imagine th e other feels or portray the behaviour of the other. Here, a
protagonist is involved emotionally with an absent person, who (latter)
may be portrayed by an auxiliary ego. In rehearsal of future behaviour,
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101 Techniques In Group - II situation that necessitates the implementation of skills or the defeat of
anxiety that is presently felt to be unmastered. Thus, verbalizing inner
doubts and fears through psychodrama and attempting the task of
overcoming them may facilitat e it for clients through actions in real life.
The controlled acting -out of fearsome strivings and attitudes helps for
their clarification. In this technique, a protagonist, who is burdened, may
be encouraged to swing away at imagined persons who obstruct. This
offers the clients an opportunity for psychodramatic and sociocultural
reintegration. Thus, the psychodrama technique has given rise to several
role-playing methods that are being applied to education, industry, and
other fields. Let us understand th e psychodrama technique with the
following example: Example 6.1: A group of four participants and a group leader may be observed by four observers who sit apart from and at the back of the participants. Initial interviews of 1 hour with each participant and observer are advantageous to determine motivations, expectations, and important psychopathological manifestations. Preliminary mapping of the procedure considers group combinations, problems to be considered, objectives and desired modes of interaction. A short warm-up period is employed at the beginning of each session to establish rapport. Then the participants are assigned roles in a selected conflict situation. A discussion by the group of the issues involved with the description of possible alternative courses of action is followed by the leader’s interpretation of why various participants reacted the way that they did. Repetition of the conflict situation with the same participants offers them an opportunity to try out new adaptive methods and tests their capacities for change. It also fosters reinforcement of a new mental set. At the end of the session, the group leader renders ego support in the form of praise for individual contributions and reassurance to lower any mobilized tension or anxiety. Approximately six 1-hour group sessions are followed by individual consultation with each member to determine ongoing reactions. Another series of six group sessions, or more, may be indicated. These procedures, while effectively altering attitudes and promoting skills, may not bring significant changes in the basic personality structure. munotes.in

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102 {Source: Wolberg, L. R. (2005). The Technique of Psychotherapy Part I
and II: NJ: Jason Aronson, Inc.}
After discussing various important aspects of group
therapy/ps ychotherapy in two consecutive chapters, we will have a glance
at some criticisms of group therapy/psychotherapy at the end of this
chapter. Though group psychotherapy has contributed significantly to
treating multiple individuals at the same time for the same problem faced
by them, the quality of change in group psychotherapy is criticized for the
following aspects:
• Changes in group psychotherapy are dramatic, for example, the
attacking and aggressive person becomes quiet and considerate, the
dominant in dividual shows abilities to be submissive, etc.
• These and other such effects will become apparent, sooner or later, as
products of both group dynamics and the interpretive activities of the
therapists and group members. However, whether a transfer of
learning in the group will take place in the outside world and whether
it is sufficient to influence a better life adaptation - is questionable.
• The role played in the group is different from the roles in other
situations.
• The group expects one to behave in certain ways and one obliges.
Thus, it often offers the individual protection from the harsh realities
of the external world.
• Though one can “be oneself” in the group, defences may be checked
in the therapist’s office, and when leaving the therapist’ s office or the
group during the post -session and alternate sessions. Because there
are chances that one may reclaim the previous defences once the
person leaves the group. This truly indicates that interpersonal change
is not equivalent to intrapsychic ch ange.
• Thus, the former changes during group therapy may merely reflect the
acquisition of a new set of social roles that the individual is tied to and
that enhance the repertoire of patterns.
• It is argued rightly that intrapsychic changes are possible if the person
has the courage appreciably to test the changed assumptions and to
apply new learning in the group to the other roles played in life.
These criticisms reflect that though group therapy offers the advantages of
the group in healing various pr oblems in life and offering some good
benefits to the individuals, they still have some downsides, when it comes
to transferring the skills acquired in the group to real -life situations.
6.3 SUMMARY The present chapter imparted knowledge about the variou s special
problems or situations that should be dealt with during group therapy and
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103 Techniques In Group - II include some tendencies of clients and situations, for example, the silent
patients/clients, the mon opolizer, habitual latecomer, etc. Such behaviours
of the group or group members challenge the therapists’ skills and further
illustrate the need for therapists/counselors to learn effective leadership
skills.
We briefly learned about different group thera py approaches, such as pre -
intake groups and post -intake groups, and special age groups, such as
children and older people. We also learned about the application of
behaviour therapy, experiential therapy, and psychodrama and role -play in
the group setting in detail. In behaviour therapy, we had a glance at some
important operations in group behavioural treatment outlined by Goldstein
and Wolpe (1971) which include feedback, modelling, behaviour
rehearsal, desensitization, motivational stimulation and socia l
reinforcement. We also looked at the conditions in treating various
problems (i.e., habit disorders, lack of assertiveness, anxiety and
insomnia -like symptoms, and phobia) in group therapy along with some
behavioural techniques and exercises.
In experie ntial therapy, we learned about encounter group therapy,
marathon group therapy, and different techniques used in experiential
group therapy in considerable detail. In psychodrama and role play, we
learned about “warm -up” processes before starting the actu al group
therapy sessions. We learned about different props used in psychodrama
and role play, such as “auxiliary chair” and “magic shop”; and different
techniques used, such as role reversal, rehearsal of future behaviour, and
controlled acting -out. At th e end of the chapter, we also looked at some
criticisms regarding group therapy, despite its many advantages.
6.4 QUESTIONS 1. Discuss special problems during group therapy.
2. Discuss behaviour therapy in the context of group therapy.
3. Discuss experient ial therapy in the context of group therapy.
4. Discuss psychodrama and role play in the context of group therapy.
5. Write short notes on:
a) Pre-intake and Post -intake groups
b) Special age groups for group therapy
c) Techniques in Experiential group the rapy
d) “Warm-up” processes in psychodrama
e) Criticism of group therapy/psychotherapy.
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104 6.5 REFERENCES  Wolberg, L. R. (2005). The Technique of Psychotherapy Part I and II:
NJ: Jason Aronson, Inc.
 Jacobs, E. E., Schimmel, C. J., Masson, R. L., & Harvill, R . L. (2016).
Group Counselling: Strategies and Skills (8th Ed.). Australia:
Cengage Learning.

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105 7
INTERVENTIONS EMPHASIZING
INTEGRATION, ECLECTIC SYSTEMS,
MULTICULTURAL PERSPECTIVES – I
Unit Structure
7.0 Objectives
7.1 Introduction
7.2 Integrated and eclectic interventions
7.2.1 Reasons for the Growth of Integrated and Eclectic Approach
7.2.2 Na ture of Integrated and Eclectic Approaches
7.2.3 Integrating Treatment Systems
7.2.4 Formulating an Integrated and Eclectic Treatment System
7.2.5 Skill Development: Treatment Planning
7.2.6 Benefits of Integrated and Eclectic Approaches
7.2.7 Challen ges of Eclectic and Integrated Approaches
7.3 Effective Multicultural Counselling
7.3.1 Historical Context
7.3.2 Theoretical Principles
7.3.3 The Practice of Multicultural Counselling
7.3.4 Non -Western Theories and Techniques
7.4 Summary
7.5 Quest ions
7.6 References
7.0 OBJECTIVES After reading this chapter students will be able
• To understand the Integrated and eclectic interventions
• To learn Effective Multicultural Counselling
7.1 INTRODUCTION Apart from traditional therapies that we have le arnt before, there is a
growing popularity of two other approaches, viz., integrated and eclectic
interventions Apart from that as the world has become one due to
globalization and people are not hesitant to migrate to other countries in
search of better l ife, multicultural counselling, has also become crucial
part of effective counselling. In this chapter we will discuss each of these
topics.
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106 7.2 INTEGRATED AND ECLECTIC INTERVENTIONS When a therapist chooses intervention techniques from various theories
and combines them in one intervention program that is best suited to the
specific needs of the client. It is called integrated intervention. It is free of
theoretical orientations. Eclectic intervention, on the other hand, refers to
combining, in a systema tic manner, compatible features of various types
of interventions, even if these interventions are from incompatible
theoretical orientation and then combining them into a harmonious
composite intervention.
7.2.1 Reasons for the Growth of Integrated and Ec lectic Approach :
Integrated and eclectic therapies are growing in popularity for various
reasons. Prochaska & Norcross (2007) has identified around 12 reasons as
mentioned here -
1. Though a vast number of intervention techniques (more than 400
hundred identifiable techniques) have mushroomed up but none of
them can individually capture the whole gamut of human experiences
across the entire life span.
2. There is a growing trend of clients coming from variety of
sociocultural backgrounds and having mu ch more complex problems.
To provide effective intervention, the therapists need to pay attention
to sociocultural aspects of client’s life instead of focusing on only
internal factors within a person that may be causing the problems.
3. There is a grow ing realization that in spite of having variety of
intervention systems, none of these systems are self -sufficient in
successfully taking care of all problems of the clients.
4. The growing importance of solution -focused brief approaches that
encourage cl inicians to draw on and combine interventions from
various systems of therapy to find the most effective and efficient
strategy for each treatment situation
5. Due to technology advancement, clinicians have ample opportunities
to get educated and trained through case studies and other informative
literature. This gives them a chance to study, observe, and gain
experience in numerous intervention approaches.
6. Many state and national credentialing bodies has also made it
mandatory for clinicians to be a t least post graduate as well as to keep
acquiring further credits through continuing education so that there is
continued professional growth and development of new skills and
ideas.
7. Many stake holders such as managed care organizations,
governmental agencies, consumers, etc., are demanding accountability
of the clinicians to provide effective and efficient intervention for
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107 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I treatment approach for each client, through planning and docu menting
their work for better transparency and accountability.
8. There are very strong empirical evidences indicating which
treatment approaches have greater potential to successfully treat
particular people, disorders, or problems (Seligman & Reichen berg,
2007).
9. Manuals giving details of empirically validated treatment plans for
specific mental disorders are easily available in abundance.
10. Organizations such as the Society for the Exploration of
Psychotherapy Integration have come up that fo cus on studying and
promoting treatment integration.
11. There are many models available now that give directions for logical
and therapeutically sound integration of treatment approaches.
12. Even therapists have become more aware to the fact that common
factors among various intervention programs such as therapeutic
alliance, are as important for the success of the treatment as are
specific strategies.
7.2.2 Nature of Integrated and Eclectic Approaches :
Initially by using the term eclectic orientation, c linicians meant that they
have taken techniques from more than one intervention approaches.
While some of the clinicians using eclectic approach were very clear about
the reason for drawing from various theoretical approaches and combining
them into one i ntervention program, others did it in illogical, muddled and
disjointed manner. Eysenck (1970) called it lazy eclecticism, a sign of
non-professionalism and ignorance.
Types of Eclectic and Integrated Approaches
There are four identified types of eclectic ism –
1. Atheoretical eclecticism – refers to having a combination
intervention without any predominant theory of change as a base. If a
clinician does not have logical base for combination intervention,
there can be problems of clients being confused an d doubting a
clinician’s competency, clients being demotivated and non -
cooperative and problem of treatment failure.
2. Common factors eclecticism is based on the premise that there are
some common elements that promote growth and bring change in a
client. These elements are communicating support, empathy, and
unconditional positive regard.
3. Technical eclecticism – is an organized mixture of interventions.
These parts of interventions are taken from different treatment
systems purely on empirically t ested research basis and may or may
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108 interventions. However, this approach is criticised as it is not a
rational model for human development and growth.
4. Theoretical integration – it gives a co nceptual structure for
combining two or more treatment approaches to understand clients in
a better way and to provide effective treatment. Instead of paying
much attention to technical aspects, it pays attention to theoretical
base.
7.2.3 Integrating Tre atment Systems :
Many clinicians follow their own logic for making a combined
intervention program instead of systematically integrating the compatible
theories.
Mostly theories are combined on the basis of (1) cognitive and
behavioural treatment systems, (2) humanistic and cognitive approaches,
and (3) psychoanalytic and cognitive approaches (Prochaska & Norcross,
2009).
Characteristics of Sound Integrated and Eclectic Approaches :
Sound eclecticism has the following characteristics:
i) They build on the strengths of existing theories,
ii) They create a logical and orderly combination of theories to make a
unified whole.
iii) They work on fundamental principal of human behaviour and
development,
iv) A philosophy or theory of change,
v) Logic, guide lines, 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.
7.2.4 Formulating an Integrated and Eclectic Treatment System :
While designing an integrated or eclectic treatment system, clinicians need
to pay attention to many questions, such as:
1. The theory under consideration is based on which model of human
development?
2. How this treatment approach will promote the most beneficial change
in the client?
3. During interview which informational inputs should be focused on? munotes.in

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109 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I 4. What is the take o f this approach on the past influencing present and
how the clinician should deal with past experiences and difficulties,
faced by the client, while designing intervention program have of the
influence of the past on the present?
5. What is the role of i nsight in bringing change, and how the insight can
be improved during the treatment?
6. Do emotions play any role in bringing about a change and how can
intervention program help a client to identify, express and modify his
emotions.
7. Which dysfunct ional cognitions are contributing to current problems
and how they can be modified to help a client to deal with his
problems.
8. Which self -destructive and unhelpful behaviours are leading to
problems and how they can be modified to bring change.
9. What sorts of people and problems are likely to respond well to this
approach?
10. In what treatment settings and contexts is this approach likely to be
successful?
11. Can this approach be used for people coming from multicultural
backgrounds?
12. What i s the place of diagnosis and treatment planning in this
approach?
13. What are the overall goals of treatment?
14. Which types of therapeutic alliances and client -clinician interactions
are most likely to be productive?
15. To use this approach, which cl inical skills are essential?
16. Which other interventions and strategies can match with this
treatment system?
17. What modifications are needed in using this approach while dealing
with individuals, Families, or Group?
18. What will be the duration of this treatment?
19. What are the parameters for determining when to conclude the
treatment and to measure its effectiveness?
20. Is this treatment system has sufficient empirical evidence in favour of
it? What other information is required to enhance its value?
7.2.5 Skill Development: Treatment Planning :
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110 Treatment planning serves the following four purposes (Seligman, 2004a):
i) A treatment plan that has strong empirical evidence and has been
carefully designed is more likely to succeed.
ii) If the goals of the treatment and the ways of achieving those goals are
specified, it is easier for the clinician as well as the client to assess
whether progress is made towards achieving the goal and if t he
progress is not there, what changes should be incorporated.
Treatment plan is not considered as a finished product to be used,
instead it is considered as a work in progress.
iii) If the treatment is planned carefully, both client and the clinician w ill
have realistic expectations from the plan and will be hopeful about its
success.
iv) Making treatment plan is essential especially in case of integrated or
eclectic approaches used by the clinician. Such a treatment plan will
draw techniques from var ious theories and combine them into a
cohesive whole one piece that will address all the concerns of the
client.
A comprehensive treatment planning includes 12 steps:
i) Diagnosis: First of all the clinician must make 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 : After determining the diagnosis, both clien t
and clinician must together determine and write down the objectives
of the treatment that takes care of the diagnoses and problems
presented by the client.
iii) Assessments: Very often clinicians use assessment tools to ensure
that they are making accu rate diagnoses and establishing worthwhile
and viable objectives, to measure progress.
iv) Clinician: One also needs to look what type of clinician are more
likely to work more effectively with a given client. This refers to the
match between client and clinician characteristics or attributes.
v) Location of treatment : While planning the treatment, it is also
important to determine whether the treatment should be inpatient,
outpatient, or an alternative such as a day treatment program.
vi) Interventi ons: The clinician needs to state which treatment approach
will be used (e.g., cognitive therapy, solution -focused brief therapy,
Gestalt therapy).
vii) Emphasis : None of the clinicians work in identical manner. Each one
has his/her own style. Their styl es differ from each other as well as
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111 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I viii) Number of people seen in treatment. The treatment plan must state
whether individual, family, or group therapy will be the primary mode
of intervention.
ix) Timing : The treatment plan also needs to specify four scheduling
aspects of the therapeutic process: the length of each session, the
frequency of sessions, the duration of treatment, and the pacing of the
treatment process.
x) Medication : Psychologists, counsellors, and social wo rkers often
work along 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.
7.2.6 Benefits of Integrated and Eclectic Approaches :
Some of the advantages of integrated and Eclectic interventions are as
follows:
1. Integrated and Eclectic interventions are more flexible than other
treatment proce ss. They allow clinicians to make client specific
intervention plans to ensure a well fitted treatment for client.
2. Integrated and Eclectic interventions allow clinicians to be sensitive
to clients’ culture and context while planning their integrated
intervention programs and this shows their multicultural competence.
This approach is highly successful with clients belonging to non -
dominant cultures.
3. Clinicians using this approach can cater to a wider spectrum of people
and problems than those workin g with single theoretical orientation.
4. This approach permits clinicians to design intervention according to
their own beliefs about human growth and development, personality
and also to work as per their natural style.
5. It allows Clinicians to be a practitioner as well as researcher and
based on their experiences in using various orientations in a scientific
manner they can design programs that have face validity as well as
strategies that they have proven to be successful with other clients.
7.2.7 Challenges of Eclectic and Integrated Approaches :
It is easier for a counsellor to use any one specific theory for intervention
than to use an eclectic or integrated theoretical orientation for intervention.
Use of single specific theoretical orientation requires expertise in a limited
area while use of integrated or eclectic theoretical orientation requires
expertise in number of intervention systems for an effective treatment plan
for a particular client. It is next to impossible for any clinician to dev elop
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112 all kinds of problems. Clinicians who want to use eclectic or integrated
orientation need to delineate the scope of their practice.
They must carefully think through thei r 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 tradeǁ 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.
They must carefully design a client specific treatment plan for each client
to make sure that various discordant parts of treatment merge seamlessly
as whole into a chosen intervention. The intervention should not appear as
a me re collection of divergent parts, it should be a coherent composite unit
of intervention, that is well planned and has firm moorings in strong
theoretical and empirical evidence.
7.3 EFFECTIVE MULTICULTURAL COUNSELLING While interacting with the clients , counsellors trained in traditional
theories such as psychoanalytical, behaviouristic and even humanistic
theory pay attention to the client himself and overlook his social cultural
background. There are two reasons for it –
a.) the counsellor himself b elongs to western culture which emphasizes
on individualism. Even the traditional theories tend to overlook or
underplay the social cultural factors and look at individual as an
island.
b.) There has been over emphasis on positivistic, scientific view poin t
which demands objectivity and evidence for every thing happening to
around us. It emphasizes on generalizations. Consequently, instead of
treating every client as a unique person with his own web patterns of
personal and sociocultural contributors, couns ellors look for
similarities.
However, in real life, none of us are islands. By nature, human beings are
known to be social animals or species who survive and thrive in group or
community. A child is born in a cultural environment. One cannot
discount th e fact that culture dominates an individual’s each and every
aspect of life, as culture is multidimensional and dynamic.
Christopher went to the extent of saying that culture structures our thought
process, emotions and behavioural tendencies and also dete rmines the
moral framework in which actions will take place. It sets the parameter
for an individual to decide what should be considered normal or aberrant,
good or bad, what one should strive for and what should be avoided.
Human beings determine their self-identity and evaluate their self -worth
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113 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I culture gives definition of what it means to be a human. Even in
individualistic cultures, if we look beneath the surface, ‘we’ is mor e
important than ‘I’. In such a scenario, a counsellor will commit a folly if
he ignores the culture of a client.
Multiculturalism:
There are as many cultures as many societies exist within a country and
across the countries. Even within the same societ y, culture differs based
on gender, class, age, sexual orientation, disability, etc. For instance, J.
Sommers -Flanagan & Sommers -Flanagan(1997) suggested that children
have different culture than adolescents and adolescents have different
culture than adul ts. Multiculturalism refers to combination of cultures
across various cultures in different societies as well as to intracultural
differences within the same society. Psychologists who study the
similarities or universalities across cultures are known as t ransculturalists.
Multiculturalists acknowledge the fact that there are various different
cultures existing in different societies and there can be different cultural
layers within a culture too.
Multiculturalism is not just an academic exercise of unders tanding and
acknowledging various cultures, but its objective is to achieve social
justice too for everyone. One of its basic tenet is to ensure that no group is
oppressed and every group has equal opportunity. It opposes any idea or
behavior that is again st the principle of social justice - D.W. Sue et al.
(1999).
As mentioned before, previously three schools of thought - psychoanalysis,
behaviourism and humanistic theories dominated the field of
psychotherapy, but now theories of multiculturalism are acc epted as the
fourth force that influences psychotherapy. Some psychologists have
argued that all counselling is multicultural oriented and there is no need to
have separate theories of multiculturalism. This argument ensures that
existing injustices throug h cultural norms are not challenged and
oppression that is going on for ages together continues. But there are other
psychologists who propagated that knowing the fact that culture is a strong
instrument to deny social justice, multiculturalism needs to be redefined to
ensure that discrimination based on race, religion, gender, sexual
orientation, class, etc. can be prevented. Now let us look at what is
multicultural counselling.
What Is Multicultural Counseling?
Derald Wing Sue (2008) defined multicultura l counselling 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
dimensions, 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
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114 Since multiculturalism is compa ratively a new field, its definition is also
still evolving. Let us look at the historical development of this field.
7.3.1 Historical Context :
Traditionally, psychological theories have been developed by white men.
These theories contain the views and interventions that are presented
through the white males’ perspectives. It is the dominant culture of
privileged white males who decided what is normal or abnormal, what is
good or bad for all people in the world. The concept of multiculturalism
originated from the realization that application of these traditional theories
of psychotherapy had disastrous outcomes when they were applied to the
psychological functioning of people from other cultures than western
cultures, white males who did not come from upp er or middle
socioeconomic class, non -males or were in the category of non -white
males.
It was gradually realized that there are other diverse world views too apart
from the world view of these privileged white upper -class males from
western culture. The definition of normality and abnormality, good or bad,
differs from culture to culture and is equally legitimate. The generalized
assumptions made by white male culture about the definition of normality,
intelligence level of non -whites and females reeked o f racism, classism,
ageism, and sexism. These racist statements at that period of history were
ironically passed off as being sensitive to multiculturalism.
For example, in a popular periodical, Southern Literary Messenger
published in 1843, it was submit ted that it is poor White race that suffers
immensely from slavery practice, while African American thrive from this
practice of slavery. It claimed that black people are happy to be slaves and
do not want to be free and white people go through tremendous suffering
to keep these black people as slaves.
In 1851, a doctor S. A. Cartwright announced that he has discovered two
new diseases, which takes place only in Africans. The first disease was
labelled as drapetomania and the second disease was called dysae thesia.
Dysaethesia makes Africans disobedient and disrespectful while
drapetomania leads to a strong urge to run away.
Freud too claimed that compared to men, women are psychologically,
morally and biologically inferior, and they can’t be cured for this inherent
weakness.
Terman (1916) who first authored the Stanford -Binet Intelligence Scale,
was convinced that there are racial differences in intelligence and children
of different race should be put in separate classes. He went to the extreme
of sayi ng that people from other races than white should not be allowed to
reproduce and increase their numbers.
Even in recent times, DSM III included ego -dystonic homosexuality as a
disorder and the acceptance of homosexuality is very much influenced by
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115 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I There are many such examples in history that show that dominant cultures
not only focus on, and define differences as inferiorities or mental
disorders, especially if these differences are irritants for the majority
cultural people. Growing resentm ent and opposition to such bigotries led
to rise of emphasis on multiculturalism.
Now, The American Psychological Association as well as the American
Counseling Association have divisions devoted to minority -ethnic issues;
diversity issues; gay, lesbian , and bisexual issues; and social justice
concerns. Since 1994, The American Psychiatric Association’s DSM also
has sections titled “Specific Culture and Gender Features” for each
psychiatric diagnosis (Mezzich et al., 1999). Yet, we can say that
multicult ural counselling is in its infancy.
7.3.2 Theoretical Principles :
Multicultural theories illuminate the importance of culture, while dealing
with the issues of psychological functioning, psychological distress, and
psychological well -being in mental heal th area (D. W. Sue, Bingham,
Porche -Burke, & Vasquez, 1999).
Culture by nature is multidimensional and dynamic. Psychologists are still
debating about what should be included in the definition of
multiculturalism. Therefore, there is no consensus among ps ychologists on
what should be the distinct principles of multicultural theories. Yet, on the
basis of certain commonalities in the theories, certain guidelines can be
offered as principles for general multicultur al theory. These principles are:
Principle 1:
All human beings are born and brought up in a specific culture (or set of
cultures). This culture influences our entire existence, in terms of our
cognition, affect and behavior. Belonging to a specific culture can either
enhance or reduce the life opp ortunities for a person. For example, as
discussed in historical context, a white person born in middle - or upper -
class family and being a member of dominant western culture will have
many subtle advantages and entitlements, purely on the basis of his
memb ership in that culture. People in dominant culture take these
privileges for granted and remain unaware of them, unless and until these
privileges are contrasted with people from another less dominant culture.
So, the first principle is that we all are sh aped by our membership of
certain culture and subcultures and cultural experiences. Depending upon
the membership, we will be either privileged ones or suffering from
various limitations.
Principle 2:
People differentiate between groups of people and keep mentally
segregating them on the basis of race, religion, sex, sexual orientation,
ethnicity, physical and mental disabilities, and socioeconomic status.
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116 Principle 3:
A multiculturalist viewpoint emphasizes that members of different culture
must hav e a better understanding of different cultural groups and must
also aim to treat all human beings equally irrespective of their cultural
identities, and practice the principle of social justice. Being habituated to a
particular culture, it is not easy for counsellors to practice this principle.
Theory of Personality:
Multicultural counsellors believe that basically the concept of personality
is a culture -bound concept as many aspects of intra - and interpersonal
functioning differ on the basis of culture.
Individualistic versus Collectivist Orientation
Whenever multiculturalism issue is raised, it basically refers to the
characteristics and pros and cons of Western culture in comparison with
Eastern and Asian cultures. Western culture is known to be indiv idualistic
culture while Eastern and Asian cultures are known to be collectivist
cultures.
Characteristics of Individualistic cultures –
• There is lot of emphasis on personal freedom of the individuals.
• It propagates that one’s own interests are more important than the
interests of the group and one should first take care of his own
interests. Being independent and protecting one’s autonomy is the
supreme goal of every individual’s life. Being independent is also
considered to be a highly desirable vir tue.
• An individual’s self -identity and personality are separate from family
and culture.
• Individuals derive their self -worth from accomplishment of their
personal goals and not group goals.
Characteristics of Collectivist cultures –
• It emphasizes on shared group values and norms.
• An individual’s self - identity and the personality are not independent,
rather they are shaped by group memberships.
• The needs and values of the group should be more important for a
person than his own personal needs .
• Members of collectivist culture assess their own worth on the basis of
achievement of group goals commonly held by all group members.
Problems with Individualistic Culture – Limitless individual freedom
without any consideration and respect for commo n goals can be
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117 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I personal rights without any consideration for personal responsibilities
towards others. If the freedom is defined in terms of having no restrictions
on choices and no persona l burden of responsibilities is seen as unfair, it
becomes a sure recipe for psychological and social disorders and disaster
for the society itself.
A counsellor coming from an individualistic culture finds it very difficult
to understand collectivist c ultural values and personality traits and is not
able to honour them in the counselling process.
Acculturation and the Infamous Melting Pot:
Acculturation is also known as ethnocultural orientation. At individual
level, acculturation refers to “a process of giving up one’s traditional
cultural values and behaviors while taking on the values and behaviors of
the dominant social structure” (Atkinson, Lowe, & Mathews, 1995, p.
131).
Garrett and Pichette (2000) have identified five cultural orientation types
within American Indian populations,. These are -
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 either traditional
Indian culture or mainstream society. He may speak both languages.
3. Bicultural. The individual is relatively comfortable and well versed
in both sets of cultural values.
4. Assimilated. The individual is aligned more toward the mainstream
social cultur e and is not much interested in traditional tribal practices.
5. Pantraditional. The individual has seen as well as may be adopted
mainstream values but has deliberately decided and put in the efforts
to return to traditional values.
a.) Role of Accultura tion in Personality Development:
For many decades, America was known to be a melting pot. It meant that
people coming from diverse cultures to America, eventually adopt the
main stream culture of America, that is, white male culture. In other
words, the c ontention was that gradually over one or two generation, the
minority group members will give up their native cultural ways, which are
inferior to white male culture and will adopt the superior white male
culture. For example, Michel Jackson left his black culture and tried to be
a white man.
However, a decade back, it dawned upon psychologists that in melting pot,
the cultures remain identifiable, minority cultures don’t disappear in
dominant culture. They coexist with dominant culture. As people of one
culture, mingle and marry people of another culture, their cultural and munotes.in

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118 racial identity remains a unique mixture of different cultures, at individual
level.
Counsellors realize that the personality of a person belonging to minority
community and living in d ominant culture will be very different from a
person belonging to dominant culture. The problems of identity and family
relationships and functioning become a significant problem for individuals
belonging to second generation of a minority group. The membe rs of
second generation (e.g. Michel Jackson) adopt the values and norms of
dominant culture that interferes with their family relationships and with
their identity.
Swartz -Kulstad and Martin (1999) identified five different contextual
factors that signi ficantly contribute to human behavior:
1. Ethnocultural orientation or acculturation, 2. Family environment, 3.
Community environment, 4. Communication style, and 5. Language usage
(see also J. Sommers -Flanagan & Sommers -Flanagan, 2003).
b) Theory of Psyc hopathology:
According to multicultural theory, cultural and social factors play a
significant role in psychopathology of a person. Multicultural
practitioners are hesitant and take their own time, to label a deviant
behavior as pathological. They first try to understand that deviant behavior
in the cultural context of the client and his family.
7.3.3 The Practice of Multicultural Counselling :
Das (1995) said that multicultural counsellors must keep in mind the
following points:
• The behaviour, value s, and beliefs of all human beings are determined
by their culture. Culture has significant influence on both – the client
and the counsellor.
• People belonging to minority culture have difficulty in getting mental
health services for two reasons – a.) most of the mental health
services cater to dominant culture and do not understand the ethos of
minority culture, b.) most of the counsellors belong to dominant
culture and are not sensitized to other cultural variations as well as
have very stem narrow at titudes.
• If the definition of culture is broadened to include not just the race,
nationality and ethnicity, but also gender, age, social class, sexual
orientation, and disability, then it is safe to say that essentially, all
counselling types are mult icultural counselling.
• While in dominant cultures, individuals seek help due to personal
problems, in minority cultures, individuals seeking help face problems
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119 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I • Though, a counsellor need not focus on cu ltural values and conflicts
originating from those cultural values, but he should be sensitive to
the fact that cultural factors contribute significantly to a client’s
personal conflicts. Therefore, it is important to be aware of client’s
cultural values a nd practices, even if client asserts that his present
problems have nothing to do with his culture.
Preparing Yourself to Do Therapy from a Multicultural Perspective:
To be culturally competent, all multicultural mental health professionals
must have fol lowing multicultural competencies as per guidelines issued
by The American Counselling Association -
1. Awareness and Acceptance:
Mental health professionals must be aware of their own cultural
background and experiences. They should be able to effective ly
communicate what it means to be a member of their culture. They must
increasingly become aware of their own biases and fears about others’
race, gender, sexual orientation, poverty, and/or religious beliefs, etc. and
accept others’ cultural practices an d beliefs as equally valid and worthy.
2. Knowledge:
They must realize that they need to seek specific knowledge about the
cultures of their clients. They must gather information about socio -
political history, challenges faced by the culture at present, and basic
cultural beliefs, values, and practices of their clients.
3. Skills:
They must realize that sometimes they can give more effective
intervention if they tweak or alter standardized techniques and strategies
as per the needs of clients from div erse cultures. They should also develop
the competency of recognizing their own inadequacy of dealing with
clients of certain cultures, and should refer those cases to other
professionals.
Pederson (2000) suggested that it is essential for a counsellor to keep
checking and rechecking throughout his life his own beliefs and
assumptions about other culture members.
Preparing Your Client for Multicultural Therapy :
At the beginning of establishing therapeutic relationship with the client, a
counsellor has to d ecide, when he should bring up the topic of differences
in their culture. If this topic is brought up too early in the sessions, the
client gets the impression that counsellor is trying to say that his culture is
superior to client’s culture or that counse llor is finding the causes of
client’s problems in his culture rather than personal life context. So, a
counsellor has to decide when and how to highlight the issue of culture
with the client. On the other hand, if a prospective counsellor is a member
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120 the dominant culture, he experiences unique challenges in preparing his
clients from a multicultural perspective. He has to deal with an unspoken
question of the client, whether this c ounsellor (who is from different
culture) will understand me enough to help me.
Assessment Issues and Procedures:
The American Counseling Association and the American Psychological
Association have specific ethical guidelines for multicultural assessment
Assessing members of other culture requires lot of awareness of cultural
differences, sensitivity to others’ culture, and training and experience in
assessment.
The counsellor has to decide the therapeutic goals and method of
assessment needed for the c lient’s problems, keeping in mind the culture
of the client. The idea of good health and good life differs from culture to
culture and counsellor should be sensitive to what is considered good life
and health from client’s cultural perspective. He must be able to assess
cultural specific as well as more general dysfunctional behavior or
problem of the client.
The counsellor has to be alert to any biases or prejudice that may
involuntarily take place in assessment of the client. He must be cautious
about not over diagnosing or underdiagnosing or misdiagnosing the
problems of clients.
Before starting the assessment of the client, the therapist must judge the
client as a cultural being and then choose a culture -specific tests
constructed in the client ‘s nativ e language, check the norms given for
interpretation and then administer the test in client’s preferred language.
Later, the therapist must interpret the results and give feedback to the
client appropriate according to his culture.
Specific Therapy Techn iques:
Multicultural counselling emphasizes relationship with the client, keeping
in mind his cultural background, instead of emphasizing standardized
techniques. Depending upon the ethnicity and culture of the client, the
technique to be used is decided.
S. Sue (1998) has detailed three specific skills for cross -cultural
therapeutic competency. These skills are:
Scientific mindedness: Therapists with scientific mindedness will
formulate tentative hypotheses about their clients instead of making
prematur e conclusions based on their prejudices.
Dynamic sizing: Therapists knows when to generalize and be inclusive in
attributing the client’s problems to his culture, and when to individualize
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121 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I Culture -specific expertise: Therapists must have knowledge of their own
culture as well as knowledge of the client’s culture, and use intercultural
sensitivity in an effective manner.
7.3.4 Non -Western Theories and Techniques :
Since most of the th eories in psychology have originated from western
countries, it is not surprising that western cultural ideas and values have
infiltrated the thought process and knowledge bodies of the countries, on
the other side of the globe too. Consequently, the biase s inherent in
western culture such as assigning premier position to masculinist,
individualistic, essentialist, and rationalist worldviews, creating an
imbalance. Most of the time, psychologists trained in these western
culture -based theories and therapies are not even aware of their own biases
and their tendency to ignore or look down upon the experiences that do
not fit in western cultural values. Very naively these psychologists believe
that empirical evidence presented by studies carried out in west, re present
the universal truth. The life experiences, needs, desires, frustrations, pain,
etc. experienced by people in the western countries are universal and
therefore the interventions applicable to them can be used for people from
other cultures too. But this is far from truth. Of late, there is a growing
realization that people from other cultures do differ in their needs,
motives, emotions, thought process, etc. In some way people are same all
over the world, and yet in some other ways they are distinct from each
other. Psychologists, first of all, must have a deeper understanding of their
own culture and they should also have deep understanding of other
cultures too, to which their clients belong. Having a deeper understanding
of others’ culture will sen sitize the psychologists at the biases inherent in
their own culture and in their own interaction with the client.
Instead of depending on evidence based universal truths, they will start
appreciating that psychological distress is a multidimensional
phen omenon. The causes and cures of psychological distress can be due to
philosophical -ethical, religious spiritual, ancestral -familial, and even
political considerations. For example, let us look at Buddhism, an eastern
psychological theory with philosophical moorings.
Buddhism:
Of late Buddhism and one of its main principles - mindfulness, have
become very popular among western counsellors. So, let us see what is
Buddhism and how it helps in counselling. Though there are Buddhist
temples, rituals and monks that give it a religious flavour but, Buddhism
does not believe in God or some higher power, rather it is an umbrella
appellation which covers various diverse practices. To that extent, it can
be termed as a non -theistic religion and applied philosophy.
Four Noble Truths taught by Buddha, are:
1. All Human beings are suffering in some way or the other, irrespective
of their geographical location, caste, colour, creed, religion, social and
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122 2. This suffering originate s from human beings’ desires, craving, greed,
attachments with worldly things. Desires or cravings, attachments
and ignorance are the root cause of human sufferings.
3. It is possible to overcome these sufferings through enlightment,
through realization and acceptance that there is nothing permanent in
life and to attain peace, one should detach oneself from impermanent
things or people.
4. If one follows the Eightfold Path, he will be able to overcome
suffering and live without attachments.
These Ei ghtfold paths are not hierarchical steps. Morgan (1996, pp. 57 –
58) categorized these Eightfold paths into three categories - wisdom,
morality, meditation.
Wisdom :
Right understanding/ Right View :
Perceive the world as it really is, without having any del usions.
Understand that sufferings are the outcome, the cause is in our mind.
Understand that in this world and in our lives, nothing is permanent,
neither objects, nor people and nor situations. Desire to have permanency
in life is the cause of sufferings . It leads to fear of losing what one has and
craving for something that one does not have.
Right thought/ Right Intention :
One should be unselfish and compassionate in thoughts. This will purify
his mind and heart and will lead to unselfish or detached acts that are full
of compassion.
Morality:
• Right speech – one should be disciplined and not indulge in lying and
gossiping or talking in such a way that will lead to ill feelings, hatred
or hostilities.
• Right action - One should not indulge in tak ing life, stealing,
committing sexual misconduct, and taking stimulants and intoxicants.
• Right livelihood – One should take up a meaningful job or adopt a
way of life that does not cause harm or injustice to other beings.
Meditation:
• Right effort – refers to developing mental discipline that does not
allow evil thoughts or actions to rise, if such evil thoughts or actions
is already taking place, put in a conscious effort to stop it and , and
encourages what is good.
• Right mindfulness – this refer s to paying full attention to what is
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123 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives – I • Right concentration – this refers to training the mind in meditation
stages.
Meditation and Mindfulness:
Meditation is nothing but seeking mindfulness by emptying one ‘s mi nd.
Mark Epstein (1998) very aptly differentiated the concept of emptiness in
western philosophy and in Buddhism. In Buddhism, emptiness refers to
“an understanding of one’s true nature, an intuition of the absence of
inherent identity in people or in thin gs”, while in western philosophy
emptiness refers to “a tortured feeling of distress, and absence of vitality, a
sense of being not quite real enough, of disconnection.” Mark Epstein
(1998) (p. 13).
Empirical research studies have found meditation and mind fulness to be
effective in treating addictions and pain. It has been successful in
advancing the holistic health of HIV and AIDS patients, and in the
treatment of people having borderline personality disorder.
Spiritual Psychotherapy: Spirituality and Cou nselling:
In Eastern and Asian culture spirituality is considered to be an integral part
of all human beings’ psyche and life. On the other hand, people from
western culture find it hard to accept the superiority of spirituality over
logical positivistic view. One of the criticisms against interventions based
on traditional theories such as psychoanalytic, behavioural, and
humanistic -approaches, is that they treat the patients but cut off those
patients from their spirituality.
So far very little empirica l work has been done to assess the link between
spirituality and counseling and psychotherapy.
Karasu (1999) believed that spiritual psychotherapy is very effective. It
emphasizes on individual differences and interventions have to be tailor
made to fit each client individually. No two clients can be treated in the
same way. In other words, there cannot be any standardized steps or
methods that can be documented in operational manuals. It does not
assume any causes and does not make any predictions that needs to be
validated empirically. It does not believe that anything needs to be
validated with objective evidences, instead it believes that effectiveness of
interventions are influenced by belief and faith.
7.4 SUMMARY In this unit we have studied integr ated and eclectic interventions, reasons
for the growth of integrated and eclectic approach, nature of integrated and
eclectic approaches, integrating treatment systems, formulating an
integrated and eclectic treatment system, skill development: treatment
planning, benefits of integrated and eclectic approaches, challenges of
eclectic and integrated approaches, effective multicultural counselling,
historical context, theoretical principles, the practice of multicultural
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124 7.5 QUESTIONS Q. 1 Discuss in brief skill development treatment planning
Q. 2 Write detail note on effective multicultural counselling
Q. 3 Short Notes
a) Reasons for the Growth of Integrated and Eclectic Approach
b) Benefits of Integrated and Eclectic Approaches
7.6 REFERENCE  Flanagan, J. S. & Flanagan, R. S. (2004). Counselling and
psychotherapy theories in context and practice: Skills strategies and
techniques. Hoboken, NJ: John Wiley & Sons, Inc.
 Corey, G. (2013).Theory and Practic of Counselling Psychotherapy:
Systems, strategies, and skills (3rd Ed.) Pearson Education.
 Seligman, L., & Reichenberg, L. W. (2010). Theories of counselling
and psychotherapy: Systems, strategies, and skills (3rd Ed.). Pearson
Education.

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125 8
INTERVENTIONS EMPHASIZING
INTEGRATION, ECLECTIC SYSTEMS,
MULTICULTURAL PERSPECTIVES - II
Unit Structure
8.0 Objectives
8.1 Introduction
8.2 Psychoanalytical, Adlerian, Person -Centered, Behaviour Therapy
from Multicultural Perspective
8.2.1 Psychoanal ytic Therapy from Multicultural Perspective
8.2.2 Adlerian Therapy from Multicultural Perspective
8.2.3 Person -Centred Therapy from Multicultural Perspective
8.2.4 Behaviour Therapy from Multicultural Perspective
8.3 Summary
8.4 Questions
8.5 Refer ences
8.0 OBJECTIVES After reading this unit students will understand:
• Psychoanalytical, Adlerian, Person -Centered, Behaviour Therapy
from Multicultural Perspective
8.1 INTRODUCTION In the previous unit we have dwelled in detail on multicultural
counse lling. Now let us look at some of the strengths and weaknesses of
Psychoanalytic therapy, Adlerian Therapy, Person -Centred Therapy, and
Behaviour Therapy in counselling practice from multicultural perspective:
8.2 PSYCHOANALYTICAL, ADLERIAN, PERSON CENTERE D, BEHAVIOUR THERAPY FROM
MULTICULTURAL PERSPECTIVE 8.2.1 Psychoanalytic Therapy from Multicultural Perspective
Strengths from a Diversity Perspective
1. With little bit of modification of the techniques used in
psychoanalytic therapy, it can be successf ully adapted to cater to
clients from diverse cultural backgrounds.
2. Irrespective of the cultural background, one thing common among all
people is that all of them have dealt with developmental crisis that munotes.in

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126 take place in various stages of development. W ith the help of
therapist, the client can re -examines the crucial events that took place
at every developmental stages of his life and evaluate how these
events have adversely or favourably affected his life.
3. Psychotherapists go through intensive train ing. This enables them and
be alert to their own sources of countertransference, including their
biases, prejudices, and racial or ethnic stereotypes.
Shortcomings from a Diversity Perspective:
1. Traditional psychoanalytic approaches are costly, and for many
people, the cost of treatment is beyond their means.
2. Psychoanalytic therapy is generally seen as being based on upper - and
middle -class values. All clients do not share these values.
3. Most psychoanalytic approaches have ambiguity as an ingrai ned part
of the therapy. This can result in ineffectiveness of the therapy,
especially if clients due to their cultural values expect direction from
an expert. For example, many Asian American clients may prefer
directive, problem -oriented approach to coun selling and may not
continue therapy if a nondirective or unstructured approach is
employed.
4. Intrapsychic analysis may be in direct conflict with some client’s
social framework and environmental perspective.
5. Psychoanalytic therapy is more concerned with long term personality
reconstruction than with short term problem solving.
6. Atkinson et.al. (1993) was of the opinion that therapists must look at
the possibility of any external sources contributing to clients’
problems, especially if clients hav e been in an oppressive
environment.
7. The psychoanalytic approach fails to sufficiently take care of social,
cultural, and political factors that may have contributed to an
individual ‘s problem. If the therapist does not keep a balance
between the exte rnal and internal causes of clients’ problems, he may
erroneously believe that client is responsible for his present problems.
The therapist can avoid committing such an error of judgement by
adopting the non -judgemental attitude propagated by the
psychoan alytic theory.
8. Psychoanalytic approach may not be suitable for low -income clients.
Clients from low income group have typical needs that are different
from high income clients. For instance, low income clients
approaches a counsellor only when there is a crisis situation and they
want either an immediate solution or some guidance about how to
solve their problems., Their most dominant immediate problem may
be related with their existential needs, such as need for housing,
employment and child care. Th ey will benefit more from the therapy munotes.in

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127 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives –II only after these existential need related problems are taken care of. A
psychotherapist cannot successfully cater to low income clients, if
he/she has classist attitudes and is neither willing nor has the ability or
resources to help them with their existential needs first, on a free of
charge basis.
9. In such a situation, Smith suggested that instead of using
psychoanalytic therapy, the therapist should use other therapeutic
techniques such as psychoeducation, counse ling, preventive
psychology or community psychology, especially if he/she does not
want to give any free service to the client.
8.2.2 Adlerian Therapy from Multicultural Perspective :
Strengths From a Diversity Perspective :
1. Carlson and Englar -Carlson ( 2008) were of the opinion that the best
part of Adlerian theory is that it acknowledges the influence of
culture, social class, racism, spirituality, religion, family and gender
on the behavior of individuals. That is why his ideas are well accepted
across all countries, by people living in present era.
2. Broad concepts such as age, ethnicity, lifestyle, sexual/affectional
orientations, and gender differences are facilitated to come to the fore
in Adlerian therapy. At the beginning of present century, Adle r was
one of the very few psychologists to promote the idea of equality for
women, even though he did not deny that men and women differ in
various areas.
3. The Adlerian approach is known as Individual Psychology, but it
concentrates on individual in his /her social context. The clients are
motivated to look at themselves and describe themselves within their
social environments. As Arciniega and Newlon (2003) noted that
Adlerian therapy looks at the role of the family, client’s contribution
to the communit y, and encourages the sense of belonging, socially
oriented values, cooperation and collective spirit. It ignores
competitive and individualistic values. Adlerian approach states that
culture gives a chance to a person to look at himself, others around
him and the world in general in many different dimensions, which is
much more wholistic and realistic.
4. Adlerian therapy is very flexible. Instead of trying to fit clients into
any established models, the therapeutic process is customized and
rooted within a client’s culture and worldview. Adlerian counsellors
are not tied to any specific procedures, but adopt their techniques
according to each client’s needs and sociocultural background. When
the client realizes that counsellor is sensitive to their cultura l values,
they also show more willingness to explore and amend their lifestyles,
if necessary. Thus, Adlerian therapy is malleable to cultural values
that accentuate community.
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128 Shortcomings from a Diversity Perspective :
1. Keeping in sync with Western cul tural models, the Adlerian approach
considers self as autonomous and therefore the focal point for change
and responsibility. This is in contrast to Eastern or Asiatic cultural
models where self is just a part of broader social picture. In other
words, it lacks the multicultural approach.
2. Though this approach pays due attention to birth order and family
configuration, yet it is not representative of all types of families
because it is seeped into Western culture and assumes family to be a
nuclear family . People living in joint families or raised in extended
families can’t relate with its concepts.
3. This approach can’t benefit clients who do not want to explore past
childhood experiences, early memories, family experiences, and
dreams.
4. This approach is of little use for clients who do not understand that it
is important to analyze past and present lifestyle to decide the
remedial measures for current problems.
5. Clients from certain culture may consider counsellor to be an expert,
just like a medica l doctor, who has solutions for all their problems.
The Adlerian approach, on the other hand, believes that counsellor
does not have and is not expected to provide solutions to the client.
He is merely supposed to suggest or teach the client in a collabora tive
manner, the alternative ways to deal with his life problems.
6. Some clients have cultural beliefs that family matters should not be
disclosed to outsiders. Moreover, many clients are not willing to
disclose everything about their lives to the coun sellor. They reveal
only those areas of their lives, that they think is connected with their
present problem. In other words, they decide what is connected or
cause of their present problems.
8.2.3 Person -Centred Therapy from Multicultural Perspective :
Strength from a Diversity Perspective:
1. Person -centered therapy is one of the most suitable approach,
especially in the field of human relations, for people from varied
cultural backgrounds. It is immensely popular in various Western and
Eastern countrie s. It is used not only for counselling purpose, but also
for education, reducing political and racial conflicts, and for cross -
cultural communication. Various countries have embraced this
approach and tweaked it as per their cultural norms. There has been
worldwide acceptance of Roger’s approach. His work is now
available in more than 12 languages, in more than 30 countries.
2. Though person centered approach acknowledges diversity of cultures
across the world, the therapist does not make any assumptions about
the client and does not initiate the sessions with any prejudice. The munotes.in

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129 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives –II therapist is empathetic, open, believes that every client is unique and
respects the values of the client. So this approach is very apt for
people from diverse cultural backgroun ds.
3. The intervention is customized as per the uniqueness and needs of the
clients. The counsellor does not assume the position of an expert who
knows what is best for the client and dispenses solutions for all
problems of the clients. Instead, counsel lor takes up the position of a
fellow explorer and collaboratively explores the phenomenological
world of the client and keeps verifying from the client about the
accuracy of his perceptions about the client’s problems.
4. Motivational interviewing techn ique originates from person centered
approach. It is very successfully used across different gender, age,
ethnicity, and sexual orientation populations, as it is a very culturally
sensitive approach and well suitable for multicultural counselling.
Shortco mings from a Diversity Perspective :
1. One of the disadvantages of this approach is that it is too flexible and
unstructured. Many clients come to mental health clinics as
outpatients or approach a counsellor only when they are in crisis and
are unable to handle their day to day life problems. They require more
structured, task -oriented intervention for their problems. They get
disappointed when the counsellor does not give them a structured
intervention and they may discontinue the sessions.
2. The basic principles of person centered approach such as empathy,
congruence and non -directiveness are not suitable for clients from
some of the specific cultural back grounds. For instance, clients from
some cultures are not at ease with therapist openly expressin g
empathy and self -disclosure. These clients are comfortable if the
therapist expresses empathy indirectly by using task – focused
methods of intervention and acknowledging their need for
maintaining the distance. In such cases, core practices of person
centered cannot be applied in actual practice.
3. Person centered approach assumes that self -awareness, freedom,
autonomy, self -acceptance, inner -directedness, and self -actualization
are universal innate characteristics of human beings. Any hurdle in
satisfaction of these needs leads to problems. But this assumption is
reflection of individualistic, western culture bias and may not be true
for collectivistic cultures like Asian cultures.
In Asian cultures, people are driven by societal expectations. They view
giving importance to one’s own personal interests and needs, as being
selfish. Such people are least concerned about self -actualization, they are
motivated by close, harmonious interpersonal relations with others and
being useful to community. Th ey derive their identity from their role and
responsibilities in their families and not from the self as is true for western
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130 suggest ways of improving her self -actualization at th e exclusion of her
social context.
4. The therapist has to be sensitive to the fact that clients come not only
from diverse cultural backgrounds, but even clients from any one
specific cultural background too have individual differences. So, the
core pri nciples of person centered approach can not be uniformly
applied to all individuals. The therapeutic style has to be tailor made
according to the needs of the clients.
8.2.4 Behaviour Therapy from Multicultural Perspective :
Strengths from a Diversity Pers pective :
1. Some clients of a particular ethnicity are reluctant to share their
feelings and personal problems due to their cultural values.
Behavioural therapy is useful for such clients as this therapy does not
insist on clients to go through catharsis. It assumes that all problems
of the client can be overcome by just changing the specific behaviors.
2. Irrespective of cultural values, it emphasizes on the specific tasks and
actions to be carried out. It does not look at the past history of the
client but concentrates on the present problem and what should be the
done to solve those problems. So, it is problem solution -oriented
therapy. People from any culture can benefit from such an approach.
3. This therapy focuses on the techniques for learning t he new behavior
and ensuring that such behavior is maintained. So, the clients who are
interested to know what exactly should be the concrete remedial plan
of action and specific behavior to overcome their problems benefit
from this therapy.
4. While dealing with clients who are discriminated in the society due to
their caste, colour, creed, religion, etc., this therapy does take into
consideration their social and cultural environment while setting up
the therapeutic goals.
5. In present times, the behavioural approach does not target to merely
treat the behavioural problems, but also assesses the life conditions of
the client that may have triggered the current behavioural problems
and also evaluates whether it is possible to change the problem
behavior and if it is possible, whether client’s overall life situation
will improve due to this behaviour change.
6. While dealing with clients from different background or culture, the
therapist assesses the problem situation through functional analysis.
Through functional analysis, the therapist determines whether any
cultural factors are responsible for the present behavioural problem,
the impact of this behavioural problem on the client himself and to his
sociocultural environment. Then he also looks a t any resources within
the client’s sociocultural environment that may help in bringing the
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131 Interventions Emphasizing Integration, Eclectic Systems, Multicultural Perspectives –II surroundings. While such an assessment is applaudable, it can be
devastating if the counsellor is not tr ained, knowledgeable, or
sensitive to cultural values of the client. So the therapist must be
aware of the cultural parameters that determine the normality of
behavior and the importance of spirituality in the client’s life
Shortcomings from a Diversit y Perspective:
1. There is not much empirical evidence about how behavior therapy can
be maximally beneficial to people from different cultures. It is well
proven that sociocultural variables such as race, gender, ethnicity, and
sexual orientation have sig nificant impact on the techniques to be
used and the end result of the therapy. Behavioural therapists need to
pay take these factors into consideration while using therapy and also
to ensure that social justice is not violated during the therapy.
2. Behavioural counsellors pay attention to problems that are within a
person and do not pay attention to sociocultural environmental factors
that significantly influence a client’s life. Resultantly, clients do not
get much benefit from this therapy.
3. While deciding about the goals of the therapy with the client, the
counsellor should be aware of and consider the cultural and
interpersonal aspects of the client’s problems. The counsellor must
inform the client about the possible changes that can take place in his
environment. As the client learns and uses new social skills at home
and outside home, other people in his surrounding environment may
also change their reactions, it may be for good or it may create new
problems. If his changed behavior gives rise to new problems, he
should be able to discuss them with the counsellor.
8.3 SUMMARY In this unit we studied psychoanalytic therapy from multicultural
perspective, Adlerian therapy from multicultural perspective, Person -
Centred therapy from multicultural perspective and behaviour therapy
from multicultural perspective.
8.4 QUESTIONS 1. Discuss Psychoanalytic Therapy from Multicultural Perspective
2. Explain Adlerian Therapy from Multicultural Perspective
3. Write in detail on Person -Centred Therapy from Multicultural
Perspective
4. Write brief note on Behaviour Therapy from Multicultural Perspective

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132 8.5 REFERENCES  Flanagan, J. S. & Flanagan, R. S. (2004). Counselling and
psychotherapy theories in context and practice: Skills strategies and
techniques. H oboken, NJ: John Wiley & Sons, Inc.
 Corey, G. (2013).Theory and Practic of Counselling Psychotherapy:
Systems, strategies, and skills (3rd Ed.) Pearson Education.
 Seligman, L., & Reichenberg, L. W. (2010). Theories of counselling
and psychotherapy: Syste ms, strategies, and skills (3rd Ed.). Pearson
Education.

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