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Person Centered – Carl Rogers
1. View of Human Nature
a. Rogers viewed human nature as basically good
b. He believed that if given the appropriate environment of acceptance, warmth and empathy, the individual would move toward self-actualization
c. Self-actualization is the motivation that makes the individual move toward growth, meaning, and purpose
d. Person-centered is considered a phenomenological psychology in which the individual’s perception of reality is accepted as reality for the individual.
e. Person-centered is often referred to as a self theory, because of Rogers’ emphasis on the self being the result of the person’s life experiences and the person’s awareness of comparisons to others as the same or different.
f. Rogers believed that most people were provided conditional acceptance as children, which lead them to behave in ways that would assure their acceptance. However, in their need for acceptance, the individual often behaved in ways that were incongruent with the real self. Thus, the greater this incongruence between the real self and the ideal self, the greater isolated and maladjusted the person became.
2. Role of the counselor
a. The counselor sets up a environment where the client is safe to explore any aspect of the self. The counselor’s job is to facilitate the exploration through a special client-therapist relationship of unconditional positive regard, empathy, and warmth.
b. The personcentered counselor uses psychological testing on a limited basis. The Q-sort is sometimes used in assessment by the person-centered counselor. A series of 100 statements are written on cards. The statements are self-descriptions, i.e. I am capable, I am dependent, I am worthless. The client is asked to read and sort each of these statements into nine piles from most like me to least like me. Then the stacks are recorded. The client resorts the cards into what they would like to be like. The Q-sort gives an indication of the incongruence between the perceived real self and ideal self.
c. The use of diagnostic categories is discouraged as incompatible with the philosophical view of the individual as unique. Diagnosis places the counselor in a position of authority and imposes a treatment plan.
3. Goals of therapy
a. In person-centered theory are directly concerned with the individual.
The counselor facilitates the client toward:
i. Realistic self-perception
ii. Greater confidence and self-direction
iii. Sense of positive worth
iv. Greater maturity, social skill, and adaptive behavior
v. Better stress coping
vi. More fully functioning in all aspects of their lives
4. Techniques
a. The techniques used in person-centered therapy have changed over time.
b. Three periods of time in which different techniques were stressed:
i. Nondirective Period (1940-1950). In this period of theory development, the counselor focused on listening and creating a permissive atmosphere. The counselor did not provide interventions, but communicated acceptance and clarification.
ii. Reflective Period (1950-1957). During this period of time,
counselors emphasized being non-judgmental of the client, while responding to the client’s feelings and reflecting the affect accurately.
iii. Experiential Period (1957-1980) This is the period of the EWG: Empathy, Warmth and Genuineness. Empathy is the ability of the counselor to understand the emotions of the client and correctly communicate this understanding. Warmth is also referred to as acceptance and positive regard in person-centered literature. Warmth is the ability of the counselor to convey an unconditional acceptance of the client’s personhood. Genuineness or congruence is the ability to be who one really is without assuming roles or facades.
c. The counselor helps the client through accurate reflections of feelings, keeping the client focused on the concern, and clarification of feelings and information. The counselor uses open-ended questions or phrases to help the clients gain insight into experiences and necessary changes in their lives.
Test your knowledge!
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Individual Psychology – Alfred Adler
1. View of Human Nature
A) The Adlerian concept of social interest is the individual’s feeling of being part of a whole in the past, present, and the future. Adler believed that people were mainly motivated toward this feeling of belonging. He did not believe that social interest was innate but rather a result of social training.
B) Adler expressed that people strove to become successful and overcome the areas that they perceived as inferior. He referred to this process of personal growth as striving for perfection. Those who did not overcome feelings of inferiority developed an inferiority complex. Those who overcompensated for feelings of inferiority developed a superiority complex.
C) Adler believed that a person’s conscious behavior, not their unconscious, was the mainstay of personality development. Because of this concept, Adlerian theory emphasizes personal responsibility for how the individual chooses to interpret and adjust to life’s events or situations.
D) Maladjustment is defined in Adlerian theory as choosing behavior resulting in a lack of social interest or personal growth. Adler believed that misbehavior would take place when the person had become discouraged or when positive attempts at good behavior had failed to get the needed results. Encouragement to good behavior was often the recommended antidote to misbehavior.
E) Another concept is that of teleology, which simply put means that a person is as influenced by future goals as by past experiences.
F) Adlerian espoused the belief that the birth of each child changed the family substantially. He thought that the birth order of the children in the family influenced many aspects of their personality development. Briefly, characteristics of these birth positions are:
I) Oldest children are usually high achievers, parent pleasers, conforming, and are well behaved.
II) Second born children are more outgoing, less anxious, and less constrained by rules than first born children. They usually excel as what the first born does not.
III) Middle children have a feeling of being squeezed in and are concerned with perceived unfair treatment. These children learn to excel in family politics and negotiation. However, they can become very manipulative. This position also tends to develop areas of success that are not enjoyed by their siblings.
IV) The youngest child is the most apt at pleasing or entertaining the family. While they run the risk of being spoiled, they are also the most apt at getting what they want through their social skills and ability to please. They are often high achievers, because of the role models of their older siblings.
G) Only children or children born seven or more years apart from siblings are more like first born children. Children with no siblings often take on the characteristics of their parents birth order, as the parents are the only role models. While these children may mature early and be high achievers, they may lack socialization skills, expect pampering, and be selfish.
H) Adler saw the family as the basic socialization unit for the child. He believed that children’s interpretation of the events in their life was determined by the interaction with family members before the age of five. The family interactions taught the children to perceive events and situations through certain subjective evaluations of themselves and the environment, called fictions. Basic mistakes could be made based on these fictions.
Adlerians believe that some of those mistakes are (Mozak, 1984):
I) Over-generalizing in which the individual believes that everything is the same or alike.
II) False or impossible goals of security which leads the individual to try to please everyone in seeking security and avoiding danger.
III) Misperceptions of life and life’s demands which leads the individual to expect more accommodation than is reasonable and to interpret their failure to get accommodation as never getting any breaks.
IV) Minimization or denial of one’s worth results in the individual believing that they cannot be successful in life.
V) Faulty values results in a “me first” mentality with little or no regard for others.
VI) Adler believed that life took courage or a willingness to take risks without knowing the outcome. He believed that a person with a healthy life style contributed to society, had meaningful work, and had intimate relationships. He espoused cooperation between the genders as opposed to competition. He believed that well-adjusted people lived in an interdependent relationship with others in a cooperative spirit.
2. Role of the counselor
A) The counselor is as a diagnostician, teacher and model. The counselor helps the client to explore conscious thoughts, beliefs and logic for behaviors that are not in the client’s best interest or social interest. The client-counselor relationship is an equal one with the counselor sharing insights, impressions, opinions, and feelings with the client to promote the therapeutic relationship. Therapy is very cognitive with an emphasis on the examination of faulty logic and empowering the client to take responsibility to change through a re-educational process.
B) The counselor encourages the client to behave “as if” the client were who they wished to be and often provides the client with “homework” assignments outside the sessions. Adlerians are eclectic in technique with an emphasis on encouragement and responsibility.
3. Goals of Adlerian counseling
A) Goals focus on helping the client develop a healthy lifestyle and social interest. The counselor assists the client through four goals of the therapeutic process:
I) establishing a therapeutic relationship
II) examining the style of life
III) developing client insight
IV) changing behavior
B) The behavior change is the result of the individual taking personal responsibility for behavior .
4. Techniques
Confrontation – Consists of challenging the client’s private logic and behavior.
Asking “the Question” – Consists of asking the client how their life would be different if they were well? The question often asked to parents is, what would be the problem if this child were not the problem?
Encouragement – Consists of the counselor supporting the client by stating the belief in the client’s ability to take responsibility and change behavior.
Acting “as if” – Consists of instructing the client to behave “as if” there were no problem or as the person that the client would like to be.
Spiting in the client’s soup – It means that the counselor points out the purpose of the client’s behavior. Afterward, the client may continue the behavior, but cannot do so without being aware of their motivation for engaging in the behavior.
Catching oneself – Consist of helping the client learn to bring destructive behavior into awareness and stop it.
Task setting consists of helping the client set short-term goals leading toward the attainment of long-term goals.
Test your knowledge!
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Psychoanalytical Theory – Sigmund Freud
View of Human Nature
- Freud’s view of human nature is considered to be dynamic, meaning that there is an
exchange of energy and transformation. Freud used the term catharsis to describe this release of this energy. - Freud saw the personality as composed of a conscious mind, a preconscious mind and an unconscious mind. The conscious mind has knowledge of what is happening in the present. The preconscious mind contains information from both the unconscious and the conscious mind. The unconscious mind contains hidden or forgotten memories or experiences.
Structure of Personality
- The personality has three parts: the id, the ego, and the superego
- The id is present at birth and is part of the unconscious. The id is the site of the pleasure principle, the tendency of an individual to move toward pleasure and away from pain. The id does not have a sense of right or wrong, is impulsive, and is not rational. It contains the most basic of human instincts, drives, and genetic endowments.
- The ego is the second system to develop and it functions primarily in the conscious mind and in the preconscious mind. It serves as a moderator between the id and the superego, controlling wishes and desires. The ego is the site of the reality principle, the ability to interact with the outside world with appropriate goals and activities.
- The superego sets the ideal standards and morals for the individual. The superego operates on the moral principle which rewards the individual for following parental and societal dictates. Guilt is produced when a person violates the ideal ego denying or ignoring the rules of the superego.
Developmental Stages
- Oral stage is centered on the mouth as a source of pleasure.
- Anal stage is centered on the anus and elimination as a source of pleasure.
- Phallic stage is centered on the genitals and sexual identification as a source of pleasure.
- Oedipus Complex is described as the process whereby a boy desires his mother and fears castration from the father, in order to create an ally of the father, the male learns traditional male roles.
- Electra Complex is described a similar but less clearly resolved in the female child with her desire for the father, competition with the mother and thus, learns the traditional female roles.
- Latency stage is a time of little sexual interest in Freud’s developmental view. This stage is characterized with peer activities, academic and social learning, and development of physical skills.
- Genital stage begins with the onset of puberty. If the other stages have been successfully negotiated, the young person will take an interest in and establish sexual relationships.
Ego Defense Mechanisms
- Were believed by Freud to protect the individual from being overwhelmed by anxiety. He considered them normal and operating on the unconscious level. Some of the ones most often referred to are:
- Repression is the defense mechanism whereby the ego excludes any painful or undesirable thoughts, memories, feelings or impulses from the conscious.
- Projection is the defense mechanism whereby the individual assigns their own undesirable emotions and characteristics to another individual.
- Reaction Formation is the defense mechanism whereby the individual expresses the opposite emotion, feeling or impulse than that which causes anxiety.
- Displacement a defense mechanism whereby the energy that is generated toward a potentially dangerous or inappropriate target is refocused to a safe target.
- Sublimation is a positive displacement is called whereby the frustrating target is replaced with a positive target.
- Regression is the defense mechanism whereby returns to an earlier stage of development.
- Rationalization is the defense mechanism in which an individual creates a sensible explanation for an illogical or unacceptable behavior making it appear sensible or acceptable.
- Denial is a mechanism whereby an individual does not acknowledge an event or situation that may be unpleasant or traumatic.
- Identification is a defense mechanism whereby a person takes on the qualities of another person to reduce the fear and anxiety toward that person.
Role of the Counselor
To encourage the development of transference, giving the client a sense of safety and acceptance. The client freely explores difficult material and experiences from their past, gaining insight and working through unresolved issues. The counselor is an expert, who interprets for the client.
Goals of therapy include
a. Helping the client bring into the conscious the unconscious.
b. Helping the client work through a developmental stage that was not resolved or where the client became fixated.
c. Help the client adjustment to the demands of work, intimacy, and society.
Techniques
- Free Association is a process where the client verbalizes any thoughts that may without censorship, no matter how trivial the thoughts or feeling may be to the client
- Dream Analysis is a process where the client relates their dreams to the counselor. The counselor interprets the obvious or manifest content and the hidden meanings or latent content .
- Analysis of transference is a process where the client is encouraged to attribute to counselor those issues that have caused difficulties with significant authority figures in their lives. The counselor helps the client to gain insight by the conflicts and feelings expressed .
- Analysis of resistance is a process where the counselor helps the client to gain insight into what causes form the basis for a hesitation or halting of therapy.
- Interpretation is a process where the counselor helps the client to gain insight into past and present events .
Test your knowledge!
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Reasons for Using Substances
Contributor: Yvette McBride Thomas
People like to feel good. Many experiences in our world are geared toward altered states of consciousness–natural highs. These “natural highs” are derived from many experiences: roller coaster rides, skydiving, white water rafting, dancing, or anything else that can produce an adrenaline rush. Our enjoyment of these sensations begins at an early age. Small children will spin around in circles or scare each other in order to feel this altered state of consciousness. Unfortunately, “artificial highs” from drugs or alcohol are easier to obtain than natural highs, and drugs are readily available to children at an early age. The following seem to be the most common reasons for drug use today.
Parental or Guardian Influence
As seen in the previous section, the “pill for every ill” attitude that is seen in the home has a major impact on children. Approximately 80% of children’s values, morals, work ethic and attitude are derived before age 8. A child is exposed to his/her parents for the majority of his/her life before age 8. Therefore, parents will have the greatest influence on their children. A child learns many lifelong habits and attitudes from his/her parents. Unfortunately, in about 80% of cases, a child’s first exposure to alcohol and drug use is in the home. Children may see a parent drinking alcohol, popping pills or doing other drugs. Parents may have a liquor cabinet, a steady supply of beer in the refrigerator, or other drugs in the home. The influence of a child’s parents cannot be emphasized enough. Parents need to understand this and be proper role models for their children. What is the subliminal programming that is occurring every time a child opens the refrigerator and sees beer? It becomes the norm. We are not saying that parents should never drink beer in the home, but rather that they must assess the role that alcohol plays in their home.
Unfortunately, too, some children are exposed to illegal drugs from the time of their birth. Worse, some are exposed even before birth, if the mother uses during pregnancy. Such babies may be born addicted to drugs (i.e., “crack babies”). Infants may be exposed to drugs in the mother’s breast milk or in the home environment. One client in drug treatment described a baby picture of himself, in which a bottle of beer and a marijuana “joint” were photographed with him in his crib. He grew up believing that drug and alcohol use was normal for everyone. He began using at age eight and was chemically dependent and involved in the courts by age 17. Another client in treatment, an adolescent, shared a story of being beaten by her father-for smoking his marijuana. She had the black eye to prove it.
Peer-Group Influence 
Most people are aware that during the adolescent years, a person’s most influential group is their peer group. When their peers are using substances, teens often feel a need to use them as well, in order to gain acceptance, to be “tight” with their friends. Using substances because “everyone else does” may not seem to be a valid reason to adults, but to high school and junior high students, it is compelling. Failure to join in can cause a teen to become an outcast from the group-the worst fate imaginable to many teenagers. So they will often do whatever it is that their friends are doing so that they can fit in.
Even “good” kids may submit to peer pressure. For many adolescents, using drugs or alcohol can make them feel rebellious, as if they are being independent and carving out their niche in the world. It may also make them feel “grown up”. As a person grows older, he/she may decide to continue using or to stop using for many different reasons. He/she may outgrow the peer group influence but may not outgrow the substance involvement.
To Get An Effect or To Get High (Pleasure)
The majority of people using substances do so to get the mood-altering effect or some type of pleasurable sensation. Many available substances will induce a feeling of euphoria. People who use substances for pleasure, who have few problems with their substance use, are often labeled “social” users. These individuals can drink or get high on weekends just to feel good and have no resulting problems. Other persons who get involved in this type of substance use will eventually develop major substance abuse problems. No one can predict before beginning use if he/she will become drug- or alcohol- dependent.
Curiosity and Boredom
Curiosity is the most familiar reason given for first trying a substance. Curiosity is quickly satisfied. Therefore, if the person chooses to continue using the drug, he/she does so for other reasons. With the current availability of many substances, people are aware that if they want to try substances, they can. Young people are naturally curious; they are attracted to new and exciting things. Adolescents want immediate gratification and often don’t look at the possible consequences. This also leads them into trying many different drugs, to experiment with the different highs. This need for immediate gratification also allows them to get bored very easily. Obtaining and using illegal drugs is often viewed as exciting or “cool” by adolescents and can take up a large amount of time, thus alleviating their boredom.
Internal Issues
Internal issues correlate with serious substance abuse problems. Internal pressures to use include: stress, low self-worth, depression, anxiety and nervousness. Low self-esteem has been found to be a major factor in an individual’s choice to begin using substances. Alcohol and drugs are called mood-altering substances for a reason. Drugs alter (change) the mood (emotions) of the individual. They may either exacerbate an existing problem or create a new one. Many drugs also contribute to additional internal issues, such as depression, anxiety, or low self-esteem. Once again, substances may provide an easy but temporary method of dealing with these internal issues but usually cause additional problems. Often, the user doesn’t realize that substance use does not solve problems. When the substance wears off, the problem is still present, and often there are additional problems resulting from the substance use.
External Pressures
An individual may use substances to escape external pressures. These external pressures–situations with which an individual may feel uncomfortable-may include school problems, work difficulties, family problems, peer pressure, relationship issues, etc. If an individual feels upset about a certain situation and gets drunk or high, he/she may feel relief from the problem. This escape, however, will only last for a limited period of time. When the individual is no longer high, the problem will return. Using drugs or alcohol as an escape is only temporarily effective–and very dangerous.
An individual may begin to regularly rely on the drug or alcohol as a coping mechanism. This leads to addiction and produces an individual who has no other coping skills for difficult situations. Often, the use of drugs creates additional external pressures and exacerbates the existing ones. A vicious cycle occurs: the individual uses drugs or alcohol to deal with existing problems and the use causes more problems. The individual then uses more drugs to deal with these new problems. This additional use then causes more problems, which leads to more use. It is a never-ending cycle of use and problems.
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Signs and Symptoms of Substance Abuse
Physical, behavioral, and psychological signs and symptoms of substance abuse. Short and clear. Very useful information.
Treating Substance Abuse/Addiction (Part II)
Contributor: Yvette McBride Thomas
Treating Illegal Drug Addiction
- Around half a million Americans are heroin addicts, and four million are regular users of marijuana.
- Treatment is often based on the AA model.
- Because of incarceration of illegal drug abusers, jail is the usual context for treatment.
- “Stay’n Out” is a prototype of a jail treatment program that works well and has a recidivism rate of only 25%.
Treating Families where there is Substance Abuse/Addiction
- Families either promote or enable substance abuse behaviors. The whole family has to be included in the treatment.
- Children with chemically dependent parents are at risk.
- Alcoholic families tend to be isolated and lack positive role models.
- Young people from dysfunctional families use substance abuse to
- Relieve stress and anxiety and structure time.
- Keep their minds off family dynamics and on predictable problematic behaviors.
- Substitute for sex and promote pseudo-individuation (a false sense of self).
Treatment Services
- Counselor can provide information.
- Counselor may have to be confrontational with the family over the effects of substance abuse on the family and individual. An intensive systems approach must be used that also involves agencies.
- Counselor can work to help family deal with feelings, such as anger and defense mechanisms.
- Counselors can also help the family take responsibility for their behaviors.
- Developmental issues are also worked on by the family.
Treating Women and Minority Cultural Groups in Substance Abuse
- Approximately five to seven million women abuse alcohol in the US alone.
- Women face societal rebuke and chastisement for alcohol abuse.
- Barriers to treatment include need for childcare, cost, family opposition, and inadequate diagnosis.
- Little evidence exists on the benefits of AA and NA on the one-third of the AA membership that women represent due to gender differences and cultural differences.
- “Women for Sobriety” is an alternative help group program that is based on a cognitive-behavior modification approach. Thinking is changed to overcome feelings of helplessness, powerlessness, guilt, and dependence.
- Cultural differences may play a part in the recovery process. Spiritual elements may be different for women and different ethnic backgrounds.
Affiliation, Certification, and Education of Substance Abuse Counselors
IC&RC
- The International Certification & Reciprocity Consortium.
- IC&RC’s credentials include
- Alcohol and Drug Counselor (ADC)
- Advanced Alcohol and Drug Counselor (AADC)
- Clinical Supervisor (CS)
- Prevention Specialist (PS)
- Certified Criminal Justice Addictions Professional (CCJP)
- Certified Co-Occurring Disorders Professional (CCDP)
- Certified Co-Occurring Disorders Professional Diplomate (CCDPD)
- The IC&RC is currently developing a Peer Mentor (PM) credential.
TCBAP
- Texas Certification Board of Addictions Professionals
• IAAOC
- International Association of Addictions and Offender Counseling
- Focuses on the prevention, treatment, and description of abusive and addictive behaviors.
- Publishes the Journal of Addictions & Offender Counseling
• NAADAC
- National Association of Alcoholism and Drug Abuse Counselors
- A national organization that certifies addiction counselors
• NBCC
- In 1994 the National Board of Certified Counselors added a certification process for becoming a substance abuse counselor.
Two types of counselors
- Recovering counselors
- Nonrecovering counselors
Reference:
Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
Treating Substance Abuse/Addiction
Contributor: Yvette McBride Thomas
Characteristics
- About 25% of counseling cases relate to substance abuse and addiction.
- Substance abusers have dysfunctional dynamics making them difficult to work with.
- Three most common ways counselors work with addicted persons include outpatient, residential, and inpatient.
- Addicts must be “dry” or “dried out” for 30 days or more to give them a “clean” body and mind to use in doing something different and positive.
- Alcoholic family systems have an overresponsible/underresponsible phenomenon.
- Over-responsible people are codependent and seek to control others and feel inadequate when faced with disappointments but are easier with whom to work in counseling situations.
- Underfunctioning people are less motivated to change.
Factors Affecting Treatment include:
- Motivation – Most substance abusers/addicts do not desire to change and are self-centered and are comfortable where they are.
- Denial – is minimizing the effects of substance abuse/addiction on either oneself or others.
- Dual Diagnosis – An abuser/addict has more than one aspect of personality that needs treatment (i.e., addiction and depression).
- Matching – Finding the right treatment for a disorder.
- Control – the regulation of a behavior
- Relapse – the reoccurrence or recidivism of dysfunctional behaviors one they have been treated.
Treatment Strategies for Individuals
- Motivational Interviewing (MI) is used to lower resistance in substance abuse/addiction cases.
- This approach draws from person-centered counseling and includes such skills as active listening, reflection, and reframing.
- Bibliotherapy
- Bibliotherapeutic approach may work with some individuals.
- Abusers and addicts read books or view/listen to media and discuss ideas related to what they have experienced.
- Cautions to remember for counselors working with adolescents regarding alcohol and substance use:
- Working with adolescents is a treatment specialty.
- Family and significant people in their lives should be included for counseling to be effective.
- Adolescents need to be educated about what counseling is.
- Therapeutic techniques need to be specifically tailored to adolescents.
- Counselors cannot function as the adolescent’s friend.
- Counseling focus should be centered on problem solving, skill building, and just being heard.
- “Therapeutic moments” are more uneven with adolescents.
Specific Treatments
- Treating Alcohol Abuse/Addiction – Alcoholics Anonymous (AA)
- Background of AA
- AA is the oldest successful treatment program in the world and was founded in the 1930s.
- AA is a fellowship and a rehabilitation program.
- Alcoholics have “character defects” that “are feelings, beliefs, and behaviors that dispose them to seek a sense of well-being by abusing alcohol.
- Meetings are conducted with small groups and literature.
- Key component in AA
- A 12-step program that has its basis on a spiritual foundation
- Group discussions center on the need and availability of support of others and a dependence on a higher power.
- Members are never “cured;” rather they are “in recovery.”
- Emphasis is also given to responsibility, forgiveness, restitution (when possible), affirmation, ritual, and fellowship.
Treating Nicotine Addictions
- Over 25% of Americans smoke cigarettes, three million of whom are adolescents.
- About 80% of those who abuse or are addicted to alcohol smoke.
- Most nicotine dependent people are not successful as a group in their goal of smoking cessation.
Successful techniques for counselors
Telephone counseling
- Counseling consists of a 15- to 30- minute phone call where counselors give positive, nonjudgmental feedback to those who are trying to quite smoking.
- The goal is to promote self-efficacy.
- Rapid smoking
- After counseling, smokers go through a series of six 1-hour sessions where they inhale a cigarette every 6 seconds until they feel too sick to continue.
- The goal is to produce a conditioned negative response to the taste of cigarettes.
- Skills training
- Coping skills are taught after clients have learned to recognize the triggers that produce the urge to smoke.
- Most successful skills taught:
- Self-statements about the financial and health benefits of discontinuing smoking
- Oral substitutes
- Increased physical activity
- Buddy system
Treating Substance Abuse/Addiction Part II
DYI! Get ready with me.
Samantha DeLint – Youtube Channel
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