 |
| | | | | | |
Theory and Design in Counseling and Psychotherapy
Susan X Day , Iowa State University and University of Houston
| | | | | | | | | | | |
CHAPTER 13: Integrative Innovation: The Example of
Cognitive-Interpersonal Therapy
Key Terms and Essential Concepts
Theoretical integration: Blending two or more theoretical approaches,
therapists conceptualize clients’ issues and personalities with greater complexity
than only one approach would offer. The goal of integrating theories is to gain
a synergistic effect in which the more multifaceted explanations provide
more understanding of individual dynamics and more flexibility in determining
appropriate interventions.
Technical eclecticism: A collection of techniques used in counseling
offers the counselor a variety of tools for facilitating client change. A therapist
can maintain a singular focus for case conceptualization and borrow techniques
from multiple theories, if care is taken to smoothly blend the use of interventions
within the counseling process without a jarring effect. Interventions can be
chosen on the basis of empirical research validating the use of specific methods
for changing specific concerns for clients with particular characteristics.
In fact, technical eclecticism can go as far as relegating abstract theory
to less importance than considering the proven clinical strategies that guide
the counselor’s choice of interventions.
Common factors orientation: A recognition that regardless of
theoretical approach, therapists employ similar healing practices. The quality
of the counselor-client interaction and the pattern established by therapeutic
process has been shown by empirical research and by counselor agreement to be
instrumental in positive client change. In addition to warmth, empathy and unconditional
positive regard, counselors facilitate corrective emotional experiences by enhancing
hope and trust. Client change is encouraged through persuasion, challenging
misperceptions, maintaining morale, providing new experiences, and offering
accurate feedback.
Transtheoretical therapy: Using a common factors approach to
counseling can be described as conceptualizing case management across theories
without specifying which theory or theories are the major focus. Prochaska
and other collaborators define specific stages to client change and choose
counseling interventions appropriate to the client’s particular level of readiness.
The Dayton Institute’s research found that abiding by the client’s analysis
of problems gave counselors clues for determining intervention strategies across
theoretical explanations.
Systematic Treatment Selection: Empirical validation for counseling
interventions based on client characteristics and treatment variables offer
nontheoretical technical choices at particular points in the course of therapy.
STS creators reviewed research studies to determine eighteen principles and
guidelines for determining what interventions work or don’t work under specific
conditions.
Syncretism: Nonsystematic use of multiple techniques and theoretical
concepts is labeled syncretic and characterized as random and lacking thoughtfulness.
The theoretical approaches are not synchronized to form a meaningful theoretical
orientation, but instead, ill-fitting ideas and practice are used without careful
consideration.
Eclecticism: Use of theories or techniques (or both) from more
than one traditional school of thought.
Collaboration: The counselor and the client work together to
achieve client goals. Collaborating implies that the client is made aware of
treatment choices and of the purpose of different methods for achieving change.
Therapeutic alliance: The counselor and the client join together
in a relationship with both parties working toward positive client change. The
alliance includes agreement on goals, agreement on tasks, and the affective
bond between client and therapist. It is also called the helping alliance.
Three-dimensional model: To encourage the therapeutic practice
of adapting to the client’s cultural background Atkinson, Thompson, and Grant
developed a model for deciding on the counselor’s interactive stance that included
three dimensions: the client’s level of acculturation, the locus of problem
etiology, and the goals of helping.
Helper roles: The function counselors serve in order to provide
the needed intervention that will assist client change can be defined as particular
roles. In addition to counselor or therapist roles, a helper could act as an
advocate, advisor, change agent, consultant, or could facilitate indigenous
support or healing systems. These roles were defined by Atkinson and colleagues
in their research regarding cross-cultural issues, but the same roles might
apply regardless of clients’ and counselors’ cultural backgrounds.
Complementary responding: When a person interacts in ways that
reinforce another person’s interaction style, the person is responding in a
complementary way. Such interactions are called an interpersonal cycle
where the first communication elicits a predictable response. So, an angry statement
brings forth an angry response. A submissive act brings forth a dominant act.
Discontinuation of complementary responding: In therapy, the
counselor is aware of the typical response that would follow a client’s statement
and deliberately chooses to respond in an unexpected way, thus forcing the client
to consider a different response in turn.
Experiential disconfirmation: The counselor who chooses to
interact with the client in nontypical ways does not confirm the client’s interpersonal
schema and this new experience helps break the client’s pattern.
Triadic reciprocity: Bandura wrote that behavioral, cognitive,
and interpersonal factors influence human experience and that the three factors
interact. Consequently, counseling outcome can be viewed as the interaction
of the therapeutic relationship with cognitive and behavioral interventions.
Self-schema: Cognitive theorists describe the mind’s construction
of habitual patterns of thinking and behavior. The structural framework defines
a person’s sense of security, satisfaction, and anxiety and provides a basis
for preferences, beliefs, avoidances, and behavioral patterns.
Self-system: The self-system as defined by Harry Stack Sullivan
is similar to the individual’s self-concept, extended to emphasize the person’s
typical and expected interactions with other people.
Security operations: Individuals determine methods to
maintain psychological consistency and dependable interactions with others in
an attempt to gain a sense of stability.
Anxiety: Interpersonal relations theorists define personal
security as an expectation of consistent relating with others and anxiety as
habitually predicting relationships as destabilizing.
Interpersonal schema: Individuals develop cognitive constructs
over time that describe their expectations and responses in interpersonal relationships.
Selective inattention: Interpersonal schemas serve as screening
structures that permit the person to pay attention to relevant occurrences and
to ignore other events. Selecting relevant observations creates a bias that
screens out information that does not fit with the schematic view.
Cognitive-interpersonal cycle: Once people develop interpersonal
schemas for viewing relationships, they maintain the constructs by behaving
in ways that conform to their expectations and elicit predictable responses
from others. The views carried forward from past relations are also maintained
by choosing others who interact in particular ways. For example, I blurt out
my opinions, trying to show I care about the group, and others are annoyed.
I believe no one wants me in the group, and this idea is confirmed when others
ask me to wait to talk until others are finished talking.
Interpersonal markers: In session, counselors working
within an interpersonal relations approach observes the client’s typical habits
of interacting and describes out loud what these stylistic behaviors are and
then offers feedback to clients. With the client’s interactive style as a topic
for counseling, the client can explore the internal experience associated with
interactive behaviors.
Interpersonal inventory: Interpersonal therapy counselors may
use a technique of reviewing with the client a description of the current relationships
in the client’s life. Such a review allows the client to determine his interpersonal
schema and what cognitive-interpersonal cycles may be operating. When the interactive
patterns are repeated in the counseling relationship, the counselor can bring
out into the open the presence of the pattern and its impact on interactions.
Transference: When the client interacts with the counselor,
she will undoubtedly behave in similar ways as she would with other people in
his life. The client is said to transfer emotions and behaviors that define
her sense of self and her relations to others onto the counseling relationship.
The counselor, attuned to the implications of the client’s interactions, responds
with empathy and appropriate feedback, so the client’s cognitive assumptions
regarding relationships can be opened to change. This is a broader definition
of the term transference than a psychodynamic usage of the term, which
assumes that clients transfer parental relationships onto the counselor.
Metacommunication: Discussing aspects of how people are communicating
to each other is talking about their talking—metacommunication. The term
denotes an approach that makes the communication itself the topic of discussion,
rather than other content. The impact of how each person reacts to the words
of the other person can reveal interpersonal patterns arising from internal
responses.
Decentering: When a client hears feedback regarding how the
counselor feels when the client says or does something in their interactions,
the client is able to view how he is coming across to others. The client can
see his self from the outside view, rather than experiencing himself as the
primary center of the interaction. Such an external view can be a powerful means
to understand both self and others from a perspective that is not common in
most relationships.
Scope of practice: Counselors are ethically bound to define
what counseling issues and treatments they are competent to deliver and to inform
clients of what to expect in therapy.
| | | | | | | |
|
|
|
