Sunday, November 4, 2007

Adlerian Therapy and Person-Centered Therapy

Lecture Notes
Counseling with Parents
Adlerian Therapy and Person-Centered Therapy
Instructor: Jeff Garrett Ph.D.


Dreikurs Text - Children: The Challenge

Eight Principles for Parenting Children

1. Watch your tone of voice.
2. Take it easy.
3. Downgrade "Bad" Habits.
4. Have fun together.
5. Meet the challenge of TV.
6. Use religion wisely.
7. Talk with them, not to them.
8 The famile council.


Person Centered Therapy
Key Points and Terms
Developed by Carl Rogers.
Also termed Client-Centered.
Humanistic, or Phenomenological Therapy .
The person is viewed as creative, responsible, developing individual.
By providing a therapeutic atmosphere which is real, caring, and non-judgmental the person can develop their full potential.

History of PC Therapy
Carl Rogers was born 1902, Oak Park Illinois.
Family emphasized strong work ethic, responsibility and the fundamentals of religion.
Graduated 1924 from University of Wisconsin.
Started at the Union Theological Seminary then transferred to Teacher’s College, Columbia University.
Worked for 12 years at a Child-Guidance Center.
In 1939 published Clinical Treatment of the Problem Child.
Offered professorship at Ohio State University.
1940 Rogers presented Some Newer concepts in Psychotherapy at the University of Minnesota (viewed by most as the birth of Client-Centered Therapy).
Published Counseling and Psychotherapy in 1942.
During WWII served as Director of Counseling Services for the US Organizations.
Served as head of University of Chicago Counseling Center (12 years).
In 1957, Rogers published classic paper on "necessary and sufficient conditions" for therapy.
Rogers died in 1987.

Current Status of PC Therapy
Special interest of Rogers was application of his theory to international relationships
Since 1982 Biennial International Forums on PC approach
Workshops at Warm Springs
Person-Centered Review began to be published in 1986 (renamed The Person-Centered Journal).
Influenced play therapy with children.

Axline's (1947) eight principles of play therapy

Axline's (1947) eight principles of play therapy are commonly cited guidelines for person-centered play therapy (e.g., Harris & Landreth, 2001). The principles are the following (Axline, 1947, pp. 73-74):

1. The therapist must develop a warm, friendly relationship with the child, in which good rapport is established as soon as possible.

2. The therapist accepts the child exactly as he is.

3. The therapist establishes a feeling of permissiveness in the relationship so that the child feels free to express his feelings completely.

4. The therapist is alert to recognize the feelings the child is expressing and reflects those feelings back to him in such a manner that he gains insight into his behavior.

5. The therapist maintains a deep respect for the child's ability to solve his own problems if given an opportunity to do so. The responsibility to make choices and to institute change is the child's.

6. The therapist does not attempt to direct the child's actions or conversation in any manner. The child leads the way; the therapist follows.

7. The therapist does not attempt to hurry the therapy along. It is a gradual process and is recognized as such by the therapist.

8. The therapist establishes only those limitations that are necessary to anchor the therapy to the world of reality and to make the child aware of his responsibilities in the relationship.

PC Challenges:
The assumption that "the counselor knows best".
The validity of advice, suggestion, persuasion, teaching, diagnosis, and interpretation.
The belief that clients cannot understand and resolve their own problems without direct help.
The focus on problems over persons.

PC Emphasizes:
Therapy as a journey shared by people – parents and therapist
The parent’s innate striving for self-actualization
The personal characteristics of the therapist and the quality of the therapeutic relationship with parents and children
The counselor’s creation of a permissive, "growth promoting" climate
Parents and children are capable of self-directed growth if involved in a therapeutic relationship.
Person-Centered Therapy is a form of humanistic therapy.

Roger’s Basic Assumptions
Rogers believed in an actualizing tendency in all human beings – parents and children.
Represented movement towards the realization of the parent’s and child’s full potential
Viewed as part of a formative tendency
Formative tendency represents movement toward order, complexity and interrelatedness
Seen across aspects of nature including the stars, crystals, microorganisms and humans

Basic Requirements for the Therapeutic Environment (Therapist)
Genuineness/Congruence
Correspondence between the therapist’s thoughts and their behavior
Unconditional Positive Regard
Therapist’s regard/attitude remains unaltered regardless of the parent’s or child’s choice
Empathy
Profound interest and care for the parent’s and child’s perceptions and feelings

Basic Requirements for the Therapeutic Environment (Client)
Self-concept
At therapy onset, self regard/self-esteem often low
Improvement correlated with success in therapy
Locus-of-Evaluation
At therapy onset, focus on what others think
Progress associated with internal locus-of-evaluation
Experiencing
At therapy onset, rigid; Success related to flexibility

Distinctive Components of Person-Centered Therapy
Therapist’s attitude can be necessary and sufficient conditions for change.
Therapist needs to be immediately present and accessible to parents and children.
Intensive, continuous focus on the parent’s and child’s phenomenological world.
Process marked by parent’s and child’s ability to live fully in the moment.
Focus on personality change, not structure of personality

Theory of Personality - 19 Propositions.
1. The individual is center of a continually changing world of experience.
2. The individual reacts based on their reality.
3. The individual reacts as an organized whole.
4. The individual has one basic tendency – actualization.
5. Behavior is goal directed based on perception of reality.
6. Emotion accompanies and facilitates goal directed behavior.
7. Best point to understand behavior is from the individual’s frame of reference.
8. Part of the perceptual field is differentiated as the self.
9. Self is formed through interaction.
10. Values come from experience and introjection from others.
11. Experiences are integrated, ignored, or denied.
12. Behavior is generally consistent with self concept.
13. Behaviors inconsistent with self concept can occur but are seen as "not owned".
14. Psychological maladjustment comes from denied experiences.
15. Psychological adjustment occurs when experiences are assimilated.
16. Inconsistent experiences are threats.
17. Under the right conditions inconsistent experiences can be examined/assimilated.
18. When the individual integrates in all of their experiences they are more understanding of others.
19. As experiences are integrated an internal locus-of-evaluation develops.

Roger’s Theory of Personality Summarized
Behavior is best understood through the individual’s reality (perception of experiences).
For social purposes, reality is defined as common perceptions across individuals.
Personal growth occurs through decreased defensiveness.
Self actualization is the organism’s one, basic tendency (Rogers believed an organism has one basic tendency and striving which is to actualize, maintain and enhance the experiencing organism.
Experiences inconsistent with self concept are threats leading to increased rigidity.
Therapy allows the individual to accept and integrate all of their experiences.
In Roger's personality theory, behavior is defined as a goal directed attempt to satisfy an organism's needs.

Other Concepts.
Experience is the private world of the individual.
Reality basically refers to the private perceptions of the individual; Social consists of perceptions that have a high degree of commonality among individuals.
Self is the organized gestalt of "I" and "me".
According to Rogers, the center of an individual's world of experience is the individual
The process by which an individual becomes aware of an experience is known as symbolization.
In ambiguous situations individuals tend to symbolize experiences in a manner consistent with self concept.
Carl Rogers would view neurosis as the result of incongruence between the real self and the ideal self.
Carl Rogers believed all humans had a(n) actualizing tendency, which he saw as a part of the formative tendency of the world

Rogerian View of Psychotherapy
Implied Therapeutic Conditions
Parent and therapist must be in psychological contact
Parent must experience distress.
Parent must be willing to receive conditions offered by therapist.

Process of PC Therapy
Therapy begins at first contact with the parent.
In the first interview, a person centered therapist will go where the parent or child goes.
For Carl Rogers, empathy, unconditional positive regard, and congruence (genuineness) were the 3 basic requirements to create a therapeutic environment
Respect shown immediately for parent or child.
In addition to the basic requirements of the therapeutic environment for the therapist, Rogers believed the parent must focus on self-concept, locus-of-evaluation and experiencing.
Therapy’s length is determined by parent (In person centered therapy termination is decided by the parent).
Quick suggestions and reassurances are avoided.
Empathy - Understanding another individual (whether parent or child) by "living" in their internal frame of reference.
Person centered therapists believe that empathy, unconditional positive regard, and congruence are necessary and sufficient conditions for therapeutic change.
Congruence - a correspondence between the thoughts and the behavior of a therapist.
Client centered therapy focuses most heavily on the present.
A successful person centered therapy outcome would be defined by the parent’s evaluation that therapy was beneficial.

Therapist Role and Function
Function: to be present and accessible to parents, to focus on immediate experience, to be real in the relationship with parent or child.
Through the therapist’s attitude of genuine caring, respect, acceptance, and understanding, parents and children become less defensive and more open to their experience and facilitate the personal growth.
Therapist Role and Function.
Role: Therapist’s attitude and belief in the inner resources of the parent and child, not in techniques, facilitate personal change in the parent/child.
Use of self as an instrument of change.
Focuses on the quality of the therapeutic relationship with parents and children.
Serves as a model of a human being struggling toward greater realness
Is genuine, integrated, and authentic.
Can openly express feelings and attitudes that are present in the relationship with the parent/child.

Therapy Goals.
Helping a parent/child become a fully functioning person.
Parents have the capacity to define their goals.
An openness to experience.
A trust in themselves.
An internal source of evaluation.
A willingness to continue growing.

Client’s Experience in Therapy
As parents/children feel understood and accepted, their defensiveness is less necessary and they become more open to their experiences.
Therapeutic relationship activate parent’s self-healing capacities.
Emphasizes the attitudes and personal characteristics of the therapist and the quality of therapeutic relationship.
Therapist listening in an accepting way to parents and children, they learn how to listen acceptingly to themselves.

Relationship between Therapist and Parent
A central variable related to progress in person-centered therapy is the relationship between therapist and parent.
A person-centered therapist is a facilitator.
Therapeutic Techniques.
It is not technique-oriented.
A misunderstanding---this approach is simply to restate what the parent/child just said or the technique of reflection of feelings (It is incorrect).
The therapeutic relationship is the primary agent of growth in the parent/child.
Therapist’s presence: being completely engaged in the relationship with parents/children.
The best source of knowledge about the parent/child is the individual themselves.
Caring confrontations can be beneficial

Application
Counseling with parents
Counseling children
individual counseling, group counseling, businesses, international relations, community development education, marriage and family …
A variety of problems: anxiety, crisis intervention, interpersonal difficulties, depression, personality disorder…..

Contribution from a Multicultural Perspective
Contributions

Has reached more than 30 counties and has been translated to 12 languages.
Reduction of racial and political tensions…

Limitations
Some people need more structure, coping skills, directedness.
Some may focus on family or societal expectations instead of internal evaluation.
May be unfamiliar with people in different cultures.

Contribution of PC Therapy
Contributions

Active role of responsibility of parent/child.
Inner and subjective experience.
Relationship-centered.
Focus on therapist’s attitudes.
Focus on empathy, being present, and respecting the parent’s values
Value multicultural context.

Summary and Evaluation
Limitations

Discount the significance of the past.
Misunderstanding the basic concept: e.g., reflection feelings.
Parents/children in crisis situations often need more directive intervention strategies.
Parents tend to expect a more structured approach.

Bozarth’s (1998) Summarization of Research on Psychotherapy
According to Bozarth's summarization of research on psychotherapy, the most consistent variables affecting therapy are empathy, unconditional positive regard and congruence (genuineness)

Effective psychotherapy predicated on:
Relationship between therapist and client.
Most consistent variables related to effectiveness are empathy, genuineness, and unconditional positive regard.

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