Introduction to Counseling & Therapy - Essay Example

?Logbook Entries: Introduction to Counselling & Therapy Freudian Psychoanalytic Theory On the very first lecture day, my interest for the was greatly deepened by the introduction by Ms. Prina Shinebourne. Although I knew the course will not make me qualified to practice as a therapist or counselor, I appreciated the fact that it will give me a thorough overview of different counselling approaches and what to expect in therapy. Dr Karen Ciclitira’s workshop on Freudian Psychoanalytic theory was quite overwhelming for me. Although there were concepts discussed that were complicated to understand, they nevertheless held my interest. I am in awe of the imagination and genius of its founder, Sigmund Freud, who was courageous enough to stand for his beliefs at a time when society was very restrictive of such free thought. The Psychoanalytic theory is premised on the belief that human nature is greatly affected by a person’s early childhood experiences and conflicts between impulses and prohibitions. I believe the complicated theories developed by Freud became highly controversial especially in the era they were presented due to the fact that it involved psychosexual issues considered “taboo” at the time. Still, because it attracted much interest and debate, it gained a prestigious distinction in the field of Psychology to merit a great deal of influence, intensive study, modification and application (Bateman, Brown & Pedder, 2000). His idea of the three systems of personality, the id, ego and superego being in constant battle within a person makes sense to me, as I liken it to a person’s continual debate of what is right and wrong, and then behaves according to his moral decisions. Such decisions are affected by what society dictates as well as what the person truly desires for himself. Freud’s views human behavior as determined by irrational forces, unconscious motivations and biological and instinctual drives evolving in the first six years of life (Freud, 1991). His psychosexual stages namely oral, anal, phallic, latent and genital all centered on a body part that provides great pleasure at a particular stage of development. Hence, experiences that greatly affect the individual at each stage leave a mark in one’s personality. Although the Freudian view of psychosexual stages of development coincides with other contemporary theories on human growth and development, I find it too degrading. It demeans a person’s capacity to make sound judgments because he is viewed as enslaved by his biological fixations and primal needs. It is as if it implies that a person is imprisoned by his past experiences and that his horrible past determines his woeful future. To survive living with negative experiences that may have marred a person’s personality or life views, he develops “defence mechanisms” that aim to keep those traumatic experiences repressed in the unconscious (Dryden, 2007). These defence mechanisms are usually practiced by everyone in their daily life not knowing that they are applications of Freudian thought. Defence mechanisms, I believe is one aspect of the Psychoanalytic theory that I would find useful in my practice as a counselor, as the patterned use of whichever kind already says a lot about the coping style and personality of the client. Personally, upon reading the list of common defence mechanisms, I related to many of it, and immediately caused me to reflect on why I use them and realize that in most instances, I am personally to blame for negative consequences of my decisions and behaviours. Equally impressive were the theories of Klein and Winnicott in applying psychoanalytic theories to children. Their theories dealt with several issues concerning young children and their primary relationships with their parents (Klein, 2000). They gave more clarity to the links between childhood and adulthood emotional and psychological issues. The goals of Psychoanalytic therapy are settling unresolved conflicts in a person’s past that deeply affect his current patterns of behavior and personality. It may involve bringing repressed painful memories to resurface to be dealt with consciously through the techniques of free association, dream analysis, hypnosis, transference, and analysis of resistance handled by a skilled psychoanalyst (McLeod, 2007). This tedious process intends for the client to reach a level of self-understanding for him to be able to move on with his life without the heavy emotional baggage he has been carrying all his life. This understanding is necessary for an eventual change in character. The lecture’s presentation of Psychodynamic theories’ strengths and weaknesses is very insightful. Although it was criticized to be lacking in scientific evidence as to its effectiveness as a psychological therapy, many would attest to its value in explaining many things about human nature. Application of its theories has found its way in many fields such as in understanding child development and education, apart from therapy. I salute Freud for all the brilliant ideas he has come up with, but my personal evaluation of Psychoanalytic therapy is that it is too heavy for my taste. Requiring a client to undergo such a challenging journey to his past in order to gain enlightenment may have its advantages, and I believe in its goals of self-understanding. However, dwelling too much in the past may also be a waste of time, as what is more essential upon gaining such awareness is the process of moving forward. Cognitive Behaviour Therapy Ms. Prina Shinebourne again introduced the next counseling approach which was Cognitive Behaviour Therapy. From its name, it is easy to understand that this approach was born as a combination of cognitive and behaviourist theories. Behaviour therapy was founded to counteract psychoanalytic theories which were deemed to be lacking in scientific basis. Hence, more empirical evidence to support behaviour therapy were done, mostly through experiments using animals and babies (Little Albert). However, what was lacking with behaviourist theories was the consideration of an individual’s thoughts, beliefs and interpretations believed to play significant roles in a person’s behaviour. Cognitive theories gave much importance to these. Putting together the two theories to come up with a sensible framework resulted in an effective therapy approach which I consider to be my favourite among all the approaches discussed in the module. As I understand the lecture, clients suffering from psychological problems are assumed to focus more on their flaws that pull them down than on their potentials that may spur them up to success. The basic premise of Cognitive Behavior Therapy is the clients’ erratic or exaggerated beliefs that it is their fault why they came to such a dreadful state (Beck, 1975). The goal of therapy is to help the client realize that reorganizing the way they view situations will call for a corresponding reorganization in behavior – sort of marrying the concepts of “mind over matter” and “self-fulfilling prophecy”. As an example, a recovering alcoholic will think that he has mustered enough discipline over alcohol (mind over matter), hence, he strives to be strong and sober enough to resist a drink offered to him at a party (self-fulfilling prophecy). The focus of Cognitive Behavior Therapy is more on thinking and acting more than just expressing feelings, which was more of the concentration of other kinds of therapies. It deals with the client’s present and not his past, although it acknowledges that his irrational thinking might have come from past negative experiences. The duration of the therapy process is usually short, as it immediately cuts to the core and does away with useless preliminaries. Personally, I can summarize Cognitive Behavior Therapy as the consideration of one’s perspective in life. One’s viewpoint of facts, ideas or situations colors everything one does, says and thinks. Person-Centered Therapy Dr. George Sandamas discussed Person-Centered Therapy and immediately, I felt a connection with the approach. Person-centered therapy stems from the theories of Carl Rogers, a noted psychologist who espoused humanistic views in therapy. His non-directive approaches to the therapeutic process raised a lot of eyebrows when it was introduced because it seemed to have thrown scientific techniques out the window and instead focused on the inherent needs of the client as a human being instead of a mere subject of therapy. This approach has great respect for a client’s subjective views and potential for self-actualization. It offers a fresh and hopeful perspective on its views on human nature. The main ingredient to successful therapy is a warm and caring counselor imbued with attributes such as congruence, unconditional positive regard and accurate empathic understanding. Such qualities are hard to come by in counselors and therapists nowadays. Rogers believe that possession of such qualities in addition to a high level of maturity qualifies a person to practice as a person-centered therapist, as it does not require a specialized training. Being a sensitive and tactful listener who exudes total acceptance of the client can compensate for the lack of formal counseling techniques (Corey, 2005). Being congruent means being real and authentic – no discrepancy between one’s perceptions and one’s being. A counselor needs to be congruent himself before he can decipher incongruence in his clients. His wisdom enables him to spot clients whose ideal self-concept is far from the truth, (i.e. the mistaken perception of one’s greatness in a skill when in reality, he is very poor at it). His goals include helping his clients have an openness to experience, a trust in themselves, an internal source of evaluation and a willingness to continue growing. The ability of a counsellor to accurately empathize with a client’s subjective experiences on an interpersonal, cognitive and affective level is essential in fully unlocking the client’s perceptions, feelings and motivations for his behavior (McLeod, 2007). The therapist’s enormous capacity to understand and accept the client no matter what communicates to the client that he is a worthy person. However, the therapist must caution against being swayed by emotions of his clients to justify excuses for wrong decisions, as he must always have a firm grasp of what is right and wrong. As the saying goes, “Love the sinner but not the sin”. This is not to say that the therapist holds the moral compass in the therapy sessions, but he is in a position to influence the “awakened” client to come up with his own appropriate decisions from the therapy point forward. A client comes to a counselor with a feeling of helplessness, powerlessness and an inability to make decisions or effectively direct his own life. He finds refuge in therapy with a warm, trustworthy and accepting friend who is there for him in his seemingly lowest point. He feels safe enough to shed his mask and just be. He finds freedom to express his innermost feelings, be they positive or negative, and is assured that he will remain acceptable. The counselor in turn, lays aside his own thinking and feeling and tries to enter the client’s world to fully understand him (McLeod, 2003). In this kind of relationship, the client finds opportunity to grow and overcome his feelings of failure – and commences his healing by deciding on a positive action towards self-actualization. Although I believe in sharing deep dark secrets with a close, long-time friend, I found the theories of Person-centered therapy to be too good to be true, and more personal than professional especially after being exposed to other psychological approaches. The rather naive views that clients must be embraced with unconditional positive regard seems ideal, as if handing would-be counselors rose-colored lenses to see with. I do not feel comfortable with my jaded perception because deep inside I would really want to believe that such an approach is truly successful. However, my doubts that there is a human counselor with such immense patience and understanding while maintaining professional judgment impair my full confidence in the approach. The Counselling Relationship Dr. Sandamas continued with this next session about the how a counselor’s relationship with his client should be. Heslop (1992) emphasized how difficult it is for a client to open up to a stranger unless that person shows genuine care for him. Although acting is part of many professions, it is not called for in counseling and therapy, as counselors and therapists need to be real in how they deal with their clients. Horwitz (1974) termed the counseling relationship as a therapeutic alliance which means both the counselor and the client join forces to help client in his problem. Rogers’ If-Then hypothesis on how a counselor should approach his or her relationship with the client is very helpful in keeping the counselor focused on the objective goal of therapy (The Counselling Relationship lecture notes). Facilitative conditions of therapy include genuineness, full acceptance and empathy on the part of the counselor. Having all three would result in the counselor developing his self-esteem knowing that he is being valued, is encouraged to be more open about his innermost thoughts and emotions because of the trust developed in the relationship. The client gains more self-understanding and becomes more knowledgeable of how he deals with issues. Eventually, he develops more autonomy to deal with such on his own. After being exposed to various counseling approaches, I felt ready to learn about the mechanics of therapy. I realized that it was not as easy as it seems, considering so much reflection, restraint and investment in thinking and feeling are entailed in each session. I liken it to a catholic confession where a person confesses all his sins to a priest while the priest listens and dispenses advise. However, in a counseling session, the counselor does not extract due penance from the client. Coming to therapy is enough proof that he is aware of issues, sins, included. It is up to him how to come out of the session strong enough to face whatever reality would pose. CBT for Substance Mis-Use Of all the counseling approaches discussed, my preference is the Cognitive Behaviour Therapy. Choosing this topic for my essay prompted me to read more about it, especially in application to the problem of substance mis-use. Dr. Jenny Maslin explained the intricate considerations in the evolution of the substance abuse problems that can be traced back as far as early childhood traumatic experiences. It also meticulously studies the interplay of thoughts, moods, physical sensations and behaviours within the client’s environment (Padesky & Mooney, 1990). Overall, the lecture presented a highly logical sequence of understanding the substance mis-use/abuse problem and seriously works on both the client’s thinking and perception (cognitive part) and the resulting behaviour of such thoughts (behaviour part). I have met several people who have been “hooked” into the habit of drinking or doing drugs and for them it has become a normal part of their lifestyle. For most of them, it does not seem to disrupt the normal course of their lives, and for some of them, they are not even aware that it is causing them troubles. Reading the DSM-IV-TR (2002), I realize that some of them may already be sufferers of problem substance abuse, although I would not know to what extent. It is ultimately their decision to stop using the drugs and alcohol and pursue clean living. CBT proves to be an effective method of helping them out if they wish. Being a friend, I will share with them my knowledge of CBT, and hope that they will not take it as unsolicited advice. Taking tips from the previous lecture on the counseling relationship, I would need to learn how to establish their trust and eventually a “pseudo-therapeutic alliance” (pseudo-TA). Knowing I am not authorized to be a therapist or counselor, I may refer them to Dr. Maslin for help. In the meantime, I can add helping them as one of my goals in pursuing a future career being a counselor who practices CBT. Counselling in Occupational Health and Health Care Settings The previous lecture on applying CBT on a more specific problem already broadened my thinking on how to practice theories I have learned, however, the current lectures facilitated by Ms. Katy Filer on how one can actually be a practicing counselor/psychotherapist/psychologist were very helpful for me. Ms. Filer gave a more specific route in the advancement of one’s career from being a student to being a practitioner (ex. which courses/degrees/accreditations are necessary to be able to practice professionally). As she explained the options, I know in my heart that I would like to have a future in Counseling and Educational Psychology because I know I have the gift of helping others with their problems. I especially look forward to working with students because I am concerned at the alarming rate of increase in youth problems and learning disabilities. I would like to be instrumental in helping the youth of today be the well-adjusted, productive leaders of tomorrow. Ms. Filer’s lecture on counseling in health care settings further broadened my horizons in the area of counseling. Being healthy constitutes an individual’s well-being in all body, mind and spirit. People stricken with a deadly disease such as Cancer or AIDS are in need of counseling so that they will be better able to deal with their life-changing situations. Their families need counseling as well so they can better support their sick family member as well as prepare them for his or her inevitable death. Although more and more treatment approaches are developed, the pain that illness brings does not stop at the physical. Emotional and spiritual health may be brought about by counseling and therapy not only for the patient but for also for the family and carers too. Counselling with children and young people Most psychological theories I have learned claim that much of an individual’s personality and behaviour have been shaped from early childhood. Freud, for one, emphasizes the importance of positive childhood experiences because if the opposite happen, much trauma will leave the child scarred for life. The same beliefs are held by the proponents of Cognitive Behaviour Therapy, as evidenced by Beck’s (1989) cognitive theory of emotional disorder. This model studies early childhood experiences as contributory to adult patterns of behaviours. As responsible adults, counsellors have a duty to help and protect children, in compliance with the Children’s Act 2004, the legislative support of Every Child Matters programme. This act aims to “improve and integrate children's services, promote early intervention, provide strong leadership and bring together different professionals in multi-disciplinary teams in order achieve positive outcomes for children and young people and their families” (DfEs Children Act and Reports, 2004). The five key outcomes set out in Every Child Matters namely: being healthy, staying safe, enjoying and achieving, making a positive contribution and economic well-being (Every Child Matters: Change for Children). Dr. Nolas presented interventions and support strategies for children besieged with emotional and psychological problems. Dissecting sources of such problems as most likely caused by biological or psychological factors and caused or aggravated by family, school and community triggers. It may be pathetic that at their age, children and adolescents are already suffering emotional and psychological problems which may impede their overall growth and development. However, as more people and organizations are showing concern, more support systems are becoming available to help them. Examples are more training schools such as the Anna Freud Centre which aim to uphold the emotional health of children. More organizations are setting up internet support for families and the children themselves such as Kids Company and Child Line. These are accessible to children to turn to when they have problems they could not share with any other familiar person. Sometimes, it feels safer to talk to someone who does not know you because you do not stand to be judged as the person they know. The positive news is that more awareness of child and adolescent problems have brought on multi-agency working together to support and provide the necessary interventions for these children so they still stand a chance for a brighter tomorrow. Research in/on clinical practice Dr. Nolas’ lecture stressed the importance of ongoing research and development of psychotherapeutic clinical practice. Even if bright proponents have left a great legacy in various therapeutic approaches, there still needs to be constant evaluation if they still work, considering people continue to evolve. Although the basic premises remain, new and better methods of implementing the therapy may emerge and prove to be more beneficial to clients (McLeod, 2001). Research opens up one’s mind to welcome different perspectives, so even an accomplished professional should not be complacent with knowing so much. Final Entry I have always been fascinated with counselling and therapy. Taking this course was interesting and exciting for me because I get to learn about something I’ve always longed to know about. I appreciate the chronological order of the lectures for this module, as it goes from theory to practice. Knowing how various counseling theories and approaches work empowers me to choose which ones I prefer to specialize in. For now, I have chosen Cognitive Behaviour Therapy due to its sound and sensible theories and practices. How problematic people are helped by talking to a counselor and come out of the therapy as whole persons, on their way to healing, is something I would like to get involved in as a future career. I feel all the lectures, tasks and interactions I’ve experienced in this module will go a long way in helping me reach that dream. References Bateman, A., Brown, D., & Pedder, J. (2000). Introduction to Psychotherapy. An Outline of Psychodynamic Principles and Practice. London: Routledge. Beck, A.T. (1975) Depression: Cause & Treatment. Philadelphia: University of Pennsylvania, Press. Beck’s (1989) Cognitive Theory of emotional disorder, as mentioned in the Shinebourne (2010) lecture Corey, G. (2005) Theory and Practice of Counseling and Psychotherapy, 7th ed. Brooks/Cole, a division of Thomson Learning Inc. DfEs Children Act and Reports, (2004) information retrieved on 10 January 2011 from http://dfes.gov.uk/publications/childrenactreport/#2004 Dryden, W. (2007) Dryden’s Handbook of Individual Therapy. London. Sage DSM-IV-TR (text revision of 2002) Substance abuse, Retrieved on December 21, 2010 From:http://allpsych.com/disorders/substance/substanceabuse.html; http://dsmivtr.org/2-3changes.cfm Every Child Matters: Change for Children. Retrieved on January 10, 2011 from http://www.everychildmatters.gov.uk Freud, S. (1991). Two Short Accounts of Psycho-Analysis. Five Lectures on Psychoanalysis. The Question of Lay Analysis. London: Penguin. Heslop, A. (1992). Qualities of the effective counsellor. The Child Care Worker. Vol. 10 (6) pp.10-11 Horwitz (1974) as mentioned in the Counselling Relationship lecture by Dr. Sandamas Klein, M. (2000). The Psychodynamic Counselling Primer. A Concise, Accessible, Comprehensive Introduction. Ross-on-Wye: PCCS Books. Kline, P. (1995). Psychology and Freudian Theory. London: Routledge. McLeod, J. (2001). Qualitative Research in Counselling and Psychotherapy. London: Sage McLeod, J. (2003).The counsellor’s workbook. Open University Press. McLeod, J. (2007) Counselling Skills. Milton Keynes. OUP. Padesky, C.A. and Mooney, K.A. (1990). Clinical tip: Presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14 (available from www.padesky.com/clinicalcorner.htm).Salkovskis, P.M. (2002). Empirically grounded clinical interventions: Cognitive Behavioural Therapy progressing through a multi-dimensional approach to clinical science. Behavioural and Cognitive Psychotherapy, 30, 3-9. Read More