MA Psy_Sem-3_Psychotherapies_Unit-1_P-2

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M.A.Psychology OBJECTIVES PRINCIPLES &ETHICAL ISSUES IN PSYCHOTHERAPY Course Code MAP613 OBJECTIVES Semester: III PRINCIPLES e-Lesson: 2 &ETHICAL ISSUES 1 IN SLM Unit: PSYCHOTHERAPY P 608) INSTITUTE OF DISTANCE AND ONLINE LEARNING

OBJECTIVES PRINCIPLES &ETHICAL ISSUES IN PSYCHOTHERAPY INTRODUCTION 3 OBJECTIVES Psychotherapy plays an important role to help individuals suffering from psychological Describe the objectives and principles of problems. psychotherapy.. Psychotherapy is the treatment. Explain ethical issues in psychotherapy. Psychotherapy is a generic term covering the entire spectrum of psychological treatment methods. P 6011) INSTITUTE OF DISTANCE AND ONLINE LEARNING

TOPICS TO BE COVERED Psychotherapy is more than a talk between two people regarding some problem. What are the lists of ethical issues in psychotherapy? List down principles of psychotherapy. OBJECTIVES PRINCIPLES &ETHICAL ISSUES IN PSYCHOTHERAPY

Introducti onThe process of therapy has many steps, and begins before the client comes for the first appointment. Below are several steps and some tips on managing them.

First Inquiry The client's first inquiry is often a phone call or email about the possibility of therapy. You should express interest in working with the client, and set up a time to meet.

First Appointment It is important to realize that the client may be anxious, upset, or in turmoil when they come for their appointment.

The Start Of Therapy ■ Therapy begins with a first interview. ■ It is a relational process, where the therapist, as a person, directs the process and communicates verbally and non- verbally what therapy is like. ■ They \"listen\" to what is said and not said, what is communicated in verbal and in non-verbal ways. ■ Sullivan notes that many patients become annoyed when the therapist asks \"obvious\" questions, and suggests that therapists should explain they are interested in the client's unique perceptions. Different people experience \"obvious\" stresses and make \"common sense\" choices for a range of different reasons.

■ He also recommends constantly assessing whether your questions and the client's answers have alternate meanings. ■ For example Where do you live?\" based on an assumption that the client has a stable residence, ■ Are you married?\" based on an assumption that the therapist will not understand the client's problems without some frame of reference,

Interview stages ■ The Inception is the beginning of the interview. The reason for referral, greeting, previously reviewed information, and ethical concerns of confidentiality and informed consent are discussed during this stage. ■ The Reconnaissance entails gathering information about the problems and stresses that bring the client to therapy. ■ The Detailed Inquiry entails gathering specific and detailed information from the client, separating relevant from irrelevant information, and understanding the balance of problems and stresses compared to resources and strengths. This can include, for example, knowing what the client has tried to resolve problems before, and asking what has been helpful and what has not. ■ The final phase is Termination, the end of the interview

The Initial Interview, Do's And Don'ts ■ Do not argue with, minimize, or challenge clients. ■ Do not praise clients or give false assurances. ■ Do not interpret the client's words or actions to the client, or speculate on the dynamics underlying their personal functioning or the functioning of those around them. ■ Do not offer a diagnosis. ■ Do not interrogate clients on sensitive areas of their lives.

Note Taking Newer therapists may feel taking notes helps them remember the content of the therapy session, and this is likely true ■ Clients usually do not know what is and is not important to therapists. They may believe some thoughts and feelings are quite normal, or that everyone experiences the same things, and so they may not have the perspective to think otherwise. ■ Clients may not want to reveal certain things until they are sure they can trust their therapists ■ Some things are emotionally painful to face, or require insight and understanding to recognize. As a result, clients may not face these things not as a way to deceive their therapists, but rather as a way to deceive themselves. They may not realize patterns, triggers, or signs and so are not able to report them.

Resistanc e Resistance is a way clients protect themselves from painful experiences.

Establishing Rapport ■ The need to be dependent and receive sympathy and understanding (social support) ■ The need for unqualified acceptance and validation (unconditional positive regard) ■ The need to reveal painful feelings and ideas; while Freud called this catharsis and felt it was not therapeutic, others disagree and believe that \"lifting\" or \"sharing\" an emotional \"burden\" is a powerful form of healing in and of itself. ■ The need for education about an illness, which often makes a problem seem less threatening, confusing, and powerful, and offers some hope. ■ The need for transference, or to work out a problem with another person who will set aside their own needs long enough to help clients understand and resolve their conflicts.

The therapist communicates: ■ Understanding of the problem ■ Interest in the person as a person ■ Tolerance and acceptance ■ Freedom to experiment with different values and beliefs, without judgment or pressure ■ Objectivity about problems but empathy and understanding for the person experiencing them

Do your best to avoid: ■ Exclamations of surprise, over concern, or doubt ■ Flattery and praise ■ Moral judgments or criticisms ■ Expressions that may be interpreted as punishment, impatience, false promises, bragging, or threatening ■ Expressions that maybe interpreted as blaming or rejecting ■ Quick interpretations, advice, dream interpretation, and psycho-babble

Reflective Listening ■ Open-ended questions (can you tell me more about that?) ■ Allowing the client to determine important areas for inquiry and the nature of his problems ■ Talking less, listening MORE ■ Remaining cool, calm, and patient ■ Remembering that your understanding of the client may be wrong or incomplete

Counseling versus Psychotherapy Psychotherapy (Engler and Goleman, 1992) - Is the general name for a variety of psychological interventions designed to help people resolve, emotional, behavioral, or interpersonal problems of various kinds and improve the quality of their lives.

Counseling versus Psychotherapy Counseling is a professional relationships that empowers diverse individuals, families, and group to accomplish mental health, wellness, education, and career goals. (ACA, 2010)

…counseling vs psychotherapy Over the years there have plethora of definitions of counseling that suggest it could be anything from a problem-solving, directive, and rational approach to helping normal people – an approach that is distinguishable from psychotherapy (Williamson, 1950, 1958); - to a process that is similar to but less intensive than psychotherapy (Nugent & Jones, 2005); - to an approach that suggests that there is no essential difference between the two (Neukrug: Patterson, 1986).

…counseling vs psychotherapy The word Guidance appeared around 1600 and was defined as “the process of guiding an individual”. Early Guidance work involved individuals giving moralistic and direct advice. This definition continued until the twentieth century, when the vocational guidance counselors used the word to describe the act of “guiding” an individual into a profession and offering suggestion for life skills. With the development of psychoanalysis near the end of the nineteenth century came the word psychotherapy. Meaning “caring for the soul”, the world derived from the Greek words psyche

…counseling vs psychotherapy meaning spirit or soul, and therapeutikos, meaning caring for another (Kleinke, 1994) During the early part of 20th century, vocational guidance counselors became increasingly dissatisfied with the word guidance and its heavy emphasis on advice giving and morality. Consequently, the word counseling was adopted to indicate that vocational counselors, like the psychoanalysts who practiced psychotherapy, dealt with social and emotional issues.

…counseling vs psychotherapy As mental health workers became more prevalent during the mid-1900, they too adopted the word counseling, rather used the word guidance with its moralistic implications, or psychotherapy, which was associated with psychoanalysis. In the training of counselors today, the word guidance has tended to take a back seat to the word counseling, while the worlds counseling and psychotherapy are generally used interchangeably in textbooks (e.i. Theory and Practice of Counseling and Psychotherpy, Corey)

…counseling vs psychotherapy Despite the lack of distinction made in most texts, a differentiation between counseling and psychotherapy is likely to be made by the average person, perhaps by many counseling students, and even by professors of counseling. Acknowledging this common usage, one model of understanding these terms would place guidance and psychotherapy on opposite extremes, with counseling falling somewhere midway on the continuum.

…counseling vs psychotherapy GUIDANCE COUNSELLING PSYCHOTHERAP Y Short-term Long-term Modifying behavior Personality reconstruction Surface issues Deep-seated issues Here and now There and then Preventive Restorative Conscious Unconscious Helper- Helpee- centered centered

…counseling vs psychotherapy Comparison of Mental Health Professionals (Neukrug, 2012) Whether we call it guidance, counseling, or psychoterapy, in todays world we find a number of professionals practicing it. In fact, although difference in the training of mental health professionals exist, over the years their professional duties have begun to overlap (Todd & Bohart, 2006).

SIX STAGES Stage One: Relationship building Stage Two: Assessment and diagnosis Stage Three: Formulation of counseling goals Stage Four: Intervention and problem solving Stage Five: Termination and Follow Up Stage Six: Research and evaluation

General Categories of Counseling and Psychotherapy Approaches (Corey, 2009) 1. Psychodynamic Approaches 2. Experiential and Relationship- Oriented Approaches 3. Action-Oriented Therapies 4. Systems-Oriented Approaches 5. Postmodern Approaches

Psychodynamic Approaches a. Psychoanalytic therapy – is based largely on insight, unconscious motivation, and reconstruction of personality b. Adlerian therapy – differs from psychoanalytic theory in many respects but it can broadly be considered an analytic perspective. It focus on meaning, goals, purposeful behavior, conscious action, belonging and social interest.

Experiential and Relationship Oriented-Approaches a. Existential approach – stress the concern for what it means to be fully human. It suggests certain themes that are part of the human condition such as freedom and responsibility, anxiety, guilt, awareness of being finite, creating meaning in the world and shaping one’s future by making active choices. b. Person-centered approach – which is rooted in humanistic philosophy, places emphasis on the basic attitudes of the therapist. It maintains the quality of the client-therapist relationship. c. Gestalt therapy – which offers range of experiment to help clients gain awareness of what they are experiencing in the here and now – that, is the present.

Action-Oriented Therapies a. Reality Therapy – focuses on clients’ current behavior and stresses developing clear plans for new behavior. b. Behavior Therapy – puts a premium on doing and taking steps to make concrete changes c. Rational Emotive Behavior therapy and Cognitive therapy – highlight the necessity of learning how to challenge dysfunctional beliefs and automatic thoughts that lead to behavioral problems.

Systems Perspective The system orientation stresses the importance of understanding individuals in the context of the surroundings that influence their development. a. Feminist Therapy b. Family Therapy

Post Modern Approaches Challenges the basic assumptions of most of the traditional approaches by assuming that there is no single truth and reality is socially constructed through human interaction. a. social constructionism b. solution-focused brief therapy c. narrative therapy

Note: Discussant of Counseling Theories/Therapy/Psychotherapy Framework of discussions: • Proponent/s • View of Human/Theory of Personality • Sources/Nature of Difficulty/Maladjustment • Goal of Counseling • Role of Counselor • Counseling Strategies • Steps in Counseling • Contributions/Limitations

WHAT IS PSYCHOTHERAPY? Psychotherapy is a systematic and scientific way of changing thought emotion or behavior of a person which is based on psychological principle .

COMMON FACTORS IN PSYCHOTHERAPIES ❖ Therapeutic relationship ❖ Active listening ❖ Release of Emotion ❖ Restoration of morale

COMMON FACTORS IN PSYCHOTHERAPIES ❖ Providing information ❖ Providing rational for treatment ❖ Advice and guidance ❖ Suggestion

ETHICAL ISSUES Beneficence and non maleficence Fidelity and responsibility Autonomy Integrity Justice Respect for people right & dignity Informed Consent Confidentiality

CONCLUSION These ethics assist in such circumstances by presenting attention to ethical factors that can be considered and may prove to be more useful. Ethics statements alleviate the possibility of making professional judgments in situations that are changing and full of uncertainties. Approving statement of ethics, members of the American Counselling Association are committing themselves to engaging with the challenge of striving to be ethical, even when doing so involves making difficult decisions or acting courageously.

MULTIPLE CHOICE QUESTIONS 1.Which of the following is a not a principle of psychotherapy? a. Mechanics of therapeutic change b. Dynamics of therapeutic change c. Both a and b d. None of these Answer-C 2. ___________ aims at the solution of clients’ problems and is a much-misunderstood concept. a. Counselling b. Guidance c. Therapy d. None of these Answer-A

3. ___________ aims at the solution of clients’ problems and is a much-misunderstood concept. a. Counselling b. Guidance c. Therapy d. None of these Answer- A 4. -------------------------- is the term given to a number of procedures that provide active help, in the form of fact giving and interpretation. a. Counselling b. Guidance c. Therapy d. None of these Answer- B 41

REFERENCES Corey G. (2001).Theory and Practice of Counselling and Psychotherapy, Brooks/ Cole, Thomson Learning: U.S.A. Sharf R. S. (2000). Theories of Psychotherapy & Counselling, (2nd edition). University of Delaware: Brooks/Cole, Thomson Learning: U.S.A.

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