Integrative Counseling

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Integrative Counseling

• EDCE 655
• Theories Techniques II

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Integrative Approach

• Not a grab bag approach
• A systematic approach!
• Know the Key Concepts

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Factors of Awareness
Spirit Feel
Mind Body Think Act
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Factors Effecting Who What you Are
Cognitive
Behavioral
Environmental
Spiritual
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Challenges with Integrative Counseling

• Be alert to mixing theories with incompatible
  underlying assumptions
• Irrational vs. Rational
• Beware of subscribing to one central or universal
  view of human nature remain OPEN
• Select a counseling framework that fits your
  personality

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Integrative Counseling

• Eclectic Counseling concepts from a variety of
  systems
• Comprehensive approach
• Product of great deal of clinical practice
• Wide range of clients no single theory
• 1982 eclectic most popular among clinical
  counseling psychologists (41.2)
• 1990s continue toward integration
• Integrative includes spiritual dimension
• Jung

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Integrative Therapeutic Goals

• Diverse depending on theory
• Explore clients expectations goals

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Integrative Counselors Function Role

• Roles vary according to the model used
• Educational?
• Facilitative?
• Confrontive?
• Defining the role depends on
• Type of counseling
• Counselors level of training
• The clientele
• Therapeutic setting

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Integrative Control of Client Behavior

• Structure
• Amount depends on client circumstances
• Most Structured
• During initial interview

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Relationship with the Client

• Characteristics of successful counselor genuine
  respect, flexibility, sense of humor, warmth,
  etc.
• Be yourself
• Try to get a match between client and counselor
• Outcome studies support this

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Outcome research for eclecticism Lambert (1986)
contends that eclecticism provides the broad
base needed for integration of research findings

• Substantial number of outpatients improve
  spontaneously with out the benefit of formal
  psychotherapy
• Most of major approaches have been tested with
  empirical research has shown that psychotherapy
  is generally effective
• Common factors associated with positive outcomes
  include
• Support factors counselor / client relationship
• Learning factors insight, cognitive learning
  self-acceptance
• Action factors reality testing, modeling,
  practice, facing fears
• Specific techniques can be selected for dealing
  with specific problems

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Clients Experience in Integrative Counseling

• Most some degree of suffering, pain, or
  discontent problems can range from marital
  problems to existential concerns
• Clients want expert help and fast results
• Counselor keep clients characteristics in mind
• Focus of counseling may change at different phases

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Integrative Division of Responsibility

• Establish in intake session
• Counselor client take responsibility for
  direction of therapy
• Get client involved with responsibility as soon
  as possible
• Client-initiated contracts

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Learning to Use Integrative Techniques
Appropriately

• Depends on purpose of counseling, setting,
  personality and style of counselor and client
• Technical eclecticism Lazarus multimodal
• YOU are your best technique
• Reasons for applying techniques examine
  motivations for using or avoiding techniques
• NOT A GRAB BAG!!!!

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Integrative Counseling

• THE END

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Trapped

• A 30-year-old male chemist was referred by his
  internist because he wanted to talk to someone
  about his shaky marriage. During 5 years of
  courtship and 2 years of marriage, there have
  been numerous separations, usually precipitated
  by his dissatisfaction. Although he and his wife
  share many interests and, until recently, have
  had a satisfactory sexual relationship, he thinks
  that his wife is basically a cold and
  self-centered person who has no real concern
  about his career or feelings. His dissatisfaction
  periodically builds up to a point that leads to
  fights, which often result in temporary
  separations. He then feels lonely and comes
  crawling back to her. Their relationship
  currently is one of icy separateness, and the
  patient seems to be seeking support to make a
  permanent break. Although he is in extreme
  distress because of his marital situation,
  frequently choking back the tears, there is no
  evidence that he has difficulties with other
  interpersonal relationships. He has many good
  friends, functions well in his job, and denies
  symptoms other than distress about his marital
  situation.

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Questions for Reflection Trapped

• How do you feel about this client?
• From a Brief Solution-Focused Perspective
• Why would BS-F appropriate for this client?
• What techniques would you use?
• Form an Integrative Approach
• What theoretical basis would you have to treat
  this client?
• Approach the clients thinking, feeling, or
  behavior?
• What techniques would you use?

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Treatment Planning Considerations

• Duration
• Level of Directiveness
• Supportive or Exploratory
• Cognitive/Behavioral/Affective
• Group/Individual/Family
• Relevant Counselor Variables
• Pace
• Counseling Approach
• Seligman, 1985

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Stages in the Systematic Counseling Model
Gilliand Davis (1976)
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Role of Diagnosis in Integrative Counseling

• Psychodiagnosis analysis explanation of
  clients problem
• Provides a working hypothesis not final
  category
• Arguments for psychodiagnosis
• Helps communication among professionals
• Directs the way for appropriate treatment
• Predicts the course of disorders
• Provides a framework for research

• Arguments against psychodiagnosis (generally
  existential or relationship-oriented approaches)
• No reference to clients subjective perception
• Best vantage point is through client not a system
  of classification
• Can lead to self-fulfilling prophecies
• Can narrow counselors vision
• Can reduce client to a diagnostic category
• Summary of diagnosis
• Continuing process that focuses on understanding
  the client
• Avoid labeling, or stereotyping the clinet
• Helps the counselor conceptualize the clients
  problem
• Ethical issues screen clients for
  life-threatening problems (organic disorders,
  schizophrenia, manic-depression, suicidal types
  of depression)

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Guidelines for use of Testing

• Involve clients in test-selection process
• Consider clients reasons for wanting tests
• Emphasize that tests are only tools
• Clarify purpose limits of the test
• Present interpretations results in a
  non-judgmental way
• Consider ethical standards recognize
  socioeconomic, ethnic, cultural factors

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Adaptive Counseling Therapy

• ACT is a systematic organization of techniques
  tailored specifically to each clients individual
  needs.
• It is based on situational leadership theory a
  social leadership model which likens itself to
  one of a managerial role whose coaching support
  helps the client achieve their goals.
• Identifiable characteristics clients are
  conceptualized in terms of readiness in obtaining
  targeted therapeutic goals. The higher the
  readiness, the less directive the therapist.
• Systematic Eclectic Psychotherapy Larry E.
  Beutler

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Multimodal Therapy

• MMT is considered to demonstrate technical rather
  than theoretical eclecticism.
• The goal of MMT is to unify various models /
  techniques into usable compatible tools without
  necessarily subscribing to specific theoretical
  assumptions.
• While MMT does not have one specific theory as
  its foundation, it does draw heavily from social
  learning theory, systems theory, group
  communication theory.
• The therapeutic relationship is one of trainer /
  trainee relies on bridging as a relationship
  building technique. This bridging meets the
  client in the clients preferred modality of
  expression (i.e., in the affective or cognitive
  method of dealing with their problem), then once
  the relationship has been established the client
  can be connected to other areas. This approach
  differs from most traditional therapies in that
  the many counselors seek to move the client into
  exploring other areas, choosing to circumventing
  their current realm of experiencing. The
  rationale is to meet the client where he or she
  is and work from that point of joining.
• Identifiable Characteristics use the BASIC-ID
  structure which is used to explore excesses
  deficits in behavior, affective reactions,
  sensations, imagery, cognition, interpersonal
  relationships, biological functioning. Once all
  these areas have been assessed, the technique to
  be used will be selected based on individual
  client needs.

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Eclectic Counseling PsychotherapyRelationship
Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyInterviewing
Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyAssessment
Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyIdea-Generatio
n Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyCase-Handling
Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyInsight
Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyBehavior
Management Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyEvaluation
Termination Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyPersonal
Professional Growth Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.
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Eclectic Counseling PsychotherapyResearch
Strategies
From Theories Strategies in Counseling
Psychotherapy, 2nd Ed. (1989). Gilliland, B.E.,
James, R.K., Bowman, J.T.