Psychotherapy and counseling today

560 Pages·2008·16.101 MB·English

by  Carol Shaw Austad

C
OUNSELING AND
P T
SYCHOTHERAPY ODAY
Th eory, Practice, and Research
Carol Shaw Austad
Central Connecticut State University
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Library of Congress Cataloging-in-Publication Data
Austad, Carol Shaw.
Counselling and psychotherapy today : theory, practice, and research / Carol Shaw Austad.
—1st ed.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-07-311225-1 (alk. paper)
ISBN-10: 0-07-311225-9 (alk. paper)
1. Psychotherapy—Textbooks. 2. Counselling—Textbooks. I. Title.
[DNLM: 1. Psychotherapy-methods. 2. Counselling—methods. WM 420 A932c 2009]
RC480.A848 2009
616.89'14—dc22 2008029233
Th e Internet addresses listed in the text were accurate at the time of publication. Th e inclusion of a
Web site does not indicate an endorsement by the authors or McGraw-Hill, and McGraw-Hill does
not guarantee the accuracy of the information presented at these sites.
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B C
RIEF ONTENTS
Preface xi
About the Author xviii
CHAPTER 1 Th e State of Psychotherapy and Counseling Today: Changing
Th eory, Practice, and Research 1
CHAPTER 2 P rofessionalism, Ethics, and Legal Issues in Psychotherapy 37
CHAPTER 3 Freud’s Classical Psychoanalysis 58
CHAPTER 4 Psychodynamic Th erapy Aft er Freud 90
CHAPTER 5 A dler’s Individual Psychology 120
CHAPTER 6 R ogers’s Client-Centered Th erapy 151
CHAPTER 7 Existential Th erapy 177
CHAPTER 8 Gestalt Th erapy 206
CHAPTER 9 Behavior Th erapy 232
CHAPTER 10 Cognitive Th erapy 272
CHAPTER 11 Reality Th erapy 308
CHAPTER 12 Feminist Th erapy 335
CHAPTER 13 Biopsychosocial Th erapy and Health Psychology 367
CHAPTER 14 Psychopharmacology 398
CHAPTER 15 E clectic and Other Psychotherapies 431
APPENDIX A Case Studies 458
APPENDIX B C omparison of Psychotherapies 463
References 474
Name Index 511
Subject Index 521
iii
ﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱱﱲ
C
ONTENTS
Preface xi Effi cacy Versus Eff ectiveness 23
About the Author xviii Evidence-Based Practice 24
Common Factors Versus Specifi c Techniques 28
Other Issues Related to Th eory, Practice, and
Research 29
CHAPTER 1 Th e State of Psychotherapy and
Counseling Today: Changing Diversity Awareness 30
Th eory, Practice, and Computer Literacy 30
Research 1 Length of Treatment 31
How Patients Use Psychotherapy 31
Psychotherapy and the Psychotherapist 1
Summary 33
Becoming a Psychotherapist or Counselor 2
Resources 35
Major Types of Psychotherapy 3
Class Exercises and Activities 35
Evolving Th eory, Practice, and Research of
Psychotherapy 5
Changes in Th eory 7
Emphasis on Biology 7 CHAPTER 2 Professionalism, Ethics,
and Legal Issues in
Move to More Concise Th eories 9
Psychotherapy 37
Changes in Practice 10
Business and Psychotherapy 10 Historical Context 37
Economics and Psychotherapy 11 Psychotherapy Practitioners Today 38
Managed Care 12 Where Psychotherapists Practice 41
Integrated Behavioral Health Care 14 Ethical Issues 43
Politics and Health Care 15 Competence 43
Psychopharmacology and Psychotherapy 18 Informed Consent 43
Changes in Research 18 Confi dentiality 45
Researcher/Clinician Gap 18 Involuntary Commitment 46
History of Psychotherapy Research 19 Dangerousness 46
Research Methodology 19 Duty to Warn and Protect 47
O utcome and Process Research 20 Multiple or Dual Relationships 48
Th e Equivalency Eff ect 21 Diagnosis and Assessment 48
Empirically Supported/Validated Th erapy 23 Record Keeping and HIPAA 48
iv
Contents v
Malpractice 49 CHAPTER 4 Psychodynamic Th erapy Aft er
Th e National Practitioner Data Bank 50 Freud 90
Multiculturalism and Diversity 51 Historical Context 90
Summary 54
Analytical Psychology 91
Resources 55
About Carl Jung 91
Class Exercises and Activities 56
Jungian Practice 93
Neo-freudian Psychoanalysis 94
Karen Horney’s Psychoanalysis 94
CHAPTER 3 Freud’s Classical
About Karen Horney 95
Psychoanalysis 58
About Harry Stack Sullivan 97
Historical Context 58 Harry Stack Sullivan’s Interpersonal
About Sigmund Freud 59 Psychoanalysis 97
Th eory of Classical Psychoanalysis 61 Ego Analysis and Object Relations/Self
Psychology 99
Key Concepts 61
Ego Analysis 99
Psychodynamics 61
Object Relations and Self Psychology 102
Libidinal Energy and Cathexis 62
Short-Term Dynamic Th erapy 108
Levels of Consciousness 62
Short-Term Dynamic Th erapy Practice 111
Personality Structures 62
Short-Term Dynamic Th erapy Research 113
Psychosexual Stages 64
Relational Psychoanalysis 115
Repression and Defense Mechanisms 67
Summary 116
Normal and Abnormal Behavior 69
Resources 118
Transference and Countertransference 70
Class Exercises and Activities 119
Dream Analysis 71
Practice of Classical Psychoanalysis 71
CHAPTER 5 Adler’s Individual
Assessment and Diagnosis 71
Psychology 120
Negotiation of Th erapeutic Relationship and Length
of Treatment 72
Historical Context 120
Th erapeutic Techniques 73
Psychoanalysis 120
Th e Process of Th erapy 74 About Alfred Adler 121
Th erapy in Action: Dr. John Garrett and the Case
Vaihinger’s “As If” Concept 122
of Jonathan 76
Social Justice and Feminism 122
Research Directions of Classical
Holism: Th e Undivided Self 122
Psychoanalysis 80
Prevention 123
Issues of Diversity 83
Trends in Adlerian Th erapy 123
Major Critiques of Classical
Psychoanalysis 85 Th eory of Individual Psychology 124
Summary 87 Key Concepts 125
Resources 88 Striving for Signifi cance 125
Class Exercises and Activities 89 Inferiority Complex 125
vi Contents
Social Interest and Feeling of Community 126 Practice of Client-Centered Th erapy 159
Fictional Final Goal and Style of Life 126 Assessment and Diagnosis 159
Birth Order and Family Constellation 127 Negotiation of Th erapeutic Relationship and Length
Other Adlerian Concepts 128 of Treatment 160
Normal and Abnormal Behavior 130 Th erapeutic Techniques 161
Dreikurs’s Basic Mistake 132 Th e Process of Th erapy 162
Th erapy in Action: Dr. John Roberts and the
Practice of Individual Psychology 133
Case of Jonathan 163
Assessment and Diagnosis 133
Research Directions of
Negotiation of Th erapeutic Relationship and Length
Client-Centered Th erapy 167
of Treatment 134
Issues of Diversity 171
Th erapeutic Techniques 135
Major Critiques of Client-Centered
Th e Process of Th erapy 137
Th erapy 172
Th erapy in Action: Dr. Mary Allan and the
Case of Jonathan 139 Summary 173
Resources 175
Research Directions of Individual
Psychology 144 Class Exercises and Activities 176
Issues of Diversity 145
CHAPTER 7 Existential Th erapy 177
Major Critiques of
Individual Psychology 146 Historical Context 177
Summary 147
Origins of Existential Th erapy 178
Resources 149
Existential Th erapists 179
Class Exercises and Activities 149
About Viktor Frankl 180
Th eory of Existential Th erapy 181
Key Concepts 181
CHAPTER 6 Rogers’s Client-Centered
Being in the World 182
Th erapy 151
Th e I-Am Experience 182
Historical Context 151 Four Existential Realities 182
Philosophical Roots of Humanism 152 Anxiety and Choice 184
About Carl Rogers 153 Time 184
Humanistic Th erapy Today 153 Authenticity 185
Th eory of Client-Centered Th erapy 154 Th erapy Relationship 185
Key Concepts 154 Normal and Abnormal Behavior 185
Self-Actualization 154 Th eory of Logotherapy 186
Th e Self 155 K ey Concepts 186
Congruence and Incongruence 156 Will to Meaning and Values 186
Unconditional Positive Regard 156 Freedom 188
Conditions of Worth 157 Noeticism and Noodynamics 188
Genuineness and Empathy 157 Self-Transcendence 188
Normal and Abnormal Behavior 158 Normal and Abnormal Behavior 188
Contents vii
Practice of Logotherapy 190 Th e Process of Th erapy 220
Assessment and Diagnosis 190 Th erapy in Action: Jennifer Pert and the
Case of Jonathan 221
Negotiation of Th erapeutic Relationship and Length
of Treatment 190 Research Directions in Gestalt Th erapy 226
Th erapeutic Techniques 191 Issues of Diversity 227
Th e Process of Th erapy 193 Major Critiques of Gestalt Th erapy 228
Th erapy in Action: Dr. Francine Victor and the Summary 228
Case of Jonathan 194
Resources 229
Research Directions in Class Exercises and Activities 230
Existential Th erapy 198
Issues of Diversity 201
Major Critiques of Existential Th erapy 202 CHAPTER 9 Behavior Th erapy 232
Summary 203
Historical Context 232
Resources 204
Class Exercises and Activities 205 Ivan Pavlov and Classical Conditioning 232
J. B. Watson and Behaviorism 233
B. F. Skinner and Operant Conditioning 233
About B. F. Skinner 234
CHAPTER 8 Gestalt Th erapy 206
John Dollard and Neal Miller 234
Historical Context 206 About Joseph Wolpe 235
Psychoanalysis 206 Joseph Wolpe and Counterconditioning 235
About Fritz Perls and Laura Posner Perls 207 Cognition and Behavior Th erapy 236
Gestalt Psychology 208 Th eory of Behavior Th erapy 236
Humanism, Existentialism, and Key Concepts 236
Phenomenology 208
Behavior 236
Other Infl uences on Gestalt Th erapy 209
Scientifi c Approach 237
Trends in Gestalt Th erapy 210
Classical Conditioning 238
Th eory of Gestalt Th erapy 210 Operant Conditioning 240
Key Concepts 211 Observational Learning or Modeling 242
Holism, Field Th eory, Gestalt, and Figure–Ground Normal and Abnormal Behavior 242
Relationship 211
Models of Behavior Th erapy 243
Contact and Contact Boundary 212
Exposure Th erapies 243
Awareness and Present Centeredness 213
Contingency Management and Behavior
Other Gestalt Th erapy Concepts 213
Modifi cation Th erapies 249
Normal and Abnormal Behavior 215
Observational Learning and Modeling
Practice of Gestalt Th erapy 217 Th erapies 254
Assessment and Diagnosis 217 Practice of Behavior Th erapy 256
Negotiation of Th erapeutic Relationship and Length Assessment and Diagnosis 256
of Treatment 217
Negotiation of Th erapeutic Relationship and Length
Th erapeutic Techniques 217 of Treatment 257
viii Contents
Th erapeutic Techniques 258 Practice of Beck’s Cognitive Th erapy 290
Th e Process of Th erapy 258 Assessment and Diagnosis 290
Th erapy in Action: Dr. Carl Wilson and the Negotiation of Th erapeutic Relationship and Length
Case of Jonathan 258 of Treatment 291
Research Directions in Th erapeutic Techniques 291
Behavior Th erapy 263
Th e Process of Th erapy 294
Issues of Diversity 266 Th erapy in Action: Dr. Alex Burnham and the
Major Critiques of Behavior Th erapy 267 Case of Jonathan 294
Summary 269 Research Directions in Cognitive Th erapy 300
Resources 270 Issues of Diversity 302
Class Exercises and Activities 270 Major Critiques of Cognitive Th erapy 304
Summary 305
Resources 306
CHAPTER 10 Cognitive Th erapy 272
Class Exercises and Activities 307
Historical Context 272
About Albert Ellis 273 CHAPTER 11 Reality Th erapy 308
About Aaron Beck 274
Historical Context 308
Th eory of Rational Emotive Behavior
Th erapy 275 About William Glasser 309
A-B-C-D-E Model 275 Th eory of Reality Th erapy 311
Irrational Beliefs 276 Choice and Control 311
I rrational Processes 276 Needs and Intra-Need Confl ict 312
Disputation 278 Quality World 313
Eff ective New Beliefs and Philosophies 278 Total Behavior 314
Normal and Abnormal Behavior 278 Level of Commitment 315
Practice of Rational Emotive Behavior Normal and Abnormal Behavior 316
Th erapy 279 Practice of Reality Th erapy 318
Assessment and Diagnosis 279 Assessment and Diagnosis 318
Negotiation of Th erapeutic Relationship and Length Negotiation of Th erapeutic Relationship and Length
of Treatment 279 of Treatment 318
Th erapeutic Techniques 280 Th erapeutic Techniques 319
Th e Process of Th erapy 283 Th e Process of Th erapy 322
Th erapy in Action: Dr. Rebecca Ellen and the Th erapy in Action: Dr. William Lassiter and the
Case of Jonathan 283 Case of Jonathan 322
Th eory of Beck’s Cognitive Th erapy 287 Research Directions in Reality Th erapy 328
Automatic Th oughts 287 Issues of Diversity 330
Cognitive Distortions 287 Major Critiques of Reality Th erapy 331
Cognitive Schemas, Systematic Biases, Summary 332
and Modes 288
Resources 333
Normal and Abnormal Behavior 289 Class Exercises and Activities 333
Contents ix
CHAPTER 12 Feminist Th erapy 335 Self-Management 379
Social Support 380
Historical Context 335
Stages of Change 380
Th e Waves of Feminism 336
Normal and Abnormal Behavior 381
Infl uential Feminists 338
Practice of Biopsychosocial Th erapy 382
Today’s Feminist Issues 342
Assessment and Diagnosis 382
Th eory of Feminist Th erapy 343
Negotiation of Th erapeutic Relationship and Length
Social Identity 344
of Treatment 383
Sex and Gender 344
Th erapeutic Techniques 383
Power Relationships 345
Th e Process of Th erapy 386
Normal and Abnormal Behavior 346 Th erapy in Action: Dr. Laurel Bodmin and the
Practice of Feminist Th erapy 348 Case of Jonathan 387
Assessment and Diagnosis 348 Research Directions in Biopsychosocial Th erapy
and Health Psychology 391
Negotiation of Th erapeutic Relationship and Length
of Treatment 350 Issues of Diversity 393
Th erapeutic Techniques 350 Major Critiques of Biopsychosocial Th erapy and
Th e Process of Th erapy 352 Health Psychology 394
Th erapy in Action: Dr. Anita Green and the Summary 395
Case of Jonathan 353 Resources 396
Research Directions in Feminist Th erapy 358 Class Exercises and Activities 397
Issues of Diversity 361
Major Critiques of Feminist Th erapy 361
CHAPTER 14 Psychopharmacology 398
Summary 363
Resources 364 Historical Context 398
Class Exercises and Activities 365 Psychological Perspective 398
Biological Perspective 400
Trends in Psychopharmacology 401
Th eory of Psychopharmacology 403
CHAPTER 13 Biopsychosocial Th erapy and
Overview of the Nervous System and the Brain 404
Health Psychology 367
Neurotransmitters 406
Historical Context 367 Psychotropic Medications 409
Th e Biopsychosocial Model 368 Alternative Treatments 415
Complementary and Alternative Medicine 370 Practice of Psychopharmacology 415
Behavioral Medicine, Psychosomatic Medicine, and Assessment and Diagnosis 418
Health Psychology 371
Negotiation of Th erapeutic Relationship and Length
Trends in Biopsychosocial Th erapy and Health of Treatment 418
Psychology 372
Th erapeutic Techniques 419
Th eory of Biopsychosocial Th erapy 373
Th e Process of Th erapy 419
Stress Management 373
Th erapy in Action: Dr. Christa Perry and the Case
Health Promotion and Prevention 377 of Jonathan 420
x Contents
Research Directions in Solution-Focused Brief Th erapy 438
Psychopharmacology 423 Narrative Th erapy 442
Issues of Diversity 425 Psychotherapy Models for Specifi c Problems and
Major Critiques of Psychopharmacology 426 Diagnoses 444
Summary 426 Interpersonal Psychotherapy 445
Resources 428 Dialectical Behavior Th erapy 450
Class Exercises and Activities 429 Summary 454
Resources 455
Class Exercises and Activities 456
CHAPTER 15 Eclectic and Other
Psychotherapies 431
Appendix A Case Studies 458
Eclectic and Integrationist Th erapies 431 Appendix B Comparison of Psychotherapies 463
Historical Context 431 References 474
Multimodal Th erapy 433 Name Index 511
Postmodern and Constructivist Th erapies 437 Subject Index 521
Historical Context 437