Theories of Counseling and Psychotherapy: Systems, Strategies, and Skills

570 Pages·2015·268.42 MB·English

by  Linda Seligman

FO UR TH EDI LION
THEORIES OF COUNSELING
AND PSYCHOTHERAPY
SYSTEMSs STRATEGIESp AND SKILLS
Linda Seligman
Late Professor Emeritus, George Masott Unitersiq
Lourie W. Reichenberg
Licensed Pto.fessional Counselor, Falls Church, Virginia
(D
P"rs'"
)n December 24. 2007. my friend. colleague, and co-author.
Linda Seligman, died. She once wrote "My work in this field has
been a great source of fulfillment. education, and inspiration to me.
I wish you the same experience!" With this fourth edition of
Theories of Counseling and Psychotherapy, I have tried to maintain
the same quality and high standards that Linda embraced.
This text is dedicated to her memory.
Lourie W. Reichenberg
Falls Church. VA
PREFACE
This text uas first published in 2001. and since that time it has been used by tens ot thousands
of students. I have made many changes to this fourth edition of Thforff'.s r:/' Col/rz.\-e//frg und P.9v-
c/zof/zerap.v based on developments in counseling and psychology and on feedback and reviews
recei\ ed trom students and faculty who have used this text in their courses
The basic structure of the text has t)een maintained, including {he BETA format. descriptions
ol ' important treatment approaches. skill development sections. case studies. and exercises fnr large
groups. small groups. and individuals. In addition. the discussions ot relevant research. document-
ing the validity of each approach. have been expanded. Updated information is provided on all
treatment approaches presented in the text. with considerably expanded information on many (see
the "Neu to This Edition" section later in this preface)
ORGANIZATION OF THIS TEXT
This text organizes the major theories of counseling and psychotherapy into four broad categories:
Background. Emotions. Thoughts. and Actions. Each section in the BETA format retlects the em
phasis of the underlying theories:
Backgrozlnd; Sigmtmd Freud anti classical psychoanalysis. Alfred Adler and individual psy
chology. post- and neo-Freudians. and brief psychodynamic therapy
Emofiopz.y.- Carl Rogers and person-centered thor:tpy. existential therapy. Gestalt therapy. and
newer approaches. including narrative. solution-focused. and feminist therapy
T/zoilg/zfs: Albert Ellis and rational emoti\e behavior therapy, and Aaron Beck and cognitive
therapy
Acfinns.. hehax ior therzipy. cognitive--behavioral therapy including acceptance and mindful-
ness approaches. and reality therapy
Introductory chapters on each ot ' these four areas help readers to understand the commonalities
among theories in each group Each chapter that presents a treatment systen] follows the same or-
ganization to tacilitate comparison and ease of use. beginning with a brief overview ol the approach
and a biographical sketch ot its developer. and then moving on to the theoretical concepts. goals.
ind strategies ot each treatment modulitv. Particular attention is given to the application ot each
treatment system [o people from diverse backgrounds. Finally. at the end of each chapter. skill de-
velopment and other exercises allow students to apply the knowledge they have gained about each
treatment modality. These exercises are
Skl// dave/op/neill sec/ion.' This section teaches one nr more key skills associated with the
treatment system under re\ iew
Case I//u.qfralforl wff/z f/ze /)faz.4alpzf4v.. Edie. her husband Roberto. and their daughter Ava
appear throughout the text to illustrate how treatment approaches can be used w ith both gen-
ders. ditterent ages. and ditterem cultural backgrounds
Z.Urge-grozzp eirercises; These exercises are designed to facilitate discussion and a deeper
understanding ot each treatment approach.
SING//-grozzp erercfses; These exercises provide practice in essential skill development
/pzdfvfdua/ ei'erriscs; These exercises will help readers develop self aw areness and solidify
learning.
lv
Pre face v
Although this text focuses primarily on systems of counseling and psychotherapy that are de-
signed for treatment of individuals. an overview of family systems theory is included in Chapter 1 8.
Chapter 19 discusses the nature. strengths, and shortcomings ot integrated and eclectic treatment
systems. Although these Two chapters consider a range of treatment approaches, their structure gen-
erally follows the format of the earlier chapters. Chapter 20 concludes with a synthesis of the major
treatment systems. information on how clinicians select their preferred treatment approach. and a
questionnaire to help readers identit which approach best reflects their beliefs and personal style
Dr. Seligman has written two texts organized according to the BETA fomlat that can be
used as companion pieces to Thf'nr/r.v (2/' Coilrzse/I/zg and Ps.vc/zor/zerap.v. The first text. /;unda-
me/zfa/ Sk///s .Aor JI/e/z/a/ Hea/f/z Pro#kss]ona/s (Pearson. 2009), focuses on technical skills rather
than theories. It covers some of the same skills as Their/e.s of Cours.te/f/rg alza Ps.x(./lo//zerap.\. as
well as additional technical skills necessary for clinical practice. All are covered in an in-depth and
comprehensi\e way. The second text, Co/iced/tr a/ Skf//f.#)I /t/en/a/ Hea///r Probe. . Iona/.F (Pearson
2009). reaches more advanced conceptual skills needed by clinicians. such as case conceptualiza-
tion. multicultural competency. and dealing with client crises. Although these two texts are intended
to stand alone. they can also be used in combination. Ideitlly, learners will first use T7zeor/e.\ o/'
Colin.\e/fn.q a/rd P.Tvc/ro//zerap.t to develop an understanding of the BETA fomlat and the important
treatment systems. In a subsequent course. they wou]d use the /:rll?darnell/a/ Sk///.$ and Co/zcfprua/
Skf//.s texts. Their familiarity with the BETA format and the treatment systems would facilitate their
learning and accelerate their skill development.
NEW TO THIS EDITION
Based on reviewers' comments and professors who use the tcxt in their graduate programs. signifi-
cam changes have been made to this fourth edition. It was my intent to make the text practical and
functional for both students as well as teachers.
Changes to Structure
Chapters that introduce each section in the BETA format have been rewritten to provide stu-
dents with an overview of the theories contained in that section. These section openers are
ntended to enhance students' understanding ot behavior. emotions. thoughts. and actions
while also providing a preview of the theories to be discussed in each section. In recognition
of course length anti what the reviewers report they actually use in the classroom. the Skil
Development, Case Illustration, and Exercises sections have been removed from these intro-
ductory chapters. As a result. some of the more popular SkilIDevelopmenr sections have been
moved to other chapters. while some ha\ e been eliminated
Part six. O/her Tree//ne/zr Approac/re.9, has been renamed to more accurately reflect that these
chapters are not a p:lrt of the BETA format. Chapter 1 8 is now fa/rrf/) S\srcrn.t .4/)proac/ze.9.
Chapter 19 is /rz/egrarfve Thrrapfei. and Chapter 20 is So/fdf/\'/n8 Undersrafzdlng r{/' T/raf
f/ze/zr Svs/enn. This section of integrated treatment systems remains at the end of the text for
a reason. Students should first read and learn about the main theories of psychotherapy und
give consideration to which approach best suits their philosophy before beginning to cherry-
pick techniques from different theoretical orientations. I recognize that most clinicians use
integrative approaches, and that is addressed in Chapter 1 9. along with a discussion of points
to consider when formulating a system.
In keeping with the current focus on research-supported treatments. each chapter has been
updated to include the latest research available. As can be expected. most of the new
VI Pre face
research involves cognitive and cognitive behavioral treatments (found in Chapters 12
through 16). Psychodynamic psychotherapy. experiential therapies. and interpersonal psy '
chotherapy have also been the torus ol new resettrch and that is included in Chapter\ 2. 5,
6. 18. and 19
The common factors approach and support tor the importance ot an effective and sustained
therapeutic alliance have been the Focus ot much newly published research. This intonnation
is integrated where relevant (usually in the discussion ot the therapeutic alliance ) throughout
the text. Chapter 1 . Co/z/exr. o/'f#t'crf\,e freq/ re/rf. includes an extended tlisctlssion. as tines
the chapter on theoretical integration.
The fourth edition ot this text brings a stronger iTiulticultunil torus. Beginning with Chapter 1 . in
which Hal's's ADDRESSING acronym is explained. each theoretical chapter in the text includes
a revised multicultural section intended to be more culturally sensitive
Changes to Individual Chapters
Reorganization of the constructivist theories (Chapter 1 1 ) nou incorporates what had been a
separate chapter on solution focused therapy in the previous edition. The section on lelninist
[herapy has been enlarged considerably
The chapter on post and neo-Freudians (basically ' any psychodynaltlic theory except Adlerl
has alwtt)-s been tricky. The good news and the had nous are the same in that this chapter
provides a comprchcnsi\e survey ot post Freudian psychodynamic theories. Some instruc
tons lo\e this. while some will leave it out ot the syllabus because it contains too much
nfomlation
A reorganization of Chapter 19 on integrative therapy includes enhanced consideration ot
Wachtel's cyclical psychodynamics and also the transtheoretical model ot change
Clarification of the differences between cognitive and cognitive behavioral therapy have
been made throughout Chi\piers 12 through 16. With much overlap in treatments. and much
controversy in the field about wllether the Heuer acceptance and mindfulness-bused theor-
ies are truly cognitive. arc u new wa\e ot behavioral therapy. or tire part ot Ezistern Fell
pious tnldition\ and therefore spiritual. Idecided to include then] in Chapter 16. A complete
reorganization ol ' Chapters 15 and 16 LO reduce overlap resulted in moving the history ' ot
behavioral therapy to the introductory chapter. and moving the discussion ot planning and
nipleinenting behavior change to Chapter 1 6. More informLltion on exposure based treat-
ments and CBT techniques uas also addccl [o Chapter 16. and the SkilIDevelopment section
w,as thoroughly ' revised to include exposure-based treatment for a client with a hoarding
problem. Additionalenhancemcnts to Chapter 16 include a discussion of mindlulness based
cognitive therapy
With the move of !nindfu]ness-based and dia]ectica] behavior therapies to Chapter ]6. the
decision was made to remove the chapter on emerging approaches. Although reviewers had
found the section on transpersonal therapy to be interesting. they were inclined not to teach
it in their courses due to the tlnle constraints of a 1 5 week semester. Therefore. transpersonal
approaches are not included in this edition
Resources and websites have been updated in every chapter as needed
Many more changes and additions have been made in all chapters. More than 400 new references.
!most tram the past 2 years. ha\e been added. In many cases. this is new research that has been
added to the application section ot each chapter. In other cases. new references are the result ot the
chapter changes listed above
Preface vii
These changes and additions result in a comprehensive analysis ot more than 1 5 ot the lead
ing treatment systems in use today, with shorter discussions of nearly 5o more
EFFECTIVE WAYS TO USE THIS TEXT
For itlany years I taught counseling theories. abnormal psychology, and other courses at a local
tiniversit) while also maintaining a private practice. Although very different experiences. I found
working with students and working with clienTS to be e(lually rewarding hath personally and profes-
sionally. Botl] experiences have also contributed broadly to my understanding ot what professors
wilnl in a counseling theories text. and what sttldents need to be ab]e to put [heoretica[ inateria] imo
practice. I was dina)s delighted at the end of a senlesler to hear a student say. "This is one of the
psychology textbooks I ' m going to keeps''
This text has been designed for llexibility lind ease of use. Although each college and uni\er
lily has its ou n curriculum and required courses. this text can be adapted to almost unv curriculum
in counseling and psychology and also can be used tor training and staff development. Here are a
tew suggestions for using the text
.
1 The text is ideally ' suited tor lose in a two semester or two-quarter course on theories and tech-
niques of chun\ding and psychotherapy. Such a curriculum would provide students with an in-
depth and comprehensive understanding of the fields ot counseling and psychotherapy. The First
three parts ( 1 1 chapters covering introductory material. treatment sysleills f ocused on backgrotmds.
and treatment sy\dems focused on enlnrinns ) could be covered in the first semester. with rhe remaini-
ng ttlree paris ( focusing on cognitive. behavioral. and eclectic treatment approaches) covered in the
second senlesler. It each class session covers one chapter. then any remaining classes can be used
for role-playing and exams
2. The entire text al\o could he covered in n one semester course. particularly courses tor doc-
toral and advanced minster's degree Students in which depth ot knowledge is prized. The following
illustrates one way to co\er this text in a 1 5-week semester
Week 1: Chapters I and 2 Contexts of Eftecti\e Treatment: Overview of Backcround-
Focused Treatment Systems
Week 2: Chapter 3--Sigmund Freud and Classic Psychoanalysis
Week 3: Chapter 4--Alfred Adler and India idual Psychology
Week 4: Chapters 5 and 6 Post and Neo-Freudians: Analytical Psychology. Ego Psyclologl '
Object Relations. and Sell Psychology; Brief Psychodynumic Therapy
8
Week 5: Chapters 7 and overview ot Emotion-Focused Treatment Svsteins: Carl Rogers
nnd Person-Centered CoLmseling
Week 6: Chapters 9 and 10 Existential Therapy: GesLalt Therapy
1
Week 7: Chapter 1 hnerging Approaches Emphasizing Emotions and Sensations
Week 8: ('hapters 12 and 13 overview ot Thought Focused Treatment Svstelns= Albert
Ellis and Rational Emotive Behavior Therapy
Week 9: Chapter 14 Aaron Beck and Cognitive Therapy
Week 10: Chapters 15 and 16--Oder\iew of Action-F'ocused Treatment Systems: Behavior
Therapy and Cognitive--Behax ioral Therapy
Week 1 1: Chapter 17 Reality Therapy
Week 2: Chapter 18--Family ' Systems Approaches
1
Week 13: Chapters 19 Integrative Therapies
Week 14: Chapter 20 Solidit ing Understanding of Treatment Systems
Week 15: Conclusion. finalexamination
Vlll Pre face
3. Chapters can easily and logically be selected and combined to create a course. For example.
the following ]5 selected chapters encompass the four types ol clinical approaches in the BETA
format (background. eriiotions. thoughts. actions) and constitute a one-semester course on estah
lished theories of counseling:
Chapter 1 : Contexts of Effective Treatment
Chapter 3: Sigmund Freud and Classic Psychoanalysis
Chapter 4: A]fred Ad]er and ]ndividua] Psychology
Chapter 5: Post- and Neo-Freudians: Analytical Psychology. Ego Psychology, Object
Relations. and Self Psychology
Chapter 8: Carl Rogers and Person-Centered Counseling
Chapter 9: Existential Therapy
Chapter 10: Gestalt Therapy
Chapter 1 1 : Emerging Approaches Emphasizing Emotions and Sensations
Chapter 1 3: Albers Ellis and Rational Emotive Behavior Therapy
Chapter 14: Aaron Beck and Cognitive Therapy
Chapter 6: Behavior Therapy and Cogniti\e Behavioral Therapy
1
Chapter 17: Reality Therapy
Chapter 1 8: Family Systems Approaches
Chapter 19: integrative Therapies
Chapter 20: Solidifying Understanding of Treatment Systems
In a 1 5-week semester. one chapter could be covered per week. providing a comprehensive picture
of the major treatment approaches
4. A variety of short courses or seminars can be created from the contents of this text. For exam-
ple. Purl [wo could be used for a course on psychodynamic and psychoanalytic approaches to treat-
ment; Part three for a course on process experiential approaches in counseling and psychothenlpy
Pans four and five could be combined for a comprehensive look at cognitive and behavioral treat-
ment systems: and PaH six for a course on eclectic and integrated approaches to treatment
5. The Skill Development sections are designed to accompany the treatment system taught in
that plLrticular chapter. However. these sections can be used independently of the theoretical por
lions. perhaps taught in a subsequent semester following a course on theories ot counseliitg and
psychotherapy or used as part of a practicum or internship to facilitate skill development
6. Like the Skill Developmem sections. the exercises are intended to accompany review of the
treatment system in each chapter. However. they are designed to be used flexibly. Large group ex
erases are appropriate for classroom discussion. Smallgroup exercises allow clusters of tout learn-
ers [o practice and improve their clinical skills with the benefit ot peer feedback and support
Individual exercises offer people the opportunity to work alone and apply their learning to them-
selves. u,ith their responses written in journals
Facult) members. ot course. can choose to use any or allot the exercises that accompany each
chapter. Ideally, time should be allocated. either during or outside ot class. tor at least some ot the
large- and small-group exercises in each chapter. However. it time is limited, the individual exercises
enable students to continue their learning and skill development outside of class. Although instruc-
tors indy decide lo review students' joumals at the end of a course [o determine whether they have
completed the individual exercises. I encourage them not to gracie or evaluate these journals so thn
students reel free to express themselves. try out new skills, and gain lemming and belt-awareness
Students should be told at the beginning of the course whether they will be required to share their
.Journals in any way
Pref:ace ix
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ACKNOWLEDGMENTS
I am grateful for the generosit) of my family and friends who indulge me the isolation required to
write these texts. This is my fourth jump down the rabbit hole, and I am always cognizant of the re-
sponsibilities others take on while I am single mindedly absorbed in my work. I owe a special note
of gratitude to Sumita Anand Changela, MA, for her research assistance over the summer. and for
updating the application of the counseling theories to multicultural groups in many of this book's
chapters
I am indebted to Meredith Passel, senior acquisitions editor at Pearson. M'ithout her efforts
this text would not have been published. Further thanks to her editorial assistant Krista Slavicek, to
Don Laurila. production manager, and to Lorretta Palagi. copyeditor, for her astute editorial eye and
sharp red pencil.
I would like to acknowledge and thank the reviewers for their helpful comments and sugges-
tions to the fourth edition: Devika Dibya Choudhuri, Eastem Michigan University; Large M. Jome.
University at Albany; Susan H. Packard. Edinboro University of Pennsylvania: and Timothy S.
Vandergast. William Paterson University
But above all. I would like to express my appreciation to my husband of 25 years. Neil
Reichenberg. who shares my passion for words, as wellas for our three young grandchildren: lzaak,
Jaycee. and Orion
ABOUT THE AUTHORS
Linda Seligman, PhD
Dr. Linda Seligman received a PhD in counseling psychology from Columbia University. Her pri-
mary research interests inc]uded diagnosis and treatment p]anning as we]] as counseling people with
chronic and life-threatening illnesses. Dr. Seligman was a professor at George Mason University for
25 years. She ser\ ed as co-director of the doctoral program in education. coordinator of the Coun
seling Developnaent Program. associate chair of the School of Education. and head of the Com-
mLmity Agency Counseling Program. She was later named professor emerita. Dr. Seligman also
served as associate at Johns Hopkins University and as a faculty member in counseling psychology
at R'alden University
During hcr lifetime, Dr. Seligman authored 15 texts. including Se/e('r{/zg f/lecrl\-e Treaf-
rnenf: Diagttosis and Treairnellf Piatniing in Counseling; Developmental Career Coltltseling clad
Assesslnetl!: and Protuotitlg c{ Fighting Spirit: Psychotherapy .for Cancer Pcitiettts, Stirvi\hors, attd
7'heir /?a/rif/fe.s. She also wrote more than 80 professional articles and text chapters. She lectured
throughout the United States as well as internationally on diagnosis and treatment planning and was
recognized for her expertise on that subject. In 1 990. the American Mental Health Counselors Asso-
ciation (AMHCA) designated Dr. Seligman as Researcher of the Year, in 2007, AMHCA honored
her with the title of Counselor Educator of the Year
Lourie ]N. Reichenberg, MA, LPC
Laurie W. Reichenberg is a licensed professional counselor in private practice in Falls Church.
Virginia. She a]so provides c]inica] supervision for therapists and interns at The Women's Center in
Vienna. Virginia. She earned her master's degree in counseling psycholog) from Marymount Uni-
versity. She has taught crisis counseling, abnormal psychology, and counseling theories to graduate
and undergraduate students
She is currently on the executive committee of the Virginia Association of Clinical Counselors.
lnd serves on the board of directors for the Northern Virginia Licensed Professional Counselors
Reichenberg is a member of the CrisisLink LOSS team. which provides assistance in the
community after a suicide has occurred. She served on the CrisisLink Board of Directors from 2003
to 2006. and is on the organization ' s Advisory Council . She is a past editor of the Northem Virginia
Licensed Professional Counselors. lind was the editor of the ./our/za/ o/'f/ze C'o//ege and UniversfD
'
Per.somme/ ,4.T.9ncfafion from 1 988 to 1 993. She coauthored Se/ecffng /U?(five 7'reafmelzf.s (2007.
2012) with Dr. Seligman. and has published many professional articles including a chapter on grief
lnd loss in Cri.yfs A.v.ie.9smenf, /nfeme/zflr7/z and Preverzff o/z (Jackson-Cherry & Erford, 20 1 0. 20 1 3)
She has edited more than 30 texts and monographs. Her primary interests include crisis counseling,
grief and loss. and helping indi\iduals. couples. and families cope with life transitions. She ap
preaches her work as a therapist. educator. and community volunteer. from a humanistic. person
centered. and emotionally focused perspective, and incorporates mindfulness into her practice
X