Counseling and guidance

COUNSELLING AND GUIDANCE
ABINAYA.T., MSW Page 1
UNIT 1
Guidance & Counselling
Defining Guidance and Counselling and the Difference between them.
Guidance and Counselling is defined as a planned and organized work aimed at
assisting the trainee to understand himself and his abilities and develop his
potentialities in order to solve his problems and achieve psychological, social,
educational and professional compatibility, and also to achieve his objectives
within the framework of Islamic teachings. Guidance and Counselling
complement each other though there are some differences.
Guidance is a group of planned services that include Counselling, it provides
the trainee with miscellaneous information to upgrade his feeling of
responsibility, understand himself and know his abilities and provide guidance
services to trainees.
Counselling on the other hand is the procedural aspect of guidance; it is
therefore the interaction that comes as a result of the vocational relationship
between a specialized counsellor and his student where the counsellor assists
the student to understand himself and his abilities and talents to achieve self and
environmental compatibility in order to attain the appropriate degree of mental
health in light of the techniques and specialized skills of the guidance process
The Difference Between Guidance and Counselling:
The concept of guidance and counselling reflect a common meaning that
includes awareness, assistance and change of behaviour to the better, but still
there is a difference between the two concepts:-

1- Guidance is more general and comprehensive than Counselling, it therefore
includes Counselling.
2- Guidance usually precedes Counselling and paves the way for it.
Counselling follows guidance.
3- Guidance stresses the theoretical aspect while Counselling takes care of the
practical aspect.
4- Counselling is usually the relationship between the teacher and the student
who comes for assistance; therefore it is an individualistic relationship.
Misconceptions about guidance and Counselling:
1. Some people believe that Counselling is a mere service provided by the
training institution.
2. Others believe that guidance and Counselling are services provided to
psychiatric persons only, though it is provided to normal persons.
3. Some also believe that Counselling provides ready made plans and solutions
to anyone who seeks Counselling, but the truth is that Counselling assists
individuals to understand themselves and achieve self-realization.
Guidance and counselling service
1. Religious Counselling:
The counsellor cooperates with the Institute in urging the trainee to attend
congregational prayer and implant Islamic values and Islamic doctrine into them
through religious contests, lectures and connect activities and curricular with
these Islamic values.

2. Preventive Counselling:
The preventive Counselling tries to prevent the occurrence of problems
regarding study and training and it also tries to prevent social, psychological
and health problems through inculcating awareness programs.
3. Educational Counselling:
The educational Counselling aims at assisting the trainee to proceed with his
studies smoothly by receiving new trainees and selection of gifted trainees and
trainees who stagger in their studies and set special programs that help develop
their talents and capabilities.
4. Vocational and Educational Counselling:
The Educational and Vocational Counselling aims at educating the trainees
about the various types of vocational and university education and the types of
jobs and conditions of admission and employment at institutes, centers, military
vocational institutes and colleges in order to assist in connecting education with
development plans.
5. Social and Ethical Counselling:
Social and Ethical Counselling aims at finding the suitable environment which
enables the trainee to acquire skills and expertise in order to interact with others
in accordance with the Islamic teachings.

Ethical principles of counselling and psychotherapy
Principles direct attention to important ethical responsibilities. Each
principle is described below and is followed by examples of good practice that
have been developed in response to that principle.
Ethical decisions that are strongly supported by one or more of these
principles without any contradiction from others may be regarded as reasonably
well founded. However, practitioners will encounter circumstances in which it
is impossible to reconcile all the applicable principles and choosing
between principles may be required. A decision or course of action does not
necessarily become unethical merely because it is contentious or other
practitioners would have reached different conclusions in similar circumstances.
A practitioner’s obligation is to consider all the relevant circumstances with as
much care as is reasonably possible and to be appropriately accountable for
decisions made.
Being trustworthy: honouring the trust placed in the practitioner
Being trustworthy is regarded as fundamental to understanding and resolving
ethical issues. Practitioners who adopt this principle: act in accordance with the
trust placed in them; strive to ensure that clients’ expectations are ones that have
reasonable prospects of being met; honour their agreements and promises;
regard confidentiality as an obligation arising from the client’s trust; restrict any
disclosure of confidential information about clients to furthering the purposes
for which it was originally disclosed.
Autonomy: respect for the client’s right to be self-governing
This principle emphasises the importance of developing a client’s ability to be
self-directing within therapy and all aspects of life. Practitioners who respect
their clients’ autonomy: ensure accuracy in any advertising or information given

in advance of services offered; seek freely given and adequately
informed consent; emphasise the value of voluntary participation in the services
being offered; engage in explicit contracting in advance of any commitment by
the client; protect privacy; protect confidentiality; normally make any
disclosures of confidential information conditional on the consent of the person
concerned; and inform the client in advance of foreseeable conflicts of interest
or as soon as possible after such conflicts become apparent. The principle of
autonomy opposes the manipulation of clients against their will, even for
beneficial social ends.
Beneficence: a commitment to promoting the client’s well-being
The principle of beneficence means acting in the best interests of the client
based on professional assessment. It directs attention to working strictly within
one’s limits of competence and providing services on the basis of adequate
training or experience. Ensuring that the client’s best interests are achieved
requires systematic monitoring of practice and outcomes by the best available
means. It is considered important that research and systematic reflection inform
practice. There is an obligation to use regular and on-going supervision to
enhance the quality of the services provided and to commit to updating practice
by continuing professional development. An obligation to act in the best
interests of a client may become paramount when working with clients whose
capacity for autonomy is diminished because of immaturity, lack of
understanding, extreme distress, serious disturbance or other
significant personal constraints.
Non-malfeasance: a commitment to avoiding harm to the client. Non-
malfeasance involves: avoiding sexual, financial, emotional or any other form
of client exploitation; avoiding incompetence or malpractice; not providing
services when unfit to do so due to illness, personal circumstances or
intoxication. The practitioner has an ethical responsibility to strive to mitigate

any harm caused to a client even when the harm is unavoidable or unintended.
Holding appropriate insurance may assist in restitution. Practitioners have
personal and professional responsibility to challenge, where appropriate, the
incompetence or malpractice of others; and to contribute to any investigation
and/or adjudication concerning professional practice which falls below that of a
reasonably competent practitioner and/or risks bringing discredit upon the
profession.
Justice: the fair and impartial treatment of all clients and the provision of
adequate services The principle of justice requires being just and fair to all
clients and respecting their human rights and dignity. It directs attention to
considering conscientiously any legal requirements and obligations,
and remaining alert to potential conflicts between legal and ethical obligations.
Justice in the distribution of services requires the ability to determine
impartially the provision of services for clients and the allocation of services
between clients. A commitment to fairness requires the ability to appreciate
differences between people and to be committed to equality of opportunity, and
avoiding discrimination against people or groups contrary to their legitimate
personal or social characteristics. Practitioners have a duty to strive to ensure a
fair provision of counselling and psychotherapy services, accessible and
appropriate to the needs of potential clients.
Self-respect: fostering the practitioner’s self-knowledge and care for self
The principle of self-respect means that the practitioner appropriately applies all
the above principles as entitlements for self. This includes seeking counselling
or therapy and other opportunities for personal development as required. There
is an ethical responsibility to use supervision for appropriate personal and
professional support and development, and to seek training and other
opportunities for continuing professional development. Guarding against
financial liabilities arising from work undertaken usually requires obtaining

appropriate insurance. The principle of self-respect encourages active
engagement in life-enhancing activities and relationships that are independent
of relationships in counselling or psychotherapy.
Characteristics of counsellor
The practitioner’s personal moral qualities are of the utmost importance
to clients. Many of the personal qualities considered important in the provision
of services have an ethical or moral component and are therefore considered as
virtues or good personal qualities. It is inappropriate to prescribe that
all practitioners possess these qualities, since it is fundamental that these
personal qualities are deeply rooted in the person concerned and developed out
of personal commitment rather than the requirement of an external authority.
Personal qualities to which counsellors and psychotherapists are
strongly encouraged to aspire include:
Empathy: the ability to communicate understanding of another
person’s experience from that person’s perspective.
Sincerity: a personal commitment to consistency between what is professed and
what is done.
Integrity: commitment to being moral in dealings with others,
personal straightforwardness, honesty and coherence.
Resilience: the capacity to work with the client’s concerns without
being personally diminished.
Respect: showing appropriate esteem to others and their understanding
of themselves.
Humility: the ability to assess accurately and acknowledge one’s own strengths
and weaknesses.

Competence: the effective deployment of the skills and knowledge needed to
do what is required.
Fairness: the consistent application of appropriate criteria to inform
decisions and actions.
Wisdom: possession of sound judgement that informs practice.
Courage: the capacity to act in spite of known fears, risks and uncertainty.
A Brief History of Counselling and Therapy
Counselling has not had a long history in its current form, yet it has happened
for centuries and longer.
Family and religion
There has been a long need for Counselling in helping individuals with
transitions and other difficulties in their lives. The long tradition of Counselling
is first of family members helping with advice. Parents counsel their children.
Grandparents and other family elders offer the wisdom of the years.
In a close community, there may also be tribal elders or others with a concern
for mental well-being. This role for many years was (and still is) taken on by
the priest or religious person. For the individual, the priest offers confidentiality
that enables discussion of family matters or things that are secret from the
family. The priest meanwhile gets to steadily inculcate religious values, making
it a valued relationship on both sides. The church tended to view mental illness
as some form of possession and treatment, including exorcism, was of the soul
rather than the body.
Those with more incurable issues were generally tolerated. The village idiot
was found a place in the fields and others were cared for or handled within the
community.

The industrial revolution
With the age of the enlightenment and the rise of the industrial revolution
through the eighteenth and nineteenth centuries, populations became mobile as
they sought employment in towns and cities that were often far from their
original homes. This separated them from their natural counselors, although the
religious support was still available. Yet with the rise of science, the power of
the church declined and it was not always able to give the help that was needed.
Capitalism and science also had subtle effects on beliefs, values and general
cognition. Everything had to be explained. The work ethic was dominant and
hedonism was an option for only a few.
Along with the concentration of towns and cities came the need to protect its
citizens and civic organizations such as police forces were developed. In small
communities the power of shame and the threat of banishment is enough to
sustain social control. In town, anonymity is an option which brings its own
problems. Particularly in America, social mobility was very much a norm.
As much to protect the populace as the individual concerned, somewhere
between the workhouse, hospital and prison sat the lunatic asylum. Here, the
insane (as well as a few unhappy individuals who had embarrassed their
families) were incarcerated with little treatment.
Science scoffed at the notion of possession by demons but had little idea what
to do beyond basic approaches such as drugging and leeching. In the cruel days
of misfit sideshows, the asylum was just another place to go and laugh at those
less fortunate.
The rise of psychotherapy
Hypnotism had been known about for some time (Mesmer lived around the turn
of the eighteenth century), and was popular through the ninteenth century and
was used as an informal therapeutic method. Nevertheless it perplexed
scientists who were suspicious of its shamanistic roots.

With the continued development and dominance of scientific medicine,
establishment attention was eventually turned to matters of the mind
(something that empiricists had largely ignored as impenetrable). Medical
science took over as the caretakers of the mentally disturbed and a new age of
and discipline of psychiatry arose towards the end of the nineteenth century.
Sigmund Freud was perhaps the most significant pioneer in seeking to
understand and treat mental problems, at least in those who lived in normal
society but who suffered from emotional and behavioral difficulties. Rather
than try to treat mental problems as a physical issue, he chose to listen to them
and try to work out what was happening from what they said, and then apply
treatment in the opposite direction, again through words.
Despite massive leaps, Freud was still trapped by notions of his day, such as the
assumption that mental problems had an emotional basis and the derivation of
ideas such as libido came from nineteenth century biological theories.
Psychoanalysis thus developed and was evolved by people such as Jaques
Lacan and Melanie Klein into the approaches still used today. This was not
without some internal division of opinion and Klein famously split with
Sigmund Freud's daughter, the more traditionalist Anna.
Behaviorism and humanism
In the way that a thing creates its opposite, the assumptions of psychoanalysis
were challenged in the scientific search for hard evidence,
andbehaviorism and conditioning became popular for the focus on the external,
measurable behavior.
In the opposite direction, and particularly in the more liberal America, a
different view arose amongst people such as Carl Rogers, Albert Ellis, Eric
Berne and Abraham Maslow. These put the person and their experience at the
middle of attention, as opposed to the more therapist and method focus of
psychoanalysis. This may seem unfair but the humanist approach is just that -

human. It sees the client as a collaborative partner, not as a patient to be treated
by an expert. Humanism, even more than Behaviorism and quite unlike
Psychoanalysis, has a focus on the present rather than the past.
Humanism was largely a practitioner philosophy and was largely ignored by
academe for a long time. Nevertheless its warm message resonated with both
therapists and clients and it was widely used. Despite secular leanings, this
approach was influenced by Protestant values such as free choice by the
individual and the personal journey.
Secular society
With the decline of the church as a social institution that exists at the heart of
the community and the lives of its people, there arose a vacuum of meaning and
care. Without the comfort of promised salvation, many lost their sense of
purpose in the meaningless daily drudge. And without the sage and certain
advice of the priest, the neuroses of industrial living worsened.
Cities can be lonely places. With family far away and fickle friends who enjoy
the fun but step back when emotional support is needed, a person can be out
and dancing yet feel terribly alone.
In such an environment there is a vacuum, a pent-up need for help towards the
making of meaning for individual lives. It was this need, this pull, that created
the new disciplines of therapy and Counselling. It was the loss created by
sundered societies that drove some to despair and other to consider what succor
and treatment could be provided to create a more harmonious. Those who
wanted just to do good and those who saw the social imperative worked to
develop ways and means of putting people back together and back into society.
In pursuit of happiness and the American Dream, self-development was a
common focus. Even in the first world war, the US army employed
psychologists and psychological testing was widespread.

Twentieth century expansion
Psychotherapy first caught on in a significant way in the USA, helped by a
receptive culture and by European analysts who moved there away from fascist
oppression. These ideas were then adopted into the American culture.
Humanism in particular, as described above, was a particularly American
approach. There is a notion of the 'empty self' and an American theme has been
the search for meaning and the focus on the individual's story (the empty self is
also a possible cause in the rise of consumerism and advertising).
In the latter half of the twentieth century, Counselling developed significantly
as a distinct profession, differing from therapy at least in the contexts of use
and often in the types of issues faced. Counselling happens in the social
community, in schools and colleges as well as homes. Counselling is often paid
for by the community or is voluntarily offered (such as the Samaritans).
Therapy is more likely to be a private practice. Therapy is largely found in the
therapist's work room. Counselling addresses issues from small to large.
Therapy tends to deal in the bigger issues. Counselling may be limited. Therapy
can continue as long as the client is able to pay.
As with other new domains, there has been division of viewpoint and evolution
of schools of thought. There have been views of Counselling and therapy as a
means to social change. The counselor-client relationship has been questioned.
Even the dynamics resulting from the structure of expert-patient has been
questioned.
Throughout the development of Counselling and therapy, there has been an
evolution of thought about the way people are perceived and hence treated.
Freud viewed the person as conflicted and hidden. Behaviorists saw people as
predictable machines. Humanists had a more botanical image, with ideas of
feeding and growth. The perception of the client can significantly affect the
counselor's view and hence how they interact with them.

UNIT 2
Group counselling
Group counselling is a form of therapy, which posits that people benefit from
shared experiences. Usually, it's focused on a particular issue, like obsessive-
compulsive disorder orangery. While a therapist usually manages the group,
contributions from other members are considered valuable since all in the group
share similar issues.
One of the main principals behind group Counselling is the idea that dealing
with specific issues may cause isolation, and a feeling that one is alone in facing
his or her problems. This form of Counselling attempts to counteract isolation
by assembling people with similar issues to enforce that difficulties are not
singular to one person. Additionally, knowing other people with similar troubles
can be comforting to individuals who may not have access in their own family
and friends to people with the same problem.
Group Counselling may be highly organized, with people doing specific
activities together and then sharing the results. Alternately, it may be more
freeform, where members share their current issues related to the group’s
purpose. One person’s verbal contributions to a group might be discussed,
validated, and provoke problem solving by other group members in a session. It
might also be an entry into a discussion regarding a certain aspect of an illness
or condition that is then primarily led by the therapist.
Group Counselling Techniques
Psychotherapy, on the other hand, is a distinct form of
psychological Counselling. Sessions may occur in an individual setting or
through groupCounselling, but are always administered by a person trained
and

licensed in psychology.
While there are several support groups that exist to provide guidance and a
mechanism for recovery to substance abusers, not all groups for substance
abusers are necessarily group therapy or group Counselling. The distinction
between substance abuse group therapy and supportgroups is that the first are
led by mental health and substance abuse treatment professionals, while
support groups are often peer-led and do not offer psychotherapy
or Counselling within the context of the group's operations.
Group Counselling Activities
Additionally, knowing other people with similar troubles can be comforting to
individuals who may not have access in their own family and friends to people
with the same problem. Group Counselling may be highly organized, with
people doing specific activities together and then sharing the results.
The activities are conducted in a group setting to make it easier for participants
to share intimate thoughts and recover from psychological problems, to foster a
stronger bond within the group, and to carry out group Counselling. A trained
facilitator typically presides over the activities and the group therapy.
Career Counselling
Career Counselling, career guidance and career coaching are similar in nature to
other types of Counselling or coaching, e.g. marriage or psychological
Counselling. What unites all types of professional Counselling is the role of
practitioners, who combine giving advice on their topic of expertise with
Counselling techniques that support clients in making complex decisions and
facing difficult situations. The focus of career Counselling is generally on issues

such as career exploration, career change, personal career development and
other career related issues.
Around the globe, countless definitions, concepts and terminology exist for
career Counselling - particularly due to cultural and linguistic
differences.[1]
This even affects the most central term
Counselling (or: counselling in British English) which is often substituted with
the word guidance as in career guidance. For example, in the UK, career
Counselling would usually be referred to as careers advice or guidance. Due to
the widespread reference to both career guidance and career
Counselling among policy-makers, academics and practitioners around the
world, references to career guidance and counselling are becoming
common.[2]
Accordingly, this article emphasizes a broad understanding of
career Counselling which involves a variety of professionals activities
commonly associated with career Counselling, guidance, coaching, and advise.
More specific roles and activities associated with career Counselling are
explained below.
Related professional activities
Career Counselling or career guidance includes a wide variety of professional
activities which focus on supporting people in dealing with career-related
challenges - both preventively and in difficult situations (such as
unemployment). Career counselors work with people from various walks of life,
such as adolescents seeking to explore career options, experienced professionals
contemplating a career change, parents who want to return to the world of work
after taking time to raise their child, or people seeking employment. Career
counselling is also offered in various settings, including in groups and
individually, in person or by means of digital communication.

Several approaches have been undertaken to systemize the variety of
professional activities related to career guidance and Counselling. In the most
recent attempt, the Network for Innovation in Career Guidance and Counselling
in Europe (NICE) - a consortium of 45 European institutions of higher
education in the field of career Counselling - has agreed on a system of
professional roles for guidance counselors. Each of these five roles is seen as an
important facet of the career guidance and counselling profession. Career
counselors performing in any of these roles are expected to behave
professionally, e.g. by following ethical standards in their practice. The NICE
Professional Roles (NPR) are:[3]
The Career Educator "supports people in developing their own career
management competences"
The Career Information & Assessment Expert "supports people in assessing
their personal characteristics and needs, then connecting them with the labour
market and education systems"
The Career Counsellor "supports individuals in understanding their situations,
so as to work through issues towards solutions"
The Programme & Service Manager "ensures the quality and delivery of career
guidance and counselling organisations' services"
The Social Systems Intervener & Developer "supports clients (even) in crisis
and works to change systems for the better"
Benefits
Professional career counselors can support people with career-related challenges
in many ways (see above). Through their expertise in career development and
labor markets, they can put a person's qualification, experience, strengths and
weakness in a broad perspective taking into consideration their desired salary,

personal hobbies and interests, location, job market and educational
possibilities. Through their counselling and teaching abilities, career counselors
can additionally support people in gaining a better understanding of what really
matters for them personally, how they can plan their careers autonomously, or
help them in making tough decisions and getting through times of crisis.
Finally, career counselors are often capable of supporting their clients in finding
suitable placements/ jobs, in working out conflicts with their employers, or
finding the support of other helpful services.
It is due to these various benefits of career Counselling that policy-makers in
many countries of the world publicly fund guidance services. For example, the
European Union understands career guidance and Counselling as an instrument
to effectively combat social exclusion and increase citizens' employability.[8]
History
Frank Parson's Choosing a Vocation (1909) was perhaps the first major work
which is concerned with careers guidance. While until the 1970s a strongly
normative approach was characteristic for theories (e.g. of Donald E.
Super's life-span approach) and practice of career Counselling (e.g. concept
of matching), new models have their starting point in the individual needs and
transferable skills of the clients while managing biographical breaks and
discontinuities. Career development is no longer viewed as a linear process.
More consideration is now placed on nonlinear, chance and unplanned
influences.
Training
Up until now there is no standardized qualification path for professional career
counselors, although various certificates are offered nationally and
internationally (e.g. by professional associations), and the number of academic
degree programs in career guidance and/or career Counselling is growing

worldwide. Still, in most countries, basically anybody could call themselves a
"career counselor" (unlike engineers or psychologists whose professions are
protected legally). At the same time, policy makers agree that the competence of
career counselors is one of the most important factors in ensuring that people
receive high quality support in dealing with their career questions.[9]
Depending
on the country of their education, career counselors may have a variety of
academic backgrounds: In Europe, for instance, degrees in (vocational/
industrial/ organization) psychology and educational sciences are among the
most common, but backgrounds in sociology, public administration and other
sciences are also frequent.[10]
At the same time, many training programs for
career counselors are becoming increasingly multidisciplinary.
Professional career guidance centres
There are many career guidance and Counselling centres all over the world.
They give services of guidance and Counselling on higher studies, possibilities,
chances and nature of courses and institutes. Also that these services are offered
either fixing up a meeting with the Experts or having telephonic conversations
with the guide or even the online guidance which is very common these days
with the people getting services on click of their mouse. There are many such
service providers all over the world providing online Counselling to people
about their career or conducting a psychometric test to know the persons
aptitude as well as interests.
Career testing
People who participate in career Counselling can benefit from the use of
aptitude tests, or career testing. Career testing is often done online and provides
insightful and relatively objective information about which jobs may be suitable
for the test taker based on combination of their interests, values and skills.
Career tests usually provide a list of recommended jobs that match the test

takers attributes with those of people with similar personalities who enjoy/are
successful at their jobs. There are various ways to test an individual for which
field he is suitable, psychometric testing being one among them.
Psychometric testing covers a wide range of skills, interests and values of
people and can be of use in career Counselling in different ways. For example,
the information won from such tests can be of help for the professionals who
mentor, coach or counsel individuals. With psychometric testing, there is no
pass or fail, but the quality of the information won from the tests can vary.
Psychometric testing uses in-depth psychological profiles to assess personality
and intellectual levels. Different test companies use different theoretical
approaches to testing, such as the psychometric approach, the psychodynamic
approach, the social learning approach and the humanist approach. Different test
companies have their own methods of testing, some of them being protected
with copyrights. Two commonly used assessments are the Strong Interest
Inventory and the MBTI, for example. Usually, psychometric testing uses
multiple sets of questions relating to personality type, how the test taker would
handle aspects of work and home life, what his or her goals are for the future
and his or her strengths and weaknesses. If the test taker is honest and the
employed tests follow scientific standards, the results should be fairly accurate
and useful for career Counselling activities.
Challenges
One of the major challenges associated with career Counselling is encouraging
participants to engage in the process. For example in the UK 70% of people
under 14 say they have had no careers advice while 45% of people over 14 have
had no or very poor/limited advice.[11]
In a related issue some client groups tend to reject the interventions made by
professional career counselors preferring to rely on the advice of peers or

superiors within their own profession. Jackson et al. found that 44% of doctors
in training felt that senior members of their own profession were best placed to
give careers advice.[12]
Furthermore it is recognised that the giving of career
advice is something that is widely spread through a range of formal and
informal roles. In addition to career counselors it is also common for teachers,
managers, trainers and Human Resources(HR) specialists to give formal support
in career choices. Similarly it is also common for people to seek informal
support from friends and family around their career choices and to bypass career
professionals altogether. Today increasingly people rely on career web portals
to seek advice on resume writing and handling interviews; as also to research on
various professions and companies. It has even become possible to take
vocational assessments online.
Marital counselling
Couples counselling, previously known as marital therapy or marriage
guidance, address the problems arising from adult sexual or intimate
relationships. The relationship, rather than the two individuals, is the 'client'.
Our very closest relationship: a marriage; co-habitation or civil partnership, is
based on intimacy and trust. When it stops working we are affected deeply and
our health and happiness suffer. Our sense of identity and self-worth often rests
on the strength of our relationships and we can despair when our prime
relationship fails.
Pressures of work, family, money and health all take their toll. Suddenly the
relationship that once recharged us leaves us drained and disappointed.
Patterns of behaving that we learned as children often re-emerge in our adult
relationship. A childhood 'scapegoat' may start to feel blamed for everything by
the partner who once adored them.

Signs you have relationship problems
 communication breaks down
 sex has ended or causes problems
 arguments continue without resolution
 violence erupts
 depression or other health problems recur
 the bond of trust is eroded or broken.
It is normal for relationships to suffer as the pressure and strains of everyday
life mount. Love may disappear, replaced by resentment and anger. Each
partner can view this differently depending on their own experience of family
life. One may despair, while the other may view it as a temporary blip.
Where a couple has attached hastily - in response to a passion, pregnancy or
other need, disappointments can surface and fester when the excitement
subsides. Renegotiating, with a skilled counsellor, can help build a more
realistic and deeper relationship.
When is the right time for couple counselling?
 There has been a betrayal of trust; an affair, debt or secret.
 Talking causes confusion or unbearable anger.
 Separation or Divorce seem like the only option.
 Desire has gone or sex is no fun.
 Arguments and bickering go on and on.
If possible, attend together unless there is domestic violence or fear.
Counselling can be undertaken with one partner if that feels more comfortable.

Being able to manage conflict, arguments and rows is the foundation stone to a
good relationship. It is unrealistic to hope that arguments can be avoided.
Two people come with their own values and beliefs and both must feel heard in
order to thrive. This may mean developing new skills.
Differences need to be acknowledged; otherwise we merge or one partner is
unheard. Then one partner may dominate and the other 'disappears'.
Arguments are a healthy and essential part of any relationship and can energise
it if carried out skilfully. Indirect anger and domestic violence are destructive.
Counselling can help with understanding the messages about conflict that we
may have inherited from our family and offer new skills.
Causes of relationship problems
 lack of negotiation can shatter expectations
 stress can fracture a relationship
 illness can deplete both partners
 birth of a child can leave a partner feeling abandoned
 depression can leave a partner feeling deserted
 external pressures can sever the couple bond
 disappointment can lead to anger and hostility
 life changes
 children leaving home can allow resentments to resurface.
Relationships need solid foundations; two unhappy people with unresolved
issues rarely make a long-term happy relationship. It may be tempting to feel

that our partner or colleague can compensate for earlier pain and loss, but this
hope often leads to further disappointment.
Enter a relationship as healthily as possible for the best chance of long-term
happiness. The pleasure is in wanting to be with someone rather than the tension
of feeling needy and dependent.
Self-respect and liking oneself are the important ingredients for a good
relationship. If they are in short supply you may consider counselling to address
them.
Individual work or bereavement counselling may help you move on following a
separation or bereavement.
How can couples counselling help?
 Destructive patterns of relating can be recognised and addressed.
 Conflict and communication can be improved.
 New relationship skills can be learned.
 The impact of change and loss can be examined.
 Relationships can be more successful.
 Abusive relationships and domestic violence can be acknowledged.
Sex can be a source of great enjoyment within a long-term relationship and any
problems it poses can leave one partner feeling rejected or angry. Loss of desire
is often an early sign of problems.
Psychosexual issues can highlight a problem within the relationship or arise
from the past. Childhood sexual abuse, for example, can impact on an otherwise
happy relationship and can be helped with a suitably qualified practitioner.
Other sexual problems may have a physical or medical cause, but can often be
addressed with a good therapist.

Communicating and staying connected during difficult times may feel
impossible. When two people no longer relate, their relationship is in crisis.
Often a betrayal of some type follows; an affair or a secret debt as the
breakdown is acted out. Skills are available to help you listen and be heard,
particularly when the unbearable needs to be heard and acknowledged.
This is the classic time when couples seek help. A new depth of understanding
can be reached or a couple may feel they must separate or divorce.
Separation & divorce counselling can help explore whether trust can be repaired
or the relationship will need to be rebuilt. If not, it can allow the couple to split
with more understanding and less hostility.
Sex Therapy
Relationship problems can arise from sexual difficulties, but sexual problems
may also be an indication of deeper problems in the relationship. Sexual
difficulties can emerge at any time, but especially in times of stress and change.
Sex essentially is fun and can be one of the great rewards of being together.
While one partner may use the frequency of sex to gauge how he or she is loved
and valued, the other may have intimacy as the benchmark. When a couple have
'gone off' sex, it can reveal their deeper attitude to trust, love and control. Is the
problem about unsatisfactory sex or does the sexual problem indicate a deeper
issue that needs to be explored? Emotional trust is the foundation stone of
physical intimacy.
Signs of a relationship sex issue
o Sex is no longer on the agenda.
o Sex is difficult or painful for one partner.
o Sex causes disappointment.
o One partner has gone off sex.

Families pass on unspoken messages about sex which can cause unnecessary
distress in couples. Often individuals need to explore their own sexuality away
from such pressures.
What feels good and what feels disappointing? Attitudes inherited from
childhood or out of ignorance can cause unnecessary misery. Cultural pressure
may require a detached and analytical re-examination to allow a couple to make
their own rules.
Sometimes traumatic sexual experiences from childhood or past relationships
can emerge in a present relationship. With trust these can be explored and
resolved.
Causes of sex issues
o physical – due to alcohol, drugs or illness
o pregnancy
o aging or loss of self-esteem
o anxieties and Stress
o loss of status or change in circumstances
o betrayal of trust.
How can counselling help sex issues?
Relationship counselling can help explore the physical communication and the
understanding of what sex means to two particular people. Sex may be
mechanical and a way to maintain a safe distance for one person. In such cases,
the partner may mourn the lack of intimacy and trust which would allow them
to feel safe and enjoy sex.
Withdrawal of sex can happen when a person has no alternative way to express
their anger and disappointment – so the forbidden feelings are acted out in the
bedroom. Control and power are often issues in difficult sexual relationships as

one partner may be unconsciously exerting the control and power they feel they
lack outside the bedroom.
If the problem is around a dysfunction, a couple can be referred
for psychosexual therapy with a suitably qualified person.
Family therapy
Family therapy, also referred to as couple and family therapy, marriage and
family therapy, family systems therapy, and family Counselling, is a branch
of psychotherapy that works with families and couples in intimate
relationships to nurture change and development. It tends to view change in
terms of the systems of interaction between family members. It emphasizes
family relationships as an important factor in psychological health.
The different schools of family therapy have in common a belief that, regardless
of the origin of the problem, and regardless of whether the clients consider it an
"individual" or "family" issue, involving families in solutions often benefits
clients. This involvement of families is commonly accomplished by their direct
participation in the therapy session. The skills of the family therapist thus
include the ability to influence conversations in a way that catalyses the
strengths, wisdom, and support of the wider system.
In the field's early years, many clinicians defined the family in a narrow,
traditional manner usually including parents and children. As the field has
evolved, the concept of the family is more commonly defined in terms of
strongly supportive, long-term roles and relationships between people who may
or may not be related by blood or marriage.
The conceptual frameworks developed by family therapists, especially those
of family systems theorists, have been applied to a wide range of human
behaviour, includingorganisational dynamics and the study of greatness.

UNIT 3
Psychoanalytic theory
Sigmund Freud
Psychoanalytic theory refers to the definition of personality organization and
the dynamics of personality development that underlie and guide the
psychoanalytic and psycho dynamic psychotherapy, called psychoanalysis, a
clinical method for treating psychopathology. First laid out by Sigmund
Freud in the late 19th century, psychoanalytic theory has undergone many
refinements since his work. Psychoanalytic theory came to full prominence in
the last third of the twentieth century as part of the flow of critical discourse
regarding psychological treatments after the 1960s, long after Freud's death in
1939, and its validity is now widely disputed or rejected. Freud had ceased his
analysis of the brain and his physiological studies and shifted his focus to the
study of the mind and the related psychological attributes making up the mind,
and on treatment using free association and the phenomena of transference. His
study emphasized the recognition of childhood events that could potentially

influence the mental functioning of adults. His examination of the genetic and
then the developmental aspects gave the psychoanalytic theory its
characteristics.[6]
Starting with his publication of The Interpretation of
Dreams in 1899, his theories began to gain prominence.
Definition
Through the scope of a psychoanalytic lens, humans are described as having
sexual and aggressive drives. Psychoanalytic theorists believe that human
behavior is deterministic. It is governed by irrational forces, and the
unconscious, as well instinctual and biological drives. Due to this deterministic
nature, psychoanalytic theorists do not believe in free will.
The Beginnings
Freud first began his studies on psychoanalysis and in collaboration with
Dr. Josef Breuer, especially when it came to the study on Anna O. [8]
The
relationship between Freud and Breuer was a mix of admiration and
competition, based on the fact that they were working together on the Anna O.
case and must balance two different ideas as to her diagnosis and treatment.
Today, Breuer can be considered the grandfather of psychoanalysis.[9]
Anna O.
was subject to both physical and psychological disturbances, such as not being
able to drink out of fear.[10]
Breuer and Freud both found that hypnosis was a
great help in discovering more about Anna O. and her treatment. The research
and ideas behind the study on Anna O. was highly referenced in Freud's lectures
on the origin and development of psychoanalysis.
These observations led Freud to theorize that the problems faced by hysterical
patients could be associated to painful childhood experiences that could not be
recalled. The influence of these lost memories shaped the feelings, thoughts and
behaviours of patients. These studies contributed to the development of the
psychoanalytic theory.

Personality Structure
Sigmund Freud determined that the personality consists of three different
elements, the id, the ego and the superego. The id is the aspect of personality
that is driven by internal and basic drives and needs. These are typically
instinctual, such as hunger, thirst, and the drive for sex, or libido. The id acts in
accordance with the pleasure principle, in that it avoids pain and seeks pleasure.
Due to the instinctual quality of the id, it is impulsive and often unaware of
implications of actions. The ego is driven by reality principle. The ego works to
balance both the id and superego. In order to balance these, it works to achieve
the id's drive in the most realistic ways. It seeks to rationalize the id's instinct
and please the drives that will benefit the individual in the long term. It helps
separate what is real, and realistic of our drives as well as being realistic about
the standards that the superego sets for the individual. The superego is driven by
morality principle. It acts in connection with the morality of higher thought and
action. Instead of instinctively acting like the id, the superego works to act in
socially acceptable ways. It employs morality, judging our sense of wrong and
right and using guilt to encourage socially acceptable behavior.
The Unconscious
The unconscious is the portion of the mind of which a person is not aware.
Freud said that it is the unconscious that exposes the true feelings, emotions,
and thoughts of the individual. There are variety of psychoanalytic techniques
used to access and understand the unconscious, ranging from methods like
hypnosis, free association, dream analysis. Dreams allow us to explore the
unconscious; according to Freud, they are "the 'royal road' to the
unconscious". Dreams are composed of latent and manifest content. Whereas
latent content is the underlying meaning of a dream that may not be
remembered when a person wakes up, manifest content is the content from the

dream that a person remembers upon waking and can be analyzed by a
psychoanalytic psychologist. Exploring and understanding the manifest content
of dreams can inform the individual of complexes or disorders that may be
under the surface of their personality. Dreams can provide access to the
unconscious that is not easily accessible. Freudian slips (also known
as parapraxes) occurs when the ego and superego do not work properly,
exposing the id and internal drives or wants. They are considered mistakes
revealing the unconscious. Examples range from calling someone by the wrong
name, misinterpreting a spoken or written word, or simply saying the wrong
thing.
Defense Mechanisms
The ego balances the id, the superego and reality in order to maintain a healthy
state of consciousness. It thus reacts to protect the individual from any stressors
and anxiety by distorting reality. This prevents threatening unconscious
thoughts and material from entering the consciousness.
The different types of defensemechanisms are:
Repression,reaction, denial, projection, displacement, sublimation, regression,
and rationalization.
Psychology theories
Psychosexual development
Freud's take on the development of the personality (psyche). It is a stage theory
that believes progress occurs through stages as the libido is directed to different
body parts. The different stages, listed in order of progression, are: Oral, Anal,
Phallic (Oedipus complex), Latency, Genital. The Genital stage is achieved if a
person has met all of his or her needs throughout the other stages with enough

available sexual energy. If the individual does not have his or her needs met in a
given stage, he or she will become fixated, or "stuck" in that stage.
Neo-analytic theory
Freud's theory and work with psychosexual development lead to Neo-
Analytic/ Neo-Freudians who also believed in the importance of the
unconscious, dream interpretations, defense mechanisms and the integral
influence childhood experiences but had objections to the theory as well. They
do not support the idea that development of the personality stops at age 6,
instead they believed development spreads across the lifespan. They extended
Freud's work and encompassed more influence from the environment and the
importance of conscious thought along with the unconscious. The most
important theorists are Erik Erikson (Psychosocial Development), Anna
Freud, Carl Jung, Alfred Adler and Karen Horney, and including the school
of object relations.
Classical Adlerian psychotherapy
Classical Adlerian psychotherapy may involve individual psychotherapy,
couple therapy, or family therapy, brief or lengthier therapy - but all such
approaches follow parallel paths, which are rooted in the individual
psychology of Alfred Adler.
Adler's psychotherapy
Adler's therapy involved identifying an individual's private life plan, explaining
its self-defeating, useless and predictable aspects, and encouraging a shift of
interest towards social and communal goals. Among the specific techniques
used were paradoxes, humorous or historical examples, analysis of the self-
protective role of symptoms, and reduction of transference by encouraging self-
responsibility. Adler also favoured what has been called 'prescribing the

symptom' - a form of anti-suggestion aimed at making the client's self-defeating
behavior less attractive to them.
Based on a growth model of the mind, Adler's approach aimed at fostering
social interest, and reducing repetitive life styles based on archaic private logic.
With its emphasis on reasoning with the patient, classical Adlerian therapy has
affinities with the later approach of Cognitive behavioral therapy.
History of Classical Adlerian Psychotherapy
Alfred Adler was greatly influenced by early socialism and Freud. This can be
seen in his early work and theories. He emphasized that individuals themselves
can change their lives. Adler and Freud respected one another; however, Adler
did not fully agree or accept Freud’s theories. Adler believed childhood
experiences have influences on people’s current problems, but he also did not
believe they are the only contributions. He also emphasizes free will and an
inborn drive as contributors to current problems people face. He doesn’t believe
individuals are victims of their past experiences.
Classical Adlerian Psychotherapy
Adlerian psychotherapy is unique in the sense that each client has their own
individual type of therapy. The therapy, however, is created by the therapist on
a six phase process. The overall goal of the therapy is to establish a relationship
between client and community in order not only to challenge the client's
unhealthy and unrealistic thoughts of the world, but also to challenge them to
replace self-defeating behaviors for ones that will lead to a more positive and
healthy lifestyle.
Phase 1
This stage focuses on support and is broken down into two stages. The first
stage emphasizes empathy and relationships. The therapist provides warmth,

acceptance, and generate hope while giving reassurance and encouragement to
the client. The second stage in this phase is focused on gathering information on
the client. Early childhood memories and influences are sought out as well as
details that provide information on how the client faces life problems.
Phase 2
The primary focus in phase two is on encouragement. This is done through two
stages of clarification and encouragement. Therapists clarify any vague thinking
with Socratic questioning and evaluate the consequences of various actions or
ideas. They help the client correct inappropriate ideas about his or her self and
others. They also help the client create alternative ways of thinking to move
his/her life into a new direction while clarifying feelings.
Phase 3
Insight is the headline for phase 3. Interpretation and recognition, as well as
knowing are the focus of the Insight phase. The client will learn to interpret
his/her feelings and goals as well as identify what s/he has avoided in the past.
This stage integrates many Freudian ideas such as dreams, daydreams, and
recollections. The Knowing stage is where the client is now fully aware of
his/her lifestyle and does not require any additional help with this. They know
and accept what they need to change.
Phase 4
The fourth phase is all about change. Change is first addressed through the stage
of an Emotional Breakthrough. This can be achieved through the use of role
playing, guided imagery and narration. The next stage is Doing Differently. The
client will break old patterns and change their attitude. This is achieved through
creating steps which are based on abstract ideas. The last stage in this phase is
Reinforcement. The therapist will encourage all efforts made by the client to

promote change. They will reward and affirm positive feelings and changes
while simultaneously evaluating the progress made by the client.
Phase 5
The final phase is about Challenge. The client goes through a first stage which
is characterized by social interest. S/he is instructed to give 100% in all
relationships and is encouraged to take risks. S/he is required to extend new
feelings of cooperation and empathy to others. Then, through goal redirection,
the client is challenged to release his/her old self and open a new self and live
by these new values. The last and final stage is focused on support and
launching. The therapist will inspire the client to enjoy the unfamiliar,
strengthen their feelings of connectedness to others, and to continue self growth.
Phase 6
The Meta-Therapy phase is for clients who have gone through Alder’s therapy,
readjusted their lives to better suit their goals, and who are making progress in
becoming who they want to be. This ending part of the therapy advises clients
to find out what aspects of life are truly important to them, and to pursue
these”higher values”.
Uses of Classical Adlerian Psychotherapy
1. Individual
The basic structure of individual therapy in Classical Adlerian psychotherapy is
broken down into 5 phases plus a post-therapy follow up, and each phase is
broken down into multiple stages, 13 total. Each of these stages has different
goals for the client and therapist to accomplish. This is the type of therapy
Classical Adlerian Psychotherapy was designed for.

2. Teacher-education Programs
Teacher-education programs have been designed to increase child cooperation
in classrooms. Teachers, parents, and school administrators attend these
programs and learn techniques to increase their own teaching effectiveness in
the classroom as well as how to learn to better handle children. These programs
are taught in the same manner that marital programs are taught.
3. Couple-enrichment Programs
Similar to group couple Counselling, couple-enrichment programs are
conducted by trained professionals and have groups of couples (typically about
10) attend and learn how to improve and enrich their relationships. Many
different teaching formats are used that include tools such as role playing, the
viewing of videos, and the implementation of other psycho-social exercises.
Sessions run for about an hour’s time.
4. Parent and Family Education Programs
These programs are comparable to classes taught by Family Life Educators. The
programs focus on building better family relaitonships.
Existential therapy
Existential psychotherapy is a philosophical method of therapy that operates on
the belief that inner conflict within a person is due to that individual's
confrontation with the givens of existence. These givens, as noted by Irvin D.
Yalom, are: the inevitability of death, freedom and its attendant responsibility,
existential isolation (referring tophenomenology), and finally meaninglessness.
These four givens, also referred to as ultimate concerns, form the body of
existential psychotherapy and compose the framework in which a therapist
conceptualizes a client's problem in order to develop a method of treatment. In
the British School of Existential therapy (Cooper, 2003), these givens are seen

as predictable tensions and paradoxes of the four dimensions of human
existence, the physical, social, personal and spiritual realms.
Psychological dysfunction
Because there is no single existential view, opinions about psychological
dysfunction vary.
For theorists aligned with Yalom, psychological dysfunction results from the
individual's refusal or inability to deal with the normal existential anxiety that
comes from confronting life's "givens": mortality, isolation, meaninglessness,
and freedom.
For other theorists, there is no such thing as psychological dysfunction or being
mentally ill. Every way of being is merely an expression of how one chooses to
live one's life. However, one may feel unable to come to terms with the anxiety
of being alone in the world. If so, an existential psychotherapist can assist one in
accepting these feelings rather than trying to change them as if there is
something wrong. Everyone has the freedom to choose how they are going to be
in life, however this may go unexercised because making changes is difficult; it
may appear easier and safer not to make decisions that one will be responsible
for. Many people will remain unaware of alternative choices in life for various
societal reasons.
The good life
Existentialism suggests that it is possible for people to face the anxieties of life
head-on and embrace the human condition of aloneness, to revel in the freedom
to choose and take full responsibility for their choices. They courageously take
the helm of their lives and steer in whatever direction they choose; they have the
courage to be. One does not need to arrest feelings of meaninglessness, but can
choose new meanings for their lives. By building, by loving, and by creating
one is able to live life as one's own adventure. One can accept one's own

mortality and overcome fear of death. Though the French author Albert
Camus denied the specific label of existentialist, in his novel, L'Etranger, his
main character Meursault, ends the novel by doing just this. He accepts his
mortality and rejects the constrictions of society he previously placed on
himself, leaving him unencumbered and free to live his life with an unclouded
mind.
Existential therapy
The existential psychotherapist is generally not concerned with the client's past;
instead, the emphasis is on the choices to be made in the present and future. The
counselor and the client may reflect upon how the client has answered life's
questions in the past, but attention ultimately shifts to searching for a new and
increased awareness in the present and enabling a new freedom and
responsibility to act. The patient can then accept they are not special, and that
their existence is simply coincidental, without destiny or fate. By accepting this,
they can overcome their anxieties, and instead view life as moments in which
they are fundamentally free. (The outline above is based on a strictly Sartrean
perspective)
Four worlds
Existential thinkers seek to avoid restrictive models that categorize or label
people. Instead they look for the universals that can be observed cross-
culturally. There is no existential personality theory which divides humanity
into types or reduces people to part components. Instead there is a description of
the different levels of experience and existence with which people are inevitably
confronted. The way in which a person is in the world at a particular stage can
be charted on this general map of human existence (Binswanger, 1963; Yalom,
1980; van Deurzen, 1984). One can distinguish four basic dimensions of human
existence: the physical, the social, the psychological and the spiritual. On each

of these dimensions people encounter the world and shape their attitude out of
their particular take on their experience. Their orientation towards the world
defines their reality. The four dimensions are obviously interwoven and provide
a complex four-dimensional force field for their existence. Individuals are
stretched between a positive pole of what they aspire to on each dimension and
a negative pole of what they fear.
Physical dimension On the physical dimension (Umwelt) individuals relate to
their environment and to the givens of the natural world around them. This
includes their attitude to the body they have, to the concrete surroundings they
find themselves in, to the climate and the weather, to objects and material
possessions, to the bodies of other people, their own bodily needs, to health and
illness and to their own mortality. The struggle on this dimension is, in general
terms, between the search for domination over the elements and natural law (as
in technology, or in sports) and the need to accept the limitations of natural
boundaries (as in ecology or old age). While people generally aim for security
on this dimension (through health and wealth), much of life brings a gradual
disillusionment and realization that such security can only be temporary.
Recognizing limitations can bring great release of tension.
Social dimension On the social dimension (Mitwelt) individuals relate to others
as they interact with the public world around them. This dimension includes
their response to the culture they live in, as well as to the class and race they
belong to (and also those they do not belong to). Attitudes here range from love
to hate and from cooperation to competition. The dynamic contradictions can be
understood in terms of acceptance versus rejection or belonging versus
isolation. Some people prefer to withdraw from the world of others as much as
possible. Others blindly chase public acceptance by going along with the rules
and fashions of the moment. Otherwise they try to rise above these by becoming
trendsetters themselves. By acquiring fame or other forms of power, individuals

can attain dominance over others temporarily. Sooner or later, however,
everyone is confronted with both failure and aloneness.
Psychological dimension On the psychological dimension (Eigenwelt)
individuals relate to themselves and in this way create a personal world. This
dimension includes views about their own character, their past experience and
their future possibilities. Contradictions here are often experienced in terms of
personal strengths and weaknesses. People search for a sense of identity, a
feeling of being substantial and having a self. But inevitably many events will
confront them with evidence to the contrary and plunge them into a state of
confusion or disintegration. Activity and passivity are an important polarity
here. Self-affirmation and resolution go with the former and surrender and
yielding with the latter. Facing the final dissolution of self that comes with
personal loss and the facing of death might bring anxiety and confusion to many
who have not yet given up their sense of self-importance.
Spiritual dimension On the spiritual dimension (Überwelt) (van Deurzen,
1984) individuals relate to the unknown and thus create a sense of an ideal
world, an ideology and a philosophical outlook. It is here that they find meaning
by putting all the pieces of the puzzle together for themselves. For some people
this is done by adhering to a religion or other prescriptive world view, for others
it is about discovering or attributing meaning in a more secular or personal way.
The contradictions that have to be faced on this dimension are often related to
the tension between purpose and absurdity, hope and despair. People create
their values in search of something that matters enough to live or die for,
something that may even have ultimate and universal validity. Usually the aim
is the conquest of a soul, or something that will substantially surpass mortality
(as for instance in having contributed something valuable to humankind).
Facing the void and the possibility of nothingness are the indispensable
counterparts of this quest for the eternal.

Person-centered therapy
Person-centered therapy (PCT) is also known as person-centered
psychotherapy, person-centered Counselling, client-centered
therapy and Rogerian psychotherapy. PCT is a form of talk-
psychotherapy developed by psychologist Carl Rogers in the 1940s and 1950s.
The goal of PCT is to provide clients with an opportunity to develop a sense of
self wherein they can realize how their attitudes, feelings and behavior are being
negatively affected.
Although this technique has been criticized by behaviorists for lacking structure
and by psychoanalysts for actually providing a conditional relationship[2]
it has
proven to be an effective and popular treatment.
History and influences
Person-centered therapy, now considered a founding work in
the humanistic school of psychotherapies, began formally with Carl
Rogers. "Rogerian" psychotherapy is identified as one of the major school
groups, along with psychodynamic psychotherapy, psychoanalysis (most
famously Sigmund Freud), classical Adlerian psychology, cognitive behavioral
therapy, and existential therapy (such as that pioneered by Rollo May).[8]
Rogers affirmed individual personal experience as the basis and standard for
living and therapeutic effect. Rogers identified six conditions which are needed
to produce personality changes in clients: relationship, vulnerability to anxiety
(on the part of the client), genuineness (the therapist is truly himself or herself
and incorporates some self-disclosure), the client's perception of the therapist's
genuineness, the therapist's unconditional positive regard for the client, and
accurate empathy.[9]
This emphasis contrasts with the dispassionate position
which may be intended in other therapies, particularly the more extreme
behavioral therapies. Living in the present rather than the past or future, with

organismic trust, naturalistic faith in your own thoughts and the accuracy in
your feelings, and a responsible acknowledgment of your freedom, with a view
toward participating fully in our world, contributing to other peoples' lives, are
hallmarks of Roger's Person-centered therapy. Rogers also claims that the
therapeutic process is essentially the accomplishments made by the client. The
client having already progressed further along in their growth and maturation
development, only progresses further with the aid of a psychologically favored
environment.[10]
Core Conditions
Rogers (1957; 1959) stated[9]
that there are six necessary and sufficient
conditions required for therapeutic change:
1. Therapist-Client Psychological Contact: a relationship between client
and therapist must exist, and it must be a relationship in which each
person's perception of the other is important.
2. Client in-congruence: that in-congruence exists between the client's
experience and awareness.
3. Therapist Congruence, or Genuineness: the therapist is congruent
within the therapeutic relationship. The therapist is deeply involved him
or herself - they are not "acting" - and they can draw on their own
experiences (self-disclosure) to facilitate the relationship.
4. Therapist Unconditional Positive Regard (UPR): the therapist accepts
the client unconditionally, without judgment, disapproval or approval.
This facilitates increased self-regard in the client, as they can begin to
become aware of experiences in which their view of self-worth was
distorted by others.
5. Therapist Empathic understanding: the therapist experiences an
empathic understanding of the client's internal frame of reference.

Accurate empathy on the part of the therapist helps the client believe the
therapist's unconditional love for them.
6. Client Perception: that the client perceives, to at least a minimal degree,
the therapist's UPR and empathic understanding.
Processes
Rogers asserted that the most important factor in successful therapy is the
relational climate created by the therapist's attitude to their client. He specified
three interrelated core conditions:
1. Congruence - the willingness to transparently relate to clients without
hiding behind a professional or personal facade.
2. Unconditional Positive Regard - the therapist offers an acceptance and
prizing for their client for who he or she is without conveying
disapproving feelings, actions or characteristics and demonstrating a
willingness to attentively listen without interruption, judgement or giving
advice.
3. Empathy - the therapist communicates their desire to understand and
appreciate their clients perspective.
Rogers believed that a therapist who embodies these three critical attitudes will
help liberate their client to more confidently express their true feelings without
fear of judgement. To achieve this, the client-centered therapist carefully avoids
directly challenging their client's way of communicating themselves in the
session in order to enable a deeper exploration of the issues most intimate to
them and free from external referencing.[11]
Rogers was not prescriptive in
telling his clients what to do, but believed that the answers to the patients'
questions were within the patient and not the therapist. Accordingly the
therapists' role was to create a facilitative, empathic environment wherein the
patient could discover the answers for him or herself.

UNIT 4
Rational Emotive Behaviour Therapy
Psychologist Albert Ellis created Rational Emotive Behavior Therapy, also
known as REBT.
Rational emotive behavior therapy, also known as REBT, is a type of cognitive-
behavioral therapy developed by psychologist Albert Ellis. REBT is focused on
helping clients change irrational beliefs.
History of Rational Emotive Behavior Therapy
Ellis had trained as a clinical psychologist. As he treated patients, he became
increasingly dissatisfied with the results offered by traditional psychoanalytic
therapy. He noted that while his patients were able to become aware of their
underlying problems, their behavior did not actually change.
By the 1950s, Ellis had started experimenting with other types of psychotherapy
and was heavily influenced by philosophers and psychologists including Karen
Horney and Alfred Adler as well as the work of behavioral therapists. Ellis's
goal was to develop an action-oriented approach to psychotherapy designed to

produce results by helping clients manage their emotions, cognitions, and
behaviors.
According to Ellis, "people are not disturbed by things but rather by their view
of things." The fundamental assertion of Rational Emotive Therapy is that the
way people feel is largely influenced by how they think. When people hold
irrational beliefs about themselves or the world, problems result. Because of
this, the goal of REBT is to help people alter illogical beliefs and negative
thinking patterns in order to overcome psychological problems and mental
distress.
Rational emotive behavior therapy was one of the very first types of cognitive
therapies. Ellis first began developing REBT during the early 1950s and initially
called his approach rational therapy. In 1959, the technique was redubbed
rational emotive therapy and later rechristened rational emotive behavior
therapy in 1992. Ellis continued to work on REBT until his death in 2007.
The ABC Model
Ellis suggested that people mistakenly blame external events for unhappiness.
He argued, however, that it is our interpretation of these events that truly lies at
the heart of our psychological distress. To explain this process, Ellis developed
what he referred to as the ABC Model:
 A – Activating Event: Something happens in the environment around you.
 B – Beliefs: You hold a belief about the event or situation.
 C – Consequence: You have an emotional response to your belief.

The Basic Steps in Rational Emotive Behavior Therapy
1. Identifying the underlying irrational thought patterns and beliefs.
The very first step in the process is to identify the irrational thoughts, feelings,
and beliefs that lead to psychological distress. In many cases, these irrational
beliefs are reflected as absolutes, as in "I must," "I should," or "I cannot."
According to Ellis, some of the most common irrational beliefs include:
 Feeling excessively upset over other people's mistakes or misconduct.
 Believing that you must be 100 percent competent and successful in
everything to be valued and worthwhile.
 Believing that you will be happier if you avoid life's difficulties or challenges.
 Feeling that you have no control over your own happiness; that your
contentment and joy are dependent upon external forces.
By holding such unyielding beliefs, it becomes almost impossible to respond to
situations in a psychologically healthy way. Possessing such rigid expectations
of ourselves and others only leads to disappointment, recrimination, regret, and
anxiety.
2. Challenging the irrational beliefs.
Once these underlying feelings have been identified, the next step is to
challenge these mistaken beliefs. In order to do this, the therapist must dispute
these beliefs using very direct and even confrontational methods. Ellis
suggested that rather than simply being warm and supportive, the therapist
needs to be blunt, honest, and logical in order to push people toward changing
their thoughts and behaviors.

3. Gaining Insight and Recognizing Irrational Thought Patterns
As you might imagine, REBT can be a daunting process for the client. Facing
irrational thought patterns can be difficult, especially because accepting these
beliefs as unhealthy is far from easy. Once the client has identified the
problematic beliefs, the process of actually changing these thoughts can be even
more difficult.
While it is perfectly normal to feel upset when you make a mistake, the goal of
REBT is to help people respond rationally to such situations. When faced with
this type of situation in the future, the emotionally healthy response would be to
realize that while it would be wonderful to be perfect and never make mistakes,
it is not realistic to expect success in every endeavor. You made a mistake. But
that's okay because everyone makes mistakes. All you can do is learn from the
situation and move on.
It is also important to recognize that while rational emotive behavior therapy
utilizes cognitive strategies to help clients, it also focuses on emotions and
behaviors as well. In addition to identifying and disputing irrational beliefs,
therapists and clients also work together to target the emotional responses that
accompany problematic thoughts. Clients are also encouraged to change
unwanted behaviors using such things as meditation, journaling, and guided
imagery.
REBT can be effective in the treatment of a range of psychological disorders
including anxiety disorders and phobias as well as specific behaviors such as
severe shyness and excessive approval seeking.

Behavioural Therapy
Behavioral therapy is a treatment that helps change potentially self-destructing
behaviors. It is also called behavioral modification or cognitive behavioral
therapy. Medical professionals use this type of therapy to replace bad habits with
good ones. The therapy also helps you cope with difficult situations. It is most often
used to treat anxiety disorders. However, you don’t have to be diagnosed with a
mental health disorder to benefit.
What Is Behavioral Therapy Used For?
Behavioral therapy is used by psychotherapists, psychiatrists, and other qualified
medical professionals. It is usually used to help treat anxiety and mood disorders.
These include:
 obsessive-compulsive disorder (OCD)
 post-traumatic stress disorder (PTSD)
 depression
 social phobia
 bipolar disorder
 schizophrenia

This treatment can help patients cope with certain mental disorders. It can also
be used to treat:
 autism
 personality disorders
 substance abuse
 eating disorders
This therapy is also used on patients with chronic diseases to help manage pain.
For example, cancer patients use learned techniques to better copewith radiation
therapy. Doctors often recommend behavioral modification to pregnant women
who can’t safely take medications. This form of treatment can also help with
emotional grief.
Techniques Used
Therapists create treatment plans specifically tailored to individual conditions.
Some exercises may include:
 discussions about coping mechanisms
 role playing
 breathing and relaxation methods
 positive reinforcement
 activities to promote focus
 journal writing
 social skills training
 modifications in responses to anger, fear, and pain
Therapists sometimes ask patients to think about situations that scare them. The
goal is not to frighten them but to help them develop different coping skills

Benefits
The general benefit is increased quality of life. Specific benefits vary depending
on what condition is being treated. These can include:
 reduced incidents of self-harm
 improved social skills
 better functioning in unfamiliar situations
 improved emotional expressions
 less outbursts
Cognitive Behavior Therapy
Dr. Aaron Beck
Cognitive behavior therapy (CBT) is a type of psychotherapeutic treatment that
helps patients understand the thoughts and feelings that influence behaviors.
CBT is commonly used to treat a wide range of disorders including phobias,
addiction, depression and anxiety.
Cognitive behavior therapy is generally short-term and focused on helping
clients deal with a very specific problem. During the course of treatment, people

learn how to identify and change destructive or disturbing thought patterns that
have a negative influence on behavior.
Cognitive Behavior Therapy Basics
The underlying concept behind CBT is that our thoughts and feelings play a
fundamental role in our behavior. For example, a person who spends a lot of
time thinking about plane crashes, runway accidents, and other air disasters may
find themselves avoiding air travel. The goal of cognitive behavior therapy is to
teach patients that while they cannot control every aspect of the world around
them, they can take control of how they interpret and deal with things in their
environment.
Cognitive behavior therapy has become increasingly popular in recent years
with both mental health consumers and treatment professionals. Because CBT is
usually a short-term treatment option, it is often more affordable than some
other types of therapy. CBT is also empirically supported and has been shown
to effectively help patients overcome a wide variety of maladaptive behaviors.
Types of Cognitive Behavior Therapy
According to the British Association of Behavioural and Cognitive
Psychotherapies, "Cognitive and behavioural psychotherapies are a range of
therapies based on concepts and principles derived from psychological models
of human emotion and behaviour. They include a wide range of treatment
approaches for emotional disorders, along a continuum from structured
individual psychotherapy to self help material."
There are a number of different approaches to CBT that are regularly used by
mental health professionals. These types include:

 Rational Emotive Therapy
 Cognitive Therapy
 Multimodal Therapy
The Components of Cognitive Behavior Therapy
People often experience thoughts or feelings that reinforce or compound faulty
beliefs. Such beliefs can result in problematic behaviors that can affect
numerous life areas, including family, romantic relationships, work, and
academics. For example, a person suffering from low self-esteem might
experience negative thoughts about his or her own abilities or appearance. As a
result of these negative thinking patterns, the individual might start avoiding
social situations or pass up opportunities for advancement at work or at school.
In order to combat these destructive thoughts and behaviors, a cognitive-
behavioral therapist begins by helping the client to identify the problematic
beliefs. This stage, known as functional analysis, is important for learning how
thoughts, feelings, and situations can contribute to maladaptive behaviors. The
process can be difficult, especially for patients who struggle with introspection,
but it can ultimately lead to self-discovery and insights that are an essential part
of the treatment process.
The second part of cognitive behavior therapy focuses on the actual behaviors
that are contributing to the problem. The client begins to learn and practice new
skills that can then be put into use in real-world situations. For example, a
person suffering from drug addiction might start practicing new coping skills
and rehearsing ways to avoid or deal with social situations that could potentially
trigger a relapse.

In most cases, CBT is a gradual process that helps a person take incremental
steps towards abehavior change. Someone suffering from social anxiety might
start by simply imagining himself in an anxiety-provoking social situation.
Next, the client might start practicing conversations with friends, family, and
acquaintances. By progressively working toward a larger goal, the process
seems less daunting and the goals easier to achieve.
Uses of Cognitive Behavior Therapy
Cognitive behavior therapy has been used to treat people suffering from a wide
range of disorders, including anxiety, phobias, depression, and addiction. CBT
is one of the most researched types of therapy, in part because treatment is
focused on highly specific goals and results can be measured relatively easily.
Cognitive behavior therapy is often best-suited for clients who are comfortable
with introspection. In order for CBT to be effective, the individual must be
ready and willing to spend time and effort analyzing his or her thoughts and
feelings. Such self-analysis can be difficult, but it is a great way to learn more
about how internal states impact outward behavior.
Cognitive behavior therapy is also well-suited for people looking for a short-
term treatment option that does not necessarily involve pharmacological
medication. One of the greatest benefits of cognitive-behavior therapy is that it
helps clients develop coping skills that can be useful both now and in the future.
Criticisms of Cognitive Behavior Therapy
Initially, some patients suggest that while they recognize that certain thoughts
are not rational or healthy, simply becoming aware of these thoughts does not
make it easy to stop having them. It is important to note that CBT does not just

involve identifying these thought patterns; it is focused on using a wide range of
strategies to help clients overcome these thoughts. Such strategies may include
journaling, role-playing, relaxation techniques, and mental distractions.
Reality therapy

Reality therapy (RT) is an approach to psychotherapy and Counselling.
Developed by William Glasser in the 1960s, RT differs from
conventional psychiatry, psychoanalysis and medical model schools
of psychotherapy in that it focuses on what Glasser calls psychiatry's three Rs:
realism, responsibility, and right-and-wrong, rather than symptoms of mental
disorders. Reality therapy maintains that the individual is suffering from a
socially universal human condition rather than a mental illness. It is in the
unsuccessful attainment of basic needs that a person's behavior moves away
from the norm. Since fulfilling essential needs is part of a person's present life,
reality therapy does not concern itself with a client's past. Neither does this type
of therapy deal with unconscious mental processes. In these ways reality
therapy is very different from other forms of psychotherapy.
The reality therapy approach to Counselling and problem-solving focuses on the
here-and-now actions of the client and the ability to create and choose a better
future. Typically, clients seek to discover what they really want and how they
are currently choosing to behave in order to achieve these goals. According to
Glasser, the social component of psychological disorders has been highly
overlooked in the rush to label the population as sick or mentally ill. Reality
therapy attempts to separate the client from the behavior. Just because someone
is experiencing distress resulting from a social problem does not make him sick;
it just makes him out of sync with his psychological needs.
Process of RT
Involvement
Establishing a relationship with the client is believed to be the most important
factor in all types of therapy. Without this relationship, the other steps will not
be effective. This is also known as developing a good rapport with the client. In
extreme cases, the therapist may be the only person in the client's life who is

willing to put up with the client's behavior long enough to establish a
relationship, which can require a great deal of patience from the therapist. In
other cases, the client is a part of many relationships, but just needs a
relationship with a more consistently positive emphasis. According to Glasser,
the client needs to feel that the therapist is someone that he would want in his
"Quality World".
Evaluating current behavior
The therapist must emphasize the here and now with the client, focusing on the
current behaviors and attitudes. The therapist asks the client to make a value
judgment about his or her current behavior (which presumably is not beneficial,
otherwise the client may not have negative consequences from behavior
motivating enough to seek therapy). In many cases the therapist must press the
client to examine the effects of his or her behavior, but it is important that the
judgment be made by the client and not the therapist. According to Glasser, it is
important for the client to feel that he is in control of his own life.[14]
Planning possible behaviour
Plan some behavior that is likely to work better. The client is likely to need
some suggestions and prompting from the therapist, but it helps if the plan itself
comes from the client. It is important that the initial steps be small enough that
the client is almost certain to succeed, in order to build confidence. In many
cases, the client's problem is the result of a bad relationship with someone, and
since the client cannot change anyone else's behavior, the therapist will focus on
things the client can do unilaterally. The client may be concerned that the other
person will take advantage of this and not reciprocate, but in most cases a
change in behavior will ease the tension enough that the other person also backs
off. If this does not happen, the therapist will also encourage the client to build
more positive relationships with other people. The relationship with the

therapist sustains the client long enough for them to establish these other
relationships.
Principles of RT
There are several basic principles of reality therapy that must be applied to
make this technique most successful.
1. Focus on the present and avoid discussing the past because all human
problems are caused by unsatisfying present relationships.
2. Avoid discussing symptoms and complaints as much as possible since
these are often the ineffective ways that clients choose to deal with (and
hold on to) unsatisfying relationships.
3. Understand the concept of total behavior, which means focus on what
clients can do, directly act, and think. *Spend less time on what they
cannot do directly such as changing their feelings and physiology.
Feelings and physiology can be changed indirectly, but only if there is a
change in the acting and thinking.
4. Avoid criticizing, blaming and/or complaining and help clients do the
same. By doing this, they learn to avoid these extremely harmful external
control behaviors that destroy relationships.
5. Remain non-judgmental and non-coercive, but encourage people to judge
all they are doing by the Choice Theory axiom: Is what I am doing
getting me closer to the people I need? If the choice of behaviors is not
getting people closer, then the therapist works to help the client find new
behaviors that lead to a better connection.
6. Teach clients that legitimate or not, excuses stand directly in the way of
their ability to make needed connections.
7. Focus on specifics. Find out as soon as possible who clients are
disconnected from and work to help them choose reconnecting behaviors.

If they are completely disconnected, focus on helping them find a new
connection.
8. Help them make specific, workable plans to reconnect with the people
they need, and then follow through on what was planned by helping them
evaluate their progress. Based on their experience, therapists may suggest
plans, but should not give the message that there is only one plan. A plan
is always open to revision or rejection by the client.
9. Be patient and supportive but keep focusing on the source of the problem:
disconnectedness. Clients who have been disconnected for a long time
will find it difficult to reconnect. They are often so involved in the
harmful behavior that they have lost sight of the fact that they need to
reconnect. Help them to understand Choice Theory and explain that
whatever their complaint, reconnecting is the best possible solution to
their problem.
UNIT 5
Expressive therapy
Expressive therapy, also known as the expressive therapies, expressive arts
therapy or creative arts therapy, is the use of the creative arts as a form
of therapy. Unlike traditional art expression, the process of creation is
emphasized rather than the final product. Expressive therapy is predicated on
the assumption that people can heal through use of imagination and the various
forms of creative expression.

Types of expressive therapy
Expressive therapy is an umbrella term. Some common types of expressive
therapy include:
 art therapy
 dance therapy, also known as dance/movement therapy
 drama therapy
 psychodrama
 music therapy
 writing therapy, a term which may encompass journaling, poetry therapy,
and bibliotherapy
 Therapeutic Recreation
 horticultural therapy
Horticultural therapy is often not listed with other expressive therapies; it is not
universally considered a form of expressive therapy or creative arts therapy.
All expressive therapists share the belief that through creative expression and
the tapping of the imagination, a person can examine the body, feelings,
emotions and his or her thought process. However, expressive arts therapy is its
own therapeutic discipline, an inter-modal discipline where the therapist and
client move freely between drawing, dancing, music, drama, and poetry.
Although often separated by the form of creative art, some expressive therapists
consider themselves intermodal, using expression in general, rather than a
specific discipline to treat clients, altering their approach based on the clients'
needs, or through using multiple forms of expression with the same client to aid
with deeper exploration.
Expressive arts therapy is the practice of using imagery, storytelling, dance,
music, drama, poetry, movement, horticulture, dreamwork, and visual arts
together, in an integrated way, to foster human growth, development, and

healing. It is about reclaiming our innate capacity as human beings for creative
expression of our individual and collective human experience in artistic form.
Expressive arts therapy is also about experiencing the natural capacity of
creative expression and creative community for healing.
Music therapy
Power of Music by Louis Gallait. A brother and sister resting before an old tomb.
The brother is attempting to comfort his sibling by playing the violin, and she
has fallen into a deep sleep, "oblivious of all grief, mental and physical."
Music therapy is the use of interventions to accomplish individual goals within
a therapeutic relationship by a professional who has completed an approved
music therapy program. Music therapy is an allied health profession and one of
the expressive therapies, consisting of a process in which a music therapist uses
music and all of its facets—physical, emotional, mental, social, aesthetic, and
spiritual—to help clients improve their health. Music therapists primarily help
clients improve their health in several domains, such as cognitive
functioning, motor skills, emotional development, social skills, and quality of
life, by using music experiences such as free improvisation, singing, and

listening to, discussing, and moving to music to achieve treatment goals. It has a
wide qualitative and quantitative research literature base and incorporates
clinical therapy, psychotherapy, bio musicology, musical acoustics, music
theory, psychoacoustics, embodied music cognition, aesthetics of
music, sensory integration, and comparative musicology. Referrals to music
therapy services may be made by other health care professionals such as
physicians, psychologists, physical therapists, and occupational therapists.
Clients can also choose to pursue music therapy services without a referral (i.e.,
self-referral).
Music therapists are found in nearly every area of the helping professions. Some
commonly found practices include developmental work (communication, motor
skills, etc.) with individuals with special needs, songwriting and listening in
reminiscence/orientation work with the elderly, processing and relaxation work,
and rhythmic entrainment for physical rehabilitation in stroke victims. Music
therapy is also used in some medical hospitals, cancer centers, schools, alcohol
and drug recovery programs, psychiatric hospitals, and correctional facilities.
History of music therapy
Music has been used as a healing force for centuries. Apollo is the ancient
Greek god of music and of medicine. Aesculapius was said to cure diseases of
the mind by using song and music, and music therapy was used in Egyptian
temples. Plato said that music affected the emotions and could influence the
character of an individual. Aristotle taught that music affects the soul and
described music as a force that purified the emotions. Aulus Cornelius
Celsus advocated the sound of cymbals and running water for the treatment of
mental disorders. Music therapy was practiced in biblical times, when David
played the harp to rid King Saul of a bad spirit. As early as 400
B.C., Hippocrates played music for his mental patients. In the thirteenth
century, Arab hospitals contained music-rooms for the benefit of the

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