6teoridanpendekatanpengalamandalamkaunseling Personcentredtheorygestalttheoryexistentialtheory...

Teori dan Pendekatan Pengalaman dalam Kaunseling – PERSON CENTRED THEORY, GESTALT

THEORY, EXISTENTIAL THEORY

TAJUK 6

Person-Centered Theory

a.k.a., Humanistic or Rogerian Therapy

Person-Centered Therapy (A reaction against the directive and psychoanalytic approaches)

• Challenges:– The assumption that “the counselor knows

best”– The validity of advice, suggestion, persuasion,

teaching, diagnosis, and interpretation

– The belief that clients cannot understand and resolve their own problems without direct help

– The focus on problems over persons

Theory and Practice of Counseling and Psychotherapy - Chapter 7 (1)

Overview

• Founder: Carl Rogers. Born in Oak Park, IL-1902. Trained at University of Wisconsin and Columbia University. His educational background was in agriculture, science, philosophy, theology, education and psychology. Fundamental shift in theory from helper-to-client to person-to-person.

Person-Centered Therapy• Emphasizes:

– Therapy as a journey shared by two fallible people– The person’s innate striving for self-actualization– The personal characteristics of the therapist and

the quality of the therapeutic relationship– The counselor’s creation of a permissive, “growth

promoting” climate– People are capable of self-directed growth if

involved in a therapeutic relationship


Major philosophies and nature of humans

• Human beings are essentially rational, constructive, positive, independent, realistic, cooperative, trustworthy, accepting, forward moving and full of potential. Humans, like all organisms, naturally tend toward actualization of their full potential. (Gilliland & James, 1998)

• Experience is key to Rogerian theory. Because each person’s perception of his or her own experience is unique, the client is the only expert on his or her own life.

(Gilliland & James, 1998)

Major constructs• Actualizing tendency. The inherent tendency of the person to

develop in ways that serve to maintain or promote growth.• Conditions of worth. A person’s worth is conditional when his

or her self-esteem is based on significant others’ valuation of experience.

• Congruence. The state of consonance among the person’s acting, thinking and feeling states. When experiences are wholly integrated into the self-concept.

• Empathic understanding. One perceives as if one were the other person but without ever losing the “as if” condition.


Major constructs• Experience (noun). All the cognitive and affective events

within the person that are available or potentially available to his or her awareness.

• Experience (verb). To receive the impact of all the sensory or physiological events happening at the present moment.

• Genuineness. The state where there is no difference between the real and the perceived selves.

• Organismic valuing process. The process whereby experiences are accurately perceived, constantly updated, and valued in terms of the satisfaction experienced by the person.


Major constructs• Positive regard. The perception of the self-experience of

another person that leads the individual to feel warmth, liking and respect for the acceptance of that person.

• Positive self-regard. A positive attitude toward the self that is not dependent on the perceptions of significant others.

• Self-actualization tendency. The tendency of the person to move toward achieving his or her full potential.

• Self-Concept. The person’s total internal view of self in relation to the experiences of being and functioning within the environment.


Major constructs• Self-Experience. Any event in the individual’s

perceptual field that he or she sees as relating to the “self,” “me,” or “I.”

• Unconditional Positive Regard. The individual’s perception of another person without ascription of greater or lesser worthiness to that person. It is characterized by a total rather than a conditional acceptance of the other person.

• Unconditional self-regard. The perception of the self in such a way that no self-experience can be discriminated as being more or less worthy of positive regard than any other self-experience.

(Walker & Brokaw, 2005)

The Self

• According to Rogers, the Self:– Is organized and consistent– Includes one’s perceptions of all that comprises “I” or “me”– Includes the relationship among I or me an other people

and features of life, as well as the value and importance of these relationships

– Is available to consciousness but it is not always conscious at any given moment

– The shape of the self is constantly changing, yet always recognizable

A self actualized person has the following characteristics

• Open to experience• Aware of all experience• Deal w/change in creative ways• Socially effective• Lives existentially• Lives in the here and now• Trusts self

Major personality constructs• Personality theory has not been of major concern to

person-centered therapists, rather the manner in which change comes about in the human personality has been the focus. (Gilliland & James, 1998)

• Each person is unique and has the ability to reach his or her full potential.

• Once the self-concept is formed, two additional needs are acquired: – the need for positive regard from others – the need for positive self-regard

Nature of “maladaptivity”

• Rogerian theory speaks primarily of “incongruence” as the primary maladaptivity. Maladaptivity relates to the blocks that are put in the road to actualization. (Gilliland & James, 1998)

• Also, external locus of control and looking to others for worth are seen as maladaptive.

Major goals of counseling

• The central focus of counseling is the client’s experiencing of feelings.

A Growth-Promoting Climate

• Congruence - genuineness or realness• Unconditional positive regard- acceptance

and caring, but not approval of all behavior• Accurate empathic understanding – an

ability to deeply grasp the client’s subjective world– Helper attitudes are more important than

knowledgeTheory and Practice of Counseling and Psychotherapy - Chapter 7 (3)

Major techniques/strategies• The most important technique in person-centered

counseling is the establishment of the relationship between client and counselor as one of mutual trust and safety. The relationship is the beginning, the main event and the end of the counseling. The counselor deals directly, in the here and now, with the client’s feelings and experiences rather than intellectualize about the experiences.

• Person-centered theory is a phenomenological approach—each person is unique.

Six Conditions (necessary and sufficient for personality changes to occur)

1. Two persons are in psychological contact2. The first, the client, is experiencing incongruency3. The second person, the therapist, is congruent or integrated

in the relationship4. The therapist experiences unconditional positive regard or

real caring for the client5. The therapist experiences empathy for the client’s internal

frame of reference and endeavors to communicate this to the client

6. The communication to the client is, to a minimal degree, achieved


Major roles of counselor and client

• Because of the essential nature of the relationship, the major role of counselor is to create an atmosphere of genuineness, unconditional positive regard and empathic understanding and to reflect content to the client.

• The reflection may include the counselor’s own feelings so long as they are genuine and the counselor owns them as his or her own.

• The challenges for the counselor lie in his or her willingness to also be changed by and grow through the counseling relationship and to be open and transparent to the client.

Major roles of counselor and client

• The client’s role is to do, think, say or feel whatever they are experiencing in the moment.

• Within the atmosphere of unconditional positive regard, the client will be able to experience his or her feeling about the experiences and the incongruence in his or her life and will by nature, know and choose the course toward growth and actualization.

The Therapist

• Focuses on the quality of the therapeutic relationship

• Serves as a model of a human being struggling toward greater realness

• Is genuine, integrated, and authentic, without a false front

• Can openly express feelings and attitudes that are present in the relationship with the client


Gestalt Therapy

Be who you are and say what you feel because those who mind don’t matter and those who matter don’t mind.

Dr. Seuss

© 2011 Brooks/Cole, A Division of Cengage Learning

Chapter Objectives

After reading this chapter, you should be able to: • Outline the development of Gestalt therapy and Fritz Perls

• Explain the theory of Gestalt therapy including its core concepts

• Discuss the counseling relationship and goals in Gestalt therapy

• Describe assessment, process, and techniques in Gestalt therapy

• Demonstrate some therapeutic techniques

• Clarify the effectiveness of Gestalt therapy

• Discuss Gestalt play therapy


Fritz Perls

• A native of Germany• Childhood of questioning and rebellion• Degree from Friedrich Wilhelm University in 1921• Worked in South Africa for 12 years and there

formulated all the ideas he would later call Gestalt therapy

• Lived in New York, Miami, California and British Columbia


The Nature of People

• The most important areas of concern are the thoughts and feelings that people are experiencing at the moment

• Normal healthy behavior occurs when people act and react as total organisms.

• Many people fragment their lives, distributing concentration and attention among several things at one time


The Nature of People

• View of human nature is positive

• People are capable of becoming self-regulating beings who can achieve a sense of unity and integration in their lives

• “Lose your mind and come to your senses”

• Awareness alone can be curative

• With full awareness self-regulation develops and the total person takes control


General principles for healthy functioning

1. Valuing the here-and-now in order to experience each minute fully

2. Embracing self-awareness and experience, understanding and accepting all parts of self

3. Prizing wholeness or responsibility and understanding life is a process; as people mature they move past old ways and become more self-sufficient, self-observing, and self-understanding

(Fall et al., 2004)


People cause themselves problems by not handling their lives in these ways:

• Lacking contact with their environment.

• Confluence: incorporate themselves into others or the environment into themselves

• Unfinished business: unfulfilled needs, unfinished situations


Cause of problems

• Fragmentation: inability to find what one needs caused fragmentation

• Top/under dog: split between what they should do and what they want to do

• Polarities: need to resolve conflicts between existing polarities


Five Types of Polarities

1. Physical: masculine-feminine, and parasympathetic-sympathetic nervous system

2. Emotional: pleasure-pain, love-hate, excitement-depression, love-hate

3. Mental: Parent-child, feeling-reason, top dog-underdog

4. Spiritual: intellectual doubt – dogmatism5. Inter-Individual: man-woman, black-white,

Christian-Jew


Theory of Counseling

The five layers of neurosis (counseling stages)1. Phony Layer: Trying to be what they are not2. Phobic Layer: Aware of the fears that force the Phony

game3. Impasse Layer: Shed environmental supports of their game

without a better way to cope with fears and dislikes4. Implosive Layer: Aware of how they limit themselves and

begin to experiment with new behaviors5. Explosive Layer: Discover unused energy tied up

maintaining a phony existence


Theory of Counseling

1. Body language – project thoughts onto empty chair as significant person

2. Direct experience of the here and now – Integration and maturation – Gestalts as new needs

3. Help people help themselves grow up4. Integration is creating whole person whose

behavior matches their inner state5. People should: grow in awareness – take

responsibility for their actions – move from environmental support to self support


A sampling of counseling methods

• “I” language: Disallow “you” as in “you know how it is”

• Substitute “won’t” for “can’t”Insist on client taking responsibility

• Substitute “what” and “how” for “why”“what do you feel” not “why do you feel”

• No gossiping: talk to people not about peopleUse an empty chair to talk to


A sampling of counseling methods

• Change questions to statements“I should” not “do you think I should”

• Take responsibility: Right now I feel _______and I take _______ % of the responsibility

• Sentence completion“I help/hurt myself when I ___________


Sampling of counseling methods

• Bipolarities – Top/under dog or I should vs. I wanto Use an empty chair for a discussiono Client sits in one chair to defend “I should”o Moves to another chair to discuss “I want

• My greatest weaknesso Write a paragraph on my greatest weakness and why

it is a strength


Decision Making

SYNERGISE

SYNTHESIZE

TOP DOG“I SHOULD”

UNDER DOG“I WANT”

COMPROMISE


Counseling method

Integrate thoughts and feelings For three closest people write

• “I resent _____” • “I demand _____” and • “I appreciate _____”


Counseling methods

Fantasy Games for creating awareness• Client fantasizes being an animal and tries to

understand what it feels like

• Wise person: client asks and answers one question to/from a wise person


Counseling Methods

Dream Work• Dreaming is an awareness of the world

• Pieces of a dream are fragments of a personality that must be integrated

• Describe a dream – list the objects – client gives a voice to each part and has them converse


Gestalt Play Therapy

• Concern of therapy is the integrated functioning of all aspects of the child so that senses, body, emotions, and intellect are well coordinated in a creative adjustment

• A dance that sometimes the counselor leads and other times the child leads

• Contact is having the ability to be completely present in a situation



• Goal is to restore the child’s natural functioning and self-regulatory processes

• Experiencing the contacting process leads to integration, choice and change



Focus on development of inner strength and confidence in the child through opportunities to make choices, achieve mastery, own their projections, participate in imaginative play, and expel aggressive energy appropriately


Cross-cultural Applications

• Works well for some and offends others (such as cultures where emotions are not expressed)

• Dedicated to lifestyle change rather than problem resolution: If you learn how to behave, the problems will take care of themselves.

• Present oriented but past can be dealt with using empty chair

• People are responsible for their lives – no victims – discounts the past

• Counselor must (in all cases) adapt to the culture and world view of their clients


Managed Health Care

1. Managed health care companies would have difficulties with this approach because of the lack of specificity

2. How do you know when therapy is finished? When the client has achieved the open honest manner of interaction

3. Can be viewed as instant cure because that sometimes happens quickly

Theory and Practice of Counseling and Psychotherapy

MacDonald Existential Therapy

Questions?• What key concepts do you know in terms of

existential therapy?• What is the meaning or purpose of your life?

– What do you want from life? – Where is the source of meaning for you in life?

• How do you work through a sense of “no self” and feeling alone?

• What are the possible reasons that people tend to blame others for their problems?

• What is the positive motivation of being anxious?• If you only have 30 days left, what’s your feelings?

What will you do?

Question

• What key concepts do you know in terms of existential therapy?

Existential Therapy A Philosophical/Intellectual Approach to Therapy

• View of Human Nature– The capacity for self-awareness– The tension between freedom & responsibility– The creation of an identity & establishing meaningful

relationships– The search for meaning, purpose, and values of life– Accepting anxiety as a condition of living– The awareness of death and nonbeing

The Capacity for Self-Awareness

• We can reflect and make choices because we are capable of self-awareness.

• Expanding our awareness in realizing that:– We are finite - time is limited– We have the potential, the choice, to act or not to act– Meaning is not automatic - we must seek it– We are subject to loneliness, meaninglessness, emptiness,

guilt, and isolation

Question

• What are the possible reasons that people tend to blame others for their problems?

Freedom and Responsibility

• We are free to choose among alternatives• We are responsible for our lives, for our action, and

for our failure to take action.• Blaming others for their problems---

– Recognize how they allowed others to decide for them and the price they pay

– Encourage them to consider the alternative options

Striving for Identity • Identity is “the courage to be”

– We must trust ourselves to search within and find our own answers

– Our great fear is that we will discover that there is no core, no self

• Struggling with our identity: – Challenging clients---in what ways that they have

lost touch with they identity and letting others to design their life.

Question?

• How do you work through a sense of “no self” and feeling alone?

Relationship to others • Aloneness

– We are alone---So, we must give a sense of meaning to life, decide how we will live, have a relationship with ourselves, and learn to listen to ourselves.

• Relatedness– We need to create a close relationship with others– Challenging clients----What they get from they

relationship? How they avoid close relationship?

Question

• What is the meaning or purpose of your life?– What do you want from life? – Where is the source of meaning for you in life?

The Search for Meaning

• Therapists trust is important in teaching clients to trust their own capacity to find their way of being.

• Meaninglessness in life leads to emptiness and hollowness (existential vacuum)

• Finding meaning in life is a by-product of engagement, which is a commitment to creating, loving, working, and building.

Question

• What is the positive motivation of being anxious?

Anxiety – A Condition of Living

• Anxiety arises from one’s strivings to survive. • Existential anxiety is normal

– an outcome of being confronted with the four given of existence: death, freedom, existential isolation, and meaninglessness.

– Recognize existential anxiety and find ways to deal with it constructively.

– Anxiety can be a stimulus for growth as we become aware of and accept our freedom

– If we have the courage to face ourselves and life we may be frightened, but we will be able to change

Question

• If you only have 30 days left, what’s your feelings? What will you do?

Awareness of Death

• Death provides the motivation for us to live our lives fully and take advantage of each opportunity to do something meaningful.

Therapeutic Goals

• To expand self-awareness• To increase potential choices• To help client accept the responsibility for

their choice• To help the client experience authentic

existence

Therapist’s Function and Role

• Understand the client’s subjective world• Encourage clients to accept personal

responsibility• When clients blame others, therapist is likely

to ask them how they contributed to their situation.

Client’s Experience in Therapy

• They are challenged to take responsibility for how they now choose to be, decide how they want to be different, and take actions.

• Major themes in therapy sessions are anxiety, freedom and responsibility, isolation, death, and the search for meaning.

• Assist client in facing life with courage, hope, and a willingness to find meaning in life.

Relationship Between Therapist and Client• Therapy is a journey taken by therapist and client

– The person-to-person relationship is key– The relationship demands that therapists be in contact

with their own world• The core of the therapeutic relationship

– Respect and faith in the clients’ potential to cope and discover alternative ways of being

– Therapists share their reactions to clients with genuine concern and empathy as one way of deepening the therapeutic relationship.

Therapeutic techniques and procedures

• It is not technique-oriented• The interventions are based on philosophical

views about the nature of human existence.• Free for draw techniques from other orientations• The use of therapist self is the core of therapy

Questions

• Which populations is existential therapy particularly useful?

• Which issues is existential therapy particularly useful?

Areas of Application

• Grief work, facing a significant decision, developmental crisis, coping with failures in marriage and work, dealing with physical limitations due to age……

From a multicultural perspective

• Contributions– Applicable to diverse clients to search for meaning

for life– Be able to examine the behavior is influenced by

social and cultural factors.– Help clients to weigh the alternatives and

consequences.– Change external environment and recognize how

they contribute

From a multicultural perspective

• Limitations– Excessively individualistic– Ignore social factors that cause human problems– Even if clients change internally, they see little hope the

external realities of racism or discrimination will change– For many cultures, it is not possible to talk about self and

self-determination apart from the context of the social network

– Many clients expect a structured and problem-oriented approach instead of discussion of philosophical questions.

Summary and Evaluation

• Contributions– Stress self-determination accepting the personal

responsibility along with freedom– View oneself as the author of one’s life– Understand the value of anxiety and guilty, the positive

meaning of death, the positive aspects of being alone and choosing for oneself

– Enable clients to examine how their behavior is being influenced by social and cultural conditioning.

Summary and Evaluation

• Limitations– Lacks of a systemic principles and practice

for therapy– No empirical research validation yet– Limited to apply to lower-functioning clients,

clients who need directions, are concerned about meeting basic needs, and lack of verbal skills

Case 1

• I find myself terrified when I am alone. I need people around me constantly, and if I’m forced to be alone, then I run from myself by watching TV. I’d like to learn how to be alone and feel comfortable about it.– What are the issues?– What can you do to help this client?

Case 2

• I feel like my existence does not matter to anyone. If I were to die today, I fully believe that it wouldn’t make a difference to anyone.– What are the issues?– What can you do to help this client?

Case 3

• I rarely feel close to another person. While I want this closeness, I am frightened of being rejected. Instead of letting anyone get close to me, I build walls that keep them removed. What can I do to lessen my fear of being rejected?– What are the issues?– What can you do to help this client?

Questions

• Please discuss at least three questions to ask speakers regarding the career issues in social work, private practice, counseling, and family and marriage?

THE CREATIVE COUNSELLOR:

INTEGRATING THE EXPRESSIVE ARTS INTO

YOUR THERAPEUTIC PRACTICE

By Jannah Tudiver, MA, CCC, LPC& Catherine Fawcett, MA, MSW, RSW

INTRODUCTIONS

& WARM-UP ACTIVITY

WHY USE THE EXPRESSIVE ARTS IN YOUR PRACTICE?

• New tool for your “toolkit”• Address client issues• Well suited to brief therapy• Stay inspired & avoid burnout• Practice self-care

CREATIVE EXPRESSION & MENTAL HEALTH

1800’s to the 1900’s:

• Arts as adjunct to medicine & psychiatry

• “Moral therapy” for mental illness

1920’s:

• Joseph Moreno: psychodrama• Florence Goodenough: art

assessment for cognitive development

• Margaret Lowenfield: foundations of play therapy & sandtray therapy

1930’s and 1940’s:

• Expressive therapies more well known

• Self-expression as “alternative” to talk therapy

• Major psychiatric hospitals include arts in treatment

1950’s ONWARDS… (abridged version)

• Professional associations & standards developed• Expressive therapies integrated into medical, mental

health, & rehabilitative settings

WHAT ARE THE “EXPRESSIVE THERAPIES”?

“The use of art, music, dance/movement, drama, poetry/creative writing, play, and sandtray within the context of psychotherapy, counseling, rehabilitation, or health care” – Cathy Malchiodi, 2005

TYPES OF EXPRESSIVE THERAPIES:

• Art Therapy• Music Therapy• Drama Therapy• Dance/Movement Therapy• Poetry Therapy• Play Therapy• Sandtray Therapy• **Expressive Arts Therapy

Each discipline has its own association, qualifications, & professional standards

COMMON THEMES AMONG EXPRESSIVE THERAPIES:

• Sensory-based• Creativity• Aesthetic focus• Action-based/body-based

WHAT IS “EXPRESSIVE ARTS THERAPY”?

• Arts-based psychotherapy• Interdisciplinary• Integrates the arts eg. imagery,

dance, music, drama, poetry, movement, & visual arts

• Goal: wellness & healing

BACKGROUND OF EXPRESSIVE ARTS THERAPY:

• Newest arts-based therapy• Began in 1970’s at Lesley

College Graduate School

ALTERNATE NAMES FOR EXPRESSIVE ARTS THERAPY:

• “Expressive Therapy”• “Integrative Arts Therapy”• “Intermodal Expressive

Therapy”• “Multimodal Expressive

Therapy”

“A rose by any other name would smell as sweet…”

GUIDING PRINCIPLES OF EXPRESSIVE ARTS THERAPY:

• Reclaims our innate capacity for creative expression

• Creative expression is a healing, ‘growth producing’ process

• Therapeutic transformation possible through expression

GUIDING PRINCIPLES OF EXPRESSIVE ARTS THERAPY:

• The arts are for everyone• Low skill/high sensitivity• Depth-oriented• “Layering” of modalities

KEY THEORISTS IN EXPRESSIVE ARTS THERAPY:

Natalie Rogers: “creative connection”; person-centered

Shaun McNiff: “therapy of the imagination”; “art as medicine”

Paulo Knill: arts are “within each other”; “de-centering process”

APPALACHIAN STATE’S PERSPECTIVE:

• Natural world as model for creative process

• Reclaiming ancient integration of arts & life & healing

• Dream-work emphasis• The ‘person of the therapist’

ASSOCIATION & REGISTRATION

• International Expressive Arts Therapy Association (IEATA), 1994– Registered Expressive Arts

Therapist (REAT) & Registered Expressive Arts Consultant/ Educator (REACE)

• Additional Resources: – Creative Arts in Counselling

Chapter, CCPA– See Resource List

WHAT POPULATIONS WILL THIS WORK WITH?

The expressive arts are used with a variety of populations & presenting issues including:

• Psychiatric disorders• Developmental disorders• Cognitive disabilities• Issues including: addiction,

trauma, grief, anxiety, & depression

EXPRESSIVE ARTS ARE UTILIZED WITH:

• Clients of all ages• Clients with diverse backgrounds• Individuals & families• Groups• Outreach programs

Expressive Arts Therapy is practiced & taught in many countries eg. Peru, Israel & Switzerland

WHO USES EXPRESSIVE THERAPIES?

Approximately 30,000 practitioners in the U.S. are formally trained in therapeutic use of the arts

Arts-based interventions have been integrated into fields such as medicine, social work, counselling, psychiatry & psychology

CURRENT RESEARCH Recent research topics on the therapeutic use of expressive arts include:

• Creative writing in prevention & psychotherapy

• Music therapy in hospice & palliative care• Creative therapies in treatment for PTSD• Dance therapy for women survivors of

sexual abuse• Increasing counsellor empathy through

theatre exercises• Guided imagery & relaxation for women in

early stage breast cancer• Promoting positive mental health through

art therapy• The use of the arts in grief & loss

A HANDS-ON EXPERIENCE

SIMPLE WAYS TO INTEGRATE THE EXPRESSIVE ARTS INTO YOUR THERAPEUTIC PRACTICE…

RECOMMENDATIONS FOR PRACTICE:

• Try the activity 1st yourself • Focus on process over product• Respond to art with process

comments; avoid likes & dislikes• Counter negative statements eg “I

can’t do art”• Explore when to participate versus

when to be a witness• Create openings & closings

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