What counseling theory am i

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selF QuizziNg & practice

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Theories at-a-Glance The tables in this book compare theories over a range of topics, thereby providing you with the ability to easily compare, contrast, and grasp the practical aspects of each theory. These tables also serve as invaluable resources that can be used to review the key concepts, philoso- phies, limitations, contributions to multicultural counseling, applications, techniques, and goals of all theories in this text.

The following chart provides a convenient guide to the tables in this text.

Pages

6–7 Table 1.1 Overview of Contemporary Counseling Models

62–63 Table 4.1 Ego-Defense Mechanisms

65–66 Table 4.2 Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages

432 Table 15.1 The Basic Philosophies

433–434 Table 15.2 Key Concepts

438 Table 15.3 Goals of Therapy

441–442 Table 15.4 The Therapeutic Relationship

443–444 Table 15.5 Techniques of Therapy

444–445 Table 15.6 Applications of the Approaches

446 Table 15.7 Contributions to Multicultural Counseling

447 Table 15.8 Limitations in Multicultural Counseling

448–449 Table 15.9 Contributions of the Approaches

449–450 Table 15.10 Limitations of the Approaches

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Overview of Focus Questions for the Theories For the chapters dealing with the different theories, you will have a basic understand- ing of this book if you can answer the following questions as they apply to each of the eleven theories:

Who are the key figures (founder or founders) associated with the approach?

What are some of the basic assumptions underlying this approach?

What are a few of the key concepts that are essential to this theory?

What do you consider to be the most important goals of this therapy?

What is the role the therapeutic relationship plays in terms of therapy outcomes?

What are a few of the techniques from this therapy model that you would want to incorporate into your counseling practice?

What are some of the ways that this theory is applied to client populations, settings, and treat- ment of problems?

What do you see as the major strength of this theory from a diversity perspective?

What do you see as the major shortcoming of this theory from a diversity perspective?

What do you consider to be the most significant contribution of this approach?

What do you consider to be the most significant limitation of this approach?

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Australia • Brazil • Mexico • Singapore • United Kingdom • United States

Gerald Corey California State University, Fullerton Diplomate in Counseling Psychology,

American Board of Professional Psychology

Theory and PracTice of counseling and

PsychoTheraPy Tenth Edition

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Theory and Practice of Counseling and Psychotherapy, Tenth Edition Gerald Corey

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To the founders and key figures of the theories presented

in this book—with appreciation for their contributions

to contemporary counseling practice.

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iv

abouT The auThor

gerald corey is Professor Emeritus of Human Services and Counseling at California State University at Fullerton. He received his doctorate in counseling from the University of Southern California. He is a Diplomate in Counseling Psy- chology, American Board of Professional Psychology; a licensed psychologist; and a National Certified Counselor. He is a Fellow of the American Psychological Associa- tion (Division 17, Counseling Psychology; and Division 49, Group Psychotherapy); a Fellow of the American Counseling Association; and a Fellow of the Association for Specialists in Group Work. He also holds memberships in the American Group Psychotherapy Association; the American Mental Health Counselors Association; the Association for Spiritual, Ethical, and Religious Values in Counseling; the Asso- ciation for Counselor Education and Supervision; and the Western Association of Counselor Education and Supervision. Both Jerry and Marianne Corey received the Lifetime Achievement Award from the American Mental Health Counselors Associ- ation in 2011, and both of them received the Eminent Career Award from ASGW in 2001. Jerry was given the Outstanding Professor of the Year Award from California State University at Fullerton in 1991. He regularly teaches both undergraduate and graduate courses in group counseling and ethics in counseling. He is the author or coauthor of 15 textbooks in counseling currently in print, along with more than 60 journal articles and book chapters. Several of his books have been translated into other languages. Theory and Practice of Counseling and Psychotherapy has been trans- lated into Arabic, Indonesian, Portuguese, Turkish, Korean, and Chinese. Theory and Practice of Group Counseling has been translated into Korean, Chinese, Spanish, and Russian. Issues and Ethics in the Helping Professions has been translated into Korean, Japanese, and Chinese.

In the past 40 years Jerry and Marianne Corey have conducted group counsel- ing training workshops for mental health professionals at many universities in the United States as well as in Canada, Mexico, China, Hong Kong, Korea, Germany, Belgium, Scotland, England, and Ireland. In his leisure time, Jerry likes to travel, hike and bicycle in the mountains, and drive his 1931 Model A Ford. Marianne and Jerry have been married since 1964. They have two adult daughters, Heidi and Cindy, two granddaughters (Kyla and Keegan), and one grandson (Corey).

Recent publications by Jerry Corey, all with Cengage Learning, include:

ŠŠ Theory and Practice of Group Counseling, Ninth Edition (and Student Manual) (2016)

ŠŠ Becoming a Helper, Seventh Edition (2016, with Marianne Schneider Corey)

ŠŠ Issues and Ethics in the Helping Professions, Ninth Edition (2015, with Mari- anne Schneider Corey, Cindy Corey, and Patrick Callanan)

ŠŠ Group Techniques, Fourth Edition (2015, with Marianne Schneider Corey, Patrick Callanan, and J. Michael Russell)

ŠŠ Groups: Process and Practice, Ninth Edition (2014, with Marianne Schnei- der Corey and Cindy Corey)

iv

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v

ŠŠ I Never Knew I Had a Choice, Tenth Edition (2014, with Marianne Schneider Corey)

ŠŠ Case Approach to Counseling and Psychotherapy, Eighth Edition (2013) ŠŠ The Art of Integrative Counseling, Third Edition (2013)

Jerry Corey is coauthor (with Barbara Herlihy) of Boundary Issues in Counseling: Multiple Roles and Responsibilities, Third Edition (2015) and ACA Ethical Standards Case- book, Seventh Edition (2015); he is coauthor (with Robert Haynes, Patrice Moulton, and Michelle Muratori) of Clinical Supervision in the Helping Professions: A Practical Guide, Second Edition (2010); he is the author of Creating Your Professional Path: Les- sons From My Journey (2010). All four of these books are published by the American Counseling Association.

He has also made several educational DVD programs on various aspects of counseling practice: (1) Ethics in Action: DVD and Workbook (2015, with Marianne Schneider Corey and Robert Haynes); (2) Groups in Action: Evolution and Challenges DVD and Workbook (2014, with Marianne Schneider Corey and Robert Haynes); (3) DVD for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes (2013); (4) DVD for Integrative Counseling: The Case of Ruth and Lecturettes (2013, with Robert Haynes); and (5) DVD for Theory and Practice of Group Counseling (2012). All of these programs are available through Cengage Learning.

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Preface xi

PART 1

BASIC ISSUES IN COUNSELING PRACTICE

1 Introduction and Overview 1 introduction 2 Where I Stand 3 Suggestions for Using the Book 5 Overview of the Theory Chapters 6 Introduction to the Case of Stan 9 Introduction to the Case of Gwen 13

2 The Counselor: Person and Professional 17

introduction 18 The Counselor as a Therapeutic Person 18 Personal Therapy for the Counselor 20 The Counselor’s Values and the Therapeutic Process 22 Becoming an Effective Multicultural Counselor 25 Issues Faced by Beginning Therapists 28 Summary 35

3 Ethical Issues in Counseling Practice 37

introduction 38 Putting Clients’ Needs Before Your Own 38 Ethical Decision Making 39 The Right of Informed Consent 41 Dimensions of Confidentiality 42 Ethical Issues From a Multicultural Perspective 43 Ethical Issues in the Assessment Process 45 Ethical Aspects of Evidence-Based Practice 48 Managing Multiple Relationships in Counseling Practice 49 Becoming an Ethical Counselor 52 Summary 53

Where to Go From Here 53 Recommended Supplementary Readings for Part 1 54

PART 2

THEORIES AND TECHNIQUES OF COUNSELING

4 Psychoanalytic Therapy 57 introduction 58 Key Concepts 59 The Therapeutic Process 66 Application: Therapeutic Techniques and Procedures 72 Jung’s Perspective on the Development of Personality 77 Contemporary Trends: Object-Relations Theory, Self Psychology, and Relational Psychoanalysis 79 Psychoanalytic Therapy From a Multicultural Perspective 84 Psychoanalytic Therapy applied to the case of stan 85 Psychoanalytic Therapy applied to the case of gwen 87 Summary and Evaluation 89 Self-Reflection and Discussion Questions 92 Where to Go From Here 92 Recommended Supplementary Readings 93

5 Adlerian Therapy 95 introduction 98 Key Concepts 98 The Therapeutic Process 104 Application: Therapeutic Techniques and Procedures 108 Adlerian Therapy From a Multicultural Perspective 119 adlerian Therapy applied to the case of stan 121 adlerian Therapy applied to the case of gwen 122

Contents

vii

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viii Contents

Summary and Evaluation 124 Self-Reflection and Discussion Questions 126 Where to Go From Here 127 Recommended Supplementary Readings 128

6 Existential Therapy 129 introduction 132 Key Concepts 137 The Therapeutic Process 146 Application: Therapeutic Techniques and Procedures 149 Existential Therapy From a Multicultural Perspective 153 existential Therapy applied to the case of stan 155 existential Therapy applied to the case of gwen 156 Summary and Evaluation 157 Self-Reflection and Discussion Questions 160 Where to Go From Here 160 Recommended Supplementary Readings 162

7 Person-Centered Therapy 163 introduction 165 Key Concepts 170 The Therapeutic Process 171 Application: Therapeutic Techniques and Procedures 176 Person-Centered Expressive Arts Therapy 180 Motivational Interviewing 182 Person-Centered Therapy From a Multicultural Perspective 184 Person-centered Therapy applied to the case of stan 186 Person-centered Therapy applied to the case of gwen 187 Summary and Evaluation 190 Self-Reflection and Discussion Questions 193 Where to Go From Here 193 Recommended Supplementary Readings 195

8 Gestalt Therapy 197 introduction 199 Key Concepts 200 The Therapeutic Process 206

Application: Therapeutic Techniques and Procedures 211 Gestalt Therapy From a Multicultural Perspective 220 gestalt Therapy applied to the case of stan 221 gestalt Therapy applied to the case of gwen 223 Summary and Evaluation 224 Self-Reflection and Discussion Questions 227 Where to Go From Here 227 Recommended Supplementary Readings 229

9 Behavior Therapy 231 introduction 233 Key Concepts 236 The Therapeutic Process 238 Application: Therapeutic Techniques and Procedures 240 Behavior Therapy From a Multicultural Perspective 258 behavior Therapy applied to the case of stan 259 behavior Therapy applied to the case of gwen 260 Summary and Evaluation 262 Self-Reflection and Discussion Questions 265 Where to Go From Here 266 Recommended Supplementary Readings 267

10 Cognitive Behavior Therapy 269 introduction 270 Albert Ellis’s Rational Emotive Behavior Therapy 270 Key Concepts 272 The Therapeutic Process 273 Application: Therapeutic Techniques and Procedures 275 Aaron Beck’s Cognitive Therapy 281 Christine Padesky and Kathleen Mooney’s Strengths-Based Cognitive Behavioral Therapy 289 Donald Meichenbaum’s Cognitive Behavior Modification 293 Cognitive Behavior Therapy From a Multicultural Perspective 298 cognitive behavior Therapy applied to the case of stan 300 cognitive behavior Therapy applied to the case of gwen 302 Summary and Evaluation 303

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Contents ix

Self-Reflection and Discussion Questions 307 Where to Go From Here 308 Recommended Supplementary Readings 310

11 Choice Theory/Reality Therapy 311

introduction 313 Key Concepts 314 The Therapeutic Process 318 Application: Therapeutic Techniques and Procedures 320 Choice Theory/Reality Therapy From a Multicultural Perspective 327 reality Therapy applied to the case of stan 329 reality Therapy applied to the case of gwen 331 Summary and Evaluation 332 Self-Reflection and Discussion Questions 334 Where to Go From Here 334 Recommended Supplementary Readings 336

12 Feminist Therapy 337 introduction 339 Key Concepts 341 The Therapeutic Process 345 Application: Therapeutic Techniques and Procedures 348 Feminist Therapy From a Multicultural and Social Justice Perspective 354 feminist Therapy applied to the case of stan 355 feminist Therapy applied to the case of gwen 357 Summary and Evaluation 360 Self-Reflection and Discussion Questions 364 Where to Go From Here 364 Recommended Supplementary Readings 366

13 Postmodern Approaches 367 Some Contemporary Founders of Postmodern Therapies 368 Introduction to Social Constructionism 368 Solution-Focused Brief Therapy 371 Narrative Therapy 382 Postmodern Approaches From a Multicultural Perspective 390 Postmodern approaches applied to the case of stan 392

Postmodern approaches applied to the case of gwen 394 Summary and Evaluation 396 Self-Reflection and Discussion Questions 398 Where to Go From Here 399 Recommended Supplementary Readings 400

14 Family Systems Therapy 403 introduction 404 Development of Family Systems Therapy 406 A Multilayered Process of Family Therapy 409 Family Systems Therapy From a Multicultural Perspective 415 family Therapy applied to the case of stan 417 family Therapy applied to the case of gwen 420 Summary and Evaluation 422 Self-Reflection and Discussion Questions 424 Where to Go From Here 424 Recommended Supplementary Readings 425

PART 3

INTEGRATION AND APPLICATION

15 An Integrative Perspective 427 introduction 428 The Movement Toward Psychotherapy Integration 428 Issues Related to the Therapeutic Process 437 The Place of Techniques and Evaluation in Counseling 443 an integrative approach applied to the case of stan 452 an integrative approach applied to the case of gwen 455 Summary 456 Concluding Comments 457 Self-Reflection and Discussion Questions 458 Where to Go From Here 458 Recommended Supplementary Readings 459

references and suggested readings 461

name index 481

subject index 485

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Preface to Tenth Edition

T his book is intended for counseling courses for undergraduate and graduate students in psychology, counselor education, human services, and the mental health professions. It surveys the major concepts and practices of the contemporary therapeutic systems and addresses some ethical and professional issues in counsel- ing practice. The book aims to teach students to select wisely from various theories and techniques and to begin to develop a personal style of counseling.

I have found that students appreciate an overview of the divergent contempo- rary approaches to counseling and psychotherapy. They also consistently say that the first course in counseling means more to them when it deals with them person- ally. Therefore, I stress the practical applications of the material and encourage per- sonal reflection. Using this book can be both a personal and an academic learning experience.

In this tenth edition, every effort has been made to retain the major qualities that students and professors have found useful in the previous editions: the succinct overview of the key concepts of each theory and their implications for practice, the straightforward and personal style, and the book’s comprehensive scope. Care has been taken to present the theories in an accurate and fair way. I have attempted to be simple, clear, and concise. Because many students want suggestions for supple- mentary reading as they study each therapy approach, I have included an updated reading list at the end of each chapter and a list of references for each chapter at the end of the book.

This tenth edition updates the material and refines existing discussions. Part 1 deals with issues that are basic to the practice of counseling and psychotherapy. Chapter 1 puts the book into perspective, then students are introduced to the counselor—as a person and a professional—in Chapter 2. This chapter addresses a number of topics pertaining to the role of the counselor as a person and the ther- apeutic relationship. Chapter 3 introduces students to some key ethical issues in counseling practice, and several of the topics in this chapter have been updated and expanded. Expanded coverage is given to the ACA’s 2014 Code of Ethics.

Part 2 is devoted to a consideration of 11 theories of counseling. Each of the theory chapters follows a common organizational pattern, and students can easily compare and contrast the various models. This pattern includes core topics such as key concepts, the therapeutic process, therapeutic techniques and procedures, mul- ticultural perspectives, the theory applied to the case of Stan and new to this edition to the case of Gwen, and summary and evaluation. In this tenth edition, each of the chapters in Part 2 has been revised, updated, and expanded to reflect recent trends, and references have been updated as well. Revisions were based on the recommenda- tions of experts in each theory, all of whom are listed in the Acknowledgments sec- tion. Attention was given to current trends and recent developments in the practice of each theoretical approach.

xi

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xii PrefaCe to tenth edition

Each of the 11 theory chapters summarizes key points and evaluates the con- tributions, strengths, limitations, and applications of these theories. Special atten- tion is given to evaluating each theory from a multicultural perspective as well, with a commentary on the strengths and shortcomings of the theory in working with diverse client populations. The consistent organization of the summary and evalu- ation sections makes comparing theories easier. Students are given recommenda- tions regarding where to look for further training for all of the approaches in the Where To Go From Here sections at the end of the chapter. Updated annotated lists of reading suggestions along with DVD resources are offered to stimulate students to expand on the material and broaden their learning.

In Part 3, Chapter 15 develops the notion that an integrative approach to coun- seling practice is in keeping with meeting the needs of diverse client populations in many different settings. Numerous tables and other integrating material help stu- dents compare and contrast the 11 approaches.

What’s new in This Tenth edition Features of the tenth edition include Learning Objectives for all the theory chapters; Self-Reflection and Discussion Questions at the end of each theory chapter to facilitate thinking and interaction in class; and a new Case of Gwen, who is a composite of many clients, to complement the Case of Stan feature. Guest contributor Dr. Kel- lie Kirksey describes her way of working with Gwen from each of the theoretical perspectives.

Significant changes for the tenth edition for each of the theory chapters are out- lined below:

chapter 4 Psychoanalytic Therapy ŠŠ New material on countertransference, its role in psychoanalytic therapy,

and guidelines for effectively dealing with countertransference ŠŠ Expanded discussion of brief psychodynamic therapy and its application

chapter 5 adlerian Therapy ŠŠ Revised material on the life tasks ŠŠ More emphasis on goals for the educational process of therapy ŠŠ More on the role of assessment and diagnosis ŠŠ New material on early recollections with concrete examples ŠŠ Many new examples to bring Adlerian concepts to life ŠŠ Revised discussion of reorientation and encouragement process ŠŠ Expanded discussion of Adlerian techniques

chapter 6 existential Therapy ŠŠ Revised material on existential anxiety and its implications for therapy ŠŠ Revised section on the client–therapist relationship ŠŠ Expanded discussion of tasks of the existential therapist

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PrefaCe to tenth edition xiii

chapter 7 Person-centered Therapy ŠŠ Expanded discussion of clients as active self-healers ŠŠ Updated coverage of the core conditions of congruence, unconditional

positive regard, and empathy ŠŠ More attention to the diversity of styles of therapists practicing person-

centered therapy ŠŠ More emphasis on how the basic philosophy of the person-centered

approach is appropriate for working with diverse client populations ŠŠ A new section on emotion-focused therapy, stressing the role of emotions

as a route to change ŠŠ Revised section on motivational interviewing (person-centered approach

with a twist)

chapter 8 gestalt Therapy ŠŠ Revised discussion of the role of experiments in Gestalt therapy and

how they differ from techniques and structured exercises ŠŠ New emphasis on therapist presence, the role of dialogue in therapy,

and the therapeutic relationship ŠŠ Expanded discussion of therapist authenticity and self-disclosure ŠŠ More attention to the contemporary relational approach to Gestalt

practice

chapter 9 behavior Therapy ŠŠ Increased attention to the “third-generation” or “new wave” behavior

therapies ŠŠ Updating of section on EMDR ŠŠ Expanded and updated discussion of the role of mindfulness and

acceptance strategies in contemporary behavior therapy ŠŠ New and expanded material on mindfulness-based cognitive therapy

and stress reduction ŠŠ Expanded and revised treatment of dialectical behavior therapy

chapter 10 cognitive behavior Therapy ŠŠ Major reorganization and updating of the entire chapter ŠŠ Streamlining and updating of Albert Ellis’s rational emotive behavior

therapy ŠŠ Revised and expanded coverage of Aaron Beck’s cognitive therapy ŠŠ Increased coverage of Judith Beck’s role in the development of cognitive

therapy ŠŠ New section on Christine Padesky’s strength-based cognitive behavior

therapy ŠŠ Increased attention on Donald Meichenbaum’s influence in the devel-

opment of CBT ŠŠ More clinical examples to illustrate key CBT techniques and concepts ŠŠ Expanded coverage of a comparison among the various CBT approaches

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xiv PrefaCe to tenth edition

chapter 11 choice Theory/reality Therapy ŠŠ Revision of the relationship of choice theory to reality therapy ŠŠ More practical examples of reality therapy practice

chapter 12 feminist Therapy ŠŠ Updated and expanded treatment of the principles of feminist therapy ŠŠ Increased attention given to cultural and social justice perspectives ŠŠ More emphasis on concepts of power, privilege, discrimination, and

empowerment ŠŠ Expansion of relational-cultural theory and implications for practice ŠŠ Revised and expanded discussion on therapeutic techniques and

strategies ŠŠ Revised material on strengths from a diversity perspective

chapter 13 Postmodern approaches ŠŠ Updated coverage on parallels between solution-focused brief therapy

(SFBT) and positive psychology ŠŠ Broadened discussion of the key concepts of SFBT ŠŠ More emphasis on the client-as-expert in the therapy relationship in

postmodern approaches ŠŠ More clinical examples to illustrate the use of SFBT techniques ŠŠ New material on the defining characteristics of brief therapy ŠŠ Increased emphasis on the collaborative nature of narrative therapy and

SFBT ŠŠ Revision of narrative therapy section

chapter 14 family systems Therapy ŠŠ Streamlined to focus mainly on an integrative approach to family

therapy ŠŠ More on recent developments in family systems therapy ŠŠ More attention given to feminism, multiculturalism, and postmodern

constructionism as applied to family therapy

Chapter 15 (“An Integrative Perspective”) pulls together themes from all 11 theo- retical orientations. This chapter represents a major revision of the discussion of the psychotherapy integration movement; updates of the various integrative approaches; revision of the section on integration of spirituality in counseling; added material on research demonstrating the therapeutic alliance; expanded discussion on the central role of the client in determining therapy outcomes; new section on feedback-informed treatment; and updated coverage of the conclusions from the research literature on the effectiveness of psychotherapy. New to this chapter are two cases (Stan and Gwen) that illustrate integrative approaches. Chapter 15 develops the notion that an integrative approach to counseling practice is in keeping with meeting the needs of diverse client populations in many different settings. Numerous tables and other integrating mate- rial help students compare and contrast the 11 approaches.

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PrefaCe to tenth edition xv

This text can be used in a flexible way. Some instructors will follow the sequenc- ing of chapters in the book. Others will prefer to begin with the theory chapters (Part 2) and then deal later with the student’s personal characteristics and ethical issues. The topics can be covered in whatever order makes the most sense. Readers are offered some suggestions for using this book in Chapter 1.

In this edition I have made every effort to incorporate those aspects that have worked best in the courses on counseling theory and practice that I teach. To help readers apply theory to practice, I have also revised the Student Manual, which is designed for experiential work. The Student Manual for Theory and Practice of Counseling and Psychotherapy still contains open-ended questions, many new cases for explora- tion and discussion, structured exercises, self-inventories, and a variety of activities that can be done both in class and out of class. The tenth edition features a struc- tured overview, as well as a glossary, for each of the theories, and chapter quizzes for assessing the level of student mastery of basic concepts. New to this tenth edition of the Student Manual are experiential exercises for the Case of Gwen and questions raised by experts in each of the theory chapters. Each expert addresses the same six ques- tions as applied to each of the given theories.

MindTap™ is a new online resource available to accompany this textbook. It contains the video program for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes, a glossary of key terms, interviews with experts (questions and answers by experts in the various theories), and case examples for each of the theories illustrating ways of applying these concepts and techniques to a counseling case. A concise version of working with Stan from an integrative perspective now appears in Chapter 15. Chapter 16, “Case Illustration: An Integrative Approach in Working With Stan,” has been deleted from this edition but is available on Mind- Tap™. A chapter covering Transactional Analysis is also available on MindTap™.

Case Approach to Counseling and Psychotherapy (Eighth Edition) features experts working with the case of Ruth from the various therapeutic approaches. The case- book, which is now available online, can supplement this book or stand alone.

Accompanying this tenth edition of the text and Student Manual are lecturettes on how I draw from key concepts and techniques from the various theories pre- sented in the book. This DVD program has been developed for student purchase and use as a self-study program, and it completes an ideal learning package. The Art of Integrative Counseling (Third Edition), which expands on the material in Chapter 15 of the textbook, also complements this book.

Some professors have found the textbook and the Student Manual or MindTap™ to be ideal companions and realistic resources for a single course. Others like to use the textbook and the casebook as companions. With this revision it is now possible to have a unique learning package of several books, along with the DVD for Integra- tive Counseling: The Case of Ruth and Lecturettes. The Case Approach to Counseling and Psy- chotherapy and the Art of Integrative Counseling can also be used in a various classes, a few of which include case-management practicum, fieldwork courses, or counseling techniques courses.

Also available is a revised and updated Instructor’s Resource Manual, which includes suggestions for teaching the course, class activities to stimulate interest, PowerPoint presentations for all chapters, and a variety of test questions and a final examina- tion. This instructor’s manual is now geared for the following learning package:

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xvi PrefaCe to tenth edition

Theory and Practice of Counseling and Psychotherapy, Student Manual for Theory and Practice of Counseling and Psychotherapy, Case Approach to Counseling and Psychotherapy, The Art of Integrative Counseling, and two video programs: DVD for Integrative Counseling: The Case of Ruth and Lecturettes, and DVD for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes.

Acknowledgments The suggestions I received from the many readers of prior editions who took the time to complete the surveys have been most helpful in the revision process. Many other people have contributed ideas that have found their way into this tenth edi- tion. I especially appreciate the time and efforts of those who participated in a pre- revision review and offered constructive criticism and supportive commentaries, as well as those professors who have used this book and provided me with feedback that has been most useful in these revisions. Those who reviewed selected parts of the manuscript of the tenth edition are:

Jude Austin, doctoral student, University of Wyoming Julius Austin, doctoral student, University of Wyoming Mark E. Young, University of Central Florida Robert Haynes, Borderline Productions Beverly Palmer, California State University at Dominguez Hills James Robert Bitter, East Tennessee State University Patricia Robertson, East Tennessee State University Jamie Bludworth, Arizona State University Michelle Muratori, Johns Hopkins University Jake Morris, Lipscomb University

Special thanks are extended to the chapter reviewers, who provided consultation and detailed critiques. Their insightful and valuable comments have generally been incorporated into this edition:

ŠŠ Chapter 4 (Psychoanalytic Therapy): William Blau, Copper Mountain College, Joshua Tree, California

ŠŠ Chapter 5 (Adlerian Therapy): Matt Englar-Carlson, California State University, Fullerton; Jon Carlson, Governors State University; Jon Sperry, Lynn University, Boca Raton. James Robert Bitter, East Tennessee State University, and I coau- thored Chapter 5.

ŠŠ Chapter 6 (Existential Therapy): Emmy van Deurzen, New School of Psy- chotherapy and Counselling, London, England, and University of Sheffield; J. Michael Russell of California State University, Fullerton; David N. Elkins, Graduate School of Education and Psychology, Pepperdine University; Bryan Farha, Oklahoma City College

ŠŠ Chapter 7 (Person-Centered Therapy): Natalie Rogers, Person-Centered Expres- sive Arts Associates, Cotati, California; David N. Elkins, Graduate School of Education and Psychology, Pepperdine University; David Cain, California

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PrefaCe to tenth edition xvii

School of Professional Psychology at Alliant International University, San Diego

ŠŠ Chapter 8 (Gestalt Therapy): Jon Frew, Private Practice, Vancouver, Washing- ton, and Pacific University, Oregon; Lynne Jacobs, Pacific Gestalt Institute in Los Angeles; Gary Yontef, Pacific Gestalt Institute in Los Angeles; Jude Austin, doctoral student, University of Wyoming; Julius Austin, doctoral student, Uni- versity of Wyoming

ŠŠ Chapter 9 (Behavior Therapy): Sherry Cormier, West Virginia University; Frank M. Dattilio, Harvard Medical School, and the University of Pennsylvania School of Medicine; Ronald D. Siegel, Harvard Medical School

ŠŠ Chapter 10 (Cognitive Behavior Therapy): Sherry Cormier, West Virginia University; Christine A. Padesky, Center for Cognitive Therapy at Huntington Beach, California; Frank M. Dattilio, Harvard Medical School, and the University of Pennsylvania School of Medicine; Beverly Palmer, California State University at Dominguez Hills; Jamie Bludworth, Arizona State University; Jude Austin, doctoral student, University of Wyoming; Julius Austin, doctoral student, University of Wyoming; Jon Sperry, Lynn University, Boca Raton; Debbie Joffe Ellis

ŠŠ Chapter 11 (Choice Theory/Reality Therapy): Robert Wubbolding, Center for Reality Therapy, Cincinnati, Ohio

ŠŠ Chapter 12 (Feminist Therapy): Carolyn Zerbe Enns, Cornell College; James Robert Bitter, East Tennessee State University; Patricia Robertson, East Ten- nessee State University; Elizabeth Kincade, Indiana University of Pennsylvania; Susan Rachael Seem, The College at Brockport, State University of New York; Kellie Kirksey, Cleveland Institute of Wellness; Amanda La Guardia of Sam Houston State University. Barbara Herlihy, University of New Orleans, and I coauthored Chapter 12.

ŠŠ Chapter 13 (Postmodern Approaches): John Winslade, California State University, San Bernardino; John Murphy, University of Central Arkansas

ŠŠ Chapter 14 (Family Systems Therapy): James Robert Bitter, East Tennessee State University, and I co-authored Chapter 14.

ŠŠ Chapter 15 (An Integrative Perspective): Scott D. Miller, The International Center for Clinical Excellence; Beverly Palmer, California State University at Dominguez Hills; Jude Austin, doctoral student, University of Wyoming; Julius Austin, doctoral student, University of Wyoming

ŠŠ The Case of Gwen (all theory chapters) was written by Kellie Kirksey, Cleveland Clinic Center for Integrative Medicine

This book is the result of a team effort, which includes the combined efforts of a number of people at Cengage Learning. These people include Jon-David Hague, Product Director; Julie Martinez, Product Manager, Counseling, Human Services, and Social Work; Vernon Boes, Art Director, for his work on the interior design and cover of this book; Kyra Kane, Associate Content Developer, who coordinates the

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xviii PrefaCe to tenth edition

MindTap™ program and other supplementary materials for the book; Michelle Muratori, Johns Hopkins University, for her work on updating the Instructor’s Resource Manual and assisting in developing other supplements; and Rita Jaramillo, Content Project Manager. Thanks to Ben Kolstad of Cenveo® Publisher Services, who coordinated the production of this book. Special recognition goes to Kay Mikel, the manuscript editor of this edition, whose exceptional editorial talents continue to keep this book reader friendly. I appreciate Susan Cunningham’s work in creat- ing and revising test items to accompany this text and in preparing the index. The efforts and dedication of all of these people certainly contribute to the high quality of this edition.

Gerald Corey

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1

1Introduction and Overview

1. Understand the author’s philosophical stance.

2. Identify suggested ways to use this book.

3. Differentiate between each contemporary counseling model discussed in this book.

4. Identify key issues within the case of Stan.

5. Identify key issues within the case of Gwen.

L e a r n i n g O b j e c t i v e s

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2 CHAPTER ONE

Introduction Counseling students can begin to acquire a counseling style tailored to their own personality by familiarizing themselves with the major approaches to therapeu- tic practice. This book surveys 11 approaches to counseling and psychotherapy, presenting the key concepts of each approach and discussing features such as the therapeutic process (including goals), the client–therapist relationship, and spe- cific procedures used in the practice of counseling. This information will help you develop a balanced view of the major ideas of each of the theories and acquaint you with the practical techniques commonly employed by counselors who adhere to each approach. I encourage you to keep an open mind and to seriously consider both the unique contributions and the particular limitations of each therapeutic system presented in Part 2.

You cannot gain the knowledge and experience you need to synthesize various approaches by merely completing an introductory course in counseling theory. This process will take many years of study, training, and practical counseling experience. Nevertheless, I recommend a personal integration as a framework for the profes- sional education of counselors. When students are presented with a single model and are expected to subscribe to it alone, their effectiveness will be limited when working with a diverse range of future clients.

An undisciplined mixture of approaches, however, can be an excuse for failing to develop a sound rationale for systematically adhering to certain concepts and to the techniques that are extensions of them. It is easy to pick and choose fragments from the various therapies because they support our biases and preconceptions. By studying the models presented in this book, you will have a better sense of how to integrate concepts and techniques from different approaches when defining your own personal synthesis and framework for counseling.

Each therapeutic approach has useful dimensions. It is not a matter of a theory being “right” or “wrong,” as every theory offers a unique contribution to understand- ing human behavior and has unique implications for counseling practice. Accepting the validity of one model does not necessarily imply rejecting other models. There is a clear place for theoretical pluralism, especially in a society that is becoming increasingly diverse.

Although I suggest that you remain open to incorporating diverse approaches into your own personal synthesis—or integrative approach to counseling—let me caution that you can become overwhelmed and confused if you attempt to learn everything at once, especially if this is your introductory course in counseling theories. A case can be made for initially getting an overview of the major theoreti- cal orientations, and then learning a particular approach by becoming steeped in that approach for some time, rather than superficially grasping many theoretical approaches. An integrative perspective is not developed in a random fashion; rather, it is an ongoing process that is well thought out. Successfully integrating concepts and techniques from diverse models requires years of reflective practice and a great deal of reading about the various theories. In Chapter 15 I discuss in more depth some ways to begin designing your integrative approach to counseling practice.

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INTROduCTION ANd OvERvIEw 3

visit CengageBrain.com or watch the dvd for the video program on Chapter 1, Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes. I suggest that you view the brief lecturette for each chapter in this book prior to reading the chapter.

Where I Stand My philosophical orientation is strongly influenced by the existential approach. Because this approach does not prescribe a set of techniques and pro- cedures, I draw techniques from the other models of therapy that are presented in this book. I particularly like to use role-playing techniques. When people reenact scenes from their lives, they tend to become more psychologically engaged than when they merely report anecdotes about themselves. I also incorporate many tech- niques derived from cognitive behavior therapy.

The psychoanalytic emphasis on early psychosexual and psychosocial develop- ment is useful. Our past plays a crucial role in shaping our current personality and behavior. I challenge the deterministic notion that humans are the product of their early conditioning and, thus, are victims of their past. But I believe that an explora- tion of the past is often useful, particularly to the degree that the past continues to influence present-day emotional or behavioral difficulties.

I value the cognitive behavioral focus on how our thinking affects the way we feel and behave. These therapies also emphasize current behavior. Thinking and feeling are important dimensions, but it can be a mistake to overemphasize them and not explore how clients are behaving. What people are doing often provides a good clue to what they really want. I also like the emphasis on specific goals and on encourag- ing clients to formulate concrete aims for their own therapy sessions and in life.

More approaches have been developing methods that involve collaboration between therapist and client, making the therapeutic venture a shared responsibil- ity. This collaborative relationship, coupled with teaching clients ways to use what they learn in therapy in their everyday lives, empowers clients to take an active stance in their world. It is imperative that clients be active, not only in their counseling sessions but in daily life as well. Homework, collaboratively designed by clients and therapists, can be a vehicle for assisting clients in putting into action what they are learning in therapy.

A related assumption of mine is that we can exercise increasing freedom to cre- ate our own future. Accepting personal responsibility does not imply that we can be anything we want to be. Social, environmental, cultural, and biological realities oftentimes limit our freedom of choice. Being able to choose must be considered in the sociopolitical contexts that exert pressure or create constraints; oppression is a reality that can restrict our ability to choose our future. We are also influenced by our social environment, and much of our behavior is a product of learning and conditioning. That being said, I believe an increased awareness of these contextual forces enables us to address these realities. It is crucial to learn how to cope with the external and internal forces that influence our decisions and behavior.

Feminist therapy has contributed an awareness of how environmental and social conditions contribute to the problems of women and men and how gender-role

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4 CHAPTER ONE

socialization leads to a lack of gender equality. Family therapy teaches us that it is not possible to understand the individual apart from the context of the system. Both family therapy and feminist therapy are based on the premise that to understand the individual it is essential to take into consideration the interpersonal dimensions and the sociocultural context rather than focusing primarily on the intrapsychic domain. This comprehensive approach to counseling goes beyond understanding our internal dynamics and addresses the environmental and systemic realities that influence us.

My philosophy of counseling challenges the assumption that therapy is exclu- sively aimed at “curing” psychological “ailments.” Such a focus on the medical model restricts therapeutic practice because it stresses deficits rather than strengths. Instead, I agree with the postmodern approaches (see Chapter 13), which are grounded on the assumption that people have both internal and external resources to draw upon when constructing solutions to their problems. Therapists will view these individuals quite differently if they acknowledge that their clients possess competencies rather than pathologies. I view each individual as having resources and competencies that can be discovered and built upon in therapy.

Psychotherapy is a process of engagement between two people, both of whom are bound to change through the therapeutic venture. At its best, this is a collabora- tive process that involves both the therapist and the client in co-constructing solu- tions regarding life’s tasks. Most of the theories described in this book emphasize the collaborative nature of the practice of psychotherapy.

Therapists are not in business to change clients, to give them quick advice, or to solve their problems for them. Instead, counselors facilitate healing through a pro- cess of genuine dialogue with their clients. The kind of person a therapist is remains the most critical factor affecting the client and promoting change. If practitioners possess wide knowledge, both theoretical and practical, yet lack human qualities of compassion, caring, good faith, honesty, presence, realness, and sensitivity, they are more like technicians. I believe that those who function exclusively as technicians do not make a significant difference in the lives of their clients. It is essential that coun- selors explore their own values, attitudes, and beliefs in depth and work to increase their own awareness. Throughout the book I encourage you to find ways to apply what you are reading to your personal life. Doing so will take you beyond a mere academic understanding of these theories.

With respect to mastering the techniques of counseling and applying them appropriately and effectively, it is my belief that you are your own very best tech- nique. Your engagement with your clients is useful in moving the therapeutic pro- cess along. It is impossible to separate the techniques you use from your personality and the relationship you have with your clients.

Administering techniques to clients without regard for the relationship vari- ables is ineffective. Techniques cannot substitute for the hard work it takes to develop a constructive client–therapist relationship. Although you can learn atti- tudes and skills and acquire certain knowledge about personality dynamics and the therapeutic process, much of effective therapy is the product of artistry. Counseling entails far more than becoming a skilled technician. It implies that you are able to establish and maintain a good working relationship with your clients, that you can draw on your own experiences and reactions, and that you can identify techniques suited to the needs of your clients.

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INTROduCTION ANd OvERvIEw 5

As a counselor, you need to remain open to your own personal development and to address your personal problems. The most powerful ways for you to teach your clients is by the behavior you model and by the ways you connect with them. I sug- gest you experience a wide variety of techniques yourself as a client. Reading about a technique in a book is one thing; actually experiencing it from the vantage point of a client is quite another. If you have practiced mindfulness exercises, for example, you will have a much better sense for guiding clients in the practice of becoming increas- ingly mindful in daily life. If you have carried out real-life homework assignments as part of your own self-change program, you can increase your empathy for clients and their potential problems. Your own anxiety over self-disclosing and addressing personal concerns can be a most useful anchoring point as you work with the anxiet- ies of your clients. The courage you display in your own personal therapy will help you appreciate how essential courage is for your clients.

Your personal characteristics are of primary importance in becoming a counselor, but it is not sufficient to be merely a good person with good intentions. To be effective, you also must have supervised experiences in counseling and sound knowledge of counseling theory and techniques. Further, it is essential to be well grounded in the various theories of personality and to learn how they are related to theories of counseling. Your conception of the person and the individual characteristics of your client affect the interventions you will make. Differences between you and your client may require modification of certain aspects of the theories. Some practitioners make the mistake of relying on one type of intervention (supportive, confrontational, information giv- ing) for most clients with whom they work. In reality, different clients may respond better to one type of intervention than to another. Even during the course of an individual’s therapy, different interventions may be needed at different times. Prac- titioners should acquire a broad base of counseling techniques that are suitable for individual clients rather than forcing clients to fit one approach to counseling.

Suggestions for Using the Book Here are some specific recommendations on how to get the fullest value from this book. The personal tone of the book invites you to relate what you are reading to your own experiences. As you read Chapter 2, “The Counselor: Person and Profes- sional,” begin the process of reflecting on your needs, motivations, values, and life experiences. Consider how you are likely to bring the person you are becoming into your professional work. You will assimilate much more knowledge about the vari- ous therapies if you make a conscious attempt to apply the key concepts and tech- niques of these theories to your own personal life. Chapter 2 helps you think about how to use yourself as your single most important therapeutic instrument, and it addresses a number of significant ethical issues in counseling practice.

Before you study each of the theories chapters, I suggest that you at least briefly read Chapter 15, which provides a comprehensive review of the key concepts from all 11 theories presented in this textbook. I try to show how an integration of these perspectives can form the basis for creating your own personal synthesis to coun- seling. In developing an integrative perspective, it is essential to think holistically. To understand human functioning, it is imperative to account for the physical,

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6 CHAPTER ONE

emotional, mental, social, cultural, political, and spiritual dimensions. If any one of these facets of human experience is neglected, a theory is limited in explaining how we think, feel, and act.

To provide you with a consistent framework for comparing and contrasting the various therapies, the 11 theory chapters share a common format. This format includes a few notes on the personal history of the founder or another key figure; a brief historical sketch showing how and why each theory developed at the time it did; a discussion of the approach’s key concepts; an overview of the therapeutic process, including the therapist’s role and client’s work; therapeutic techniques and procedures; applications of the theory from a multicultural perspective; application of the theory to the cases of Stan and Gwen; a summary; a critique of the theory with emphasis on contributions and limitations; suggestions of how to continue your learning about each approach; and suggestions for further reading.

Refer to the Preface for a complete description of other resources that fit as a package and complement this textbook, including Student Manual for Theory and Practice of Counseling and Psychotherapy and DVD for Integrative Counseling: The Case of Ruth and Lecturettes. In addition, in DVD for Theory and Practice of Counseling and Psycho- therapy: The Case of Stan and Lecturettes I demonstrate my way of counseling Stan from the various theoretical approaches in 13 sessions and present my perspective on the key concepts of each theory in a brief lecture, with emphasis on the practical applica- tion of the theory.

Overview of the Theory Chapters I have selected 11 therapeutic approaches for this book. Table 1.1 presents an overview of these approaches, which are explored in depth in Chapters 4 through 14. I have grouped these approaches into four general categories.

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TabLe 1.1 Overview of Contemporary Counseling Models

Psychodynamic Approaches

Psychoanalytic therapy Founder: Sigmund Freud. A theory of personality development, a philosophy of human nature, and a method of psychotherapy that focuses on unconscious factors that motivate behavior. Attention is given to the events of the first six years of life as determinants of the later development of personality.

Adlerian therapy Founder: Alfred Adler. Key Figure: Following Adler, Rudolf Dreikurs is credited with popularizing this approach in the United States. This is a growth model that stresses assuming responsibility, creating one’s own destiny, and finding meaning and goals to create a purposeful life. Key concepts are used in most other current therapies.

Experiential and Relationship-Oriented Therapies

Existential therapy Key figures: Viktor Frankl, Rollo May, and Irvin Yalom. Reacting against the tendency to view therapy as a system of well-defined techniques, this model stresses building therapy on the basic conditions of human existence, such as choice, the freedom and responsibility to shape one’s life, and self-determination. It focuses on the quality of the person-to-person therapeutic relationship.

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INTROduCTION ANd OvERvIEw 7

Person-centered therapy Founder: Carl Rogers; Key figure: Natalie Rogers. This approach was developed during the 1940s as a nondirective reaction against psychoanalysis. Based on a subjective view of human experiencing, it places faith in and gives responsibility to the client in dealing with problems and concerns.

Gestalt therapy Founders: Fritz and Laura Perls; Key figures: Miriam and Erving Polster. An experiential therapy stressing awareness and integration; it grew as a reaction against analytic therapy. It integrates the functioning of body and mind and places emphasis on the therapeutic relationship.

Cognitive Behavioral Approaches

Behavior therapy Key figures: B. F. Skinner, and Albert Bandura. This approach applies the principles of learning to the resolution of specific behavioral problems. Results are subject to continual experimentation. The methods of this approach are always in the process of refinement. The mindfulness and acceptance-based approaches are rapidly gaining popularity.

Cognitive behavior therapy Founders: Albert Ellis and A. T. Beck. Albert Ellis founded rational emotive behavior therapy, a highly didactic, cognitive, action-oriented model of therapy, and A. T. Beck founded cognitive therapy, which gives a primary role to thinking as it influences behavior. Judith Beck continues to develop CBT; Christine Padesky has developed strengths-based CBT; and Donald Meichenbaum, who helped develop cognitive behavior therapy, has made significant contributions to resilience as a factor in coping with trauma.

Choice theory/Reality therapy

Founder: William Glasser. Key figure: Robert Wubbolding. This short-term approach is based on choice theory and focuses on the client assuming responsibility in the present. Through the therapeutic process, the client is able to learn more effective ways of meeting her or his needs.

Systems and Postmodern Approaches

Feminist therapy This approach grew out of the efforts of many women, a few of whom are Jean Baker Miller, Carolyn Zerbe Enns, Oliva Espin, and Laura Brown. A central concept is the concern for the psychological oppression of women. Focusing on the constraints imposed by the sociopolitical status to which women have been relegated, this approach explores women’s identity development, self-concept, goals and aspirations, and emotional well-being.

Postmodern approaches A number of key figures are associated with the development of these various approaches to therapy. Steve de Shazer and Insoo Kim Berg are the cofounders of solution-focused brief therapy. Michael White and David Epston are the major figures associated with narrative therapy. Social constructionism, solution-focused brief therapy, and narrative therapy all assume that there is no single truth; rather, it is believed that reality is socially constructed through human interaction. These approaches maintain that the client is an expert in his or her own life.

Family systems therapy A number of significant figures have been pioneers of the family systems approach, two of whom include Murray Bowen and Virginia Satir. This systemic approach is based on the assumption that the key to changing the individual is understanding and working with the family.

First are the psychodynamic approaches. Psychoanalytic therapy is based largely on insight, unconscious motivation, and reconstruction of the personality. The psy- choanalytic model appears first because it has had a major influence on all of the formal systems of psychotherapy. Some of the therapeutic models are extensions of

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8 CHAPTER ONE

psychoanalysis, others are modifications of analytic concepts and procedures, and still others emerged as a reaction against psychoanalysis. Many theories of psycho- therapy have borrowed and integrated principles and techniques from psychoana- lytic approaches.

Adlerian therapy differs from psychoanalytic theory in many respects, but it can broadly be considered an analytic perspective. Adlerians focus on meaning, goals, purposeful behavior, conscious action, belonging, and social interest. Although Adlerian theory accounts for present behavior by studying childhood experiences, it does not focus on unconscious dynamics.

The second category comprises the experiential and relationship-oriented therapies: the existential approach, the person-centered approach, and Gestalt therapy. The existential approach stresses a concern for what it means to be fully human. It suggests certain themes that are part of the human condition, such as freedom and respon- sibility, anxiety, guilt, awareness of being finite, creating meaning in the world, and shaping one’s future by making active choices. This approach is not a unified school of therapy with a clear theory and a systematic set of techniques. Rather, it is a philos- ophy of counseling that stresses the divergent methods of understanding the subjec- tive world of the person. The person-centered approach, which is rooted in a humanistic philosophy, places emphasis on the basic attitudes of the therapist. It maintains that the quality of the client–therapist relationship is the prime determinant of the outcomes of the therapeutic process. Philosophically, this approach assumes that clients have the capacity for self-direction without active intervention and direction on the therapist’s part. Another experiential approach is Gestalt therapy, which offers a range of experiments to help clients gain awareness of what they are experiencing in the here and now—that is, the present. In contrast to person-centered therapists, Gestalt therapists tend to take an active role, yet they follow the leads provided by their clients. These approaches tend to emphasize emotion as a route to bringing about change, and in a sense, they can be considered emotion-focused therapies.

Third are the cognitive behavioral approaches, sometimes known as the action- oriented therapies because they all emphasize translating insights into behavioral action. These approaches include choice theory/reality therapy, behavior therapy, rational emotive behavior therapy, and cognitive therapy. Reality therapy focuses on clients’ current behavior and stresses developing clear plans for new behaviors. Like reality therapy, behavior therapy puts a premium on doing and on taking steps to make concrete changes. A current trend in behavior therapy is toward paying increased attention to cognitive factors as an important determinant of behavior. Rational emo- tive behavior therapy and cognitive therapy highlight the necessity of learning how to challenge inaccurate beliefs and automatic thoughts that lead to behavioral prob- lems. These cognitive behavioral approaches are used to help people modify their inaccurate and self-defeating assumptions and to develop new patterns of acting.

The fourth general approach encompasses the systems and postmodern perspectives. Feminist therapy and family therapy are systems approaches, but they also share postmodern notions. The systems orientation stresses the importance of under- standing individuals in the context of the surroundings that influence their devel- opment. To bring about individual change, it is essential to pay attention to how the individual’s personality has been affected by his or her gender-role socialization, culture, family, and other systems.

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INTROduCTION ANd OvERvIEw 9

The postmodern approaches include social constructionism, solution-focused brief therapy, and narrative therapy. These newer approaches challenge the basic assump- tions of most of the traditional approaches by assuming that there is no single truth and that reality is socially constructed through human interaction. Both the post- modern and the systemic theories focus on how people produce their own lives in the context of systems, interactions, social conditioning, and discourse.

In my view, practitioners need to pay attention to what their clients are thinking, feeling, and doing, and a complete therapy system must address all three of these fac- ets. Some of the therapies included here highlight the role that cognitive factors play in counseling. Others place emphasis on the experiential aspects of counseling and the role of feelings. Still others emphasize putting plans into action and learning by doing. Combining all of these dimensions provides the basis for a comprehensive therapy.

Introduction to the Case of Stan You will learn a great deal by seeing a theory in action, preferably in a live demonstration or as part of experiential activities in which you function in the alter- nating roles of client and counselor. An online program (available in DVD format as well) demonstrates one or two techniques from each of the theories. As Stan’s coun- selor, I show how I would apply some of the principles of each of the theories you are studying to Stan. Many of my students find this case history of the hypothetical cli- ent (Stan) helpful in understanding how various techniques are applied to the same person. Stan’s case, which describes his life and struggles, is presented here to give you significant background material to draw from as you study the applications of the theories. Each of the 11 theory chapters in Part 2 includes a discussion of how a therapist with the orientation under discussion is likely to proceed with Stan. We examine the answers to questions such as these:

ŠŠ What themes in Stan’s life merit special attention in therapy? ŠŠ What concepts would be useful to you in working with Stan on his

problems? ŠŠ What are the general goals of Stan’s therapy? ŠŠ What possible techniques and methods would best meet these goals? ŠŠ What are some characteristics of the relationship between Stan and his

therapist? ŠŠ How might the therapist proceed? ŠŠ How might the therapist evaluate the process and treatment outcomes

of therapy?

In Chapter 15 (which I recommend you read early) I explain how I would work with Stan, suggesting concepts and techniques I would draw on from many of the mod- els (forming an integrative approach).

A single case illustrates both contrasts and parallels among the approaches. It also will help you understand the practical applications of the 11 models and provide a basis for integrating them. A summary of the intake interview with Stan, his autobiography, and some key themes in his life are presented next to provide a context for making sense of the way therapists with various theoretical orientations

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10 CHAPTER ONE

might work with Stan. Try to find attributes of each approach that you can incorpo- rate into a personalized style of counseling.

Intake Interview and Stan’s Autobiography The setting is a community mental health agency where both individual and group counseling are available. Stan comes to counseling because of his drinking. He was convicted of driving under the influence, and the judge determined that he needed professional help. Stan recognizes that he does have problems, but he is not con- vinced that he is addicted to alcohol. Stan arrives for an intake interview and pro- vides the counselor with this information:

At the present time I work in construction. I like building houses, but probably won’t stay in construction for the rest of my life. When it comes to my personal life, I’ve always had difficulty in getting along with people. I could be called a “loner.” I like people in my life, but I don’t seem to know how to stay close to people. It probably has a lot to do with why I drink. I’m not very good at making friends or getting close to people. Probably the reason I sometimes drink a bit too much is because I’m so scared when it comes to socializing. Even though I hate to admit it, when I drink, things are not quite so overwhelming. When I look at others, they seem to know the right things to say. Next to them I feel dumb. I’m afraid that people don’t find me very interesting. I’d like to turn my life around, but I just don’t know where to begin. That’s why I went back to school. I’m a part- time college student majoring in psychology. I want to better myself. In one of my classes, Psychology of Personal Adjustment, we talked about ourselves and how people change. We also had to write an autobiographical paper.

That is the essence of Stan’s introduction. The counselor says that she would like to read his autobiography. Stan hopes it will give her a better understanding of where he has been and where he would like to go. He brings her the autobiography, which reads as follows:

Where am I currently in my life? At 35 I feel that I’ve wasted most of my life. I should be finished with college and into a career by now, but instead I’m only a junior. I can’t afford to really commit myself to pursuing college full time because I need to work to support myself. Even though construction work is hard, I like the satisfaction I get when I look at what I have done.