Digital Clinical Experience: Assessing the Heart, Lungs, and Peripheral Vascular System

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PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:1). ZERO (0) PLAGIARISM,2). 5 REFERENCES, NO MORE THAN 5 YEARS OR LESS THAN 5 YEARS/APA 7 WRITING STYLE/FORMAT3). PLEASE FIND THE ATTACHED RUBRIC DETAILS, SHADOW HEALTH TEMPLATE, PROVIDER DOCUMENTATION NOTESIn order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.In this DCE Assignment, you will conduct a focused exam related to chest pain using the simulation too, Shadow Health. Consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.Take a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?To PrepareReview this week’s Learning Resources and the Advanced Health Assessment and Diagnostic Reasoning media program and consider the insights they provide related to heart, lungs, and peripheral vascular system.Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation with the Shadow Health platform. Review the examples also provided.Review the DCE (Shadow Health) Documentation Template for Focused Exam: Chest Pain found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.Review the Week 7 DCE Focused Exam: Chest Pain Rubric provided in the Assignment submission area for details on completing the Assignment in Shadow Health.Consider what history would be necessary to collect from the patient.Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?DCE Focused Exam: Chest Pain Assignment:Complete the following in Shadow Health:Cardiovascular Concept Lab (Required)Respiratory(Recommended but not required)Cardiovascular (Recommended but not required)Episodic/Focused Note for Focused Exam (Required): Chest Pain

Defining Internal and External Evidence

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Defining Internal and External EvidenceDiscuss the difference between external and internal evidence as it relates to your PICOT search strategy.Address the strengths and weaknesses of searching in a databank versus a web-based search engine. You must use two databanks mentioned in the text. (Medline and PubMed)

Case Study 1: Reducing Disease Risk Mary P. is a 57-year-old operating room nurse who works full-time at a local hospital. She is 65 inches tall and weighs 160 pounds. She has a family history of diabetes and heart disease and was recently diagnosed with

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Case Study 1: Reducing Disease Risk[1]Mary P. is a 57-year-old operating room nurse who works full-time at a local hospital. She is 65 inches tall and weighs 160 pounds. She has a family history of diabetes and heart disease and was recently diagnosed with high blood cholesterol. She has declined the cholesterol-lowering medication her doctor prescribed, and says she would like to explore other methods for lowering her cholesterol first. For the past few weeks, Mary has been taking a tablespoon of coconut oil every day after reading on the Internet that this will lower her cholesterol. She admits she has little time or energy to exercise. Her diet history reveals she often skips breakfast or has a donut or bagel with cream cheese at work. She drinks several cups of coffee each morning with cream and sugar. Lunch is a salad with crackers and iced tea with sugar in the hospital cafeteria. She occasionally drinks one or two glasses of wine in the evening, especially after a stressful day at work. She lives alone and relies on frozen dinners or other convenience foods in the evening. An analysis of her diet reveals an average daily intake of 200 grams carbohydrate, 50 grams protein, and 80 grams of fat.1.   Taking into account her current lifestyle and personal food preferences, what food habits might be difficult for Mary to change?2.   How might her emotions contribute to her food and drink choices?3.   Using Table 1-2, calculate Mary’s average daily kcalorie intake from carbohydrates, protein, and fat. Add these figures to together to arrive at her total daily caloric intake.4.   What percentage of her daily calories is provided by carbohydrates? Protein? Fat?5.   Compare the composition of Mary’s diet with the Acceptable Macronutrient Distribution Ranges (AMDR).6.   How would you use the information above to make dietary recommendations for Mary?7.   What are some credible sources of nutrition information from Table H1-1 that could provide information to help Mary lower her blood cholesterol?[1] Contributed by Barbara Quinn.

Counseling Theory- Psychoanalytic Theory Essay

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Counseling Theory- Psychoanalytic Theory Essay

  • The psychoanalytic approach emphasizes the importance of early childhood development and events.  Do you find that current problems are mostly rooted in early childhood events or influences?  To what extent do you believe people can resolve their adult problems that stem from childhood without exploring past events?  When you apply this basic psychoanalytic concept specifically to yourself, what connections between your own past and present are you aware? Counseling Theory- Psychoanalytic Theory Essay

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The Place of Techniques and Evaluation in Counseling

Drawing on Techniques from Various Approaches

Techniques of Therapy

Applications of the Approaches

Contributions to Multicultural Counseling

Limitations in Multicultural Counseling

Contributions of the Approaches

Overview of Contemporary Counseling Models

Ego-Defense Mechanisms

Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages Counseling Theory- Psychoanalytic Theory Essay

The Basic Philosophies

Key Concepts

Goals of Therapy

The Therapeutic Relationship

Limitations of the Approaches

 

 

 

 

 

 

 

The Place of Techniques and Evaluation in Counseling

Drawing on Techniques from Various Approaches

 

Techniques of Therapy

Psychoanalytic therapy The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference, and countertransference. Techniques are designed to help clients gain access to their unconscious conflicts, which leads to insight and eventual assimilation of new material by the ego.
Adlerian therapy Adlerians pay more attention to the subjective experiences of clients than to using techniques. Some techniques include gathering life-history data (family constellation, early recollections, personal priorities), sharing interpretations with clients, offering encouragement, and assisting clients in searching for new possibilities.
Existential therapy Few techniques flow from this approach because it stresses understanding first and technique second. The therapist can borrow techniques from other approaches and incorporate them in an existential framework. Diagnosis, testing, and external measurements are not deemed important. Issues addressed are freedom and responsibility, isolation and relationships, meaning and meaninglessness, living and dying.
Person-centered therapy This approach uses few techniques but stresses the attitudes of the therapist and a “way of being.” Therapists strive for active listening, reflection of feelings, clarification, “being there” for the client, and focusing on the moment-to-moment experiencing of the client. This model does not include diagnostic testing, interpretation, taking a case history, or questioning or probing for information.
Gestalt therapy A wide range of experiments are designed to intensify experiencing and to integrate conflicting feelings. Experiments are co-created by therapist and client through an I/Thou dialogue. Therapists have latitude to creatively invent their own experiments. Formal diagnosis and testing are not a required part of therapy.
Behavior therapy The main techniques are reinforcement, shaping, modeling, systematic desensitization, relaxation methods, flooding, eye movement and desensitization reprocessing, cognitive restructuring, social skills training, self-management programs, mindfulness and acceptance methods, behavioral rehearsal, and coaching. Diagnosis or assessment is done at the outset to determine a treatment plan. Questions concentrate on “what,” “how,” and “when” (but not “why”). Contracts and homework assignments are also typically used.
Cognitive behavior therapy Therapists use a variety of cognitive, emotive, and behavioral techniques; diverse methods are tailored to suit individual clients. This is an active, directive, time-limited, present-centered, psychoeducational, structured therapy. Some techniques include engaging in Socratic dialogue, collaborative empiricism, debating irrational beliefs, carrying out homework assignments, gathering data on assumptions one has made, keeping a record of activities, forming alternative interpretations, learning new coping skills, changing one’s language and thinking patterns, role playing, imagery, confronting faulty beliefs, self-instructional training, and stress inoculation training.
Choice theory/ Reality therapy This is an active, directive, and didactic therapy. Skillful questioning is a central technique used for the duration of the therapy process. Various techniques may be used to get clients to evaluate what they are presently doing to see if they are willing to change. If clients decide that their present behavior is not effective, they develop a specific plan for change and make a commitment to follow through Counseling Theory- Psychoanalytic Theory Essay.
Feminist therapy Although techniques from traditional approaches are used, feminist practitioners tend to employ consciousness-raising techniques aimed at helping clients recognize the impact of gender-role socialization on their lives. Other techniques frequently used include gender-role analysis and intervention, power analysis and intervention, demystifying therapy, bibliotherapy, journal writing, therapist self-disclosure, assertiveness training, reframing and relabeling, cognitive restructuring, identifying and challenging untested beliefs, role playing, psychodramatic methods, group work, and social action.
Postmodern approaches In solution-focused therapy the main technique involves change-talk, with emphasis on times in a client’s life when the problem was not a problem. Other techniques include creative use of questioning, the miracle question, and scaling questions, which assist clients in developing alternative stories. In narrative therapy, specific techniques include listening to a client’s problem-saturated story without getting stuck, externalizing and naming the problem, externalizing conversations, and discovering clues to competence. Narrative therapists often write letters to clients and assist them in finding an audience that will support their changes and new stories.
Family systems therapy A variety of techniques may be used, depending on the particular theoretical orientation of the therapist. Some techniques include genograms, teaching, asking questions, joining the family, tracking sequences, family mapping, reframing, restructuring, enactments, and setting boundaries. Techniques may be experiential, cognitive, or behavioral in nature. Most are designed to bring about change in a short time.

Techniques of Therapy

 

Applications of the Approaches

Psychoanalytic therapy Candidates for analytic therapy include professionals who want to become therapists, people who have had intensive therapy and want to go further, and those who are in psychological pain. Analytic therapy is not recommended for self-centered and impulsive individuals or for people with psychotic disorders. Techniques can be applied to individual and group therapy.
Adlerian therapy Because the approach is based on a growth model, it is applicable to such varied spheres of life as child guidance, parent–child counseling, marital and family therapy, individual counseling with all age groups, correctional and rehabilitation counseling, group counseling, substance abuse programs, and brief counseling. It is ideally suited to preventive care and alleviating a broad range of conditions that interfere with growth.
Existential therapy This approach is especially suited to people facing a developmental crisis or a transition in life and for those with existential concerns (making choices, dealing with freedom and responsibility, coping with guilt and anxiety, making sense of life, and finding values) or those seeking personal enhancement. The approach can be applied to both individual and group counseling, and to couples and family therapy, crisis intervention, and community mental health work.
Person-centered therapy Has wide applicability to individual and group counseling. It is especially well suited for the initial phases of crisis intervention work. Its principles have been applied to couples and family therapy, community programs, administration and management, and human relations training. It is a useful approach for teaching, parent–child relations, and for working with groups of people from diverse cultural backgrounds.
Gestalt therapy Addresses a wide range of problems and populations: crisis intervention, treatment of a range of psychosomatic disorders, couples and family therapy, awareness training of mental health professionals, behavior problems in children, and teaching and learning. It is well suited to both individual and group counseling. The methods are powerful catalysts for opening up feelings and getting clients into contact with their present-centered experience.
Behavior therapy A pragmatic approach based on empirical validation of results. Enjoys wide applicability to individual, group, couples, and family counseling. Some problems to which the approach is well suited are phobic disorders, depression, trauma, sexual disorders, children’s behavioral disorders, stuttering, and prevention of cardiovascular disease. Beyond clinical practice, its principles are applied in fields such as pediatrics, stress management, behavioral medicine, education, and geriatrics Counseling Theory- Psychoanalytic Theory Essay.
Cognitive behavior therapy Has been widely applied to treatment of depression, anxiety, relationship problems, stress management, skill training, substance abuse, assertion training, eating disorders, panic attacks, performance anxiety, and social phobias. CBT is especially useful for assisting people in modifying their cognitions. Many self-help approaches utilize its principles. CBT can be applied to a wide range of client populations with a variety of specific problems.
Choice theory/ Reality therapy Geared to teaching people ways of using choice theory in everyday living to increase effective behaviors. It has been applied to individual counseling with a wide range of clients, group counseling, working with youthful law offenders, and couples and family therapy. In some instances it is well suited to brief therapy and crisis intervention.
Feminist therapy Principles and techniques can be applied to a range of therapeutic modalities such as individual therapy, relationship counseling, family therapy, group counseling, and community intervention. The approach can be applied to both women and men with the goal of bringing about empowerment.
Postmodern approaches Solution-focused therapy is well suited for people with adjustment disorders and for problems of anxiety and depression. Narrative therapy is now being used for a broad range of human difficulties including eating disorders, family distress, depression, and relationship concerns. These approaches can be applied to working with children, adolescents, adults, couples, families, and the community in a wide variety of settings. Both solution-focused and narrative approaches lend themselves to group counseling and to school counseling.
Family systems therapy Useful for dealing with marital distress, problems of communicating among family members, power struggles, crisis situations in the family, helping individuals attain their potential, and enhancing the overall functioning of the family.

 

 

 

Applications of the Approaches

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contributions to Multicultural Counseling

Psychoanalytic therapy Its focus on family dynamics is appropriate for working with many cultural groups. The therapist’s formality appeals to clients who expect professional distance. Notion of ego defense is helpful in understanding inner dynamics and dealing with environmental stresses.
Adlerian therapy Its focus on social interest, helping others, collectivism, pursuing meaning in life, importance of family, goal orientation, and belonging is congruent with the values of many cultures. Focus on person-in-the-environment allows for cultural factors to be explored.
Existential therapy Focus is on understanding client’s phenomenological world, including cultural background. This approach leads to empowerment in an oppressive society. Existential therapy can help clients examine their options for change within the context of their cultural realities. The existential approach is particularly suited to counseling diverse clients because of the philosophical foundation that emphasizes the human condition.
Person-centered therapy Focus is on breaking cultural barriers and facilitating open dialogue among diverse cultural populations. Main strengths are respect for clients’ values, active listening, welcoming of differences, nonjudgmental attitude, understanding, willingness to allow clients to determine what will be explored in sessions, and prizing cultural pluralism.
Gestalt therapy Its focus on expressing oneself nonverbally is congruent with those cultures that look beyond words for messages. Provides many experiments in working with clients who have cultural injunctions against freely expressing feelings. Can help to overcome language barrier with bilingual clients.

Focus on bodily expressions is a subtle way to help clients recognize their conflicts.
Behavior therapy Focus on behavior, rather than on feelings, is compatible with many cultures. Strengths include a collaborative relationship between counselor and client in working toward mutually agreed-upon goals, continual assessment to determine if the techniques are suited to clients’ unique situations, assisting clients in learning practical skills, an educational focus, and stress on self-management strategies.
Cognitive behavior therapy Focus is on a collaborative approach that offers clients opportunities to express their areas of concern. The psychoeducational dimensions are often useful in exploring cultural conflicts and teaching new behavior. The emphasis on thinking (as opposed to identifying and expressing feelings) is likely to be acceptable to many clients. The focus on teaching and learning tends to avoid the stigma of mental illness. Clients are likely to value the active and directive stance of the therapist.
Choice theory/ Reality therapy Focus is on clients making their own evaluation of behavior (including how they respond to their culture). Through personal assessment clients can determine the degree to which their needs and wants are being satisfied. They can find a balance between retaining their own ethnic identity and integrating some of the values and practices of the dominant society.
Feminist therapy Focus is on both individual change and social transformation. A key contribution is that both the women’s movement and the multicultural movement have called attention to the negative impact of discrimination and oppression for both women and men. Emphasizes the influence of expected cultural roles and explores client’s satisfaction with and knowledge of these roles.
Postmodern approaches Focus is on the social and cultural context of behavior. Stories that are being authored in the therapy office need to be anchored in the social world in which the client lives. Therapists do not make assumptions about people and honor each client’s unique story and cultural background. Therapists take an active role in challenging social and cultural injustices that lead to oppression of certain groups. Therapy becomes a process of liberation from oppressive cultural values and enables clients to become active agents of their destinies.
Family systems therapy Focus is on the family or community system. Many ethnic and cultural groups place value on the role of the extended family. Many family therapies deal with extended family members and with support systems. Networking is a part of the process, which is congruent with the values of many clients. There is a greater chance for individual change if other family members are supportive. This approach offers ways of working toward the health of the family unit and the welfare of each member Counseling Theory- Psychoanalytic Theory Essay.

Contributions to Multicultural Counseling

Limitations in Multicultural Counseling

Psychoanalytic therapy Its focus on insight, intrapsychic dynamics, and long-term treatment is often not valued by clients who prefer to learn coping skills for dealing with pressing daily concerns. Internal focus is often in conflict with cultural values that stress an interpersonal and environmental focus.
Adlerian therapy This approach’s detailed interview about one’s family background can conflict with cultures that have injunctions against disclosing family matters. Some clients may view the counselor as an authority who will provide answers to problems, which conflicts with the egalitarian, person-to person spirit as a way to reduce social distance.
Existential therapy Values of individuality, freedom, autonomy, and self-realization often conflict with cultural values of collectivism, respect for tradition, deference to authority, and interdependence. Some may be deterred by the absence of specific techniques. Others will expect more focus on surviving in their world.
Person-centered therapy Some of the core values of this approach may not be congruent with the client’s culture. Lack of counselor direction and structure are unacceptable for clients who are seeking help and immediate answers from a knowledgeable professional.
Gestalt therapy Clients who have been culturally conditioned to be emotionally reserved may not embrace Gestalt experiments. Some may not see how “being aware of present experiencing” will lead to solving their problems.
Behavior therapy Family members may not value clients’ newly acquired assertive style, so clients must be taught how to cope with resistance by others. Counselors need to help clients assess the possible consequences of making behavioral changes.
Cognitive behavior therapy Before too quickly attempting to change the beliefs and actions of clients, it is essential for the therapist to understand and respect their world. Some clients may have serious reservations about questioning their basic cultural values and beliefs. Clients could become dependent on the therapist choosing appropriate ways to solve problems.
Choice theory/ Reality therapy This approach stresses taking charge of one’s own life, yet some clients are more interested in changing their external environment. Counselors need to appreciate the role of discrimination and racism and help clients deal with social and political realities.
Feminist therapy This model has been criticized for its bias toward the values of White, middle-class, heterosexual women, which are not applicable to many other groups of women nor to men. Therapists need to assess with their clients the price of making significant personal change, which may result in isolation from extended family as clients assume new roles and make life changes.
Postmodern approaches Some clients come to therapy wanting to talk about their problems and may be put off by the insistence on talking about exceptions to their problems. Clients may view the therapist as an expert and be reluctant to view themselves as experts. Certain clients may doubt the helpfulness of a therapist who assumes a “not-knowing” position.
Family systems therapy Family therapy rests on value assumptions that are not congruent with the values of clients from some cultures. Western concepts such as individuation, self-actualization, self-determination, independence, and self-expression may be foreign to some clients. In some cultures, admitting problems within the family is shameful. The value of “keeping problems within the family” may make it difficult to explore conflicts openly.

 

 

 

Contributions of the Approaches

Psychoanalytic therapy More than any other system, this approach has generated controversy as well as exploration and has stimulated further thinking and development of therapy. It has provided a detailed and comprehensive description of personality structure and functioning. It has brought into prominence factors such as the unconscious as a determinant of behavior and the role of trauma during the first six years of life. It has developed several techniques for tapping the unconscious and shed light on the dynamics of transference and countertransference, resistance, anxiety, and the mechanisms of ego defense Counseling Theory- Psychoanalytic Theory Essay.
Adlerian therapy A key contribution is the influence that Adlerian concepts have had on other systems and the integration of these concepts into various contemporary therapies. This is one of the first approaches to therapy that was humanistic, unified, holistic, and goal-oriented and that put an emphasis on social and psychological factors.
Existential therapy Its major contribution is recognition of the need for a subjective approach based on a complete view of the human condition. It calls attention to the need for a philosophical statement on what it means to be a person. Stress on the I/Thou relationship lessens the chances of dehumanizing therapy. It provides a perspective for understanding anxiety, guilt, freedom, death, isolation, and commitment.
Person-centered therapy Clients take an active stance and assume responsibility for the direction of therapy. This unique approach has been subjected to empirical testing, and as a result both theory and methods have been modified. It is an open system. People without advanced training can benefit by translating the therapeutic conditions to both their personal and professional lives. Basic concepts are straightforward and easy to grasp and apply. It is a foundation for building a trusting relationship, applicable to all therapies.
Gestalt therapy The emphasis on direct experiencing and doing rather than on merely talking about feelings provides a perspective on growth and enhancement, not merely a treatment of disorders. It uses clients’ behavior as the basis for making them aware of their inner creative potential. The approach to dreams is a unique, creative tool to help clients discover basic conflicts. Therapy is viewed as an existential encounter; it is process-oriented, not technique-oriented. It recognizes nonverbal behavior as a key to understanding.
Behavior therapy Emphasis is on assessment and evaluation techniques, thus providing a basis for accountable practice. Specific problems are identified, and clients are kept informed about progress toward their goals. The approach has demonstrated effectiveness in many areas of human functioning. The roles of the therapist as reinforcer, model, teacher, and consultant are explicit. The approach has undergone extensive expansion, and research literature abounds. No longer is it a mechanistic approach, for it now makes room for cognitive factors and encourages self-directed programs for behavioral change.
Cognitive behavior therapy Major contributions include emphasis on a comprehensive therapeutic practice; numerous cognitive, emotive, and behavioral techniques; an openness to incorporating techniques from other approaches; and a methodology for challenging and changing faulty or negative thinking. Most forms can be integrated into other mainstream therapies. REBT makes full use of action oriented homework, various psychoeducational methods, and keeping records of progress. CT is a structured therapy that has a good track record for treating depression and anxiety in a short time. Strengths-based CBT is a form of positive psychology that addresses the resources within the client for change.
Choice theory/ Reality therapy This is a positive approach with an action orientation that relies on simple and clear concepts that are easily grasped in many helping professions. It can be used by teachers, nurses, ministers, educators, social workers, and counselors. Due to the direct methods, it appeals to many clients who are often seen as resistant to therapy. It is a short-term approach that can be applied to a diverse population, and it has been a significant force in challenging the medical model of therapy.
Feminist therapy The feminist perspective is responsible for encouraging increasing numbers of women to question gender stereotypes and to reject limited views of what a woman is expected to be. It is paving the way for gender-sensitive practice and bringing attention to the gendered uses of power in relationships. The unified feminist voice brought attention to the extent and implications of child abuse, incest, rape, sexual harassment, and domestic violence. Feminist principles and interventions can be incorporated in other therapy approaches.
Postmodern approaches The brevity of these approaches fit well with the limitations imposed by a managed care structure. The emphasis on client strengths and competence appeals to clients who want to create solutions and revise their life stories in a positive direction. Clients are not blamed for their problems but are helped to understand how they might relate in more satisfying ways to such problems. A strength of these approaches is the question format that invites clients to view themselves in new and more effective ways.
Family systems therapy From a systemic perspective, neither the individual nor the family is blamed for a particular dysfunction. The family is empowered through the process of identifying and exploring interactional patterns. Working with an entire unit provides a new perspective on understanding and working through both individual problems and relationship concerns. By exploring one’s family of origin, there are increased opportunities to resolve other conflicts in systems outside of the family Counseling Theory- Psychoanalytic Theory Essay

Contributions of the Approaches

Limitations of the Approaches

Psychoanalytic therapy Requires lengthy training for therapists and much time and expense for clients. The model stresses biological and instinctual factors to the neglect of social, cultural, and interpersonal ones. Its methods are less applicable for solving specific daily life problems of clients and may not be appropriate for some ethnic and cultural groups. Many clients lack the degree of ego strength needed for regressive and reconstructive therapy. It may be inappropriate for certain counseling settings.
Adlerian therapy Weak in terms of precision, testability, and empirical validity. Few attempts have been made to validate the basic concepts by scientific methods. Tends to oversimplify some complex human problems and is based heavily on common sense.
Existential therapy Many basic concepts are fuzzy and ill-defined, making its general framework abstract at times. Lacks a systematic statement of principles and practices of therapy. Has limited applicability to lower functioning and nonverbal clients and to clients in extreme crisis who need direction.
Person-centered therapy Possible danger from the therapist who remains passive and inactive, limiting responses to reflection. Many clients feel a need for greater direction, more structure, and more techniques. Clients in crisis may need more directive measures. Applied to individual counseling, some cultural groups will expect more counselor activity.
Gestalt therapy Techniques lead to intense emotional expression; if these feelings are not explored and if cognitive work is not done, clients are likely to be left unfinished and will not have a sense of integration of their learning. Clients who have difficulty using imagination may not profit from certain experiments.
Behavior therapy Major criticisms are that it may change behavior but not feelings; that it ignores the relational factors in therapy; that it does not provide insight; that it ignores historical causes of present behavior; that it involves control by the therapist; and that it is limited in its capacity to address certain aspects of the human condition.
Cognitive behavior therapy Tends to play down emotions, does not focus on exploring the unconscious or underlying conflicts, de-emphasizes the value of insight, and sometimes does not give enough weight to the client’s past. CBT might be too structured for some clients.

 

Choice theory/ Reality therapy Discounts the therapeutic value of exploration of the client’s past, dreams, the unconscious, early childhood experiences, and transference. The approach is limited to less complex problems. It is a problem-solving therapy that tends to discourage exploration of deeper emotional issues.
Feminist therapy A possible limitation is the potential for therapists to impose a new set of values on clients—such as striving for equality, power in relationships, defining oneself, freedom to pursue a career outside the home, and the right to an education. Therapists need to keep in mind that clients are their own best experts, which means it is up to them to decide which values to live by.
Postmodern approaches There is little empirical validation of the effectiveness of therapy outcomes. Some critics contend that these approaches endorse cheerleading and an overly positive perspective. Some are critical of the stance taken by most postmodern therapists regarding assessment and diagnosis, and also react negatively to the “not-knowing” stance of the therapist. Because some of the solution-focused and narrative therapy techniques are relatively easy to learn, practitioners may use these interventions in a mechanical way or implement these techniques without a sound rationale.
Family systems therapy Limitations include problems in being able to involve all the members of a family in the therapy. Some family members may be resistant to changing the structure of the system. Therapists’ self knowledge and willingness to work on their own family-of-origin issues is crucial, for the potential for countertransference is high. It is essential that the therapist be well trained, receive quality supervision, and be competent in assessing and treating individuals in a family context Counseling Theory- Psychoanalytic Theory Essay.

Limitations of the Approaches

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.
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 Counseling Theory- Psychoanalytic Theory Essay.
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 Founder: William Glasser. Key figure: Robert Wubbolding. This short-term approach is based therapy 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.

 

 

 

 

 

 

 

 

Overview of Contemporary Counseling Models

Ego-Defense Mechanisms

  Defense Uses for Behavior
Repression Threatening or painful thoughts and feelings are excluded from awareness. One of the most important Freudian processes, it is the basis of many other ego defenses and of neurotic disorders. Freud explained repression as an involuntary removal of something from consciousness. It is assumed that most of the painful events of the first five or six years of life are buried, yet these events do influence later behavior.
Denial “Closing one’s eyes” to the existence of a threatening aspect of reality. Denial of reality is perhaps the simplest of all self defense mechanisms. It is a way of distorting what the individual thinks, feels, or perceives in a traumatic situation. This mechanism is similar to repression, yet it generally operates at preconscious and conscious levels.
Reaction formation Actively expressing the opposite impulse when confronted with a threatening impulse. By developing conscious attitudes and behaviors that are diametrically opposed to disturbing desires, people do not have to face the anxiety that would result if they were to recognize these dimensions of themselves. Individuals may conceal hate with a facade of love, be extremely nice when they harbor negative reactions, or mask cruelty with excessive kindness.
Projection Attributing to others one’s own unacceptable desires and impulses. This is a mechanism of self-deception. Lustful, aggressive, or other impulses are seen as being possessed by “those people out there, but not by me.”
Displacement Directing energy toward another object or person when the original object or person is inaccessible. Displacement is a way of coping with anxiety that involves discharging impulses by shifting from a threatening object to a “safer target.” For example, the meek man who feels intimidated by his boss comes home and unloads inappropriate hostility onto his children.
Rationalization Manufacturing “good” reasons to explain away a bruised ego. Rationalization helps justify specific behaviors, and it aids in softening the blow connected with disappointments. When people do not get positions, they have applied for in their work, they think of logical reasons they did not succeed, and they sometimes attempt to convince themselves that they really did not want the position anyway.
Sublimation Diverting sexual or aggressive energy into other channels. Energy is usually diverted into socially acceptable and sometimes even admirable channels. For example, aggressive impulses can be channeled into athletic activities, so that the person finds a way of expressing aggressive feelings and, as an added bonus, is often praised.
Regression Going back to an earlier phase of development when there were fewer demands. In the face of severe stress or extreme challenge, individuals may attempt to cope with their anxiety by clinging to immature and inappropriate behaviors. For example, children who are frightened in school may indulge in infantile behavior such as weeping, excessive dependence, thumb-sucking, hiding, or clinging to the teacher.
Introjection Taking in and “swallowing” the values and standards of others. Positive forms of introjection include incorporation of parental values or the attributes and values of the therapist (assuming that these are not merely uncritically accepted). One negative example is that in concentration camps some of the prisoners dealt with overwhelming anxiety by accepting the values of the enemy through identification with the aggressor.
Identification Identifying with successful causes, organizations, or people in the hope that you will be perceived as worthwhile. Identification can enhance self-worth and protect one from a sense of being a failure. This is part of the developmental process by which children learn gender-role behaviors, but it can also be a defensive reaction when used by people who feel basically inferior Counseling Theory- Psychoanalytic Theory Essay.
Compensation Masking perceived weaknesses or developing certain positive traits to make up for limitations. This mechanism can have direct adjustive value, and it can also be an attempt by the person to say “Don’t see the ways in which I am inferior, but see me in my accomplishments.”

 

 

 

 

Ego-Defense Mechanisms

 

 

 

 

 

 

Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages

Period of Life Freud Erikson
First year of life Oral stage

Sucking at mother’s breasts satisfies need for food and pleasure. Infant needs to get basic nurturing, or later feelings of greediness and acquisitiveness may develop. Oral fixations result from deprivation of oral gratification in infancy. Later personality problems can include mistrust of others, rejecting others; love, and fear of or inability to form intimate relationships.

 Infancy: Trust versus mistrust

If significant others provide for basic physical and emotional needs, infant develops a sense of trust. If basic needs are not met, an attitude of mistrust toward the world, especially toward interpersonal relationships, is the result.
Ages 1-3 Anal stage

Anal zone becomes of major significance in formation of personality. Main developmental tasks include learning independence, accepting personal power, and learning to express negative feelings such as rage and aggression. Parental discipline patterns and attitudes have significant consequences for child’s later personality development.

 Early childhood: Autonomy versus shame and doubt

A time for developing autonomy. Basic struggle is between a sense of self-reliance and a sense of self-doubt. Child needs to explore and experiment, to make mistakes, and to test limits. If parents promote dependency, child’s autonomy is inhibited and capacity to deal with world successfully is hampered.
Ages 3-6 Phallic stage

Basic conflict centers on unconscious incestuous desires that child develops for parent of opposite sex and that, because of their threatening nature, are repressed. Male phallic stage, known as Oedipus complex, involves mother as love object for boy. Female phallic stage, known as Electra complex, involves girl’s striving for father’s love and approval. How parents respond, verbally and nonverbally, to child’s emerging sexuality has an impact on sexual attitudes and feelings that child develops.

 Preschool age: Initiative versus guilt

Basic task is to achieve a sense of competence and initiative. If children are given freedom to select personally meaningful activities, they tend to develop a positive view of self and follow through with their projects. If they are not allowed to make their own decisions, they tend to develop guilt over taking initiative. They then refrain from taking an active stance and allow others to choose for them.
Ages 6-12 Latency stage

After the torment of sexual impulses of preceding years, this period is relatively quiescent. Sexual interests are replaced by interests in school, playmates, sports, and a range of new activities. This is a time of socialization as child turns outward and forms relationships with others.

 School age: Industry versus inferiority

Child needs to expand understanding of world, continue to develop appropriate gender-role identity, and learn the basic skills required for school success. Basic task is to achieve a sense of industry, which refers to setting and attaining personal goals. Failure to do so results in a sense of inadequacy.
Ages 12-18 Genital stage

Old themes of phallic stage are revived. This stage begins with puberty and lasts until senility sets in. Even though there are societal restrictions and taboos, adolescents can deal with sexual energy by investing it in various socially acceptable activities such as forming friendships, engaging in art or in sports, and preparing for a career.

 Adolescence: Identity versus role confusion A time of transition between childhood and adulthood.

A time for testing limits, for breaking dependent ties, and for establishing a new identity. Major conflicts center on clarification of self-identity, life goals, and life’s meaning. Failure to achieve a sense of identity results in role confusion.

 

Period of Life Freud Erikson
Ages 18-35 Genital stage continues

Core characteristic of mature adult is the freedom “to love and to work.” This move toward adulthood involves freedom from parental influence and capacity to care for others.

 Young adulthood: Intimacy versus isolation. Developmental task at this time is to form intimate relationships. Failure to achieve intimacy can lead to alienation and isolation.
Ages 35-60 Genital stage continues Middle age: Generativity versus stagnation. There is a need to go beyond self and family and be involved in helping the next generation. This is a time of adjusting to the discrepancy between one’s dream and one’s actual accomplishments. Failure to achieve a sense of productivity often leads to psychological stagnation.
Ages 60+ Genital stage continues Later life: Integrity versus despair

If one looks back on life with few regrets and feels personally worthwhile, ego integrity results. Failure to achieve ego integrity can lead to feelings of despair, hopelessness, guilt, resentment, and self-rejection.

 

 

 

 

 

 

Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages

 

 

 

The Basic Philosophies

Psychoanalytic therapy Human beings are basically determined by psychic energy and by early experiences. Unconscious motives and conflicts are central in present behavior. Early development is of critical importance because later personality problems have their roots in repressed childhood conflicts.
Adlerian therapy Humans are motivated by social interest, by striving toward goals, by inferiority and superiority, and by dealing with the tasks of life. Emphasis is on the individual’s positive capacities to live in society cooperatively. People have the capacity to interpret, influence, and create events. Each person at an early age creates a unique style of life, which tends to remain relatively constant throughout life.
Existential therapy The central focus is on the nature of the human condition, which includes a capacity for self awareness, freedom of choice to decide one’s fate, responsibility, anxiety, the search for meaning, being alone and being in relation with others, striving for authenticity, and facing living and dying.
Person-centered therapy Positive view of people; we have an inclination toward becoming fully functioning. In the context of the therapeutic relationship, the client experiences feelings that were previously denied to awareness.

The client moves toward increased awareness, spontaneity, trust in self, and inner-directedness.
Gestalt therapy The person strives for wholeness and integration of thinking, feeling, and behaving. Some key concepts include contact with self and others, contact boundaries, and awareness. The view is nondeterministic in that the person is viewed as having the capacity to recognize how earlier influences are related to present difficulties. As an experiential approach, it is grounded in the here and now and emphasizes awareness, personal choice, and responsibility.
Behavior therapy Behavior is the product of learning. We are both the product and the producer of the environment. Traditional behavior therapy is based on classical and operant principles. Contemporary behavior therapy has branched out in many directions, including mindfulness and acceptance approaches.
Cognitive behavior therapy Individuals tend to incorporate faulty thinking, which leads to emotional and behavioral disturbances. Cognitions are the major determinants of how we feel and act. Therapy is primarily oriented toward cognition and behavior, and it stresses the role of thinking, deciding, questioning, doing, and redeciding. This is a psychoeducational model, which emphasizes therapy as a learning process, including acquiring and practicing new skills, learning new ways of thinking, and acquiring more effective ways of coping with problems.
Choice theory/ Reality therapy Based on choice theory, this approach assumes that we need quality relationships to be happy. Psychological problems are the result of our resisting control by others or of our attempt to control others. Choice theory is an explanation of human nature and how to best achieve satisfying interpersonal relationships.
Feminist therapy Feminists criticize many traditional theories to the degree that they are based on gender-biased concepts, such as being androcentric, gender centric, ethnocentric, heterosexist, and intrapsychic. The constructs of feminist therapy include being gender fair, flexible, interactionist, and life-span-oriented. Gender and power are at the heart of feminist therapy. This is a systems approach that recognizes the cultural, social, and political factors that contribute to an individual’s problems.
Postmodern approaches Based on the premise that there are multiple realities and multiple truths, postmodern therapies reject the idea that reality is external and can be grasped. People create meaning in their lives through conversations with others. The postmodern approaches avoid pathologizing clients, take a dim view of diagnosis, avoid searching for underlying causes of problems, and place a high value on discovering clients’ strengths and resources. Rather than talking about problems, the focus of therapy is on creating solutions in the present and the future.
Family systems therapy The family is viewed from an interactive and systemic perspective. Clients are connected to a living system; a change in one part of the system will result in a change in other parts. The family provides the context for understanding how individuals function in relationship to others and how they behave. Treatment deals with the family unit. An individual’s dysfunctional behavior grows out of the interactional unit of the family and out of larger systems as well.

 

 

 

 

The Basic Philosophies

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Key Concepts

Psychoanalytic therapy Normal personality development is based on successful resolution and integration of psychosexual stages of development. Faulty personality development is the result of inadequate resolution of some specific stage. Anxiety is a result of repression of basic conflicts. Unconscious processes are centrally related to current behavior.
Adlerian therapy Key concepts include the unity of personality, the need to view people from their subjective perspective, and the importance of life goals that give direction to behavior. People are motivated by social interest and by finding goals to give life meaning. Other key concepts are striving for significance and superiority, developing a unique lifestyle, and understanding the family constellation. Therapy is a matter of providing encouragement and assisting clients in changing their cognitive perspective and behavior.
Existential therapy Essentially an experiential approach to counseling rather than a firm theoretical model, it stresses core human conditions. Interest is on the present and on what one is becoming. The approach has a future orientation and stresses self-awareness before action.
Person-centered therapy The client has the potential to become aware of problems and the means to resolve them. Faith is placed in the client’s capacity for self-direction. Mental health is a congruence of ideal self and real self. Maladjustment is the result of a discrepancy between what one wants to be and what one is. In therapy attention is given to the present moment and on experiencing and expressing feelings.
Gestalt therapy Emphasis is on the “what” and “how” of experiencing in the here and now to help clients accept all aspects of themselves. Key concepts include holism, figure-formation process, awareness, unfinished business and avoidance, contact, and energy.
Behavior therapy Focus is on overt behavior, precision in specifying goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes. Present behavior is given attention. Therapy is based on the principles of learning theory. Normal behavior is learned through reinforcement and imitation. Abnormal behavior is the result of faulty learning.
Cognitive behavior therapy Although psychological problems may be rooted in childhood, they are reinforced by present ways of thinking. A person’s belief system and thinking is the primary cause of disorders. Internal dialogue plays a central role in one’s behavior. Clients focus on examining faulty assumptions and misconceptions and on replacing these with effective beliefs.
Choice theory/ Reality therapy The basic focus is on what clients are doing and how to get them to evaluate whether their present actions are working for them. People are mainly motivated to satisfy their needs, especially the need for significant relationships. The approach rejects the medical model, the notion of transference, the unconscious, and dwelling on one’s past.
Feminist therapy Core principles of feminist therapy are that the personal is political, therapists have a commitment to social change, women’s voices and ways of knowing are valued and women’s experiences are honored, the counseling relationship is egalitarian, therapy focuses on strengths and a reformulated definition of psychological distress, and all types of oppression are recognized.
Postmodern approaches Therapy tends to be brief and addresses the present and the future. The person is not the problem; the problem is the problem. The emphasis is on externalizing the problem and looking for exceptions to the problem. Therapy consists of a collaborative dialogue in which the therapist and the client co-create solutions. By identifying instances when the problem did not exist, clients can create new meanings for themselves and fashion a new life story.
Family systems therapy Focus is on communication patterns within a family, both verbal and nonverbal. Problems in relationships are likely to be passed on from generation to generation. Key concepts vary depending on specific orientation but include differentiation, triangles, power coalitions, family-of-origin dynamics, functional versus dysfunctional interaction patterns, and dealing with here-and-now interactions. The present is more important than exploring past experiences.

 

 

Key Concepts

Goals of Therapy

Psychoanalytic therapy To make the unconscious conscious. To reconstruct the basic personality. To assist clients in reliving earlier experiences and working through repressed conflicts. To achieve intellectual and emotional awareness.
Adlerian therapy To challenge clients’ basic premises and life goals. To offer encouragement so individuals can develop socially useful goals and increase social interest. To develop the client’s sense of belonging.
Existential therapy To help people see that they are free and to become aware of their possibilities. To challenge them to recognize that they are responsible for events that they formerly thought were happening to them. To identify factors that block freedom.
Person-centered therapy To provide a safe climate conducive to clients’ self-exploration. To help clients recognize blocks to growth and experience aspects of self that were formerly denied or distorted. To enable them to move toward openness, greater trust in self, willingness to be a process, and increased spontaneity and aliveness. To find meaning in life and to experience life fully. To become more self-directed.
Gestalt therapy To assist clients in gaining awareness of moment-to-moment experiencing and to expand the capacity to make choices. To foster integration of the self.
Behavior therapy To eliminate maladaptive behaviors and learn more effective behaviors. To identify factors that influence behavior and find out what can be done about problematic behavior. To encourage clients to take an active and collaborative role in clearly setting treatment goals and evaluating how well these goals are being met.
Cognitive behavior therapy To teach clients to confront faulty beliefs with contradictory evidence that they gather and evaluate. To help clients seek out their faulty beliefs and minimize them. To become aware of automatic thoughts and to change them. To assist clients in identifying their inner strengths, and to explore the kind of life they would like to have.
Choice theory/ Reality therapy To help people become more effective in meeting all of their psychological needs. To enable clients to get reconnected with the people they have chosen to put into their quality worlds and teach clients choice theory.
Feminist therapy To bring about transformation both in the individual client and in society. To assist clients in recognizing, claiming, and using their personal power to free themselves from the limitations of gender-role socialization. To confront all forms of institutional policies that discriminate or oppress on any basis.
Postmodern approaches To change the way clients, view problems and what they can do about these concerns. To collaboratively establish specific, clear, concrete, realistic, and observable goals leading to increased positive change. To help clients create a self-identity grounded on competence and resourcefulness so they can resolve present and future concerns. To assist clients in viewing their lives in positive ways, rather than being problem saturated.
Family systems therapy To help family members gain awareness of patterns of relationships that are not working well and to create new ways of interacting. To identify how a client’s problematic behavior may serve a function or purpose for the family. To understand how dysfunctional patterns can be handed down across generations. To recognize how family rules can affect each family member. To understand how past family of origin experiences continue to have an impact on individuals.

 

The Therapeutic Relationship

Psychoanalytic therapy The classical analyst remains anonymous, and clients develop projections toward him or her. The focus is on reducing the resistances that develop in working with transference and on establishing more rational control. Clients undergo long-term analysis, engage in free association to uncover conflicts, and gain insight by talking. The analyst makes interpretations to teach clients the meaning of current behavior as it relates to the past. In contemporary relational psychoanalytic therapy, the relationship is central, and emphasis is given to here-and-now dimensions of this relationship.
Adlerian therapy The emphasis is on joint responsibility, on mutually determining goals, on mutual trust and respect, and on equality. The focus is on identifying, exploring, and disclosing mistaken goals and faulty assumptions within the person’s lifestyle.
Existential therapy The therapist’s main tasks are to accurately grasp clients’ being in the world and to establish a personal and authentic encounter with them. The immediacy of the client–therapist relationship and the authenticity of the here-and-now encounter are stressed. Both client and therapist can be changed by the encounter.
Person-centered therapy The relationship is of primary importance. The qualities of the therapist, including genuineness, warmth, accurate empathy, respect, and being nonjudgmental—and communication of these attitudes to clients—are stressed. Clients use this genuine relationship with the therapist to help them transfer what they learn to other relationships.
Gestalt therapy Central importance is given to the I/Thou relationship and the quality of the therapist’s presence. The therapist’s attitudes and behavior count more than the techniques used. The therapist does not interpret for clients but assists them in developing the means to make their own interpretations. Clients identify and work on unfinished business from the past that interferes with current functioning.
Behavior therapy The therapist is active and directive and functions as a teacher or mentor in helping clients learn more effective behavior. Clients must be active in the process and experiment with new behaviors. Although a quality client–therapist relationship is not viewed as sufficient to bring about change, it is considered essential for implementing behavioral procedures.

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Cognitive behavior therapy In REBT the therapist functions as a teacher and the client as a student. The therapist is highly directive and teaches clients an A-B-C model of changing their cognitions. In CT the focus is on a collaborative relationship. Using a Socratic dialogue, the therapist assists clients in identifying dysfunctional beliefs and discovering alternative rules for living. The therapist promotes corrective experiences that lead to learning new skills. Clients gain insight into their problems and then must actively practice changing self-defeating thinking and acting. In strengths-based CBT, active incorporation of client strengths encourages full engagement in therapy and often provides avenues for change that otherwise would be missed.
Choice theory/ Reality therapy A fundamental task is for the therapist to create a good relationship with the client. Therapists are then able to engage clients in an evaluation of all of their relationships with respect to what they want and how effective they are in getting this. Therapists find out what clients want, ask what they are choosing to do, invite them to evaluate present behavior, help them make plans for change, and get them to make a commitment. The therapist is a client’s advocate, as long as the client is willing to attempt to behave responsibly.
Feminist therapy The therapeutic relationship is based on empowerment and egalitarianism. Therapists actively break down the hierarchy of power and reduce artificial barriers by engaging in appropriate self disclosure and teaching clients about the therapy process. Therapists strive to create a collaborative relationship in which clients can become their own expert.

 

Postmodern approaches Therapy is a collaborative partnership. Clients are viewed as the experts on their own life. Therapists use questioning dialogue to help clients free themselves from their problem-saturated stories and create new life-affirming stories. Solution-focused therapists assume an active role in guiding the client away from problem-talk and toward solution-talk. Clients are encouraged to explore their strengths and to create solutions that will lead to a richer future. Narrative therapists assist clients in externalizing problems and guide them in examining self-limiting stories and creating new and more liberating stories Counseling Theory- Psychoanalytic Theory Essay.
Family systems therapy The family therapist functions as a teacher, coach, model, and consultant. The family learns ways to detect and solve problems that are keeping members stuck, and it learns about patterns that have been transmitted from generation to generation. Some approaches focus on the role of therapist as expert; others concentrate on intensifying what is going on in the here and now of the family session. All family therapists are concerned with the process of family interaction and teaching patterns of communication.

 

 

Counseling Theory- Psychoanalytic Theory Essay

Case Study Treatment Plan: The Assessment Process Essay

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Case Study Treatment Plan: The Assessment Process Essay

For this assignment, complete the Assessment Process sections of the treatment plan for your course project. This treatment plan is based on the case study you selected for your course project. You can review the case studies in the Case Study Treatment Plan media piece available in the resources.

The Assessment Process sections of the treatment plan that you will complete for this assignment consist of the following:

  • Identifying information.
  • Presenting problem.
  • Previous treatments Case Study Treatment Plan: The Assessment Process Essay.
  • Strengths, weaknesses, and social support systems.
  • Assessment.
  • Diagnosis.
  • References.

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The sections of the treatment plan you submit for this assignment should be 4–5 pages in length, with a minimum of two references from current articles in the professional literature in counseling. Be sure to cite your references in current APA format.

To assist you in completing this assignment, please use the Case Study Treatment Plan Template (available in the resources) to organize your work. Each section of the template includes a description of the type of information you must include. You should type your paper directly into this template, save it as a Word document with your name, and then submit it to the assignment area Case Study Treatment Plan: The Assessment Process Essay.

For additional information, see the course project description.

Submit your paper to Turnitin before you post it to the assignment area so you can catch any areas that are showing up as possible plagiarism.

Note: Your instructor may also use the Writing Feedback Tool to provide feedback on your writing. In the tool, click on the linked resources for helpful writing information.

 

THE CASE STUDY

Oscar is a 19-year-old Hispanic male who is the oldest of 5 children. His family has been farming the same land for 4 generations. Currently they grow vegetables for the regional grocery chain’s produce departments. They live in a rural area of the county. Three generations live in two separate houses on their land. They are fiercely independent and have little to do with people in town, although the family itself is extremely close knit.

Oscar is currently a freshman at the same college his father attended, majoring in agriculture. When he came home for spring break, his parents noticed significant changes in his appearance. He had lost weight, looked haggard, wasn’t sleeping and seemed irritable and argumentative. He told his parents that he did not want to return to college after the break. He went on to say that his roommate had placed cameras in the room so he could record everything Oscar did while the roommate was absent. His grades were poor and he expressed that he believed his instructors were prejudiced against him. This poor performance was in stark contrast to his performance in high school, where he was in the top 10% of his class. Within days of coming home he had stopped showering and began wearing multiple layers of clothes (3 pairs of jeans and 4 t-shirts). He became essentially non-communicative, responding to questions with one-word answers and not initiating conversation. Oscar seemed unhappy or irritable whenever he encountered a member of his family and began spending all his time in his room. He even refused to talk with his youngest brother, with whom he had always been close. He did not take meals with his family, a long-standing tradition in his family, and left his room only in the middle of the night. He could then be heard opening drawers in the kitchen, going into his siblings’ rooms and leaving the house for long periods of time.

The family (parents and grandparents) became very disturbed and consulted their priest. The priest recommended that the parents take Oscar to see a fellow parishioner who is also a counselor. This counselor was also disturbed with Oscar’s presentation and recommended hospitalization. The family was very reluctant, but eventually agreed. By the time they got to the hospital, Oscar was essentially non-communicative, only nodding or shaking his head in response to direct questions.

The parents provided history that indicated Oscar had been a good student in high school and had participated in the school’s FFA club. He has always wanted to carry on the family tradition of farming. He did not have many friends, but the family attributed that to their living in the country.

The psychiatrist diagnosed Oscar with major depressive disorder, single episode, severe with psychotic features and prescribed anti-depressants. He was released three weeks later, with some improvement. One week later he was readmitted, with the same presentation he had at the previous admission. This time, though, his father reported that he had found a cache of knives in the barn, some from the house, some from the grandparent’s house and some from the barn itself. When he asked Oscar about them, Oscar responded that he needed them to protect himself from attacks. When his father asked from whom, Oscar responded that he had seen one of his college professors in the field of broccoli. That same day, Oscar’s mother found notes stuffed between Oscar’s mattress and box springs in Oscar’s handwriting. The content of them was Oscar arguing with someone about killing his younger siblings. One side did not want to do it and begged to not have to; the other side ordered the killings, saying that was the only way to keep them safe. In light of these two events, both parents were afraid for Oscar to remain at the house. Oscar swore that he would never hurt any of his family and said that was why he had been keeping away from them. His parents could not be sure that no harm would come and were unable to watch Oscar day and night. Therefore, they readmitted him to the hospital.

During this admission, Oscar was more forthcoming with his treatment team. Once they had this additional information, the team realized that Oscar’s initial diagnosis had been wrong. They began a re-assessment. Oscar acknowledged that the problems began about the time of the new semester. He was unable to complete his school work, as he was “consumed” with the need to follow instructions that were being given to him. These instructions actually began with a buzzing in his head, which quickly evolved into specific directions. When pressed, he acknowledged that he did not know who was giving him the directions, though he sometimes thought it might be Jesus. These instructions were for him to keep a log of every time he heard a door close on his hallway in the dorm. Oscar came to believe that doing this was the only way to keep his family safe from dark angels. Oscar tried to keep these voices quiet by smoking marijuana on a daily basis. While this helped in the short term, it also made it more difficult for him to complete any of his school work. By the time for spring break, the messages had begun to change. He was no longer able to keep his family safe by keeping a list; the voices told him he would have to kill them. Oscar knew that he did not want to kill his family. He could also not avoid going home for spring break. Therefore, he devised the plan to isolate himself Case Study Treatment Plan: The Assessment Process Essay.

Once the family recovered from their initial shock and as Oscar began to show some improvement with his new, anti-psychotic, medication, his parents and grandparents wanted to take him home to the farm. They believed that life on the farm, being outside and with hard, physical labor would cure Oscar. Finally, Oscar agreed to tell them what has been happening with him. At that point, the family agreed to residential treatment for Oscar. When asked if anyone else in the family has ever had symptoms like this, the grandfather acknowledged that he had a brother (Oscar’s uncle) who had religious visions. This brother left the family and became a monk. Later the family heard that he had died under mysterious circumstances. One of the other monks at the monastery told Oscar’s grandfather that his brother had died from engaging in a prolonged fast. The family is very lucky on two counts: 1) they have their medical insurance through the farmer’s co-op and it includes coverage for residential treatment for up to a year, and 2) this hospital has a residential treatment unit for late adolescents and young adults. You are working as a counselor at the Residential Treatment facility where Oscar has been placed. He will be here for a minimum of 6 months and as long as one year. Professional staff at this facility includes 3 counselors, an addictions counselor, a social worker (currently on maternity leave), a psychologist, and 2 nurses on every shift. Oscar’s psychiatrist is also on staff and will continue to follow his care.

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The social worker usually coordinates clients’ treatment plans; however she is currently away on maternity leave so you will be the lead therapist who is coordinating Oscar’s treatment during the next 45 days. Once she returns, you will collaborate with her for developing Oscar’s post-residential treatment and resources for him and his family Case Study Treatment Plan: The Assessment Process Essay

Family Genogram Project Paper

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Family Genogram Project Paper

1

COUN 601

Family Genogram Project Instructions

Building Your Family Genogram

Part I (GenoPro Genogram Software)

A genogram (pronounced: jen-uh-gram) is “a pictorial representation of family relationships across several generations. It is a convenient organizing device to help you identify family patterns or develop hypotheses about family functioning” (GenoPro.com). The genogram resembles a family tree; however, it includes additional relationships among individuals. This instrument facilitates the practitioner and his client’s identification an understanding of patterns in family history. The genogram also does a better job than a pedigree chart in mapping out relationships and traits Family Genogram Project Paper.

Even though there are a plethora of books and websites on the subject of genograms, it is worth noting that Monica McGoldrick and Randy Gerson are responsible for its initial development and popularity in clinical settings. The structure of a genogram is by and large determined by the imagination and creativity of its author. Some of the most common features on a genogram are information related to the number of families, children in a given family, and the birth order of the family members—including the number of births and deaths.

Index Person: In constructing the genogram, identify yourself as the “index person” and complete the genogram on your family.

Focus: The focus of this genogram will be on family strengths and resilience, family patterns, rules or ways of being, and the overall health of the family. Of course, you should also address any issues and concerns that may be discovered; however, do not make the genogram problem-focused, even though this is typically how it is used in counseling.

Construction: You will submit your genogram through the assignment manager via GenoPro, found by clicking the “assignments” button. This submission will come in as a GenoPro document. You will also need to attach your narrative on an MS Word document. Make sure to include the following items:

· Two preceding generations—that is, the genogram must include the index person, his/her parents, and his/her grandparents (three generations, in all). It would also be imperative that, in the event of the index person being involved in a marital or significant relationship, mention must be made of the significant other involved, including their immediate family such as their parents, siblings, and children. In the case where the index person is either a parent or a grand-parent, his/her children must be included in the genogram.

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· Use the symbols as illustrated within the GenoPro software to indicate the nature of many of the relationships among family members. Be sure to indicate yourself as the index person by drawing a double circle or double square around yourself. Do not forget to include the current date on your genogram.

· Use the relationship lines to indicate significant relationships within the family system. Do not use the “normal” line provided by GenoPro. This only crowds the graphic and makes it difficult to read.

· Include a legend at the bottom right corner of the genogram document. The legend must only include items represented on the genogram Family Genogram Project Paper.

· In order to make it easy to understand, ensure that there are notes on the genogram graphic regarding people, family events, etc., in their appropriate places (for example, on the side of a relevant person or generation). Even though this is not required for the successful completion of the assignment, it may be helpful to interview other family members about important areas of their family history. It would also be a good idea to include labels (a word or two will do) about each family member’s strengths—especially those that are either known by the index person or have a relevant connection to them.

· GenoPro gives you the freedom you need to manipulate your genogram to allow enhanced viewing on a computer system. You can shorten or lengthen lines, move entire family units around to maximize space, and more. Your objective is to work with the graph to create a genogram that is easy to view and can be understood at a glance.

Analysis: Once you have completed your genogram, you will need to interpret your family map. Analyze the genogram and who you are in the context of the family based on race/ethnicity, culture, class, gender, spiritual tradition, family life cycle, etc.

Part II (Microsoft Word document)

Written Narrative: After analyzing your genogram graphic following the guidelines above, state your interpretation of yourself in clear terms. Do this by writing a paper that describes the contributions that religion, gender, race, culture, etc., and your own unique family history have made to your personal identity. Do not forget to demonstrate your understanding of key concepts learned in this course. Apart from the quality of your written work, you will also be graded on your ability to widely, deeply, and accurately analyze and utilize theoretical concepts in describing your family’s interactional process.

Rest assured that this paper will be kept confidential. Be reminded that you are solely responsible for any information you choose to disclose in this project. Also note that you are under no obligation to reveal any information that you choose not to reveal.

The following outline must be used for your paper, using current APA format:

I. Briefly introduce your family. Discuss the sociopolitical, cultural, economic, spiritual, etc. issues in your family. Do not spend a lot of time describing demographic details that can be observed on the genogram.

· You can use first person in this narrative.

· You will not need an abstract; however, you will need a cover page. A reference page must be provided if you use citations.

II. Using the data gathered and the analyses you have made based upon your genogram and other resources, address the following questions:

A. What do you understand about yourself within the context of this multigenerational family?

B. How do the cultural, historical, and personal characteristic aspects of the information impact your understanding of the self?

C. If at all, what are the family lifecycle-related issues in the past or present that have influenced your family and/or interface with question D?

D. What intergenerational dynamics, patterns and/or themes that you have identified influence you (or others) in your current family? Jump to the last section of the present document, “Interpreting Genograms” and then draw a conclusion about your analysis.

E. What areas do you need to work on in order to become a better spouse, parent, counselor, and godly person?

Conclude this part of the assignment with personal reflections on the development of this project. Were there any issues that came to light? What did you learn?

This assignment is due by 11:59 p.m. (ET) on Sunday of Module/Week 6.

How to Build a Genogram

(Many of the symbols and definitions are adopted from GenoPro.com)

 

Although there is general agreement on the basic genogram structure and symbols, there are some variations from one author to another and some in the GenoPro software program on how to depict certain family situations, such as cutoffs, adoptions etc. (Bowen, 1980; Kramer, 1985; McGoldrick, Gerson, & Shellenberger, 1999). The following are the common to genogram construction. The male is represented by a square and the female by a circle. You may also use a diamond for a pet and the question mark for unknown gender.

Deaths are typically represented by putting an “X” through the symbol. (If you ever do a genogram with a client, ask the client how he/she would like to represent the death since putting an “X” through the symbol without their permission could be traumatizing.) Family Genogram Project Paper

For one to be called a parent, they would have to have at least 1 of the 3 types of children: biological/natural, foster, or adopted. On the genogram, a triangle is the standard diagrammatic representation of a pregnancy, a miscarriage, or an abortion. While an abortion is represented with a horizontal line on top of the triangle, a diagonal cross in the same position indicates the death of a baby through a miscarriage. As for a still birth, it is displayed the same as its gender, though the gender symbol is two times smaller, while the diagonal cross remains the same size.

The reason is obvious as to why the children on a genogram are placed below the family line, starting from the oldest to the youngest, and from the left hand to right. Take note that these are vitally important rules to remember down the road, as the family system becomes labyrinthine. The GenoPro software, however, does allow variations in this area.

Birth, marriage, divorce, and death dates may be indicated by the initial and year (i.e., b. 89). The ages of the individuals are put in as numbers in the markers. Alcoholism (or other relevant issues) is frequently indicated by filling in the bottom part of the individual’s marker.

image1.png Genogram symbols for child links and special birth

The child links are joined together for multiple births, such as twins, triplets, etc. Identical twins (or triplets, etc.) are displayed with a horizontal line between the siblings. In the example below, the mother had two fraternal twin brothers, two identical twin sisters and triplets, one of which died at birth.

image2.png Child links are joined for multiple births such as twins and triplets

There are 4 general rules to keep in mind:

1. The female is always at the right of the family and the male is always at the left.

2. Where there is ambiguity, it is recommended to assume a male-female relationship instead of a same sex relationship.

3. It is assumed that a spouse must always be closer to his/her first partner than to subsequent partners (if any).

4. The youngest child is always at the right of the family and the oldest child is always at the left.

Family Relationships

The next genogram component is the family relationship to describe the union of 2 individuals, typically through marriage. Other family relationships are divorce, separation, cohabitation, engagement, etc. Each completed genogram needs a legend to describe the various symbols. This legend should include the emotional relationship and family relationship lines indicated on your genogram.

GenoPro uses this type of indicator for emotional and relationship lines. When there may be a discrepancy between this document and GenoPro, use GenoPro.

image3.png Legend of family relationships

Each type of family relationship is described in the table below:

image4.png This family relationship represents a married couple. There is no special symbol to distinguish a civil marriage and/or a religious marriage.
image5.png This is the generic symbol to describe a married couple no longer living together. A separation is displayed by a single oblique bar.
image6.png The married couple is separated and started legal procedure for an eventual divorce. If you know a couple is separated but you are not sure about the legal procedure, it is recommended to use the separation in fact symbol.
image7.png The married couple has divorced. No comments.
image8.png The marriage was annulled. This is a rare case, but it must be included.
image9.png One of the spouses died while married. Use this symbol only when the surviving spouse re-married. Otherwise, everyone in your ancestry will be widowed.
image10.png The two individuals are in the process of getting married.
image11.png Same as above except the individuals are living together before getting married.
image12.png There is a legal paper trail about the cohabitation. The two individuals have written contract about the cohabitation status, involving benefits such as parental responsibility, common ownership, and inheritance.
image13.png The two individuals no longer live together and are in the process of terminating their cohabitation contract.
image14.png The cohabitation contract has been terminated.
image15.png One of the partners is deceased. This situation is similar to widowed; the difference is the two individuals had a cohabitation contract rather than a marriage contract. Again, use this symbol if the surviving partner has had other partners, or every legal cohabitation will end by either a separation or a death.
image16.png Although there is no legal definition of cohabitation, it generally means to live together as a couple without being married. Use this relationship to define the generic common law spouse. There is no such thing as illegal cohabitation.
image17.png The generic symbol of two individuals no longer living together.
image18.png The two individuals lived together until one of the partner died. Same as legal cohabitation and decease, but no cohabitation agreement had been written.
image19.png A relationship where two individuals live together, but there is no affection towards another Family Genogram Project Paper.
image20.png The action of seeing someone or dating. Be aware the terms boyfriend and girlfriend are often used for cohabitation, but not exclusively.
image21.png The two individuals are no longer dating. This could be called ex-boyfriend or ex-girlfriend. Be aware, the term ex-boyfriend and ex-girlfriend may also be used for cohabitation and separation, but not exclusively.
image22.png This is the polite term for having a mistress or a one night stand. Select this relation if children are the product of such a relationship.
image23.png One individual is abusing or has abused the other individual, including date-rape, drug-rape, and wife-rape. This type of relationship is mostly used in therapy or when a child was the product of such relationship.
image24.png A relationship not specified in the list above or is unknown to the creator of the genogram. Use this symbol to highlight an unusual type of relationship.
image25.png A blank value is used to describe an unspecified relationship when creating a new family. This is the symbol used to indicate that the user has not yet specified the type of relationship.

A family always has two parents. Use the appropriate family relationship symbol to describe the status of the family. For instance, a single parent family (single mother or single father) is still a family of two individuals, but one individual left. If a new partner or spouse is replacing one parent, create a new family to describe the relationship of the new couple Family Genogram Project Paper.

Emotional Relationships

Although the family relationship may describe the emotional bond between the two parents, the emotional relationship component can be used to describe the emotional bond between any two individuals in the genealogy tree.

image26.png Legend of emotional relationships

Each type of emotional relationship is described in the table below. The legend symbols have been made bigger so you can see them better.

image27.png Define a cutoff relationship where the two individuals have no contact at all; characterized by extreme disengagement and emotional intensity.
image28.png Define an apathetic relationship where one or both of the individuals is indifferent to the other.
image29.png Define a distant relationship between two individuals. Communication is very limited, usually because of lifestyle differences.
image30.png Define a plain/normal relationship. This is not very useful, except to highlight a normal relationship among massively dysfunctional relationships. Therefore do not use this unless there is a situation as stated above. This emotional relationship may resemble the identical twins; however if you take a closer look, the line is colored in gray. When twins are present, the child links are connected together, producing an inverted V. If a plain/normal relationship has to be displayed, then create a non-linear line between the two twins.
image31.png Define a close relationship (friendship) between two individuals. The two individuals are friends and share secrets.
image32.png Define an intimate relationship, where communication is open, uncensored, and without secrets.
image33.png Define a fused relationship between two individuals. Each submerges “self” in the other, and the partners become fused with little space for their own identities. There are great books about this topic.
image34.png Define a hostile relationship between two individuals. The two individuals have conflicts and argue on major issues.
image35.png Define a distant-hostile relationship between two individuals. The two individuals rarely see each other, but when they are together, they argue and are hostile towards another.
image36.png Define a close-hostile relationship between two individuals. These people have frequent contact but argue and keep secrets from one another.
image37.png Define a fused-hostile relationship between two individuals. These individuals are always together yet unable to live without arguing.
image38.png Define a violent relationship between two individuals. The two individuals have conflicts which result in extreme actions such as physical force or excessive power.
image39.png The two individuals rarely see each other, but when they are together, they argue and exhibit violent behavior.
image40.png The two individuals have frequent contact, yet argue and exhibit violent behavior when together.
image41.png A violent behavior to avoid a break in the relationship when intimacy/fusion is difficult or impossible to maintain. Fusion compromises the feelings, identities and self-direction of each, thus creating instability.
image42.png One individual is abusing another individual. Use this relationship if you don’t know the exact type of abuse.
image43.png One individual is physically abusing another individual. Any non-accidental injury to an individual, typically to a child or a woman. This includes hitting, kicking, slapping, shaking, burning, pinching, hair pulling, biting, choking, throwing, shoving, whipping, or paddling.
image44.png One individual is emotionally abusing another individual. Any attitude or behavior which interferes with mental health or social development is emotional abuse. This includes yelling, screaming, name-calling, shaming, negative comparisons to others, telling them they are “bad, no good, worthless” or “a mistake”.
image45.png One individual is sexually abusing another individual. Sexual abuse is any sexual act between an adult and child, or a forced sexual action between two adults. This includes fondling, penetration, intercourse, exploitation, pornography, exhibitionism, child prostitution, group sex, oral sex, or forced observation of sexual acts.
image46.png Failure to provide for a child’s physical needs. This includes lack of supervision, inappropriate housing or shelter, inadequate provision of food, inappropriate clothing for season or weather, abandonment, denial of medical care, and inadequate hygiene.
image47.png One individual is focused unhealthily (obsessed) on another individual.
image48.png The two individuals never met. Again, this relationship is not used often but can be handy to explicitly confirm the two individuals never met. It is up to the creator of the genogram to give details about the relationship, such as “never met physically” but “met online”.
image49.png An emotional relationship not defined in the list. Use a comment to elaborate on the details of the relationship

Creating Genograms

The following are questions to consider in creating a genogram. Review your personal history and the people, existing support systems, or events that may have influenced you.

1. Who lives in the household? Where do other family members live?

2. How is each person related?

3. How do other family members view you?

4. What are changes that have occurred in the family?

5. Has anyone else lived with your family? When? Where are they now? Family Genogram Project Paper

6. Are there any family members who have had a medical or mental illness of any kind? Who are they and how are they related to you? When did the problem(s) begin? What kind of treatment was helpful for them or available to them?

7. Are there any family members who are very close? Friends who are close? Who are they?

8. Which members help out when you need them?

9. How do you get along with each member in your home? In your family?

10. Whom do you see as the strong one? The weak one? The sick one? The bad one? The mad one? The one with all the problems? The dominant one? The submissive one? The successful one? The failure? The warm one, cold one, caring one, distant one, or the selfish one?

11. Has anyone in your family had serious medical problems? Who and what did they have?

12. What roles have you played in your family?

13. How did the family react when a particular family member was born? When a particular family member died?

14. Are there any family members who do not speak to each other or who have ever had a period of not speaking? Are there any who were/are in serious conflict?

15. Are there any family members who are extremely close? Who helps out when needed? In whom do family members confide?

16. What sort of issues occurred between the couples in your family?

17. How does each parent get along with each child? Have any family members had particular problems dealing with their children?

18. Any job changes? Unemployment? How do you like your job? What is the economic situation?

Interpreting Genograms

There are many ways to interpret a genogram. As a rule of thumb, the data must be analyzed for the following:

1. Multi-Generational Issues: Repetitive symptom, relationship, or functioning patterns can be seen across the family and over generations. Thus, you ought to examine the genogram for repeated triangles, coalitions, cut-offs, patterns of conflict, over-and under-functioning, etc.

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2. Dates: Dates provide information that helps put events in perspective. For example, coincidence of dates (e.g., death of one family member or anniversary of death occurring at the same time as symptom onset in another, or the age at symptom onset coinciding with the age of problem development of another family member. Dates throw light on the impact of sequential or simultaneous happenings whose relatedness may be otherwise hard to ascertain. For example, if you find out that an individual or family was dealing with several mishaps within a given year, you can see the effect these stresses would have on family members, such as a young baby or an older child leaving home.

3. Change and Life Cycle Transitions: Changes in functioning and relationships that correspond with critical family life events. Of particular interest are untimely life cycle transitions (e.g., births, marriages, or deaths) that occur “off-schedule.”

4. Traumas: Traumas can have a dramatic impact on people. Experiencing such events as abuse; war; natural disasters; etc., their timing, and how people reacted are critical to examine.

5. Gender: Gender beliefs and values do have an influential role in families. They often create complications within the context of cross-cultural marriages, especially when involving members of different gender beliefs. A common example of such a case is if a family has sent clear messages that men are strong and do not show emotions (especially hurtful ones), you may come to understand why a given younger-generation married couple would be struggling to communicate Family Genogram Project Paper.

6. Secrets: Secrets in a family not only take energy away from a family, but may reveal important information about boundaries and communication patterns in the family system.

7. Losses: The issue of losses is a fundamental factor in genograms. Some of the points to note under this category are: the event of sudden and critical illness, economic hardships, sudden death, disabilities, unanticipated loss or shortage of income, miscarriages, divorces, etc. Even though the impact of such losses varies from person to person, the question is: “To what extent was this event perceived as a loss?” Not all these events are perceived as losses, and the depth of loss also does vary greatly.

Much of the information and materials in this document were taken from the GenoPro website such as the rules, symbols, family relations, emotional relationship pages. Permission was given to do so by the developer of GenoPro to the developer of this document.

GenoPro Software. www.genopro.com [permission to use symbols and other materials from

GenoPro has been granted to the creator of the document]

McGoldrick, M., Gerson, R., & Petry, S. (2007). Genograms: Assessment and intervention

(3rd ed.). New York: W.W. Norton and Company

Page 6 of 14 Family Genogram Project Paper

Counseling Theory- Theoretical Orientation Development Plan Paper

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Counseling Theory- Theoretical Orientation Development Plan Paper

Behavior Therapy or Cognitive Behavior therapy    

Required Assignments (RAs) are substantive assignments intended to measure student performance against selected course objectives and/or program outcomes within a course. RAs are completed by all students across all Argosy University campuses and delivery formats without exception.

Each RA contributes to a significant portion of the overall course grade and is assessed by faculty using the grading criteria designed for that assignment. These are individual assignments and students earn individual grades. Required Assignment: Theoretical Orientation Development Plan Paper 300 pts

Description of RA: From what you have learned in this course, select a theoretical perspective that interests you the most. In this assignment, you will conduct a literature search on that theoretical approach and develop a personalized plan for your continued development Counseling Theory- Theoretical Orientation Development Plan Paper.

Theoretical Orientation Development Plan Paper Review the literature and construct a paper presenting and supporting your personal counseling theoretical preference (choosing from the major theories studied in this course). You should conduct a computerized literature search on the particular theoretical approach that feels like the best fit. Remember to select a theory that aligns with your worldview and your perspective of the best therapeutic relationship. References should be from empirical/scholarly works that support and further define the position. You should include the following in your paper:

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• Summarize the fundamental elements of your theory of choice, including definitions of important terms, personality development, and major historical figures associated with the theory.

• Explain how your personal worldview (e.g. core beliefs about others and the world) connects to the theory of choice. • Explain how the therapeutic relationship aligns with your interpersonal style.

• Discuss how your theory of choice addresses the multicultural nature of our diverse society.

• Present support for the effectiveness of your chosen theoretical approach by examining and analyzing the existing efficacy-based research. Include findings across age groups, gender, and/or multicultural groups.

• Discuss limitations of your chosen therapeutic approach, including any clients or presenting problems for which it may not be appropriate. Support your ideas with findings from existing research on the approach.

• Identify the ethical standards from the American Counseling Association’s Code of Ethics (2014) that apply to the use of an approach determined to be unsuitable for a particular group or presenting problem. Discuss the potential harm that could be caused by applying an unsuitable approach. Spring 1 – 2018

• Provide an example of how you would apply a minimum of two specific theoretical techniques to a fictitious client’s need Counseling Theory- Theoretical Orientation Development Plan Paper.

• Provide a plan for how you will continue to develop your knowledge and skills related to that theory.

Your final deliverable will be a Word document, approximately 8-10 pages in length, utilizing a minimum of 7 scholarly references. Your paper should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, punctuation, and APA format.

 

CACREP Standards: 2.F.5.a, 5.C.1.a, 5.C.1.b, 2.F.5.g, 2.F.5.h, 2.F.5.j, 5.C.3.b, 2.F.5.n, 2.F.2.c,

5.C.2.c, 2.F.1.i, 5.C.2.l

Theoretical Summary:   Summarize the fundamental elements of your theory of choice, including   definitions of important terms, personality development, and major historical   figures associated with the theory.

Summary clearly states all critical elements of the theory of choice.   All relevant technical terms are defined, theoretical understanding of   personality development is described, and the importance of each historical   figure is clearly and accurately stated. /40   pts.

 

Personal Worldview: Explain how your personal worldview connects   to the theory of choice.

Correlation between the   student’s worldview and the theory of choice is clearly stated. The effect of   the worldview towards the use of the theory is appropriate. /20   pts.

 

Interpersonal Style: Explain how the   therapeutic relationship described in your theory of choice aligns with your   interpersonal style.

Correlation   between important aspects of the therapeutic relationship and the student’s   interpersonal style is clearly stated. How the student’s interpersonal style   would be appropriate or be a challenge is clearly stated. /20   pts Counseling Theory- Theoretical Orientation Development Plan Paper.

 

Cultural and

Developmental Considerations: Discuss how your   theory of choice addresses the multicultural nature of our diverse society   and individual developmental needs.

The effect of the theory   towards a variety of clients is accurate and clearly stated. /38   pts.

 

Theoretical Strengths: Present   research findings in support of the effectiveness of your chosen theoretical   approach.

Findings   are presented of at least one peer-reviewed, efficacy study on the chosen   theoretical approach. /30   pts.

 

Theoretical Limitations: Present   research findings related to the limitations of your chosen theoretical   approach.

Findings   are presented of at least one peer-reviewed study examining the limitations   of the chosen approach. /30   pts.

 

Ethical Considerations: Identify at   least two ethical standards from the ACA Code of Ethics that address the   inappropriate use of an approach or technique. Discuss specific, potential   harmful effects of doing so.

At   least two relevant ethical standards are identified, defined, and applied to   the potential misapplication of a technique or approach. At least two examples of potential harmful   effects are identified. /30   pts.

 

Technique Application: Provide an   example of how you would apply a minimum of two

specifically theoretical   techniques to a fictitious client’s need.

The   description of implementation correctly aligns with each theory. Specific   needs of the client are addressed, and the description of how each theory   addresses the specific needs is clear and accurate. /54   pts.

 

Plan for Development:   Describe how you will continue to develop your knowledge and skills related   to the selected theory.

The   plan includes details and specific resources that will be accessed and   utilized to increase and enhance knowledge and skills related to the theory   of choice. /10   pts.

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Academic Writing

Write in a clear, concise, and organized manner; demonstrate ethical   scholarship in accurate representation and attribution of sources (i.e. APA);   and display accurate spelling, grammar, and punctuation.

Written   in a clear, concise, and organized manner; demonstrated ethical scholarship   in appropriate and accurate representation and attribution of sources; and   displayed accurate spelling, grammar, and punctuation. Use of scholarly   sources aligns with specified assignment requirements. /28   pts Counseling Theory- Theoretical Orientation Development Plan Paper.

Dave is a 46-year-old attorney with a family history of heart disease (his father had a heart attack at the age of 56) whose recent blood tests reveal high blood LDL cholesterol and triglyceride levels. His doctor has advised him to eat less fat in his di

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Dave is a 46-year-old attorney with a family history of heart disease (his father had a heart attack at the age of 56) whose recent blood tests reveal high blood LDL cholesterol and triglyceride levels. His doctor has advised him to eat less fat in his diet. Dave is a self-confessed “foodie” and he enjoys wine and cheese at several social functions each week. He cooks with “real” butter at home and uses half milk and half cream in his coffee. Although fairly inactive, Dave keeps his weight stable at 170 pounds. He is 5 feet 10 inches tall. 1. What factors may be contributing to Dave’s elevated cholesterol and triglyceride levels? 2. From the history given, identify the main sources of saturated fat in Dave’s diet. What are some reasonable changes he could make to lower his intake of saturated fat from these foods? 3. Assume Dave eats about 2000 kcalories a day and that his doctor has advised him to limit his fat intake to 35 percent of his daily kcalories. Refer to the “How to” feature (p. 155) of this chapter to calculate his personal Daily Value for fat. 4. According to the 2010 Dietary Guidelines for Americans, what is the maximum percentage of kcalories from saturated fat that Dave should consume each day? Remembering that 1 gram of fat contains 9 kcalories, calculate the maximum grams of saturated fat that Dave should eat each day based on his daily intake of 2000 kcalories. 5. Using information from Highlight 5, what additional advice would you offer Dave to improve his heart health? 6. Plan a one-day menu for Dave with higher amounts of healthful fatty acids and lower amounts of harmful fatty acids.

Using The Triage Assessment Form Paper Example

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Using The Triage Assessment Form Paper Example

Using the Triage Assessment Form

After reading the case examples in the Myer and Conte (2006) article, you have a better understanding of how to use one type of assessment tool. A Microsoft Word copy of the Triage Assessment Form (TAF) is included in the assignment Resources. The most current version of this form is also shown in your James and Gilliland (2013) text, pages 63–65. Use the form to analyze Jordan, described below. You can save the form as you have completed it as a MS Word document or as a PDF document, and attach the form to your written paper as an appendix Using The Triage Assessment Form Paper Example.

Rate the client in each of the three domains (Affective, Behavioral, and Cognitive) using the Severity Scale included with each domain on the Triage Assessment Form (TAF) and total the scores. Describe, in detail, the rationale for your ratings, including your judgment about how intense and directive the treatment should be based upon the total score. In your discussion of the rationale, summarize diagnostic skills and techniques that can be used to screen for addiction, aggression, and danger to self and others, as you note these risks in your client. Similarly, a possible co-occurring mental disorder (such as substance abuse) may become apparent during a crisis, disaster, or other trauma-causing event that ties in with your assessment during the client’s crisis. Note this as well in your rationale.

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Project Objectives

To successfully complete this project, you will be expected to:

 

·         Summarize diagnostic skills and techniques used to screen for addiction, aggression, and danger to self and others, as well as co-occurring mental disorders during a crisis, disaster, or other trauma-causing events.

 

·         Evaluate key elements of the crisis, disaster, or trauma-causing event including the nature of the crisis and associated risks, including client and counselor safety.

 

·         Discuss developmental and cultural considerations in crisis assessment and intervention Using The Triage Assessment Form Paper Example.

 

·         Exhibit proficiency in effective, credible academic writing, and critical thinking skills.

 

Note: A template for your APA formatted paper is included in the assignment Resources. Please use the template to present the assignment criteria in an organized way. The headings guide you to the criteria, and the details that are included describe what is necessary to complete the assignment to a Distinguished degree.

Case

Jordan

Jordan arrives at counseling saying that her husband, Jake, left the house earlier that day in an agitated mood and with his rifle, and tearfully discloses concerns about her safety and his. She states that her friend, who has been worried about her for some time, insisted that she see a counselor. Jordan says she was surprised at Jake’s abrupt departure because she was unaware of any plans he had to go hunting, and if he was not going hunting, why he would take his gun out. She recalls that she and Jake had fought the previous night over his drinking. Jordan reports that she asked Jake to stop drinking so much, and in response, he threatened her and slammed a few doors. She recalls that Jake said he liked being a little drunk and pushed her back against the kitchen counter at one point. When Jake went back into a spare bedroom to sleep that night, Jordan found numerous beer bottles in the den and a large empty whiskey bottle in front of his truck. Jordan states that it was not unusual for Jake to put his rifle in his truck when he planned to go hunting, but when he had done so today, he had still been quite angry about her accusation that he was drinking too much. After he left, Jordan reports that she began shaking. She felt fear for her own safety, so she called her friend who insisted that she speak to a counselor. While Jordan was on her way to counseling, her husband called her. He seemed calm, asked about her day, and said nothing about the previous night or his abrupt departure. Jordan states that this switch in mood from extreme aggression to a pleasant tone “seems weird.” Jordan asks for help in dealing with her husband’s odd behaviors. She fears for her own safety and the safety of her husband, but is unwilling to call the police. As she speaks, she is agitated and continually looks over at the doorway, as though expecting it to burst open Using The Triage Assessment Form Paper Example.

 

Project Requirements

 

·         Content: Prepare a comprehensive paper that includes all elements described.

 

·         Components: The paper must include a title page, abstract, and reference list.

 

·         Written communication: Develop accurate written communication and thoughts that convey the overall goals of the project and do not detract from the overall message.

 

·         APA formatting: Resources and citations must be formatted according to APA (6th Edition) style and formatting.

 

·         Number of pages: The body of the paper should fall within 3–5 pages of text, plus 3 pages of the Triage Assessment Form, excluding title page and reference list.

 

·         Number of resources: Minimum of 4 current resources, published within the last 12 years, and you may include your text as one.

 

·         Font and font size: Times New Roman, 12-point.

 

Submit the completed paper and form to the assignment area Using The Triage Assessment Form Paper Example.

Psych 635 Ethics In Conditioning Research Paper

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Psych 635 Ethics In Conditioning Research Paper

Complete Parts 1 and 2 for this assignment.

Part 1

Watch “Pavlov’s Experiments on Dogs” and “Pavlov’s Experiments on Children” in the Week Two Electronic Reserve Readings.

Part 2

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Prepare a research proposal for one of Pavlov’s research experiments involving children, adjusting it for current principles of ethical guidelines

  • Read the article ““The General Ethical Principles of Psychologists”
  • Identify one of the ethical violations and propose an alternative approach that would meet current ethical standards.

Format your paper consistent with APA guidelines. Psych 635 Ethics In Conditioning Research Paper