Counseling and Psychotherapy

1

COUNSELING AND PSYCHOTHERAPY

Term 9: May, 2005

Carolyn Zerbe Enns, Ph. D.

Office: Law 106D

Phone: 895-4351 (office); 895-6605 (home)

e-mail:

Class Hours: Monday -Friday 9-11:15 A.M. and 12:30-3 P.M. for lab/class activities

Objectives:

1. To provide an overview of current psychotherapies and their roots.

2. To provide information about the therapeutic process and an overview of basic communication and counseling skills. To provide an experiential laboratory for learning and practicing communication skills essential to the counseling process.

3. To examine current issues and innovations in psychotherapy, including multi-cultural issues, ethical dilemmas, and feminist concerns.

4. To apply counseling principles to diverse problems and case studies.

5. To provide opportunities to compare, contrast, and integrate various theories of counseling and psychotherapy.

6. To encourage class members to pursue independent reading and research projects on counseling and psychotherapy.

7. To develop self-evaluation skills, writing skills, and critical thinking skills.

8. To examine personal qualities that support and hinder efforts to be therapeutic.

9. To examine, integrate, and critique research relevant to psychotherapy.

Texts:

Corey, Gerald. (2001). Theory and practice of counseling and psychotherapy (6th ed.). Belmont, CA: Wadsworth.

Reserve readings (consult the daily reading schedule).

Tests:

Students will complete two tests, which are scheduled for Thursday, May 12 and Wednesday, May 25. Tests will include both objective items and essays. Tests will be designed to assess your knowledge of content, as well as your ability to compare, contrast, and integrate material in a meaningful way.

Papers:

Class members will complete (a) occasional overnight reaction papers, (b) an application/transcript paper, and (c) a final case study-research paper or counseling process/outcome research paper. Due dates are Tuesday, May 17 (application/transcript paper) and Monday, May 23 (final research paper).

Grading:

Grades will be based on the percentage of the total points earned.

A=94%, A-=90%, B+=88%, B=83%, B-=80%, C+=78%, C=73%, C-=70%.

Tentative point values for assignments:

Tests60-75 points each

Short overnight assignments20-25 points

Application/transcript paper30-35 points

Case study/research paper65-70 points

Attendance/active participation25-30 points

Description of Papers

Communication Skills and Reflection: Videotape and Transcript of a Helping Conversation.

Due: Tuesday, May 17 Length: 5-7 pages

This assignment will focus on the interviewing skills you will learn and practice during this course. To complete this task, you will conduct a role-play interview with a classmate or another volunteer, and the interaction should be videotaped. The total interaction time with your role-play partner should be between 20-30 minutes in length. For the written portion of the assignment, you will turn in (cued to the appropriate place) a transcript of 5-7 minutes of interaction. You may select one section/chunk or provide samples from several segments of the tape. The selections you use should include a section in which you are relatively active (e.g., say something at regular intervals). You should make efforts to include at least three specific sets of skills in this interaction: attending, inviting/questioning, and reflecting/conveying empathy. After creating the tape, you should also view a section of the tape and solicit the feedback of at least one other member of the class. This peer feedback should inform your observations and self-evaluation of the taped material. You will be graded primarily on your self-evaluation and reflections about the interview rather than your interview “performance.” More specifically, you will:

a. Identify a 5-7 minute segment of tape (or 5-7 minutes of segments taken from different parts of the conversation) and transcribe (word for word) the interaction. (Note: the selection may represent one chunk or several shorter segments. Also, it may occasionally be appropriate to condense long client responses.)

b. Watch the tape with at least one other class member and use the feedback you gain to inform your written commentary about the experience.

c. Write a 3-5 page reaction to the interview. First, you should describe the goal you had in mind. Were you trying to gather information? Were you attempting to explore a problem in more depth? Did you want to help the interviewee focus on emotion? You should also reflect upon your own performance (e.g., what you did well, what you might have done differently, what skills come naturally to you, what skills are challenging, etc.). You should also talk about how you believe the interviewee reacted to the interaction. How did he/she respond to your attempts at different interactions or exchanges? Do you think he/she was helped? Why or why not? Finally, in light of your reflection on the interview, please conclude by explaining whether you believe you met your goal for that section of the interview.

Please remember that you may not meet all your goals. I am most concerned that you bring sincere effort to the task. You will be graded primarily on the thoughtfulness and accuracy of your reflections on the interaction, as well as on the accuracy of your transcription.

Final Paper: Case Study and Comparative Analysis of Two Therapy Approaches or Brief Research Review of an Approach to Therapy

Due: Monday, May 23 Length: 9-12 pages

Option A. This paper will provide an opportunity for you to compare and contrast the use of two different therapy approaches with the same “client.” You will then describe in detail how therapy would be conducted from each of these two perspectives. Please note that some approaches (e.g., feminist therapy) are not strongly linked to the work of one individual, and you may discuss that perspective in general. Other approaches (e.g., cognitive therapy) are associated closely with one or more theorists (e.g., Beck and Ellis) who have very different ideas. In those instances, you should select one of theorists (e.g., Aaron Beck) to represent that particular perspective in your paper. You cannot compare two therapists from the same general perspective (e.g., two cognitive theorists or two existential therapists) as your paper assignment. You will be required to use four professional sources (in addition to your textbook) when writing this paper. You should have at least one source for each of the therapy approaches that you are using. The source does not have to be written by the original theorist (e.g., Carl Rogers); it can be written about the therapy (e.g., Person-Centered Therapy). The source may also provide information about the specific problem or issue described in the case study. You should rely primarily on journal articles and professional books for your resources, and at least two of your sources should be from these types of print materials. Given the fact that major practitioners and theorists now maintain web-sites, you may use a maximum of two such sources. Be sure that these sources are sponsored and administered by individuals with respected academic credentials. You should use APA style for this paper (or the primarily writing style of your primary discipline) to include citations within the text of your paper, as well as to provide title and reference pages.

The first part of this paper will involve writing a case study or modifying a case study. I encourage you to write a case study that reflects a problem and/or relationship issues that are of special interest to you. The write-up of the case study is due on Tuesday, May 10. It should include a description and development of the problem, how it creates difficulties for the person, and why the individual is seeking help. You may also comment on a variety of background factors such as family dynamics, previous problems, and the strengths of the individual.

The final paper should begin with the case study, and should then describe the following issues for each approach. I encourage you to also include a short script to illustrate any of the items listed below.

The Therapeutic RelationshipWhat is the nature of the therapy relationship? (collaborative?

directive?)

How is the therapy relationship established?

How critical is the relationship to therapy outcome?

AssessmentHow is assessment completed? What are its goals?

What kinds of assessments would likely be used? (e.g., interview? specific tests?, etc.)

When/how does assessment occur?

Counseling GoalsHow would the therapist conceptualize/explain the problems of the client? (This is a crucial question.)

Given the above explanation for the client’s problems, what

are the therapy goals likely to be?

When/how are goals chosen? (e.g., collaborative?

dictated? beginning of treatment? change over time?)

Interventions/TechniquesWhat specific types of interventions is the therapist likely to use and why? Be specific in describing the interventions and the rationale for implementing them. (These are also especially important questions.)

Diversity IssuesHow would the type of therapy you are reviewing address any issues of diversity that are raised by your case? (e.g. race/ethnicity, gender, age)

Please note that you may not simply review two approaches, but need to apply concepts specifically to your case study. Thus, illustrations and examples are important. Your paper should also conclude with some side-by-side comparisons of the approaches and your thoughts about which approach you believe would be most effective in this case. Make sure you support your response.

Option B. This paper provides an opportunity for you to explore the frameworks of one or two approaches to psychotherapy and to discuss and integrate this material with the findings of research studies relevant to the therapy. Research studies may focus on either psychotherapy process variables or outcomes. You should use a minimum of 2-3 sources to inform your discussion of the therapy and 3-4 research studies. For the initial discussion of the therapy, you may focus on the set of questions identified under option A. Approaches to psychotherapy for which psychotherapy research is most readily available are the manualized therapies such as cognitive-behavioral therapy, mindfulness-based therapies, interpersonal therapy, and process-experiential therapies. You may also wish to focus on the practice of a specific therapy as it relates to a specific type of problem such as depression, eating disorders, or stress management.

Resource Materials on Reserve in Cole Library

Corey, G. (1995 & 2005). Case approach to counseling and psychotherapy (4th ed. & 6th ed.). Wadsworth.

Corsini, R. J., & Wedding, D. (Eds.). (1995, 2000, 2005). Current psychotherapies (5th, 6th, & 7th eds. Itasca, IL: Peacock & Brooks/Cole.

Gurman, A. S., & Messer, S. B. (Eds.). (1995). Essential psychotherapies: Theory and practice. Guilford.

Kornstein, S. G., & Clayton, A. H. (Eds.). (2002). Women’s mental health: A comprehensive textbook.Guilford.

Malchiodi, C. A. (Ed.). (2005). Expressive therapies.Guilford Press.

Nathan, P. E., & Gorman, J. M. (Eds.). (1998). A guide to treatments that work. New York: OxfordUniversity Press.

Wachtel, P. L. & Messer, S. B. (Eds.). (1997). Theories of psychotherapy: Origins and evolution. Washington, DC: American Psychological Association.

Some Guidelines for Participating in this Class

Attendance:

You should plan to attend every class session, unless there is a valid reason for your absence. Promptness is appreciated. Unexcused absences, particularly unexcused absences from lab sessions have a bearing on your grade (e.g., overall grade lowered by 1/3-1/2 a grade for more than one unexcused absence). If you have a specific reason for missing, please let me know prior to the event or immediately upon returning to class.

Communication Skills Practice: Its Strengths and Limitations:

As a part of this course, you will be engaging in the practice of specific types of communication skills, such as reflecting the verbal and emotional content of others’ words. This will be done in role-play situations. Although these are similar to some of the basic interviewing skills used by counselors and therapists in their professional work, you are not being trained to conduct counseling or to intervene with individuals in the manner that a professional would. I hope that you will learn something about good, general communication skills in this class, but please be aware that completing this class does not prepare you to take on a professional role. Communication skills training, however, should help you develop skills that will be useful to you in most professions, including counseling.

Getting the most out of this course:

I hope you will come to class with an open frame of mind and the willingness to take some modest interpersonal risks, especially in the experiential components of the course. In this beginning course in counseling, you are not expected to demonstrate mastery, but rather, the willingness to try out new communication skills. I hope you will challenge yourself to become an active and involved participant. In addition, you will gain more from this course by reading required materials before class sessions, and by reading widely outside of class.

Respect confidentiality:

Being actively involved small groups and role-playing activities involves some level of personal self-disclosure. To facilitate the creation of a trusting environment for learning and practicing these skills, I ask that you not share any personal information or reactions from your small groups outside of the classroom. I also encourage you to be very cautious about using any personal scenarios when role-playing communication and listening skills. You may believe that the information you are sharing is innocent or not emotionally-laden for you, but may discover that the information brings up emotions that surprise you. If you use friends’ or family members’ troubles as material for role-plays, be sure that you do not name the person, that you alter important facts to disguise identities, and that there is no way the person could be identified from the information you share. If you have any concerns about information shared within your small group or about what is or is not appropriate to reveal within those settings, please consult with me.

Videotaping Equipment:

For your second paper, you will be using the video set-up in the Law Hall 4th floor lab. This equipment cannot be removed from that room, and you will only have access to this room when I am in the building (the room is locked to prevent tampering with equipment). You should check with me in advance to make sure I will be available to let you in to the room. Make sure that your recording is audible and viewable before you turn it in.

Class Schedule

Note: With the exception of readings for May 2, readings should be completed before class sessions on the days for which they are assigned.

Monday, May 2

Introduction and overview

Does psychotherapy work?

A.M. class and P.M. movie

Reading:

Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50, 965-974.

Lebow, J. (2004, November/December). The push for evidence: The debate about the proper method for studying therapy heats up. Psychotherapy Networker, 85-86. (handout)

Recommended:

DeAngelis, T. (2005, March). Shaping evidence-based practice. Monitor on Psychology, 26-31.

Glenn, D. (2003, October 24). Nightmare scenarios. The Chronicle of Higher Education, A14-A17.

Wedding, D. & Niemec, R. M. (2003). The clinical use of films in psychotherapy. Journal of Clinical Psychology, 59, 207-215.

Tuesday, May 3

The counselor as a person and professional

Does psychotherapy work? (continued discussion of readings for May 2)

Person-centered therapies

Reading:

Corey, chapters 1 (skim), 2 (skim), & 7

Layton, Molly. (2005, March/April). Facing darkness: The limits of empathy. Psychotherapy Networker, 33-25, 58-59.

Read one of the following:

Carl Rogers (1980). Empathic: An unappreciated way of being. From A way of being (1980)

Carl Rogers (1958). The characteristics of a helping relationship. From Personnel and Guidance Journal.

Wednesday, May 4

Person-centered therapies continued

Existential Therapy

Reading: Corey, chapter 6. From the Yalom reader or The gift of therapy:

The four ultimate concerns. (1998). From The Yalom reader.

CBT is not what it’s cracked up to be…or, don’t be afraid of the EVT bogeyman. (ch. 76)

Avoid diagnosis (except for insurance companies). (ch. 2).

Create a new therapy for each patient.(ch.10)

Engage in personal therapy. (ch. 12) The here-and-now---Use it, use it, use it. (ch. 14) Why use the here-and-now? (ch. 15) Using the here-and-now—Growing rabbit ears. (ch. 16) Search for here-and-now equivalents. (ch. 17)

Thursday, May 5

Gestalt therapy

Reading: Corey, chapter 8

Kellogg, S. (2004). Dialogical encounters: Contemporary perspectives on “chairwork” in psychotherapy. Psychotherapy: Theory, Research, Practice, Training. 41, 310-320.

Sharf, R. (2004). Creative arts therapies. Brief excerpt from Theories of Psychotherapy & Counseling.

Malchiodi, C. A. (2005). Expressive therapies: History, theory, and practice, or Art therapy. Both in C. A. Malchiodi (Ed.), Expressive therapies. New York: Guilford.

Friday, May 6

Ethics and psychotherapy

Reading: Corey, chapters 2 and 3

American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073. Sections 3.05, all of sections 4 & 10.

Sommers-Flanagan, R., Elliott, D., & Sommers-Flanagan, J. (1998). Exploring the edges: Boundaries and breaks. Ethics and Behavior, 8, 37-48.

Monday, May 9

Contemporary psychodynamic approaches

Jungian and object relations methods

Reading: Corey, chapter 4

Weinberg, George. (1990). The taboo scarf. From The taboo scarf and other tales of psychotherapy.

Optional/for enrichment:

Enns, C. Z., & Kasai, M. (2003). Hakoniwa: Japanese sandplay therapy. The Counseling Psychologist, 31,93-112.

Homeyer, L. E., & Sweeney, D. S. (2005). Sandtray therapy. In C. A. Malchiodi (Ed.), Expressive therapies.

Tuesday, May 10

The cognitive-behavioral therapies

Reading: Corey, chapter 11

Laidlaw, T. M., & Dwivedi, P. (2002). Combining cognitive, emotional, behavioural and, dare we say it, the spiritual: A review of Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse.

Schmidt, S. (2004). Mindfulness and healing intention: Concepts, practice, and research evaluation. Journal of Alternative and Complementary Medicine, 10, S7-S14.