1. Discuss the values in teaching and therapy. The value free hypothesis (by Freud) says that the client's unconscious dynamic governs what they do. Freud did not want to have any personality in therapy. He did not think that the therapist should ever express their values; hence, the sessions were value free. The value neutral/phenomenological is Rogerian thought that encouraged therapists to put aside their own values. The counselor should be neutral and get into the head of the client. The value informed belief says that therapists really do transmit their values. Therefore, they should be open and explicit about them so that the client can make an informed decision.

2. Discuss Worthington's cognitive-behavior process model of helping relationships. Therapy should be strategic and have a plan. This process is cognitive-behavioral and suggests that what we think and feel affects how we behave. It is a process and model of helping relationships.

3. Discuss three ways of integrating secular theories. Theoretical integration is when a person of one theoretical persuasion tries to mold another theory into it. The common factors hypothesis assumes that there are common factors across all psychotherapies that make them successful. Technical eclecticism draws from different theories, maybe through metatheory or maybe through the rationale of doing what works.

4. Discuss some common factors. In 1961 or 1962, Nicholas Hobbs came up with a Rogerian new cosmology. He said that all psychotherapies: (1) provide for intimacy without hurt, (2) take sting out of symbols, (3) use transference neurosis (people act out problems with therapist), (4) let people practice decision-making in a controlled environment, and (5) lets the client develop a new way of looking at the world (new cosmology). Perry London said that problems result when people feel like they have lost their sense of control. He put rats in water and discovered that they survived for 72 hours until they lost hope. People are the same way. We all need a sense of control, and we do not like to lose it. To restore the client's sense of control, we can name/rename the problem. Another way is to reduce the person's defenses and self-consciousness (either by soothing the client or by beating them up). A third way is to teach the client new attitudes and reinforce old attitudes. Marvin Goldfried thought that commonality could only be achieved at middle levels (clinical strategies or principles of change). His beliefs should lead to corrective experiences and offering the client direct feedback. Michael Mahoney defined the three "R's" for helping: role-defined relationship, rationale for how and why change should begin, and rituals to accomplish change. All therapies have these.

5. Discuss the elements of all psychotherapy theories. The elements are personality theory, causes of problems, the theory of change, and the techniques to promote change.

6. Discuss personality theory. The therapist only needs to be concerned about the relevant parts that are causing the problem. Finding the problem usually leads to an obvious solution. However, the solution might be hard to implement. Personality is based on needs. People have a need for meaning in their life and for intimacy and affection. We want to know how things fit together in the world. We get meaning from intimate relationships and from knowing that we can make things happen. To achieve these situations, a person will establish goals. We are whole and interconnected.

7. Discuss the causes of problems. For psychotherapy, Worthington divides people up based on behavior, cognitions, emotions, body (soma), and spirit. These five parts connect and interact with each other. The physical and social environment are also parts, and when people are upset, all seven parts become affected. When a person gets disturbed, the five parts and the environment get disturbed.

When someone comes to counseling, it does not matter how the problem began. Each disturbed part is the real problem, and the therapist wants to stabilize one or two parts in order to make the whole system less disturbed. A cognitive therapist will work on cognitions. Rogers would work on emotions. Behaviorists usually want to change the environment. A family therapist works on the family's social environment. No therapeutic system tries to treat everything. The therapist does not want to waste valuable early sessions assessing all the parts because coming at the client from seven different directions would be confusing for the client.

8. Discuss promoting change. First, your relationship with the person is the most important key to your promoting change. Ellis would probably disagree, but most theorists would not. Second, you join with the clients and then take them in a new direction. Third, you help clients see their problems, options, and goals differently. Fourth, you use techniques that are compatible with the new perspective. Fifth, you adopt goals consistent with the level of the depth of the problem (assess first, then treat).

9. Discuss entering the client's life through the open door. The therapist enters into the client's life through the open door of their conversation. This helps the counselor to understand the problem from the client's point of view. The therapist should communicate that understanding back to the client. Finally, according to Borden, the therapist should establish an emotional bond with the client.

10. Discuss helping the client evolve a new conceptualization of the problem. This is reconceptualizing the problem with the client, and it should be done with the client, not to the client. The conceptualization must differ from the client's previous conceptualization because what the client was doing already did not work. Therefore, the therapist needs to begin this process before seeing the client. Perhaps the most difficult part of therapy for the neophyte counselor is how to get the conceptualization from his head to the client's head. The client must buy into the new conceptualization. One method is to focus attention selectively. First, observe the client's problem and ask questions to get more information and promote further thinking. Ideally, the therapist will get the client to see what is happening. You want to create a sense of wonder for the client to help them make the connection. Another method is to use a healing metaphor. The best therapists use the client's metaphor in a different context to change how the problem is viewed.

11. Discuss how the therapist and client decide on an action. In-session action plans should be supplemented by out-of-session action plans. Doing homework is an important part of therapy so that the client will not get sidetracked between sessions. If the patient does not act immediately on lessons learned, then the lessons will probably be forgotten.

The therapist must motivate the client to carry out the plans that they devise. He or she can use rationale to let the client know what the plans will accomplish. He or she can provide explanation to explain the plan very carefully and make sure that the client understands. He or she can try to get the patient to make a verbal commitment to carry out the plan. He or she can repeat the plan, give homework, and make the plan their source of motivation. He or she can check up to make sure that the homework is being done.

Getting the client to put the plan into effect is the most important part of therapy because the client can get feedback. The therapist should support the client's attempts to change by asking what happened with the plan and by expressing an interest in the client's life. The therapist can follow-up on the client's attempts to change by analyzing events in the client's life in light of the new conceptualization and by repeating the plan and objectives.

He or she can make explicit plans for generalization and maintenance. Cognitive events (what you think) drive behavior. Environmental events and structures (relatively permanent) drive cognitive events. So do cognitive structures, which are relatively permanent things that go on in one's head. Cognitive events also influence cognitive structures. Behavior leads to consequences, and they lead back into the system. These factors change when therapy ends, so the therapist must try to change the relatively permanent things.

Once enough change has occurred, the sessions can end. The first part was to reconceptualize the problem(30%-40%), followed by the actual process of change. When termination comes, the client often has difficulty, and this leads to ambivalence. Termination is best when done gradually.

				Tom of Bethany

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