2AgendaChapters 10, 11, 12, 13Experiential Group Exercises: Questioning – Compare Person-Centered Approach with Gestalt Approach; Dreams – Compare Psychoanalytic Approach with Gestalt Approach; Transactional Analysis
3Course CompetenciesDefining the origins of group counseling, including the leaders and time framesApplying specific theories of practice to group counselingApplying group dynamics and processesModeling appropriate group techniques for use in schools, community, and organizational settingsProviding and synthesizing the exchange of feedback between self and other leaders and group members
5Person-Centered Group Approach The Person-Centered Approach Challenges:The assumption that “the group leader knows best”The validity of advice, suggestion, persuasion, teaching, diagnosis, and interpretationThe belief that group members cannot understand and resolve their own problems without active and directive intervention of the leaderThe focus on problems over personsThe necessity of using techniques to get or keep a group moving
6HumanismOverlaps with Existentialism, but focuses on human capacities aimed at growth:Love, freedom, choice, creativity, purpose, relatedness, meaning, values, self-actualization, autonomy, responsibilityCarl Rogers, Rollo May, Abraham Maslow, Clark Moustakas, Sidney Jourard, Fritz Perls, James Bugental
7Humanism – Key Concepts Self-awareness – people who are self-aware can make more life-affirming choices.Phenomenological approach – understand reality from client’s perspectiveSelf-actualization - Innate process by which a person tends to grow spiritually and realize potentialSelf-determining – although influenced by past, individuals determine who they become through choiceRespect for subjective experience of each person – that people are capable of acting in responsible and caring ways in interpersonal relationships
8Person-Centered Approach [PCA] PCA in group practice emphasizes:Therapy as a shared journeyThe person’s innate striving for self-actualizationThe personal characteristics of the facilitator and the quality of the therapeutic relationships within the groupThe facilitator’s creation of a permissive, “growth promoting” climatePeople are capable of self-directed growth if the core conditions are presentTrust in the group process: Members can be trusted to move in a constructive direction
9Person Centered Approach In nondirective counseling the therapist’s realness and empathy are emphasized, and the therapeutic relationship rather than the therapist’s techniques are viewed as the central factor in facilitating change.Basic trust in the client’s ability to move forward if conditions fostering growth are present
10Therapeutic Conditions for Growth Congruence—genuineness or realnessThe greater the extent to which facilitators are real, the more members will change and growUnconditional positive regard and acceptanceCaring not contaminated by judgmentAn attitude of receptiveness toward the subjective and experiential world of the membersEmpathyThis is the ability to deeply grasp the member’s subjective worldFacilitator’s attitudes are more important than knowledge
11Congruence & Genuineness Therapist is real, genuine, integrated & authentic during therapy; human being struggling for realnessTherapist has no false front; match of inner & outer expression of experienceTherapist can openly express feelings, thoughts, reactions & attitudes present in relationships with client
12Unconditional Positive Regard Therapist communicates deep & genuine caring for client as a personCaring is unconditional-no evaluation or judgment of client’s feelings, thoughts or behaviorsCaring does not come from need of reciprocal caring of therapist by clientAcceptance & recognition of client’s right to have own beliefs & feelings
13Accurate Empathic Understanding Therapist understands client’s experience & feelings as revealed in interactionTherapist tries to sense client’s subjective experience in here and nowSense the other’s feelings as if my ownCapable of reflecting the experience of client back to client-encourages client to be more reflectiveEncourages client’s own understanding & clarification of beliefs and worldviews
14Six Core ConditionsNecessary and sufficient for personality changes to occur1. Two persons are in psychological contact2. The first, the client, is experiencing incongruency3. The second person, the therapist, is congruent or integrated in the relationship4. The therapist experiences unconditional positive regard or real caring for the client5. The therapist experiences empathy for the client’s internal frame of reference and endeavors to communicate this to the client6. The communication to the client is, to a minimal degree, achieved
15Process of Therapy Client’s communications about externals & not self Client describes feelings but not recognize or “own” them personallyClient talks about self as an object in terms of past experiencesClient experiences feelings in present-just describes them with distrust & fearClient experiences & expresses feelings freely in present-feelings bubble upClient accepts own feelings in immediacy & richnessClient trusts new experiences & relates to others openly & freely
16The Group CounselorFocuses on the quality of the therapeutic relationshipUnderstands that the presence of facilitator is of the utmost importanceMore concerned about personal qualities rather than techniques of leading a groupServes as a model of a human being struggling toward greater realnessIs genuine, integrated, and authentic, without a false frontCan openly express feelings and attitudes that are present in the relationship with the group membersUnderstands the role of group counselor is that of a facilitator—using self as an instrument of change
18Person-Centered Expressive Arts Natalie RogersPrinciples of expressive arts therapyExpressive arts as a multimodal approach to integrating mind, body, emotions, and spiritual inner resources through art formsAll people have the ability to be creativeThe creative process is healingConditions that foster creativityOpenness to experienceInternal locus of evaluationSome guidelines for creative expression in groupsImportant to offer stimulating and challenging experiencesEssential to create a nonjudgmental and supportive climateThe facilitator’s “way of being” is more important than techniques used in expressive arts therapy
19Evaluation of PCA in Groups Contributions and strengths of the approachA good foundation for the initial stage of most groupsValue is placed on empathy and respect for membersValues and principles of PCA can be incorporated into many other approachesThis approach places prime emphasis on the group counselor as a personThe philosophy can be a basic part of working with culturally diverse client populationsLimitations of the approachMany leaders want and need more structure than this approach allows
20Gestalt Therapy Fritz Perls (1893-1970) Germany Married Laura Perls in 1930US in 1946Founded New York Institute of Gestalt Therapy
21Therapeutic Goals in Groups Existential and Phenomenological—it is grounded in the member’s “here and now” experienceEmphasizes how each member views the worldInitial goal is for group members to gain awareness of what they are experiencing and doing nowPromotes direct experiencing rather than the abstractness of talking about situationsRather than talk about a childhood trauma, the group participant is encouraged to become the hurt childAs members acquire present-centered awareness, significant unfinished business emergesAwareness is seen as curative and growth-producing
22Continuum of Awareness Awareness involves staying with the moment-to-moment flow of experiencingBy staying with present-centered awareness, members discover how they function in the worldGroup leaders ask “what” and “how” questionsWhat are you experiencing now?How are you experiencing your anxiety in your body?
23Four Major Principles of Gestalt Therapy Holism-interested in the whole person-emphasis on integration-thoughts, feelings, behaviors, body, & dreamsField Theory-organism must be seen in its environment or its context as part of a constantly changing field; everything is relational, in flux, interrelated & in processFigure Formation Process-tracks how some aspect of the environmental field emerges from the background and becomes a focal point of the individual’s attentionOrganismic self-regulation-restore equilibrium or contribute to growth & change
24The Here-and-Now Our “power is in the present” Nothing exists except the “now”The past is gone and the future has not yet arrivedThe past is important, but only as it is related to present functioningA here-and-now focus brings vitality to a groupFor many people the power of the present is lostThey may focus on their past mistakes or engage in endless resolutions and plans for the futureThe challenge is to come into closer contact with ongoing experiencing from moment to moment
25Unfinished Business Feelings about the past are unexpressed These feelings are associated with distinct memories and fantasiesFeelings not fully experienced linger in the background and interfere with effective contact and functioningResult:Preoccupation, compulsive behavior, wariness, oppressive energy, and self-defeating behaviorUnfinished business needs to be addressed so that we can move toward health and integration
26Contact and Disturbances to Contact CONTACT – interacting with nature and with other people without losing one’s individualityDISTURBANCES TO CONTACT – the defenses we develop to prevent us from experiencing the present fullyGestalt therapist focuses on disturbances to contactFive contact boundary disturbances:IntrojectionProjectionRetroflectionConfluenceDeflection
27Introjection-channel of resistance Tendency to uncritically accept others’ beliefs and standards without assimilating them to make them congruent with who we arePassively incorporate what the environment provides, spending little time on becoming clear about what we need or want
28Projection -channel of resistance Disown aspects of self by assigning them to environmentTrouble distinguishing between inside & outside worldDisown attributes of self that are inconsistent with self-image & put onto other peopleTo avoid taking responsibility for our own feelings & person who we really areKeeps us powerless to initiate change
29Deflection -channel of resistance Process of distraction-keep difficult to sustain sense of contact with realityOveruse of humor, abstract generalizations & questions rather than statements-results in emotional depletionDiminished emotional experience-by speaking through and for others
30Confluence-channel of resistance Blurring differentiation between self & environmentIn relationships, it is a need to fit in, an absence of conflict, a belief all people feel & think same wayHigh need for acceptance, approvalStay safe, never express own feelings
31Energy and Blocks to Energy Unexpressed emotions create a blockage in the bodyEnergyIn a Gestalt group, the focus is on energy—within individuals and with the group as a wholeGestalt leaders pay attention to where energy is located, how it is used, and how it can be blockedBlocks to energyThese blocks manifest themselves in the body in various waysMembers may not be aware of their energy or where it is locatedExperiments can be designed to assist members in becoming aware of the ways they may be blocking their energy
32Role of Gestalt LeaderGestalt leaders encourage members to heighten their awarenessGestalt leaders focus on contact, awareness, and experimentationGestalt leaders take an active role in creating experiments to assist members in gaining awarenessMain role of leader is to create a safe climate that allows members to feel free in trying out new ways of being and behavingCentral role of the relationship:Contemporary Gestalt practice emphasizes a dialogic relationship (attitude)Emphasis is on presence, authentic dialogue, gentleness, and self-expression by the leader
33Client’s Process in Gestalt Work Discovery - Surprises for clientnew realizations about selfnovel view about old situationsnew look at significant otherAccommodationrecognition they have a choicetry new behaviors in safety of groupexpand awareness in real worldAssimilationLearning to influence environmentDeal with surprises encountered dailyConfidence to improve and improvise
34Paying Attention to Language To encourage self-awareness:Change “It” talk to “I”-Ex. “I am frightened”, instead of “It’s frightening”.Change “You” talk to “I” talk to take responsibility for feelings, opinions, etc. – “You feel hurt” to “I feel hurt”Questions can put other members on the defensive.Pay attention to qualifiers such as “but” because they diminish the power of statements.Substitute “won’t” for “can’t” to be more honest and take responsibility.Leaders should not challenge members’ language in the early stages when developing trust and safety.
35Therapeutic Experiments Not a technique or exercise that is prescribed to bring about an actionPhenomenologically based and evolve out of what is occurring within members in the present momentMembers are encouraged to try new behaviors and pay attention to what they are experiencingA creative happening, rather than a group exercise that the leaders might prepare prior to a group meeting
36Experiments Internal dialogue exercise Making the rounds Rehearsal exerciseExaggeration exerciseStaying with the feelings
37Internal Dialogues Fantasy dialogues promote awareness Dialogues between opposing sides of selfDialogues with a parent or significant otherCan use the “empty chair” technique
38Making the RoundsIn a group, go up to each person in the group and speak to or do something with each oneGoal: confronting, take risks, disclose self, try new behaviors to grow and change
39Rehearsal ExerciseBehavioral rehearsal: role playing a planned for new behavior with a person or people in client’s environmentTo reduce stage fright, anxiety or fear “not do the role right”Encourages spontaneity and willingness to experiment with new behaviors
40Exaggeration Exercise Exaggerate movement or gesture repeatedly to intensify feelings attached to behavior to make inner meaning clearerTrembling hands or feet, slouched posture, bent shoulders, clenched fists, tight frowning, facial grimacing, crossed arms
41Staying with the Feelings Keep client from escaping fromFearful stimuliAvoiding unpleasant feelingsEncourage to go deeper into feelings or behavior which they wish to avoid (“How are you…”)Facing, confronting & experiencing feelings-to unblock and make way for new levels of growth-takes courage & painLeader avoids telling members the meaning of their gestures, postures, and body symptoms, so that members are more able to stay with what they are experiencing and eventually find their own meaning.
42Dream Work in Groups Principles of Gestalt dream work Dreams contain an existential messageDreams are not interpreted by the leaderMembers discover their own meaning of their dreamsGuidelines for working with a dream in a groupRelive the dream as though it were happening nowMembers asked what interests them about the dreamMembers are encouraged to become different parts of the dreamCreate dialogue between the various aspects of the dreamMembers suggest what they think a dream might be telling themOther members can share with the person working with the dream how they are affected
43Evaluation Strengths Limitations Integrates theory, practice, research Shown to benefit clients with various disordersLimitationsInept therapists may use powerful interventions to stir up emotions and not sufficiently help clients to work through and obtain closure.
44Transactional Analysis Eric Berne ( ) Canada/UsTA evolved out of Berne’s dissatisfaction with psychoanalysisMary & Robert GouldingRedecision therapy – combination of TA, Gestalt, psychodrama, behavior therapy
45Transactional Analysis Transactional Analysis (TA) is an interactional and contractual approach to groupsTA is basically a psychoeducational approach to group workTA is grounded on the assumption that people make present decisions based on their early experiencesRedecision therapy is a form of TA that assists group members in taking charge of their lives by deciding how they will changeThe practice of TA is ideally suited to group workBasic assumption of TA is that we are in charge of what we do, of the ways we think, and of how we feel
46Key Concepts of TAPeople have a basic trio of Parent, Adult, and Child (P-A-C) ego statesNeed for strokesInjunctions and counterinjunctionsDecisions and redecisionsGamesBasic psychological life positions
47TA Ego States or Personality Aspects ParentAdultChild
48The Ego StatesMembers are taught how to recognize in which ego state they are functioning at any given timeThe Parent ego stateThis ego state contains the values, morals, core beliefs, and behaviors incorporated from parentsThis ego state can be expressed in critical or nurturing behaviorThe Adult ego stateThis ego state is the objective part of personality and functions as a data processorThe Child ego stateThis ego state consists of feelings, impulses, and spontaneous actions
49Ego States Parent act and feel much as those who raised us. Controlling Parent…follows rules, accepts slogans, holds opinions without thinking first of facts.Nurturing Parent…Supportive and protective toward others, offers help and guidance.
50Ego States Ways of Acting in the Parent Ego State … a frown or stern look.… tone of voice.… pointing of the index finger.… arms folded as to say “what are you doing?”… uses phrases like; “you should,” “you ought to,” “that is right!”… words such as; sympathizing, punishing. moralizing, judging, giving orders, criticizing.
51Ego States Child what we were when we were young. Adapted Child…Polite, sociable, recognizes the rights of others, adapts behavior to suit them, can resent the rights/demands of others, complies grudgingly, feels unsure about themselves, procrastinates .Natural Child…Open to life, spontaneous, filled with the sense of wonder and delight, self centered, aggressive, rebellious, does not consider the consequences of feeling or actions.
52Ego States Ways of Behaving in the Child Ego State … smiling, laughing, having fun.… tone of voice.… crying, having tantrums, getting into trouble.… childlike facial expressions.… uses words/phrases like; “Wow!,” “Gosh!,” “I wish,” “I feel.”
53Ego States Adult … figures things out logically. looks at the facts and reasons - the computer in us.Adult… figures things out logically.… takes responsibility for thoughts, feelings and actions.… solves problems and makes decisions.
54Ego States Ways of Behaving in the Adult Ego State … straight forward facial expression.… active listener, eyes blink every 3 to 5 seconds showing attention.… speaks of probabilities.… uses phrases like; “In my opinion,” “Based on what I have observed,” “So far the facts seem to indicate.”
55TA GroupMembers recognize in which of the ego states they are functioning at any given timeGoal is to decide whether that state or another state is more appropriateMember decides if change is warranted
56The Need for StrokesA transaction is a basic unit of communication, consisting of an exchange of strokes between 2 peoplePeople need to receive physical and psychological strokes to develop a sense of trust in the worldPositive strokes express warmth, affection, approval, and appreciationNegative strokes can be given to set limits: “Stop it right there!”When group members understand how strokes (exchanges) affect their behavior, they can choose the kinds of exchanges they wantMembers sometimes have a difficult time in asking for or receiving positive strokes
57InjunctionsInjunctions are messages (many nonverbally) issued from the parent’s own Child Ego state when the parent feels threatened by a child’s behavior.Some examples of injunctions which are expressions of disappointment, frustration, anxiety, unhappiness:“Don’t be”• “Don’t be close”• “Don’t think”• “Don’t feel”In TA groups members explore the “dos” and “don’ts” by which they were trained to liveOnce members identify the messages they have internalized, they can critically examine them to decide if they want to continue living by them
58Counterinjunctions Messages issued from the parent’s Parent Ego state Convey the shoulds, oughts & dos of parental expectations“Be perfect”, “Try hard”, “Be strong”, “Please me”Like injunctions, group members become aware of these shoulds, oughts, & dos and determine whether they are willing to continue living by them.
59Decisions and Redecisions Group work may address the decisions made in response to parental injunctions and counterinjunctions.TA group members learn to relive these early decisions and make new ones.
60Decisions and Redecisions Early decisionsBased on injunctions, we make early decisionsEarly decisions had a purpose at one time, yet they may not be functional as we become adultsTA groups allow members to examine early decisionsMaking new decisionsAn assumption in TA is that whatever we decided can be redecidedRedecision is done emotionally, not just cognitivelyMembers can create a new ending to scenes where early decisions were made• New endings can result in a new beginning• New beginnings allow members to think, feel, and act in revitalized ways
61Decisions and Redecisions Group leaders assist a member to return to some critical point in childhood.The group member re-experiences the scene, reliving it in the here-and-now, but with a different outcome.After experiencing a redecision in the old scene, they design experiments to practice new behaviors to support the redecision.
62Games We PlayGames—an ongoing series of transactions that ends with a negative payoffGames are designed to prevent intimacyThe process of game playing:We receive strokesWe maintain and defend our early decisions; find evidence to support our view of the worldRackets—unpleasant feelings people experience after a game; learned in childhood & maladaptive in adulthoodMembers can identify the games they played as children and the games they currently playIn a group, members can become aware of games they play and decide if they want to live more honestly and authentically
63Basic Life PositionsTA identifies four basic psychological life positions that determine how people feel about themselves and how they relate to others:I’m OK—You’re OK: generally game freeI’m OK—You’re not OK: position of people who project problems on othersI’m not OK—You’re OK: powerless positionI’m not OK—You’re not OK: futility & despair, unable to cope in the real world
64Life Script A life script is a plan for life A personal life script is an unconscious plan made in childhoodA life script is blueprint that tells us where we are goingScript analysisIn TA groups the members become aware of how they acquired their life scriptMembers can learn how to free themselves of self-defeating patternsGroup members act out portions of their life script, learn about the injunctions they accepted as children, the decisions they made in response, & the games and rackets they currently use to keep the early decisions alive.
65Roles of the Group Leader Explains key concepts of TACreates a climate that assists members in gaining awarenessChallenges members to discover and experiment with changeFacilitates the members in fulfilling their contractsFocus is between group leader and group member, rather than interactions between group members
66The Therapeutic Contract Contracts: The Structure of the Therapeutic RelationshipTA is a contractual form of group therapyMembers must have the capacity and willingness to understand and design a therapeutic contractContracts allow members to specify their goalsContracts assist members in identifying how they will be different as a result of their participation in groupMembers learn that therapy is a shared ventureA well-stated contract provide a basis for members to determine if they are getting what they want from the group experienceContracts are not rigid and are open to revision
67Evaluation of TA Strengths Emphasis on contracts encourage the members’ empowerment and responsibility for change.Brief therapyLimitationsRequires extensive training to use the psychodrama techniquesAs a cognitive approach, feelings are usually not explored; genuine contact between group leader and members may not be achieved
68Cognitive Behavioral Approaches A set of clinical procedures relying on experimental findings of psychological researchBased on principles of learning that are systematically appliedTreatment goals are specific and measurableFocusing on the member’s current problemsTo help people change maladaptive to adaptive behaviorsThe therapy is largely educational—teaching group members skills of self-management
69Key Names in Behavioral Therapy Arnold Lazarus-role of therapeutic change-brief, efficient & effective psychotherapy-Multimodal TherapyAlbert Bandura-introduced cognition as focus of behavior therapyAlbert Ellis-Rational Emotive TherapyAaron Beck-Cognitive therapy for depressionDonald Meichenbaum-treatments for stress inoculation & self-instructional training
70Cognitive Behavioral Leaders Cognitive behavioral group leaders:Use brief, active, directive, collaborative psychoeducational model of therapyAssume that most problematic behaviors, cognitions, and emotions have been learned and can be modified by new learningAssume that change can occur without insight into underlying dynamicsFollow the progress of group members by collecting data before, during, and after all interventionsOrientation of the cognitive behavioral leader:May develop strategies from diverse theoretical viewpointsIs both a clinician and scientist who tests the efficacy of techniquesSystematically adheres to specification and measurement
71Unique Characteristics of CBT Different from other group approaches, CBT relies on the scientific method1. Behavioral assessment▪ Involves a set of procedures used to get information that will guide the development of a treatment plan2. Precise therapeutic goals▪ CBT focuses concretely on specific target areas of change▪ Identifying goals determines direction of therapeuticmovement3. Treatment plan▪ Treatment plan is based on specified goals▪ Members are expected to take an active role with tasks4. Objective evaluation▪ Emphasis is on evaluating effectiveness of techniques used▪ Evaluation is an ongoing process
72Role of CBT Group Leader CBT groups have a detailed, concrete, problem-oriented structureLeaders use short-term interventionsLeaders need to be skilled in brief interventionsCBT leader assumes the role of teacher and encouragerSome specific educational and therapeutic functions:They draw on a wide array of techniques to help members reach goalsThey model appropriate behaviorsThey model active participation and collaborationThey provide reinforcement to members for new learningThey help members develop a plan for change
73Therapeutic Techniques Reinforcement—specified event that strengthens the tendency for a response to be repeated (Ex. Praise)Contingency contracts—behaviors to be performed are spelled out; time period; reinforcement; recordsModeling—clients learn through observation and imitation of leader & members (Ex. Role-play)Behavior rehearsal—practicing a new behavior in a sessionCoaching-coach sits behind member who is rehearsingHomework—affords members opportunities to practice new skills in between sessions
74Therapeutic Techniques Feedback-fellow group members can provide reactions with praise & encouragementCognitive restructuring—identifying and evaluating one’s cognitions and learning to replace negative cognitions with constructive cognitionsProblem Solving- goal is to identify the most effective solution to a problem and provide training in cognitive & behavioral skills so group member can apply themBuddy System-members assist each other in designing homework tasks and monitoring their completion
75Social Skills Training Groups Social skills training deals with one’s ability to interact effectively with others in various social situationsSocial skills training includes these strategies: psychoeducation, modeling, behavior rehearsal, role playing, and feedbackThree formats of social skills training:Sheldon Rose model of structuring social skills trainingMembers role-play problem situations & assign themselves homeworkSocial effectiveness training (SET)A treatment program aimed at reducing social anxiety and improving interpersonal skills; utilize modeling, behavioral rehearsal; reinforcementAssertion trainingGroups that increase members’ behavioral repertoire so they can make the choice of being assertive or not; express themselves in a way that reflects sensitivity to feelings and rights of others
76Cognitive Therapy Groups Aaron BeckCognitive therapy (CT) is an insight-focused therapyCT can be applied to a wide range of groupsEmphasizes changing negative thoughts and maladaptive beliefsTheoretical assumptions of CTPeople’s internal communication is accessible to introspectionClients’ beliefs have highly personal meaningsThese meanings can be discovered by the client rather than being taught or interpreted by the therapist
77Theory, Goals & Principles of CT Basic theory:To understand the nature of an emotional episode or disturbance it is essential to focus on the cognitive content of an individual’s reaction to the upsetting event or stream of thoughtsGoals:To change the way clients think by using their automatic thoughts to reach the core schemata and begin to introduce the idea of schema restructuringPrinciples:Automatic thoughts: personalized notions that are triggered by particular stimuli that lead to emotional responses
78Focus of Cognitive Therapy Group Emphasis is on the present and approach is time limitedGroup sessions focused on current problemsPast can be brought into group session when this is relevant to understanding and resolving present problemsMembers identify self-defeating beliefsThey learn to refute core beliefs and faulty thinkingEmpirically test beliefs with Socratic dialogue, carry out homework assignments, gather data on assumptions, keep record of activities, form alternative interpretationsEx. “Where is the evidence for _____________?”CT in groups is task orientedMembers learn that most effective way to change dysfunctional emotions and behaviors is to modify inaccurate thinking
79Stress Management Training in Groups Donald MeichenbaumStress inoculation training (SIT) involves:A combination of information giving, Socratic discussion, cognitive restructuring, problem solving, relaxation training, behavior rehearsal, self-monitoring, self-instruction, and self-reinforcementPremise:As a prerequisite to behavior change, clients must notice how they think, feel, and behave, and what impact they have on othersBasic assumption:Distressing emotions and stress are typically the result of maladaptive thoughts
80Stress Inoculation Training (SIT) Three-stage modelConceptual-educational: clients participate in assessment process, goals setting & self-monitoring processSkills acquisition: clients learn & rehearse coping strategies (relaxation training, cognitive restructuring (Beck’s CT), problem solving, time management)Application: transfer & maintenance of change – monitor homework, training is relapse prevention
81Multimodal Group Therapy Arnold LazarusStresses therapeutic flexibility and versatility since each client is uniqueLazarus calls for technical eclecticismDrawing techniques from a variety of theoretical models without embracing any of the modelsMultimodal therapy begins with a comprehensive assessment of all modalitiesEmploys the BASIC I.D. assessment structureLends itself to brief treatment based on assessmentMultimodal therapists operate on premise that breadth is more important than depth
82BASIC I.D.7 areas of personality functioning which must be accounted for in a complete assessment and treatment program:B=BehaviorA=Affective ResponseS=SensationsI=ImagesC=CognitionsI=Interpersonal RelationsD=Drugs, Biological Functions, Nutrition, Exercise
83Principles of Multimodal Therapy Humans act & interact across seven areas of BASIC I.D.These modalities are interconnected & must be treated as an interactive systemAccurate evaluation(diagnosis)is best accomplished by systematically assessing the 7 modalities & their interactionComprehensive approach to treatment involves specific correction of significant problems across the BASIC I.D.
84Multimodal Group Therapy Technical EclecticismDraws on strategies from a variety of approaches without having to embrace any of the diverse theoretical positionsRequires breadth, depth, & specificityThe larger the leader’s repertoire of methods, the more likely it is that therapy will be effective
85Mindfulness and Acceptance Mindfulness and acceptance-based cognitive behavior therapyRepresents the new wave in CBTIn mindfulness practice, clients train themselves to focus on present experienceAcceptance is a process of receiving present experience without judgment, but with curiosity and striving for full awareness of the present momentMajor approaches of this recent development of CBTDialectical behavior therapy: aimed at helping clients to accept their emotions while changing the emotional experienceMindfulness-based stress reduction: meditation, yogaMindfulness-based cognitive therapy: clients suffering from depression become aware of thoughts and feelingsAcceptance and commitment therapy: involves fully accepting present experience and mindfully letting go of obstacles
86Evaluation of Cognitive Behavioral Approaches to Group StrengthsEmphasis on education and preventionResearch exists that determine its efficacyDemonstrated effective for a variety of issues and a variety of individualsWide range of techniquesLimitationsLeaders need a wide repertoire of skillsToo much structure can prevent individuals from meeting their needs