Principles of Counseling and Psychotherapy: Learning the Essential Domains and Nonlinear Thinking of Master Practitioners

Cover
Half Title
Title Page
Copyright Page
Dedication
Table of Contents
Preface to the Third Edition
Acknowledgments
Introduction: Learning to Think Like a Therapist: Characteristics of Expert Therapist Thinking and Why It Is Important ...
	The Problem of the Sorcerer’s Apprentice
	Learning From Experts: Those Who Demonstrate Their Effectiveness
	Are Some Therapists Really Better Than Others?
	How Do Master Clinicians Achieve Mastery?
	Learning to Think Like a Therapist: The Characteristics of Expert Therapist Thinking and Why It Is Important
		Linear Versus Nonlinear Thinking
		Nonlinear Thinking
		Am I a Nonlinear Thinker?
		Expertise and Learning How to Think Like a Practitioner
	How Will This Be Done?: Development of Mastery and Deliberate Practice
		So How Will This Be Accomplished?
		Mental Models, Deliberate Practice, Nonlinear Thinking, and Client Change
	The Purpose of This Book
1 Overview of the State of Psychotherapy and the Domains of Competence
	The Current State of Psychotherapy
		Therapy Is Effective in Helping People With Mental Illness
		Therapy Can Be Effective Quickly and Is a Cost-Effective Treatment
		Despite These Potential Benefits, Therapy Is Often Underutilized
		The Painful Truth: Effective Therapy Is Not Being Provided On a Consistent Basis
	Improving the Process of Learning How to Become an Effective Therapist: Proposed Solutions and Their Limitations
		The Movement Toward Manualization Or Evidence-Based Psychological Practices
		The Search for an Integrated Approach to Therapy
	Convergence of Understanding: Learning and Understanding the Seven Domains of Competence
		What Are Domains?
		What Domains Are Not
		Introducing the Seven Domains of Competence
		A Developmental Model of Therapist Growth: Guiding the Reader Through the Learning Process to Help Speed Understanding …
	Stoltenberg’s Developmental Model
		Integrating Stoltenberg’s Developmental Model With the Seven Domains
	Conclusion
The Level 1 Practitioner Profile
	2 The Domain of Connecting With and Engaging the Client: Listening
		Introduction: The Mob Boss Is Your Client
		Listening
			How Do You Listen in a Linear Way?
				Listening for Content Or Information
				Listening for Feelings
			How to Listen in a Nonlinear Way
				Listening for Congruence (I.e., Correspondence—or Lack of Correspondence—between What Is Said and What Is Meant)
				Listening for Absence (I.e., What Is Not Said—by Silence, Avoidance, Or Information Overload)
				Listening for Presence (Nonverbal Behaviors That Add Meaning)
				Listening for Inference (The Purpose Behind “I Don’t Want ...” Statements)
				Listening for Resistance: The Desire Not to Change
		Possible Meanings Associated With Statements in Deliberate Practice Exercise: Beginning the Use of Nonlinear Thinking
		Answers to Deliberate Practice Exercise: Clinical Nonlinear Listening
		Notes
	3 The Domain of Connecting With and Engaging the Client: Responding
		Introduction
		Linear Responding
			Responding to Content Or Information
			Responding to Feelings
			Advanced Linear Responding
		Nonlinear Responding
			Nonlinear Responding to Incongruence (I.e., “I Hear That There Is More Than One Side to This”)
			Nonlinear Responding to Absence (I.e., “I See What You Are Not Showing Me”)
			Nonlinear Responding to Presence (I.e., “I See What Your Body Is Saying, Even If You Don’t”)
			Nonlinear Responding to Inference (I.e., “I Hear What You Are Not Saying”)
			Nonlinear Responding to Resistance (I.e., “I Understand That You Might Not Be Ready for This”)
		Conclusion
		Answers to the Spoonerism Exercise
		Notes
	4 The Domain of Assessment: Clients’ Symptoms, Stages of Change, Needs, Strengths, and Resources
		Introduction: Every Story Must Have a Beginning, Middle, and an End
		Assessing the Client: Symptoms, Diagnoses, Strengths, and (Untapped) Resources
			Linear Methods of Assessment: Looking for Symptoms and Diagnoses
			The Goal of the Biopsychosocial Interview
			Linear Methods of Assessment: Looking for Strengths and Resources
			Nonlinear Methods of Assessing for Strengths and Resources
				Looking for Unused Or Misused Power
				Symptoms as Solutions: Misused Power
				Other Examples of Misused Power
				Connecting With Untapped Social Supports
		Assessing a Client’s Readiness for Change: The Stages of Change Model
			Precontemplation
			Contemplation
			Preparation for Action
			Action
			Maintenance
			Relapse
		How to Identify a Client’s Stage of Change
			Moving Through the Stages of Change
		Conclusion
		Answer to Nonlinear Thinking Exercise
		Notes
	5 The Domain of Assessment: The Theme Behind a Client’s Narrative, Therapeutic Goals, and Case Conceptualization
		Introduction
		Assessment: The Theme Behind a Client’s Narrative
			Theme of Desperation: “I Have a Problem That I Need to Work On!”
			Theme of Helplessness: The Symptom Is Out of Control (“I Can’t Help Myself”)
			Theme of Hopelessness: “I Have a Chronic Problem”
			Theme of Defensiveness: “Who Or What Is the Problem? (Cause It’s Not Me!)”
			Theme of Exhaustion: Being Overwhelmed (Physically, Emotionally, And/or Psychologically)
			Theme of Despair: The Experience of Loss
			Theme of Fear and Confusion: Double-Binds
		Case Conceptualization
		Therapeutic Goals
		Making Good Therapeutic Goals
		What Happens When Goals Don’t Align?
		Conclusion
		Notes
	6 The Domain of Establishing and Maintaining the Therapeutic Relationship and the Therapeutic Alliance: Demonstrably Effective Elements
		Introduction: The King’s Speech
		Research Findings: The Therapeutic Relationship and the Therapeutic Alliance
		Factors That Contribute to the Therapeutic Relationship
		Selected Findings of the First Task Force (2002)
		Selected Findings of the Second Task Force (2011)
		Selected Findings of the Third Task Force (2019)
		Demonstrably Effective Element of the Therapeutic Relationship: The Therapeutic Alliance
			Positive Affective Bond
			Therapeutic Tasks
			Consensus On Goals
			Research On the Therapeutic Alliance
			Conclusions On the Therapeutic Alliance
		Demonstrably Effective Element of the Therapeutic Relationship: Empathy
			Empathic Rapport
			Communicative Attunement
			Person Empathy
		Demonstrably Effective Elements of the Therapeutic Relationship: Collecting Client Feedback
		Demonstrably Effective Elements of the Therapeutic Relationship: Positive Regard and Affirmation
		Conclusion
		Notes
	7 The Domain of Establishing and Maintaining the Therapeutic Relationship and the Therapeutic Alliance: Probably Effective …
		Introduction
		Probably Effective: Congruence/Genuineness
		Probably Effective: Managing Countertransference
			Countertransference
		Promising Elements of the Therapeutic Relationship (But Insufficient Research to Judge): Ruptures to the Therapeutic Alliance
			Therapeutic Ruptures and Nonlinear Thinking
			Identifying Ruptures to the Therapeutic Alliance
			Repairing Ruptures to the Therapeutic Alliance
		Promising Elements of the Therapeutic Relationship (But Insufficient Research to Judge): Self-Disclosure and Immediacy
		Methods of Adapting the Therapeutic Relationship
		Demonstrably Effective Method of Adapting the Therapeutic Relationship: Cultural Adaptations and Multicultural Competence
		Demonstrably Effective Method of Adapting the Therapeutic Relationship: Religion and Spirituality
		Demonstrably Effective Method of Adapting the Therapeutic Relationship: Patient Preference
		Probably Effective Method of Adapting the Therapeutic Relationship: Reactance Level
			Reactance
			Ethically Maintaining the Therapeutic Relationship
			Boundary and Role Management: Boundaries
			Ethics and Boundaries
			Boundary and Role Management: Multiple Roles
			Flexibility of Boundaries
		What Not to Do in a Therapeutic Relationship
		Conclusion
The Level 2 Practitioner Profile
	8 The Domain of Understanding Clients’ Cognitive Schemas: Foundations
		Introduction: The Shawshank Schema
		What Are Schemas? Where Do They Come From?
			Three General Characteristics of Schemas
			Schemas Help Guide Our Responses to New Experiences
		Personality Development and Core Schema Dynamics
		View of Self
			View of Self and Optimism
			View of Self and the Family of Origin
		View of Others
			View of Others: Positive Or Negative
			View of Others and the Family of Origin
		View of the World and View of Life
			View of Life and the World, and Family of Origin
		Conclusion
		Answers
			Deliberate Practice Exercise: View of Self
			Deliberate Practice Exercise: View of Others
			Deliberate Practice Exercise: View of Life and the World
	9 The Domain of Understanding Clients’ Cognitive Schemas: Assessment and Clinical Conceptualization
		Introduction
		Schema Dynamics and Cognitive Distortions
			Schema Dynamics, Cognitive Distortions, and Psychological Disorders
		Schema Dynamics and the Development of Personality Disorders
		Linear Thinking, Listening, and Responding to Clients’ Schema Dynamics
		Nonlinear Thinking, Listening, and Responding to Clients’ Schema Dynamics
			Rigid Schema Dynamics and Linear and Nonlinear Listening: Absolutes, Dichotomies, Extremes, Polarities, and Exclusionary Thinking
		Elements of Formal Assessment in Understanding Clients’ Schema Dynamics
			Readiness for Change
			Client Resources
			Themes
			Client Goals
		Using the Therapeutic Relationship to Better Understand Clients’ Schema Dynamics
			Therapeutic Alliance
			Therapeutic Ruptures and Client Schemas
		Utilizing Assessment of Clients’ Schema Dynamics
			Using Family-Of-Origin Dynamics to Understand Clients’ Schema Dynamics
			Sibling Position and the Development of Schemas
			Early Childhood Recollections
			Collecting ECRs
		Clinically Working With Clients’ Schema Dynamics
			Assimilation, Accommodation, and Green Eggs and Ham
			Linear Methods of Intervening With Client Schema Dynamics: Facilitating Assimilation
			Assimilation and First-Order Change
			Nonlinear Methods of Intervening With Client Schema Dynamics: Facilitating Accommodation
			Metaphor and Second-Order Change
		Putting the Pieces of the Client’s Story Together: Schema Dynamics, Clinical Formulations, and Case Conceptualization
		Conclusion
		Notes
	10 The Domain of Addressing and Managing Clients’ Emotional States: Basic Understandings
		Introduction: Good Will Hunting and Emotions
			But What Are Emotions?
		Lingering Misperceptions of Emotions
			Emotions Are Weak, Feminine, and to Be Feared
			Catharsis of Emotion as Sufficient for Change
			Emotions Are to Be Avoided, Contained, and Neutralized in Treatment
		Understanding and Differentiating: Expressions of Affect, Internal Feelings, Emotional States and Moods, Primary Emotions, …
			Expressions of Affect
			Internal Feelings
			Emotional States
			Primary Emotions
			Secondary Emotions
			Background Emotions Or Mood
			Emotions, Mood, and Affect
		The Appraisal Process
			Primary Appraisals and Assessment of Threats and Benefits
			Secondary Appraisals and Responses to Threats
			Problem-Focused Versus Emotion-Focused Coping
			The Relationship Between Schemas, Appraisal, Emotions, and Behavior
		The Link Between Common Negative Emotions and Psychological Disorders in Counseling
			The Continuum From Fear to Anxiety
			The Continuum From Sadness to Depression
			The Continuum From Anger to Chronic Impulsivity
		Conclusion
		Answer to Ashley’s Schema Dynamics
		Notes
	11 The Domain of Addressing and Managing Clients’ Emotional States: Managing Emotions in Therapy
		Introduction
		Using Other Domains in Dealing With Clients’ Emotions
			Listening and Responding
				Nonlinear Listening for Expressions of Affect
			The Therapeutic Relationship and Emotions
		Emotion-Focused Therapy Using the Relationship Between Emotions and Schema Dynamics
			EFT: Therapeutically Working With Emotions: Coaching the Therapist’s Approach to Working Successfully With Emotions
			EFT: Therapeutically Working With Emotions: Focusing to Foster Recognition and Reflection of Emotions
			EFT: Therapeutically Working With Emotions: Revelation, Reflecting, and Focusing
		Using Mindfulness to Help Clients Understand and Manage Emotions Therapeutically
			Definition of Mindfulness
			Mindfulness-Based Cognitive Therapy: Basic Mindfulness and Getting Emotional Distance
			Using Elements of Acceptance and Commitment Therapy to Therapeutically Work With Emotions
			Acceptance
			Cognitive Diffusion
			Contact With the Present Moment
			Observing the Self as Context
			Values
			Committed Action
			Using Elements of Dialectical Behavioral Therapy to Therapeutically Work With Emotions
			Mindfulness
			Distress Tolerance
			Emotion Regulation
			Interpersonal Effectiveness
		Conclusion
	12 The Domain of Addressing and Resolving Ambivalence: Understanding and Identifying Client Ambivalence
		Introduction: Odysseus’s Dilemma
		Understanding Clinical Ambivalence
			Definition
			Types of Ambivalence
			What Ambivalent Rats Can Tell Us About Human Behavior
		Our Nonlinear Brain: Ambivalence
		Linear and Nonlinear Views of Ambivalence
		Listening for and Recognizing Ambivalence
			Listening for Congruence
			Listening for Absence
			Listening for Presence
			Listening for Inference
			Listening for Resistance
			Stages of Change and Ambivalence
			What About the Therapeutic Relationship?
			Schema Dynamics and Ambivalence
			Emotions and Emotional Reactions and Ambivalence
		Behavioral Manifestations of Ambivalence
			Flight Into Illness and Flight Into Health
			Secondary Gain
			Double-Binds (Revisited)
		Take-Aways for Practitioners
		Conclusion
		Answer to Buridan’s Bridge Puzzle
		Notes
	13 The Domain of Addressing and Resolving Ambivalence: Working With and Resolving Client Ambivalence
		Introduction: The Kobayashi Maru
		Linear Strategies and Interventions to Manage and Resolve Client Ambivalence
			Resolving Ambivalence: Holding a Mirror Up to a Client
			Awareness, Ambivalence, and Effective Treatment
			Pacing, Reactance, and Nonlinear Thinking
		Nonlinear Approaches: Using Solution-Focused and Narrative Therapy Methods to Help Manage and Resolve Ambivalence
			The Miracle Question
			Scaling Questions
			Externalizing the Problem
		Nonlinear Approaches: Using Motivational Interviewing to Help Manage and Resolve Ambivalence
			OARS: Basic Motivational Interviewing Methods
			Using Reflection and Responses Beyond Reflection to Address Ambivalence
			Rolling With the Resistance
			Developing Discrepancies
			Listening for and Eliciting Change Talk
		Successful Resolution of Ambivalence
		Take-Aways for Practitioners
		Conclusion
		Notes
	14 Summary, Strategies, Tactics and the Level 3 Practitioner
		Nonlinear Thinking and the Domains of Competence Revisited
		So What Is the Point to All This?
		Objectives, Strategies, and Tactics
			Objectives
			Strategies
			Tactics
				Critical Thinking and Clinical Judgment
		Nonlinear Thinking, and Second-Order Change
		A Preview of the Level 3 Practitioner
		The Final Secret: Deliberate Practice and Back to the Sorcerer’s Apprentice
References
Index