UNIT 3- TECHNIQUES OF COUNSELING: A

PSYCHOANALYTIC TECHNIQUE
UNIT - III (24 hours)

A. Techniques of Counseling:

● Psychoanalytic Techniques (Freud)

● Behaviour Therapy
● Person-centered Therapy
● Cognitive Therapy.

UNIT 3- TECHNIQUES OF COUNSELING:

PSYCHOANALYTIC TECHNIQUES

Introduction
● Sigmund Freud, referred to as the father of psychotherapy, developed the traditional
form of psychotherapy known as Classic Psychoanalysis over 100 years ago.
● Freud’s psychoanalytic system is a model of personality development and an approach
to psychotherapy.
● He focused on psychodynamic factors that motivate behavior, wherein he emphasized
on the role of the unconscious, and developed the first therapeutic procedures for
understanding and modifying the structure of one’s basic character.

View of Human Nature/ Theoretical Background

● Freud’s view of human nature is dynamic with the transformation and exchange of
energy within the personality.
● According to him, our behavior is determined by irrational forces, unconscious
motivations, and biological and instinctual drives as these evolve through key
psychosexual stages in the first 6 years of life.

● Instincts are central to the Freudian approach.

● Although he originally used the term libido to refer to sexual energy, he later broadened
it to include the energy of all life instincts. These instincts serve the purpose of the
survival of the individual and the human race; they are oriented toward growth,
development, and creativity. Freud includes all pleasurable acts in his concept of the life
instincts; he sees the goal as gaining pleasure and avoiding pain.
● Freud also postulates death instincts, which account for the aggressive drive. Managing
this aggressive drive is a major challenge to the human race. In Freud’s view, both
sexual and aggressive drives are powerful determinants of why people act as they do.

● Levels of Consciousness
● Freud believed that behavior and personality were derived from the constant and unique
interaction of conflicting psychological forces that operate at three different levels of
awareness: conscious (attuned to an awareness of the outside world), preconscious
(that contains hidden memories or forgotten experiences that can be remembered), and
unconscious (containing the instinctual, repressed, and powerful forces).

● Structure of Personality
● According to the psychoanalytic view, the personality consists of three systems: the id,
the ego, and the superego. The dynamics of personality consist of the ways in which
psychic energy is distributed to the id, ego, and superego.
1. Id comprises amoral basic instincts, which operate according to the pleasure
principle.
2. Ego is the conscious, decision-making “executive of the mind,” which operates
according to the reality principle.
3. Superego is the conscience of the mind that contains the values of parental
figures and that operates according to the moral principle.

The id and the superego are confined to the unconscious; the ego operates
primarily in the conscious but also in the preconscious and unconscious.

● Psychoanalysis is also built on what Freud referred to as psychosexual developmental

stages. Each of the stages focuses on a zone of pleasure that is dominant at a particular
time:
 1. Oral stage, where the mouth is the chief pleasure zone and basic gratification is
from sucking and biting
2. Anal stage, where delight is in either withholding or eliminating feces
3. Phallic stage, where the chief zone of pleasure is the sex organs, and members
of both sexes must work through their sexual desires
4. Latency, where energy is focused on peer activities and personal mastery of
cognitive learning and physical skills
5. Genital stage, where if all has gone well previously, each gender takes more
interest in the other and normal heterosexual patterns of interaction appear.

● Excessive frustration or overindulgence in the first three stages are the main difficulties
that can arise going through these stages, in which case the person could become
fixated (or arrested) at that level of development and/or overly dependent on the use of
immature defense mechanisms (i.e., ways of coping with anxiety on an unconscious
level by denying or distorting reality).
The Therapeutic Process

Goals

1. The goals of psychoanalysis focus mainly on personal adjustment, usually inducing a

reorganization of internal forces within the person.
● In most cases, a primary goal is to help the client become more aware of the
unconscious aspects of their personality and to work through current reactions
that may be dysfunctional.
● Psychoanalysis aims to bring about changes in a person’s personality and
character structure by helping them try to resolve unconscious conflicts within
themselves and develop more satisfactory ways of dealing with their problems.
● Patients should be able to distinguish their own view of reality from real events
that have taken place.
2. A second major goal is to help a client work through a developmental stage not
previously resolved and achieve self-understanding. If accomplished, clients become
unstuck and are able to live more productively.
3. Environmental Adjustment: Another goal of psychoanalysis is helping clients cope with
the demands of the society in which they live. Psychoanalysis stresses environmental
adjustment, especially in the areas of work and intimacy. The focus is on strengthening
the ego so that perceptions and plans become more realistic.
4. Self-understanding: which is achieved through analysis of childhood experiences that
are reconstructed, interpreted, and analyzed. The insight that develops helps bring about
changes in feelings and behaviors. Due to the greater self-understanding, patients
should become more adept at resolving unconscious conflicts within themselves, they
should know themselves better and feel more authentic or real.

Therapist’s Function and Roles

● In classical psychoanalysis, analysts typically assume an anonymous stance, which is
sometimes called the “blank-screen” approach.
○ They engage in very little self-disclosure and maintain a sense of neutrality to
foster a transference relationship, in which their clients will make projections
onto them.
○ If therapists say little about themselves and rarely share their personal reactions,
the assumption is that whatever the client feels toward them will largely be the
product of feelings associated with other significant figures from the past.
○ These projections, which have their origins in unfinished and repressed
situations, are considered “grist for the mill,” and their analysis is the very
essence of therapeutic work.
● One of the central functions of analysis is to help clients acquire the freedom to love,
work, and play.
○ Other functions include assisting clients in achieving self-awareness, honesty,
and more effective personal relationships; and in gaining control over impulsive
and irrational behavior.
○ The analyst listens, learns, and decides when to make appropriate
interpretations. A major function of interpretation is to accelerate the process of
uncovering unconscious material.
● Organizing these therapeutic processes within the context of understanding personality
structure and psychodynamics enables the analyst to formulate the nature of the
client’s problems. One of the central functions of the analyst is to teach clients the
meaning of these processes (through interpretation) so that they are able to achieve
insight into their problems, increase their awareness of ways to change, and thus gain
more control over their lives.
● Whether clients change depends considerably more on their readiness to change than
on the accuracy of the therapist’s interpretations. If the therapist pushes the client too
rapidly or offers ill-timed interpretations, therapy will not be effective. Change occurs
through the process of reworking old patterns so that clients might become freer to act
in new ways.
Relationship Between Therapist and Client

● There are some differences between how the therapeutic relationship is conceptualized by
classical analysis and current relational analysis. The classical analyst stands outside the
relationship, comments on it, and offers insight producing interpretations. In contemporary
relational psychoanalysis, the therapist does not strive for a detached and objective stance.
Instead, the participation of the therapist is a given, and they have an impact on the client and
on the here-and-now interaction that occurs in the therapy context.

● Contemporary psychoanalytic theory and practice highlights the importance of the therapeutic
relationship as a therapeutic factor in bringing about change. Current psychodynamic
therapists view the emotional communication between themselves and their clients as a useful
way to gain information and create connection.

● Transference is the client’s unconscious shifting to the analyst of feelings and fantasies that
are reactions to significant others in the client’s past. Transference involves the unconscious
repetition of the past in the present. The relational model of psychoanalysis regards
transference as being an interactive process between the client and the therapist. A client often
has a variety of feelings and reactions to a therapist, including a mixture of positive and
negative feelings. When these feelings become conscious, clients can understand and resolve
“unfinished business” from these past relationships. In short, the analyst becomes a current
substitute for significant others.

● If therapy is to produce change, the transference relationship must be worked through.

Working through is achieved by repeating interpretations and by exploring forms of resistance.
Clients have many opportunities to see the variety of ways in which their core conflicts and core
defenses are manifested in their daily life.

● The intense therapeutic relationship between the therapist and client is bound to ignite some of
the unconscious conflicts within therapists. Known as countertransference, this phenomenon
occurs when there is an inappropriate effect, when therapists respond in irrational ways, or
when they lose their objectivity in a relationship because their own conflicts are triggered. In a
broader sense, countertransference involves the therapist’s total emotional response to a client.

● It is critical that therapists become aware of the countertransference so that their reactions
toward clients do not interfere with their objectivity. Not all countertransference reactions are
detrimental to therapeutic progress. Indeed, countertransference reactions can provide an
 important means for understanding the world of the client. According to Gelso and Hayes,
countertransference can greatly benefit therapeutic work, if therapists study their internal
reactions and use them to understand their clients. A therapist with a relational perspective
pays attention to his or her countertransference reactions and observations to a particular client
and uses this as a part of therapy.

● The client–therapist relationship is of vital importance in psychoanalytic therapy. As a result of

this relationship, particularly in working through the transference situation, clients acquire
insights into the workings of their unconscious process. Awareness of and insights into
repressed material are the bases of the analytic growth process. Clients come to understand
the association between their past experiences and their current behavior. The psychoanalytic
approach assumes that without this dynamic self-understanding there can be no substantial
personality change or resolution of present conflicts.

Techniques
Psychoanalytic techniques are most often applied within a specific setting. Although each technique
is examined separately here, in practice they are integrated.

1. Free Association:
● This technique involves the client to pay close attention to their thought content and free
themselves from the criticism for the same and essentially just experience and verbalize
these.
● This is because the self-criticism or ego dissolves to reveal the unconscious content that
was unable to surface up to consciousness and thus act as a source of distress. The content of
free association may be bodily sensations, feelings, fantasies, thoughts, memories, recent
events, and the analyst.
● The therapist is supposed to be cognisant of any disruptions in the free-association process that
may indicate that the content is provoking anxiety, even slips of tongue or omitted material are
paid close attention.
● Moreover, the sequence of associations made also provide information to better understand the
connection clients make about certain events. This unconscious content is then interpreted by
the therapist.

2. Dream Analysis:
● Freud believed that dreams were a main avenue to understanding the unconscious, even calling
them “the royal road to the unconscious.” He thought dreams were an attempt to fulfill a
 childhood wish or express unacknowledged sexual desires.
● In dream analysis, clients are encouraged to dream and remember dreams. The counselor is
especially sensitive to two aspects of dreams:
○ the manifest content (obvious meaning) and
○ the latent content (hidden but true meaning).
● The technique of dream work was thus established to help convert the manifest content
which was experienced by the client in the dream, to the latent content which provided the
core hidden meaning behind what the client had experienced as the manifest content.
● The counselor first encourages the patient to free-associate to various aspects of the dream,
and to try and remember feelings evoked by the dream. Then the counselor processes their
associations to help them become aware of the repressed meaning of the material. This helps
them develop new insights.

3. Analysis of Transference:
● In transference, the client projects onto the therapist characteristics of another person, usually a
parent, and reacts to the therapist as though he or she really does possess those
characteristics.
● Transference involves a distortion or misperception of the therapist and is not a direct response
to the way the therapist actually is.
○ The unobserved and neutral psychoanalyst is more likely to elicit transference
reactions than is a therapist who engages in self-disclosure and interacts more actively
with clients.
○ Transference can be positive, negative, or mixed.
○ The analyst encourages this transference and interprets the positive or negative feelings
expressed. The release of feelings is therapeutic, an emotional catharsis. But the real
value of these experiences lies in the client’s increased self-knowledge, which comes
through the counselor’s analysis of the transference. Those who experience
transference and understand what is happening are then freed to move on to another
developmental stage.
● Countertransference has been defined as the moment-to-moment conscious or unconscious
reactions of the analyst to the patient and the content they present.
○ It is usually thought to also present the analyst’s own chronic distortions or internal
attitude towards what the client presents and is thus supposed to be resolved by the
analyst outside the therapy room.
 ○ It helps the therapist to self-analyze in order to provide an appropriate emotional
experience to the client.

4. Analysis of Resistance:
● Freud also discovered that his patients were often quite unwilling or unable to recall the
traumatic memories which he defined as resistance. As his clinical experience expanded,
he found that, in the majority of patients he treated, resistance was not a matter of simply
reluctance to cooperate, but a matter of the operation of active forces in the mind, of which the
patients themselves were often quite unaware, and which tended to maintain the exclusion from
consciousness of painful or distressing material. Freud described this active force that
worked to exclude particular mental contents from conscious awareness as repression.
● During the course of analysis or therapy, patients may resist the analytical process, usually
unconsciously, by a number of different means:
○ being late for appointments, forgetting appointments, or losing interest in therapy.
○ During the counseling hour, they may have trouble recalling or free-associating.
○ Outside of counseling, resistance is often manifested by carrying out other issues, such
as binge drinking or having extramarital affairs.

● A counselor’s analysis of resistance can help clients gain insight into it as well as other
behaviors. If resistance is not dealt with, the therapeutic process will probably come to a halt.

5. Interpretation:
● Interpretation is the verbal communication by the analyst of an hypothesis regarding an
unconscious conflict of the client that mostly emerges from the patient’s communication in the
therapeutic process.

● Interpretation should be considered part of the techniques we have already examined and
complementary to them. When interpreting, the counselor helps the client understand the
meaning of past and present personal events. Interpretation encompasses explanations and
analysis of a client’s thoughts, feelings, and actions. The patient’s readiness to accept the material
and incorporate it into his own view of himself is a significant consideration. If the interpretation is
too deep, the patient may not be able to accept it and bring it into conscious awareness.

● Interpretations may take the following forms:

 a) clarification, by which the analyst attempts to clarify what is consciously going on in the
patient’s mind;

b) confrontation, that is, tactful bringing into awareness nonverbal aspects of the patient’s
behavior; and

c) interpretation proper, the analyst’s proposed hypothesis of the unconscious meaning that
relates all these aspects of the patient’s communication to each other.

● Once this is accomplished, individuals could gain insight to work through previously repressed
material and make connections to their current difficulties, leading to positive change.

Strengths and Contributions

1. The approach emphasizes the importance of sexuality and the unconscious in human behavior.
Before this theory came into being, sexuality (especially childhood sexuality) was denied, and little
attention was paid to unconscious forces.
2. The approach lends itself to empirical studies; it is heuristic. Freud’s proposals have generated a
tremendous amount of research.
3. The approach provides a theoretical base of support for a number of diagnostic instruments.
Some psychological tests, such as the Thematic Apperception Test or the Rorschach Ink Blots,
are rooted in psychoanalytic theory.
4. Psychoanalysis continues to evolve and most recently has emphasized adaptive processes and
social relations.
5. The approach appears to be effective for those who suffer from a wide variety of disorders,
including hysteria, narcissism, obsessive-compulsive reactions, character disorders, anxiety,
phobias, and sexual difficulties.
6. The approach stresses the importance of developmental growth stages.

Limitations
1. The classical psychoanalytic approach is time-consuming and expensive. A person who
undergoes psychoanalysis is usually seen three to five times a week over a period of years.
2. The approach does not seem to lend itself to working with older clients or even a large variety of
clients. “Patients benefiting most from analysis” are mainly “middle-aged men and women
oppressed by a sense of futility and searching for meaning in life”.
3. The approach has been claimed almost exclusively by psychiatry, despite Freud’s wishes.
Counselors and psychologists without medical degrees have had a difficult time getting extensive
 training in psychoanalysis.
4. The approach is based on many concepts that are not easily communicated or understood—
the id, ego, and superego, for instance. Psychoanalytical terminology seems overly complicated.
5. The approach is deterministic. Freud was criticized for attributing too much to biological forces
within the person. These critics attributed more influence on personality development to various
factors: environmental, especially social, influences; innate strivings to actualize all of one’s
potential; one’s own creativity; even spiritual factors.
6. For instance, Freud attributed certain limitations in women to be a result of gender—that is, of
being female
HUMANISTIC TECHNIQUES

Introduction

The term humanistic, focuses on the potential of individuals to actively choose and purposefully
decide about matters related to themselves and their environments. Professionals who embrace
humanistic counseling approaches help people increase self-understanding through experiencing their
feelings. The term is broad and encompasses counseling theories that are focused on people as
decision makers and initiators of their own growth and development.

The humanistic school of psychology began in the 1950s and its major figures include Carl Rogers
(1961) and Abraham Maslow (1970). Humanistic psychologists wanted a psychology that focused on
healthy, rational, higher motivations.

The approach has two common elements:

● Behaviour is understood in terms of the subjective experience of the individual: the

phenomenological perspective. This accepts the subjective experience of the individual as a
valid source of information about their values, motives and the meaning of their behaviour.
● Behaviour is not constrained by either past experiences or current circumstances. The individual
has ‘free will’ and makes behavioural choices independent of past learning history or the
unconscious influence of innate drives. This perspective is concerned with processes such as
love, hope, creativity, values, meaning, personal growth, and self-fulfillment. Certain underlying
themes and principles of humanistic psychology can be identified, including the self as a
unifying theme and a focus on values and personal growth. In using the concept of self as a
unifying theme, humanistic psychologists emphasize the importance of individuality. Carl
Rogers developed the most systematic formulation of the self-concept in a series of propositions
which may be summarized as follows:
○ Each individual exists in a private world of experience in which the I, me, or myself
is the center.
○ The most basic striving of an individual is toward the maintenance, enhancement, and
actualization of the self, and his or her inner tendencies are toward health and
wholeness under normal conditions.
○ Perceived threat to the self is followed by a defence, including a tightening of
perception and behavior and the introduction of self-defense mechanisms.
Humanistic psychologists emphasize that values and the process of choice are key in guiding our
behavior and achieving meaningful and fulfilling lives. Development of values and a sense of own
identity based on personal experiences rather than blindly accepting the values of others can help
become self-actualizing, meaning that we are achieving our full potential. According to this view,
psychopathology is essentially the blocking or distortion of personal growth and the natural tendency
toward physical and mental health.

Person Centered Approach

Person-centered therapy, also known as person-centered or client-centered counselling, is a

humanistic approach that deals with the ways in which individuals perceive themselves
consciously, rather than how a counsellor can interpret their unconscious thoughts or ideas.
Created in the 1950s by psychologist Carl Rogers, the person-centered approach ultimately sees
human beings as having an innate tendency to develop towards their full potential. However, this ability
can become blocked or distorted by certain life experiences, particularly those experiences which affect
our sense of value.

The therapist in this approach works to understand an individual’s experience from their perspective.
The therapist must positively value the client as a person in all aspects of their humanity while aiming to
be open and genuine. This is vital in helping the client feel accepted, and better able to understand their
own feelings. The approach can help the client to reconnect with their inner values and sense of self-
worth, thus enabling them to find their own way to move forward and progress.

The Therapeutic Process

Goals of Counselling

The person-centered approach aims toward the client achieving a greater degree of independence
and integration. Its focus is on the person, not on the person’s presenting problem. Rogers (1977) did
not believe the aim of therapy was to solve problems. Rather, it was to assist clients in their growth
process so clients could better cope with their current and future problems.

The therapist aims to provide an environment in which the individual can identify their own life goals
and how they wish to determine them: to place them on the pathway to self-actualization. This is done
by creating a non-judgmental and free setting in which the individual is able to explore new ways of
being. Person-centered therapists are in agreement on the matter of not setting goals for what clients
need to change, yet they differ on the matter of how to best help clients achieve their own goals.
Rogers (1961) described people who are becoming increasingly actualized as having (1) an openness
to experience, (2) a trust in themselves, (3) an internal source of evaluation, and (4) a willingness to
continue growing. Encouraging these characteristics is the basic goal of person-centered therapy.

Role of the Counsellor

● The counselor’s role is a holistic one. In person-centered therapy, the attitude of the therapists,
rather than their knowledge, theories, or techniques, facilitate personality change in the client.
The therapist thus uses themselves as an instrument of change.
● When they encounter the client on a person-to-person level, their “role” is to be without
roles. They do not get lost in a professional role.
● It is the therapist’s attitude and belief in the inner resources of the client that create the
therapeutic climate for growth. The therapy atmosphere focuses on the counselor–client
relationship, which Rogers describes as one with a special “I-Thou” personal quality.
● Instead of viewing clients in preconceived diagnostic categories, the therapist meets them on a
moment-to-moment experiential basis and enters their world. Neither the client nor the
counselor knows what direction the sessions will take or what goals will emerge in the process.
● The client is a person in process who is “entitled to direct his or her own therapy”. Thus, the
counselor trusts the client to develop an agenda on which he or she wishes to work.
● The counselor’s job is to work as a facilitator rather than a director. In the person-centered
approach, the counselor is the process expert and expert learner (of the client).
● The therapist’s function is to be present and accessible to clients and to focus on their
immediate experience.
● The counselor is aware of the client’s verbal and nonverbal language, and the counselor reflects
back what he or she is hearing or observing. By being congruent, accepting, and empathic, the
therapist is a catalyst for change.
● Through the therapist’s attitude of genuine caring, respect, acceptance, support, and
understanding, clients get the necessary freedom to explore areas of their life that were either
denied awareness or distorted.

Client’s Experience in Therapy

● Therapeutic change depends on clients’ perceptions both of their own experience in therapy
and of the counselor’s basic attitudes. If the counselor creates a climate conducive to self-
exploration, clients have the opportunity to explore the full range of their experience,
which includes their feelings, beliefs, behavior, and worldview.
 ● Clients come to the counselor in a state of incongruence. One reason that clients seek therapy
is a feeling of basic helplessness, powerlessness, and an inability to make decisions or
effectively direct their own lives. They may hope to find “the way” through the guidance of the
therapist.
● Within the person-centered framework, however, clients soon learn that they can be responsible
for themselves in the relationship and that they can learn to be freer by using the relationship to
gain greater self-understanding.
● As counseling progresses, clients are able to explore a wider range of beliefs and feelings. As
clients feel understood and accepted, they become less defensive and become more open to
their experience.
● Because they feel safer and are less vulnerable, they become more realistic, perceive others
with greater accuracy, and become better able to understand and accept others.
● Individuals in therapy come to appreciate themselves more as they are, and their behavior
shows more flexibility and creativity.
● They move in the direction of being more in contact with what they are experiencing at the
present moment, less bound by the past, less determined, freer to make decisions, and
increasingly trusting in themselves to manage their own lives.
● With increased freedom, they tend to become more mature psychologically and more
actualized.

The philosophy of person-centered therapy is grounded on the assumption that it is clients who heal
themselves, who create their own self-growth, and who are the primary agents of change. The therapy
relationship provides a supportive structure within which clients’ self-healing capacities are activated.

Relationship between Therapist and Client

Rogers (1957) based his hypothesis of the “necessary and sufficient conditions for therapeutic
personality change” on the quality of the relationship. Rogers (1967) hypothesized further that
“significant positive personality change does not occur except in a relationship”. Rogers’s hypothesis
was formulated on the basis of many years of his professional experience, and it remains basically
unchanged to this day. This hypothesis is stated:

1. Two persons are in psychological contact.

2. The first, whom we shall term the client, is in a state of incongruence, being vulnerable or
anxious.
3. The second person, whom we term the therapist, is congruent (real or genuine) in the
 relationship.
4. The therapist experiences unconditional positive regard for the client.
5. The therapist experiences an empathic understanding of the client’s internal frame of
reference and endeavors to communicate this experience to the client.
6. The communication to the client of the therapist’s empathic understanding and unconditional
positive regard is to a minimal degree achieved. If the therapeutic core conditions exist over
some period of time, constructive personality change will occur. The core conditions do
not vary according to client type.

Further, they are both necessary and sufficient for therapeutic change to occur. From Rogers’s
perspective the client–therapist relationship is characterized by equality. As clients experience the
therapist listening in an accepting way to them, they gradually learn how to listen acceptingly to
themselves. This approach is perhaps best characterized as a way of being and as a shared journey in
which therapist and client reveal their humanness and participate in a growth experience. This means
that therapists are invested in broadening their own life experiences and are willing to do what it takes
to deepen their self-knowledge.

The core therapist conditions of empathy, unconditional positive regard, and congruence have
been subsequently embraced by many therapeutic schools as essential in facilitating therapeutic
change. These core qualities of therapists, along with the therapist’s presence, work holistically to
create a safe environment for learning to occur.

Techniques

For person-centered therapists, the quality of the counseling relationship is much more important than
techniques. Rogers (1957) believed there are three necessary and sufficient (i.e., core) conditions of
counseling:
1. empathy,
2. unconditional positive regard (acceptance, prizing), and
3. congruence (genuineness, openness, authenticity, transparency).

Empathy may be subjective, interpersonal, or objective. “Subjective empathy enables a counselor to

momentarily experience what it is like to be a client, interpersonal empathy relates to understanding a
client’s phenomenological experience, and objective empathy uses reputable knowledge sources
outside of a client’s frame of reference”.

In therapeutic situations, empathy is primarily the counselor’s ability to feel with clients and convey this
understanding back to them. This may be done in multiple ways but, essentially, empathy is an attempt
to think with, rather than for or about, the client and to grasp the client’s communications, intentions,
and meanings.

Unconditional positive regard, also known as acceptance, is a deep and genuine caring for the client
as a person—that is, prizing the person just for being (Rogers, 1961, 1980). Therapists value and
warmly accept clients without placing stipulations on their acceptance; communicate that clients are
free to have feelings and experiences. Acceptance is the recognition of clients’ rights to have their own
beliefs and feelings; not the approval of all behavior. The greater the degree of caring, accepting, and
valuing the client in a non-possessive way, the greater the chance that therapy will be successful.

Congruence is the condition of being transparent in the therapeutic relationship by giving up roles and
facades). Implies that therapists are real, genuine, integrated, and authentic during the therapy. They
are without a false front, their inner experience and outer expression of that experience match, and they
can openly express feelings, thoughts, reactions, and attitudes that are present in the relationship with
the client. Person-centered therapy stresses that counseling will be inhibited if the counselor feels one
way about the client but acts in a different way. Rogers’s concept of congruence does not imply that
only a fully self-actualized therapist can be effective in counseling. If therapists are congruent in their
relationships with clients, however, trust will be generated and the process of therapy will get under
way. Congruence exists on a continuum rather than on an all-or-nothing basis, as is true of all three
characteristics.

Strengths and Contributions

● The approach revolutionized the counseling profession by linking counseling with
psychotherapy and demystifying it by making audiotapes of actual sessions and publishing
actual transcripts of counseling sessions.
● It is applicable to a wide range of human problems, including institutional changes, labour–
management relationships, leadership development, career decision making, and international
diplomacy.
● It has generated extensive research. It initially set the standard for doing research on counseling
variables, especially those that Rogers deemed “necessary and sufficient” to bring about
therapeutic change.
● The approach is effective in a number of settings. It is appropriate in treating mild to moderate
anxiety states, adjustment disorders, and conditions not attributable to mental disorders, such
as uncomplicated bereavement or interpersonal relations.
 ● It focuses on the open and accepting relationship established by counselors and clients and the
short-term nature of the helping process.
● The basics of the approach take a relatively short time to learn. Furthermore, it is the basis for
several new and emerging approaches to treatment, and it is frequently combined with other
theoretical orientations to counseling.
● The approach has a positive view of human nature and it continues to evolve.

Limitations
● The approach may be too simplistic, optimistic, leisurely, and unfocused for clients in crisis or
who need more structure and direction.
● It has limited applicability and is seldom employed with the severely disabled or young children.
● The approach ignores diagnosis, the unconscious, developmental theories, and innately
generated sexual and aggressive drives.
● The approach deals only with surface issues and does not challenge the client to explore
deeper areas.
● Because person-centered counseling is short term, it may not make a permanent impact on the
person.
● The approach is more attitudinal than technique-based. It is void of specific techniques to bring
about client change
BEHAVIOURAL TECHNIQUES

Introduction
● Counselors who take a behavioral approach seek to help clients learn new, appropriate ways
of acting, or help them modify or eliminate excessive actions. In such cases, adaptive
behaviors replace those that were maladaptive, and the counselor functions as a learning
specialist for the client.
● Behavior therapists have been able to apply basic principles such as reinforcement,
extinction, shaping of behavior, and modeling to help clients.
● Behavior therapy focuses on observable behaviors rather than the unconscious; on the
present rather than the past; and on short-term treatment, clear goals, and rapid change.
● There are 4 models of behavioral approach used in learning.
1. Emotional learning model based on Pavlov's classical conditioning.
2. Reinforcement learning model based on skinner's operant conditioning.
3. Social learning model based on Bandura's Modeling.
4. Cognitive behavioral model based on Ellis's, Beck's and others self-management.

View of Human Nature

1. Although genetics play a role, individual differences are derived primarily from different
experiences.
2. Human personality is not composed of traits.
3. An assumption that all behavior is learned, whether adaptive or maladaptive. Behavior is
learned and acquired largely through modeling, conditioning, and reinforcement.
4. Behavior therapy seeks to understand and change behavior. A concentration on processes
closely associated with overt behavior (except for cognitive–behaviorists).
5. Therapy should be based on the scientific method and be systematic, empirical, and
experimental.
6. A focus on setting up well-defined therapy goals with their clients. Goals should be stated in
behavioral, specific, and measurable terms, with progress assessed regularly.
7. The focus of treatment should generally be on the present. Even if behaviors are long-standing,
they are maintained by factors in the current environment.
8. Behaviors must be viewed in the context in which they occur.
9. A client’s environment can be manipulated to increase appropriate behaviors and decrease
harmful behaviors.
 10. Education—promoting new learning and transfer of learning—is an important aspect of
behavior therapy. A belief that learning can be effective in changing maladaptive behavior.
11. People need to take an active part in their treatment to successfully change their behaviors.
Clients have primary responsibility for defining their goals and completing homework tasks. The
treatment plan is formulated collaboratively, with both client and clinician participating actively in
that process.

The Therapeutic Process:

GOALS
1. The general goals of behavior therapy are to increase personal choice and to create new
conditions for learning.
2. The focus is on modifying or eliminating the maladaptive behaviors that clients display,
while helping them acquire healthy, constructive ways of acting. Just to eliminate a behavior is
not enough; unproductive actions must be replaced with productive ways of responding.
3. A major step in the behavioral approach is for counselors and clients to reach mutually agreed-
on goals. The client, with the help of the therapist, defines specific treatment goals at the outset
of the therapeutic process. Goals must be clear, concrete, understood, and agreed on by the
client and the counselor.
● Although assessment and treatment occur together, a formal assessment takes place
prior to treatment to determine behaviors that are targets of change. Continual
assessment throughout therapy determines the degree to which identified goals are
being met.
● Contemporary behavior therapy stresses clients’ active role in deciding about their
treatment.

ROLE OF THE THERAPIST

1. Behaviorally oriented practitioners tend to be active and directive and function as consultants
and problem solvers.

2. A large part of the therapist’s role is to teach concrete skills through the provision of
instructions, modeling, and performance feedback. In the process, the counselor functions as a
consultant, teacher, adviser, reinforcer, and facilitator. They may even instruct, supervise or
support people in the client’s environment who are assisting in the change process.
 3. Behavior therapists conduct a thorough functional assessment (or behavioral analysis) to
identify the maintaining conditions by systematically gathering information about situational
antecedents, the dimensions of the problem behavior, and the consequences of the problem.
This is known as the ABC model, which addresses antecedents, behaviors, and consequences. This
model of behavior suggests that behavior (B) is influenced by some particular events that precede it,
called antecedents (A), and by certain events that follow it called consequences (C).

THERAPEUTIC RELATIONSHIP
1. Most behavioral practitioners stress the value of establishing a collaborative working
relationship emphasizing flexibility and versatility.

2. Most behavioral practitioners contend that factors such as warmth, empathy, authenticity,
permissiveness, and acceptance are necessary, but not sufficient, for behavior change to
occur. Behavior therapists assume that clients make progress primarily because of the specific
behavioral techniques used rather than because of the relationship with the therapist.

3. A cornerstone of behavior therapy is identifying specific goals at the outset of the therapeutic
process. Although the client generally determines what behavior will be changed, the therapist
typically determines how this behavior can best be modified.

EXPERIENCE OF THE CLIENT

1. Behavioral therapy provides clients with a well-defined system of procedures to use. Both
therapist and client play an active role in this mode of therapy. The therapist teaches the client
skills and the client engages in behavioral rehearsal with feedback until skills are well learned
and generally receives active homework assignments.

2. The client plays a huge role in therapy where they must be motivated to change, work on
themselves and cooperate with the therapist both in therapy and in real life. This is essential for
change.

3. It is only when the transfer of changes is made from the sessions to everyday life and
when the effects of therapy are extended beyond termination that treatment can be considered
successful. It is clear that clients are expected to do more than merely gather insights; they
have to be willing to make changes and to continue implementing new behavior once formal
treatment has ended.
 TECHNIQUES
A strength of the behavioral approaches is the development of specific therapeutic procedures that
must be shown to be effective through objective means. The results of behavioral interventions become
clear because therapists receive continual direct feedback from their clients. A hallmark of the
behavioral approaches is that the therapeutic techniques are empirically supported and evidence-
based practice is highly valued.

1. Activity scheduling.
● Planning activities that are rewarding and provide a sense of accomplishment can help people
in many ways.
● Having a schedule provides focus and direction, which can counteract inertia, confusion, and
problems in decision making.
● It can limit excessive sleeping or television watching and prevent isolation. It increases optimism
and reduces depression by helping people realize that they can enjoy their lives and have
successes.
● For example, a person who is overwhelmed by a recent job loss can benefit from preparing a
realistic schedule of activities to find another job. The schedule should list the activities, when
they will be performed, and how much time will be spent on each task.

2. Aversion Therapy.
● Sometimes linking undesirable behaviors with negative experiences motivates change.
● Based on classical conditioning principles, it is effective when a client has had strong
positive association to something, the pursuit of which has brought about negative
consequences for the client, aversion therapy can help the client develop a negative
association to that thing. e.g. addictions to alcohol, cigarettes, drugs etc.
● The counselor and the client use an aversive unconditioned stimulus and unconditioned
response, such as discomfort from a painful but not harmful electric shock.
● The client experiences the aversive reaction (unconditioned response) while they attend
to the conditioned stimulus for example, seeing, smelling and smoking a cigarette.
● After repeated trials, whenever they encounter the conditioned stimulus in reality or in
imagery, they experience the aversive reaction (conditioned response).

3. Behavioral rehearsal.
- This strategy gives people an opportunity to practice a challenging task.
 - The rehearsal might involve a role-play with the clinician or a practice session with a
friend.
- Tape-recording the rehearsal or observing oneself in the mirror while practicing the
desired behavior offers opportunities for feedback and improvement.
- For example, improving social skills— by practicing ways to initiate and maintain
conversations or invite other people to join them in social activities.

4. Biofeedback.
- Biofeedback involves the use of instruments that monitor bodily functions such as heart
rate, sweat gland activity, skin temperature, and pulse rate and give people feedback on
those functions via a sound or light.
- Biofeedback can promote reductions in tension and anxiety and increased relaxation. It
also can have physical and medical benefits such as lowering blood pressure and
improving pain control.

5. Modeling.

- Modeling as a therapeutic technique occurs when a client observes the behavior of

another person and makes use of that observation.
- Learning how the model performs the behavior and what happens to the model as a
consequence of learning the behavior are both a part of the technique.
- In behavior therapy, the five basic functions of modelling (Spiegler & Guevremont, 2010)
are teaching, prompting, motivating by reinforcing behavior, reducing anxiety as a result,
and discouraging maladaptive behaviour. (smoking as an example)

6. Reinforcements
- Reinforcement is a stimulus that maintains or increases the probability or
frequency of occurrence of the behavior exhibited immediately before the presentation
of the stimulus. It may be positive or negative.
- Positive reinforcement is the presentation of stimulus which increases the likelihood of
occurrence of the behaviour in future (for example food or praise from the parents).
- Negative reinforcement is the removal of stimulus which increases the likelihood of
occurrence of the behavior in future (e.g. The removed stimulus is often painful and
noxious aspects like removal of electric shock).
- Reinforcements and rewards encourage behavior change, enhance learning, and solidify
gains. Reinforcements should be carefully selected and planned; they should be
 meaningful and worthwhile to the person so that they are motivating and should be
realistic and reasonable. For example, giving a child a video game for cleaning his room
once is not realistic, but setting aside $3 toward the purchase of a video game each
week the child cleans his room 5 out of 7 days probably is.
- Reinforcers are actual items, events or responses that are pleasurable and rewarding.
Reinforcer can be classified in various ways: Primary reinforcers (which are essential for
life like food, drink etc.), Secondary reinforcer (which act like reinforcer because of
pairing with a primary reinforcer like money, tokes etc) and Social reinforcers (events
which have significance at the emotional level like a smile, praise etc).
- These reinforcers can be presented in a variety of ways: may be based on a
contingency, immediately or later after the desired behaviour, consistently or
sporadically after every desired behaviour, in varying amounts and clarity.

7. Token economies.
- Particularly useful in group settings such as schools, day treatment programs,
hospitals, prisons, and even families
- Behavioral rules or guidelines first must be established and then understood and learned
by all participants. These guidelines are generally written out and posted to maintain
awareness.
- Then a system of rapidly identifying and recording each person’s performance of the
desired behaviors is developed.
- Finally, a system of rewards is developed. The rewards should be clear, realistic, and
meaningful to the participants and be given in ways that are fair and consistent.
- In a typical token economy, the stars, points, or poker chips are used like trading stamps
to earn privileges. For example, 2 points might be exchanged for television time or a
telephone call, 5 points might merit a trip to the movies, and 15 points might be
exchanged for a new CD.

- Opportunities should be provided for frequent redemption of rewards to provide

reinforcement. In addition, social reinforcement (praise, appropriate physical affection)
should be paired with the material rewards to develop intrinsic motivation and
internalization of the desired behaviors. Generalization of the behaviors outside of the
therapeutic setting promotes their establishment.

8. Relaxation
 ● Relaxation is often combined with other techniques such as systematic desensitization,
abdominal breathing, hypnosis, and visual imagery.
● Teaching relaxation strategies in a treatment session and encouraging practice between
sessions can facilitate people’s efforts to reduce stress and anxiety and make
behavioral changes.
● Several well-established relaxation strategies are available,
○ including progressive muscle relaxation (sequentially tensing and relaxing
each muscle group in the body);
○ a body scan (each part of the body is systematically assessed and relaxed); and
○ simple exercises such as head rolls, shoulder shrugs, and shaking one’s body
until it feels loose and relaxed.

9. Shaping.
● This technique is used to effect a gradual change in behaviors.
● People make successive approximations of desired behaviors, eventually leading to new
patterns of behavior.
● For example, a person with social anxiety may first enter a social engagement (not
making conversation), then greet at least two people, then stay in a social engagement
for longer and ask people questions, finally, may spend more time.

10. Assertiveness Training.

● Assertiveness training groups are designed for those who have difficulty in asking for
what they want or who have difficulty in expressing negative feelings, such as
anger and disagreement.
● Important goals of assertiveness training are-
○ One of the first goals, learning how to identify and discriminate among assertive, aggressive, and
passive behaviors, is addressed through teaching the differences between these behaviors through
demonstration or role play.
○ Another goal is to teach individuals that they have the right to express themselves while at the same
time respecting the rights of others.
○ A key goal is to learn assertiveness skills, which are demonstrated, practiced, and tried out in real
situations.
● Assertiveness training can be applied to a variety of concerns, such as working with
cultural issues and with women’s sexual issues.
11. Contingency Contracts
Contingency contracts spell out-
● the behaviors to be performed, changed, or discontinued;
● the rewards associated with the achievement of these goals; and
● the conditions under which rewards are to be received.

12. Systematic Desensitization

● Developed by Joseph Wolpe (1958), systematic desensitization was designed to treat
patients who presented with extreme anxiety or fear toward specific events, people,
or objects, or had generalized fears.
● The basic approach is to have clients replace their anxious feelings with relaxation.
1. The first step is to teach the client relaxation responses that compete with and replace anxiety.
2. Second, the events that make the client anxious are assessed and arranged by degrees of anxiety,
called anxiety hierarchies.
3. The third step of desensitization is to have the client imagine anxiety-evoking situations while being
relaxed.
● Repeated in a gradual manner, so that relaxation is paired with thoughts of events that
had previously evoked anxiety, the client is systematically desensitized to situations that
had previously created anxiety.
● For Example: A child is experiencing fear of crossing the road. For a few days the
mother can take the child to the road & just stand & talk about other things. Then, after
2-3 days mother & child cross the road while they are talking. This may reduce the
anxiety in a child as they cross the road in a relaxed manner.
● Therapy is very useful for clients who have developed certain fears, specially to
domestic animals, like dogs. Some therapists have used pleasant thoughts as a
substitute for deep muscle relaxation.

13. Implosive (Flooding) Therapy.

● In flooding, people are exposed to high doses of a feared stimulus in the
expectation that this will desensitize them to the feared stimulus. An example is
putting a person with a fear of balloons in a room full of balloons.
○ In imaginal flooding, the client is exposed to the mental image of a frightening
or anxiety-producing object or event and continues to experience the image of
the event until the anxiety gradually diminishes.
 The exposure is not to the actual situation but to an image of a frightening
situation such as being mugged or being in an airplane.
○ The basic procedure in imaginary flooding is to develop scenes that frighten or
induce anxiety in the client and then have the client imagine the scene fully and
indicate the Subjective Units Discomfort (SUD). With continual exposure, the
SUDs should be reduced to a point where discomfort is no longer experienced.
○ Often relaxation exercises are practiced before flooding to make the imagery
more real and, after the flooding, to return to a low level of anxiety.
● Another imaginal flooding approach is implosive therapy, developed by Thomas
Stampfl (1966). In implosive therapy, the scenes are exaggerated rather than realistic,
and hypotheses are made about stimuli in the scene that may cause the fear or anxiety.
● Imaginal flooding (including implosive therapy) is not widely used for the high level of
anxiety the client is exposed to will not be reduced. Also, flooding and implosive
therapies can be quite unpleasant for clients, who must re-experience anxiety.

14. Chaining- Complex behaviours can be taught to a child by breaking it down into small and simple
steps. Each step is taught separately and sequentially until the whole behaviour is learned. There are
two types of chaining: Forward chaining (starting from the first step sequentially) and Backward
chaining (last step is taught first, then till the first step)
15. Extinction- Extinction involves withdrawing the payoff of an undesirable behavior in hopes of reducing
or eliminating it. Coaching the parents to pay attention to positive behavior and ignore misbehavior as
much as possible is likely to reduce negative behavior.

Strengths
1. Behavior therapy is diverse with respect to basic concepts and techniques that can be applied
in coping with specific problems with a diverse range of clients
2. An advantage that behavior therapists have is the wide variety of specific behavioral
techniques at their disposal. Because behavior therapy stresses doing, as opposed to merely
talking about problems and gathering insights, practitioners use many behavioral strategies to
assist clients in formulating a plan of action for changing behavior.
3. It emphasizes research into and assessment of treatment outcomes. It is up to practitioners
to demonstrate that therapy is working. If progress is not being made, therapists look carefully at
the original analysis and treatment plan.
 4. Deals directly with symptoms. Because most clients seek help for specific problems,
counselors who work directly with symptoms are often able to assist clients immediately.
5. Focuses on the present. A client does not have to examine the past to obtain help in the
present.
6. A behavioral approach saves both time and money.
7. Based on learning theory, which is a well-formulated way of documenting how new behaviors
are acquired.
8. The approach is objective in defining and dealing with problems and demystifies the
process of counseling.

Limitations
1. The approach is also sometimes applied mechanically, and has been best demonstrated under
controlled conditions that differ significantly from the natural conditions.
2. Clients are not encouraged to experience their emotions. In concentrating on how clients are
behaving or thinking, some behavior therapists tend to play down the working through of
emotional issues.
3. Behavior therapy ignores the important relational factors in therapy and just treats the
behaviour not the human as a whole. Critics contend that many behaviorists have taken the
person out of personality
4. Behavior therapy does not provide insight.
5. Behavior therapy treats symptoms rather than causes.
6. Unlike other approaches, this approach does not take into account the history or
developmental stages of patients.
7. Behavior therapy involves control and manipulation by the therapist.
8. The approach programs the client toward minimum or tolerable levels of behaving,
reinforces conformity, stifles creativity, and ignores client needs for self-fulfillment, self-
actualization, and feelings of self-worth.
9. A future challenge for behavior therapists is to develop empirically based recommendations
for how behavior therapy can optimally serve culturally diverse clients. Instead of viewing
clients in the context of their sociocultural environment, these practitioners concentrate too
much on problems within the individual. In doing so they may overlook significant issues in the
lives of clients.
COGNITIVE TECHNIQUES

INTRODUCTION
Cognitions are thoughts, beliefs, and internal images that people have about events in their lives.
Cognitive counseling theories focus on mental processes and their influences on mental health and
behavior. A common premise of all cognitive approaches is that how people think largely determines
how they feel and behave.
The cognitive behavior therapies, which combine both cognitive and behavioral principles and
methods in a short-term treatment approach, have generated more empirical research than any other
psychotherapy model.

Attributes of cognitive approach:

1. a collaborative relationship between client and therapist,
2. the premise that psychological distress is largely a function of disturbances in cognitive
processes,
3. a focus on changing cognitions to produce desired changes in affect and behavior,
4. a present-centered,
5. time-limited focus,
6. an active and directive stance by the therapist, and
7. an educational treatment focusing on specific and structured target problems.

In addition, both cognitive therapy and the cognitive behavioral therapies are based on a structured
psychoeducational model, emphasize the role of homework, place responsibility on the client to
assume an active role both during and outside therapy sessions, emphasize developing a strong
therapeutic alliance, and draw from a variety of cognitive and behavioral strategies to bring about
change.

ALBERT ELLIS’ RATIONAL EMOTIVE BEHAVIOR THERAPY

INTRODUCTION:
REB is a cognitive behaviour approach that emphasises thinking, judgement, decision-making,
analysis, and doing.

The basic assumption of REBT is that-

1) People contribute to their own psychological problems and specific symptoms by their
rigid beliefs about events and situations.
 2) REBT is based on the assumption that cognitions, emotions, and behaviours interact
significantly and have a reciprocal cause-and-effect relationship.

THE ABC FRAMEWORK:

It is a useful tool for understanding the client's feelings, thoughts, events, and behaviour.

● A is the existence of a fact/an activating event/inference about an event

● B is the person's belief about A
● C is the emotional and behavioural consequence or reaction of the individual which can
either be healthy or unhealthy.
● A (the activating event) does not cause C (the emotional consequence). Instead, B (the
person’s belief about A) largely creates C.

● Further, dispute or debate (D) involves exploring beliefs and their consequences to determine
whether they are rational or irrational.
● The fifth step, E (Effect) aims to produce effective rational beliefs and philosophy.
● The final step, F, represents the new feelings and behaviors resulting from effective rational
beliefs.

Cognitive restructuring: It is a key technique in cognitive therapy, teaching individuals to

replace irrational beliefs with rational ones.

AARON BECK’S COGNITIVE THERAPY

It focuses on psychological problems stemming from common processes like faulty thinking,
incorrect inferences and failing to distinguish between fantasy and reality.

CT is an insight-focused therapy with a strong psychoeducational component, that emphasises

recognizing and changing unrealistic negative thoughts and maladaptive beliefs. It is highly
collaborative and involves designing specific learning experiences to help clients monitor
automatic thoughts, examine their validity, understand the relationship between cognition,
feelings, and behaviour, develop more accurate and realistic cognitions, and change underlying
beliefs and assumptions.

The theoretical assumptions of cognitive therapy are:

1. that people’s internal communication is accessible to introspection,
2. that clients’ beliefs have highly personal meanings
3. that these meanings can be discovered by the client rather than being taught or interpreted
by the therapist.

BASIC PRINCIPLES OF COGNITIVE THERAPY

Levels of schema
Cognitive therapists believe that individual beliefs begin in early childhood and develop
throughout life. Early childhood experiences lead to basic beliefs about oneself and one’s world.

These beliefs can be organised into cognitive schemas- "hypothesised mental structures that
organise information" that encompass the core beliefs. Normally, individuals experience support
and love from parents, which lead to beliefs such as “I am lovable” and “I am competent,” which
in turn lead to positive views of themselves in adulthood.

Core beliefs are central ideas about ourselves that underlie many of our automatic cognitions
and usually are reflected in our intermediate beliefs. They can be described as "global, rigid,
and overgeneralized"

These developmental experiences, along with critical incidents or traumatic experiences,

influence individuals’ belief systems leading to conditional beliefs such as “If others don’t like
what I do, I am not valuable.” Such beliefs may become basic to the individual as negative
cognitive schemas.

Intermediate beliefs often reflect extreme and absolute rules and attitudes that shape people's
automatic thoughts.

Young identified common maladaptive schemas that can lead to the development of many
psychological disorders in childhood. Early maladaptive schemas are resistant to change and
cause difficulties in an individual's lives.

These schemas lead to automatic thoughts, resulting in unpleasant feelings, similar to the
"preconscious" in Freud's theory. These thoughts occur spontaneously without effort or choice
and are often distorted, extreme, or inaccurate. These are associated with both emotions
evoked by the automatic thoughts (sadness, fear, anger) and physiological responses
(dizziness, feeling tense, increase in heart rate).
Negative automatic thoughts are errors in processing, through which perceptions and
interpretations of experiences are distorted. NATs are the stream of cognitions that constantly
flow throughout our minds. They are automatic, distorted, plausible, involuntary, unhelpful,
habitual and covers an extensive range of stimuli.

NATs can be understood as:

A) Selective abstraction. Sometimes individuals pick out an idea or fact from an event to
support their depressed or negative thinking.

B) Overgeneralization. Making a rule based on a few negative events, individuals distort

their thinking through overgeneralization.

C) Magnification or minimization. Cognitive distortions can occur when individuals

magnify imperfections or minimize good points. They lead to conclusions that support a
belief of inferiority and a feeling of depression.

D) Personalization. Taking an event that is unrelated to the individual and making it

meaningful produces the cognitive distortion of personalization.
 E) Arbitrary inference. Jumping to a conclusion in the absence of supporting evidence or
even despite evidence to the contrary.

F) Dichotomous thinking: Conceptualizing shades-of-gray phenomena in black-or- white

categories.

NAT is the final outcome under cognitive distortions which are the cognitions that comprise
psychological disorders and perpetuate a systematic bias in information processing. Cognitive
distortions appear when information processing is inaccurate or ineffective.

David Burns offered different cognitive distortions, and he has added a few:

● Jumping to conclusions: Burns’s term for arbitrary inference.

● Mental filter: Burns’s term for selective abstraction.
● Blame: Listed by Burns with, and as a converse to, personalization: attributing internal
responsibility entirely to external events.
● All-or-nothing thinking: Burns’s term for dichotomous thinking.
● Disqualifying the positive: Akin to minimization, this distortion specifically involves
arbitrarily concluding that positive experiences “don’t count” in an evaluation process.
● Emotional reasoning: The assumption that emotions reflect reality.
● Should statements: Distorted attempts to motivate oneself and others by psychological
force.
● Labelling and mislabeling: A form of overgeneralization and all-or-nothing thinking in
which one labels a total phenomenon based on one experience. This distortion can be
directed at oneself, as when a salesman loses one account and thinks of himself as
incompetent.
● Mind reading. This refers to the idea that we know what another person is thinking
about us.
● Negative prediction. When an individual believes that something bad is going to
happen, and there is no evidence to support this, this is a negative prediction.
● Catastrophizing. In this cognitive distortion, individuals take one event they are
concerned about and exaggerate it so that they become fearful.
● Should statements. Distorted attempts to motivate oneself and others by psychological
force.
Goals
● The general goals of REBT are to assist people in
○ minimizing emotional disturbances,
○ decreasing self-defeating self-behaviors, and
○ becoming more self actualized so that they can lead a happier existence.
● Major subgoals are to help individuals
○ think more clearly and rationally,
○ feel more appropriately, and
○ act more efficiently and effectively in achieving goals of living happily.
● Individuals learn to deal effectively with negative feelings such as sorrow, regret, frustration, and
annoyance. They deal with unhealthy negative feelings such as depression, anxiety, and
worthlessness by using an effective rational emotive behavior philosophy.

The basic goal of cognitive therapy is to remove biases or distortions in thinking so that individuals
may function more effectively. Patients’ cognitive distortions are challenged, tested, and discussed to
bring about more positive feelings, behaviors, and thinking. To remove biases or distortions in thinking,
therapists attend not just to automatic thoughts but also to the cognitive schemas that they represent.

Therapeutic Alliance
Beck’s view of the client–therapist relationship is that it is collaborative. Clients are expected to
participate fully in the process of behavior or cognitive–behavioral therapy and take responsibility for
presenting their concerns, identifying their goals, and implementing plans for change. Clinicians
typically encourage clients to try out new behaviors, complete tasks between sessions, self-monitor,
and provide feedback to the clinicians. Cognitive therapists subscribe to social learning theory. That
is, they believe that people’s cognitions—their mental images; their beliefs; their conclusions,
expectations, and predictions—are influenced by significant others through the actions and ideas they
model, reinforce, and punish.

More so than many other theories of therapy, cognitive-behavioural therapy is structured in its
approach. The initial session or sessions deal with assessment of the problem, development of a
collaborative relationship, and case conceptualization. The counselor is, first and foremost, warm,
empathic, and genuine. These attitudes, and their associated skills such as nonverbal attending and
verbal reflection, are considered absolutely necessary for constructive client change. However, they are
not sufficient. In addition, to the essential therapeutic qualities, a cognitive counselor must have
expertise in the theory and techniques of cognitive therapy.
Techniques
Systematic assessment of alternatives (cost/benefit analysis). help people make wise decisions or
choices by listing their options, along with pros and cons, assigning numbers on a scale of 1-10,
showing the importance of each pros & cons. Finally, they total the numbers assigned to the pros and
cons of each option.

Reattribution. Patients are given a plausible, normalizing explanation for the symptoms of concern, to
improve those symptoms as well as patients' moods.

Externalization of voices- the client who has successfully challenged a distorted belief is invited to
switch roles with the counselor. The counselor tries to convince the client of the distorted beliefs, and
the client argues how the beliefs are inaccurate and not useful and argues in favor of more accurate
and useful beliefs.

Problem Solving. Problem-solving strategies are incorporated for the purpose of optimally changing
cognitive distortions. For example, patients are encouraged to make a list of what he/she needs to do
then break the large tasks into small steps. Patients are then encouraged to run an experiment to see if
they can accomplish the task one step at a time. Patients’ successful experiences are used to
disconfirm their cognitive distortions, allowing them to gain better problem-solving skills throughout the
therapy process.

Thought stopping- Thought stopping involves saying “Stop!” either aloud or subvocally each time the
unwanted thought recurs and replacing it with a more positive thought. Over time, the harmful thought
is likely to diminish in frequency and intensity.

Diversions or distractions. These can help people reduce their negative thinking.

Self-talk. This is a technique in which people repeat to themselves many times a day positive and
encouraging phrases that they have identified as helpful, such as “You can do it.”

Affirmations. An affirmation is a sort of slogan that is positive and reinforcing. People can post these in
prominent places such as the refrigerator or the mirror where they will see them frequently and be
reminded to shift their thinking.

Keeping diaries. Diaries about events, realistic and distorted cognitions, emotions, and efforts to make
positive changes can increase people’s awareness of their inner and outer experiences. They serve as
a way to track both progress and difficulties.
Letter writing. another avenue for exploring and expressing thoughts and feelings.

Relabeling or reframing experiences or perceptions. This can help people think differently about
them.

Role-playing. Role-playing can enable people to actualize some of the new thoughts they have about
themselves. In rational emotive role-play, clients play the emotional part of the mind while clinicians
play the rational part; the two then engage in a dialogue.

When role-playing a dialogue between old and new thoughts, clients use two chairs to represent both
their old and their new thoughts by moving from one chair to another. This can help people clarify
changes in their thinking and solidify rational thoughts.

Distancing. Distancing involves projecting into the future to put a problem in perspective and diminish
its importance. A woman realized that getting a B in a college course would mean little to her in 10
years.

Bibliotherapy. reading about other people who have coped well with experiences similar to the client’s,
can help a person modify his or her thinking.

Graded task assignments- are activities that clients complete between sessions. Starting with easy
assignments that guarantee success, clinicians gradually increase the difficulty of the tasks, so that
people continue to learn from them and feel a sense of mastery and accomplishment.

Cognitive and Covert Modeling- involves modeling inner speech, a form of covert behavior. Thus,
self-instruction training first uses “cognitive modeling,” in which adults model the use of problem-solving
skills by talking aloud while performing a task. Using this technique, the adult verbally models defining
the problem, focusing attention on task requirements, and providing self praise and corrective
feedback.

Visual Imagery. imagery techniques can help stop or change distressing images and reduce negative
emotions. When a person has trouble internalizing cognitive changes, it is also helpful to use imagery.
The process is as follows: (1) Provide education about imagery, (2) Help clients elicit their images, and
(3) Change and replace unhelpful or distressing images.

Implosive (Flooding) Therapy. In flooding, people are exposed to high doses of a feared stimulus in
the expectation that this will desensitize them to the feared stimulus. In imaginal flooding, the client is
exposed to the mental image of a frightening or anxiety-producing object or event and continues to
experience the image of the event until the anxiety gradually diminishes.

Another imaginal flooding approach is implosive therapy, wherein the scenes are exaggerated rather
than realistic, and hypotheses are made about stimuli in the scene that may cause the fear or anxiety.

Guided discovery. Sometimes called Socratic dialogue, helps clients change maladaptive beliefs and
assumptions. The therapist guides the client in discovering new ways of thinking and behaving by
asking a series of questions that make use of existing information to challenge beliefs.

Homework. Much work in cognitive therapy takes place between sessions so that skills can be applied
to real-life settings. Specific assignments are given to help the client collect data, test cognitive and
behavior changes, and work on material developed in previous sessions.

ADDITIONAL TECHNIQUES FOR BECK

Understanding idiosyncratic meaning. Different words can have different meanings for people,
depending on their automatic thoughts and cognitive schemas. Often it is not enough for therapists to
assume that they know what the client means by certain words. Questioning the client helps both
therapist and client to understand the client’s thinking process.

Challenging absolutes. Clients often present their distress through making extreme statements such
as “Everyone at work is smarter than I am.” Often it is helpful for the therapist to question or challenge
the absolute statement so that the client can present it more accurately.

Labeling of distortions. This can be helpful to clients in categorizing automatic thoughts that interfere
with their reasoning.

Decatastrophizing. Clients may be very afraid of an outcome that is unlikely to happen. The “what-if”
technique often works with this fear. It is particularly appropriate when clients overreact to a possible
outcome.

Challenging all-or-nothing thinking. Sometimes clients describe things as all or nothing. In such a
case, the therapist uses a process called scaling, which turns a dichotomy into a continuum.

Cognitive rehearsal. Use of imagination in dealing with upcoming events can be helpful. For example,
a woman can imagine herself talking to her boss and having a successful interview. The therapist asks
her to imagine the interview with the boss and then asks the patient questions about the imagined
interview.

Other cognitive strategies include “examining criteria” and “define terms”: The client is asked to
define key terms and labels such as “worthless,” “success,” and “failure,” which often results in moving
from global, overgeneralized concepts to specific, often achievable goals.
The “double standard technique” involves the client applying his own beliefs about himself to
someone he loves. They then can be invited to role-play what they would say to the loved one who
believed that about themself, and then to practice saying the same things to oneself.

Current trends (mention only for beck)

Cognitive therapists have added mindfulness meditation techniques to their treatment strategies for
a variety of disorders. Mindfulness-based cognitive therapy does not focus on changing the content of
thoughts and feelings.
Schema-focused cognitive therapy has been developed for individuals with personality disorders
such as borderline disorders, as well as difficult problems such as eating disorders, childhood abuse,
and substance abuse. In schema-focused cognitive therapy, there is more emphasis on the client–
therapist relationship. Also, the therapist is more likely to explore schemas that developed in early
childhood than in traditional cognitive therapy

Strengths
● Beck made pioneering efforts in the treatment of anxiety, phobias, and depression. The effects
of cognitive therapy on depression and hopelessness have been demonstrated through
research to be maintained for at least one year after treatment. Cognitive therapy has been
applied to a wide range of clinical populations that Beck did not originally believe were
appropriate for this model, including treatment for posttraumatic stress disorder, schizophrenia,
delusional disorders, bipolar disorder, and various personality disorders. The credibility of the
cognitive model grows out of the fact that many of its propositions have been empirically tested.
● Beck demonstrated that a structured therapy that is present centered and problem oriented can
be very effective in treating depression and anxiety in a relatively short time. A strength of
cognitive therapy is its focus on developing a detailed case conceptualization as a way to
understand how clients view their world. A key strength of all the cognitive behavioral therapies
is that they are integrative forms of psychotherapy.
● It is applicable in a number of cultural settings based on its well-researched, evidence-based
 and proven efficacy.
● One of the strengths of REBT is the focus on teaching clients ways to carry on their own therapy
without the direct intervention of a therapist. They are respectful and collaborative, encouraging
people to take responsibility for themselves.
● These approaches emphasize goal setting, accountability, and results.
● Although improved behaviors and thinking are the targets, treatment also seeks to improve
emotional health.

Limitations

● Cognitive therapy has been criticized for focusing too much on the power of positive thinking;
being too superficial and simplistic; denying the importance of the client’s past; being too
technique oriented; failing to use the therapeutic relationship; working only on eliminating
symptoms, but failing to explore the underlying causes of difficulties; ignoring the role of
unconscious factors; and neglecting the role of feelings.
● Another potential limitation involves the misuse of the therapist’s power by imposing ideas of
what constitutes rational thinking. Due to the active and directive nature of this approach, it is
particularly important for practitioners to know themselves well and to avoid imposing their own
philosophy of life on their clients.
● CBT is structured and requires clients to be active, by completing home-work and performing
activities. It is demanding. Clinicians as well as clients must be active and innovative. The
approach is more complex than it would appear on the surface.
● Sometimes, treatment limited to CBT is not the ideal approach for all clients. An initial focus on
cognitions and behavior can promote change and enhance motivation. For people with long-
standing and deep-seated problems, perhaps stemming from an early history of abuse and
inadequate parenting, psychodynamic and other approaches should probably be combined with
behavior therapy and CBT.
● Clinicians may become so caught up in the power of CBT that they fail to help clients take
adequate responsibility for their treatment and progress. As a result, people may feel
manipulated and powerless rather than experience the growth in self-worth and competence
that should result from treatment.
● Cognitive therapy also is demanding of clinicians. Clinicians must be organized, comfortable
with structure, and willing to use inventories and forms to elicit and assess clients' concerns and
progress. Planning and effort are integral to the success of cognitive therapy.