Analytical Psychotherapy, Person-Centered Therapy: How an individual progresses through the four stages of Analytic therapy

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Analytical Psychotherapy, Person-Centered Therapy: How an individual progresses through the four stages of Analytic therapy.

Confession covers the client provided history of his/her personal life, feelings, and conscious and unconscious secrets. This is the first stage of Analytic therapy and includes the client’s initial descriptions of his/her personal life, the presenting problem, and discussions of underlying problems, secrets, concerns, or other issues, either conscious or unconscious. This intense sharing allows the client to benefit from confessing to hidden feelings, relieving the client from feelings of guilt or feelings of being the only person to have ever felt this way. Transference occurs during this time. The client projects his/her own feelings onto the therapist. A client may have strong feelings of anger and resentment toward his father. In therapy the client may view the therapist as being angry toward the client.

Elucidation is a clarification of what has happened during the therapeutic relationship, specifically describing the transference that has occurred and its likely origins in infancy. This is stage describes the therapist’s assistance in helping the client see and understand the source of the transference and bringing a level of insight to the client of his/her personal short comings. The client is encouraged to accept him/herself along with these shortcomings. The client mentioned above, may be told in therapy that his/her anger is due to his/her anger that was directed toward an absent father who left the family when the client was an infant. The anger was intensified by the client’s mother’s overtly angry descriptions of the father and any other father figure in the client’s life. The client might be told that this anger affects others who experience similar childhood events and that the client is not tied to this anger forever.

Education describes the activities with the client that helps him/her become more adaptive socially. This stage covers the conscious aspects of the personality that the client can use to develop a healthier lifestyle. A plan may be developed with the client that could assist the client in achieving a more responsible life. The client’s anger is discussed and a schema for resolving the anger is developed with the client that will help the client deal more effectively with future male figures.

Transformation describes the desire in some clients to continue on in therapy toward greater self-actualization. Not all clients enter this stage. It is often prevalent in adults during mid-life who are searching for greater meaning to their lives. The client has progressed through the three previous stages, but is now interested in exploring additional development toward a life that is more whole or complete. The client expresses interest in developing other aspects of his/her life.
The Client-Centered therapist must make sure three facilitative conditions are met in his/her relationship with the client (also called the Therapeutic Triad). The three therapist-offered facilitative conditions are congruence, empathy, and unconditional positive regard. Carl Rogers believes that these three conditions are necessary in the establishment of a therapeutic relationship. Without them change is less likely to occur.

Congruence refers to the genuineness between the thoughts and behaviors of the therapist. The therapist reflects his/her real and true self to the client during therapy, not a professional image that is not in keeping with the true feelings or thoughts of the therapist.

Empathy describes a profound interest in the feelings and meanings of the client and the client’s statements. It is a sharing of feeling with the client.

Unconditional positive regard describes an ultimate level of acceptance on the part of the therapists. The therapist presents to the client that there is nothing that can be said that will shake the therapist’s acceptance of that person.

This triad works by providing the opportunity for a supportive relationship to develop between the client and the therapist. The combination of genuinely sharing values with the client, Congruence; exhibiting warm interest in and sharing emotions with the client, Empathy; and doing each of these while showing a genuine level of acceptance, unconditional positive regard; meets the majority of the universal needs all clients face. Meeting these needs is a large part of the therapeutic process. Limitations from the therapist’s point of view may be an inability to express one or all three of these with a specific client due to either the client’s background or behaviors or the background of the therapist. Limitations from the client’s point of view may surround an inability to communicate well, a severe cognitive limitation, or being so heavily guarded in sharing personal information that little or no information is provided to the therapist. This provides an opportunity for the client to return to the mother-child relationship, hopefully one that is positive, warm, caring and safe. It fosters a calm place from which to discuss and examine problems.
Rational Emotive Behavior Therapy (REBT): How REBT is used for brief psychotherapy and in marriage and family therapy and the use of the A-B-C model for psychotherapy.
Ellis’s ABC model is based on the assumption that though an emotional consequence (C) may appear to be related to a significant event (A), it is more likely related to a specific value or belief system (B). By recognizing that it is not “A” that causes “C”, but rather the person’s belief system or “B” that is the primary cause of “C”, helps the person clarify his/her own part in the contribution of “C”. The client who presents as emotionally distraught and is citing distress regarding a particular event or issue, can benefit from the use of Rational Emotive Behavior Therapy (REBT) in determining how the source of the emotional conflict or concern is related to the client’s belief system.

In a marriage, REBT can help both partners realize a more honest appraisal of what is causing their concerns. For example: The wife presents that she is angry because the husband is lazy and shiftless. She says this is because he does not take out the garbage as he should. In taking a history, this sequence is discovered. The wife asks her husband to carry out the garbage in the morning and he says he will. Later in the day she discovers he has left for work for the week and did not take out the garbage as promised. She describes intense anger at what she describes as his lack of responsiveness, lack of caring, lack of concern, his lack of desire toward her, and her feelings of undesirability. Using REBT the wife is led to an understanding that her husband’s failure to comply with her wishes is not a reflection of her lack of desirability or a reflection of his true worth. It is just a mistake by someone who forgot. She recognizes that her belief system has led her to this way of thinking and that by examining her belief system from a rational point of view, she is able to release or defuse her emotions over this issue. The therapist disputes her irrational beliefs and helps her gain more rational ones. For individual therapy the session is often taped for the client to listen to the session repeatedly and a form is provided for the client to use in doing self-therapy using the REBT method following or in between sessions.

The concept is similar for work with family therapy as well as in marriage therapy. In both instances, REBT can assist the members of the family in examining how their irrational belief systems can cause faulty logical conclusions in interpreting the behaviors of others and lead to needless emotional turmoil. In marriage therapy the members are often seen together. Work is toward helping each see, that though they may disagree with one another, their level of being upset is not justified by the events or relationships.

In family therapy the adults are sometimes seen separately from the children, though they may be all viewed at once to get a sense of the types of group behaviors. Children are led to see that parents are not perfect and that to expect such is irrational. The same process is done with the parents, encouraging acceptance. Tolerance for self and others is taught.

REBT is designed to help the client face the irrational and illogical beliefs that are at the heart of the individual’s distress. The therapist provides unconditional positive regard, but in a no nonsense way disputes irrationally held theories or beliefs held by the client. The therapist spends a good deal of time educating the client and leads from information provided by the client into new areas where the client may be holding other illogical beliefs. Homework is assigned and the therapist approaches the client from a ‘tough love’ standpoint, insisting that therapy is hard work and should be approached as a significant task to be accomplished. It focuses on removing the “should’s”, “must’s”, and “ought’s” that many people collect in their lives, replacing these with “… it would be better if..”. This shift in thinking assists in the removal of blame, guilt, shame, anger, disappointment, and disillusionment, which are at the source of much of the angst clients bring to therapy.
Core concepts of Behavioral therapy: classical conditioning, operant conditioning, extinction, discrimination learning, social-cognitive learning

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