Feminist Therapy

Contributors include:

Jean Baker Miller


Carol Zerbe Enns


Olivia M. Espin


Laura S. Brown

• This theory bases behavior according to one's biological gender.

Key Concepts

• Gender-fair approaches- Explains behavior of men and women in terms of socialization processes
• Flexible-multicultural perspective- Nonjudgmental concepts and strategies are applied equally
• Interactionist- Focuses on the thinking, feeling, and behaving dimensions of human experience
• Life-span perspective- Believes that human development is a lifelong process instead of by stages

Feminist Perspectives on Personality Development

• Our personalities are developed through societal gender roles
• Recognize that women's search for connectedness with others is crucial to their development
• Gender schemas- Internal belief of gender roles created by society

Principles of Feminist Therapy

1. The personal is political- An individual's problem is rooted from a political and social context
2. Commitment to social change- A transformation in society
3. Women's and girl's voices and ways of knowing are valued and their experiences are honored
4. Egalitarian relationship- Clients are the experts of their own lives
5. A focus on strengths and a reformulated definition of psychological distress
6. All types of oppression are recognized

Feminist Goals for Clients

• Become aware of their own gender-role socialization process
• Identify their internalized messages and replace them with more self-enhancing beliefs
• Understand how sexist and oppressive societal beliefs and practices influence them in negative ways
• Develop skills to create change in the environment
• Restructure institutions to rid them of discriminatory practices
• Develop a wide range of behaviors chosen freely by client
• Evaluate the impact of social factors
• Develop a sense of personal and social power
• Recognize the power of relationships and connectedness
• Trust their own experience and their intuition

Techniques and Strategies

• Empowerment- Recognizing power over one's own life
• Self-disclosure
• Gender-role analysis
• Gender-role intervention
• Power analysis
• Bibliotherapy
• Assertiveness training
• Reframing and relabeling
• Social activities
• Group work

My View: I agree with this approach in the fact that society plays a huge role on gender roles and one's personality development. However, we as individuals are free to choose what kind of person we want to be, but the environment and society have the biggest impact on who we choose to be as a person.

Mind-Body Therapy

Body Psychotherapy

• Focuses on the client's non-conscious thoughts and emotions which are stored on the right side of the brain.

Perspectives

• Our body impacts our thinking and our thinking reflects our body
• Our emotions are sensed first by the body then are noticed by the mind

Goals

• Establish trust and therapist/client relationship
• Re-programming long term, non-conscious emotional reactions
• Becoming aware of how we experience emotions in our body and how they affect our thoughts

Therapy Process

• Uses physical sensations as signals to guide therapy
• Resolves emotional problems by working directly and interactively with the nervous system

Techniques

• Brain scan
• Neurofeedback devices
• Exercises that pay attention to the nervous system and how it responds and learning to quiet or regulate the nervous system
• Yoga

As you calm the body, you naturally calm the mind.

My View: I love this type of therapy because there are many times when anxiety can increase in my life and I feel that this therapy could be very helpful. I currently practice Yoga and it is truly effective for when I am highly stressed out. It is amazing how clear my mind becomes after relaxing my entire body. I would suggest this therapy to anyone as a way to manage everyday stress.

Family Systems Therapy

Contributors include:
Alfred Adler

Murray Bowen

Virginia Satir

Carl Whitaker

Salvador Minuchin

Jay Haley

Cloe Madanes

Family Systems Perspective

• Individuals are best understood by observing interactions amongst family members
• One's behavior is connected within family and the way the family functions
• The family is assessed along with "identified" client to determine behavior

Differences between Systemic and Individual Approaches

Individual

• Focus on accurate diagnosis
• Therapy is person-centered
• Focuses on causes, purposes, and cognitive processing of problem
• Concerned with client's experiences and perspective
• Establish treatment for client

Systemic

• Explore family functioning of client
• Include family members in therapy
• Focus on family relationships
• Concerned with external aspects that might affect the family's perspective
• Design treatment for client based upon external factors that interrupt success

Adlerian Family Therapy- Introduced by Alfred Adler, Rudolf Dreikurs, Oscar Christensen, and Manford Sonstegard

• Focuses on the present with little reflection on past

Goals

• Allow parents to be leaders
• Discover interaction patterns in family
• Promote effective parenting

Therapy Process

• Form a mutual relationship
• Discover birth order and goals
• Explore daily interactions between members

Multi-generational Family Therapy- Introduced by Murray Bowen

• Focuses on past and present time
• Discovers where the family was originated

Therapy Goals

• Differentiate the self
• Change the individual within the functioning of the family
• Decrease anxiety

Questions and cognitive processes are used to differentiate the self and to determine the family's origin.

Techniques and Innovations

• Genograms- Pictorial display of family relationships and medical history
• Deal with family-of-origin issues
• Remove oneself from the family's emotional system

Human Validation Process Model- Introduced by Virginia Satir

• This approach focuses on the here and now time frame.

Therapy goals

• Increase growth, self-esteem, and connection between family members
• Lead family to civil communication and interaction

Therapy Process

• Family is guided to move from original standpoint through chaos to new possibilities.

Techniques and Innovations

• Understanding the feelings of the client
• Role playing
• Touch and communication
• Sculpting
• Family-life chronology

Experiential/Symbolic Family Therapy- Introduced by Carl Whitaker

• Focuses on the present time

Goals

• Encourage spontaneity, creativity, autonomy, and ability to play

Therapy Process

• Awareness and plans to change are planted in therapy sessions.

Techniques and Innovations

• Co-therapy
• Self-disclosure
• Confrontation
• Using oneself to change

Structural Family Therapy- Introduced by Salvador Minuchin

• Focus on present and past

Therapy Goals

• Restructure family organization
• Alter dysfunctional family patterns

Therapy Process

• Therapist joins family in leadership role
• Family structure is changed
• Boundaries are set

Techniques and Innovations

• Joining
• Setting boundaries
• Unbalancing
• Reframing
• Enactments
• Ordeals
• Paradoxical interventions

Strategic Family Therapy- Introduced by Jay Haley and Cloe Madanes

• Focuses on present and future

Therapy Goals

• Eliminate presenting problem
• Alter dysfunctional patterns
• Interrupt sequence

Therapy Process

• Change occurs through actionoriented instructions and paradoxical interventions in which client is asked to observe the frequency of a certain symptom.

Techniques and Innovations

• Reframing
• Instructions and self-contradictory statements
• Pretending
• Enactments

My View: Family Systems Therapy is not a favorite of mine simply because I believe everyone is their own person regardless of your family members. Yes, the environment and members can and will have some impact and effect on one's behavior; however, we are each responsible for our own choices in who we want to become.

Postmodern Approaches

Founders include:
Insoo Kim Berg

Steve de Shazer

Michael White

David Epston

Postmodernists believe that an individual's reality is based upon one's use of language.

• Social constructionism-Once a definition of self is adopted, it is hard for one to recognize behaviors counter to that definition.

Example: It is hard for an individual that suffers from chronic depression to imagine a mindset of happiness or a good mood.

Solution-focused brief therapy- Introduced by Steve de Shazer and Insoo Kim Berg

• Focuses on future possibilities and solutions
• Avoids discovering how the problem starts
• Clients choose goals they want to achieve
• Incorporate optimistic thinking
• Establish effective patterns of behavior
• Discovering client's desires through basic conversation

The Therapeutic Process

Step 1: Clients are given an opportunity to describe their problems
Step 2: The therapist works to establish goals with client as soon as possible
Step 3: Clients explore their exceptions to their problems
Step 4: Therapist offers feedback, provides encouragement and suggestions to further solve their problem
Step 5: Progress is evaluated and solution to problem is determined

SFBT Goals

• Therapist provides an encouraging and changing environment
• Clients establish their own goals for therapy
• Small, realistic goals for change are developed
• To increase client's hope and willingness to change
• Encourage clients to engage in solution talk instead of problem talk

Techniques

• Pretherapy change- Scheduling an appointment and discussing changes prior to
• Exception questions- Clients are asked when the current problem did not occur or when it would have been expected to occur
• The Miracle question- Clients are asked "What if the problem is solved?" and their reaction
• Scaling questions- Rating the client's feeling or moods during the problem compared to if the problem was solved
• Formula first session task- Homework assignment between sessions
• Therapist feedback- Consists of compliments and suggestions
• Terminating- Once solution is determined, the therapeutic relationship can be terminated

Narrative Therapy- Introduced by Michael White and David Epston

• Constructing the meaning of life in interpretive stories.

Key Concepts

• Listening to client's stories ( what we see, feel, and do)
• Changing one's hopeless story to an encouraging story
• Listen to clients without judgement

The Therapeutic Process

• Collaborate with client to personify the problem
• Explore the effect of the problem
• Offer different viewpoints of meanings to the problem
• Discover when the problem was not effective and begin to rewrite one's story
• Client is required to envision future possibilities
• Client needs to act and live out their new story

Narrative Therapy Goals

• Being able to express new language
• Develop new meanings for problematic thoughts, feelings, and behaviors
• Increase awareness of impact of various aspects of dominant culture on human life

Techniques

• Questions- Therapist's way of generating experience
• Externalization and Deconstruction- The problem is the problem; diminishing assumptions and opening up different possibilities
• Search for unique outcomes- Discusses with the client about moments of choice or success regarding the problem
• Alternative stories and Reauthoring- Encouraging clients to be the author of different stories
• Documenting the evidence- Clients are encouraged to develop an audience to express their stories to; Living and acting out their new story

My View: Postmodern Therapy reminds me of Cognitive Behavior Therapy as far as claiming that our thoughts effect our behavior in which effects our emotions and Postmodernists focus on the effect of one's speech on behavior. I think this approach can be effective for individuals who feel as if they are trapped by their emotions and have lost all hope for change.

Reality Therapy was introduced by William Glasser and Robert E. Wubbolding

• RT therapists believe the problem lies within the fact of the client being in a current unsatisfying relationship or the lack of a relationship all together.

Key Concepts

Choice Theory

• We are all born with five encoded needs:

1. Survival
2. Love and belonging
3. Power
4. Freedom
5. Fun

• Quality world- We store up wants in our minds.
• Picture album- Developing images of our wants and ways to satisfy them

Total behavior

• Behavior is made up of four components that accompany our actions, thoughts, and feelings.

1. Acting
2. Thinking
3. Feeling
4. Physiology

Characteristics of Reality Therapy

• Emphasizing choice and responsibility
• Therapists reject transference and be who they truly are
• Focus on the present
• Avoid focusing on symptoms
• Only rely on DSM-IV-TR for diagnosis

Goals of Reality Therapy

• Help clients get connected with the people they desire a relationship with
• Learning sufficient ways for a client to fulfill their needs
• Setting short and long term goals
• Therapists assist clients in making responsible choices
• Help clients become accepting of help
• Develop a therapist/client connection

Techniques

• Creating the counseling environment
• Incorporating procedures that lead to change in behavior

The "WDEP" System

• WANTS- Discovering the client's desires
• DIRECTION AND DOING- Focusing on the present
• SELF-EVALUATION- Examining goals, actions, wants, etc.
• PLANNING AND ACTION- Fulfilling the client's wants and needs





My View: I think the name for this approach is very well fitting, in that as humans we do have needs and wants that we want to be satisfied and met. However, sometimes the choices we make in order to meet our needs are not healthy, creating maladaptive habits. Therefore, I think Reality Therapy is a very healthy approach to consider as far as making better choices and developing a sufficient strategy towards fulfilling one's needs and desires.

Cognitive Behavior Therapy

Albert Ellis, Aaron T. Beck, Judith Beck, and Donald Meichenbaum make up Cognitive Behavior Therapy with each of their approaches.

Rational emotive behavior therapy- Introduced by Albert Ellis

• A common approach that is still used in treatment today
• REBT- the idea of this approach is that one's cognitive thinking, emotions, and behavior all interact and effect one another.

A-B-C Framework

• This model reflects the understanding in which REBT is based upon.

A (activating event) <-- B (belief) --> C (emotional and behavioral consequence)

                  

D (disputing intervention) --> E (effect) --> F (new feeling)

Cognitive restructuring

• The practice of replacing irrational beliefs with rational beliefs.
• Monitoring self-speech, improving self-speech by replacing negative language with adaptive speech

Goals of CBT

• Separating evaluation of behaviors from evaluation of self
• Accepting oneself for who they are
• Establishing healthy behaviors
• Learn how to accept others
• Creating realistic and self-enhancing goals

Homework

• Clients are required to carry out assignments that will increase self-enhancement and are checked periodically to view their progress.

Techniques

Cognitive Methods

• Diminishing irrational beliefs
• Cognitive homework (challenging beliefs)
• Bibliotherapy (reading and researching approaches)
• Altering one's language
• Psychoeducational methods (educating clients about the nature of therapy)

Emotive Techniques

• Rational emotive imagery- Clients imagine challenging situations in which create disturbing feelings, then are trained to replace those emotions with healthy emotions.
• Using humor
• Role playing
• Shame-attacking exercises

Behavioral Techniques

• Operant conditioning
• Self-management principles
• Systematic desensitization
• Relaxation techniques
• Modeling
• Homework assignments

Aaron Beck's Cognitive Therapy

• How a client feels and behaves determines their perception and functioning in life.

Principles of Cognitive Therapy

• Automatic thoughts- Gathering and weighing the evidence in support of their beliefs
• Discovering cognitive distortions and their effect
• Arbitrary inferences- Making assumptions with no supportive evidence
• Selective abstraction- Focusing on the negative
• Overgeneralization- Extreme beliefs being applied to innappropriate events
• Magnification and minimization- Perceiving a situation in a false manner (too light, too great)
• Personalization- Relating external events to themselves without support for this connection
• Labeling and mislabeling- Identifying oneself by the imperfections
• Dichotomous thinking- Black and white, your either one way or the other

Applying Cognitive Therapy

• Indentifying and examining one's beliefs, exploring how their beliefs were established, modifying one's beliefs.
• Activity scheduling
• Behavioral experiments
• Skills training
• Role playing
• Behavioral rehearsal
• Exposure therapy

Donald Meichenbaum's Cognitive Behavior Modification 

• Focuses on changing one's self verbalizations

How Behavior Changes

1. Self-observation
2. Start a new internal dialogue- Begin to notice the opportunities for change in behavior
3. Learn new skills- Interrupting the downward spiral of thinking, feeling, and behaving by learning coping mechanism.

Stress Inoculation Training

• Teaching clients ways to manage stress
• Expose clients to anxiety-provoking situations by means of role playing and imagery
• Require clients to evaluate their anxiety level
• Teach clients to become aware of the anxiety-provoking cognitions they experience in stressful situations
• Help clients examine these thoughts by reevaluating their self-statements
• Have clients note the level of anxiety following the reevaluation

Constructivist Narrative Perspective

• Focuses on the stories clients tell about themselves and others regarding significant events in their lives
• Gives more emphasis to past development
• Targets deeper core beliefs
• Explores the behavioral impact a client pays for holding on to certain roots

My View: When I was learning about this approach, it took me back to social psychology where I learned that one's thoughts effects one's actions therefore producing one's behavior. This approach is based upon that and I agree with it. It is like chain of events that link up together, one thing is effected and created by the other and if you are struggling in certain behavior, this is an excellent approach to consider in helping to change behavior.

Behavior Therapy is introduced by B.F. Skinner, Albert Bandura, and Arnold Lazarus who all share their part in the development of Behavior Therapy as well as others you will learn below.

Four Areas of Development make up Behavior Therapy

Classical Conditioning- developed by Ivan Pavlov

• The study between stimulus and response

Ex: Getting anxious when seeing a date posted for a future exam because anxiety has increased while taking previous exams.

Operant Conditioning- developed by B.F. Skinner

• Reinforcements are used to produce a certain behavior

Positive reinforcement

• Ex:Rewarding a child with candy after achieving a good grade on a test or assignment

Negative reinforcement

• Ex: A child doesn't want to eat the vegetables on his plate, child cries, vegetables get taken away

Social Learning Theory- developed by Albert Bandura

• Behavior is developed through a pattern of modeling

Ex: Imitation of actions such as a child smoking because they have seen their parents smoke; therefore, they think this act is acceptable.

Cognitive Behavior Therapy- mostly contributed by Jean Piaget

• How one's thoughts and subjective reality affects their behavior

Piaget claimed that there are FOUR stages of cognitive behavior

1. Sensorimotor (birth-2 yrs) -senses and motor skills are used for understanding
2. Preoperational (2-6 yrs)- only see the world from one's own view
3. Concrete Operational (7-11 yrs)- Logical thinking is applied for understanding
4. Formal Operational (From 12 on)- Abstract thoughts begin to develop

Key Concepts

1. Treatment goals are set and effectiveness is assessed
2. All characteristics of behavior is observed
3. Current problems and present factors of client are assessed
4. Clients are required to act out certain behavior in order to bring change, including exercises and role-play
5. Self-understanding and insight to one's self is practiced
6. Consistent assessment; observation and self-monitoring is key
7. Individual treatments are used for the appropriate condition

Behavior Goals

• Forming therapist/client relationship
• Treatment goals are agreed upon both therapist and client and continually assessed throughout treatment
• Personal choice should be increased
• New conditions for learning should be developed

Behavior Techniques

• Positive reinforcement
• Negative reinforcement
• Postive punishment- (Ex: Time out for a child misbehaving)
• Negative punishment- (Ex: Taking recess away from child because of misbehavior)
• Progressive Muscle Relaxation- Used to relax the body and mind in hopes of reducing stress and anxiety
• Systematic Desensitization- Used to reduce anxiety by exposing oneself to an anxiety-arousing situation
• Vivo Flooding- Prolonged exposure to anxiety in hopes of reducing anxiety
• Assertion training- The client has the privelage of expressing oneself in the choice of behavior
• Self-management programs- Learning how to cope with one's own problems



My View on Behavior Therapy: I think that the four areas of development that make up this theory are essential and effective for treatment. Operant conditioning can be useful during the first stages of a child's life as far as teaching them discipline and responsibility. I think the Behavior approach can be effective for discovering one's behavior and what techniques best fit the individual.