1. Agenda Setting and Adherence
Essentially, both practitioner and client should decide what to discuss and how to spend the time of the session (Cully and Teten, 2008). On the video session, the step setting agenda was completed at the start of the session representing the typical structure of CBT (Kinsella and Garland, 2008). Because the video simulates the client’ first session, the therapist gives an overview of what the session will include and suggests the matters to discuss giving a brief idea of the timings. Feedback from the client was sought and the client was also invited to add anything that she would like to discuss to the agenda, as proposed by Hughes, Herron, and Younge (2014). The content in the agenda setting defined was adequate
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In the first session it is important to establish a strong therapeutic alliance (Primary Psychiatry, 2006). Clients will obtain a beneficial treatment when they feel that the relationship with the therapist is collaborative, safe, and trusted (Cully and Teten, 2008). On the video it is possible to observe both, therapist and client, participating actively in the session, and this, according to Kinsella and Garland (2008), means that a collaborative style of treatment is being established. The video session shows the therapist and the client working together in a collaborative style. Collaboratively, both practitioner and client identified the problem, set the goals, and defined the expectations of the treatment (Simos, 2009). This improves the growth of a solid therapeutic relationship whereby the therapist and the client understand each other reciprocally (Dattilio and Hanna, 2012). Collaboration was present throughout all phases of the video session. It is possible to observe collaboration during the agenda setting, the formulation, the treatment plan, and throughout the homework assignment (Dobson and Dobson, …show more content…
In CBT, during the first contact with the client, it is important that the therapist displays: empathy, by showing respect for the client (Salkoviskis and Rachman, 1996), positive regard, and genuineness to determinate positive outcomes (Hofmann and Reinecke, 2010). In the video, it is possible to observe the therapist displaying empathy through showing professional concern and understanding for the client’s problem (Salkoviskis and Rachman, 1996). The therapist shows to be an active listener by being open to any message of the client and attempting to clarify and confirm the messages (Cully and Teten, 2008). On the video, the therapist demonstrates warmth and accuracy by using the same language as the client and by using the same adjectives that she used when describing her problem (Marshall and Turnbull, 1996). The therapist also reflected genuineness during the video, by giving attention to the client and keeping eye contact (Cully and Teten, 2008). All this will promote the client seeing the therapist as a self-confident and a skilful professional (Whitfield, Davidson, and Garland,
I personally do not really like this aspect of CBT for few reasons. One of the reasons is that the client may purposely try to fake good or bad. Other times while describing the problem, it could the combination of good and bad. I also believe that even though focusing on both the content and process is not always doable, a balance of both the content and the process is required. For instance, in of the class exercises, Professor Sugar took a role of the client whereas one of the students in the class took a role of the therapist. During this exercise, the student seemed stuck when he paid all the attention to the problem the way that client was describing. I think it is significant because focusing on the content can help give an idea to the therapist of his/her current situation however focusing on the process can give a sense how the problem is internalized in client’s
These techniques include showing concern for clients through active listening and empathy, showing respect for and confidence in clients, focusing on client’s strong points and positive traits, resources, replacing discouraging thoughts with encouraging ones, and helping clients to develop a sense of humor about life. (Watts & Pietrzak,2000,p 443) Another method, as mentioned earlier is building a strong rapport with the client. Therapists use a variety of techniques to facilitate change in the client’s behavior. Therapists help clients to choose alternative behaviors to the behaviors that are maladaptive. The next method is getting the client to change how he or she views a situation. This is done inside and outside of counseling. Through this technique a client comes to realize their abilities and strengths. Last but not least, therapists help clients draw on their resources and strengths when faced with a situation that seems troublesome. (Watts & Pietrzak,2000,p
While CBT has many advantages, it alone does not encompass all of the concepts I believe are necessary to tackle a client’s needs. Therefore, I draw upon concepts from various theories to assist clients in achieving their goals. Pulling from Reality therapy, a key concept I utilize is focusing on what the client is doing and how to get them to evaluate whether they’re present actions are working for them. CBT does use some form of this in the sense that one must examine and establish their cognitive misconceptions; however, I prefer to extract this concept from Reality therapy because CBT tends to do so by focusing on the past. I am a firm believer that while the past can shape who you are, it does little good to remain focused on it. Focusing on overt behavior, precision in specifying the goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes all come from Behavior therapy (Corey, 2013, p. 474). Behavior therapy is highly structured much like that of CBT. By utilizing this aspect of Behavior therapy, I am better able to closely observe where a client is currently and where they are headed. Lastly, I pull from Person-Centered therapy as the final key concept of my counseling approach. PCT focuses on the fact that client’s have the potential to become aware of their problems and resolve them (Corey, 2013). This Person-Centered therapy concept has overlap with CBT as
Although, this session ended with amazing results, I feel as though I need more practice with this type of therapy. I have to continue to practice on allowing the patient to come up with their own solutions. I found it hard not giving advice to my client, because I already knew the situation. However, in the end I found myself very proud, because even though this was not a real therapy session, but the client was able to find a real solution to her problem. This experience is one that teaches the therapist restraint, it allows one to step back and listen. It also gives the client the opportunity to reach a solution themselves without someone giving them the answer to their
...ential impediment to postmodern and CBT interventions is practitioner incompetence. Psychological harm to clients is a potential danger of interventions implemented by untrained or inexperienced therapists. Likewise, the attitude and professional maturity of the practitioner are crucial to the value of the therapeutic process. In both approaches, whether taking on the role of teacher or collaborator, the therapist’s stance is one of positive regard, caring, and being with the client. While techniques and therapeutic styles may vary between and within the postmodern and CBT counseling approaches, they both enlist the client’s diligent participation and collaboration throughout the stages of therapy to accomplish positive therapeutic outcomes.
Counseling skills has provided me with a valuable insight into the helping relationship and how it is both created and maintained in order to encourage growth and development in the client. The factors involved within the helping relationship include considering Roger’s core conditions, congruence, unconditional positive regard and empathy as the three main characteristics necessary in a helping relationship. In order to fully incorporate all three of Roger’s core conditions, I as the counselor must be self-aware, as a lack of self-awareness may inhibit truly listening and understanding the client; self-awareness can be enhanced through exercises such as Johari’s window. Counseling skills such as body language and active listening also plays a role within encouraging the client to open up and can help me as the counselor convey empathy.
Research has shown that a strong therapeutic alliance is necessary for establishing a beneficial contact between the therapist and the client. If the therapist does not encourage the creation of a reliable therapeutic alliance from the beginning of the treatment, it will be hard to develop a constructive relationship with the client later. Establishing the therapeutic alliance will increase the chances of achieving the goal of the treatment because the clients will be willing to cooperate if they trust and respect the therapist. Clients are not likely to cooperate with therapists who impose their authority aggressively. Instead of imposing their authority on the patient, therapists should develop work with their patients by building a mutual relationship based on trust, understanding, and respect for the client.
Ruddy, N. B., Borresen, D. A., & Gunn Jr., W. B. (2008). Colocating with medical professionals: A new model of integrated care. In The collaborative psychotherapist: Creating reciprocal relationships with medical professionals (pp.115–133). Washington, DC: American Psychological Association.
Understanding the counseling session from the client’s perspective is a very important aspect in the development of a therapeutic relationship. A clinician must be an excellent listener, while being to pay attention to the client’s body language, affect and tone. The dynamics in the counseling session that is beneficial to the client include the recognition of the pain that the client is feeling. The detrimental part of this includes a misunderstanding of the real issues, a lack of consideration of the cultural aspects of the client, and a lack of clinical experience or listening skills. In this presentation, we will discuss the positive and negative aspects of the counseling session from the client’s perspective which includes the client’s attitudes, feelings, and emotions of the counseling session. We will next examine the propensity of the client to reveal or not reveal information to the counselor, and how transference, and counter-transference can have an effect on the counselor-client relationship.
Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., . . . Wilson, G. T. (2009). Mind the gap: Improving the dissemination of CBT. Behaviour Research and Therapy, 47(11), 902-909. doi:http://dx.doi.org/10.1016/j.brat.2009.07.003
In the preparation phase, the therapist starts to teach the client some self-care techniques that could guide the client to control his/her emotions (Bartson, 2011). Self-care techniques are also very helpful in guiding the clients’ emotions during and between sessions (Bartson, 2011). In this stage of the therapy, the therapist is able to thoroughly explain the therapy to the patient in the aspect of the process, expectations during and after therapy (Bartson, 2011). Trust is usually developed in this phase of the therapy between the therapist and the client (Bartson,
Furthermore, my goal is to let client fix their problems on their own through insight and guidance from the therapist. I envision a successful therapeutic process being when a client follows their goals and achieves positive outcomes in their lives. I seek to gain a therapeutic process with my clients by building rapport, trust, and helping them gain insight. When my clients are stuck and need motivation, I plan to remind them about their goals and the positive things that will come with change. If family is important to a client, informing the client about their family and their happiness may help motivate them to continue to
t's problems. Instead, it should permit the client to feel that she has support to dive into emotions she might have been afraid to do so before entering client centered therapy. It is interesting to note according to Raskin et al. ( 2011), “Our basic practice [client centered therapy] remains true to the core conditions no matter who our client may be. We also assert that our ability to form an initial therapeutic relationship depends on our own openness to and appreciation of respect for all kinds of difference” (p. 183).
Current research implies that an empathetic clinician-client relationship and interrelated ecosystems play the majority role in the success of therapy (Kilpatrick & Holland, 2009). The clinician’s ability to be present and actively perceive what the client is experiencing is of utmost importance in creating a therapeutic alliance. It is imperative that the clinician gains positive regard towards the client and their environment displaying honest acceptance towards the client no matter what issues are presented in session. This closely relates to a sincere presentation of genuineness that instills a feeling of honesty within the client and clinician (Kilpatrick & Holland, 2009). An experienced clinician builds upon the therapeutic
However, CBT relies heavily on therapeutic relationship for the success of the treatment. Many may decide that CBT feels cold and too mechanical due to the heavy focus on cognitions and the structure. In Beck’s earliest manuscripts, however, he stresses the importance of developing a strong therapeutic relationship with the client (Beck, 2011). Throughout the counseling process, the counselor works to build trust and rapport with the client through collaboration and encouraging optimism (Seligman & Reichenberg, 2014). The therapeutic relationship remains collaborative, empathetic, active, flexible, nonjudgmental, and goal-oriented (Seligman & Reichenberg, 2014). Due to the collaborative nature of the therapeutic relationship, the counselor encourages the client to provided feedback throughout the process. Anytime problems arise within the relationship, the counselor and client explore them together (Beck,