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Theoretical Summary Paper: This course introduces students to the major theories of counseling that have been developed over the past century. Although there are countless theories of psychotherapy, this course is designed to focus on the major theories that have historically impacted therapeutic development and intervention. This assignment requires you to choose a specific theory you like (from the textbook/PowerPoints/notes from class) and write a summary. A summary gives the reader a brief overview of the main points (important information). Your summary should include: a brief introduction of the theorist (s), describe key concepts, explain techniques, and identify strengths and limitations of the theory, etc. Please do not use the author’s words; it will be an act of plagiarism. You must use your own words. Your summary should be between 5-8 pages, which does not include the title and reference page.

Due in 12 hours

Existential Therapy
Probing the nature of being human


Rollo May
Born April 21, 1909, in Ada, Ohio. (died in 1994)
Childhood was not particularly pleasant
His parents didn’t get along and eventually divorced
His sister had a psychotic breakdown

Went to Michigan State (asked to leave because of involvement with a radical student magazine). Received B.A. from Oberlin College in Ohio.

After graduation, went to Greece
Taught English at Anatolia College for three years
Worked as an itinerant artist
Studied briefly with Alfred Adler

Returned to U.S. and entered Seminary (received B.D. in 1938)
Suffered from tuberculosis (spent three years in a sanatorium).  Facing the possibility of death was probably the turning point of his life
Studied psychoanalysis at White Institute. Met Harry Stack Sullivan, Erich Fromm.
Went to Columbia University in New York, where in 1949 he received the first PhD in clinical psychology that institution ever awarded.
Taught at a variety of top schools.  In 1958, he edited the book Existence, which introduced existential psychology to the U.S. 


Existential Theory
Based in philosophy
“How did I get into the world? Why was I not asked about it, why was I not informed of the rules and regulations but just thrust into the ranks as if I had been bought by a peddling shanghaier of human beings? How did I get involved in this big enterprise called actuality? Why should I be involved? Isn’t it a matter of choice? And if I am compelled to be involved, where is the manager—I have something to say about this. Is there no manager? To whom shall I make my complaint?”
Helps people examine issues of personal meaning
“Now it is no longer a matter of deciding what to do, but of deciding how to decide.”
Less about theory and more about offering perspective on the human condition


Basic Assumptions of Existential Therapy
The Primacy of Experience: Every individual is unique
Isolation: We are born alone and die alone.
Personal Meaning: What is the purpose for living?
How we live our life (being-in-the-world)
Do we visit all the rooms in our house?
Self Awareness: Live in the here and now


Basic Dimensions of Existentialism
Self-awareness –the greater the awareness the greater the potential freedom; everything is a choice; anxiety accompanies awareness of our finitude and the consequences of our choices.
Freedom and responsibility — bad faith of not accepting responsibility -“There are no victims here.”
Creating oneself and relationships — looking beyond the conventional guidance and what others expect of us; using our sense of aloneness to get in touch with what are truly our values and goals
Choosing relatedness
Challenging clients—-What they get from they relationship? How they avoid close relationship?

Basic Assumptions (free choice)
Free Choice: People can choose what they become

Freedom: People have fear of freedom because with freedom comes choice and the possibility of choosing poorly (responsibility)


Basic Assumptions (responsibility)
Responsibility: We are responsible for our own lives
Genes and environment are important. They are just not deterministic
Many individuals, at some point, struggle with accepting this responsibility and, therefore, deny or limit their own freedom
Sartre: “Statements of bad faith”; inauthentic to assume that our existence is controlled by forces external to ourselves
Displace responsibility onto others (“My boss made me work late”)
Think of self as helpless victim of circumstances (racism)
Attribute behavior to unconscious drives (“I’d never do something like that”)
Absolve themselves of responsibility by a sort of temporary insanity (“It was the beer talking”)


What are the possible reasons that people tend to blame others for their problems?

Existential Principles (Rollo May)
Wish: To be in touch with what one really wants
Will:  To organize oneself in order to achieve one’s goals (roughly “ego”) or “the ability to make wishes come true.” 
Neo-puritan: All will, but no love.  Amazing self-discipline, can “make things happen”… but no wishes to act upon.  So they become “anal” and perfectionistic, but empty and “dried-up.”  (archetype?)
Infantile: All wishes but no will.  Filled with dreams and desires, lack self-discipline to make anything of their dreams and desires, and so become dependent and conformist.  They love, but their love means little.  (archetype?)
Creative: A balance of these two: “Man’s task is to unite love and will.” 


What is the meaning or purpose of your life?
What do you want from life?
Where is the source of meaning for you in life?

Anxiety and fear
Neurotic anxiety is not good.
Choices are opportunities, not problems

Sometimes “life happens” Deaths, accidents and traumas can:
Force us to become aware of a problem
Force us to reconsider how we live life
Cause us to accept responsibility for the direction of our life
Existential anxiety
Makes us aware of the “big issues.”
Helps us steer an effective path through life
Helps us become aware of separations from:
Cannot be lived with constantly, but should be revisited time to time


The gift of death
Death: It kills us but without it we would not know we were alive
“As death, when we come to consider it closely, is the true goal of our existence, I have formed during the last few years such close relations with this best and truest friend of mankind, that his image is not only no longer terrifying to me, but is indeed very soothing and consoling! And I thank my God for graciously granting me the opportunity . . . of learning that death is the key which unlocks the door to our true happiness.”
– Wolfgang Amadeus Mozart


May’s stages of development
(age-salient, not age-dependent)
Innocence — the pre-egoic, pre-self-conscious stage of the infant. The innocent is pre-moral (i.e., is neither bad nor good).  Like a wild animal that kills to eat, the innocent is only doing what he or she must.  But innocents do have a degree of will in the form of a drive to fulfill their needs!
Rebellion — the childhood and adolescent stage of ego development or self-consciousness. It is characterized primarily through contrast with adults, from the “no” of the two year old to the “no way” of the teenager.  The rebellious person wants freedom, but does not yet understand the responsibility that goes with it.  The teenager may want to spend her allowance in any way she chooses — yet still expect the parents to provide the money, and complain about unfairness if she doesn’t get it!
Ordinary — the normal adult ego: conventional and a little boring.  This person has learned responsibility, but finds it too demanding, and so seeks refuge in conformity and traditional values.
Creative — the authentic adult, the existential stage, beyond ego and self-actualizing.  This is the person who, accepting destiny, faces anxiety with courage!


Therapeutic Goals
Find meaning in life — even from the terrible
Change meanings to those that are more healthy and adaptive
To “live as if you were living already for the second time and as if you had acted the first time as wrongly as you are about to act now” (Frankl, Man’s Search for Meaning)
How can this be accomplished?
Listen and understand client’s worldview.
Communicate your understanding to client.
Only when client recognizes that therapist understands, can therapy focus on shifting meanings.


The Therapeutic Process
Being in the moment: Focusing on the here and now.
Focus on owning feelings, desires, and actions
Can’t vs. Won’t
Whose unconscious is it?
Making connections to the past: Clients are encouraged to emotionally relive past life events.
Integrating the felt experience (including in therapy) into primary relationships
Integrating what was learned: Being a new person in the present moment.
Deal and confront inability to feel and/or want
Identify and deal with conflicting wants
Help client process the “what ifs”


Specialized techniques (Lukas, 1984)
Reframing — searches for the positive in the situation.  Must wait until client feels heard
Paradoxical intention — encourages client to do what client is afraid might happen.  Returns control to the client.

Dereflection — redirects focus from the maladaptive to the healthy
You’ve been spending a lot of time worrying about your daughter — and driving you both crazy!  Perhaps this would be a good week to find something else to do.  You’ve talked about wanting to…


Situational reconstruction
think of three ways in which a situation could be better and three ways in which it could be worse – to help people move on from the place they are stuck
Compensatory self improvement
work on areas that you have control when you are in a situation you don’t control

Disadvantages of Existential Therapy
It is dense, complex and difficult to master.
There is very little guidance for the practitioner.
You can be an existentialist but you cannot do it. It is not about technique but your own personal stance.


Existential & Phenomenological – it is grounded in the client’s “here and now”
Goal: clients gain awareness of feelings and behaviors in the here and now
Promotes direct experiencing rather than talking about situations
talk about a childhood trauma vs. become the hurt child

Goal Gestalt Therapy

Gain awareness
Know the environment
Know oneself
Learn about dominant ways of avoiding contact
What does the resistance (defense) does for the client
What it protects the person from
What it keeps the person from experiencing
Accept oneself and responsibility for self
Allow oneself to make contact

Areas of Application
Grief work, facing a significant decision, developmental crisis, coping with failures in marriage and work, dealing with physical limitations due to age……

From a multicultural perspective
Applicable to diverse clients to search for meaning for life
Be able to examine the behavior is influenced by social and cultural factors.
Help clients to weigh the alternatives and consequences.
Change external environment and recognize how they contribute

From a multicultural perspective
Excessively individualistic
Ignore social factors that cause human problems
Even if clients change internally, they see little hope the external realities of racism or discrimination will change
For many cultures, it is not possible to talk about self and self-determination apart from the context of the social network
Many clients expect a structured and problem-oriented approach instead of discussion of philosophical questions.

Summary and Evaluation
Lacks of a systemic principles and practice for therapy
No empirical research validation yet
Limited to apply to lower-functioning clients, clients who need directions, are concerned about meeting basic needs, and lack of verbal skills

Case 1
I find myself terrified when I am alone. I need people around me constantly, and if I’m forced to be alone, then I run from myself by watching TV. I’d like to learn how to be alone and feel comfortable about it.
What are the issues?
What can you do to help this client?

Case 2
I feel like my existence does not matter to anyone. If I were to die today, I fully believe that it wouldn’t make a difference to anyone.
What are the issues?
What can you do to help this client?

Case 3
I rarely feel close to another person. While I want this closeness, I am frightened of being rejected. Instead of letting anyone get close to me, I build walls that keep them removed. What can I do to lessen my fear of being rejected?
What are the issues?
What can you do to help this client?

Dialectical Behavior Therapy


General Overview
Marsha Linehan
Orientation combines systemic/transactional approach, CBT, Buddhism, and principles of Dialectics.
Developed for use with persons with BPD, but has also been applied to suicidal behavior in adolescents and bulimia.


Four Keys
focuses on improving an individual’s ability to accept and be present in the current moment.
Distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. relationships.

Emotional Regulation:
covers strategies to manage and change intense emotions that are causing problems in a person’s life.
Interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens

Linehan’s Theory of the Development of BPD
Based on a bio-social theory of BPD.


Philosophical perspective of dialectics: balancing opposites.
Find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking.
DBT promotes a both-and rather than an either-or outlook.

Therapists’ Working Assumptions about the Client
The client wants to change, and despite appearances, is trying his/her best as a particular time.
His/Her behavior pattern is understandable given his/her background and present circumstances.
In spite of this, he/she needs to try harder if things are to improve.
Clients can not fail at DBT.


Therapists’ Dialectical Style
Reciprocal communication vs. Irreverent communication.
Accepting of the client as he/she is, but encouraging change.
Centered and firm, yet flexible when the circumstances require it.
Nurturing, but benevolently demanding.


Clients’ and Therapists’ Agreements
To work in therapy for a specified period of time, and to attend the majority of therapy session.
If suicidal or para-suicidal behaviors are present, he/she must agree to work on reducing these.
To work on therapy interfering behaviors.
To attend skills training.


Modes of Treatment
Individual therapy.
Group skills training.
Telephone contact.
Therapist consultation.


Skills Training
Core mindfulness skills.
Interpersonal effectiveness.
Emotion modulation skills.
Distress tolerance skills.


Individual Therapy
Stages of therapy.
Hierarchy of therapy targets.
Treatment strategies.


Stages of Therapy
Stage 1: focus on suicidal behaviors and therapy interfering behaviors.
Stage 2: focus on PTSD related problems.
Stage 3: focus on self-esteem and individual treatment goals.


Hierarchy of Therapy Targets
Decreasing suicidal behaviors.
Decreasing therapy interfering behaviors.
Decreasing behaviors that interfere with quality of life.
Increasing behavioral skills.
Decreasing behaviors related to post-traumatic stress.
Improving self-esteem.
Individual targets negotiated with the client.


Treatment Strategies
Contingency management.
Cognitive therapy.
Exposure based therapies.


Play Therapy


History of Play Therapy
Sigmund Freud first used PT in 1909
Carl Rogers introduced person-centered theory
Virginia Axline-created non-directive play therapy
Current definition
“the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.”



The Association for Play Therapy (APT)
1982 to foster contact among mental health professionals interested in exploring and, when developmentally appropriate, applying the therapeutic power of play to communicate with and treat clients, particularly children.

What is Child-Centered Play Therapy
Restate what the child says (if anything)
Reflect feeling and content
Set limits in the playroom that prohibit the student from hurting self, you, or materials
Emphasis on the child and the natural way that a child can work out an issue


Children’s natural language is play. Play is a developmentally appropriate way that children express themselves. (Axline and Landreth)
Play is a natural way for children to express feelings/emotions (Drewes)

Many children learn through hands-on activities and movement (Gardner’s Theory of Multiple Intelligences)

Play therapy matches with Piaget’s theory of cognitive development (Ray et. Al, 2005)
Preoperational stage (ages 2-7): language skills are not as developed as internal awareness
Concrete Operations Stage (ages 8-11): limits in abstract reasoning- play helps bridge gap between concrete experience and abstract thought

Practical applications in the school
Play therapy can be used to assist in GEIS and IEPs to inform classroom observations and social-emotional analysis

Solution Focused Brief Therapy
It works well for clients and cultures who like a fast, no-nonsense, down-to-earth approach and who are not interested in the cognitive, behavioral or affective components of a problem.
Places emphasis on the future rather than the present or past.
All people are free to make choices.
Client’s are their own experts who know what is best for them.
The therapist accepts the client’s view of reality.

Solution Focused Brief Therapy
Places emphasis on the future rather than the present or past.
All people are free to make choices.
Client’s are their own experts who know what is best for them.
The therapist accepts the client’s view of reality.

Solution Focused Brief Therapy
“If it ain’t broke, don’t fix it”: The client determines the goals of counseling, not the therapist.
“Once you know what works, do more of it”: This helps the client see positive behaviors and reinforces proactive behaviors.
“If it’s broke, do something to fix it. If it doesn’t work, don’t do it again”: If it is not working there is no need to try it again.

De Shazer’s Miracle
Suppose that one night, while you are asleep, there is a miracle and the problem that brought you here is solved. However, because you are asleep you don’t know that the miracle has already happened. When you wake up in the morning, what will be different that will tell you that the miracle has taken place? What else?

De Shazer’s Miracle
What difference would you (& others) notice?
What are the first things you notice?
Has any of this ever happened before?
Would it help to recreate any of these miracles?
What would need to happen to do this?

The Nightmare Question:
Think about having a terrible nightmare where your problem was amplified.

What would be happening to let you know your nightmare came true?

This might be used when client minimizes or denies his or her problem.

Techniques: Tracking
The counselor is an observer
The counselor restates what the child is doing without adding negative or positive statements
Children are allowed to process on their own without counselor interpretation


Experiential Activity with Tracking and Reflection
What did you notice from the client’s play?
What themes can you draw from it?
What would you write in notes about the child?


Directive Play Therapy
Directive = Counselor leads or guides session
Creative activities are used to guide counseling sessions in order to gauge the thoughts, feelings, and behaviors of the client
Goal oriented
Allows for specific evidence of change and growth in the child


Techniques: Cognitive Behavioral Play Therapy
The emphasis is on developing new, more adaptive thoughts and behaviors
The counselor uses techniques to guide student in using more helpful coping strategies to deal with problems
Pairs concrete examples with abstract ideas and emotions


Experiential Activity: Balloons
How did the activity help explain the thought-feeling connection?
For which developmental levels is this appropriate?
How can this activity help the counselor/student with goal setting?


Applying play into your Counseling
Play, art, story-telling, and music can be integrated with multiple theoretical approaches
Play can be used as a medium within a counseling session to bring ease to any aged child
Middle and high school students may even long for a modality of expression other than spoken language
Direct questions do not always produce direct responses


Who is using Play Therapy
In 2005, 105 counseling graduate programs in the US offered at least one course in play therapy
In 2005, 978 school counselors from ACA and APT were surveyed about their theoretical background and 66.6% responded child-centered with cognitive behavioral in second at 9.2%
Of those responding to the survey, the average number of graduate courses taken in Play Therapy was 1.5


Who is using Play Therapy
Elementary school counselors were survey about opinions of Play Therapy (381 School Counselors)
97% of the school counselors believed that play was the natural language of a child
In a qualitative section responders indicated that limitations to using Play Therapy in schools included lack of time with students and lack of training (2005)


Balloons of Anger

Nurf Game

Butterflies and Anxiety



Sand Tray, Puppets, Jenga

Cotton Balls
Group/Family Work

Sand Tray Therapy
Sandplay Therapy is often used with those who have suffered some form of trauma, neglect, or abuse.

The client chooses from a large collection of toys and builds a small “world” in the tray that reflects what is going on in their lives.
The therapist observes the choice and arrangement of toys without interruption, allowing the person to find answers within themselves.

The client and therapist analyze and discuss the client’s toy choices, their arrangement pattern in the sand, and their symbolic or metaphoric meanings.
Sandplay therapy may consist of a single session or last as long as several years.

Dora Kalff
Sandplay therapy was developed in the late 1950s
Jungian training and Eastern philosophical beliefs.

The scene creation phase, in which clients arrange their minatures  in the tray, is very important and is central to the sandtray therapy experience.
In humanistic sandtray therapy, the processing phase helps clients to focus on the sandtray scene and their inner experiencing as they explore their scene.

Final Thoughts
Play therapy allows children to process and proceed at their own pace
Developmentally appropriate
Works with culturally diverse children, labeled children, and those experiencing trauma
Graduate students should be aware of and trained in play therapy to face the needs they will encounter in the school/clinical system


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