Chapter One: Introduction to

Psychotherapy and Counseling

Theory and Technique
Background and Overview
 Opening stories
– First client
– Second client
– 22 years later
 Determining why people suffer, how they change,
and how to help them live more satisfying and
gratifying lives is a huge task.
Historical Context
 The Father of Psychotherapy?
 Alternative Historical-Cultural Realities:
Three Perspectives
– The biomedical perspective
– The religious/spiritual perspective
– The psychosocial perspective
Definitions of Counseling and
Psychotherapy
 What is Psychotherapy?
 What is Counseling?
 What are the Differences between
Psychotherapy and Counseling?
 A Working Definition of Counseling and
Psychotherapy: “A trained person who
practices the artful application of
scientifically derived principles . . . (see p.
9).
What is a Theory?
 “A coherent group of general propositions
used as principles of explanation for a class
of phenomena” (Random House, 1993, p.
1967).
 For counseling and psychotherapy, a theory
needs to accurately describe, explain, and
predict a wide range of therapist and client
behaviors (p. 9).
Modern Therapy: Does it work?
 Eysenck’s early review
 A celebration of effectiveness
 Is psychotherapy harmful?
 Are psychotherapy researchers and
practitioners objective?
What Helps Clients: Common
Factors or Specific Techniques?
 Specific techniques
 Common therapeutic factors
– Extratherapeutic change (40%)
– Therapeutic relationship (30%)
– Expectancy (15%)
– Techniques (15%)
 Techniques or common factors? The wrong
question
Ethical Essentials
 Confidentiality
 Multiple roles
 Client harm: The sexual abuse of therapy
clients
 Competence and informed consent
 Additional ethical issues
Emergence of Personal Theory
 Your first client and your first theory
 Your emerging personal theory (see
Practitioner Commentary, 1.1)
 A summary of 12 major theoretical
perspectives (see Table 1.1)
Our Biases
 Our theoretical roots
 Balance and uncertainty
 Theory versus technique
The Zeitgeist, the Ortgeist, and
the Poltergeist
 Zeitgeist: The spirit of the time
 Ortgeist: The spirit of the place
 Poltergeist: A mischievous spirit or ghost
 Experience your theory (see Practitioner
Commentary 1.2)
Concluding Comments
 You’ve just been on a quick tour of some
major issues in counseling and
psychotherapy.
 We wish you the best as you explore the
main theories of therapy in greater depth.
Student Review Assignments
 Critical corner
 Reviewing key terms
 Review questions
Critical Corner
 1. Most of the psychological theories
reviewed in this book were developed by
privileged, White, and European or
American males. Given the narrow origins
of these theories, how can the information
provided be useful to you as a developing
mental health professional?
Critical Corner (continued)
 2.  Smith, Glass, and Miller in their extended
meta-analysis of therapy outcome studies
concluded that the average person treated in
therapy was better off than 80% of the untreated
sample. Of course, they neglected to comment on
the inverse fact that average untreated person was
better off than about 20% of the treated clients.
What does this inverse statement suggest? Are
there large numbers of treated therapy clients who
are getting worse? Or are some untreated clients
somehow spontaneously getting better?
Critical Corner (continued)
 3. In this chapter we’ve suggested that you
begin to explore different theories and that,
in the end, perhaps the best theory will be
your personal theory. Is this a valid
suggestion? Might you be better off to
simply adopt a particular theory and hang in
there with it, despite its limitations?
Wouldn’t you be better off just knowing
one theory very well, rather than knowing a
little bit about many different perspectives?
Reviewing Key Terms
 The biomedical perspective
 The religious/spiritual perspective
 The psychosocial perspective
 Trephining
 Meta-analysis
 The Do Do bird effect
 Extratherapeutic change
 Confidentiality
Key Terms (continued)
 Informed consent
 Zeitgeist
 Ortgeist
 Poltergeist
Review Questions
 1. What is the difference between a therapeutic
experience and a therapy experience?
 2. Who was Hans Eysenck? Why is he important
to the evolution of psychotherapy and counseling?
 3. What are the common factors and their relative
importance as described by Lambert (1992)?
 4. Why is sexual contact between therapist and
client now referred to as sexual abuse of clients?
 5. What are the limits of confidentiality in
therapy?