PSYCHOTHERAPY AND

COUNSELING ESSENTIALS: AN
INTRODUCTION

Chapter One
 WHAT IS A THEORY?

• “A theory involves a gathering together and organizing of knowledge about a

particular object or phenomenon” (Sommers-Flanagan, J. & Sommers-
Flanagan, R., 2018, p. 3).

• A counseling or psychotherapy theory needs to accurately describe, explain,

and predict a wide range of therapist and client behaviors.

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 HISTORICAL CONTEXT

• Origin of psychotherapy?

• What is meant by the following

statement?
“In psychology, even the rats are white
and male.”

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 HISTORICAL-CULTURAL
PERSPECTIVES

• The biomedical perspective

• Then: trephining
• Now: serotonin hypothesis

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 HISTORICAL-CULTURAL
PERSPECTIVES II

• The religious/spiritual perspective

• Then: Evil spirits
• Now: Mindful acceptance
• Now: What else?

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 HISTORICAL-CULTURAL
PERSPECTIVES III

• The Psychosocial Perspective

• Then: Verbal and relational interactions
• Now: CBT; solution-focused; others?

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 HISTORICAL-CULTURAL
PERSPECTIVES IV

• Feminist and multicultural perspectives

• Then: Emphasize relationship and community
over individuality.
• Now: Has this changed? Perhaps a greater
emphasis on minority voices

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 DEFINITIONS OF COUNSELING
AND PSYCHOTHERAPY

• What is psychotherapy?
• Anna O: The talking (expressive) cure
• Now: The psychoeducational (learning) cure

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 DEFINITIONS OF COUNSELING
AND PSYCHOTHERAPY

• What is counseling?
• More of a focus on “normal-functioning”
individuals?
• Other descriptions?

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 COUNSELING VERSUS
PSYCHOTHERAPY I

• “Counseling and psychotherapy are the same

qualitatively; they differ only quantitatively;
there is nothing that a psychotherapist does
that a counselor does not do” (Corsini &
Wedding, 2000, p. 2).

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 A WORKING DEFINITION

A process that involves

•a trained professional who abides by
•accepted ethical guidelines and has
•competencies for working with
•diverse individuals who are in distress or have life problems
that have led them to
•seek help (possibly at the insistence of others) or they may be

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 DEFINITION II

• seeking personal growth, but either way, these parties

• establish an explicit agreement (informed consent) to
• work together (more or less collaboratively) toward
• mutually agreed upon or acceptable goals

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 THE SCIENTIFIC CONTEXT OF
COUNSELING AND
PSYCHOTHERAPY

• Common Therapeutic Factors: Many exist

• Lambert’s (1992) model includes:
– Extratherapeutic change (40%)
– Therapeutic relationship (30%)
– Expectancy (15%)
– Techniques (15%)

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 THE SCIENTIFIC CONTEXT OF
COUNSELING AND PSYCHOTHERAPY V

• What Constitutes Evidence? Efficacy,

Effectiveness, and Other Research
Models
• Efficacy research—Randomized controlled
trials (RCTs) Efficacy research has high
internal validity and are often produce
empirically supported treatments (ESTs)

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 ETHICAL ESSENTIALS

• Competence and Informed Consent—

Explaining therapy and establishing a
“treatment contract”

• Qualitative study (Woodside et al., 2007)

• Work out your own issues
• Work within a learning community
• Skills practice and feedback

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 ETHICAL ESSENTIALS II

• Multicultural Competence
• Self-awareness
• Multicultural knowledge
• Culturally specific skills
• Advocacy

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 ETHICAL ESSENTIALS II

• Confidentiality
• What are some practical examples of
confidentiality?
• What are the limits of confidentiality?
• What makes confidentiality so central?

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 ETHICAL ESSENTIALS III

• Multiple Roles and Boundaries

• What are some possible multiple roles? What are
your thoughts on touching clients?
• The Sexual Abuse of Therapy Clients
• There is always a power differential.

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 ETHICAL ESSENTIALS IV

• Doing No Harm: A Convergence of

Ethics and Science
• Therapist factors: Little empathy; overly
confrontational; inadequate assessment; poor
therapist fit
• Client factors: Low motivation; high
psychopathology; low personal resources
• Psychological intervention factors: Potentially
harmful therapies (PHTs; Lillienfeld, 2007)

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 ETHICAL ESSENTIALS V

• A Plan for Maximizing Positive Outcomes

• Use evidence-based relationships, like the working
alliance and Rogerian core conditions.
• Integrate empirically supported treatments
• Use evidence-based principles
• Avoid negative outcomes factors.
• Use flexible, culturally sensitive, assessment procedures.
• Use practice-based evidence or progress monitoring
(PM).

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 NEUROSCIENCE TERMINOLOGY

• Frontal lobe
• Parietal lobe
• Temporal lobes
• Occipital lobe
• Hemispheres (right and left)
• Neurons and neurotransmitters
• Axon
• Dendrite

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)

 EMERGENCE OF PERSONAL
THEORY

• Personal theory involves putting your self into one of

the available theoretical orientations

• What’s your “natural” theoretical orientation?

(Sommers-Flanagan, J. & Sommers-Flanagan, R., 2018)