INTEGRATIVE

APPROACHES Session 4

TO Pauline Elwell
pauline.elwell@canterbury.ac.uk

COUNSELLING
AND THERAPY
 o To analyse and develop a practice-based understanding of these
theories through active engagement in skills practice throughout the
module.
o To engage critically with the approaches and to explore their
suitability for different populations of clients in different contexts.
o To explore a range of challenging issues raised in counselling,

MODULE including loss, separation, bereavement, addiction, self-harm.

AIMS o To apply and evaluate the application of advanced counselling and

interpersonal skills, including challenge, immediacy and use of
silence. Critically
o To evaluate the impact of the social and cultural context in which
counselling takes place and develop appropriate understanding of
diversity and multicultural approaches within the helping professions.
 o Clearly explain an integrative approach to counselling in practice.

oAnalyse and critically evaluate Transactional Analysis to understand

communication and relationships within the helping encounter.

oAnalyse the integration and application of Transactional Analysis

MODULE (TA), Cognitive Behavioural Therapy (CBT) or Solution Focused

(Brief) Therapy (SFT or SFBT) in helping relationships, using an

OUTCOM integrative model.

ES oIdentify and apply counselling skills and approaches for working

with a range of challenging issues with due reflection upon the
issues of diversity and power within the helping interaction,
recognising developmental and learning needs.
CONTRACT
oRespect each other’s rights to their opinions/views oMobiles – on desks if necessary for dependents an/or

oAdopt a non-judgemental approach (if possible?) only use for session activities

oPunctuality – plan to arrive / start on time.

oShare if/when you feel safe to do so
oListening – giving space/not interrupting
oPositive/supportive learning environment
oTaking responsibility for the contract
oEngage fully in learning activities
oBehave assertively/positively
oConfidentiality (within the boundaries discussed at
oRespond respectfully
time of contract ) anonymity
oHow can we challenge when we feel that the
oEmbracing diversity
contract has not been adhered to?
 Congruence

CORE
CONDITIO Acceptance – Unconditional
Positive Regard
NS
Empathy
 THEORETICAL
APPROACHES
The majority of the mainstream approaches and
theoretical models, can be considered under one of
four primary ‘umbrella’ headings:

o Psychodynamic Approaches
o Humanistic Approaches
o Cognitive-Behavioural Approaches
o Integrative or Pluralistic Approaches.
 INTEGRATIVE
APPROACH -
DEFINITIONS
Cognitive Person-
‘Integration covers a wide range of
perspectives, making it impossible to present a
Behavioural centred
unified set of theoretical assumptions in a way Therapy Therapy
that may be possible for purist approaches’

(Dryden and Reeves (2014)

‘the counsellor brings together elements from

different theories and models into a new theory Solution
Transactiona
or model’ (McLeod (1998) Focussed
l Analysis
Therapy
‘What is integrated is any knowledge that
helps me understand the client, her process,
myself and the therapy’ (Worsley, 2011)
 oScaling – “on a scale of 1-10, where are you
now?”
• reflect on positive situation, “so you’re about halfway
CHARACTE up the scale already!”
oMiracle question – “imagine that a miracle
RISTICS OF occurs over night and the problem that you
SOLUTION brought here today has disappeared, how will
you know that this miracle has taken place?”
FOCUSSED • this highlights what would be present in the client’s
life if the problem didn’t exist
oExceptions – “have there been times when X is
less of a problem?”
• this helps to identify what works and what the client
might be able to focus on.
SOLUTION FOCUSED
QUESTIONING
HOW DO WE ENSURE SFT IS
PERSON-CENTRED?
oUse of Paraphrasing
oClients Language
oBuilding an alternative SF Picture/ vision
oEvaluation and steps to success ‘how will we
know if it is working/ moving towards goal’
 oPsychological formulation of the problem (a picture of why the
problem exists)
oStructured sessions
oGoal-directed (working towards change)

CHARACTER oExamining and questioning and challenging unhelpful thinking

ISTICS OF oUse of specific techniques to create change

CBT
CURWEN, B (2000) BRIEF
oUse of ‘homework’
oTime-limited Intervention
COGNITIVE BEHAVIOUR
THERAPY. LONDON; SAGE o‘Here and Now Principle’ focus on what is happening now not
in the past
oEmpowering philosophy with a view to the client becoming
their own therapist
SELF-DESTRUCTIVE
BELIEFS AND
AUTOMATIC
NEGATIVE THOUGHTS

oThese are negative thoughts or

beliefs that we are not able to
control or manage successfully.
oThese in turn impact on how
we behave and/or feel
oThese might involve self
criticisms, being critical of
others or exaggerations of
circumstances
SELF-DESTRUCTIVE BELIEFS AND THEIR (POSSIBLE)
CONSEQUENCES
Self-destructive belief Consequence
Should, must, ought-to, have-to Should, must, ought- to, have-to
I must do well at school, I should pass all my exams with A grades Working too hard, panic attacks, stress-related behaviours
My parents should let me do what I want like my friend’s parents Rebellion! Arguments and fights with parents and family
do
Lack of self esteem, unhealthy eating, risk of eating disorders
I ought to be as thin as the celebrities in the magazines

Catastrophising
Catastrophising (** What does this mean?)
If I don’t smoke that joint/steal that handbag everyone will hate
me Risk-taking or dangerous behaviour ‘going along with the crowd’

My boyfriend has dumped me. How can I ever face my friends Telling lies, trivialising, putting on a ‘brave face’ in front of friends
again?
Choosing not to take action because it’s bound to fail
There’s no point in going for that job, I’ll never get it
SELF-DESTRUCTIVE BELIEFS AND THEIR CONSEQUENCES (CONTINUED)
Always and never
I’m always rubbish at maths. There’s no point even trying
There’s no part in asking my dad if I can go. He never says yes to anything
It’s always my fault when things go wrong
Intolerance of others beliefs
My sister always does that, just to spite me
That’s the second time my friend has forgotten we’re going out. She does it
on purpose
Why can’t he get drunk like the rest of us? He’s so boring!
Blaming beliefs
I can’t go out, my mum won’t let me
It’s not fair. My sister gets all of the attention. No-one’s bothered about me
My friends keep getting me into trouble at school, it’s always them, never
me.
Negative self-perception beliefs
I’m rubbish, I’m stupid, I’m fat, I’m ugly, I’m bad, I’m unloveable
Always and never
Never taking risks, under-performing, accepting failure
Refusing to ask, difficulty in hearing negative responses, fear of failure
Fatalistic, passive aggressive behaviour
Intolerance of others beliefs
Aggressive, negative feelings towards sister
Damaging relationship with friend, expressing anger, feeling hurt and unloved
Intolerance. Possibly losing a friendship
Blaming beliefs
A passive response .Someone else is the ‘bad guy’
Reinforces negative feelings without having to accept responsibility or examine
them further
No need to change because it wasn’t ‘my fault’ in the first place!
Negative self-perception beliefs
In each of the examples the young person might ‘act out’ or ‘live up’ to their
belief, reinforcing the belief through their behaviour. They are likely to feel
unhappy, unpopular and unlikeable
HOW DO WE ENSURE CBT IS
PERSON-CENTRED?
HOW DO WE ENSURE TA IS
PERSON-CENTRED?
o Questioning and reflecting back used to identify states.
o Counsellors are able to judge on an on-going basis whether clients are re-playing
their childhood (Child), accessing communication learned from parent or parental
figures (Parent) or responding directly in the here and now (Adult)
o Counsellors who understand and can identify their own ego states, are able to
monitor their responses to clients
o Counsellors with this knowledge can help themselves and their clients to choose
which response they want to make – client centered.
ASSIGNMENT

1. Case study- 2000 words (50%) Due: 13 th March 2pm

Analyse and critically evaluate a case study in relation to theory.

2. Reflective essay 2000 words (50%) Due: 17th April

Focussing on a particular area explaining and evaluating the most
appropriate approaches.
ASSIGNMENT 1

1. Case study- 2000 words (50%) Due: 13 th March 2pm

Analyse and critically evaluate a case study in relation to theory.
oBackground information
oPresenting issue
oProposed theoretical approach
oTechnique selected
oDiscussion
oConclusion
ASSIGNMENT WRITING
WORKSHOP
Planning our case studies:
oStructure
oKey theories
oKey texts
STUDENT SURVEYS
https://www.canterbury.ac.uk/our-students/ug-current/student-voice/uk-engagement-
survey
STUDENT REPS MEETING
Specifically:
1.Attendance: what are the barriers students are facing?

2.Module evaluations: this is an area where we are only finding between 1 and 5 students

per module completing these. We want to increase this as this is a key way we want to

work to improve the course. What are the barriers to completing the evaluations and

what can the course team do to support students with this.

More generally
3.What is going well?
4.What needs to be improved?
5.What do you want more of and what less of?
ACADEMIC DEVELOPMENT
WEEK
Tutorials:
I am offering tutorials Mon/Tues/Thurs/Fri – please sign up- sheet will be available
during the session.