Monday, October 20, 2014

Experiential Therapy

Experiential Therapy


Theory Foundation

■ Modern person has means to live but often has no meaning to live for- this is the malady of our times, meaninglessness or existential vacuum

■ Purpose of therapy is to challenge people to find meaning and purpose through suffering,
work and love

■ It takes courage to BE 

  • Our choices determine the kind of person we are
  • We are in constant struggle with:


  1. Our want to grow toward maturity and independence
  2. Realizing expansion and growth is often a painful process
  3. Struggling between security and dependence and delights and pain of growth


■ Phenomenological approach

  • People’s perceptions or subjective realities are considered to be valid data for investigation
  • Phenomenological discrepancies
  • Two people perceiving the same situation differently

■ Non-Deterministic approach
o Existentialist argue that it is an oversimplification to view people as controlled by fixed physical laws
o Encouragement of theories that consider individual initiative, creativity, and self fulfillment
o Focus on active, positive aspects of human growth

I-Though dialogue vs. I-It Dialogue
o I-though

  • human confirms the other person as being of unique valued
  • Direct mutual relationship

o I-it

  • Person uses others but does not value them for themselves
  • Utilitarian

o Self disclosing of therapist emotional response to client’s demonstration of valuing of client’s feelings and perspective.




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Monday, October 13, 2014

Experiential Therapy

Experiential Therapy



Aim of Existential Therapy

■ Rejects deterministic outlook on mankind

■ People are free and responsible for their choices and actions

■ People are the authors of their lives

■ Existential therapy encourages clients to:

  • o Reflect on life
  • o Recognize range of alternatives
  • o Decide among them


Goal

  • o Help clients recognize ways they passively accepted circumstances and surrendered control
  • o Help clients to start to consciously shape their own lives by exploring options for creating a meaningful existence.



Tasks of the Therapist
■ Invite clients to recognize how they have allowed others to decide for them

■ Encourage clients to take steps toward autonomy

■ The Question
o “Although you have lived in a certain pattern, now that you recognize the price of some of your ways, are you willing to consider creating a new pattern?”

■ Relationship between therapist and client

  • o Therapy is a journey taken by BOTH therapist and client

● The person to person relationship is key
● The relationship demands that therapists be in contact with their own phenomenological world

  • o The core of the therapeutic relationship

● Respect and faith in the client’s potential to cope.
● Sharing reactions with genuine concern and empathy






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Monday, October 6, 2014

Adlerian Therapy Social Interest

Adlerian Therapy 



Social Interest

■ Adler’s most significant and distinctive concept.
■ Refers to an individual’s attitude toward and awareness of being part of the human community.
■ Mental health is measured by the degree to which we successfully share with others and are concerned with their welfare.
■ Happiness and success are largely related to social connectedness.


Role of Birth Order Psychological Positions

■ Motivates later behavior.
■ First born/ Oldest o Favored pseudo-parents, high achievers

  • o Receives more attention, spoiled

■ Second born

  • o Rivalry and competition
  • o Behaves a in a race, often opposite first child

■ Middle Child

  • o Often feels squeezed out

■ Last born

  • o More pampered, “baby,” creative, rebellious, revolutionary, avant-garde

■ Only Child

  • o Does not learn to share or cooperate with other children
  • o Learns to deal with adults



Encouragement

■ Encouragement is the most powerful method available for changing a person’s beliefs
■ Helps build self-confidence and stimulates courage
■ Discouragement is the basic condition that prevents people from functioning
■ Clients are encouraged to recognize that they have he power to choose and act differently


5 Basic Tasks

■ Acceptance
■ Achieving Intimacy
■ Work
■ Spiritual Dimension
■ Community/Friendship






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Monday, September 29, 2014

Basic Dimensions of the Human Condition

Experiential Therapy



Basic Dimensions of the Human Condition

■ The capacity for self awareness:

  • o The greater our awareness, the greater our possibilities for freedom
  • o Awareness is realizing

● We are finite- time is limited
● We have potential, the choice to act or not to act
● Meaning is not automatic- we must seek it
● We are subject to loneliness, meaninglessness, emptiness, guilt and isolation

■ The tension between freedom and responsibility

  • o People are free to choose among alternatives and have a large role in shaping personal destinies
  • o Manner in which we live and what we become are result of our choices
  • o People must accept responsibility for directing own lives


■ Creation of an identity and establishing meaningful relationships

  • o Identity is the courage to be
  • o We must trust ourselves to search within and find our own answers
  • o Our great fear is that we will discover there is no core, no self
  • o Aloneness

● We must tolerate being alone with self
● We must have a relationship with ourselves first

  • o Struggling with identity

● We are trapped in doing mode to avoid experience of being

  • o Relatedness

● At their best our relationships are based on our desire for fulfillment, not our deprivation

■ The search for meaning

  • o Like pleasure, meaning but be pursued

● Finding meaning in life is a byproduct of a commitment to creating, loving, and working

  • o Life is not meaningful in itself, the individual must create and discover meaning
  • o Goals deal with

● Discarding old values
● Coping with meaninglessness
● Creating new meaning

■ Accepting anxiety as a condition of living

  • o Anxiety arises from striving to survive and maintain own being
  • o Existential anxiety is normal- life cannot be lived, not can death be faced, without anxiety

● Anxiety can be a stimulus for growth as we become aware of and accept our freedom
● We can blunt our anxiety by creating the illusion that there is security to life
● If we have the courage to face ourselves and life we may be frightened, but we will be able to change

  • o Neurotic anxiety creates guilt


■ The awareness of death and nonbeing

  • o Awareness of death is a basic human condition which gives significant to our living
  • o We must think about death if we are to think significantly about life
  • o If we defend against death our lives can become meaningless
  • o We learn to live in the “now”
  • o One day at a time results in a zest for life and creativity





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Thursday, September 18, 2014

Interdisciplinary Collaboration

Interdisciplinary Collaboration



Interdisciplinary Collaboration is the convergence of multiple disciplines on a team to serve a client. Interdisciplinary teams are commonly found in nursing homes, substance abuse treatment centers, psychiatric hospitals, medical facilities, rehabilitation centers, the military and correctional programs. Depending on the setting, a social worker may join with a team member who is a psychiatrist, psychologist, nurse, physician, other medical provider, teacher, clergy, administrator, marriage and family therapist, drug counselor, probation officer or other relevant professional or provider.

Interdisciplinary collaboration within a team setting is a powerful modality than can serve a client or client system without the limits of any one treating profession. The expertise and divergent thought may create a clinical, educational or other environmental picture that would have otherwise been missed if addressed by any one discipline. When multiple disciplines discuss and debate a case, the values and perspectives of those professions weed out the limitations or confirm the merits of any particular intervention approach, maintaining a check-and-balance system unavailable to any one profession.

Those who have worked for any length of time in an interdisciplinary setting also become aware of turf battles and a natural deference that may be given to one profession over another. For example, it is not uncommon for a collaborative team in a psychiatric hospital setting to defer to the psychiatrist or in a medical hospital setting to deter to the physician. However, there is an inherent danger in this because these individuals are likely the ones least involved with the client or patient and who have the least amount of time spent interacting and observing. While their training may be the most extensive, the family counselor or recreational therapist may have information that may directly contradict the information presented to the medical doctor.
Social Workers have a unique role to play in the interdisciplinary team, and must assert professionalism and appropriate diplomacy at all times. While Social Work training may look similar to training in other fields, professional ethics and values are unique from other professions. For example, while working in a mental health clinic undergoing budgetary cuts, a director who is trained in another mental health field may not put the same emphasis into maintaining a counseling program for low-income people as a social worker that is directed by specific values and ethics, spelled out in the NASW Code of Ethics, to strongly advocate for a contingency plan to make a provision for low-income individuals in need of mental health services.

Example:
Mary, a 68 year old, lives in a nursing home for the past 21 years following a stroke that left her in a wheelchair. She is described by many on the staff as “bitter“ and “difficult,“ often making up allegations that one of the nursing staff has withheld a pain medication or treated her poorly in some way. She has often been caught lying, with other staff and patients observing a situation in which Mary says one thing happened when the opposite was true. This has caused an air of fear in the workers assigned to work with Mary, further exacerbating the situation.

The interdisciplinary team is made up of the Director of Nursing, the treating physician, recreational therapist, occupational therapist and social worker. The nursing staff has the most interaction with the patient, and has begun to see Mary as a “trouble maker“ who has an “agenda,“ and is seeking an intervention that will protect the nursing staff from legal complication and will hold Mary accountable for her lies. The physician believes the issue is conflicting personalities and an alteration in staffing patterns will improve the situation. The recreational and occupational therapist have observed the contrary manner in which Mary has treated staff and peers and are not certain how to proceed. The social worker decided to meet with Mary, believing there is more to the story. He discovers a long history of rejection by family members and friends after her stroke, including her spouse who left shortly after the stroke. The social worker discovered Mary has a pattern of “leaving“ others (i.e. making them leave before they choose to leave) out of emotional protection. He designs an intervention to target issues of abandonment with Mary, and educates the treatment team about Marys use of pushing others away to protect herself emotionally, rather than to personally attack staff.

In the example:
The social worker was able to discern underlying issues not otherwise detected using a medical model or discovered in daily interactions with Mary. Approaching Mary and assessing her biopsychosocial history more fully gave a different assessment than the one observed in her daily interactions.





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