Theoretical Model of Integration - Essay Example

Integration Core model of integration a) Theory Base – Person Centered Therapy Person Centered Therapy (PCT) is one of the major orientations of psychotherapy and represents a unique category of psychological intervention because it derives from person centered and behavioral psychological models of human behavior that include for instance, theories of normal and abnormal development, and theories of emotion and psychopathology. The person centered psychotherapy, is based on the clinical application of extensively researched theories of behavior, such as learning theory (in which the role of classical and operant conditioning are seen as primary). Early behavioral approaches did not directly investigate the role of cognition and person centered processes in the development or maintenance of emotional disorders. Person centered therapy is based on the clinical application of the more recent, but now also extensive research into the prominent role of cognitions in the development of emotional disorders. The term ‘Person Centered Therapy’ (PCT) is variously used to refer to therapy based on the pragmatic combination of principles of person centered theories. New PCT interventions are keeping pace with developments in the academic discipline of psychology in areas such as attention, perception, reasoning, decision making etc. Person centered and/or client centered psychotherapists work with individuals, families and groups. The approaches can be used to help anyone irrespective of ability, culture, race, gender or sexual preference. Person centered and/or behavioral psychotherapies can be used on their own or in conjunction with medication, depending on the severity or nature of each client’s problem. b) Psychoanalysis The father of this school of thought was the infamous Sigmund Freud, who about a century ago changed the entire perspective on how humanity used to view the structure of personality. Though largely controversial, yet ironically the words his critics use to highlights defects in him, are also given to the scientific world by Freud himself. By far, his greatest of contributions to the science of psychology is the concept of ‘unconscious’, and his attempt to interpret dreams. Before him, for centuries, understanding behavior was considered to be the job of physiologists and philosophers. It was after him, that truly the birth of an individual science of psychology came into existent, which had concepts, theories and hypotheses, which were specific to the specialization of this science alone. “Traditional psychoanalysis is quite complex and time consuming,” (Brown, 2000, p. 121). The concept of understanding the realm of the unconscious, however, is crucial for Jane. This one factor alone, can provide her more insight into human behavior than volumes of books. The unconscious, essentially, is the grand storehouse of all the hidden desires of human beings. All the uncomfortable feelings, violent motives, repressed sexual feelings, aggressive tendencies and the like, all are a part of the unconscious. Interesting, however powerful these emotions are in their entirety, they never show their effect directly. They come in hidden and indirect ways, and are underlying the normal actions and expressions that humans emit. The structure of personality, as defined by Freud is also one of the milestones in psychology. He divided this structure into three parts: Id, Ego and Super Ego. The Id primarily contains the biological drive of the individual. All the primal needs, including hunger thirst, sex, excretion and sleep are governed by Id. It works on the pleasure principles, and wants to satisfy its needs no matter what the circumstances. The Ego is the psychological linkage between the Id and Super Ego and maintains harmony between the two. The Super Ego, is the sociological drive which draws the parameters and limits of behaviors and describes the values and norms for behavior. The stress that Freud gave on childhood was unprecedented in his time as far as affecting personality is concerned. He gave various stages of development in the early years, and helped explaining the concept as to how important events in those times can be defining for the entire period of life. c) Cognitive Behavioral Therapy Cognitive Behavior Therapy (CBT) is one of the major orientations of psychotherapy and represents a unique category of psychological intervention because it derives from cognitive and behavioral psychological models of human behavior that include for instance, theories of normal and abnormal development, and theories of emotion and psychopathology. The term cognition is used in several different loosely related ways. In psychology it is used to refer to the mental processes of an individual, with particular relation to a view that argues that the mind has internal mental states (such as beliefs, desires and intentions) and can be understood in terms of information processing, especially when a lot of abstraction or concretization is involved, or processes such as involving knowledge, expertise or learning for example are at work. It is also used in a wider sense to mean the act of knowing or knowledge, and may be interpreted in a social or cultural sense to describe the emergent development of knowledge and concepts within a group that culminate in both thought and action. Behavior therapy, the earliest of the cognitive and behavioral psychotherapies, is based on the clinical application of extensively researched theories of behavior, such as learning theory (in which the role of classical and operant conditioning are seen as primary). Early behavioral approaches did not directly investigate the role of cognition and cognitive processes in the development or maintenance of emotional disorders. Cognitive therapy is based on the clinical application of the more recent, but now also extensive research into the prominent role of cognitions in the development of emotional disorders. The term ‘Cognitive-Behavioral Therapy’ (CBT) is variously used to refer to behavior therapy, cognitive therapy, and to therapy based on the pragmatic combination of principles of behavioral and cognitive theories. New CBT interventions are keeping pace with developments in the academic discipline of psychology in areas such as attention, perception, reasoning, decision making etc. Gerald Egans’ Skilled helper model There are three stages within this model and stage one is about helping the client tell their story and reflect on any unexplored opportunities. To help clients become aware of any blind spots which are hindering unused opportunities. To help clients gain leverage and start with issues that will make the greatest difference. Some clients will come with so many problems and therefore beginning with the problem that is causing the client the most concern will be most beneficial. This can help the client cope initially and provide them the incentive to move on. Baldwin,1980; Janosik, 1984 believe that “Although crisis intervention is sometimes seen as a special form of counseling, it can also be seen as a rapid application of the three stages of the helping process to the most distressing aspects of a crisis situation”. It is important to recognize when using this model that if a client does not want to operate through more complex issues and focuses on trivial matters, counseling will not be appropriate at this moment. Stage two of this model allows clients to look forward to the future by helping them see what success can look like. By allowing them to have choices and to set achievable goals to enable them to make changes which shall make a difference to their lives. In order for these goals to be achieved clients must commit themselves fully to the planning process therefore it is important for the client to find reasons to go on. Gerard Egan believes that without strong commitment, change agendas end up as no more than just good ideas. Stage three is about helping the client execute their plan of action to reach their goals. This has to be realistic and must fit the individual’s lifestyle so that it can be sustainable. Hasty and disorganized action can actually have adverse consequences. Integration The process of research, therapy and the skills required by psychotherapists involve: (a) Assessment – knowledge and understanding of a range of assessments. (b) Formulation – to derive formulations of presenting problems or situations which integrate information from assessments within a coherent framework drawing upon theory and evidence based practice. (c) Intervention – On the basis of the formulation the therapist will be able to implement therapy or intervention techniques appropriate to the presenting problem and to the psychological and social circumstances of the client. (d) Evaluation – to select and implement appropriate methods to evaluate the effectiveness, acceptability and broader impact of the interventions (both individual and organizational), and use this information to inform and shape practice. This method would allow a way of being with clients based on an equal partnership, each party bringing something to the relationship. The therapist brings skills and knowledge of psychological processes, theories of emotion and techniques that have helped others and could help the current client. The client is an expert in their own experience, and brings their own resources. The therapist should not have pre-conceived ideas about where the therapy is going. The overall aim is for the individual to attribute improvement in their problems to their own efforts, in collaboration with the psychotherapist. Therapy is not experienced as something that has been “done to” the client. Here, the concept of formulation deliberates upon a unique map or hypothesis of presenting problems or situations which integrate information from assessments within a coherent framework drawing upon theory and evidence based practice. Socratic dialogue/ guided discovery – is a style of questioning to both gently probe for people’s meanings and to stimulate alternative ideas. It involves exploring and reflecting on styles of reasoning and thinking and possibilities to think differently. is not about trying to prove a client wrong and the therapist right, or getting into unhelpful debates – rather by skillfully collaborating, clients come to see for themselves (discover) that there are alternatives Paruska Clarksons five aspects of the therapeutic relationship Founded on research evidence, Clarkson believes that it is not any specific psychological counseling paradigm itself that is the quintessence of therapeutic effectiveness but the tangible therapeutic relationship between the therapist and client. Clarkson declares that there are five types of relationships potentially present in the therapeutic encounter. These may be listed as (i) the working alliance, (ii) the transference/counter transference relationship, (iii) the developmentally needed/reparative relationship, (iv) the person-to-person relationship, and (v) the transpersonal relationship. The theoretical framework of the five relationships demonstrates how this was utilized in the clinical context with a male client; what were for him the implications of the therapeutic relationship assisting him to overcome low self-esteem, childhood sexual abuse, and depression. Example of a client Karen Mercer explains a lucid account of such a patient treated with this approach. ‘This is also an excellent approach when working with young carers. Many young people need answers to problems at a certain time in their lives. Louise was 15 and came to see me regarding her anger. Mum had chronic asthma, compounded by her alcoholism. Mum had taken an overdose on 4 occasions in the last two years. Louise spent her days worrying about her. ‘Louise wanted to join the army but was scared to leave mum. She felt life was hopeless. I started on step 3 of stage one of helping. I needed Louise to focus on the opportunity of joining the army. I wanted her to acknowledge her blind spots and see that her anger was not her main problem and it was because of her potential unused opportunity of making the most of her life. Another blind spot was her inability to see that her needs were as important as her mum’s. ‘Stage two was then used with Louise to help her see how her future could be. We discussed all the opportunities the army could bring, she became excited as she was able to have a glimpse of a successful and bright future. The possibility of actually joining the army was becoming a reality and Louise needed my encouragement to see this through. She knew she would have to put herself first and this was a new experience for her. ‘Stage three was about helping her put her needs first, I had to take into consideration her mum’s dependency on Louise and knew that to enable any change was going to be slow. We planned to meet weekly and each week I found out for Louise, information on the army. We used half the session talking about her own needs as well as her mum’s and how to plan for her future in the army. ‘Stage four was about Louise putting her plan into action. Louise did not join the army, instead she went to catering college and was voted best student. On evaluating this piece of work it seems that Louise was angry at her needs not being met and her future seemingly hopeless. She thought moving away from the situation was the answer, but by acknowledging her unused opportunities was enough for her to see that there was a hopeful future and it didn’t mean removing herself from her family to gain this. Louise realised she would have missed her mum too much and she wanted to be there for her. Louise feels she has the best of both worlds now; a career and her mum, who despite everything she loves very much.’ Conclusion Identify oneself clearly with a readable identification badge, which helps to make us more approachable. Be aware of your own attitudes. These are clearly transmitted both verbally and non-verbally. Awareness of your own expectations and recognition that they are simply expectations based on your own culture and experience is helpful. A preliminary step in the process of developing a culturally appropriate service is the willingness to engage in some self-analysis to establish your own beliefs, attitudes, expectations and practices, which can then be affirmed or modified as appropriate. Explore ways of accommodating different requests and cultural practices. For instance, in some situations it may be possible to allow a woman concerned about modesty to wear pyjamas to surgery rather than a hospital gown. The approaches and roles of different therapies in the management and care of the patient’s/client’s condition have been explained. Further, these types of services are offered both in the hospital and a community setting and care should therefore be taken to ensure patients’/clients’ needs are taken account in arrangements for making appointments and home visits. Consider the patient’s medical and non-medical (social) needs. Employ a multidisciplinary approach involving a range of health professionals. Allow patients and their families’ considerable self-determination in the process of planning for their care and needs. Check that the patient, family and care providers fully understand the proposed care plan. Ensure that post-therapeutic care involves co-operation and collaboration between the therapist and relevant home and community care services. References Brown, R. (2000). Therapeutic Counseling. New York: Brooks/Cole. Mischel, W. (1986). Introduction to Personality. New York: HRW, 4th edition. Mercer, K. (1999). Models and Settings for Counselling Children and Young People. Quality Training. Read More