Psychotherapy Integration Paper

Running Header Psychotherapy Integration Psychotherapy Integration Elaine T. Gayden Mississippi College Instructor Dr. J. Southern Theories Personality Counseling November 18, 2010 Psychotherapy Integration Abstract Psychotherapy Integration is an approach that uses more than any single theory or technique. The earlier pioneers in integration were following a trend that was introduced by Freud into psychoanalysis. It is said that common factors approach to integration came about because of the assumption that all effective methods of psychotherapy share somewhat critical and curative factors. Psychotherapy Integration is to integrate therapies that will derive a goal to maximize a patients exposure to the unique combination of therapeutic
factors that will best help him or her with their problems. Psychotherapy Integration Cognitive-Behavioral Therapy In studying the different theories, I felt that Reality Therapy, Cognitive Therapy, and Behavioral Therapy had a great impact on me. In Cognitive-Behavioral Therapy, the therapists tries its best to work with the patient to identify the underlying thoughts that might be causing their distress. The therapist then tries and come up with techniques they feel will alter the resulting behavior. Cognitive-Behavioral Therapy uses the cognitive restructuring approach to try and modify the behavior. In using this therapy we learn that patients have certain beliefs, known as schemas, these schemas are what have a negative impact on the patients behavior and functioning. For example, a patient suffering from schizophrenia may develop a social phobia because he is convinced he is not likable, uninteresting, or convinced unwanted. The therapist would put this schema to a test by asking the patient to name family and friends that care for them and seem to enjoy their company. By allowing the patient to see that others value them, the therapist brings to a head the irrationalness of the patients thought process. The therapist also provides a new thought process for the patient to change his previous behavior patterns (i.e., he feels he is an interesting and likeable person, and now he shouldnt have any problems making new friends or social acquaintances). There are other techniques that can be used with this therapy, such as conditioning (reinforcements to encourage desired behaviors, whether the reinforcements be positive or negative) and systematic desensitization (gradual exposure to anxiety-producing situations in order to extinguish the rear response) can also be used to reintroduce the patient to social situations. One thing about Cognitive-Behavioral Therapy is it is not used to tell people how they should feel. Because people have a desire to Psychotherapy Integration change their behaviors and feelings they seek therapy. Most people would very much like to limit problems in their lives. Therefore, therapy will teach them how to deal more calmly with their problems, and thus putting them in a position that makes them feel better and be able to use their own intellect, resources, and knowledge to resolve problems on their own. Cognitive Therapy helps the patient help himself or herself by learning self-help skills. This can be done through homework assignments that will help the patient change the way they think, feel, and behave. Cognitive-Behavioral Therapy is practical and action oriented to help the patient gain independence so they will be able to effectively deal with issues in their lives. Cognitive and cognitive behavioral therapies have often proved helpful to clients suffering from depression, anxiety, panic and obsessive-compulsive disorders. Also, we do certain things based on what we are feeling and thinking. We also feel a certain way based on what we are thinking and on what we have done. Behavioral Therapy Behavioral Therapy is a psychological technique based on the premise that bad behaviors can be modified or changed by learning new, more appropriate behaviors to replace them. Behavior Therapy core interventions are based on functional analysis. Behavior Therapy deals with a lot of issues such as couples relationships, chronic pain, anorexia, depression, and obesity to name a few. Many see behavior therapy basically as a waste of time and non-effective. I on the other hand do believe that behavior can be learned or modified. By the 1970s, Behavior Therapy enjoyed widespread popularity as a treatment approach. Over the past two decades, the attention of behavioral therapists has focused increasingly on their clients cognitive process, an Psychotherapy Integration many therapists have begun to use cognitive behavior therapy to change clients unhealthy behavior by replacing negative or self-defeating thought patterns with more positive ones. Behavior Therapy is known to be based as scientific due in part to Ivan Pavlov and B.F. Skinner. However, this basis has been questioned by psychologists and is causing them to begin studying behavior therapy more. Behavioral Therapist feel as if using different methods (systematic desensitization, exposure and response prevention, behavior modification, flooding, operant conditioning, convert condition, observational learning, contingency management, matching law and habit reversal training) can change ones behavior can be changed or modified, but only if and when one ready for change. However, some of these methods are questionable to me and I have to wonder do they really work. Even though, behavior therapy can be seen as beneficial and powerful on changing a persons personality, some of the methods that have worked in the past are beginning to lose favor. In todays society what is called Third Generation Behavior Therapy is becoming more interesting, this is because it focus on more of a radical behaviorism than a cognitive one. Treatment is usually administered in an out-patient setting in either a group or individual session. Treatment is relatively short compared to other forms of psychotherapy, usually lasting no longer than 16 weeks. There are several different techniques used in behavioral therapy to help patients modify their bad behavior, they are listed in the chart that you will see below. TechniqueDescriptionBehavioral Homework AssignmentsThe therapist will give the client a homework assignment to complete between sessions.
Whether or not it is effective depends on if the client does it or not. These assignments are given to try and get the client to discover new strategies that was discussed in therapy.Contingency ContractThis is where the therapist enters into a written or verbal contract with the patient of the desired behaviors. The contract will have consequences included in it for positive and negative reinforcements.ModelingThe patient will learn acceptable behavior through observations.Rehearsed BehaviorThe therapist and patient engage in role-playing where the therapist demonstrates efficient verbal responses to different situations that the patient is required to imitate.Skills Training TechniquesThe patient is required to enter an educational program to learn life skills (i.e., social, parenting, etc.).Progressive RelaxationThis is a technique where the therapist uses to try and get the patient to relax their muscles in the body and calm and even breathing until the body is free of any type of tension. This technique is used to relieve anxiety and stress in the patient and prepare the patient for systematic desensitization.Systematic DesensitizationThe therapist uses this type of technique to help the
patient overcome phobias and anxiety disorders. The therapist will introduce relaxation techniques. The therapist might also have the patient to create an anxiety hierarchy in order from least to most distressing. The therapist will have the client to use the relaxation technique to go through the hierarchy until the client reach a relaxed state and no longer show fear. FloodingThe therapist day that flooding is a learned fear that needs to be unlearned. This means they want the patient to face their fears (i.e., if someone is afraid of frogs, then you should locked them is a room with a frog until they stop freaking out). The therapist will try and get the patient to realize that a phobia is an unnecessary fear to a non-dangerous thing or situation. Psychotherapy Integration Reality Therapy Reality Therapy is a cognitive-Behavioral approach. Its main focus is on helping the client to become aware of, and if necessary, change his/her thoughts and actions. Reality Therapy, which goes hand and hand with Choice Theory, deals with the present and the future and not on past events. Reality Therapy has been around since the 1960s. Dr. William Glasser formed it. In Reality Therapy there are five classifications and they are PowerOne feels power and worthwhile when they accomplish achievements or thought of winning.Love and BelongingThis includes groups, families, and love ones.FreedomConsists of one feeling independent, having their own space or autonomy.FunIncludes pleasure and enjoyment.SurvivalIncludes those things you feel is detrimental to your survival such as food, shelter, and intimacy (sex). In Reality Therapy the core of its existence hinges on us acting to meet the needs of power, love and belonging, freedom, fun, and survival.
However, sometimes we dont act effectively. Socializing with people is an effective way to meet our need for belonging. For example standing on a wall at a dance and expecting for someone to just come over and ask you Psychotherapy Integration to dance is an ineffective way of meeting that need. It may work generally in most cases, but may be painful and carry a high price for ourselves and others. The key to feeling loved and belonging is what we want. Of course you just dont wake up in the mornings and say I must meet this particular need today. We would probably say something like I wonder if a few of my friends wouldnt mind having pot-luck dinner Friday night or maybe we can get together and go to the basketball game. Therefore, as we see in Reality therapy we thrive as social beings on our wants. Our needs arent too much of a factor. We basically concentrate on our wants, how to achieve what we want, and we often times fantasize about what we want.. So, in Reality Therapy counseling, the therapist will see whether or not a client is meeting his/her needs by asking three basic questions 1. What do you want 2. What are you doing to get what you want 3. is it working Behavior, in reality Therapy and in William Glassers Choice Theory terms, is
composed of four basic aspects Thinking, Acting, Feeling, and Physiology. One can directly choose our thoughts and actions we have great difficulty in directly choosing our feelings and our physiology (headaches, nervous tics, heart racing, etc.). The therapist would help the client realize that they must devise a workable plan to make better choices. The heart of the workable plan in reality therapy is that it must concentrate on the things that are in the clients control to do. The client will probably ask the therapist for some suggestions but it will help if the plan itself is totally that of the clients. firstly, the initial steps should be small enough that the client is almost certain to succeed in order to build his/her confidence. Psychotherapy Integration Emotions are a wonderful, immediate, and alive source of information about how we are doing and whether we are happy with what is going in our lives. But it is very hard to choose and to change our emotions directly. It is easier to change our thinking to decide, for example that we no longer think of ourselves as victims or to decide that in our thought we will only concentrate on what we can do rather than what we think someone else should do. So, Reality Therapy approach is about changing what we do as a key to changing how we feel and to getting what we want. Control is also considered very important and a key issue in Reality Therapy. To meet their needs human beings feel they need control like the husband that wants steak and bake potato on the table at 700 p.m., another wants a corner office with two bay windows, another wants to be the captain of the basketball team, control can get us into trouble in two primary ways when we try to control others, and when we use inhibiting factors (such as drug s and alcohol) that makes us think we have control. When we must realize that the only person we can really control is yourself. This is why it is vital to stick to what is in our control to do and to respect the right of other people to meet their needs. Counseling is often thought to concentrate on dipping into the past. However, in Reality therapy it visit the past but to a lesser extent than other therapies that are used. This is the difference between Reality Therapy and other therapies. Reality Therapy only wants to visit the past to learn about the bad things that happened to us as well as the good things (successes) that also happened in our past. The therapist want the client to move on from the past quickly so the client can concentrate on his or her needs and wants in the present and in the future. This is because it is our present perceptions that influence Psychotherapy Integration our present behavior and so this is the perceptions that the Reality Therapy therapist helps the client to work through. Therefore, Reality Therapy is a therapy of hope based on the conviction that we are products of our past but we do not have to continue to be victims. Psychotherapists have always been interested in new developments in the social sciences, the natural sciences, philosophy, theology, the arts, and literature. Most of the psychotherapists did not want to learn from each other if their ideas and allegiances were different. However, as time goes by a small group of scholars and clinicians have crossed sectarian lines. Their goal is to develop the most effective forms of psychotherapy possible. This includes the integration of therapies that involves the best and brightest concepts and methods into new theories and practical systems of treatments. It seems that this method of Psychotherapy Integration is working out because more publications, journals, and professional societies are evolving. Psychotherapy Integration References Arkowitz, H. (1991). Psychotherapy integration comes of age. Journal of psychotherapy. I Integration, I, 14. Corey, G. (2009). Theory and practice of counseling and psychotherapy. (8th Ed.), Thomason Brooks/Cole. Cronkite, K. (1995). On the edge of darkness Conversations about conquering depression. New York Delta. Favaro, A. Santonastaso, P. (1998). Impulsive and compulsive self-injurious behavior in bulimia nervosa prevalence and psychological correlates. Journal of Nervous and Mental Disease, 186(3), 157-65. Freud, Sigmund. (Vol. 10, pp. 153 318). London Hogarth Press. (original work published 1909). Glasser, W. (1998). Choice Theory. A new psychology of personal freedom. HarperCollins. Landecker, H. (1992). The role of childhood sexual trauma in the etiology borderline Personality disorder Considerations for Diagnosis and Treatment. Psychotherapy, 29, 234 42. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York The Guilford press. Linehan, M. M., Armstrong, h., Suarez, A. Allmon, D. Heard, H. (1991). Cognitive- Behavioral treatment of chronically Para suicidal borderline patients. Archives Of General Psychiatry, 48, 1060 1064. PAGE PAGE 5