As the theoretical and professional foundations of counseling have progressed, a natural evolution has been the development of ethical standards to help regulate the practice of multicultural counseling. Ibrahim and Arredondo (1986) authored a proposal to develop specific ethical standards regarding multicultural counseling in the areas of education, research, assessment, and practice. LaFromboise and Foster (1989) extended this discussion by bringing attention to other issues related to ethics in counseling that involved participants in research and right to treatment. The appropriate use of therapeutic strategies is still an evolving question. It is quite clear that their use is inappropriate in an acute crisis situation. Their use also is inappropriate in psychiatric disabilities where clients are not able or willing to question themselves or to take responsibility. Their appropriate use requires concomitant cognitive development and psychological intactness as well as fitting timing. Because these strategies are rather new to psychotherapy, the specifics of the analysis are often in neighbouring social science disciplines. Counsellors are considered as helping professionals. Learning to be a helping professional has been described as a complex and overwhelming process (Byrne, 1995; Kottler & Hazler, 1997; Martin & Moore, 1995; Young, 1998). Thus, their use of proper theoretical approaches in helping adolescents are imperative to their practice.
There are three commonly employed practices, the cognitive-behavioural, the psychoanalytic, and the Humanistic approaches. Among the three, the cognitive-behavioural model is the most prevalently used. Cognitive-behavioral treatment has been applied to various disorders including anxiety, aggression, depression, attention deficit-hyperactivity disorder, pain, and learning disabilities. Research on the nature of these disorders, a description of related treatment strategies, and an illustrative review of treatment outcome data is provided. Discussion focuses on a consideration of familial involvement, developmental factors, and methodological issues that require research attention. Cognitive-behavioral therapy (CBT) uses performance-based and cognitive interventions to produce changes in thinking, feeling, and behavior (Kendall, 1991). It concerns itself with both the external environment and the individual’s internal processing of the world. In CBT, the therapist is a consultant, diagnostician, and educator. As a consultant, the therapist provides ideas for experimentation, helps sort through experiences, and promotes problem solving. As a diagnostician, the therapist gathers varied data and integrates them to determine what is best for the adolescent client based on the current situation. As an educator, the therapist participates with clients to influence them to think for him or herself, maximize personal strengths, and acquire cognitive skills and behavior control. Behavioral models focus on behavior; interventions work to change behavior and outcome evaluation is based on these changes. Cognitive therapy views changing behavior alone as too narrowly focused; however, in CBT the performance-based feature of behavioral treatment is not eliminated. CBT focuses on how people respond to their cognitive interpretations experiences rather than the environment or the experience itself, and how their thoughts and behaviors are related. It combines cognition change procedures with behavioral contingency management and learning experiences designed to help change distorted or deficient information processing (Kendall, 1991). Therapeutic experiences involve emotion and cognitive processing. Therapists guide teens through their cognitive processing before, during, and after the behavioral experiences, while attending to the emotional state of the teenagers. Cognitive skills are first taught in an emotionally safe situation, but it is not enough to teach cognitive processing in the absence of affective arousal: After skill acquisition there is need for practice in the use of cognitive skills under conditions of affective arousal. The new experiences broaden the way an adolescent can view his or her world — they do not remove unwanted prior history, but help develop healthier ways to make sense of future experiences. CBT does not seek to uncover unconscious early trauma or biological, neurological, and genetic contributions to psychological dysfunction, but instead strives to build a new, more adaptive way to process the world. CBT has been applied to normal teenagers under stress and to children diagnosed as anxiety-disordered. In reality-based stress from medical or dental procedures, teens were prepared with coping strategies — resulting in less anxiety (Peterson & Shigetomi, 1981; Siegel & Peterson, 1981). When the teens were taught coping strategies through the use of modeling, they were found to be even more capable of coping with the stressful procedures. Kane and Kendall (1989) provided four children diagnosed with over-anxious disorder with 16 to 20 individual, hour-long sessions. The CBT focused on recognizing feelings and cognitions associated with an anxiety-provoking situation, and developing and evaluating a plan to cope. Modeling, role-play, relaxation, and contingent reinforcement aided in the acquisition of these skills. Once learned, the skills were practiced in vivo (while affectively aroused) and encouraged through social reinforcement. Changes in anxiety were demonstrated in parent reports, independent clinician’s ratings, and teen’s self-reports. In addition, specific target behaviors were improved, and follow-up reports evidenced reasonable maintenance of gains. In general, CBT interventions have been and remain promising, with research findings suggesting applications for certain specific disorders. Nevertheless, more effort is required in the areas of treatment development, treatment integrity and duration, and treatment expansion. It is only after these efforts, and along with properly controlled randomized clinical trials, that one can examine and determine treatment effectiveness.
Another approach is the humanistic theory. The said theory has undergone extensive developments to include culture systematically. The work of Bingswanger (1963) and Boss (1963) translated the existential premise of being-in-the-world into specific counseling and therapy strategies. Miller (1991) emphasized the concept of self-in-relation that focuses on the individual in context. In cognitive-behavioral theory, authors like Cheek (1976) and Kantrowics and Ballou (1992) have pioneered the inclusion of culturally relevant practices. Cheek adapted traditional assertiveness training for African American clients who view rights differently. Kantrowics and Ballou shifted their behavioral theory approach from an individualistic focus to one reflecting feministic reappraisals. A more recent proposition by Sue, Ivey, and Pedersen (1996) advocated for a culture-centered meta-theory that would preserve the integrity of different counseling approaches while organizing their theoretical and philosophical assumptions in one cultural framework. Moreover, Rogers, founder of client-centered therapy, a humanistic form of treatment, often used the scientific method to provide support for his approach to counseling (Rogers, Gendlin, Kiesler, & Truax, 1967), even though this system was originally rooted more in philosophy than science (Hansen, 1999). Moreover, becoming a counselor normally entails achieving a graduate-level university degree, which is usually displayed in the counselor’s office as a reminder of the supposed intellectual and scientific respectability of the counseling methods (Torrey, 1972). Being associated with science seems to be an important part of the persuasive narrative requirement in our society (Frank & Frank, 1991).
And lastly, is the Freudian model of psychoanalytic counseling. As described by Patton and Meara (1992), four major principles of psychoanalytic counseling were taught to the counselors. These principles were helping the client to communicate freely using such techniques as counselor restraint; helping the client to communicate naturally; using counselor empathy and counter transference to understand and communicate to the client; and promoting client understanding (or insight) through techniques such as confrontation and interpretation. Counselors were expected to listen to their clients with a psychoanalytic perspective and identify maladaptive patterns of relating to the counselor and others in an effort to help the clients understand these patterns and seek to change them.
Reference:
Bingswanger, L. (1963). Being-in-the world: Selected papers of Ludwig Binswanger. New York: Basic Books.
Boss, M. (1963). Psychoanalysis and daseinsanalysis. New York: Basic Books.
Byrne, R. H. (1995). Becoming a master counselor: An introduction to the profession. Pacific Grove, CA: Brooks/Cole.
Cheek, D. (1976). Assertive Black … puzzled White. San Luis Obispo, CA: Impact.
Frank, J. D., & Frank, J. B. (1991). Persuasion and healing (3rd ed.). Baltimore: Johns Hopkins University Press.
Ibrahim, F. A., & Arredondo, P. M. (1986). Ethical standards for cross-cultural counseling: Counselor preparation, practice, assessment, and research. Journal of Counseling and Development, 64, 349-352.
Kane, M. T., & Kendall, P. C. (1989). Anxiety disorders in children: A multiple-baseline evaluation of a cognitive-behavioral treatment. Behavior Therapy, 20, 499-508
Kantrowics, R., & Ballou, M. (1992). A feminist critique of cognitive-behavioral theory. In L. Brown & M. Ballou (Eds.), Theories of personality and psychopathology: Feminist reappraisals (pp. 70-87). New York: Guilford.
Kendall, P. C. (1991). Guiding theory for treating children and adolescents. In P. C. Kendall (Ed. , Child and adolescent therapy: cognitive-behavioral procedures (pp. 3-22). New York: Guilford Press.
Kottler, J. A., & Hazler, R. J. (1997). What you never learned in graduate school: A survival guide for therapists. New York: Norton.
LaFromboise, T. D., & Foster, S. L. (1989). Ethics in multicultural counseling. In P. B. Pedersen, J. G. Draguns, J. Lonner, & J. E. Trimble (Eds.), Counseling across cultures (3rd ed., pp. 115-136). Honolulu: University of Hawaii Press.
Martin, D. G., & Moore, A. D. (1995). Basics of clinical practice: A guidebook for trainees in the helping professions. Prospect Heights, IL: Waveland Press.
Miller, J. B. (1991). The development of women’s sense of self. In J. V. Jordan, A. G. Kaplan, J. B. Miller, I. P. Stiver, & J. L. Surry (Eds.), Women’s growth in connection: Writings from the Stone Center (pp. 11-26). New York: Guilford.
Patton , M. J., & Meara, N. M. ( 1992 ). Psychoanalytic counseling. Chichester, England: Wiley.
Peterson, L., & Shigetomi, C. (1981). The use of coping techniques in minimizing anxiety in hospitalized children. Behavior Therapy, 12, 1-14.
Rogers, C., Gendlin, G., Kiesler, D., & Truax, C. (Eds.). (1967). The therapeutic relationship and its impact: A study of psychotherapy with schizophrenics. Madison: University of Wisconsin Press.
Siegel, L. J., & Peterson, L. (1981). Maintenance effects of coping skills and sensory information on young children’s response to repeated dental procedures. Behavior Therapy, 12, 530-535.
Sue, D. W., Ivey, A. E., & Pedersen, P. B. (1996). Theory of multicultural counseling and therapy. Pacific Grove, CA: Brooks/Cole.
Torrey, E. (1972). The mind game; witchdoctors and psychiatrists. New York: Emerson Hall.
Young, M. E. (1998). Learning the art of helping: Building blocks and techniques. Upper Saddle River, NJ: Prentice-Hail.
Credit:ivythesis.typepad.com
0 comments:
Post a Comment