The perception of the world is subjective and based individual experiences. Constructivist theories acknowledge that psychological realities are private.
Theoretical Concepts
Five basic themes:
Active agency: People are active participants in shaping their lives
Order: People seek order and organization to create meaning of experiences
Self and identity: The relationship we have with ourself is vital to life quality
Social symbolic processes: Order, meaning, and identity stem form social interactions and symbolic processes
Dynamic dialectical development: People experience constant cycles leading to organization or disorganization
(Mahoney, 2003) Radical constructivists: Reality is different for everyone and limited by biological structures of the brain and its abilities Social constructivists: Believe reality is shaped by social constructs and how a person is born and raised Critical constructivists: Both individual and social processes contribute to reality Therapeutic alliance:
Collaborative and nonauthoritarian
View clients with positive regard and see them as pro-active, goal-directed, and purposeful
People can be helped and understood if context is paid attention to
Treatment
Focus on current problems
Explore reoccurring patterns and difficulties
Early attachments play an important role in development
People create roles and ideas about themselves and then check them out
Language is an important component (people make meaning through language)
Stresses the importance of the individual in society
Narrative Therapy
Narrative therapy:
People make meanings of themselves and their world through interpretations
Through exploration, deconstruction, and revision of problematic stories, people can alter the script and create a sense of empowerment
Loosening people's perceptions helps to facilitate positive change and development
People use comparisons as a way to acquire new information (Monk, 1997)
Drawing attention to subtle changes promotes empowerment
The goal was to understand people and provide additional perspectives, not fix them (Lee, 1997)
Stories become the roadmap of our lives
Nature of stories:
Dominant stories:
A single story that influences how a person behaves
Can impact and change other stories
Lost, untold, or marginalized stories:
Can portray a life absent of problems
Value can be found if attention is paid to lost, untold, or marginalized stories
Dominant stories can cause lost, untold, and marginalized stories to go unnoticed
Stories resulting in unhappiness:
Constricting narratives that are accepted by the dominant culture
Fragmented or disorganized stories
Psychological distress occurs when a story is disrupted
Therapeutic alliance: The clinician and the client are both responsible for shaping the treatment process. The clinician is the expert of narrative therapy, and the client is seen as the expert on themselves and their stories. Clinician's facilitate change and are not responsible for changing people. The client and clinician work together to deconstruct stories in hopes of creating a new outcome.
Treatment
Deconstructing stories: Stories are dissected and analyzed before they are able to be changed.
Landscape of consciousness: Values, feelings, beliefs, and attitudes within a person's stories
Landscape of action: Behaviors related to the events of a person's stories
Mapping: Current problems are linked to stories, showing how issues usually emerge and are dealt with
Externalization: Separates people's identities from their problems and reduces feelings of blame or guilt
Revisioning and reauthoring:
Revisions to a person's story can be made after the story is deconstructed
Clinicians suggest alternative viewpoints, but client ultimately decides and accepts changes
Changing the story and changing people's vision about their life goes hand and hand
Therapeutic documents
Documents agreed upon by the client and the clinician
Prepared by the clinician
Can be used as a concrete form that promotes clients' reflection
Importance of social network:
Stories have cultural and interpersonal meanings that are derived from cultural and social interactions
Solution-Focused Brief Therapy
Solution-focused brief therapy:
Seeks solutions instead of underlying issues
Progressed is measured by growth made, not by number of sessions
Pays little to no attention on history and the origin of the problem
Focuses on the present and future (de Shazer, 1985)
Assumptions:
Complaints emanate from behaviors influenced by a person's view of the world
Limited amount of information needed to solve a complaint, don't need to determine the origin of the issue
People are doing their best
Focus on positive growth or change, no matter how small, creates hope and sheds light on what is working
Change is constant, focus is directed towards positive change that is already set in motion
Treatment
Stages of treatment:
Identifying a solvable problem: Client and clinician develop goals and interventions that are within the client's control
Establishing goals: The goals that are established by the clinician and the client are specific, measurable, observable, and concrete. The miracle question is a popular strategy used to help establish the goals of the client. A counselor asks the client to imagine they woke up and their problem was fixed, how would they know? The miracle question helps the clinician develop possible solutions (de Shazer, 1991). Goals can take three forms.
Changing the doing: Changing the behaviors or actions taken in situations
Changing the viewing: Altering the way a person thinks about a situation
Access to resources: Discovering solutions and strengths (O'Hanlon & Weiner-David, 1989)
Design an intervention: Counselors must have an understanding of their client and also creative strategies that they can use to facilitate and encourage change.
Strategic tasks: These tasks are planned out and often written so the client can agree to them. There are three types of tasks that relate to the client's motivation.
Visitors or window shoppers: Clients' do not have a clear issue, therefore clinicians' should use compliments only to avoid jeopardizing failure
Complainants: Observational tasks should be given to people who have complaints but expect others to change. These tasks help a person become more aware of themselves.
Action tasks: Clients' who want to take steps in finding solutions should utilize action tasks. Action tasks help to empower the client, as well as enact change.
Positive new behaviors and changes are identified and emphasized: When a client completes a task, they should focus on any changes made, how they made the changes, and how the outcome may have been different. It is important for their issues to be seen as external so clients' feel there is more possibility for change.
Stabilization: Gains are consolidated and perspectives are shifted in a positive direction. In this stage clinicians may prevent progress to allow people to adjust to the changes they have made.
Termination: Clients typically initiate termination when they reach their desired goal. Since the focus is on finding solutions for presenting issues rather than childhood issues, clients may return for additional counseling in the future. The goal of therapy is to help the client become self-reliant and confident so they can resolve issues on their own in the future.
(de Shazer, 1985)
Timing: Solution-focused brief therapy is time limited. Both the counselor and the client share the presumption that treatment will be short. The average treatment length ranges between three to five sessions (Prochaska & Norcross, 2009). Solution-focused brief therapy can also last longer is the client has not met their goal but continues to make positive progress.
Therapeutic alliance:
Clinicians seen as responsible for creating and presenting solutions
Relationship is viewed as reciprocal
Active listening, empathy, open questioning, explanation, reassurance, and suggestions are crucial to the process
Interpretation and confrontation are rarely used
Social systems can be integrated into treatment
Solutions:
Identifying exceptions: Examining time periods when difficulties were not present so information about how to create change can be gathered
Solution-talk: Clinicians focus on solutions rather than problems
Use open questions
Presuppositional language (problems are temporary)
Normalize problems
Focus on coping behaviors
Highlight strengths and successes
Use hypothetical solutions
Concentrate on changing behaviors
Use rituals, metaphors, stories, and symbols
Use words like change, different, possibility, what, and how
Inclusive language (incompatible outcomes coexist)
Reframe and relabel to provide various perspectives
Match client's vocabulary and style of talking
(Seligman & Reichenberg, 2014)
Make suggestions
Indirectness and implied suggestions can be more powerful than direct suggestions
Solution prescriptions can be individualized or standard and assist in the discovery of ways to resolve issues
Feminist Therapy
Feminist therapy views people's internal and external worlds as subjective and objective and an internal part of the therapeutic process (Seligman & Reichenberg, 2014)
Focuses on the here and now
Emphasizes individual and group empowerment
Self-actualization is vital
Feminist therapy and women: Issues that women face often stem from societal messages (Seligman & Reichenberg, 2014). Feminist therapy also recognizes the importance of cultures and their values/belief systems (Enns, 2004).
Feminist therapy and men: The feminist therapy approach is not limited to females. Men can also benefit from the approach when dealing with issues such as, gender role expectations, expressing emotions, anger issues, and deconstructing their internal scripts. The approach is considered feminist if it supports feminist models and outcomes, encourages empowerment, addresses biases, and causes a better understanding of social factors (Brown, 2010).
Therapeutic alliance: Clinicians show respect and empathy and are seen as support systems instead of experts. Clinicians and clients work together to set goals and determine the pace of treatment.
Relational power: Focuses on relationships and connections. The ability to create and maintain positive relationships creates psychological strength and resilience (Seligman & Reichenberg, 2014)
Treatment
Strategies:
Consciousness-raising: Increasing awareness of oppression for marginalized groups
Gender role analysis: Gender roles determined by the cultural context and expectations of society
Relabeling and reframing: Issues are reframed to fit what it is like to be a women in society (As a result, self-blame is avoided)
Assertiveness training: Clients learn how to become more assertive without being aggressive
Therapy-demystifying strategies: Decreases power differences between the client and the clinician (clients call clinicians by first name, clinicians use more self-disclosure)