Unit 7:  Approaches to Unit 7:  Approaches to Psychotherapy I - Psychotherapy I - Seminar     Seminar       

This week we read chapters 12 This week we read chapters 12 and 13, the topic for the Seminar and 13, the topic for the Seminar Discussion: Discussion: 

Humanistic Case StudyHumanistic Case Study

Discussion Scenario Part Discussion Scenario Part 11

Dr. Greenwald is a clinical psychologist Dr. Greenwald is a clinical psychologist who identifies his approach to who identifies his approach to psychotherapy as humanistic. As such, psychotherapy as humanistic. As such, he believes that it is important to he believes that it is important to provide each client with unconditional provide each client with unconditional positive regard (UPR), or to positive regard (UPR), or to communicate to the client that he or communicate to the client that he or she is valued, appreciated, accepted, she is valued, appreciated, accepted, and "prized" regardless of what he or and "prized" regardless of what he or she may say or do. she may say or do.

Discussion Scenario Part Discussion Scenario Part 22

Several weeks ago, Dr. Greenwald began Several weeks ago, Dr. Greenwald began working with a new client named Steven, working with a new client named Steven, who struggles with generalized anxiety who struggles with generalized anxiety disorder. As Steven's trust and rapport disorder. As Steven's trust and rapport with Dr. Greenwald has increased, he has with Dr. Greenwald has increased, he has admitted more and more about himself. admitted more and more about himself. After a number of sessions, Steven After a number of sessions, Steven confided in Dr. Greenwald that many years confided in Dr. Greenwald that many years ago, he raped a woman. Dr. Greenwald ago, he raped a woman. Dr. Greenwald views rape as a reprehensible act. views rape as a reprehensible act.

Discussion Scenario Part Discussion Scenario Part 22

Several weeks ago, Dr. Greenwald began Several weeks ago, Dr. Greenwald began working with a new client named Steven, working with a new client named Steven, who struggles with generalized anxiety who struggles with generalized anxiety disorder. As Steven's trust and rapport disorder. As Steven's trust and rapport with Dr. Greenwald has increased, he has with Dr. Greenwald has increased, he has admitted more and more about himself. admitted more and more about himself. After a number of sessions, Steven After a number of sessions, Steven confided in Dr. Greenwald that many years confided in Dr. Greenwald that many years ago, he raped a woman. Dr. Greenwald ago, he raped a woman. Dr. Greenwald views rape as a reprehensible act. views rape as a reprehensible act.

Discussion QuestionDiscussion Question

What is the fundamental foundation of What is the fundamental foundation of the school of Humanistic the school of Humanistic Psychotherapy?Psychotherapy?

Humanistic Humanistic PsychotherapyPsychotherapy Carl Rogers was a leading figureCarl Rogers was a leading figure

– Abraham Maslow was anotherAbraham Maslow was another Humanism was a reaction against Humanism was a reaction against

Freud’s approachFreud’s approach Assumed that human nature wasn’t so Assumed that human nature wasn’t so

bad (e.g., id-driven)bad (e.g., id-driven) Overlapping terms for humanism Overlapping terms for humanism

include “nondirective,” “client-include “nondirective,” “client-centered,” and “person-centered” centered,” and “person-centered”

Humanistic Concepts: Humanistic Concepts: Clinical ImplicationsClinical Implications People have an inborn tendency People have an inborn tendency

toward self-actualizationtoward self-actualization People also have a need for People also have a need for

positive regard—warmth, positive regard—warmth, acceptance, “prizing”acceptance, “prizing”

Sometimes, people are forced to Sometimes, people are forced to sacrifice self-actualization in order sacrifice self-actualization in order to obtain positive regard from to obtain positive regard from important others (e.g., parents)important others (e.g., parents)

Goal of Humanistic Goal of Humanistic PsychotherapyPsychotherapy Primary goal of humanistic Primary goal of humanistic

psychotherapy is to foster self-psychotherapy is to foster self-actualization actualization

Problems stem from stifled self-Problems stem from stifled self-actualization or growthactualization or growth

Therapist’s task is to create a climate Therapist’s task is to create a climate in which the client can resume their in which the client can resume their natural growth toward psychological natural growth toward psychological wellness wellness

Goal of Humanistic Goal of Humanistic Therapy (cont.)Therapy (cont.) In humanistic therapy, there are no In humanistic therapy, there are no

conditions of worth on the clientconditions of worth on the client– Clients’ real selves can match their Clients’ real selves can match their

ideal selvesideal selves– This match is known as congruence, This match is known as congruence,

and is the root of psychological and is the root of psychological wellnesswellness

– Mismatch between real and ideal Mismatch between real and ideal selves is known as incongruence, and selves is known as incongruence, and is the root of psychopathologyis the root of psychopathology

Three Essential Three Essential Therapeutic ConditionsTherapeutic Conditions EmpathyEmpathy

– the therapist is able to sense the client’s the therapist is able to sense the client’s emotions just as the client wouldemotions just as the client would

– a deep, nonjudgmental, compassionate a deep, nonjudgmental, compassionate understanding of the client’s experiences understanding of the client’s experiences

Unconditional Positive RegardUnconditional Positive Regard– Accepting or “prizing” the client “no matter Accepting or “prizing” the client “no matter

what” and without judgmentwhat” and without judgment GenuinenessGenuineness

– Honesty toward client, rather than playing a Honesty toward client, rather than playing a rolerole

Discussion QuestionDiscussion Question

In your opinion, what role should In your opinion, what role should unconditional positive regard play in unconditional positive regard play in Steven's psychotherapy?Steven's psychotherapy?

Necessary and Necessary and Sufficient?Sufficient? Rogers boldly argued that empathy, Rogers boldly argued that empathy,

unconditional positive regard, and unconditional positive regard, and genuineness were necessary and genuineness were necessary and sufficient for successful therapy with sufficient for successful therapy with any client any client – No other techniques needed for anyoneNo other techniques needed for anyone

A controversial claimA controversial claim Research is inconsistent; generally Research is inconsistent; generally

supports necessary, but not sufficientsupports necessary, but not sufficient

Discussion QuestionDiscussion Question

In your opinion, can Dr. Greenwald's In your opinion, can Dr. Greenwald's positive regard for Steven be truly positive regard for Steven be truly unconditional, especially if he knows unconditional, especially if he knows that Steven committed an act he finds that Steven committed an act he finds reprehensible?reprehensible?

Therapist Attitudes, Therapist Attitudes, Not BehaviorsNot Behaviors Rogers emphasized that Rogers emphasized that

empathy, unconditional positive empathy, unconditional positive regard, and genuineness are regard, and genuineness are attitudes, not specific behaviorsattitudes, not specific behaviors

Therapy should not be Therapy should not be mechanical or formulaicmechanical or formulaic– Attitudes, not specific techniques or Attitudes, not specific techniques or

skills, should be emphasizedskills, should be emphasized

Discussion QuestionDiscussion Question

In your opinion, what role should In your opinion, what role should genuineness play in Steven's genuineness play in Steven's psychotherapy?psychotherapy?

Reflection: An Reflection: An Important Therapist Important Therapist ResponseResponse Reflection of feeling is one therapist Reflection of feeling is one therapist

response that humanists do emphasizeresponse that humanists do emphasize Reflection takes place when a Reflection takes place when a

therapist responds to a client by therapist responds to a client by rephrasing or restating the client’s rephrasing or restating the client’s statements in a way that highlights the statements in a way that highlights the client’s feelings or emotions client’s feelings or emotions

Communicates all three key Communicates all three key ingredientsingredients

Should be done with humility and not Should be done with humility and not mechanicallymechanically

Discussion QuestionDiscussion Question

Is there any reason you should violate Is there any reason you should violate the privilege of confidentiality because the privilege of confidentiality because of the information that Steven of the information that Steven committed rape?  If so, who should committed rape?  If so, who should you tell?you tell?

Alternatives to Alternatives to HumanismHumanism Historical alternativesHistorical alternatives

– Existential psychotherapyExistential psychotherapy Rollo May, Victor Frankl, Irvin YalomRollo May, Victor Frankl, Irvin Yalom Address anxiety of inescapable solitude of Address anxiety of inescapable solitude of

lifelife

– Gestalt therapyGestalt therapy Fritz PerlsFritz Perls Holistic approach to enhancing current Holistic approach to enhancing current

experience (“the now”); often uses role-experience (“the now”); often uses role-playsplays

Alternatives to Alternatives to Humanism (cont.)Humanism (cont.) Contemporary AlternativesContemporary Alternatives

– Motivational InterviewingMotivational Interviewing William MillerWilliam Miller Address clients’ ambivalence or uncertainty Address clients’ ambivalence or uncertainty

about making major changes to their way of life about making major changes to their way of life Help clients see the discrepancy between their Help clients see the discrepancy between their

behavior and their own values behavior and their own values

– Positive Psychology movementPositive Psychology movement Martin SeligmanMartin Seligman Overlaps with humanism by emphasizing Overlaps with humanism by emphasizing

human strengths, assets, and potentialhuman strengths, assets, and potential

Outcome IssuesOutcome Issues

Carl Rogers was a pioneer of Carl Rogers was a pioneer of psychotherapy outcome research, despite psychotherapy outcome research, despite inherent problems in defining and inherent problems in defining and measuring humanistic conceptsmeasuring humanistic concepts

However, in more recent years However, in more recent years humanistic outcome research has humanistic outcome research has decreaseddecreased

Recent meta-analyses suggest it is Recent meta-analyses suggest it is beneficial, at about the same rate as beneficial, at about the same rate as most other major therapiesmost other major therapies

Questions?Questions?