Theory and Practice of Counseling

California State University, Fullerton

Diplomate in Counseling Psychology

American Board of Professional Psychology

Theory and Practice of Counseling

and Psychotherapy

G E R A L D C O R E Y

ninth edition

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About the Author GERALD COREY is a Professor Emeritus of Human Serv- ices at California State University at Fullerton and a licensed psychologist. He received his doctorate in counseling from the University of Southern California. He is a Diplomate in Counseling Psychology, American Board of Professional Psychology; a National Certified Counselor; a Fellow of the American Psychological Association (Counseling Psychol- ogy); a Fellow of the American Counseling Association; and a Fellow of the Association for Specialists in Group Work. He also holds memberships in the American Group Psycho-

therapy Association; the American Mental Health Counselors Association; the As- sociation for Spiritual, Ethical, and Religious Values in Counseling; the Associa- tion for Counselor Education and Supervision; and the Western Association for Coun selor Education and Supervision.

Along with Marianne Schneider Corey, Jerry received the Lifetime Achieve- ment Award from the American Mental Health Counselors Association in 2011 and the Eminent Career Award from the Association for Specialists in Group Work in 2001. Jerry was the recipient of the Outstanding Professor of the Year Award from California State University at Fullerton in 1991. He teaches both undergraduate and graduate courses in group counseling, as well as courses in experiential groups, the theory and practice of counseling, theories of coun- seling, and professional ethics. He is the author or coauthor of 16 textbooks in counseling currently in print, 5 student videos/DVDs with workbooks, and more than 60 articles in professional publications. Theory and Practice of Coun- seling and Psychotherapy has been translated into the Arabic, Indonesian, Por- tuguese, Korean, Chinese, and Turkish languages. Theory and Practice of Group Counseling has been translated into Chinese, Korean, Russian, and Spanish. Issues and Ethics in the Helping Professions has been translated into Korean, Japa- nese, and Chinese.

Jerry and Marianne Corey often presents workshop in group counseling. In the past 35 years the Coreys have conducted group counseling training workshops for mental health professionals at many universities in the United States as well as in Korea, Ireland, Germany, Belgium, Scotland, Mexico, China, Hong Kong, and Canada. The Coreys also frequently give presentations and workshops at state and national professional conferences. In his leisure time, Jerry likes to travel, hike and bicycle in the mountains, and drive his 1931 Model A Ford.

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Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.

Recent publications by Jerry Corey, all with Brooks/Cole, Cengage Learning, include:

Case Approach to Counseling and Psychotherapy, Eighth Edition (2013) The Art of Integrative Counseling, Third Edition (2013) Theory and Practice of Group Counseling (and Student Manual, Eighth Edition,

2012) Becoming a Helper, Sixth Edition (2011, with Marianne Schneider Corey) Issues in Ethics in the Helping Professions, Eighth Edition (2011, with Marianne

Schneider Corey and Patrick Callanan) Groups: Process and Practice, Eighth Edition (2010, with Marianne Schneider

Corey and Cindy Corey) I Never Knew I Had a Choice, Ninth Edition (2010, with Marianne Schneider

Corey) Group Techniques, Third Edition (2004, with Marianne Schneider Corey,

Patrick Callanan, and J. Michael Russell)

Jerry is coauthor (with Barbara Herlihy) of Boundary Issues in Counseling: Multiple Roles and Responsibilities, Second Edition (2006) and ACA Ethical Standards Case- book, Sixth Edition (2006); he is coauthor (with Robert Haynes, Patrice Moulton, and Michelle Muratori) of Clinical Supervision in the Helping Professions: A Practi- cal Guide, Second Edition (2010); he is the author of Creating Your Professional Path: Lessons From My Journey (2010). All four of these books are published by the American Counseling Association.

He also has made several educational DVD and video programs on various as- pects of counseling practice: DVD for Theory and Practice of Counseling and Psycho- therapy: The Case of Stan and Lecturettes (2013); DVD for Integrative Counseling: The Case of Ruth and Lecturettes (2013, with Robert Haynes); DVD—Theory and Practice of Group Counseling (2012); Groups in Action: Evolution and Challenges—DVD and Workbook (2006, with Marianne Schneider Corey and Robert Haynes); and Ethics in Action: CD-ROM (2003, with Marianne Schneider Corey and Robert Haynes). All of these programs are available through Brooks/Cole, Cengage Learning.

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Theory and Practice of Counseling and Psychotherapy, Ninth Edition Gerald Corey

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To Terry Hendrix and in memory of Claire Verduin, our first editors at Brooks/Cole; they had faith

in the potential of this book and encouraged us to write early in our careers.

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PREFACE XI I

PART 1

Basic Issues in Counseling Practice�3

1 Introduction and Overview�4 Introduction 5

Where I Stand 6

Suggestions for Using the Book 8

Overview of the Theory Chapters 9

Introduction to the Case of Stan 13

2 The Counselor: Person and Professional�17 Introduction 18

The Counselor as a Therapeutic Person 18

Personal Therapy for the Counselor 20

The Counselor’s Values and the Therapeutic Process 22

Becoming an Effective Multicultural Counselor 24

Issues Faced by Beginning Therapists 28

Summary 34

3 Ethical Issues in Counseling Practice�36 Introduction 37

Putting Clients’ Needs Before Your Own 37

Ethical Decision Making 38

The Right of Informed Consent 40

Dimensions of Confidentiality 41

Ethical Issues in a Multicultural Perspective 42

Ethical Issues in the Assessment Process 44

Ethical Aspects of Evidence-Based Practice 46

Contents

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Managing Multiple Relationships in Counseling Practice 48

Becoming an Ethical Counselor 51

Summary 52

Where to Go From Here 52

Recommended Supplementary Readings for Part 1 53

References and Suggested Readings for Part 1 55

PART 2

Theories and Techniques of Counseling 61

4 Psychoanalytic Therapy 62 Introduction 63

Key Concepts 64

The Therapeutic Process 72

Application: Therapeutic Techniques and Procedures 78

Jung’s Perspective on the Development of Personality 83

Contemporary Trends: Object-Relations Theory, Self Psychology, and Relational Psychoanalysis 85

Psychoanalytic Therapy From a Multicultural Perspective 91

Psychoanalytic Therapy Applied to the Case of Stan 92

Summary and Evaluation 94

Where to Go From Here 97

Recommended Supplementary Readings 98

References and Suggested Readings 99

5 Adlerian Therapy 101 Introduction 102

Key Concepts 103

The Therapeutic Process 109

Application: Therapeutic Techniques and Procedures 113

Adlerian Therapy From a Multicultural Perspective 123

Adlerian Therapy Applied to the Case of Stan 125

Summary and Evaluation 127

Where to Go From Here 129

Recommended Supplementary Readings 131

References and Suggested Readings 132

6 Existential Therapy 136 Introduction 139

Key Concepts 145

The Therapeutic Process 154

Application: Therapeutic Techniques and Procedures 157

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Existential Therapy From a Multicultural Perspective 160

Existential Therapy Applied to the Case of Stan 162

Summary and Evaluation 163

Where to Go From Here 166

Recommended Supplementary Readings 168

References and Suggested Readings 169

7 Person-Centered Therapy 172 Introduction 173

Key Concepts 178

The Therapeutic Process 179

Application: Therapeutic Techniques and Procedures 184

Person-Centered Expressive Arts Therapy 189

Motivational Interviewing 191

Person-Centered Therapy From a Multicultural Perspective 194

Person-Centered Therapy Applied to the Case of Stan 196

Summary and Evaluation 197

Where to Go From Here 203

Recommended Supplementary Readings 205

References and Suggested Readings 206

8 Gestalt Therapy 210 Introduction 212

Key Concepts 213

The Therapeutic Process 219

Application: Therapeutic Techniques and Procedures 224

Gestalt Therapy From a Multicultural Perspective 233

Gestalt Therapy Applied to the Case of Stan 234

Summary and Evaluation 236

Where to Go From Here 239

Recommended Supplementary Readings 241

References and Suggested Readings 241

9 Behavior Therapy 244 Introduction 247

Key Concepts 250

The Therapeutic Process 252

Application: Therapeutic Techniques and Procedures 255

Behavior Therapy From a Multicultural Perspective 274

Behavior Therapy Applied to the Case of Stan 276

Summary and Evaluation 277

Where to Go From Here 281

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Recommended Supplementary Readings 282

References and Suggested Readings 282

10 Cognitive Behavior Therapy 287 Introduction 290

Albert Ellis’s Rational Emotive Behavior Therapy 291

Key Concepts 292

The Therapeutic Process 295

Application: Therapeutic Techniques and Procedures 297

Aaron Beck’s Cognitive Therapy 302

Donald Meichenbaum’s Cognitive Behavior Modification 310

Cognitive Behavior Therapy From a Multicultural Perspective 315

Cognitive Behavior Therapy Applied to the Case of Stan 318

Summary and Evaluation 320

Where to Go From Here 324

Recommended Supplementary Readings 327

References and Suggested Readings 327

11 Reality Therapy 333 Introduction 335

Key Concepts 336

The Therapeutic Process 340

Application: Therapeutic Techniques and Procedures 342

Reality Therapy From a Multicultural Perspective 349

Reality Therapy Applied to the Case of Stan 352

Summary and Evaluation 354

Where to Go From Here 356

Recommended Supplementary Readings 357

References and Suggested Readings 358

12 Feminist Therapy 360 Introduction 362

Key Concepts 367

The Therapeutic Process 370

Application: Therapeutic Techniques and Procedures 373

Feminist Therapy From a Multicultural and Social Justice Perspective 380

Feminist Therapy Applied to the Case of Stan 382

Summary and Evaluation 384

Where to Go From Here 388

Recommended Supplementary Readings 390

References and Suggested Readings 391

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13 Postmodern Approaches 395 Introduction to Social Constructionism 397

Solution-Focused Brief Therapy 400

Narrative Therapy 410

Postmodern Approaches From a Multicultural Perspective 419

Postmodern Approaches Applied to the Case of Stan 421

Summary and Evaluation 423

Where to Go From Here 426

Recommended Supplementary Readings 429

References and Suggested Readings 429

14 Family Systems Therapy 432 Introduction 434

Development of Family Systems Therapy and Personal Development of the Family Therapist 437

A Multilayered Process of Family Therapy 445

Family Systems Therapy From a Multicultural Perspective 451

Family Systems Therapy Applied to the Case of Stan 452

Summary and Evaluation 456

Where to Go From Here 458

Recommended Supplementary Readings 458

References and Suggested Readings 459

PART 3

Integration and Application�463

15 An Integrative Perspective�464 Introduction 465

The Movement Toward Psychotherapy Integration 465

Issues Related to the Therapeutic Process 477

The Place of Techniques and Evaluation in Counseling 483

Summary 497

Where to Go From Here 498

Recommended Supplementary Readings 499

References and Suggested Readings 499

16 Case Illustration: An Integrative Approach in Working With Stan 503

Counseling Stan: Integration of Therapies 504

Concluding Comments 521

AUTHOR INDEX 523

SUBJECT INDEX 528

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This book is intended for counseling courses for undergraduate and graduate stu- dents in psychology, counselor education, human services, and the mental health professions. It surveys the major concepts and practices of the contemporary ther- apeutic systems and addresses some ethical and professional issues in counseling practice. The book aims to teach students to select wisely from various theories and techniques and to begin to develop a personal style of counseling.

I have found that students appreciate an overview of the divergent contem- porary approaches to counseling and psychotherapy. They also consistently say that the first course in counseling means more to them when it deals with them personally. Therefore, I stress the practical application of the material and encour- age reflection. Using this book can be both a personal and an academic learning experience.

In this ninth edition, every effort has been made to retain the major qualities that students and professors have found helpful in the previous editions: the suc- cinct overview of the key concepts of each theory and their implications for prac- tice, the straightforward and personal style, and the book’s comprehensive scope. Care has been taken to present the theories in an accurate and fair way. I have at- tempted to be simple, clear, and concise. Because many students want suggestions for supplementary reading as they study each therapy approach, I have included an updated reading list at the end of each chapter.

This edition updates the material and refines existing discussions. Part 1 deals with issues that are basic to the practice of counseling and psychotherapy. Chapter 1 puts the book into perspective, then students are introduced to the counselor— as a person and a professional—in Chapter 2. This chapter addresses a number of topics pertaining to the role of the counselor as a person and the therapeutic relationship. Chapter 3 introduces students to some key ethical issues in coun- seling practice, and several of the topics in this chapter have been updated and expanded.

Part 2 is devoted to a consideration of 11 theories of counseling. Each of the theory chapters follows a common organizational pattern, and students can easily compare and contrast the various models. This pattern includes core topics such as key concepts, the therapeutic process, therapeutic techniques and procedures, multicultural perspectives, theory applied to the case of Stan, and summary and evaluation. In this ninth edition, all of the chapters in Part 2 have been revised, updated, and expanded to reflect recent trends. Revisions were based on the rec- ommendations of experts in each theory, all of whom are listed in the Acknowledg- ments section. Both expert and general reviewers provided suggestions for adding, replacing, and expanding material for this edition. Attention was given to current

Preface

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trends and recent developments in the practice of each theoretical approach. For each chapter in Part 2, the citations have been updated.

Each of the 11 theory chapters summarizes key points and evaluates the con- tributions, strengths, limitations, and applications of these theories. Special attention is given to evaluating each theory from a multicultural perspective as well, with a commentary on the strengths and shortcomings of the theory in working with diverse client populations. The consistent organization of the sum- mary and evaluation sections makes comparing theories easier. Students are given recommendations regarding where to look for further training for all of the approaches. Updated annotated lists of reading suggestions and extensive refer- ences at the end of these chapters are offered to stimulate students to expand on the material and broaden their learning through further reading. In addition, a list of DVD resources has been added to the ninth edition for each of the theory chapters.

what’s new in this edition Significant changes for the ninth edition for each of the theory chapters are out- lined below:

chapter 4 Psychoanalytic Therapy Increased emphasis on the role of the relationship in analytic therapy Increased coverage on contemporary psychodynamic therapy Broadened discussion of relational psychoanalysis A new perspective on therapist neutrality and anonymity More emphasis on the role of termination in analytic therapy New material on countertransference, its role in psychoanalytic therapy, and

guidelines for effectively dealing with countertransference Expanded discussion of resistance and how to work with it effectively Revised and expanded section on brief psychodynamic therapy

chapter 5 Adlerian Therapy Revised material on the concept of lifestyle Expanded discussion of social interest New material on early recollections Streamlined discussion of some key concepts

chapter 6 Existential Therapy Revised material on existential themes New and expanded coverage of the contributions of Irvin Yalom and James

Bugental to existential therapy More attention on international developments of existential therapy New material on main aims of existential therapy Revised section on the client–therapist relationship Revised discussion of strengths of the approach from a diversity perspective New discussion of integration of existential concepts in other therapies

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chapter 7 Person-Centered Therapy Expanded coverage on the contributions and influence of Carl Rogers on the

counseling profession New section on the Abraham Maslow’s contributions to humanistic philosophy

and psychology New material on Maslow’s concept of self-actualization and relation to person-

centered philosophy Broadened discussion of clients as active self-healers Updated coverage of the core conditions of congruence, unconditional positive

regard, and empathy Recent research on contextual factors as the main predictors of effective therapy New material on the limitations and criticisms of the approach New material on the diversity of styles of practicing person-centered therapy More emphasis on how the basic philosophy of the person-centered approach

can be applied to other therapeutic modalities Inclusion of emotion-focused therapy, stressing the role of emotions as a route

to change Revised coverage on person-centered expressive arts New section on motivational interviewing (person-centered approach with a twist) Additional coverage of the stages of change as applied to motivational inter-

viewing

chapter 8 Gestalt Therapy Revised discussion of the role of experiments in Gestalt therapy More emphasis on therapist presence Added description of emotion-focused therapy and its relationship to Gestalt

therapy More attention to the relational approach to Gestalt practice

chapter 9 Behavior Therapy Increased attention to the trends in contemporary behavior therapy Broadened discussion of the role of the therapeutic relationship in behavior

therapy Expanded and updated discussion of social skills training Revision of multimodal therapy section Revised discussion of systematic desensitization and exposure procedures Revision of section on EMDR More attention to the role of mindfulness and acceptance strategies in contem-

porary behavior therapy New material on mindfulness-based cognitive therapy and stress reduction Expanded and revised treatment of dialectical behavior therapy

chapter 10 Cognitive Behavior Therapy Revised and expanded coverage of Aaron Beck’s cognitive therapy Increased coverage of Judith Beck’s role in the development of cognitive therapy

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Increased attention on Donald Meichenbaum’s influence in the development of CBT

New material on Meichenbaum’s stress inoculation training Revised section on Meichenbaum’s constructivist approach to CBT Increased coverage of relapse prevention Increased discussion of CBT from a multicultural perspective New material on the potential limitations of the multicultural applications of CBT

chapter 11 Reality Therapy Revised discussion of the relationship of choice theory to reality therapy Expanded discussion of the role of questions in reality therapy Revision of section on the role of planning in reality therapy More emphasis on the value of reality therapy with reluctant clients Additional material on reality therapy from a diversity perspective

chapter 12 Feminist Therapy Updated treatment of the principles of feminist therapy Updated discussion of the role of assessment and diagnosis in feminist therapy Increased attention given to empowerment New example of applying feminist therapy interventions with the case of Alma Revised and expanded discussion on therapeutic techniques and strategies

chapter 13 Postmodern Approaches Additional material on parallels between solution-focused brief therapy and

positive psychology Broadened discussion of the key concepts of solution-focused brief therapy

(SFBT) More emphasis on the client-as-expert in the therapy relationship in postmod-

ern approaches Revision of material on techniques in the postmodern approaches New material on listening with an open mind in narrative therapy More emphasis on the collaborative nature of narrative therapy and SFBT

chapter 14 Family Systems Therapy A reconceptualization and streamlining of the chapter New section describing the multilayered process of family therapy More emphasis on the personal development of the family therapist Addition of reflection questions to assist in the personal application of family

theory New material on genogram work for understanding the self of the therapist

and clients Expanded section on recent developments in family therapy New material on the postmodern perspective on family therapy More attention given to feminism, multiculturalism, and postmodern constru-

ctionism as applied to family therapy

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In Part 3 readers are helped to put the concepts together in a meaningful way through a discussion of the integrative perspective and consideration of a case study. Chapter 15 (“An Integrative Perspective”) pulls together themes from all 11 theoretical orientations. This chapter has been revised to expand discus- sion of the psychotherapy integration movement; revise treatment of the various integrative approaches; update and expand the section on integration of multi- cultural issues in counseling; revise the section on integration of spirituality in counseling; add material on research demonstrating the importance of the thera- peutic relationship; more discussion on the central role of the client in determin- ing therapy outcomes; and update coverage of the conclusions from the research literature on the effectiveness of psychotherapy. Chapter 15 develops the notion that an integrative approach to counseling practice is in keeping with meeting the needs of diverse client populations in many different settings. Numerous tables and other integrating material help students compare and contrast the 11 approaches.

The “Case of Stan” has been retained in Chapter 16 to help readers see the application of a variety of techniques at various stages in the counseling process with the same client. This chapter illustrates an integrative approach that draws from all the therapies and applies a thinking, feeling, and behaving model in counseling Stan. Applying the various theories to a single case example allows for a comparison among the approaches. The video program (DVD for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes) can be used as an ideal supplement to this chapter. For each of the 13 sessions in the DVD program in my counseling with Stan, I apply just a few selected techniques designed to illustrate each theory in action. New to accompany this ninth edition is a series of lecturettes that I present for each chapter in this textbook. This ex- panded DVD program now includes both demonstrations of my counseling with Stan and brief lectures that highlight my perspective on the practical applications of each theory.

This text can be used in a flexible way. Some instructors will follow my se- quencing of chapters. Others will prefer to begin with the theory chapters (Part 2) and then deal later with the student’s personal characteristics and ethical issues. The topics can be covered in whatever order makes the most sense. Readers are offered some suggestions for using this book in Chapter 1.

In this edition I have made every effort to incorporate those aspects that have worked best in the courses on counseling theory and practice that I regularly teach. To help readers apply theory to practice, I have also revised the Student Manual, which is designed for experiential work. The Student Manual for Theory and Prac- tice of Counseling and Psychotherapy still contains open-ended questions, many new cases for exploration and discussion, structured exercises, self-inventories, and a variety of activities that can be done both in class and out of class. The ninth edition features a structured overview, as well as a glossary, for each of the theories, and chapter quizzes for assessing the level of student mastery of basic concepts.

CourseMate, a new online resource, is available to accompany this textbook. It contains the video program for Theory and Practice of Counseling and Psychotherapy:

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The Case of Stan and Lecturettes, as well as a glossary of key terms, interviews with ex- perts (questions and answers by experts in the various theories), and case examples for each of the theories illustrating ways of applying these concepts and techniques to a counseling case.

The newly revised and enlarged Case Approach to Counseling and Psychotherapy (Eighth Edition) features experts working with the case of Ruth from the vari- ous therapeutic approaches. The casebook can either supplement this book or stand alone. An additional chapter covering transactional analysis is available on WebTutor.® This material is provided in the same format as the 11 theory chapters in this book and includes experiential exercises that can be completed individually or in small groups.

Accompanying this ninth edition of the text and Student Manual is a DVD for Integrative Counseling: The Case of Ruth and Lecturettes, in which I demonstrate an integrative approach in counseling Ruth (the central character in the casebook). It contains lecturettes on how I draw from key concepts and techniques from the various theories presented in the book. This DVD program has been developed for student purchase and use as a self-study program, and it makes an ideal learning package that can be used in conjunction with this text and the Student Manual. The Art of Integrative Counseling (Third Edition), which expands on the material in Chapter 15 of the textbook, also complements this book.

Some professors have found the textbook and the Student Manual or the online program (CourseMate) to be ideal companions and realistic resources for a single course. Others like to use the textbook and the casebook as companions. With this revision it is now possible to have a unique learning package of several books, along with the DVD for Integrative Counseling: The Case of Ruth and Lecturettes. The Case Approach to Counseling and Psychotherapy and the Art of Integrative Counseling can also be used in a various classes, a few of which include case-management practicum, fieldwork courses, or counseling techniques courses.

Also available is a revised and updated Instructor’s Resource Manual, which includes suggestions for teaching the course, class activities to stimulate inter- est, PowerPoint presentations for all chapters, and a variety of test questions and final examinations. This instructor’s manual is now geared for the following learning package: Theory and Practice of Counseling and Psychotherapy, Student Manual for Theory and Practice of Counseling and Psychotherapy, Case Approach to Counseling and Psychotherapy, The Art of Integrative Counseling, and two video programs: DVD for Integrative Counseling: The Case of Ruth and Lecturettes, and DVD for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes.

Acknowledgments The suggestions I received from the many readers of prior editions who took the time to complete the survey at the end of the book have been most helpful. Many other people have contributed ideas that have found their way into this ninth edition. I especially appreciate the time and efforts of the manuscript reviewers, who offered constructive criticism and supportive commentaries, as well as those

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professors who have used this book and provided me with feedback that has been most useful in these revisions. Those who reviewed the complete manuscript of the ninth edition are:

Sylinda Banks, Norfolk State University Jayne Barnes, Nashua Community College Eric Bruns, Campbellsville University Joya Crear, George Mason University Samantha Daniel, Fayetteville State University Melodie Frick, West Texas A&M University Amanda Healey, Sam Houston State University Paula Nelson, Saint Leo University Terence Patterson, University of San Francisco Holly Seirup, Hofstra University

Special thanks are extended to the chapter reviewers, who provided consulta- tion and detailed critiques. Their insightful and valuable comments have generally been incorporated into this edition:

Chapter 4 (Psychoanalytic Therapy): William Blau, Copper Mountain College, Joshua Tree, California; and J. Michael Russell of California State University, Fullerton

Chapter 5 (Adlerian Therapy): James Robert Bitter, East Tennessee State University, and I coauthored Chapter 5

Chapter 6 (Existential Therapy): Emmy van Deurzen, New School of Psy- chotherapy and Counselling, London, England, and University of Sheffield; J. Michael Russell of California State University, Fullerton; David N. Elkins, Graduate School of Education and Psychology, Pepperdine University; Bryan Farha, Oklahoma City College; Jamie Bludworth, private practice, Phoeniz, Arizona; Kirk Schneider, the Existential-Humanistic Institute; and Victor Yalom, president, Psychotherapy.Net

Chapter 7 (Person-Centered Therapy): Natalie Rogers, Person-Centered Ex- pressive Arts Associates, Cotati, California; David N. Elkins, Graduate School of Education and Psychology, Pepperdine University; and David Cain, Cali- fornia School of Professional Psychology at Alliant International University, San Diego

Chapter 8 (Gestalt Therapy): Jon Frew, Private Practice, Vancouver, Washington, and Pacific University, Oregon; Ansel Woldt, Kent State University

Chapter 9 (Behavior Therapy): Sherry Cormier, West Virginia University; Frank M. Dattilio, Harvard Medical School, and the University of Pennsylvania School of Medicine; and Arnold A. Lazarus, Rutgers University, and the Lazarus Institute

Chapter 10 (Cognitive Behavior Therapy): Sherry Cormier, West Virginia University; Frank M. Dattilio, Harvard Medical School, and the University of Pennsylvania School of Medicine; Windy Dryden, Professor of Psychothera- peutic Studies at Goldsmiths College, London; and Donald Meichenbaum, Research Director of the Melissa Institute for Violence Prevention

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Chapter 11 (Reality Therapy): Robert Wubbolding, Center for Reality Therapy, Cincinnati, Ohio

Chapter 12 (Feminist Therapy): Carolyn Zerbe Enns, Cornell College; Barbara Herlihy, University of New Orleans, and I coauthored Chapter 12

Chapter 13 (Postmodern Approaches): John Winslade, California State Uni- versity, San Bernardino; Linda Metcalf, Texas Women’s University, and the Solution Focused Institute for Education and Training; and John Murphy, Uni- versity of Central Arkansas

Chapter 14 (Family Systems Therapy): Jon Carlson, Governors State Univer- sity; James Robert Bitter, East Tennessee State University, and I coauthored Chapter 14

I want to acknowledge those on the Brooks/Cole, Cengage Learning team who are involved with our projects. These people include Seth Dobrin, editor of counseling, social work, and human services; Julie Martinez, consulting editor, who monitored the review process; Caryl Gorska, for her work on the interior design and cover of this book; Elizabeth Momb, media editor; Naomi Dreyers, supplemental materials for the book; Michelle Muratori, Johns Hopkins University, for her work on up- dating the Instructor’s Resource Manual and assisting in developing the other sup- plements; and Rita Jaramillo, project manager. We thank Ben Kolstad of Cenveo Publisher Services, who coordinated the production of this book. Special recogni- tion goes to Kay Mikel, the manuscript editor of this edition, whose exceptional editorial talents continue to keep this book reader friendly. We appreciate Susan Cunningham’s work in preparing the index. The efforts and dedication of all of these people certainly contribute to the high quality of this edition.

– Gerald Corey

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3

part 1

Basic Issues in Counseling Practice

1 Introduction and Overview 4

2 The Counselor: Person and Professional 17

3 Ethical Issues in Counseling Practice 36

Recommended Supplementary Readings for Part 1 53

References and Suggested Readings for Part 1 55

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4

introduction

where i stand

suggestions for using the book

overview of the theory chapters

introduction to the case of stan

• Intake Interview and Stan’s Autobiography

• Overview of Some Key Themes in Stan’s Life

chapter 1

Introduction and Overview

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introduction Counseling students can begin to acquire a counseling style tailored to their own personality by familiarizing themselves with the major approaches to therapeutic practice. This book surveys 11 approaches to counseling and psychotherapy, pre- senting the key concepts of each approach and discussing features such as the therapeutic process (including goals), the client–therapist relationship, and spe- cifi c procedures used in the practice of counseling. This information will help you develop a balanced view of the major ideas of each of the theories and acquaint you with the practical techniques commonly employed by counselors who adhere to each approach. I encourage you to keep an open mind and to seriously consider both the unique contributions and the particular limitations of each therapeutic system presented in Part 2.

You do not gain the knowledge and experience needed to synthesize various approaches by merely completing an introductory course in counseling theory. This process will take many years of study, training, and practical counseling ex- perience. Nevertheless, I recommend a personal integration as a framework for the professional education of counselors. The danger in presenting one model to which all students are expected to subscribe is that it can limit their effectiveness in working with a diverse range of future clients.

An undisciplined mixture of approaches, however, can be an excuse for failing to develop a sound rationale for systematically adhering to certain con- cepts and to the techniques that are extensions of them. It is easy to pick and choose fragments from the various therapies because they support our biases and preconceptions. By studying the models presented in this book, you will have a better sense of how to integrate concepts and techniques from differ- ent approaches when defi ning your own personal synthesis and framework for counseling.

Each therapeutic approach has useful dimensions. It is not a matter of a theory being “right” or “wrong,” as every theory offers a unique contribution to under- standing human behavior and has unique implications for counseling practice. Accepting the validity of one model does not necessarily imply rejecting other models. There is a clear place for theoretical pluralism, especially in a society that is becoming increasingly diverse.

Although I suggest that you remain open to incorporating diverse approaches into your own personal synthesis—or integrative approach to counseling—let me caution that you can become overwhelmed and confused if you attempt to learn everything at once, especially if this is your introductory course in coun- seling theories. A case can be made for initially getting an overview of the major theoretical orientations, and then learning a particular approach by becoming steeped in that approach for some time, rather than superfi cially grasping many theoretical approaches. An integrative perspective is not developed in a random fashion; rather, it is an ongoing process that is well thought out. Successfully integrating concepts and techniques from diverse models requires years of refl ec- tive practice and a great deal of reading about the various theories. In Chapter 15

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I discuss in more depth some ways to begin designing your integrative approach to counseling practice.

See the video program for Chapter 1, DVD for Theory and Practice of Counseling and Psychotherapy: The Case of Stan and Lecturettes. I suggest that you view the brief lecturette for each chapter in this book prior to reading the chapter.

where i stand My philosophical orientation is strongly infl uenced by the existential approach. Because this approach does not prescribe a set of techniques and procedures, I draw techniques from the other models of therapy that are presented in this book. I particularly like to use role-playing techniques. When people reenact scenes from their lives, they tend to become more psychologically engaged than when they merely report anecdotes about themselves. I also incorporate many techniques derived from cognitive behavior therapy.

The psychoanalytic emphasis on early psychosexual and psychosocial develop- ment is useful. Our past plays a crucial role in shaping our current personality and behavior. I challenge the deterministic notion that humans are the product of their early conditioning and, thus, are victims of their past. But I believe that an explora- tion of the past is often useful, particularly to the degree that the past continues to infl uence present-day emotional or behavioral diffi culties.

I value the cognitive behavioral focus on how our thinking affects the way we feel and behave. These therapies also emphasize current behavior. Thinking and feeling are important dimensions, but it can be a mistake to overemphasize them and not explore how clients are behaving. What people are doing often gives us a good clue to what they really want. I also like the emphasis on specifi c goals and on encouraging clients to formulate concrete aims for their own therapy sessions and in life. Contracts between clients and therapists can be very useful. I frequently suggest either specifi c homework assignments or ask my clients to devise their own assignments, or together we develop goals and tasks that guide the therapy process.

More approaches have been developing methods that involve collaboration be- tween therapist and client, making the therapeutic venture a shared responsibility. This collaborative relationship, coupled with teaching clients ways to use what they learn in therapy in their everyday lives, empowers clients to take an active stance in their world. It is imperative that clients be active, not only in their counseling sessions but in daily life as well. Homework can be a vehicle for assisting clients in putting into action what they are learning in therapy.

A related assumption of mine is that we can exercise increasing freedom to cre- ate our future. The acceptance of personal responsibility does not imply that we can be anything that we want. Social, environmental, cultural, and biological realities oftentimes limit our freedom of choice. Being able to choose must be considered in the sociopolitical contexts that exert pressure or create constraints; oppression is a reality that can restrict our ability to choose our future. We are also infl uenced by our social environment, and much of our behavior is a product of learning and

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conditioning. That being said, I believe an increased awareness of these contextual forces enables us to address these realities. It is crucial to learn how to cope with the external and internal forces that limit our decisions and behavior.

Feminist therapy has contributed an awareness of how environmental and social conditions contribute to the problems of women and men and how gender- role socialization leads to a lack of gender equality. Family therapy teaches us that it is not possible to understand the individual apart from the context of the system. Both family therapy and feminist therapy are based on the premise that to un- derstand the individual it is essential to take into consideration the interpersonal dimensions and the sociocultural context rather than focusing primarily on the intrapsychic domain. Thus a comprehensive approach to counseling goes beyond focusing on our internal dynamics and addresses those environmental and sys- temic realities that infl uence us.

My philosophy of counseling does not include the assumption that therapy is exclusively for the “sick” and is aimed at “curing” psychological “ailments.” Such a focus on the medical model restricts therapeutic practice because it stresses defi cits rather than strengths. Instead, I agree with the postmodern approaches (see Chapter 13), which are grounded on the assumption that people have both internal and external resources to draw upon when constructing solutions to their problems. Therapists will view these individuals quite differently if they acknowl- edge that their clients possess competencies rather than pathologies. I view each individual as having resources and competencies that can be discovered and built upon in therapy.

Psychotherapy is a process of engagement between two people, both of whom are bound to change through the therapeutic venture. At its best, this is a collabora- tive process that involves both the therapist and the client in co-constructing solutions to concerns. Most of the theories described in this book emphasize the collaborative nature of the practice of psychotherapy.

Therapists are not in business to change clients, to give them quick advice, or to solve their problems for them. Instead, counselors facilitate healing through a process of genuine dialogue with their clients. The kind of person a therapist is remains the most critical factor affecting the client and promoting change. If practitioners possess wide knowledge, both theoretical and practical, yet lack human qualities of compassion, caring, good faith, honesty, presence, realness, and sensitivity, they are more like technicians. In my judgment those who func- tion exclusively as technicians do not make a signifi cant difference in the lives of their clients. It is essential that counselors explore their own values, attitudes, and beliefs in depth and work to increase their own awareness. Throughout the book, I encourage you to fi nd ways to personally relate to each of the therapies. Applying this material to yourself personally takes you beyond a mere academic understand- ing of theories.

With respect to mastering the techniques of counseling and applying them appropriately and effectively, it is my belief that you are your own very best tech- nique. Your reactions to your clients, including sharing how you are affected in the relationship with them, are useful in moving the therapeutic process along.

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