The Art of Integrative Counseling, 2nd Edition

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He served as the director of clinical training for the counseling psychology program from — He has served on more than dissertation and thesis committees. Kinnier has conducted research in several areas but his main interest has been on topics related to values clarification, decision making, and meaning in life. He has published about 70 articles, chapters, and books. Journal of Counseling and Development Counseling and Values COM Internship. Degree Clusters. HST Internship. Kaleidoscope newsletter BIS Topics. Spanish Spanish for the Professions. Richard Kinnier.

Counseling and Counseling Psychology. Mailcode Bio Research Teaching Public Work. Fax Education Ph. Counseling, Columbia University B. Psychology, Boston College Research Interests Meaning in life, moral values. Publications Kinnier, R. Group exercises that may increase your self-knowledge and wisdom. Kinnier, R. The point of it all 2nd ed. Acton, MA: XanEdu.

The meaning of life, according to the great and the good 2nd. Bath, England: Palazzo Editions, Ltd. The main contributors to a future utopia. Current Psychology, 30, Partch, J. Values and messages conveyed in college commencement speeches. Here we help the client to untangle self-perpetuating vicious cycles between their Environment, Cognition, Emotion, Behaviour and Physiology, so that they can unlearn what is dysfunctional and learn new, more functional, approaches. Guided Discovery processes such as Socratic Questioning and Behavioural Experimentation are used at this level, and many techniques from other approaches can also be usefully integrated; Mindfulness training is a well-known example e.

Segal, Z. The central aim of Integrative CBT is cognitive change: change in the way we see things, interpret events, talk to ourselves, pay attention to certain aspects of our environment, put meaning on our lives, etc. This level therefore takes us a step beyond the work of Egan etc, into the specifically cognitive focus at the heart of the model.

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For instance, in a depressed client, their negative thoughts feed their depressed feelings, lack of activity, and exhaustion, and are in turn reinforced by each of these symptoms. Integrative CBT gives attention to all four pieces of this symptom cycle, but is Cognitive-Behavioural in being especially focused on helping the client to make relevant changes in their thinking and in their behaviour, in order to reverse the damaging vicious cycles.

Integrative CBT therapists therefore need to be comfortable in working with emotion, behaviour, cognition and physiology. When we are overanxious about something e. When we do manage to make changes in a vicious cycle like this, we do so through Experiential Relearning — discovering through experience that our fears are not well grounded. Sometimes we are lucky, and this process happens without it being deliberately planned or structured e. But when we are really stuck, this process of change requires more Structured Experiential Relearning; a relevant self-help book may provide sufficient structure for some people, but many people need the process to be professionally Facilitated by a therapist.

At this level of Integrative CBT, as in Cognitive Therapy, the learned habits of thinking and behaviour which keep the problem going can be unlearned and replaced through a process of Guided Discovery, using two very powerful therapeutic tools: Socratic Questioning and Behavioural Experiments. This then leads into a probing, testing process, where the basis of beliefs are examined and questioned, not just in relation to their truth, but also their current relevance, value, importance, meaning, usefulness etc.

Behavioural Experiments are different from the Behavioural Change work we discussed at Level 2. Even when the focus is mainly at other levels, therapeutic choices are best guided by a broad Case Formulation. These templates can be called Schemas; their contents e. Persons suggests that this kind of formulation can explain how current problems are precipitated, and how they actually make sense in the light of underlying schemas and current triggers. A typical diagram for a Schema-based case formulation is shown below. Since not all difficulties can be resolved through therapy, clients may need help to understand and process the realities of the human condition which necessarily remain.

Some of these may be specific to their circumstances and history, or to their particular mental health problems e. Others arise from the evolved vulnerabilities of our species e. Here the therapist tries to help the client towards a greater understanding of themselves as a human being, incorporating whatever perspectives they find helpful, whether philosophical, cultural, scientific, existential, or spiritual.

Beyond Brief Counseling and Therapy: An Integrative Approach, 2nd Edition

Focusing on what it means to be human can help the client to more deeply understand their vulnerability to the problems they have grappled with; not just why they are individually vulnerable to depression, or addiction, or relationship difficulties, but why human beings in general are vulnerable. This can be a great help with the process of normalising and de-stigmatising problems, and developing self-compassion. Not everything is possible for everyone, and limits are set by factors such as age, resources, previous choices, personality and values.

The fact that therapeutic planning happens within limits isn't necessarily bad news.

Integrative Psychotherapy - It's roots - history - and methods

Working within limits is where the creative action is; ask any artist or composer — or any recovering alcoholic. Some view of what it is to be human is implicit in every approach to psychotherapy, and should be made as explicit as possible. A view of the human condition is not just something that we come to at the end of therapy, but a theme that runs right through the process, and influences what both client and therapist believe to be possible.

The personal philosophies of being human which can be found amongst clients and therapists obviously vary enormously; along with this, there are the formal psychological theories of human nature on which any therapeutic approach is based, for example the optimistic, growth-oriented perspective of the Humanistic approaches, the relatively pessimistic Freudian view, or the pragmatic, scientific model of most Cognitive-Behavioural schools.

Since the role of the therapist is to help the client towards a greater understanding of themselves as a human being, incorporating whatever philosophical, cultural, scientific, existential, or spiritual perspectives the client finds helpful, the best that can be done is to discuss these issues explicitly at appropriate points in therapy by raising the question of long-term goals, values, etc. Client and therapist do not have to fully agree, though too great a difference in views may simply not work for the client especially in relation to value-laden issues such as abortion, pornography, etc.

Finally, I want to say a bit more about the process of choosing what level to focus on at any particular moment in therapy; I am not just describing a theoretical model here, but how I actually work.

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It is possible to look the five levels of Integrative CBT as a progression, and over the whole period of therapy with a client this may in fact be accurate. Yes, it does get more complicated once you try starting to problem-solve with a client, while also keeping an eye on the integrity of the therapeutic relationship; and it gets even more complicated when you add in some cognitive restructuring and developmental exploration. Of course it is easier if you take an approach which concentrates on just one of these — but is that good enough for the client?

Well, it depends on the issues. Some clients may just need some problem-solving, skill-learning assistance; they may not even need much attention paid to the therapeutic relationship, just the minimum necessary for a working alliance. On the other hand, clients with specific mental health issues such as OCD or anger problems may need to postpone much of this kind of practical work until they have learnt to think and feel differently about their problems through cognitive-behavioural re-learning at levels 3 and 4; otherwise they may be trying to solve the wrong problems e.

To be genuinely integrative, rather than just eclectic, an approach needs to be based on a core theory of therapeutic change. While this change may need to be facilitated by the direct cognitive restructuring techniques of traditional CBT Level 3 , it equally may require a containing relationship Level 1 , problem-solving tools and direction Level 2 , developmental exploration, including at a transferential level Level 4 , and some attempt to set problems and recovery within the context of the human condition Level 5.

A case is therefore formulated in primarily cognitive terms i. This clearly involves a wide skill-set, if the therapist is to be flexible enough to meet a client at any of these levels.

Alford, B. New York: Guilford Press. New York: International Universities Press. The Art of Integrative Counseling (): Gerald Corey: Books

Guilford Press. Journal of Psychotherapy. Beck, J. Bennett-Levy, J. Oxford: OUP. Burns, D. New York: Plume. Egan, G. Thomson Learning.