Theoretical Application

INSTRUCTIONS – Theoretical Application

1. Goals you will work on with Rona (make sure the goals align with the psychoanalytic therapeutic approach).

2. Interventions and techniques you will use with Rona, based on psychoanalytic established goals. Be very specific. Assume that you will have up to three sessions with her.

3. Cultural considerations you will keep in mind while using the psychoanalytic approach with Rona.

4. Strengths and limitations of using the psychoanalytic theory with Rona.

CASE STUDY – THE CASE OF RONA

Presenting Information: Rona is a 45-year old woman with no health problems. She is seeking counseling due to feelings of despondency, guilt, and despair.

Rona was previously married to Max and is in contact with her former husband of 10 years, who, like Rona, helps to support their daughter, Leisha, and their young grandson. Recently, Rona’s aging mother fell and broke her hip and came to live with Rona after being released from rehabilitation therapy. Leisha, who recently lost her job, is talking about bringing her son and a coming to live with Rona.

Rona feels overwhelmed with the demands on her time and energy. She states that she loves her mother, her daughter, and her grandchild, but feels “pulled in too many directions.” She states that after her divorce, and after Leisha left home, she had gone back to school to complete an associate’s degree. After adjusting to living alone, she found that she had enjoyed challenging herself to reach for new goals.

Social History: Rona grew up in a rural environment; her parents worked in jobs that supported a rural economy. Rona states that she “did not fit in” and moved to the nearby city as soon as she graduated from high school. She became pregnant with Leisha shortly after meeting Max, and states that she “kept to herself” because of her negative social experiences while growing up and the demands of working and raising her daughter. Recently, however, she has met someone and has enjoyed going out and exploring a new relationship.

Occupational and Educational History: Rona found work as a home health aide when she left home and moved to the city, and she discovered that she excelled in that role. Recently, she entered a program at her local community college to become a certified Medical Assistant, a goal that excited her and gave her hope for a better life in her middle-adult years. Her current feelings of distress are rising because she anticipates having to give up on her dream. For the Unit 4 Assignment, imagine that you are beginning your second session with Rona, and you are ready to work on assisting her in changing her life, from the psychoanalytic therapy approach.

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PSYCHOANALYTIC THERAPY

PSYCHOANALYTIC THERAPY

 

Key Concepts

View of Human Nature

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The Freudian view of human nature is basically deterministic. According to Freud, our behavior is determined by irrational forces, unconscious motivations, and biological and instinctual drives as these evolve through key psychosexual stages in the first six years of life.

Instincts are central to the Freudian approach. Although he originally used the term libido to refer to sexual energy, he later broadened it to include the energy of all the life instincts. These instincts serve the purpose of the survival of the individual and the human race; they are oriented toward growth, development, and creativity. Libido, then, should be understood as a source of motivation that encompasses sexual energy but goes beyond it. Freud includes all pleasurable acts in his concept of the life instincts; he sees the goal of much of life as gaining pleasure and avoiding pain.

Freud also postulates death instincts, which account for the aggressive drive. At times, people manifest through their behavior an unconscious wish to die or to hurt themselves or others. Managing this aggressive drive is a major challenge to the human race. In Freud’s view, both sexual and aggressive drives are powerful determinants of why people act as they do.

Structure of Personality

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According to the Freudian psychoanalytic view, the personality consists of three systems: the id, the ego, and the superego. These are names for psychological structures and should not be thought of as manikins that separately operate the personality; one’s personality functions as a whole rather than as three discrete segments. The id is roughly all the untamed drives or impulses that might be likened to the biological component. The ego attempts to organize and mediate between the id and

 

the reality of dangers posed by the id’s impulses. One way to protect ourselves from the dangers of our own drives is to establish a superego, which is the internalized social component, largely rooted in what the person imagines to be the expectations of parental figures. Because the point of taking in these imagined expectations is to protect ourselves from our own impulses, the superego may be more punitive and demanding than the person’s parents really were. Actions of the ego may or may not be conscious. For example, defenses typically are not conscious. Because ego and consciousness are not the same, the slogan for psychoanalysis has shifted from “making the unconscious conscious” to “where there was id, let there be ego.”

From the orthodox Freudian perspective, humans are viewed as energy systems. The dynamics of personality consist of the ways in which psychic energy is distributed to the id, ego, and superego. Because the amount of energy is limited, one system gains control over the available energy at the expense of the other two systems. Behavior is determined by this psychic energy.

The ID  The id is the original system of personality; at birth a person is all id. The id is the primary source of psychic energy and the seat of the instincts. It lacks organization and is blind, demanding, and insistent. A cauldron of seething excitement, the id cannot tolerate tension, and it functions to discharge tension immediately. Ruled by the pleasure principle, which is aimed at reducing tension, avoiding pain, and gaining pleasure, the id is illogical, amoral, and driven to satisfy instinctual needs. The id never matures, remaining the spoiled brat of personality. It does not think but only wishes or acts. The id is largely unconscious, or out of awareness.

The Ego  The ego has contact with the external world of reality. It is the “executive” that governs, controls, and regulates the personality. As a “traffic cop,” it mediates between the instincts and the surrounding environment. The ego controls consciousness and exercises censorship. Ruled by the reality principle, the ego does realistic and logical thinking and formulates plans of action for satisfying needs. The ego, as the seat of intelligence and rationality, checks and controls the blind impulses of the id. Whereas the id knows only subjective reality, the ego distinguishes between mental images and things in the external world.

The Superego  The superego is the judicial branch of personality. It includes a person’s moral code, the main concern being whether an action is good or bad, right or wrong. It represents the ideal rather than the real and strives not for pleasure but for perfection. The superego represents the traditional values and ideals of society as they are handed down from parents to children. It functions to inhibit the id impulses, to persuade the ego to substitute moralistic goals for realistic ones, and to strive for perfection. As the internalization of the standards of parents and society, the superego is related to psychological rewards and punishments. The rewards are feelings of pride and self-love; the punishments are feelings of guilt and inferiority.

Consciousness and the Unconscious

Perhaps Freud’s greatest contributions are his concepts of the unconscious and of the levels of consciousness, which are the keys to understanding behavior and the

 

problems of personality. The unconscious cannot be studied directly but is inferred from behavior. Clinical evidence for postulating the unconscious includes the following: (1) dreams, which are symbolic representations of unconscious needs, wishes, and conflicts; (2) slips of the tongue and forgetting, for example, a familiar name; (3) posthypnotic suggestions; (4) material derived from free-association techniques; (5) material derived from projective techniques; and (6) the symbolic content of psychotic symptoms.

For Freud, consciousness is a thin slice of the total mind. Like the greater part of the iceberg that lies below the surface of the water, the larger part of the mind exists below the surface of awareness. The unconscious stores all experiences, memories, and repressed material. Needs and motivations that are inaccessible—that is, out of awareness—are also outside the sphere of conscious control. Most psychological functioning exists in the out-of-awareness realm. The aim of psychoanalytic therapy is to make the unconscious motives conscious, for only then can an individual exercise choice. Understanding the role of the unconscious is central to grasping the essence of the psychoanalytic model of behavior.

Unconscious processes are at the root of all forms of neurotic symptoms and behaviors. From this perspective, a “cure” is based on uncovering the meaning of symptoms, the causes of behavior, and the repressed materials that interfere with healthy functioning. It is to be noted, however, that intellectual insight alone does not resolve the symptom. The client’s need to cling to old patterns (repetition) must be confronted by working through transference distortions, a process discussed later in this chapter.

Anxiety

Also essential to the psychoanalytic approach is its concept of anxiety. Anxiety is a feeling of dread that results from repressed feelings, memories, desires, and experiences that emerge to the surface of awareness. It can be considered as a state of tension that motivates us to do something. It develops out of a conflict among the id, ego, and superego over control of the available psychic energy. The function of anxiety is to warn of impending danger.

There are three kinds of anxiety: reality, neurotic, and moral. Reality anxiety is the fear of danger from the external world, and the level of such anxiety is proportionate to the degree of real threat. Neurotic and moral anxieties are evoked by threats to the “balance of power” within the person. They signal to the ego that unless appropriate measures are taken the danger may increase until the ego is overthrown. Neurotic anxiety is the fear that the instincts will get out of hand and cause the person to do something for which she or he will be punished. Moral anxiety is the fear of one’s own conscience. People with a well-developed conscience tend to feel guilty when they do something contrary to their moral code. When the ego cannot control anxiety by rational and direct methods, it relies on indirect ones—namely, ego-defense behavior.

Ego-Defense Mechanisms

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Ego-defense mechanisms help the individual cope with anxiety and prevent the ego from being overwhelmed. Rather than being pathological, ego defenses

 

are normal behaviors that can have adaptive value provided they do not become a style of life that enables the individual to avoid facing reality. The defenses employed depend on the individual’s level of development and degree of anxiety. Defense mechanisms have two characteristics in common: (1) they either deny or distort reality, and (2) they operate on an unconscious level. Table 4.1 provides brief descriptions of some common ego defenses.

 

 

Development of Personality

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Importance of Early Development  A significant contribution of the psychoanalytic model is delineation of the stages of psychosexual and psychosocial stages of development from birth through adulthood. The psychosexual stages refer to the Freudian chronological phases of development, beginning in infancy.

Freud postulated three early stages of development that often bring people to counseling when not appropriately resolved. First is the oral stage, which deals with the inability to trust oneself and others, resulting in the fear of loving and forming close relationships and low self-esteem. Next, is the anal stage, which deals with the inability to recognize and express anger, leading to the denial of one’s own power as a person and the lack of a sense of autonomy. Third, is the phallic stage, which deals with the inability to fully accept one’s sexuality and sexual feelings, and also to difficulty in accepting oneself as a man or woman. According to the Freudian psychoanalytic view, these three areas of personal and social development—love and trust,

 

dealing with negative feelings, and developing a positive acceptance of sexuality—are all grounded in the first six years of life. This period is the foundation on which later personality development is built. When a child’s needs are not adequately met during these stages of development, an individual may become fixated at that stage and behave in psychologically immature ways later on in life.

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Erikson’s Psychosocial Perspective  The developmental stages postulated by Freud have been expanded by other theorists. Erik Erikson’s (1963) psychosocial perspective on personality development is especially significant. Erikson built on Freud’s ideas and extended his theory by stressing the psychosocial aspects of development beyond early childhood. The psychosocial stages refer to Erikson’s basic psychological and social tasks, which individuals need to master at intervals from infancy through old age. This stage perspective provides the counselor with the conceptual tools for understanding key developmental tasks characteristic of the various stages of life. Erikson’s theory of development holds that psychosexual growth and psychosocial growth take place together, and that at each stage of life we face the task of establishing equilibrium between ourselves and our social world. He describes development in terms of the entire life span, divided by specific crises to be resolved. According to Erikson, a crisis is equivalent to a turning point in life when we have the potential to move forward or to regress. At these turning points, we can either resolve our conflicts or fail to master the developmental task. To a large extent, our life is the result of the choices we make at each of these stages.

Erikson is often credited with bringing an emphasis on social factors to contemporary psychoanalysis. Classical psychoanalysis is grounded on id psychology, and it holds that instincts and intrapsychic conflicts are the basic factors shaping personality development (both normal and abnormal). Contemporary psychoanalysis tends to be based on ego psychology, which does not deny the role of intrapsychic conflicts but emphasizes the striving of the ego for mastery and competence throughout the human life span. Ego psychology therapists assist clients in gaining awareness of their defenses and help them develop better ways of coping with these defenses (McWilliams, 2016). Ego psychology deals with both the early and the later developmental stages, for the assumption is that current problems cannot simply be reduced to repetitions of unconscious conflicts from early childhood. The stages of adolescence, mid-adulthood, and later adulthood all involve particular crises that must be addressed. As one’s past has meaning in terms of the future, there is continuity in development, reflected by stages of growth; each stage is related to the other stages.

Viewing an individual’s development from a combined perspective that includes both psychosexual and psychosocial factors is useful. Erikson believed Freud did not go far enough in explaining the ego’s place in development and did not give enough attention to social influences throughout the life span. A comparison of Freud’s psychosexual view and Erikson’s psychosocial view of the stages of development is presented in Table 4.2.

Counseling Implications  By taking a combined psychosexual and psychosocial perspective, counselors have a helpful conceptual framework for understanding developmental issues as they appear in therapy. The key needs and developmental tasks, along with the challenges inherent at each stage of life, provide a model for understanding some of the core conflicts clients explore in their therapy sessions. Questions such as these can give direction to the therapeutic process:

· ♦What are some major developmental tasks at each stage in life, and how are these tasks related to counseling?

· ♦What themes give continuity to this individual’s life?

· ♦What are some universal concerns of people at various points in life? How can people be challenged to make life-affirming choices at these points?

· ♦What is the relationship between an individual’s current problems and significant events from earlier years?

· ♦What choices were made at critical periods, and how did the person deal with these various crises?

· ♦What are the sociocultural factors influencing development that need to be understood if therapy is to be comprehensive?

 

The Therapeutic Process

Therapeutic Goals

The ultimate goal of psychoanalytic treatment is to increase adaptive functioning, which involves the reduction of symptoms and the resolution of conflicts

 

(Wolitzky, 2011a). Two goals of Freudian psychoanalytic therapy are to make the unconscious conscious and to strengthen the ego so that behavior is based more on reality and less on instinctual cravings or irrational guilt. Successful analysis is believed to result in significant modification of the individual’s personality and character structure. Therapeutic methods are used to bring out unconscious material. Then childhood experiences are reconstructed, discussed, interpreted, and analyzed. It is clear that the process is not limited to solving problems and learning new behaviors. Rather, there is a deeper probing into the past to develop the level of self-understanding that is assumed to be necessary for a change in character. Psychoanalytic therapy is oriented toward achieving insight, but not just an intellectual understanding; it is essential that the feelings and memories associated with this self-understanding be experienced.

Therapist’s Function and Role

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In classical psychoanalysis, analysts typically assume an anonymous non-judgmental stance, which is sometimes called the “blank-screen” approach. They avoid self-disclosure and maintain a sense of neutrality to foster a transference relationship, in which their clients will make projections onto them. This transference relationship is a cornerstone of psychoanalysis and “refers to the transfer of feelings originally experienced in an early relationship to other important people in a person’s present environment” (Luborsky, O’Reilly-Landry, & Arlow, 2011, p. 18). If therapists say little about themselves and rarely share their personal reactions, the assumption is that whatever the client feels toward them will largely be the product of feelings associated with other significant figures from the past. These projections, which have their origins in unfinished and repressed situations, are considered “grist for the mill,” and their analysis is the very essence of therapeutic work.

One of the central functions of analysis is to help clients acquire the freedom to love, work, and play. Other functions include assisting clients in achieving self-awareness, honesty, and more effective personal relationships; in dealing with anxiety in a realistic way; and in gaining control over impulsive and irrational behavior. Establishing a therapeutic alliance is a primary treatment goal, and repairing any damaged alliance is essential if therapy is to progress (McWilliams, 2014). The empathic attunement to the client facilitates the analyst’s appreciation of the client’s intrapsychic world (Wolitzky, 2011b). Particular attention is given to the client’s resistances. The analyst listens in a respectful, open-minded way and decides when to make appropriate interpretations; tact and timing are essential for effective interpretations (McWilliams, 2014). A major function of interpretation is to accelerate the process of uncovering unconscious material. The psychoanalytic therapist pays attention to both what is spoken and what is unspoken, listens for gaps and inconsistencies in the client’s story, infers the meaning of reported dreams and free associations, and remains sensitive to clues concerning the client’s feelings toward the therapist.

Organizing these therapeutic processes within the context of understanding personality structure and psychodynamics enables the analyst to formulate the nature of the client’s problems. One of the central functions of the analyst is to

 

teach clients the meaning of these processes (through interpretation) so that they are able to achieve insight into their problems, increase their awareness of ways to change, and thus gain more control over their lives. A primary aim of psychodynamic approaches is to foster the capacity of clients to solve their own problems.

The process of psychoanalytic therapy is somewhat like putting the pieces of a puzzle together. Whether clients change depends considerably more on their readiness to change than on the accuracy of the therapist’s interpretations. If the therapist pushes the client too rapidly or offers ill-timed interpretations, therapy will not be effective. Change occurs through the process of reworking old patterns so that clients might become freer to act in new ways (Luborsky et al., 2011).

Client’s Experience in Therapy

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Clients interested in classical psychoanalysis must be willing to commit themselves to an intensive, long-term therapy process. After some face-to-face sessions with the analyst, clients lie on a couch and engage in free association; that is, they try to say whatever comes to mind without self-censorship. This process of free association is known as the “fundamental rule.” Clients report their feelings, experiences, associations, memories, and fantasies to the analyst. Lying on the couch encourages deep, uncensored reflections and reduces the stimuli that might interfere with getting in touch with internal conflicts and productions. It also reduces the ability of clients to “read” their analyst’s face for reactions, which fosters the projections characteristic of a transference.

The client in psychoanalysis experiences a unique relationship with the analyst. The client is free to express any idea or feeling, no matter how irresponsible, scandalous, politically incorrect, selfish, or infantile. The analyst remains nonjudgmental, listening carefully and asking questions and making interpretations as the analysis progresses. This structure encourages the client to loosen defense mechanisms and “regress,” experiencing a less rigid level of adjustment that allows for positive therapeutic growth but also involves some vulnerability. It is a responsibility of the analyst to keep the analytic situation safe for the client, so the analyst is not free to engage in spontaneous self-expression. Every intervention by the therapist is made to further the client’s progress. In classical analysis, therapeutic neutrality and anonymity are valued by the analyst, and holding a consistent setting or “frame” plays a large part in this analytic technique. Therapeutic change requires an extended period of “working through” old patterns in the safety of the therapeutic relationship.

Psycho dynamic therapy emerged as a way of shortening and simplifying the lengthy process of classical psychoanalysis (Luborsky et al., 2011). Many psychoanalytically oriented practitioners, or psychodynamic therapists (as distinct from analysts), do not use all the techniques associated with classical analysis. However, psychodynamic therapists do remain alert to transference manifestations, explore the meaning of clients’ dreams, explore both the past and the present, offer interpretations for defenses and resistance, and are concerned with unconscious material. Traditional analytic therapists make more frequent interpretations of transferences and engage in fewer supportive interventions than do psychodynamic therapists (Wolitzky, 2011a).

 

Clients in psychoanalytic therapy make a commitment with the therapist to stick with the procedures of an intensive therapeutic process. They agree to talk because their verbal productions are the heart of psychoanalytic therapy. They are typically asked not to make any radical changes in their lifestyle during the period of analysis, such as getting a divorce or quitting their job. The reason for avoiding making such changes pertains to the therapeutic process that oftentimes is unsettling and also associated with loosening of defenses. These restrictions are less relevant to psychoanalytic psychotherapy than to classical psychoanalysis. Psychoanalytic psychotherapy typically involves fewer sessions per week, the sessions are usually face to face, and the therapist is supportive; hence, there is less therapeutic “regression.”

Psychoanalytic clients are ready to terminate their sessions when they and their analyst mutually agree that they have resolved those symptoms and core conflicts that were amenable to resolution, have clarified and accepted their remaining emotional problems, have understood the historical roots of their difficulties, have mastery of core themes, have insight into how their environment affects them and how they affect the environment, have achieved reduced defensiveness, and can integrate their awareness of past problems with their present relationships. Wolitzky (201 la) lists other optimal criteria for termination, including the reduction of transference, accomplishing the main goals of therapy, an acceptance of the futility of certain strivings and childhood fantasies, an increased capacity for love and work, achieving more stable coping patterns, and a self-analytic capacity. Successful analysis answers a client’s “why” questions regarding his or her life. Curtis and Hirsch (2011) suggest that termination tends to bring up intense feelings of attachment, separation, and loss. Thus a termination date is set well enough in advance to talk about these feelings and about what the client learned in psychotherapy. Therapists assist clients in clarifying what they have done to bring about changes.

Relationship Between Therapist and Client

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There are some differences between how the therapeutic relationship is conceptualized by classical analysis and contemporary relational analysis. The classical analyst stands outside the relationship, comments on it, and offers insight-producing interpretations. In contemporary relational psychoanalysis, the therapist does not strive for an objective stance. Contemporary psychodynamic therapists focus as much on here-and-now transference as on earlier reenactment. By bringing the past into the present relationship, a new understanding of the past can unfold (Wolitzky, 2011a). Contemporary psychodynamic therapists view their emotional communication with clients as a useful way to gain information and create connection. Analytic therapy focuses on feelings, perceptions, and action that are happening in the moment in the therapy sessions (Luborsky et al., 2011McWilliams, 2014Wolitzky, 2011a2011b). The therapeutic relationship is central to increasing client self-awareness, self-understanding, and exploration (Barber, Muran, McCarthy, & Keefe, 2013). Current findings of interpersonal neurobiology lend strong support for the effectiveness of the psychoanalytic relationship when treating clients who have suffered interpersonal trauma and neglect (Schore, 2014).

 

Transference and countertransference are central to understanding psychodynamic therapy. A significant aspect of the therapeutic relationship is manifested through transference reactions. Transference is the client’s unconscious shifting to the analyst of feelings, attitudes, and fantasies (both positive and negative) that are reactions to significant others in the client’s past. Transference involves the unconscious repetition of the past in the present. “It reflects the deep patterning of old experiences in relationships as they emerge in current life” (Luborsky et al., 2011, p. 47). A client often has a mixture of positive and negative feelings and reactions to a therapist. When these feelings become conscious and are transferred to the therapist, clients can understand and resolve past “unfinished business.” As therapy progresses, childhood feelings and conflicts begin to surface from the depths of the unconscious, and clients regress emotionally. Transference takes place when clients resurrect these early intense conflicts relating to love, sexuality, hostility, anxiety, and resentment; bring them into the present; reexperience them; and attach them to the therapist. For example, clients may transfer unresolved feelings toward a stern and unloving father to the therapist, who, in their eyes, becomes stern and unloving. Angry feelings are the product of negative transference, but clients also may develop a positive transference and, for example, fall in love with the therapist, wish to be adopted, or in many other ways seek the love, acceptance, and approval of an all-powerful therapist. In short, the therapist becomes a current substitute for significant others.

If therapy is to produce change, the transference relationship must be worked through. The working-through process consists of repetitive and elaborate explorations of unconscious material and defenses, most of which originated in early childhood. Clients learn to accept their defensive structures and recognize how they may have served a purpose in the past (Rutan, Stone, & Shay, 2014). This results in a resolution of old patterns and enables clients to make new choices. Effective therapy requires that the client develop a relationship with the therapist in the present that is a corrective and integrative experience.

Clients have many opportunities to see the variety of ways in which their core conflicts and core defenses are manifested in their daily life. It is assumed that for clients to become psychologically independent they must not only become aware of this unconscious material but also achieve some level of freedom from behavior motivated by infantile strivings, such as the need for total love and acceptance from parental figures. If this demanding phase of the therapeutic relationship is not properly worked through, clients simply transfer their infantile wishes for universal love and acceptance to other figures. It is precisely in the client-therapist relationship that the manifestation of these childhood motivations becomes apparent.

Regardless of the length of psychoanalytic therapy, traces of our childhood needs and traumas will never be completely erased. Infantile conflicts may not be fully resolved, even though many aspects of transference are worked through with a therapist. We may need to struggle at times throughout our life with feelings that we project onto others as well as with unrealistic demands that we expect others to fulfill. In this sense we experience transference with many people, and our past is always a vital part of the person we are presently becoming.

It is a mistake to assume that all feelings clients have toward their therapists are manifestations of transference. Many of these reactions may have a reality base, and

 

clients’ feelings may well be directed to the here-and-now style the therapist exhibits. Not every positive response (such as liking the therapist) should be labeled “positive transference.” Conversely, a client’s anger toward the therapist may be a function of the therapist’s behavior; it is a mistake to label all negative reactions as signs of “negative transference.”

The notion of never becoming completely free of past experiences has significant implications for therapists who become intimately involved in the unresolved conflicts of their clients. Even if the conflicts of therapists have surfaced to awareness, and even if therapists have dealt with these personal issues in their own intensive therapy, they may still project distortions onto clients. Therapists’ countertransference reactions are inevitable because all therapists have unresolved conflicts and personal vulnerabilities that are activated through their professional work. From a traditional psychoanalytic perspective, countertransference is viewed as a phenomenon that occurs when there is inappropriate affect, when therapists respond in irrational ways, or when they lose their objectivity in a relationship because their own conflicts are triggered. Countertransference consists of a therapist’s unconscious emotional responses to a client based on the therapist’s own past, resulting in a distorted perception of the client’s behavior (Rutan et al., 2014). Over the years this traditional view of countertransference has broadened to include all of the therapist’s reactions, not only to the client’s transference, but to all aspects of the client’s personality and behavior. In this broader perspective, countertransference involves the therapist’s total emotional response to a client and may include withdrawal, anger, love, annoyance, powerlessness, avoidance, overidentification, control, or sadness. In today’s psychoanalytic practice, countertransference is manifested in the form of subtle nonverbal, tonal, and attitudinal actions that inevitably affect clients, either consciously or unconsciously (Curtis & Hirsch, 2011Wolitzky, 2011b).

To avoid misunderstanding and overidentification with clients, the analytic approach requires therapists to undergo their own analytic psychotherapy. McWilliams (2014) emphasizes how important it is for therapists to access and understand their unconscious and suggests that a key outcome of therapy is humility, which provides a good foundation for creating authentic, egalitarian, and healing connections with clients. Personal therapy and clinical supervision for therapists can be helpful in better understanding how internal reactions influence the therapy process and how to use these countertransference reactions to benefit the work of therapy (Hayes, Gelso, & Hummel, 2011).

Not all countertransference reactions are detrimental to therapeutic progress. Indeed, countertransference reactions are often the strongest source of data for understanding the world of the client and for self-understanding on the therapist’s part. For example, a therapist who notes a countertransference mood of irritability may learn something about a client’s pattern of being demanding, which can be explored in therapy. Viewed in this more positive way, countertransference can become a key avenue for helping the client gain self-understanding. Most research on countertransference has dealt with its deleterious effects, but Hayes (2004) suggests it would be useful to undertake systematic study of the potential therapeutic benefits of countertransference.

Psychoanalytic therapists vary in the manner in which they use their observations of countertransference. In some instances the feelings may be shared with

 

the client, but traditional analytic therapists strive to minimize their expression of countertransference while silently learning from its inevitable occurrence. The ability of therapists to gain self-understanding and to establish appropriate boundaries with clients is critical in managing and effectively using their countertransference reactions (Hayes et al., 2011).

It is of paramount importance that therapists develop some level of objectivity and not react defensively and subjectively in the face of anger, love, adulation, criticism, and other intense feelings expressed by their clients. If psychotherapists become aware of a strong aversion to certain types of clients, a strong attraction to other types of clients, psychosomatic reactions that occur at definite times in therapeutic relationships, and the like, it is imperative for them to seek professional consultation, clinical supervision, or enter their own therapy for a time to work out these personal issues that stand in the way of their being effective therapists.

Through the client-therapist relationship, clients acquire insights into the workings of their unconscious processes. Awareness of and insights into repressed material are the bases of the analytic growth process. Clients come to understand the association between their past experiences and their current behavior. The psychoanalytic approach assumes that without this dynamic self-understanding there can be no substantial personality change or resolution of present conflicts.

Application: Therapeutic Techniques and Procedures

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This section deals with the techniques most commonly used by psychoanalytically oriented therapists. It also includes a section on the applications of the psychoanalytic approach to group counseling. Psychoanalytic or psychodynamic therapy differs from traditional psychoanalysis in these ways:

· ♦The therapy has more to limited objectives than restructuring one’s personality.

· ♦The therapist is less likely to use the couch.

· ♦There are fewer sessions each week.

· ♦There is more frequent use of supportive interventions such as reassurance, expressions of empathy and support, and suggestions.

· ♦There is more emphasis on the here-and-now relationship between therapist and client.

· ♦There is more latitude for therapist self-disclosure without “polluting the transference.”

· ♦Less emphasis is given to the therapist’s neutrality.

· ♦There is a focus on mutual transference and countertransference enactments.

· ♦The focus is more on pressing practical concerns than on working with fantasy material.

The techniques of psychoanalytic therapy are aimed at increasing awareness, fostering insights into the client’s behavior, and understanding the meanings of symptoms. The therapy proceeds from the client’s talk to catharsis (or expression of emotion), to insight, to working through unconscious material. This work is done

 

to attain the goals of intellectual and emotional understanding and reeducation, which, it is hoped, will lead to personality change. The six basic techniques of psychoanalytic therapy are (1) maintaining the analytic framework, (2) free association, (3) interpretation, (4) dream analysis, (5) analysis of resistance, and (6) analysis of transference. See Case Approach to Counseling and Psychotherapy (Corey, 2013, chap. 2) for an illustration by Dr. William Blau, a psychoanalytically oriented therapist, of some treatment techniques in the case of Ruth.

Maintaining the Analytic Framework

The psychoanalytic process stresses maintaining a particular framework aimed at accomplishing the goals of this type of therapy. Maintaining the analytic framework refers to a whole range of procedural and stylistic factors, such as the analyst’s relative anonymity, maintaining neutrality and objectivity, the regularity and consistency of meetings, starting and ending the sessions on time, clarity on fees, and basic boundary issues such as the avoidance of advice giving or imposition of the therapist’s values (Curtis & Hirsch, 2011). One of the most powerful features of psychoanalytically oriented therapy is that the consistent framework is itself a therapeutic factor, comparable on an emotional level to the regular feeding of an infant. Analysts attempt to minimize departures from this consistent pattern (such as vacations, changes in fees, or changes in the meeting environment). Where departures are unavoidable, these will often be the focus of interpretations.

Free Association

Free association is a central technique in psychoanalytic therapy, and it plays a key role in the process of maintaining the analytic framework. In free association, clients are encouraged to say whatever comes to mind, regardless of how painful, silly, trivial, illogical, or irrelevant it may seem. In essence, clients try to flow with any feelings or thoughts by reporting them immediately without censorship. As the analytic work progresses, most clients will occasionally depart from this basic rule, and these resistances will be interpreted by the therapist when it is timely to do so.

Free association is one of the basic tools used to open the doors to unconscious wishes, fantasies, conflicts, and motivations. This technique often leads to some recollection of past experiences and, at times, a catharsis or release of intense feelings that have been blocked. This release is not seen as crucial in itself, however. During the free-association process, the therapist’s task is to identify the repressed material that is locked in the unconscious. The sequence of associations guides the therapist in understanding the connections clients make among events. Blockings or disruptions in associations serve as cues to anxiety-arousing material. The therapist interprets the material to clients, guiding them toward increased insight into the underlying dynamics.

As analytic therapists listen to their clients’ free associations, they hear not only the surface content but also the hidden meaning. Nothing the client says is taken at face value. For example, a slip of the tongue can suggest that an expressed emotion is accompanied by a conflicting affect. Areas that clients do not talk about are as significant as the areas they do discuss.

 

Interpretation

Interpretation consists of the analyst’s pointing out, explaining, and even teaching the client the meanings of behavior that is manifested in dreams, free association, resistances, defenses, and the therapeutic relationship itself. The functions of interpretations are to enable the ego to assimilate new material and to speed up the process of uncovering further unconscious material. Interpretation is grounded in the therapist’s assessment of the client’s personality and of the factors in the client’s past that contributed to his or her difficulties. Under contemporary definitions, interpretation includes identifying, clarifying, and translating the client’s material. Relational psychoanalytic therapists present possible meanings associated with a client’s thoughts, feelings, or events as a hypothesis rather than a truth about a client’s inner world (Curtis & Hirsch, 2011). Interpretations are provided in a collaborative manner to help clients make sense of their lives and to expand their consciousness.

The therapist uses the client’s reactions as a gauge in determining a client’s readiness to make an interpretation. It is important that interpretations be appropriately timed because the client will reject therapist interpretations that are poorly timed. A general rule is that interpretation should be presented when the phenomenon to be interpreted is close to conscious awareness. In other words, the therapist should interpret material that the client has not yet seen but is capable of tolerating and incorporating. Another general rule is that interpretation should start from the surface and go only as deep as the client is able to go.

Dream Analysis

Dream analysis is an important procedure for uncovering unconscious material and giving the client insight into some areas of unresolved problems. During sleep, defenses are lowered and repressed feelings surface. Freud sees dreams as the “royal road to the unconscious,” for in them one’s unconscious wishes, needs, and fears are expressed. Some motivations are so unacceptable to the person that they are expressed in disguised or symbolic form rather than being revealed directly.

Dreams have two levels of content: latent content and manifest content. Latent content consists of hidden, symbolic, and unconscious motives, wishes, and fears. Because they are so painful and threatening, the unconscious sexual and aggressive impulses that make up latent content are transformed into the more acceptable manifest content, which is the dream as it appears to the dreamer. The process by which the latent content of a dream is transformed into the less threatening manifest content is called dream work. The therapist’s task is to uncover disguised meanings by studying the symbols in the manifest content of the dream.

During the session, therapists may ask clients to free associate to some aspect of the manifest content of a dream for the purpose of uncovering the latent meanings. Therapists participate in the process by exploring clients’ associations with them. Interpreting the meanings of the dream elements helps clients unlock the repression that has kept the material from consciousness and relate the new insight to their present struggles. Dreams may serve as a pathway to repressed material, but dreams also provide an understanding of clients’ current functioning. Relational

 

psychoanalytic therapists are particularly interested in the connection of dreams to clients’ lives. The dream is viewed as a significant message to clients to examine something that could be problematic if left unexamined (Curtis & Hirsch, 2011).

Analysis and Interpretation of Resistance

Resistance, a concept fundamental to the practice of psychoanalysis, is anything that works against the progress of therapy and prevents the client from producing previously unconscious material. Specifically, resistance is the client’s reluctance to bring to the surface of awareness unconscious material that has been repressed. Resistance refers to any idea, attitude, feeling, or action (conscious or unconscious) that fosters the status quo and gets in the way of change. During free association or association to dreams, the client may evidence an unwillingness to relate certain thoughts, feelings, and experiences. Freud viewed resistance as an unconscious dynamic that people use to defend against the intolerable anxiety and pain that would arise if they were to become aware of their repressed impulses and feelings.

As a defense against anxiety, resistance operates specifically in psychoanalytic therapy to prevent clients and therapists from succeeding in their joint effort to gain insights into the dynamics of the unconscious. An assumption of analytic treatment is that clients wish both to change and to remain embedded in their old world. Clients tend to cling to their familiar patterns, regardless of how painful they may be. Therapists need to create a safe climate so clients can recognize resistance and explore it in therapy (Curtis & Hirsch, 2011McWilliams, 2014Wolitzky, 2011a). Because resistance blocks threatening material from entering awareness, analytic therapists point it out, but Safran and Kriss (2014) caution therapists to avoid framing resistance in a way that implies that the client is not cooperating with the treatment. Therapists’ interpretations help clients become aware of the reasons for the resistance so they can deal with them. As a general rule, therapists point out and interpret the most obvious resistances to lessen the possibility of clients’ rejecting the interpretation and to increase the chance that they will begin to look at their resistive behavior.

Resistances are not just something to be overcome. Because they are representative of usual defensive approaches in daily life, they need to be recognized as devices that defend against anxiety but that interfere with the ability to accept change that could lead to experiencing a more gratifying life. It is crucial that therapists respect the resistances of clients and assist them in working therapeutically with their defenses. When handled properly, exploring resistance can be an extremely valuable tool in understanding the client.

Analysis and Interpretation of Transference

As was mentioned earlier, transference manifests itself in the therapeutic process when earlier relationships contribute to clients distorting the present with the therapist. The transference situation is considered valuable because its manifestations provide clients with the opportunity to reexperience a variety of feelings that would otherwise be inaccessible. Through the relationship with the therapist, clients express feelings, beliefs, and desires that they have buried in their unconscious.

 

Interpreting transference is a route to elucidating the client’s intrapsychic life (Wolitzky, 2011b). Through this interpretation, clients can recognize how they are repeating the same dynamic patterns in their relationships with the therapist, with significant figures from the past, and in present relationships with significant others. Through appropriate interpretations and working through of these current expressions of early feelings, clients are able to become aware of and to gradually change some of their long-standing patterns of behavior. Analytically oriented therapists consider the process of exploring and interpreting transference feelings as the core of the therapeutic process because it is aimed at achieving increased awareness and personality change.

The analysis of transference is a central technique in both classical psychoanalysis and psychoanalytically oriented therapy, for it allows clients to achieve here-and-now insight into the influence of the past on their present functioning. Interpretation of the transference relationship enables clients to work through old conflicts that are keeping them fixated and retarding their emotional growth. In essence, the effects of early relationships are counteracted by working through a similar emotional conflict in the current therapeutic relationship. An example of utilizing transference is given in a later section on the case of Stan.

Application to Group Counseling

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The psychodynamic model offers a conceptual framework for understanding the history of the members of a group and a way of thinking about how their past is affecting them now in the group and in their everyday lives. Group leaders can think psychoanalytically, even if they do not use many psychoanalytic techniques. Regardless of their theoretical orientation, it is well for group therapists to understand such psychoanalytic phenomena as transference, countertransference, resistance, and the use of ego-defense mechanisms as reactions to anxiety.

Transference and countertransference have significant implications for the practice of group counseling and therapy. Group work may re-create early life situations that continue to affect the client. In most groups, individuals elicit a range of feelings such as attraction, anger, competition, and avoidance. These transference feelings may resemble those that members experienced toward significant people in their past. Members will most likely find symbolic mothers, fathers, siblings, and lovers in their group. Group participants frequently compete for the attention of the leader—a situation reminiscent of earlier times when they had to vie for their parents’ attention with their brothers and sisters. This rivalry can be explored in a group as a way of gaining increased awareness of how the participants dealt with competition as children and how their past success or lack of it affects their present interactions with others. A basic tenet of psychodynamic therapy groups is the notion that group participants, through their interactions within the group, re-create their social situation, implying that the group becomes a microcosm of their everyday lives (Rutan et al., 2014). Groups can provide a dynamic understanding of how people function in out-of-group situations. Projections onto the leader and onto other members are valuable clues to unresolved conflicts within the person that can be identified, explored, and worked through in the group.

 

The group therapist also has reactions to members and is affected by members’ reactions. Countertransference can be a useful tool for the group therapist to understand the dynamics that might be operating in a group. However, group leaders need to be alert to signs of unresolved internal conflicts that could interfere with effective group functioning and create a situation in which members are used to satisfy the leaders’ own unfulfilled needs. If, for example, a group leader has an extreme need to be liked and approved of, the leader might behave in ways to get members’ approval and confirmation, resulting in behaviors primarily designed to please the group members and ensure their continued support.

Group therapists need to exercise vigilance lest they misuse their power by turning the group into a forum for pushing clients to adjust by conforming to the dominant cultural values at the expense of losing their own worldview and cultural identity. Group practitioners also need to be aware of their own potential biases. The concept of countertransference can be expanded to include unacknowledged bias and prejudices that may be conveyed unintentionally through the techniques used by group therapists.

For a more extensive discussion of the psychoanalytic approach to group counseling, refer to Theory and Practice of Group Counseling (Corey, 2016, chap. 6). Psychodynamic Group Psychotherapy (Rutan et al., 2014) also provides an excellent discussion of this subject.

Jung’s Perspective on the Development of Personality

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At one time Freud referred to Carl Jung as his spiritual heir, but Jung eventually developed a theory of personality that was markedly different from Freudian psychoanalysis. Jung’s analytical psychology is an elaborate explanation of human nature that combines ideas from history, mythology, anthropology, and religion (Schultz & Schultz, 2013). Jung made monumental contributions to our deep understanding of the human personality and personal development, particularly during middle age.

Jung’s pioneering work places central importance on the psychological changes that are associated with midlife. He maintained that at midlife we need to let go of many of the values and behaviors that guided the first half of our life and confront our unconscious. We can best do this by paying attention to the messages of our dreams and by engaging in creative activities such as writing or painting. The task facing us during the midlife period is to be less influenced by rational thought and to instead give expression to these unconscious forces and integrate them into our conscious life (Schultz & Schultz, 2013).

Jung learned a great deal from his own midlife crisis. At age 81 he wrote about his recollections in his autobiography, Memories, Dreams, Reflections (1961), in which he also identified some of his major contributions. Jung made a choice to focus on the unconscious realm in his personal life, which influenced the development of his theory of personality. However, he had a very different conception of the unconscious than did Freud. Jung was a colleague of Freud’s and valued many of his contributions, but Jung eventually came to the point of not being able to support some of Freud’s basic concepts, especially his theory of sexuality. Jung (1961) recalled Freud’s

 

words to him: “My dear Jung, promise me never to abandon the sexual theory. This is the most essential thing of all. You see, we must make a dogma of it, an unshakable bulwark” (p. 150). Jung became convinced that he could no longer collaborate with Freud because he believed Freud placed his own authority over truth. Freud had little tolerance for theoreticians such as Jung and Adler who dared to challenge his theories. Although Jung had a lot to lose professionally by withdrawing from Freud, he saw no other choice. He subsequently developed a spiritual approach that places great emphasis on being impelled to find meaning in life in contrast to being driven by the psychological and biological forces described by Freud.

Jung maintained that we are not merely shaped by past events (Freudian determinism), but that we are influenced by our future as well as our past. Part of the nature of humans is to be constantly developing, growing, and moving toward a balanced and complete level of development. For Jung, our present personality is shaped both by who and what we have been and also by what we aspire to be in the future. His theory is based on the assumption that humans tend to move toward the fulfillment or realization of all of their capabilities. Achieving individuation— the harmonious integration of the conscious and unconscious aspects of personality—is an innate and primary goal. For Jung, we have both constructive and destructive forces, and to become integrated, it is essential to accept our dark side, or shadow, with its primitive impulses such as selfishness and greed. Acceptance of our shadow does not imply being dominated by this dimension of our being, but simply recognizing that this is a part of our nature.

Jung taught that many dreams contain messages from the deepest layer of the unconscious, which he described as the source of creativity. Jung referred to the collective unconscious as “the deepest and least accessible level of the psyche,” which contains the accumulation of inherited experiences of human and prehuman species (as cited in Schultz & Schultz, 2013, p. 95). Jung saw a connection between each person’s personality and the past, not only childhood events but also the history of the species. This means that some dreams may deal with an individual’s relationship to a larger whole such as the family, universal humanity, or generations over time. The images of universal experiences contained in the collective unconscious are called archetypes. Among the most important archetypes are the persona, the anima and animus, and the shadow. The persona is a mask, or public face, that we wear to protect ourselves. The animus and the anima represent both the biological and psychological aspects of masculinity and femininity, which are thought to coexist in both sexes. The shadow has the deepest roots and is the most dangerous and powerful of the archetypes. It represents our dark side, the thoughts, feelings, and actions that we tend to disown by projecting them outward. In a dream all of these parts can be considered manifestations of who and what we are.

Jung agreed with Freud that dreams provide a pathway into the unconscious, but he differed from Freud on their functions. Jung wrote that dreams have two purposes. They are prospective; that is, they help people prepare themselves for the experiences and events they anticipate in the near future. They also serve a compensatory function, working to bring about a balance between opposites within the person. They compensate for the overdevelopment of one facet of the individual’s personality (Schultz & Schultz, 2013).

 

Jung viewed dreams more as an attempt to express than as an attempt to repress and disguise. Dreams are a creative effort of the dreamer in struggling with contradiction, complexity, and confusion. The aim of the dream is resolution and integration. According to Jung, each part of the dream can be understood as some projected quality of the dreamer. His method of interpretation draws on a series of dreams obtained from a person, during the course of which the meaning gradually unfolds. If you are interested in further reading, I suggest Memories, Dreams, Reflections (Jung, 1961) and Living With Paradox: An Introduction to Jungian Psychology (Harris, 1996).

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

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Psychoanalytic theory continues to evolve. Freud emphasized intrapsychic conflicts pertaining to the gratification of basic needs. Writers in the neo-Freudian school moved away from this orthodox position and contributed to the growth and expansion of the psychoanalytic movement by incorporating the cultural and social influences on personality. Ego psychology is part of classical psychoanalysis with the emphasis placed on the vocabulary of id, ego, and superego, and on Anna Freud’s identification of defense mechanisms. She spent most of her professional life adapting psychoanalysis to children and adolescents. Erikson expanded this perspective by emphasizing psychosocial development throughout the life span.

Psychoanalytic theory has evolved, undergoing a number of reformulations over the years (McWilliams, 2016). Today psychoanalytic theory is comprised of a variety of schools, including the classical perspective, ego psychology, object relations and interpersonal psychoanalysis, self psychology, and relational psychoanalysis. Rutan, Stone, and Shay (2014) note some commonalities between these psychoanalytic perspectives: “All presuppose a supportive, warm, but neutral and fairly unobtrusive therapist who strives to create a safe, supportive, and therapeutic relationship” (p. 73).

Object-relations theory encompasses the work of a number of rather different psychoanalytic theorists who are especially concerned with investigating attachment and separation. Their emphasize is how our relationships with other people are affected by the way we have internalized our experiences of others and set up representations of others within ourselves. Object relations are interpersonal relationships as these are represented intrapsychically, and as they influence our interactions with the people around us. The term object was used by Freud to refer to that which satisfies a need, or to the significant person or thing that is the object, or target, of one’s feelings or drives. It is used interchangeably with the term other to refer to an important person to whom the child, and later the adult, becomes attached. Rather than being individuals with separate identities, others are perceived by an infant as objects for gratifying needs. Object-relations theories have diverged from orthodox psychoanalysis. However, some theorists, most notably Otto Kernberg, attempt to integrate the increasingly varied ideas that characterize this school of thought within a classical psychoanalytic framework (St. Clair, 2004).

Traditional psychoanalysis assumes that the analyst can discover and name the intrapersonal “truth” about individual clients. As psychoanalytic theory has evolved,

 

the approach has more fully considered the unconscious influence of other people. Self psychology, which grew out of the work of Heinz Kohut (1971), emphasizes how we use interpersonal relationships (self objects) to develop our own sense of self. Kohut emphasized nonjudgmental acceptance, empathy, and authenticity. Kohut and other self psychologists put empathy in the forefront of psychoanalytic healing and choose interventions based on them being genuinely empathically attuned to clients (McWilliams, 2016).

The relational model is based on the assumption that therapy is an interactive process between client and therapist. Whether called intersubjective, interpersonal, or relational, a number of contemporary psychoanalytic approaches are based on the exploration of the complex conscious and unconscious dynamics at play with respect to both therapist and client. The relational movement ushered in a new emphasis on a more egalitarian therapeutic style (McWilliams, 2016). Relational analysts put value on not knowing and approach clients with genuine curiosity. Therapists expect to participate in mutual enactments, or repetition of themes from the client’s life that evoke themes of their own.

From the time of Freud to the late 20th century, the power between analyst and patient was unequal. Contemporary relational theorists have challenged what they consider to be the authoritarian nature of the traditional psychoanalytic relationship and replaced it with a more egalitarian model. The task of relational analysis is to explore each client’s life in a creative way, customized to the therapist and client working together in a particular culture at a particular moment in time.

Mitchell (19882000) has written extensively about these new conceptualizations of the analytic relationship. He integrates developmental theory, attachment theory, systems theory, and interpersonal theory to demonstrate the profound ways in which we seek attachments with others, especially early caregivers. Interpersonal analysts believe that countertransference provides an important source of information about the client’s character and dynamics. Mitchell adds to this object-relations position a cultural dimension, noting that the caregiver’s qualities reflect the particular culture in which the person lives. We are all deeply embedded within our cultures. Different cultures maintain different values, so there can be no objective psychic truths. Our internal (unconscious) structures are all relational and relative. This is in stark contrast to the Freudian notion of universal biological drives that could be said to function in every human.

Summary of Stages of Development

Most contemporary psychoanalytic theories center on predictable developmental sequences in which the early experiences of the self shift in relation to an expanding awareness of others. Once self-other patterns are established, it is assumed they influence later interpersonal relationships. Specifically, people search for relationships that match the patterns established by their earlier experiences. People who are either overly dependent or overly detached, for example, can be repeating patterns of relating they established with their mother when they were toddlers (Hedges, 1983). These newer theories provide insight into how an individual’s inner world can cause difficulties in living in the everyday world of people and relationships (St. Clair, 2004).

 

Margaret Mahler (1968) had a central influence on contemporary object-relations theory. A pediatrician who emphasized the observation of children, she viewed the resolution of the Oedipus complex during Freud’s proposed phallic stage as less critical than the child’s progression from a symbiotic relationship with a maternal figure toward separation and individuation. Her studies focus on the interactions between the child and the mother in the first thee years of life. Mahler conceptualizes the development of the self somewhat differently from the traditional Freudian psychosexual stages. Her belief is that the individual begins in a state of psychological fusion with the mother and progresses gradually to separation. The unfinished crises and residues of the earlier state of fusion, as well as the process of separating and individuating, have a profound influence on later relationships. Object relations of later life build on the child’s search for a reconnection with the mother (St. Clair, 2004). Psychological development can be thought of as the evolution of the way in which individuals separate and differentiate themselves from others.

Mahler calls the first three or four weeks of life normal infantile autism. Here the infant is presumed to be responding more to states of physiological tension than to psychological processes. Mahler believes the infant is unable to differentiate itself from its mother in many respects at this age. According to Melanie Klein (1975), another major contributor to the object-relations perspective, the infant perceives parts—breasts, face, hands, and mouth—rather than a unified self. In this undifferentiated state there is no whole self, and there are no whole objects. When adults show the most extreme lack of psychological organization and sense of self, they may be thought of as returning to this most primitive infantile stage. Subsequent infant research by Daniel Stern (1985) has challenged this aspect of Mahler’s theory, maintaining that infants are interested in others practically from birth.

Mahler’s next phase, called symbiosis, is recognizable by the 3rd month and extends roughly through the 8th month. At this age the infant has a pronounced dependency on the mother. She (or the primary caregiver) is clearly a partner and not just an interchangeable part. The infant seems to expect a very high degree of emotional attunement with its mother.

The separation-individuation process begins in the 4th or 5th month. During this time the child moves away from symbiotic forms of relating. The child experiences separation from significant others yet still turns to them for a sense of confirmation and comfort. The child may demonstrate ambivalence, torn between enjoying separate states of independence and dependence. The toddler who proudly steps away from the parents and then runs back to be swept up in approving arms illustrates some of the main issues of this period (Hedges, 1983, p. 109). Others are looked to as approving mirrors for the child’s developing sense of self; optimally, these relationships can provide a healthy self-esteem.

Children who do not experience the opportunity to differentiate, and those who lack the opportunity to idealize others while also taking pride in themselves, may later suffer from narcissistic character disorders and problems of self-esteem. The narcissistic personality is characterized by a grandiose and exaggerated sense of self-importance and an exploitive attitude toward others, which serve the function of masking a frail self-concept. Such individuals seek attention and admiration from others. They unrealistically exaggerate their accomplishments, and they have a tendency toward extreme self-absorption. Kernberg (1975) characterizes narcissistic

 

people as focusing on themselves in their interactions with others, having a great need to be admired, possessing shallow affect, and being exploitive and, at times, parasitic in their relationships with others. Kohut (1971) characterizes such people as perceiving threats to their self-esteem and as having feelings of emptiness and deadness.

“Borderline” conditions are also rooted in the period of separation-individuation. People with a borderline personality disorder have moved into the separation process but have been thwarted by parental rejection of their individuation. In other words, a crisis ensues when the child does develop beyond the stage of symbiosis, but the parents are unable to tolerate this beginning individuation and withdraw emotional support. Borderline people are characterized by instability, irritability, self-destructive acts, impulsive anger, and extreme mood shifts. They typically experience extended periods of disillusionment, punctuated by occasional euphoria. Kernberg (1975) describes the syndrome as including a lack of clear identity, a lack of deep understanding of other people, poor impulse control, and the inability to tolerate anxiety.

Mahler’s final subphase in the separation-individuation process involves a move toward constancy of self and object. This development is typically pronounced by the 36th month (Hedges, 1983). By now others are more fully seen as separate from the self. Ideally, children can begin to relate without being overwhelmed with fears of losing their sense of individuality, and they may enter into the later psychosexual and psychosocial stages with a firm foundation of selfhood. Borderline and narcissistic disorders seem to be rooted in traumas and developmental disturbances during the separation-individuation phase. However, the full manifestations of the personality and behavioral symptoms tend to develop in early adulthood.

This chapter permits only a glimpse of the newer formulations in psychoanalytic theory. If you would like to pursue this emerging approach, good overviews can be found in Mitchell (19882000), Mitchell and Black (1995), and Wolitzky (2011b).

Treating Borderline and Narcissistic Disorders  Some of the most powerful tools for understanding borderline and narcissistic personality disorders have emerged from the psychoanalytic models. Among the most significant theorists in this area are Kernberg (197519761997Kernberg, Yeomans, Clarkin, & Levy, 2008), Kohut (197119771984), and Masterson (1976). A great deal of psychoanalytic writing deals with the nature and treatment of borderline and narcissistic personality disorders and sheds new light on the understanding of these disorders. Kohut (1984) maintains that people are their healthiest and best when they can feel both independence and attachment, taking joy in themselves and also being able to idealize others. Mature adults feel a basic security grounded in a sense of freedom, self-sufficiency, and self-esteem; they are not compulsively dependent on others but also do not have to fear closeness. If you are interested in learning more about treating individuals with borderline personality disorders from an object-relations perspective, see Psychotherapy for Borderline Personality (Clarkin, Yeomans, & Kernberg, 2006).

Some Directions of Contemporary Psychodynamic Therapy

Strupp (1992) maintains that the various contemporary modifications of psychoanalysis have infused psychodynamic psychotherapy with renewed vitality and

 

vigor. Although long-term analytic therapy will remain a luxury for most people in our society, Strupp sees a growing trend toward short-term treatments for specific disorders, limited goals, and containment of costs. Some of the directions in psychodynamic theory and practice that Strupp identifies are summarized here:

· ♦Increased attention is being given to disturbances during childhood and adolescence.

· ♦The emphasis on treatment has shifted to dealing therapeutically with chronic personality disorders, borderline conditions, and narcissistic personality disorders. There is also a movement toward devising specific treatments for specific disorders.

· ♦Increased attention is being paid to establishing a good therapeutic alliance early in therapy. A collaborative working relationship is now viewed as a key factor in a positive therapeutic outcome.

· ♦There is a renewed interest in the development of briefer forms of psychodynamic therapy, largely due to societal pressures for accountability and cost-effectiveness.

Strupp’s assessment of the current scene and his predictions for the future have been quite accurate.

The Trend Toward Brief, Time-Limited Psychodynamic Therapy  Many psychoanalytically oriented therapists are adapting their work to a time-limited framework while retaining their original focus on depth and the inner life. These therapists support the use of briefer therapy when this is indicated by the client’s needs rather than by arbitrary limits set by a managed care system. Although there are different approaches to brief psychodynamic therapy, Prochaska and Norcross (2014) believe they all share these common characteristics:

· ♦Work within the framework of time-limited therapy.

· ♦Target a specific interpersonal problem and goals during the initial session.

· ♦Assume a less neutral therapeutic stance than is true of traditional analytic approaches.

· ♦Establish a strong working alliance early in the therapy.

· ♦Use interpretation relatively early in the therapy relationship.

Messer and Warren (2001) describe brief psychodynamic therapy (BPT) as a promising approach. This adaptation applies the principles of psychodynamic theory and therapy to treating selective disorders within a preestablished time limit of, generally, 10 to 25 sessions. BPT uses key psychodynamic concepts such as the enduring impact of psychosexual, psychosocial, and object-relational stages of development; the existence of unconscious processes and resistance; the usefulness of interpretation; the importance of the working alliance; and reenactment of the client’s past emotional issues in relation to the therapist.

Most forms of the time-limited dynamic approach call upon the therapist to assume an active and directive role in quickly formulating a therapeutic focus, such as a central theme or problem area that guides the work (Levenson, 2010). Some possible goals of this approach might include conflict resolution, greater

 

access to feelings, increasing choice possibilities, improving interpersonal relationships, and symptom remission. Levenson emphasizes that the aim of time-limited dynamic therapy is not to bring about a cure but to foster changes in behavior, thinking, and feeling. This is accomplished by using the client-therapist relationship as a way to understand how the person interacts in the world. It is assumed that clients interact with the therapist in the same dysfunctional ways they interact with significant others.

McWilliams (20142016) acknowledges the pressures psychoanalytic practitioners face in creating short-term treatments that focus on unconscious processes, especially as they are manifested and influenced in the therapeutic relationship. Brief dynamic therapy tends to emphasize a client’s strengths, competencies, and resources in dealing with real-life issues. Levenson (2010) notes that a major modification of the psychoanalytic technique is the emphasis on the here and now of the client’s life rather than exploring the there and then of childhood.

BPT is an opportunity to begin the process of change, which continues long after therapy is terminated. Short-term treatments are based on conceptual approaches similar to those of long-term therapy, but the techniques used are different. Rather than asking clients to free associate, practitioners ask questions, are more direct and confrontive, and deal quickly with transference issues (Sharf, 2016). Levenson (2010) acknowledges that the interactive, directive, focused, and self-disclosing strategies of brief psychodynamic therapy are not suited for all clients or all therapists. This approach is generally not suitable for individuals with severe characterological disorders or for those with severe depression. BPT is more appropriate for people who are neurotic, motivated, and focused (Sharf, 2016).

By the end of brief therapy, clients tend to have acquired a richer range of interactions with others, and they continue to have opportunities to practice functional behaviors in daily life. At some future time, clients may have a need for additional therapy sessions to address different concerns. Instead of thinking of time-limited dynamic psychotherapy as a definitive intervention, it is best to view this approach as offering multiple, brief therapy experiences over an individual’s life span.

If you want to learn more about time-limited dynamic therapy, I recommend Brief Dynamic Therapy (Levenson, 2010).

Psychoanalytic Therapy From a Multicultural Perspective

Strengths From a Diversity Perspective

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Psycho analytically oriented therapy can be made appropriate for culturally diverse populations if techniques are modified to fit the settings in which a therapist practices. All of us have a background of childhood experiences and have addressed developmental crises throughout our lives. Erikson’s psychosocial approach, with its emphasis on critical issues in stages of development, has particular application to clients from diverse cultures. Erikson has made significant contributions to how social and cultural factors affect people in many cultures over the life span (Sharf, 2016). Therapists can help their clients review environmental situations at the various critical turning points in their lives to determine how certain events have affected them either positively or negatively.

 

Psychotherapists need to recognize and confront their own potential sources of bias and how countertransference could be conveyed unintentionally through their interventions. To the credit of the psychoanalytic approach, it stresses the value of intensive psychotherapy as part of the training of therapists. This helps therapists become aware of their own sources of countertransference, including their biases, prejudices, and racial or ethnic stereotypes.

Shortcomings From a Diversity Perspective

Traditional psychoanalytic approaches are costly, and psychoanalytic therapy is generally perceived as being based on upper- and middle-class values. All clients do not share these values, and for many the cost of treatment is prohibitive. Another shortcoming pertains to the ambiguity inherent in most psychoanalytic approaches. This can be problematic for clients from cultures who expect direction from a professional. For example, many Asian American clients may prefer a more structured, directive, problem-oriented approach to counseling and may not continue therapy if a nondirective or unstructured approach is employed. Furthermore, intrapsychic analysis may be in direct conflict with some clients’ social framework and environmental perspective. Psychoanalytic therapy is generally more concerned with long-term personality reconstruction than with short-term problems of living.

Many writers on social justice counseling emphasize how important it is to consider possible external sources of clients’ problems, especially if clients have experienced an oppressive environment. The psychoanalytic approach can be criticized for failing to adequately address the social, cultural, and political factors that result in an individual’s problems. If there is not a balance between the external and internal perspectives, clients may feel responsible for their condition. However, the nonjudgmental stance that is a cornerstone of the psychoanalytic tradition may ameliorate any tendency to blame the client.

There are likely to be some difficulties in applying a psychoanalytic approach with low-income clients. If these clients seek professional help, they are generally dealing with a crisis situation and want to finding solutions to concrete problems, or at least some direction in addressing survival needs pertaining to housing, employment, and child care. This does not imply that low-income clients are unable to profit from analytic therapy; rather, this particular orientation could be more beneficial after more pressing issues and concerns have been resolved.

 

Corey, Gerald. Theory and Practice of Counseling and Psychotherapy, 10th Edition. Cengage Learning, 20160101. VitalBook file.

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Measures of Validity

Measures of Validity

A college uses a particular admissions test, which has well documented predictive validity. However, members of a particular minority group tend to score low on this admission test. Some students who have been denied admission based on their test scores are criticizing the school for using a biased test. What steps need to be taken prior to making the conclusion the test is “biased” in the psychometric sense? How can a determination be made regarding whether or not the test is being used in a fair and equitable manner? What other measures of validity would you need as evidence to support the continuation or discontinuation of this admission test?

Include reference from: Miller, L. A., Lovler, R. L.  (2016). Foundations of psychological testing: A practical approach, 5th Edition. Thousand Oaks, CA: Sage Publications, Inc.

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Define the sampling distribution of the mean

Instructions: Complete the following exercises located at the end of each chapter and put them into a Word document to be submitted as directed by the instructor.

Show all relevant work; use the equation editor in Microsoft Word when necessary.

 

Chapter 9, numbers 9.7, 9.8, 9.9, 9.13, and 9.14

*9.7 Define the sampling distribution of the mean.

*9.8 Specify three important properties of the sampling distribution of the mean.

9.9 Indicate whether the following statements are true or false. If we took a random sample of 35 subjects from some population, the associated sampling distribution of the mean would have the following properties:

(a) Shape would approximate a normal curve.

(b) Mean would equal the one sample mean.

(c) Shape would approximate the shape of the population.

(d) Compared to the population variability, the variability would be reduced by a factor equal to the square root of 35.

(e) Mean would equal the population mean.

(f) Variability would equal the population variability.

 

*9.13 Given a sample size of 36, how large does the population standard deviation have to be for the standard error to be

(a) 1?

(b) 2?

(c) 5?

(d) 100?

 

*9.14 (a) A random sample of size 144 is taken from the local population of grade-school children. Each child estimates the number of hours per week spent watching TV. At this point, what can be said about the sampling distribution?

(b) Assume that a standard deviation, σ, of 8 hours describes the TV estimates for the local population of schoolchildren. At this point, what can be said about the sampling distribution?

(c) Assume that a mean, µ, of 21 hours describes the TV estimates for the local population of schoolchildren. Now what can be said about the sampling distribution?

(d) Roughly speaking, the sample means in the sampling distribution should deviate, on average, about ___ hours from the mean of the sampling distribution and from the mean of the population.

(e) About 95 percent of the sample means in this sampling distribution should be between ___ hours and ___ hours.

 

Chapter 10, numbers 10.9, 10.10, 10.11, and 10.12

*10.9 The normal range for a widely accepted measure of body size, the body mass index (BMI), ranges from 18.5 to 25. Using the midrange BMI score of 21.75 as the null hypothesized value for the population mean, test this hypothesis at the .01 level of significance given a random sample of 30 weight-watcher participants who show amean BMI = 22.2 and a standard deviation of 3.1.

*10.10 Let’s assume that, over the years, a paper and pencil test of anxiety yields a mean score of 35 for all incoming college freshmen. We wish to determine whether the scores of a random sample of 20 new freshmen, with a mean of 30 and a standard deviation of 10, can be viewed as coming from this population. Test at the .05 level of significance.

*10.11 According to the California Educational Code (http://www.cde.ca.gov/ls/fa/sf/pegui-demidhi.asp), students in grades 7 through 12 should receive 400 minutes of physical education every 10 school days. A random sample of 48 students has a mean of 385 minutes and a standard deviation of 53 minutes. Test the hypothesis at the .05 level of significance that the sampled population satisfies the requiremen

 

*10.12 According to a 2009 survey based on the United States census (http://www.census.gov/prod/2011pubs/acs-15.pdf), the daily one-way commute time of U.S. workers averages 25 minutes with, we’ll assume, a standard deviation of 13 minutes. An investigator wishes to determine whether the national average describes the mean commute time for all workers in the Chicago area. Commute times are obtained for a random sample of 169 workers from this area, and the mean time is found to be 22.5 minutes. Test the null hypothesis at the .05 level of significance.

Chapter 11, numbers 11.11, 11.19, and 11.20

*11.11 Give two reasons why the research hypothesis is not tested directly.

*11.19 How should a projected hypothesis test be modified if you’re particularly concerned about

(a) the type I error?

(b) the type II error?

*11.20 Consult the power curves in Figure 11.7 to estimate the approximate detection rate, rounded to the nearest tenth, for each of the following situations:

(a) a four-point effect, with a sample size of 13

(b) a ten-point effect, with a sample size of 29 (c) a seven-point effect with a sample size of 18 (Interpolate)

Chapter 12, numbers 12.7, 12.8, and 12.10

*12.7 In Question 10.5 on page 191, it was concluded that, the mean salary among the population of female members of the American Psychological Association is less than that ($82,500) for all comparable members who have a doctorate and teach full time.

(a) Given a population standard deviation of $6,000 and a sample mean salary of $80,100 for a random sample of 100 female members, construct a 99 percent confidence interval for the mean salary for all female members

(b) Given this confidence interval, is there any consistent evidence that the mean salary for all female members fall below $82,500, the mean salary for all members? Answers on page 435.

* 12.8 In Review Question 11.12 on page 218, instead of testing a hypothesis, you might prefer to construct a confidence interval for the mean weight of all 2-pound boxes of candy during a recent production shift.

(a) Given a population standard deviation of .30 ounce and a sample mean weight of 33.09 ounces for a random sample of 36 candy boxes, construct a 95 percent confidence interval.

(b) Interpret this interval, given the manufacturer’s desire to produce boxes of candy that, on the average, exceed 32 ounces.

 

*12.10 Imagine that one of the following 95 percent confidence intervals estimates the effect of vitamin C on IQ scores:

 

 

 

95 % confidence interval Lower Limit Upper Limit
1 100 102
2 95 99
3 102 106
4 90 111
5 91 98

 

 

(a) Which one most strongly supports the conclusion that vitamin C increases IQ scores?

(b) Which one implies the largest sample size?

(c) Which one most strongly supports the conclusion that vitamin C decreases IQ scores?

(d) Which one would most likely stimulate the investigator to conduct an additional experiment using larger sample sizes? Answers on page 436.

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(introduction of textbook

“Footlosse” Project After reading over these questions, watch the movie “Footloose.” You can watch the original 1984 version, or the 2011 remake. The movie is available on YouTube, Google Play, iTunes, Amazon Prime, etc.

Answer 10 of the following questions. Each question is worth 3.5 points. It is very important that you provide the justification for your responses when the question requests a justification. Your answers will probably vary from question to question, but on average, half page answers should be sufficient. 1. What perspective or definition of adolescence is best portrayed in the movie? Provide evidence and

your rationale. (introduction of textbook) 2. Identify a character who appears to have matured early and a character who matured late. Name and

describe the two characters (especially if they were not central characters) and provide the rationale for why you believe he or she matured early or late. (Chapter 1)

3. Identify at least two examples of formal operational thought. For each, provide a description of the

scene or event and provide a justification for why you think it is an illustration of formal operational thought. (Chapter 2)

4. Identify at least two examples of personal fable or imaginary audience in the movie. For each, (1)

provide a description of the scene or event, (2) state whether you think it illustrates the personal fable or the imaginary audience, and (3) provide a justification for why you think so. (chapter 2)

5. There are a number of examples of behavior that may be viewed as attempts to define one’s identity.

Identify two and provide the rationale for why you think the behavior is an attempt to identify one’s identity. (chapter 8)

6. How would Baumrind classify the parenting style used by the male lead character’s mother? The

female lead character’s father? For each, provide evidence to support your conclusion. (Chapter 4) 7. The parents of both main characters engage in autonomy granting behaviors, but do so in a very

different way. Contrast how the male lead’s mother goes about granting him autonomy with the approach taken by the female lead’s father. (chapter 9)

8. Identify at least two examples of peer pressure. For each, provide a description of the scene or event,

provide a justification for why you think there was peer pressure, and identify how the pressure was conveyed (was it verbal, imagined, etc.). (chapters 5 and 9)

9. Identify at least two pieces of evidence of peer group structure in the movie. What does the evidence

tell you about the structure of the peer groups in that town/school? (chapter 5) 10. Identify a theme that captures how adolescent sexuality is portrayed in the movie and provide evidence

that supports your theme choice. (chapter 11) 11. Identify at least 3 scenes addressing intimacy and intimacy development in relationships and explain

why the scene accurately or inaccurately depicts intimacy development. You must include at least one example of intimacy in a romantic context, and at least one in a friendship context. (chapter 10)

 

 

12. Several characters in the movie engage in problem behavior. Identify at least three examples of

different types of problem behavior exhibited by the characters. For each, discuss key causes and consequences of the behavior (embedded within the movie plot, if possible, but you are not limited to the plot for discussion of potential causes and consequences. (chapter 13)

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Case Treatment Strategy Paper Rubric

EDCO 705

 

Case Treatment Strategy Paper Rubric

Criteria Advanced 138-150 (A- to A):

Satisfies criteria w/ excellence

Proficient 126-137 (B- to B+) :

Satisfies Criteria

Developing 114-125 (C- to C+):

Satisfies most criteria

Below Expectations (F – D+):

Does not satisfy criteria

Not Present Points

Earned

  Content: 70% = 105 pts
Abstract 4-5 pts.

· An APA abstract is present with excellent content and formatting.

3-3.5 pts.

· An APA abstract is present but has either mild content and/or formatting issues.

2-2.5 pts.

· An APA abstract is present with significant content/ formatting issues.

1-1.5 pts.

· An APA abstract is present but is confused with the introduction in content/format.

0 points  
Content 78–85 pts.

· Assertions are relevant and properly supported by extensive evidence.

· All of the key content areas are addressed and properly cited.

· Utilizes best practices in traumatology with the population of interest.

· Thoroughly covers cultural considerations relevant to the population of interest.

 

71–77 pts.

· Assertions are relevant and mostly supported by evidence.

· All of the key content areas are addressed and properly cited.

· Utilizes best practices in traumatology with the population of interest.

· Includes most relevant cultural considerations to the population of interest.

65–70 pts.

· Some assertions are relevant and supported by evidence.

· Most key content areas are addressed and properly cited.

· Utilizes some best practices in traumatology with the population of interest.

· Includes some cultural considerations relevant to the population of interest.

1–64 pts.

· Assertions are not relevant nor supported by evidence.

· Some key areas are not addressed in full or omitted altogether.

· Does not utilize best practices in traumatology with the population of interest.

· Does not consider cultural factors relevant to the population of interest.

0 points  
Biblical Integration 9-10 pts

· Biblical application (verses / passages) is integrated into text with relevance clarified.

7-8 pts

· Biblical application (verses/passages) is integrated into text.

5-6 pts

· Biblical application (verses/passages) is present but not properly integrated.

1-4 pts

· Biblical terms/ verses/passages are not present and/or referenced.

   
Conclusion 4-5 pts.

· A detailed Conclusion section, with the APA heading of Conclusion, is presented at the end of the body of the report.

· A separate section for ideas for future research is included as the final paragraph.

3-3.5 pts.

· A detailed Conclusion section, with the APA heading of Conclusion, is presented at the end of the body of the report.

· A separate section for ideas for future research is included as the final paragraph.

2-2.5 pts.

· A Conclusion summary and ideas for future research are present but not detailed and/or supported by research.

1-1.5 pts.

· The Conclusion is vague and does not contain a wrap up and/or the required ideas for future research section.

0 points  
  Structure: 30% = 45 pts
Organization 14–15 pts.

· All required elements are included and presented with strong headings and organizational clarity.

· There are clear transitions between paragraphs and sections.

· The treatment of the topic is logically oriented.

· The paper meets the page length requirement, not counting title page, abstract, or reference pages.

12–13 pts.

· All required elements are included and organized.

· There are transitions between paragraphs and sections.

· The treatment of the topic is logically oriented.

· The paper meets the page length requirement, not counting title page, abstract, or reference pages.

10–11 pts.

· Most required elements are included and are mostly organized.

· The logical treatment of the topic needs improvement.

· The paper meets the page length requirement, not counting title page, abstract, or reference pages.

 

1–9 pts.

· Few or no required elements are included.

· There may not be a logical treatment of the topic.

· The paper does not meet the page length requirement, not counting title page, abstract, or reference pages.

0 points  
Style 14–15 pts.

· The paper properly uses current APA style.

· Proper headings, in-text citations, and references are formatted correctly.

· The paper reflects a graduate level voice and vocabulary.

· There are very few spelling and grammar errors.

12–13 pts.

· The paper consistently uses current APA style.

· Proper headings, in-text citations, and references are formatted with few or no errors.

· The paper reflects a graduate level voice and vocabulary.

· There are few spelling and grammar errors.

10–11 pts.

· The paper inconsistently uses APA style.

· Headings, in-text citations, and references are inconsistently formatted.

· The paper does not consistently reflect a graduate level voice and vocabulary.

· There are spelling and grammar errors.

1–9 pts.

· The paper erroneously uses or does not use APA style.

· Headings, in-text citations, and references are erroneously formatted or not present.

· The paper does not reflect a graduate level voice and vocabulary.

· There are spelling and grammar errors.

0 points  
Sources 14–15 pts.

· The Reference page meets or exceeds the required number of sources.

· All sources are referenced throughout the paper.

· All references meet current APA standards.

12–13 pts.

· The Reference page meets the required number of sources.

· Most sources are referenced throughout the paper.

· References meet current APA standards, with only minor deviations.

10–11 pts.

· The Reference page does not meet the required number of sources.

· Not all sources are referenced throughout the paper.

· References meet current APA standards, but with major issues.

1–9 pts.

· The Reference page contains few sources.

· Not enough sources are referenced throughout the paper, or none are referenced.

· References do not meet current APA standards.

0 points  
Total   / 150
  Instructor’s comments:

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Case Treatment Strategy Paper Instructions

EDCO 705

Case Treatment Strategy Paper Instructions

Your assignment is to develop a treatment strategy for the Williams family bases on the case study provided. This paper should not be a treatment plan with DSM diagnoses. Neither should it be a verbatim report of a counseling session. Rather, this paper must articulate a plan of intervention for the family that uses a community counseling approach. Imagine that you are the community counselor, that you have conducted two counseling sessions, and now you want to develop a cohesive treatment strategy for the entire family (Jeff, Sandy, Jacob and Leo). Your job is to provide a plan of action that will assist them in moving toward healing and recovery. The community counseling model will serve you well and enable you to assist the family with the multiple issues that you will see in the case. You need to hypothesize and critically assess what is going on within the family. Consider the following questions when planning your paper:

 

· Based upon what you are able to deduct from the case study and assessment of issues that may have gone unsaid, where would you–as the community mental health counselor–begin?

· What are the various, obvious, or hidden issues that you believe this family experience?

· What are the best practices for addressing their needs and issues?

· What services might you be able to provide?

· What additional services would you need to find for the family?

 

Your paper must be 10-12 pages (not including title page, abstract, or reference page; however, these are required as well). You must use current APA style (write in third person) and integrate references to at least 10 recent scholarly sources. Ideally, include both June & Black and Scott & Wolfe in a meaningful way. You must also use scholarly journal articles to support your assessment and various treatment recommendations. Include the following content, using appropriate headings:

 

1. Introduce the Williams family and provide a brief case conceptualization.

2. Describe the services that you/your community counseling agency will provide.

3. Identify services that you feel could be better provided by other agencies or organizations. These need to be actual services that are offered in your community. You need to disclose the organization, its location, the cost involved, the criteria needed for referral/approval, and contact information. If some of the needed services are not available in your local community, you have to find the closest ones that the family may, realistically, use.

 

The Case Treatment Strategy Paper is due 11:59 p.m. (ET) on Sunday of Module/Week 5.

 

Page 1 of 1

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eff and Sandy Williams present themselves

Jeff and Sandy Williams present themselves in your counseling agency. Sandy Williams has called for an appointment and cited family issues along with couple conflict between her and her husband. The office receptionist makes an appointment for the entire family of four.

Jeff and Sandy have been married 21 years. Jeff owns his own used car business, but the downturn in the economy has created financial difficulty for him and Sandy. Sandy has been employed as a teacher’s aide at a local elementary school for 10 years. Their oldest son, Jacob (18) was diagnosed with Asperger’s syndrome several years ago. The youngest son, Leo (15) is having trouble at school.

You have seen the family for two sessions; thus far, the issues presented are that Jeff has a drinking problem. He drinks each day when he arrives home from work and continues until he goes to bed. The next day he remembers little of his late night behaviors or conversations. This has created conflict between him and Sandy.

Due to slow business at the car lot, financial pressure has added to family anxieties. You sense that spending behaviors and lack of financial management are areas that may need some skill building.

Over the last 4–5 years, Jacob’s awkwardness has alienated him socially. Jacob suffers from depression and overall sadness. He feels alone, misunderstood, and struggles with any kind of social engagement. Although Jacob is present during the family counseling sessions, he is both disengaging and silent. He sits, looking at the floor and rocking back and forth. A couple of times when you attempted to draw him into the conversation, he became agitated and began screaming.

Both Sandy and Jeff are perplexed about Jacobs’s behavior, lack of social skills, and lack of empathy; however, Jeff reacts with anger toward Jacob more so than Sandy. This results in Sandy being angry with Jeff for his reaction toward Jacob. The couple also suffers from loneliness and believes that this may be connected to Jacob’s disorder. They both voice that they feel that no one really understands Jacob or what they go through as a family. Due to Jacob’s disorder, the family seldom visits with friends or extended family. Many times when they have attempted to do things socially, Jacob either acts out or wants to return home early. This, again, angers Jeff and saddens Sandy.

Sandy and Jeff are also extremely frustrated with various individuals connected with the school system. They indicated that the school is not doing enough to help either of their two sons.

Leo has not contributed much to the conversation while in counseling and seems distant and disengaged from his family. When you have made attempts to draw Leo into the conversation, he has responded with comments like, “I guess so,” or “whatever.” Leo’s grades have been slipping from a B average to a D average over the last couple of years. Leo has few close friends, stays home if he can when the family goes on an outing. He seldom goes out with the family anymore. He reported being increasingly frustrated over the last few years.

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Describe a specific and unique example of each type of research design

PSYC 300

 

· Each post should be a minimum of 250 words and have at least 2 sources

 

 

Week 5

 

Describe a specific and unique example of each type of research design (Experimental, Quasi-Experimental, Qualitative, and Correlational) and tell us why they fit the criteria for each.

 

Week 6

 

Define sampling bias in general and nonresponse bias in particular. List techniques that can be used to increase the response rate and reduce nonresponse bias.

As you come up with techniques to increase response rate and reduce bias, think of examples. Also think how these techniques could impact your study.

 

 

Week 7

Do an Internet search using search terms such as “psychology” and “poster” to find an example of a research poster from the field of psychology that has been presented at a conference. Based on information in this chapter, what are the main strengths and main weaknesses of the poster (list at least 2 of each)?  Be sure to provide a link to the poster so other class members can access the poster.

 

PLEASE CHAPTER 11 ATTACHMENT

 

Week 8

For each case study below: discuss the ethics involved in the study using the ethical framework presented in your reading.

Case No. 1: A developmental psychologist is conducting research on physiological correlates of orienting responses in newborn infants. What is his obligation with respect to sharing each child’s data with the child’s parents? Does it make a difference if the data suggest the presence of neurological abnormality in some participants?

 

Case No. 2: A local business is interested in making better decisions about which employees should be encouraged to pursue a career track in management. They ask a psychologist to administer and interpret personality tests that include measures of creativity, ego strength, and introversion/extroversion to a group of new employees. Should he honor this request? What issues are raised if the instruments used by the psychologist were developed using samples of white, middle-class men? What if the psychologist also is asked to administer an integrity test to evaluate each new employee?

 

Case No. 3: A psychologist who conducts research on jury characteristics has reported that potential jurors with specific demographic characteristics are more likely to render verdicts that favor the defense in certain types of felony cases. An attorney who is defending an accused rapist offers her a position as a consultant. She is asked to advise the defense team about which potential jurors should be eliminated during the voir dire process. Should she accept the position?

 

Case No. 4: A psychologist is a guest in a weekly radio “call-in” program. Listeners are invited to ask questions. During a show on treatment of depression, a listener calls with a “question” about someone he knows who seems “down.” He reports that this acquaintance has been missing work frequently, seems irritable most of the time, and has made comments about “getting out of the rat-race for good.” The psychologist, concerned that the caller may be actually speaking about himself, tells the caller that the friend is clinically depressed, is a likely suicide risk, and should be seen by a mental health professional as soon as possible. The psychologist then offers an appointment time in her schedule the following morning if the caller will bring his “friend” to the office for evaluation and referral to a local physician. Has she followed ethical guidelines in handling this situation?

Cases are from :http://www.psychologicalscience.org/teaching/tips/tips_0902.cfm

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Presenting Your Research

Chapter 11

 

Presenting Your Research

 

Research is complete only when the results are shared with the scientific community.

 

 

-American Psychological Association

 

Imagine that you have identified an interesting research question, reviewed the relevant literature, designed and conducted an empirical study, analyzed the data, and drawn your conclusions. There is still one more step in the process of conducting scientific research. It is time to add your research to the literature so that others can learn from it and build on it. Remember that science is a social process—a large-scale collaboration among many researchers distributed across space and time. For this reason, it could be argued that unless you make your research public in some form, you are not really engaged in science at all.

 

In this chapter, we look at how to present your research effectively. We begin with a discussion of American Psychological Association (APA) style—the primary approach to writing taken by researchers in psychology and related fields. Then we consider how to write an APA-style empirical research report. Finally, we look at some of the many other ways in which researchers present their work, including review and theoretical articles, theses and other student papers, and talks and posters at professional meetings.

 

This text was adapted by The Saylor Foundation under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License without attribution as requested by the work’s original creator or licensee.

 

 

Saylor URL: http://www.saylor.org/books

Saylor.org

263

 

11.1 American Psychological Association (APA) Style

 

 

 

1. Define APA style and list several of its most important characteristics.

 

2. Identify three levels of APA style and give examples of each.

 

3. Identify multiple sources of information about APA style.

LEARNIN G OBJE CTIVE S

 

 

What Is APA Style?

 

APA style is a set of guidelines for writing in psychology and related fields. These guidelines are set down in the Publication Manual of the American Psychological Association (APA,

2006). [1] The Publication Manual originated in 1929 as a short journal article that provided basic

standards for preparing manuscripts to be submitted for publication (Bentley et al., 1929). [2] It was later expanded and published as a book by the association and is now in its sixth edition. The primary purpose of APA style is to facilitate scientific communication by promoting clarity of expression and by standardizing the organization and content of research articles and book chapters. It is easier to write about research when you know what information to present, the order in which to present it, and even the style in which to present it. Likewise, it is easier to read about research when it is presented in familiar and expected ways.

 

APA style is best thought of as a “genre” of writing that is appropriate for presenting the results of psychological research—especially in academic and professional contexts. It is not synonymous with “good writing” in general. You would not write a literary analysis for an English class, even if it were based on psychoanalytic concepts, in APA style. You would write it in Modern Language Association (MLA) style instead. And you would not write a newspaper article, even if it were about a new breakthrough in behavioral neuroscience, in APA style. You would write it in Associated Press (AP) style instead. At the same time, you would not write an empirical research report in MLA style, in AP style, or in the style of a romance novel, an e-mail to a friend, or a shopping list. You would write it in APA style. Part of being a good writer in general is adopting a style that is appropriate to the writing task at hand, and for writing about psychological research, this is APA style.

 

The Levels of APA Style

 

Because APA style consists of a large number and variety of guidelines—the Publication Manual is nearly 300 pages long—it can be useful to think about it in terms of three basic levels. The first is the

overall organization of an article (which is covered in Chapter 2 “Getting Started in Research” of the Publication Manual). Empirical research reports, in particular, have several distinct sections that always appear in the same order:

 

1. Title page. Presents the article title and author names and affiliations.

 

2. Abstract. Summarizes the research.

 

3. Introduction. Describes previous research and the rationale for the current study.

 

4. Method. Describes how the study was conducted.

 

5. Results. Describes the results of the study.

 

6. Discussion. Summarizes the study and discusses its implications.

 

7. References. Lists the references cited throughout the article.

 

 

The second level of APA style can be referred to as high-level style (covered in Chapter 3 “Research Ethics” of the Publication Manual), which includes guidelines for the clear expression of ideas. There are two important themes here. One is that APA-style writing is formal rather than informal. It adopts a tone that is appropriate for communicating with professional colleagues—other researchers and practitioners— who share an interest in the topic. Beyond this shared interest, however, these colleagues are not necessarily similar to the writer or to each other. A graduate student in California might be writing an article that will be read by a young psychotherapist in New York City and a respected professor of psychology in Tokyo. Thus formal writing avoids slang, contractions, pop culture references, humor, and other elements that would be acceptable in talking with a friend or in writing informally.

 

The second theme of high-level APA style is that it is straightforward. This means that it communicates ideas as simply and clearly as possible, putting the focus on the ideas themselves and not on how they are communicated. Thus APA-style writing minimizes literary devices such as metaphor, imagery, irony, suspense, and so on. Again, humor is kept to a minimum. Sentences are short and direct. Technical terms must be used, but they are used to improve communication, not simply to make the writing sound more

 

 

“scientific.” For example, if participants immersed their hands in a bucket of ice water, it is better just to write this than to write that they “were subjected to a pain-inducement apparatus.” At the same time, however, there is no better way to communicate that a between-subjects design was used than to use the term “between-subjects design.”

 

APA Style and the Values of Psychology

 

Robert Madigan and his colleagues have argued that APA style has a purpose that often goes unrecognized (Madigan, Johnson, & Linton, 1995).[3] Specifically, it promotes psychologists’ scientific values and assumptions. From this perspective, many features of APA style that at first seem arbitrary actually make good sense. Following are several features of APA-style writing and the scientific values or assumptions

they reflect.

 

 

APA style feature Scientific value or assumption
 

There are very few direct quotations of other researchers.

The phenomena and theories of psychology are objective and do not depend on the specific words a particular researcher used to describe them.
 

Criticisms are directed at other researchers’ work but not at them personally.

The focus of scientific research is on drawing general conclusions about the world, not on the personalities of particular researchers.
There are many references and reference citations. Scientific research is a large-scale collaboration among many researchers.
 

Empirical research reports are organized with specific sections in a fixed order.

There is an ideal approach to conducting empirical research in psychology (even if this ideal is not always achieved in actual research).
Researchers tend to “hedge” their conclusions, e.g., “The

results suggest that…”

 

Scientific knowledge is tentative and always subject to revision based on new empirical results.

 

 

 

Another important element of high-level APA style is the avoidance of language that is biased against particular groups. This is not only to avoid offending people—why would you want to offend people who are interested in your work?—but also for the sake of scientific objectivity and accuracy. For example, the term sexual orientation should be used instead of sexual preference because people do not generally experience their orientation as a “preference,” nor is it as easily changeable as this term suggests (Committee on Lesbian and Gay Concerns, APA, 1991). [4]

 

 

The general principles for avoiding biased language are fairly simple. First, be sensitive to labels by avoiding terms that are offensive or have negative connotations. This includes terms that identify people with a disorder or other problem they happen to have. For example, patients with schizophrenia is better than schizophrenics. Second, use more specific terms rather than more general ones. For

example, Mexican Americans is better than Hispanics if everyone in the group is, in fact, Mexican American. Third, avoid objectifying research participants. Instead, acknowledge their active contribution to the research. For example, “The students completed the questionnaire” is better than “The subjects were administered the questionnaire.” Note that this principle also makes for clearer, more engaging writing. Table 11.1 “Examples of Avoiding Biased Language” shows several more examples that follow these general principles.

 

Table 11.1 Examples of Avoiding Biased Language

 

Instead of… Use…
man, men men and women, people
firemen firefighters
homosexuals, gays, bisexuals lesbians, gay men, bisexual men, bisexual women
minority specific group label (e.g., African American)
neurotics people scoring high in neuroticism
special children children with learning disabilities

 

 

The previous edition of the Publication Manual strongly discouraged the use of the term subjects (except for nonhumans) and strongly encouraged the use of participants instead. The current edition, however, acknowledges that subjects can still be appropriate in referring to human participants in areas in which it has traditionally been used (e.g., basic memory research). But it also encourages the use of more specific terms when possible: college studentschildrenrespondents, and so on.

 

The third level of APA style can be referred to as low-level style (which is covered in Chapter 4 “Theory in Psychology” through Chapter 7 “Nonexperimental Research” of the Publication Manual.) Low-level style includes all the specific guidelines pertaining to spelling, grammar, references and reference citations, numbers and statistics, figures and tables, and so on. There are so many low-level guidelines

 

 

that even experienced professionals need to consult the Publication Manual from time to time. Table 11.2 “Top 10 APA Style Errors” contains some of the most common types of APA style errors based on an analysis of manuscripts submitted to one professional journal over a 6-year period (Onwuegbuzie, Combs, Slate, & Frels, 2010). [5] These errors were committed by professional researchers but are probably similar to those that students commit the most too. See also Note 11.8 “Online APA Style Resources” in this section and, of course, the Publication Manual itself.

 

Table 11.2 Top 10 APA Style Errors

 

Error type Example
1. Use of numbers Failing to use numerals for 10 and above
 

2. Hyphenation

Failing to hyphenate compound adjectives that precede a noun (e.g., “role playing technique” should be “role-playing technique”)
3. Use of et al. Failing to use it after a reference is cited for the first time
4. Headings Not capitalizing headings correctly
5. Use of since Using since to mean because
 

6. Tables and figures

Not formatting them in APA style; repeating information that is already given in the text
7. Use of commas Failing to use a comma before and or or in a series of three or more elements
8. Use of abbreviations  

Failing to spell out a term completely before introducing an abbreviation for it

9. Spacing Not consistently double-spacing between lines
10. Use of &in references  

Using in the text or and in parentheses

 

 

Online APA Style Resources

 

The best source of information on APA style is the Publication Manual itself. However, there are also many good websites on APA style, which do an excellent job of presenting the basics for beginning researchers. Here are a few of them.

 

APA Style

 

 

http://www.apastyle.org

 

 

 

 

Doc Scribe’s APA Style Lite http://www.docstyles.com/apalite.htm Purdue Online Writing Lab

http://owl.english.purdue.edu/owl/resource/560/01 Douglas Degelman’s APA Style Essentials

http://www.vanguard.edu/Home/AcademicResources/Faculty/DougDegelman/APAStyleEssentials.aspx

 

 

APA-Style References and Citations

 

Because science is a large-scale collaboration among researchers, references to the work of other researchers are extremely important. Their importance is reflected in the extensive and detailed set of rules for formatting and using them.

References

 

At the end of an APA-style article or book chapter is a list that contains references to all the works cited in the text (and only the works cited in the text). The reference list begins on its own page, with the heading “References,” centered in upper and lower case. The references themselves are then listed alphabetically according to the last names of the first named author for each citation. (As in the rest of an APA-style manuscript, everything is double-spaced.) Many different kinds of works might be cited in APA-style articles and book chapters, including magazine articles, websites, government documents, and even television shows. Of course, you should consult the Publication Manual or Online APA Style Resources for details on how to format them. Here we will focus on formatting references for the three most common kinds of works cited in APA style: journal articles, books, and book chapters.

Journal Articles

 

For journal articles, the generic format for a reference is as follows:

 

 

 

Author, A. A., Author, B. B., & Author, C. C. (year). Title of article. Title of Journal, xx, pp–pp. doi:xx.xxxxxxxxxx

 

 

Here is a concrete example:

 

 

Adair, J. G., & Vohra, N. (2003). The explosion of knowledge, references, and citations: Psychology’s unique response to a crisis. American Psychologist, 58, 15–23. doi: 10.1037/0003-066X.58.1.15

 

 

There are several things to notice here. The reference includes a hanging indent. That is, the first line of the reference is not indented but all subsequent lines are. The authors’ names appear in the same order as on the article, which reflects the authors’ relative contributions to the research. Only the authors’ last names and initials appear, and the names are separated by commas with an ampersand (&) between the last two. This is true even when there are only two authors. Only the first word of the article title is capitalized. The only exceptions are for words that are proper nouns or adjectives (e.g., “Freudian”) or if there is a subtitle, in which case the first word of the subtitle is also capitalized. In the journal title, however, all the important words are capitalized. The journal title and volume number are italicized. At the very end of the reference is the digital object identifier (DOI), which provides a permanent link to the location of the article on the Internet. Include this if it is available. It can generally be found in the record for the item on an electronic database (e.g., PsycINFO) and is usually displayed on the first page of the published article.

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