Notes from Lecture
Current Psychotherapies (Corsini and Wedding)
Introduction - chapter 1
(COUN 603)
Instructor: Jeff Garrett Ph.D.

Defining Psychotherapy

Psychotherapy cannot be defined with any precision.

A definition might go as follows …Psychotherapy is a formal process of interaction between two parties, each party usually consisting of one person but with the possibility of amelioration of distress in one of the two parties relative to any or all of the following areas of disability or malfunction: cognitive functions (disorders of thinking), affective functions (suffering emotional discomforts), or behavioral functions (inadequacy of behavior), with the therapist having some theory of personality’s origins, development, maintenance and change with some method of treatment logically related to the theory and professional and legal approval to act as a therapist.

Is this definition comprehensive? Do all modes of therapy fit this definition? No. e.g., self therapy involves only one party and it involves no professional or legal approval.

What one authority considers to be psychotherapy may be completely different from how other authorities see the process.*

Although psychotherapy varies in form and theory the key component across approaches is the interaction between two parties aimed at easing distress experienced by one party*

According to Corsini's estimates, the primary activity in psychotherapy is listening.In Chapter 1 (p.4), Corsini illustrates how an inmate's life changed following learning he has a high IQ. This story demonstrates that psychotherapy can be broadly defined as any self concept altering experience

Counseling and Psychotherapy (Corsini and Wedding)
These terms are often used interchangeably but Corsini and Wedding differentiate between the two.

Counseling and Psychotherapy
Corsini and Wedding differeniate counseling from psychotherapy as follows.

Counseling - Short (5 sessions or less), Problem oriented, Giving info, advise, and orders, A teacher, Expert in specific area.

Psychotherapy - Long (months or years), Person oriented, Discover why they think, feel, and behave in unsatisfying ways, a detective, a generalist.

_______________________________________________

Contradictory statements:
"Counseling and psychotherapy are the same qualitatively; they differ only quantitatively." p.2
"There is nothing that a psychotherapist does that a counselor does not do." p.2
"All modes of trying to help people improve themselves via symbolic methods can be called psychotherapy" p. 3

Counseling and Psychotherapy

Jeff - The differences Corsini list appear incorrect because …
The duration of counseling can be just as long.
Managed care influences length of therapy.
Counselors can be people oriented.
Counselors can help clients discover why they think, feel and behave in unsatisfactory ways.
Counselors can act as detectives (rather than teachers).
Counselors can be generalists.
Counselors study the same body of literature.
Counselors master the same methods.

Patient or Client
Some authors use one of the two terms, and some use both. Neither is satisfactory – patient implies illness and client implies a business relationship. When you write your papers I prefer you use the term "client". If you work inpatient - use the term patient.

Psychotherapy is a method of learning

Three Modes of Psychotherapy
1. Cognition - We learn directly by experience and indirectly by experience.
2. Behavior - Learning can occur through action.
3. Affect - Learning can also occur through emotions.

All psychotherapies are methods of learning. * One child learns to swing a baseball bat by playing the game with his father while another learns from watching the game on television.

The first example reflects active or experiential learning while the second passive or informational learning.

Psychotherapy focuses on learning through the modalities of affect(ion), behavior, and cognition.

1. Cognition – we learn directly by experience and indirectly by symbols.A therapist explains to a patient how early parent-child interactions create insecurity in present relationships. This depicts passive learning*During assertiveness training a therapist engages in role playing with a patient. This is an example of active learning.

2. Behavior – learning can occur through action

3. Affection – learning can also occur through emotions or feelingsIt is not feasible to change emotions directly through psychotherapy. Therefore, the therapist must use indirect intellectual or physical methods to alter emotions

Mechanisms of Psychotherapy.
There is no consensus about what constitutes the basis for change in psychotherapy.
Corsini identified nine factors
A. Cognitive Factors
1. *Universalization - A client states "I've learned that I am not alone as others share my
problems and have experienced their own pain."
2. Insight
3. *Modeling - learns from watching the behavior of others

B. Affective Factors
4. Acceptance
5. *Alturism - the knowledge that one is the recipient and provider of love e.g., my therapist cares for me
6. Transference
C. Behavioral Factors
7. Reality Testing
8. Ventilation
9. Interacion

Nondirective counseling would be a semantic absurdity

The Current Situation in Psychotherapy*

In the early 20th century the three most prominent psychotherapy theories were espoused by Sigmund Freud, Alfred Adler, and Carl Jung. There are currently more than 400 systems of psychotherapy (e.g., some are viewed as orthodox and others as unorthodox).

In psychotherapy ideological enclaves are found. Some enclaves consist of people that believe that they have the right, the final, the complete, and the only answer – and that all other systems are incomplete, tentative, weak or simply mistaken. People within these enclaves (known as schools of therapy) tend to communicate mostly with each other. They attend conventions together, read each others writings, and develop a specialized language. They reinforce one another by counting their successes with past clients, "proving" to one another the superiority of their way of thinking. Alternative positions tend to develop, schismatic groups begin to form, and then these groups are either expelled from the original enclave or take off their own way. Historically, this has happened many times over.

Corsini believes that this situation is changing and these ideological boundaries are becoming more permeable. Garfield and Begin write "A decisive shift in opinion has quietly occurred; and it has created an irreversible change in professional attitudes about psychotherapy and behavior change. The new view is that the long-term dominance of the major theories is over and that an eclectic position has taken precedence."

Corsini – "I would go even further and state that all good therapist are eclectic. This does not mean that they do not follow a particular theory or use specific methods associated with particular approaches to therapy; it does mean that technique and method are always secondary to the clinicians sense of what is the right thing to do with a given client at a given moment in time, irrespective of theory. Put it more simply, psychotherapy remains an art. So if formal eclecticism is on the rise, this is all to the good: It shows a maturing of psychotherapy."

Why You Need to Know Each Theory Well.
In order to be effectively eclectic, you must know as many different theories and systems as possible.You cannot integrate what you do not know.Initially you should operate strictly within the given limits of one theory under close supervision from a skilled clinician of the same persuasion.Later, with clinical experience, you can begin to develop your own individual style of therapy.

The Whohowwhom Factor
The Whohowwhom factor underscores the importance of achieving change through congruency between therapist, patient and technique
What counts in psychotherapy
Who does it
How it is done
To whom it is done

Sometimes the how factor will be less important than the who and whom factorsSometimes simple is superior to something complex – less can be more.

Research
The problem (according to Strupp and Bergin, 1969) – The problem of psychotherapy research in its most general terms should be reformulated as a standard scientific question: ‘What specific therapeutic interventions produce specific changes in specific patterns under specific conditions?’

C.H. Patterson – "Before this model could be implemented we would need a taxonomy of … 1) client problems and psychological disorders, 2) personalities, 3) therapeutic techniques, 4) therapists, 5) circumstances … If we did have such systems of classifications, the practical problems would be insurmountable. Assuming five classes of variables, each with ten classifications … a research design would require 10 X 10 X 10 X 10 X 10, or 100,000 cells … So, I conclude we don’t need complex multivariate analyses and should abandon any attempt to do the crucial, perfect study of psychotherapy. It is simply not possible." (C.H. Patterson, 1987)

*C. H. Patterson asserted that it is not feasible to identify which forms of psychotherapy produce changes in specific clients under specific conditions because the statistical design of such a study requires unachievable complexity

Outcome studies are important (e.g., evidenced-based treatment) but their limitations should be acknowledged.

Psychotherapy is an art based on science, and as is true for any art, there can be no simple measures of so complex an activity.

Psychotherapy and Psychotherapist
The theorists and the system are very similar (e.g., Freud, Rogers, Moreno)As a student you should attempt to understand and determine which school of psychotherapy seems more sensible. In addition you should also attempt to find one that fits your philosophy of life, your personality, as well as your values and beliefs.

*To be an effective psychotherapist one would be best served by selecting a model of psychotherapy which matches one's own personality and/or belief system

*Corsini argued that a student should select a theory and therapeutic methodology based on his or her own personality
Current Psychotherapies (with InfoTrac ) Author: Raymond J. CorsiniCurrent Psychotherapies/Corsini and Wedding/7th ed/2005/InfoTracThis is a very thorough overview of the most popular psychotherapies today. I had to mentally prepare each time I sat down to read this book. Often times I felt the detail was unnecessary (ample detail) for the purpose of the text. However, my understanding of current psychotherapies is based on this book alone. My first Qtr of grad school/counseling/no psych background. I just got my hands on Corey, G. -- its a much easier read but, I am reading it after Corsini and Wedding. So you'll have to decide...Hope you enjoy!Current PsychotherapiesThis was a great overview of the therapies which dominate the counseling field. I have also read Gerald Corey, Theory and Practice of Counseling and Psychotherapy, 7th ed. Current Psychotherapies by Corsini and Wedding did a thorough overview with great application. I recommend it highly.Excellent introduction to the many psychotherapiesThis book provides excellent introductions to a variety of psychotherapies, indeed the most popular methods today. There are over 400 different therapies, and as such this book can not cover them all. However, the book does provide adequate detail for an indepth overview of the therapies, and comes highly recommended to beginning students and graduate students alike. more...


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