Cognitive behavior therapy before too quickly

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Cognitive behavior therapy Before too quickly attempting to change the beliefs and actions of clients, it is essential for the therapist to understand and re spect their world. Some clients may have serious reservations about questioning their basic cultural values and beliefs. Clients could become dependent on the therapist for deciding what are appropriate ways to solve problems. Theremay be a fine line between being directive and promoting dependence. Reality therapy This approach stresses taking charge of one’s own life, yet some clients hope to change their external environment. Coun selor needs to appreciate the role of discrimination and racism and help clients deal with socialand political realities. Feminist therapy This model hasbeen criticized for its bias toward the values of White, middle-class, heterosexual women, whichare not ap plicable to many other groups of women. It is based on femi nist notions of collaborative relationships, self-determination, and empowerment. Therapists need to assess with their clients the price of making significant personal change, which may re sult in isolation from extended family as clients assume new roles and make life changes. Postmodern approaches Some clients come to therapy wanting to talk about their prob lems and may be put off by the insistence on talking about ex ceptions to their problems. Clients may view the therapist as an expert and be reluctant to view themselves as experts. Cer tain clients may doubt the helpfulness of a therapist who as sumes a “know-nothing” position. Family systems therapy Family therapy rests on value assumptions that are not congru ent with the values of clients from some other cultures. Concepts such as individuation, self-actualization, self-determination, in dependence, and self-expression may be foreign to some clients. In some cultures, admitting problems within the family is shameful. The value of “keeping problems within the family” may make it difficult to explore conflicts openly. TABLE 15-9 Contributions of the Approaches Psychoanalytic therapy More than any other system, this approach has generated con troversy as well as exploration and has stimulated further thinking and development of therapy. It has provided a detailed and comprehensive description of personality structure and (continued on next page)
488 PART THREE INTEGRATION AND APPLICATION TABLE 15-9 Contributions of the Approaches (continued) functioning. It has brought into prominence factors such as the unconscious as a determinant of behavior and the role of trauma during the first 6 years of life. It has developed several techniques for tapping the unconscious and shed light on the dynamics of transference and countertransference, resistance, anxiety, and the mechanisms of ego defense. Adlerian therapy One of the first approaches to therapy that was humanistic, unified, holistic, and goal-oriented and that put an emphasis on social and psychological factors. A key contribution is the influence that Adler- ian concepts have had on other systems and the integration of these concepts into

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