Ethics and Disclosure

July 3rd, 2009

Disclosure is a controversial issue when examining therapeutic boundaries. There are two issues to consider regarding disclosure. The first is counsellor disclosure and confidentiality. The second is counsellor disclosure (ie. how much does a client disclose about their own lives to a client?).

Some counsellors would argue whatever is appropriate (but this is ambiguous). Other counsellors would argue that nothing at all should be disclosed to a client. However, there is a balance.

Firstly, when clients enter into a counselling agreement, they are often assured that their confidentiality (within limits) will be respected. This encourages honesty from the client and provides the security of knowing that their private information will not be disclosed to irrelevant individuals.

However, clients must also be aware that their counsellor could be subpoenaed to give evidence in court (Geldard & Geldard, 2005) - and if the counsellor should choose to withhold information at the hearing, the consequences could be that the counsellor would be held in contempt of court. Client files can also be subpoenaed by the court. In some states of Australia, mandatory reporting is required by counsellors in regard to such issues as child abuse.

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Source: AIPC Article Library

Related Posts: The Power of Suggestion, Culturally Relevant Ethical Decision-Making in Counseling, Client Mindsets
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TA and Contracts

June 30th, 2009

The treatment contract is an element that distinguishes transactional analysis from other therapeutic approaches.  It is a specific agreement between a therapist and a client to accomplish clearly stated goals.

Berne (quoted by Stewart and Joines, 1987) defined a contract as an explicit bilateral commitment to a well-defined course of action. James and Jongeward’s (1973, page 47) definition explains contracts further – “A contract is an Adult commitment to one’s self and/or someone else to make a change.”

Contracts specify following concerns:

  1. Who both parties are?
  2. What will they do together?
  3. How long this will take?
  4. What is the outcome of working together?
  5. How will they know when they have gotten there?
  6. How will that be beneficial to the client? 

In TA practice, therapist distinguishes three kinds of contracts: business contract, treatment contract and working agreements (Woolams and Brown, 1978).

A business contract outlines boundaries between a client and a therapist and makes explicit what can be expected. Steiner (1971) outlined four essential components: mutual consent, valid consideration, competency and lawful object.

Mutual consent means that both parties voluntary enter into a therapeutic relationship. Valid consideration is about putting mutual value into the work. Usually, it means that a therapist will put knowledge, skills and expertise, together with a safe place to assist a client in meeting own therapeutic goals.

Simultaneously, a client will pay fee by financial means or any other in advance agreed means. Competency means that both a therapist and a client must be competent to be involved in this particular kind of relationship. Competency also means that both parties have ability of cathecting the Adult ego state in a process of making a contract or during therapeutic treatment. Lawful object means that a therapist and a client will work together exclusively using legal and ethical means to obtain their results.

Life position “I am OK, you are OK” is a basis of a therapeutic work. A therapist and a client are equal and share responsibility for the change the client wants to make. To make it meaningful, both parties need to be clear about the nature of the change and contribution that each will invest in achieving it.  All ulterior messages exchanged between them should be exposed because (Stewart and Joines, 1987) it helps both to stay out of the Drama Triangle and prevents them of playing games.

It is tempting to therapists to solve clients’ problems by making assumptions about proper goals for them to achieve. That arrogant position brings a therapist to the Rescuer or even Persecutor role. Gouldings (1976) said that working without contract might mean that therapist becomes “the rapist”.

Treatment contracts are made from two alert and informed Adults with a full support of Free Child. If the contract is made from Adapted Child it will further a client’s (and sometimes a therapist’s) script.

The main component of an effective contract is in which a client positions himself or herself in one of OK positions (2 and 4) from a list below (Woolams and Brown, 1978).

  1. A client can continue to do what she/he is doing now and feel not-OK about it
  2. A client can continue to do what she/he is doing now and feel OK about it
  3. A client can do something different and feel not-OK about it.
  4. A client can do something different and feel OK about it.

It is important to have a contract clarified since it can be an indication that both counsellor and client work toward the same goal. The contract can enrich the therapeutic process. Clients usually tend to put an effort into process of change and they are motivated and energetic about it. If achievable goals were set, a client’s self esteem will be increased. Having contracts means working on goals rather than a problem, employing available resources from all ego states.

Gellert and Wilson (1978, page 11) wrote an excellent literature overview of various aspects of the goal setting and the theory of aspirations.

“When a client establishes a goal (makes a contract) the client sets up in himself a system of psychological tension that will aid him in recall of pertinent early scenes so as to achieve closure, and that the tension will remain until closure, even though the task is interrupted, so that the client will continue to work even though the therapy session may be over”.

The research done by Ferdinand Hope (quoted by Gellert and Wilson, 1978) proved that a subjective success led to an increase in a level of aspiration and a sense of failure led to lowering a level of aspiration. In his findings a level of aspiration was never lowered after success or raised after failure.

Berne (1978) also stated: “A winner is someone who succeeds in what he says he is going to do. A loser is someone who fails to accomplish what he sets out to do.

The third available type of contract that a therapist may agree with a client is so-called, working agreement. It is consider as a subcontract and it always states intentions of behaviour. It differs from the treatment contract in that it may come from any ego state, it may contradict the main treatment goal and provide a short-term protection. The usual example of the working agreement will be giving homework to clients and their responsibility will be to report on own success.

The best use of working agreement has been seen with suicidal clients who will agree on not hurting themselves while making redecision. It is a therapist’s task to invite the client to move from “a working agreement to a treatment contract and then to a redecision as soon as possible.” (Woolams and Brown, 1978, page 256).

Counsellors often use all three types of contracts and they find them useful and commitment enhancing. A sense of achievement is sometimes very powerful and provokes further actions. By having contracts, a safe place is created, there is no confusion, and there are no questions about roles and aims of seeing each other regularly.

Counsellors occasionally work without a contract having a good reason for that. If someone has a strongly developed Adapted Child and not much available Adult, making a contract may just further the script. The Adapted Child will follow the contract or will sabotage it and either may serve to reinforce the script. 

With clients who have strong Adapted Child, counselors initially work on decontamination. Once the client has enough available Adult, therapists proceed to negotiate the contract.

This article is an extract from the Ego States (TA) Professional Development course from Counselling Academy. For more information about CA courses, visit www.counsellingacademy.com.au/courses.

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Ideas on Personality Development

June 25th, 2009

Personality development has always been a hot topic in realm of mental health disciplines. From Freud to Piaget, many theories of personality balance the input of natural, genetic, and environmental factors to try to explain the foundation of human behaviour.

“Life is a learning experience. The complexity of human behaviour is finely related to the several mechanisms which define how, what and when we learn about the world. People devote varied levels of energy to observe, memorise and recount the ongoing stimuli around them - and that focus is the magical touch which produces the fascinating ambiguity of mankind.

In the realm of behavioural science (and also common sense), there is one word which is vastly used to define such effect: personality.” (Extract from the article “The Word: Personality“)

In this article, we review some general ideas about personality development from the perspective of three widely accepted therapeutic approaches: Behaviour Therapy, Gestalt Therapy and Person Centred Therapy.

Behaviour Therapy

Seligman (2006) has identified “three basic building blocks of personality” that people are born with:

  1. Primary drives
  2. Specific reflexes
  3. Innate responses to particular stimuli

The primary drives of an individual relate to drives such as toward food and warmth. Specific reflexes refer to processes such as sucking and blinking, and innate responses include behaviours such as reacting to pain (Seligman, 2006).

Behavioural theorists believe that personality is shaped by learning and unlearning throughout the lifespan. They also believe that the environment in which a child is brought up in influences the personality of the individual.

An example of how personality is developed through the eyes of a behaviourist is of self-efficacy. Self-efficacy refers to the way one believes in one’s ability. High self-efficacy is often the result of responsive behaviour by parents, non-punitive techniques, and a warm family environment (Weiten, 2007).

Gestalt Therapy

Gestalt therapy deems that people cannot be considered as separate from their environment or from interpersonal relations. The individual is seen as being self-regulating and is able to motivate oneself to solve problems. Individuals are able to work towards growth and develop as their environments allow.

A psychologically healthy person is someone who is self-regulating through the changes in life and has developed a sense of “wholeness” between mind and body (Corsini & Wedding, 2000).

Person Centred Therapy

There are a number of general ideas about personality development with regard to person-centred therapy. Basically, person-centred therapy states that personality can be fully actualised when the individual is exposed to unconditional positive regard.

An individual who has been exposed to conditional positive regard can have low self-esteem and low feelings of worth. An individual who is self-actualised will be more open to experience and less defensive, will learn to live in the moment, will trust own decision-making skills, will have more life choices and be more creative.

Resources: AIPC’s Five Therapies eBook, Five Therapies Index

Related Posts: The Power of Suggestion, Call to Blog Readers, TA and Eric Berne
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An Introduction to Ego States

June 22nd, 2009

Eric Berne, the pioneer of transactional analysis, made complex interpersonal transactions understandable when he recognised that the human personality is made up of three “ego states”. Each ego state is an entire system of thoughts, feelings, and behaviours from which we interact with one another. Parent, Adult and Child ego states and an interaction between them form the foundation of transactional analysis theory.

Ego states are a consistent pattern of thinking, feeling and behaviour. Berne’s tripartite model is an explanation of three main events that happen to all of us - childhood, the development of rational, logical thinking and exposure to parental or significant others’ influence. 

It is the concept that each person has the potential for three fully functioning ego states that separates TA from other approaches. There are two basic models of ego states, the structural and the functional model. In order to differentiate between the two, remember the following:

  1. STRUCTURE refers to the building blocks/content of the ego states, answering questions - what are they; how are they made up?
  2. FUNCTION refers to a description and process of the ego states and their respective ways of behaving.

A basic concept of TA is that a knowledge and understanding of these ego-states gives choice over which to activate.

Parent Ego State

The Parent ego state is a collection of memories that have been recorded in early years. Parental and social expectations are logged into the brain as the person perceives them. The messages are sometimes verbal, sometimes experiential and sometimes only assumed.

Eric Berne used the word “tapes” for messages and believed that the “tapes” recorded in early childhood were the most influential. What were recorded are society’s expectations and obligations that are musts, shoulds and oughts. The parent ego state is filled with judgements, values and attitudes (Wollams & Brown, 1979). In psychoanalytic terms the “parent” ego state is much like the “superego” and is about values and right/wrong.

Functionally, the Parent ego state is subdivided into the Critical Parent and the Nurturing Parent. Nurturing Parent represents more affirming and more pleasant qualities of what parents and society do for a person. Critical Parent behaviours generally represent the corrective behaviours of real parents and the prohibitive messages of society.

Both Controlling and Nurturing Parent are acceptable, but could be grossly overdone. Positive aspects of CP and NP are visible in people’s ability to extract right from wrong, to make decisions supported within and fix mistakes without guilt. Negative aspects of CP and NP could damage psychological health where people replay messages from childhood, negative or overly protective.

Adult Ego State

This ego state is not related to the person’s age, more to a developmental state. It is a logical, rational way of contacting reality. The Adult ego state is “principally concerned with transforming stimuli into pieces of information and processing and filing that information on the basis of previous experience” (Berne, 1961). It is quite similar to a data-processing computer.

From the earliest recorded “tapes” of an introjected parent, the Adult calculates what action must be taken on the basis of that information. The Adult ego state is constantly updating its own processing and storage guidelines. Eventually, the Adult ego state (the central core computer of the personality) is able to integrate all three ego states with reality.

Child Ego State

Child is the first stage to develop and is crucial for the first 5 years of personality development. The Child is similar to the Freudian concept of Id, operating on the pleasure principle, unconscious, aimed at gratification and fulfilment of needs. Child is about expressing feelings and being intuitive.

Child is typified by “I” statements, “I want”, “I need” etc. Child ego state is a function of impulses and desires to find pleasure and be happy. It collects taped information in similar ways to the Adult ego state. The early cry for food (and protest of wetness) and the later playfulness is the function of the Child ego state.

Functionally, the Child ego-state is comprised of 2 aspects: The Natural (Free) Child that is spontaneous, intuitive, creative, pleasure seeker and the Adapted Child that is compliant and conforms to wishes and demands of others, particularly parents.

The Natural Child ego state represents a playful and spontaneous part of human behaviour, from infancy to an old age. The infant may receive enjoyment from playing with a spoon and the adult may find enjoyment from golfing or cruising in Tropical Queensland. A person may be 5 years old or 50 years old but throughout life he or she plays or can be playful or thinks playfully and joyously. That is the Natural Child doing its thing.

The Adapted Child ego state represents human response which has some negativity in it, some resistance, some reaction and some deeper hostility. A disobedient child, a rebellious teenager and a person with a personality disorder may be said to be “in the Adapted Child ego state.”

It is very healthy to be naturally playful and to sometimes be strongly adapted to life or situational circumstances. Excessive indulgences in either or both can be a problem. If a person is too playful on the job he can get fired. If people are too adapted, such as being inappropriately defiant, withdrawn, unhappy, rebellious or resistant, they can choose behaviours that are appropriate.

This article is an extract from the Ego States (TA) Professional Development eCourse from Counselling Academy. For more information about CA courses, visit www.counsellingacademy.com.au/courses.

Related Posts: An introduction to AIPC by Sandra Poletto, CEO., TA and Eric Berne, Family Therapy - Concepts and Methods
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Negotiation Skills Training in Counselling

June 16th, 2009

Negotiation is defined by the Macquarie Dictionary (1998) as ‘to confer (with another) with a view to agreement’. There are no formal rules governing how these negotiations are to be conducted, although there are culturally accepted styles or approaches for doing so.

What negotiation and conflict have in common?

The obvious common denominator in negotiation and conflict is they both involve a relationship with at least one other person.

Some of the things a counsellor should be aware of when teaching a client negotiation skills as part of the conflict resolution process is that when a person enters into a negotiation or they find themselves in conflict with another person, the outcomes they and the other person desire appear to be diametrically opposed.

Otherwise there would not be a conflict or need for serious negotiation (Mindtools, 2005). A counsellor should consider the following about negotiation skills training:

  1. Determine how much the parties invested (i.e. time, money, emotion, energy). This will help establish whether the outcome is achievable and whether a negotiation will be successful.
  2. The difference between a conflict situation and entering a negotiation is that the tension levels are already high when in conflict and relationships may have already been damaged.
  3. It is common that both parties see themselves as ‘right’, and want to prove their ‘rightness’ to each other. In this sense every negotiation has potential for conflict.
  4. If both parties maintain their position of ‘rightness’, there is little opportunity for resolution or for either party to achieve their desired outcomes. Relationships may be irretrievably damaged and neither party wins.

(Source - www.mindtools.com/CommSkll/NegotiationSkills.htm)

The following are common ways individuals seek to resolve conflict:

Competing is a style in which one’s own needs are advocated over the needs of others. It relies on an aggressive style of communication, low regard for future relationships, and the exercise of coercive power. Those using a competitive style tend to seek control over a discussion, in both substance and ground rules. Competing results in responses that increase the level of threat.

Accommodating, also known as smoothing, is the opposite of competing. Persons using this style yield their needs to those of others, trying to be diplomatic. They tend to allow the needs of the group to overwhelm their own, which may not ever be stated, as preserving the relationship is seen as most important.

Avoiding is a common response to the negative perception of conflict. “Perhaps if we don’t bring it up, it will blow over,” we say to ourselves. But, generally, all that happens is that feelings get pent up, views go unexpressed, and the conflict festers until it becomes too big to ignore. Because needs and concerns go unexpressed, people are often confused, wondering what went wrong in a relationship.

Compromising is an approach to conflict in which people gain and give in a series of tradeoffs. While satisfactory, compromise is generally not satisfying. We each remain shaped by our individual perceptions of our needs and don’t necessarily understand the other side very well. We often retain a lack of trust and avoid risk-taking involved in more collaborative behaviours.

Collaborating is the pooling of individual needs and goals toward a common goal. Often called “win-win problem-solving,” collaboration requires assertive communication and cooperation in order to achieve a better solution than either individual could have achieved alone. It offers the chance for consensus, the integration of needs, and the potential to exceed the “budget of possibilities” that previously limited our views of the conflict. It brings new time, energy, and ideas to resolve the dispute meaningfully.

Source: www.ohrd.wisc.edu (Academic Leadership Support)

By understanding each style and its consequences, the results of our behaviours in various situations are obvious.

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