Psy 175 T

Counseling & Psychotherapy

Discussion on Behavior Therapy
(Textbook, pages 2 26 to 267)

Gloria P. de la Merced-Josol
February 24, 2014 (M)
N-311
Behavior Therapy
o All Behavior is learned (page 225)
o Behavioral therapy is a form of therapy rooted in the
principles of behaviorism.
o The school of thought known as behaviorism is focused on
the idea that we learn from our environment.
o In behavioral therapy, the goal is to reinforce desirable
behaviors and eliminate unwanted or maladaptive ones.
o The techniques used in this type of treatment are based on
the theories of classical conditioning and operant
conditioning.
o One important thing to note about the various behavioral
therapies is that unlike some other types of therapy that are
rooted in insight (such as psychoanalytic and humanistic
therapies), behavioral therapy is action based.

Model of Mental Health
o All learned behavior is acquired through classical conditioning
and operant conditioning.
o A persons dysfunctional behavior is viewed from the
behavioral perspective not as pathology, but as problems in
living.
o These problems arise from failure to learn needed behaviors
or from having learned behaviors that result in lack of
reinforcement or in punishment.

o Healthy functioning means painlessness and competency to
solve problems and obtain reinforcement.

o (Reference: Fall & Marquis, 2010)
Basic Assumptions (Corey, 2005 on pages 232-236)
1. Behavior therapy deals with the clients current problems
and the factors influencing them. This is opposed to an
analysis of possible historical determinants of the present
problem. Though, understanding of the past may offer
useful information related to present behavior.
2. Clients are expected to assume an active role. There are
therapeutic tasks that clients carry out in daily life, or
homework assignments which are basic part of this
approach.
3. BT emphasized teaching clients skills of self-
management, with the expectation that they will be
responsible for transferring what they learn in the
therapists office to their everyday lives.


Basic Assumptions (Corey, 2005 on pages 232-236)
4. There is direct assessment of the target problem through
observation or self-monitoring.
5. Behavior treatment interventions are individually tailored
to specific problems experienced by the clients.
6. BT is based on collaborative partnership between
therapist and client. Every attempt is made to inform
clients about the nature and course of treatment.
7. The emphasis is on practical applications. Interventions
are applied to all facets of daily life in which maladaptive
behaviors are decreased and adaptive behaviors are
increased.
8. The therapeutic goal is to increase personal choice and to
create new conditions for learning.
Basic Assumptions(
Corey, 2005 on pages 232-236 and Fall & Marquis, 2010 on pages 243 246)
9. Therapist assists clients in formulating specific measurable
goals. This process of determining therapeutic goals entails
a negotiation between client and therapist in a contract that
guides the course of therapy. Behavior therapist and clients
may alter goals throughout the therapeutic process as
needed.
10. The foundation of the Behavior therapist is to
communicate genuine empathy and positive regard for the
client.


Behavior Assessment (Corey, 2005 on page 235-)
o Behavior Assessment begins with a description of the clients complaint, which is
central to behavior therapy.
o For example: A client comes to therapy to reduce her anxiety, which is preventing her from
leaving the house. The therapist is likely to begin with a specific analysis of the nature of her
anxiety. The therapist may ask her:
1. How does she experiences the anxiety of leaving her house?
2. What does she actually do during these situations?
3. When did this problem begins?
4. In what situations does this arise?
5. What does she do at these times?
6. What are her feelings and thoughts in these situations?
7. Who is present when she experiences anxiety?
8. How do her present fears interfere with living effectively?
o After this assessment, specific behavioral goals will be developed and
strategies will be designed to help the client reduce her anxiety to a
manageable level.


Behavior Assessment (Corey, 2005 on pages 235 236)
o The client is asked to keep a record of the frequency and intensity
of occurrences and this become a tool in devising a therapeutic
plan and in deciding whether the therapy is working.

o Easy to use assessment instrument that are used are:
1. Self-report inventories;
2. Behavior Rating Scales;
3. Self-monitoring forms;
4. Simple Observational techniques
These are used to collect useful information on clients problems.

o A strength of the behavioral approach is the development of
specific therapeutic technique (Treatment plan) that must be
shown to be effective through objective means.

Behavior Therapy
o Behavioral therapists are focused on using the same learning
strategies that led to the formation of unwanted behaviors as
well as other new behaviors.
o Because of this, behavioral therapy tends to be highly focused.
o The behavior itself is the problem, and the goal is to teach
clients new behaviors to minimize or eliminate the issue. Old
learning led to the development of a problem, and so the
idea is that new learning can fix it.
Therapeutic Goals
The general goal of behavior therapy is to increase personal
choice and to create new conditions for learning.

The client, with the help of the therapist, defines specific goals
at the outset of the therapeutic process. Although,
assessment and treatment occur together, a formal
assessment takes place prior to treatment to determine
behaviors that are target for change.

The therapist assists clients in formulating specific,
measurable goals.
Clients Experience in Therapy
A large part of the therapists role is to teach concrete skills
through the provision of instructions, modeling, and
performance feedback.

The client engages in behavioral rehearsal with feedback until
skills are well-learned and generally receives active homework
assignments to complete between therapy sessions.
Relationship between Therapist & Client
The practice of Behavior therapy is based on a collaborative
partnership between therapist and client.

Factors such as warmth, empathy, authenticity and
acceptance are necessary but not sufficient for behavior
change to occur.

Behavior therapists assume that clients make progress
primarily because of the specific behavioral techniques used
rather than because of the relationship betweent herapist &
client
Self-Monitoring: Behavior Therapy
o Self-Monitoring This is the first stage of treatment. The
person is asked to keep a detailed log of all of their activities
during the day. By examining the list at the next session, the
therapist can see exactly what the person is doing.

o Example Bill, who is being seen for depression, returns with
his self-monitoring list for the past week. His therapist notices
that it consists of Bill going to work in the morning, returning
home at 5:30 p.m. and watching television uninterrupted until
11 p.m. and then going to bed.

Schedule of Weekly Activities: Behavior Therapy
o Schedule of Weekly Activities This is where the patient and
therapist work together to develop new activities that will
provide the patient with chances for positive experience.

o Example Looking at his self-monitoring sheet, Bill and his
therapist determine that watching so much television alone
gives little opportunity for positive social interaction.
Therefore, they decide that Bill will have dinner out with a
friend once a week after work and join a bowling league.

Role-Playing: Behavior Therapy
o Role Playing This is used to help the person develop new
skills and anticipate issues that may come up in social
interactions.

o Example One of the reasons that Bill stays home alone so
much is that he is shy around people. He does not know how
to start a conversation with strangers. Bill and his therapist
work on this by practicing with each other on how to start a
conversation

Behavior Modification: Behavior Therapy
o Behavior Modification In this technique the patient will
receive a reward for engaging in positive behavior.

o Example Bill wants a new fishing rod. He and his therapist
set up a behavior modification contract where he will reward
himself with a new fishing rod when he reduces his TV
watching to one hour a day and becomes involved in three
new activities

Progressive Muscle Relaxation (PMR): Relaxation Training
o Edmund Jacobson Wrote about relaxation training as a
treatment procedure.
o PMR is initially based on the assumption that muscular
tension is an underlying cause of a variety of mental and
emotional problems.
o Jacobson claimed that nervous disturbance is at the same
time mental disturbance.
o Neurosis is a form of tension disorder.
o PMR is viewed as either counterconditioning or extinction
procedure. By pairing the muscle-tension conditioned
stimulus with pleasurable relaxation, muscle tension as a
stimulus or trigger for anxiety is replaced or extinguished.
Progressive Muscle Relaxation (PMR): Relaxation Training
o PMR remains a common relaxation training approach,
although there are still other techniques which are popular,
such as:
o Breathing retraining
o Meditation
o Imagery
o hypnosis
o Beginning therapists should know how, when, and for how
long relaxation procedures should be used because of well-
documented research finding that ironically, relaxation can
trigger anxiety. (page 240)
Systematic Desensitization
o technique used to treat phobias and other extreme or erroneous
fears based on principles of behavior modification.
o In this procedure, events which cause anxiety are recalled in
imagination, and then a relaxation technique is used to dissipate the
anxiety.
o With sufficient repetition through practice, the imagined event loses
its anxiety-provoking power.
o At the end of training, when you actually face the real event, you will
find that it too, just like the imagined event, has lost its power to
make you anxious.
o Because of the potential for extreme panic reactions to occur,
which can increase the phobia, this technique should only be
conducted by a well-qualified, trained professional.
o Also, the relaxation response should be thoroughly learned before
confronting the anxiety-provoking hierarchy.


Reference: Encyclopedia of Mental Disorders: http://www.minddisorders.com/Py-Z/Systematic-desensitization.html
http://www.guidetopsychology.com/sysden.htm

Systematic desensitization
o Systematic desensitization is a therapeutic intervention that reduces
the learned link between anxiety and objects or situations that are
typically fear-producing.
o The aim of systematic desensitization is to reduce or eliminate fears or
phobias that sufferers find are distressing or that impair their ability to
manage daily life.
o By substituting a new response to a feared situation a trained
contradictory response of relaxation which is irreconcilable with an
anxious response phobic reactions are diminished or eradicated.

o This behavior modification technique, which is founded on the
principles of classical conditioning, was developed by Joseph Wolpe in
the 1950s. Some of the most common fears treated with desensitization
include fear of public speaking, fear of flying, stage fright, elevator
phobias, driving phobias and animal phobias.
o Relaxation responses are trained to occur through progressive relaxation
training , a technique initially perfected by Edmund Jacobson during the
1930s.


Relaxation Training: Systematic desensitization
o First, a clinician or behavioral therapist would train the client
with the fear of flying in relaxation techniques.
o This is very similar to meditation and there are scripts with
exact wording that can be followed.
o The therapist could begin by asking the client to close his eyes,
sit in a comfortable position, and relax all muscles while
paying close attention to breathing slowly and naturally.
o The therapist will read through the script and encourage the
client to relax each muscle in his body from his head to his
toes.
o The goal is to get the client into a completely relaxed physical
state.


Hierarchy of Fears: Systematic desensitization
o In 1958 John Wolpe developed a method of a creating a hierarchical
list of anxiety evoking stimuli in order of intensity which allows
patients to undergo adaption.
o The next step in the systematic desensitization process involves
constructing what is called a hierarchy of fears.
o A hierarchy is just a list of the things that the person identifies as fearful
related to flying in order from the least to the most anxiety-provoking.
o The list could look something like this.
1. Looking at a toy plane (least)
2. Hearing or watching a plane fly in the sky
3. Going to an airport
4. Walking onto a plane
5. Taking off and flying in the air (most)

Hierarchy of Fears: Systematic desensitization
o Once the hierarchy has been developed and the client has learned all of
the relaxation techniques, the clinician would help him associate the
two.
o He might ask the client to get into a relaxed state and then imagine the
first level of the hierarchy - the toy plane.
o Once the person is able to imagine that first level and stay relaxed, he
would move onto the next level, and so on.
o The ultimate goal would be to reach the highest level while remaining
relaxed so that flying in a plane would be possible.

Systematic Desensitization (page 241 243)
Based on classical condition developed by Joseph Wolpe.
Clients imagine successively more anxiety-arousing situations at the same time that
they engage in a behavior that competes with anxiety. Gradually, or systematically,
clients become less sensitive (desensitized) to the anxiety-arousing situation.
This procedure can be considered a form of exposure therapy because clients are
required to expose themselves to anxiety-arousing images as a way to reduce anxiety.
It is a time-consuming procedure and an effective/efficient treatment of anxiety-
related disorders.

The therapist conducts an initial interview to identify specific information about the
anxiety and to gather relevant background information about the client. This gives the
therapist a good understand of the client and the circumstances that elicit the
conditioned fears. The client is asked to begin a self-monitoring process consisting of
observing and recording situations during the week that elicit the anxiety responses.
Systematic Desensitization to continue
(page 241 243)
Steps in the use of Systematic Desensitization:
1. Relaxation Training;
2. Development of the Anxiety Hierarchy; and
3. Systematic Desensitization Proper.
The therapist uses a very quiet, soft, and pleasant voice to teach progressive muscular relaxation.
The client is asked to create imagery of previously relaxing situations, such as sitting by a lake. It
is important that the client reach a state of calm and peacefulness.
The therapist works with the client to develop an anxiety hierarchy, from worst situations to least
anxiety-provoking situation
The desensitization process begins, after several sessions when the client learned the relaxation
technique and has the anxiety hierarchy. With eyes closed, a neutral scene is presented, and the
client is asked to imagine it. If the client remains relaxed, he/she is asked to imagine the least
anxiety-arousing scene. The therapist moves progressively until the client signals that he/she is
experiencing anxiety, and the scene is terminated. Relaxation is induced again, and the scene is
re-introduced until little anxiety is experienced to it. Treatment ends when client is able to
remain in a relaxed state while imagining the scene that was formerly the most disturbing and
anxiety-producing.
Systematic Desensitization to continue
(page 241 243)
The core of systematic desensitization is repeated exposure in imagination to anxiety-
evoking situations without experiencing any negative consequences.
Homework and follow-up are essential components of successful desensitization.
(Asking the client to practice relaxation outside the session for about 30 minutes
everyday).
Gradually, clients also expose themselves to daily life situations a further way to
manage their anxieties
This is an appropriate therapy for treating phobias, but it is a misconception that it can
be applied only to treatment of anxiety. It has also been effective in dealing with
nightmares, anorexia nervosa, obsessions, compulsions, stuttering, body image
disturbances, and depression.
A safeguard is that clients are in control of the process by going their own pace and
terminating exposure when they begin to experience more anxiety than they want to
tolerate.
Exposure Therapies (pages 243- 244)
Exposure therapies are designed to treat fears and other negative emotional
responses by introducing clients, under controlled conditions, to the situations that
contributed to such problems.
1. Vivo Desensitization: involves client exposure to the actual feared situations in real
life rather than simply imagining situations. Clients engage in brief and graduated
series of exposures to feared events. Clients can terminate exposure if they
experience a high level of anxiety. The same as in systematic desensitization, clients
learned competing responses involving muscular relaxation. In some cases, the
therapist may accompany clients as they encounter feared situations.
2. Flooding: refers to either in vivo or imaginal exposure to anxiety-evoking stimuli for a
prolonged period of time. Clients experiences anxiety during the exposure but the
feared consequences do not occur. Remaining exposed to feared stimuli for a
prolonged period without engaging in any anxiety-reducing behaviors allows the
anxiety to decrease on its own.
In Vivo Desensitization
o A variation of systematic desensitization in which the anxiety-
arousing situations to which the person is exposed are real,
rather than imagined.
o In Vivo Desensitization, the patient is gradually exposed to
the actual feared stimulus over a period of sessions based on
a hierarchical list of Anxiety evoking stimuli.
o The treatment is based on the theory that the fear response
has been conditioned and that avoidance of the fear maintains
the fear. The idea is that through exposure to the stimulus,
this harmful conditioning can be unlearned.

In Vivo Desensitization
o An example of a desensitization hierarchy might look like this.
1. Get in the car and spend some time alone sitting in the drivers
seat.
2. Turn on the car and spend some time alone with the car idling.
3. Turn the car around or maybe park the car in a different spot
alone.
4. Drive the car to the end of the street and return alone.
5. Drive the car around the block then return alone.
6. Drive the car to the store and return alone.
7. Drive to the next therapy session alone, and so on.

o The idea is that the patient exposes himself to the Anxiety, then uses
relaxing techniques, and cognitive training to recover from the
attempted step.
o Building upon each success it is possible to unlearn the Anxiety and
replace it with positive conditioning.
Flooding
o Flooding is a form of behavior therapy and based on the
principles of respondent conditioning.
o It is sometimes referred to as exposure therapy or prolonged
exposure therapy.
o As a psychotherapeutic technique, it is used to treat phobia
and anxiety disorders including post-traumatic stress
disorder.
o In PTSD, it works by exposing the patient to their painful
memories, with the goal of reintegrating their repressed
emotions with their current awareness.
o Flooding was invented by psychologist Thomas Stampfl in
1967. It still is used in behavior therapy today.
Flooding
o Flooding revolves around the technique of systematic
desensitization.
o In flooding, patients are intentionally exposed to situations that
cause their greatest anxiety in order to help them learn to
overcome it.
o This process involves exposing people to fear-invoking objects or
situations intensely and rapidly.
o It is often used to treat phobias, anxiety, and other stress-related
disorders.
o During the process, the individual is prevented from escaping or
avoiding the situation.
o For example, flooding might be used to help a client who is suffering
from an intense fear of dogs. At first, the client might be exposed to
a small friendly dog for an extended period of time during which he
or she cannot leave. After repeated exposures to the dog during
which nothing bad happens, the fear response begins to fade.
Flooding VS. Systematic Desensitization
o Flooding is a psychotherapeutic method for overcoming
phobias. This is a faster (yet less efficient and more traumatic)
method of ridding fears when compared with systematic
desensitization.
o The experience can often be traumatic for a person, but may
be necessary if the phobia is causing them significant life
disturbances.
o The advantage to flooding is that it is quick and usually
effective.
o There is, however, a possibility that a fear may spontaneously
recur.
o This can be made less likely with systematic desensitization,
another form of a classical condition procedure for the
elimination of phobias.
Aversion Therapy
o Aversion therapy uses the behavioral approach principles that
new behavior can be 'learnt' in order to overcome addictions,
obsessions or, as demonstrated in Kubrick film A Clockwork
Orange, violent behavior.

o Patients undergoing aversion therapy are made to think of the
undesirable experience that they enjoy, for example, a violent
person might be shown images of violent crime, or an
alcoholic might be made to drink, while drugs or electric
shocks are administered.
o In theory, the patient will, over time, come to associate their
addiction with the negativity of electric shocks or seizures.

Aversion Therapy
o Aversion therapy uses behavioral strategies to help clients
overcome unwanted behaviors by associating a stimulus with
uncomfortable sensations.
o For example, a person who is trying to stop smoking might be
exposed to a foul smell or bad taste whenever they smoke a
cigarette.
o After repeated pairings, the unpleasant feelings associated
with the bad smell or taste might eventually become
associated with the smoking behavior.
o By accomplishing this, clients and therapists hope that the
unwanted behavior will begin to decrease or even disappear
completely.
Aversion Therapy
o This process involves pairing an undesirable behavior with an
aversive stimulus in the hope that the unwanted behavior will
eventually be reduced.
o For example, someone suffering from alcoholism might utilize
a drug known as disulfiram, which causes severe symptoms
such as headaches, nausea, anxiety, and vomiting when
combined with alcohol.
o Because the person becomes extremely ill when they drink,
the drinking behavior may be eliminated.
Uses of Aversion Therapy
1. Habits
2. Smoking
3. Alcoholism
4. Gambling
5. Violence
6. Homosexuality (historically)

Aversion Therapy
o Aversion therapy's long-term success in treating patients is
questionable;
o Patients may appear to be treated by therapy, but once out of
the view of doctors, where the deterrent drugs or electric
shocks are removed, they may feel able to return to their
addictions or undesirable behavior.
o Aversion therapy has endured much criticism in previous
decades in its use in abusing patients.
o At a time when homosexuality was considered by some to be
a mental illness, gay people were made to undergo aversion
therapy for their lifestyles. A number of fatalities have also
occurred during aversion therapy.
EMDR: Eye Movement Desensitization and Reprocessing
o EMDRs originator, Dr. Francine Shapiro, describes the procedure in
detail in a recent book, and advises that therapists use EMDR only
after completing an authorized advanced training in EMDR.
o EMDR is widely used by psychotherapists with adult trauma
survivors, including war veterans, abuse and rape survivors, and
accident and disaster survivors. EMDR also is used with traumatized
children and with adults suffering from severe anxiety or depression.

o Briefly, in EMDR a qualified therapist guides the client in vividly but
safely recalling distressing past experiences (desensitization) and
gaining new understanding (reprocessing) of the events, the
bodily and emotional feelings, and the thoughts and self-images
associated with them.
o The eye movement aspect of EMDR involves the client moving his
or her eyes in a back-and-forth (saccadic) manner while recalling
the event(s).

EMDR: Eye Movement Desensitization and Reprocessing
o Eye movement desensitization and reprocessing (EMDR) is a
fairly new, nontraditional type of psychotherapy.
o It's growing in popularity, particularly for treating post-
traumatic stress disorder (PTSD). PTSD often occurs after
experiences such as military combat, physical assault, rape, or
car accidents.
o Although research continues, EMDR remains controversial
among some health care professionals.
o At first glance, EMDR appears to approach psychological issues
in an unusual way. It does not rely on talk therapy or
medications. Instead, EMDR uses a patient's own rapid,
rhythmic eye movements. These eye movements dampen the
power of emotionally charged memories of past traumatic
events

EMDR: Eye Movement Desensitization and Reprocessing
o If you suffer from PTSD, what can you expect during an EMDR
treatment session -- which can last up to 90 minutes?
o Your therapist will move his or her fingers back and forth in front
of your face and ask you to follow these hand motions with your
eyes. At the same time, the EMDR therapist will have you recall a
disturbing event. This will include the emotions and body
sensations that go along with it.
o Gradually, the therapist will guide you to shift your thoughts to
more pleasant ones. Some therapists use alternatives to finger
movements, such as hand or toe tapping or musical tones.
o People who use the technique argue that EMDR can weaken the
effect of negative emotions. Before and after each EMDR
treatment, your therapist will ask you to rate your level of distress.
The hope is that your disturbing memories will become less
disabling.

EMDR: Eye Movement Desensitization and Reprocessing
o Although most research into EMDR has examined its use in
people with PTSD, EMDR is also used to treat many other
psychological problems. They include:

1. Panic attacks
2. Eating disorders
3. Addictions
4. Anxiety, such as discomfort with public speaking or dental
procedures

EMDR: Eye Movement Desensitization and Reprocessing
o More than 20,000 practitioners have been trained to use EMDR
since psychologist Francine Shapiro developed the technique in
1989.
o While walking through the woods one day, Shapiro happened to
notice that her own negative emotions lessened as her eyes darted
from side to side. Then, she found the same positive effect in
patients.

o EMDR appears to be a safe therapy, with no negative side effects.
Still, despite its increasing use, mental health practitioners debate
EMDR's effectiveness.
o Critics note that most EMDR studies have involved only small
numbers of participants. Other researchers, though, have shown the
treatment's effectiveness in published reports that consolidated
data from several studies.

Assertiveness training
o Assertiveness training is a form of behavior therapy designed
to help people stand up for themselvesto empower
themselves, in more contemporary terms.
o Assertiveness is a response that seeks to maintain an
appropriate balance between passivity and aggression.
o Assertive responses promote fairness and equality in human
interactions, based on a positive sense of respect for self and
others.
o Assertiveness training has a decades-long history in mental
health and personal growth groups, going back to the
women's movement of the 1970s. The approach was
introduced to encourage women to stand up for themselves
appropriately in their interactions with others.

Assertiveness training
o The purpose of assertiveness training is to teach persons
appropriate strategies for identifying and acting on their
desires, needs, and opinions while remaining respectful of
others.
o This form of training is tailored to the needs of specific
participants and the situations they find particularly
challenging.
o Assertiveness training is a broad approach that can be applied
to many different personal, academic, health care, and work
situations.
o Specific areas of intervention and change in assertiveness
training include conflict resolution, realistic goal-setting, and
stress management.

Assertiveness training
o In addition to emotional and psychological benefits, taking a
more active approach to self-determination has been shown
to have positive outcomes in many personal choices related to
health, including being assertive in risky sexual situations;
abstaining from using drugs or alcohol; and assuming
responsibility for self-care if one has a chronic illness like
diabetes or cancer.
Assertiveness training
o Assertiveness training typically begins with an information-
gathering exercise in which participants are asked to think
about and list the areas in their life in which they have
difficulty asserting themselves.
o Very often they will notice specific situations or patterns of
behavior that they want to focus on during the course.
o The next stage in assertive training is usually role-plays
designed to help participants practice clearer and more direct
forms of communicating with others.
o The role-plays allow for practice and repetition of the new
techniques, helping each person learn assertive responses by
acting on them.
Assertiveness training
o Feedback is provided to improve the response, and the role-
play is repeated.
o Eventually, each person is asked to practice assertive
techniques in everyday life, outside the training setting.
o Role-plays usually incorporate specific problems for individual
participants, such as difficulty speaking up to an overbearing
boss; setting limits to intrusive friends; or stating a clear
preference about dinner to one's spouse.
o Role-plays often include examples of aggressive and passive
responses, in addition to the assertive responses, to help
participants distinguish between these extremes as they learn
a new set of behaviors.

Assertiveness training
o Assertiveness training promotes the use of "I" statements as a way
to help individuals express their feelings and reactions to others.
o A commonly used model of an "I" statement is:
o "when you _________, I feel ___________", to help the participant
describe what they see the other person as doing, and how they
feel about that action.
o "I" statements are often contrasted with "you" statements, which
are usually not received well by others.
o For example, "When you are two hours late getting home from
work, I feel both anxious and angry," is a less accusing
communication than "You are a selfish and inconsiderate jerk for
not telling me you would be two hours late.
o Prompts are often used to help participants learn new
communication styles.
o This approach helps participants learn new ways of expressing
themselves as well as how it feels to be assertive.

Reference
Textbook:
Sommers-Flanagan, John & Sommers-Flanagan, Rita (2012). Counseling and Psychotherapy Theories in
Context and Practice: Skills, Strategies, and Techniques, Second Edition. USA: John Wiley
& Sons.

Source Book:
Corey, Gerald (2005). Theory and Practice of Counseling & psychotherapy, 7
th
edition. USA:
Brooks/Cole.

Other References:
Feist, J. & Feist, G. J. (2007). Theories of Personality. USA: McGraw Hill.

http://www.newworldencyclopedia.org/entry/Alfred_Adler



Have a safe trip home!
See you next meeting!
Adieu.



-Gloria de la Merced-Josol