Theory and Practice of Counseling and Psychotherapy by Gerald Corey

Author:Gerald Corey [Corey, Gerald]
Language: eng
Format: epub
Publisher: Cengage Textbook
Published: 2012-01-01T08:00:00+00:00

Behavior Therapy Applied to the Case of Stan

In Stan’s case many specific and

the purposes of his behavior. I then educate Stan

interrelated problems can be identi-

about how the therapy sessions (and his work

fied through an assessment process.

outside of the sessions) can help him reach his

Behaviorally, he is defensive, avoids eye contact,

goals. Early during treatment I help Stan trans-

speaks hesitantly, uses alcohol excessively, has a

late some of his general goals into concrete and

poor sleep pattern, and displays various avoid-

measurable ones. When Stan says, “I want to

ance behaviors in social and interpersonal situ-

feel better about myself,” I help him define more

ations. In the emotional area, Stan has a number

specific goals. When he says, “I want to get rid

of specific problems, some of which include

of my inferiority complex,” I reply: “What exactly

anxiety, panic attacks, depression, fear of criti-

do you mean by this?” “What are some situa-

cism and rejection, feeling worthless and stupid,

tions in which you feel inferior?” “What do you

and feeling isolated and alienated. He experi-

actually do that leads to feelings of inferiority?”

ences a range of physiological complaints such

Stan’s concrete aims include his desire to func-

as dizziness, heart palpitations, and headaches.

tion without drugs or alcohol. I suggest that he

Cognitively, he worries about death and dying,

keep a record of when he drinks and what events

has many self-defeating thoughts and beliefs, is

lead to drinking. My hope is that Stan will estab-

governed by categorical imperatives (“shoulds,”

lish goals that are based on positive markers, not

“oughts,” “musts”), engages in fatalistic thinking,

negative goals. Instead of focusing on what Stan

and compares himself negatively with others. In

would like to get rid of, I am more interested in

the interpersonal area, Stan is unassertive, has an

what he would like to acquire and develop.

unsatisfactory relationship with his parents, has

Stan indicates that he does not want to

few friends, is afraid of contact with women and

feel apologetic for his existence. I introduce

fears intimacy, and feels socially inferior.

behavioral skills training because he has trouble

After completing this assessment, I focus on

talking with his boss and coworkers. I demon-

helping Stan define the specific areas where he

strate specific skills that he can use in

would like to make changes. Before developing

approaching them more directly and confidently.

a treatment plan, I assist Stan in understanding

This procedure includes modeling, role playing,

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and behavior rehearsal. He then tries more

Stan’s presenting symptoms decrease, and he

effective behaviors with me as I play the role of

reports a greater degree of satisfaction.

the boss. I give him feedback on how strong or

apologetic he seemed.

Follow-Up: You Continue as Stan’s

Imaginal exposure and systematic desensi-

Behavior Therapist

tization are appropriate in working with Stan’s

Use these questions to help you think about how

fear of failing. Before using these

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