Term Paper: Multi-Modal Treatment of the Client's Mental Problems

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¶ … multi-modal treatment of the client's mental problems. If the root of the problem is found in early childhood, and has expressed itself then or later, in an adult, then the author may treat the condition with the techniques of Egan, Hutchens or other cognitive-behavioral theories, chosing elements from them to bring the client back to a healthy state of mind. An analysis of Egan's theory, Hutchens' theory, and a brief overview of most of today's cognitive-behavioral theories are reviewed in this paper. The author displays his own preferences for how he will approach the client-therapist relationship.

Personal Theory of Psychotherapy

Multimodal Therapy involves technical eclecticism, or the belief that treatment should consist of techniques from many schools of psychotherapy, without the psychotherapist necessarily having to declare his or her adherence solely to the theories of any one of those techniques. Multimodal therapists utilize flexibility of technique selection. They are, however, expected to be familiar with, be current on and consult current research. They must favor research-backed techniques over techniques without research backing. The multimodal therapist also tailors treatment to the needs of the individual being treated (Wikipedia 2006). In this regard, the favored client-therapist mode of relationship would have to be as a mentor and caring guide, as those who adhere to the cognitive-behavior therapy believe it should be.

Multimodal Therapy is an approach to psychotherapy founded by Arnold Lazarus. Based on the idea that human beings are also biological beings that can think, feel, act, sense, imagine, and interact; and that each of these can be addressed in psychotherapy. Multimodal assessment and treatment is built around the BASIC ID framework. ("BASIC ID" is an acronym, which stands for "Behavior, Affect, Sensation, Imagery, Cognition, Interpersonal, and Drugs/biology") (Wikipedia 2006). This is the overall approach that incorporates people-centered therapy, Gestalt, Cognitive-Behavioral and Reality therapies, among others.

Each psychotherapist's approach to counseling is an eclectic mix of several different styles. However, the Egan model of counseling utilizes several different schools of thought and appears to be a model for the contemporary counselor. Arnold Lazarus' theory of counseling also holds valuable tools from several different sources and used as a source, as well. As one who may also approach a patient who expects it to be a part of the therapy, the Christian counseling approach may be used for a client who seeks a "Christian" counselor. The therapist then can integrate his or her knowledge of psychology and theology to best treat the client. Some clients may feel comfortable just knowing their counselor is a Christian, feeling their advice can be trusted. Some clients wish to use the Bible as a reference for therapy. For some, prayer may enter into the process as well (Christian Counselors 1).

Some patients find it easier to deal with mental health issues as part of a larger spiritual problem, believing it is more acceptable to have spiritual problems than to be labeled as a "mental health" patient. Faith based therapy requires slightly more emotional input from counselors than some other modes of therapy and points of theology may interfere with planning strategies, when faiths or texts disagree. Still, if the client can relate on a faith level and find inspiration in the examples in the scriptures, then this kind of therapy may find more acceptance and therefore effect a faster positive result than other modes of therapy, when dealing with this state of mind.

The patient approaches therapy with what is considered an "unhealthy" mental or emotional state of mind. Freud believed that all neuroses were rooted in childhood sexual abuse (seduction), that a child moves from Eros through Thanatos, from one stage to the next, developing the super-ego, as he or she grew. Others, including, his own daughter, Anna Freud, and her contemporary, Melanie Klein, disputed the belief that there were stages that one passed through and to which one could not return (Freud, 1905). By doing research in play therapy, they noted there were positions into which children moved, then returned. Children went back and forth from one "position" to another, "progressing," but returning to earlier stages as well. Klein believed that children who were ill were (and remained) in the "depressive" position. These depressed children either withdrew, or expressed anxieties and aggressive fantasies that later were acted out on other, weaker or submissive members of the society they found around them when the super-ego did not restrain them. (Freud 1966) as they remained in the depressive position, great feelings of guilt over their attitudes towards their mothers or fathers are suppressed and remain with them throughout their adult life, surfacing only at times. In Sigmund Freud's analysis, most humans have this guilt and shame, but if abused or if there is a traumatic event as a child, the reaction to the event becomes a neurosis in the adult.

A counselor's first communication with the patient involves some kind of preliminary searching and analysis in the first stage of therapy. The counselor may need to determine how the patient communicates, and how the client approaches life. If the client exhibits psychotic reactions, then a different analysis and way of dealing with the past may be in order. If the patient has difficulties with anxieties and in functioning socially, the counselor may approach the patient on a whole different level, as a behavioral-cognitive therapist with reality, Gestalt and Egan's Problem Management Opportunity Development approaches. Mentoring to help the patient develop a positive frame of mind through exercises and "homework" is a part of the therapist's repertoire.

Egan's model problem management approaches involve communication skills. These skills may incorporate basic and advanced empathy, probing and challenging skills, as well as client-centered treatment planning. The Egan model can be used in many different situations, some of which have nothing to do with mentoring at all. The Egan model is generally the most effective when the client is addressed with respect, empathy and, of course, active listening.

Hutchens believes that not only is therapy a corrective emotional experience, but that it is an educational experience for both the client and therapist, and that once the counselor is able to identify what will be the best approach to the patient, he or she will be able to use every skill at his or her command to help the client meet therapy goals.

In person-centered therapy, the individual is seen as a self-determining agent responsible for the authenticity of his or her choices. The therapeutic goals are knowledge of oneself and movement toward self-directedness and balance with the support of one's therapist, who has developed a close, personal relationship with the client. This ties in with Hutchens' thinking that the experience is education, but not with Ellis' belief that the therapist must correct the client's false impressions of the way the world works. While the client determines the general direction that therapy will take, the therapist adds insight and clarification through questions put to the client that will bring him or her to awareness of self. (Rogers, 1951)

Rogers focuses on the human potential, defining human nature as inherently good and seeking one's fullest potential in life. However, unconditional regard for the client has the therapist going through the therapy with the client, rather than as a guide. The client can express him or herself without worrying about what the therapist thinks of him or her or whether they did right or wrong, as the therapist does not seek to change the client's way of thinking, even if negative expressions are made.

Gestalt therapy takes into account the whole person, including thoughts, feelings, behavior, body sensations, and dreams. The focus is on integration, how the many parts of the person fit together, and how the client interacts with the environment. (VanBuren, 2003, 1) the techniques used in Gestalt therapy vary as widely as there are therapists and clients, from principles based on Holism, Field theory, figure formation, organismic, the concept of the Now and "unfinished business." The therapist dialogues with warmth and caring, yet remains "invisible," in the role of onlooker, as the client is encouraged to interact with the environment, which is very similar to the way the therapist acts in person-centered therapy.

Results of contemporary research are important in determining if a therapy would be successful with a particular client and therapists are encouraged to only use those methods which have been tested. However, Postmodern Therapy does not utilize the results of tests, but is based on individuals simply discovering meaning for themselves in sessions with their therapists through unorthodox and sometimes untested methods. Postmodernists believe that research statistics are worthless when it comes to the practical side, that of personal interaction with one's own relevance to human experience (Simon, 1994, p. 203).

Multimodal therapy involves a complete assessment of the individual and treatments designed specifically for that individual. Arnold Lazarus developed this approach, in part, by questioning clients about the factors that had helped them in their therapy. Lazarus describes human functioning in terms of seven… [END OF PREVIEW]

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