LPC Model Answer: Therapy Constructivist Perspective

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[. . .] The original construct has deepened to the extent that she sees everything from the prism of her abandonment issues, and the expectation that they will continue. It is no wonder that she has these thoughts because of the reinforcement she has received throughout her life.

Constructs are, as mentioned previously, developed throughout the lifespan, and they can either turn toward a true reality or they can turn away from reality depending on what experiences the individual has. Because it is easy for a construct to become faulty, many people require some means of rearranging what they believe to come closer to reality. Sometimes this can be accomplished simply through maturity. The person has enough experiences that they come to understand where they were at fault in their thinking. Education is also a method that can be used as a means of gaining enough knowledge to overcome experiential deficits. However, sometimes that individual needs some unbiased coaching to help them determine a truer reality.

In the past when someone needed a counseling adjustment, it was possible for a therapist to delve deeply into the person's psyche and help them deal with a large scope of issues. This type of therapy was possible because either health insurance or the person could and would pay for it. Of course, there was always the possibility that the therapist would abuse the fact that a client could pay, but, usually, ethical considerations kept them from it. However, healthcare companies eventually started to decrease the amount of sessions that they were willing to pay for, and this created a need for new paradigms.

Therapists started looking at constructivist thinking closer because they realized that here was a new method of counseling that could work with the new time constraints that they were under. Since the constructs that people have are often very narrow, it is possible for the therapist to work with the individual to broaden those perspectives. Another reason for the switch to this new paradigm is that social constructivist thinking "may allow the profession a broad and encompassing framework for providing an array of services otherwise defined within the paradigms aligned with other professions. For example, social constructivism allows for the application of systemic-relational techniques or individual psychotherapy, depending on the consensus that emerges around a problem -- is it a relationship problem? Or is it primarily a concern best addressed individually? Because choice of approach is based on the "communities of understanding" around a problem, there is unlimited flexibility for the practitioner" (Levenson, Speed & Budman, 1995).

This is because these other professions have been studying the social constructivist approach for a long while, and what they have researched will have value for the counseling profession. No profession "operates in a vacuum" so it is important to understand where new theories can be effective for clients.

Since these facts were realized by psychotherapy researchers, they began to study the effects of this approach to counseling and found that it could be efficacious, especially when it came to new directives to decrease the number of sessions required for a client. The reason for this is that constructivism allows for brief therapy in a more complete way than other types of therapy than had been used in the past. Of course, the historical view of counseling is that it happens in a manner that fits with the development of the client through the problem. However, time constraints made this thinking untenable. An individual can talk about their problems forever and never actually make any progress, but this new type of therapy allowed counselors to set a timeline. Solutions are the mantra of brief therapy instead of a long-term therapeutic relationship. Also, studies revealed that these techniques were effective.

In an initial session the counselor may conduct themselves in much the same way as they always did. The client will give pertinent information about themselves, and help the therapist understand what the individual believes the problem is. The counselor will construct theories just like before, but will be quicker to act on them. Previous to brief therapy, the therapist may spend weeks or months allowing the consumer to talk about all of the issues that are likely present, while the counselor formulates a solid theory about what the real issue is. The therapist may require some conjoint sessions with other people involved, or they may do other research that takes time. Brief therapy does not allow the therapist the time to do all of this work. In the first counseling session the groundwork is laid, and the counselor asks open-ended questions that lead quickly to the heart of the issue.

After the initial session the therapist likely has just six to nine more sessions to assist the consumer in every way possible. This is where the social constructivist mindset lends itself to brief therapy. It will be apparent from the first interview what constructs are most troublesome for the client, and where the counselor can go as a result. The purpose of the counselor is to broaden the reality of the client. The reason that the person is having an issue is because they have a narrow perspective, and they need to understand that reality includes more than they may have thought of before. This type of therapy will work for a variety of ills.

Brief therapy, and especially solution-focused brief therapy, has been very successful with chemical dependency. The reason for this is that there is most likely an underlying cause to the reliance on a substance, and if the client can be helped to realize the broader perspective, then they can be relieved of that dependence. Solution-focused therapy establishes a goal for the sessions from the very beginning, and constantly works toward that goal. For example, a person is an alcoholic and is in therapy because of multiple DUIs. The court has ordered that the individual complete a ten therapy sessions. The focus of the therapy sessions is the cessation of alcohol dependence, but it is primarily to define the constructs the problem drinker has and arrest them. It is possible that depression is the main cause, that the alcoholic has abandonment issues, or any of a number of other problems. The therapist listens what the person says to determine how the views of that individual have caused to issue that presents itself. Knowing what the problem is, the therapist then seeks to give solutions that can work for this particular individual. This is an important step. Not every method of rearranging concepts will work for every client. In the remaining sessions the therapist must choose from a variety of solutions to determine which will work best for this particular individual.

This is the reason that constructivism is the bedrock of brief therapies. The counselor does not have the time to work with the client in the traditional manner, so they have to use this method to rapidly treat a construct. This may also mean that the person will require more therapy sessions in the future if other problems exist, but this single construct focus allows the therapist to work on a specific issue with great focus. It also allows the therapist to become a teacher of sorts. The therapist offers solutions instead of allowing the time to help the client reach these same conclusions on their own.

Personal understanding

It seems that the best way that a therapist can reach a client is to help them in any way possible. Because time is a limited quality with new regulations enforced by managed care, it was necessary that therapists find a new way to assist clients in the best way possible. The counselor is still responsible to the client, but the professional is also responsible to the paying entity in a way that they never were before. Of course, no one becomes a therapist to make a lot of money because that very rarely happens in this profession, but there is the need to make money from the profession. Thus, the therapists responsibilities are split between the desire to help individual, which is probably the reason they got into the profession in the first place, and the need to make money with the constraints that are put on the professional by the source of money. In most cases, the therapist will still lean heavily toward helping the client before anything else, and if more sessions are needed, they will probably try to get them. However, money is even tighter now than it was previously. So, it is apparent that the need for effective brief therapies is even more critical.

The duty of the therapist is to the client first; if not for personal reasons, then because a signed code of ethics says so (also because violations of that code can result in loss of license or other punishment). Since the client comes first, the therapist has to know every possible detail about brief therapies. It is… [END OF PREVIEW]

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