Ellen Perrault, PhD

•Cognitive Behavioral Theory

•Psychodynamic Theory
•Solution-Focused
•Crisis Intervention
•Family Therapy
1. Multidimensional
2. Different practice frameworks
3. Selection based on clients’
problems, goals, situation
4. Transferable
Schatz, Jenkins, & Sheafor (1990). p. 223.
Practice Theory- Offers both an explanation of
certain behaviors or situations and broad
guidelines about how these can be changed.

Click here for a list of practice theories for social work

at an individual psychotherapy l level
(Optional)
Cognitive therapy for depression;

Behavioral interventions for enuresis, headache, obsessive-compulsive

disorder, female orgasmic dysfunction, male erectile dysfunction,
marital distress, child and adolescent behavior problems, and
developmental disabilities;

Cognitive-behavioral therapy for panic disorder with or without

agoraphobia, generalized anxiety disorder, PTSD, social phobia,
irritable bowel syndrome, chronic pain, and bulimia

Crits-Christoph, 1998
Cognitive Behavioral Theory
= CBT
The following website has many handouts for information on CBT for
anxiety disorders:
https://www.anxietybc.com/resources/video/introduction-creating-
map-my-anxiety-plan
CBT has not been proven
helpful in all cases
Positive “Green” Unhelpful “Red”
thoughts thoughts
All or nothing Magnifying
thinking the negative

Predicting
failure
Labelling •Mind reading
•Fortune teller
All or nothing Magnifying
thinking the negative

Predicting
failure
Labelling • Mind reading
• Fortune teller
All or nothing Magnifying
thinking the negative

Predicting
failure
Labelling • Mind reading
• Fortune teller
“I’m so hopeless…I’ll never be good at
anything.”

This statement is which of the following cognitive

distortions?

a) All or nothing thinking

b) Magnifying the negative
c) Predicting failure
d) Labeling
“I’m so hopeless…I’ll never be good at
anything.”
Help them to examine their evidence
“Are you proud of your daughter…or your work?”
“Do you have any friends?”
“Have you failed at everything?”
 “I’m so hopeless…I’ll never be good at
anything.”
Negative Thoughts Coping Counters

1. 1.

2. 2.

Explore past successes

3. 3.

4. 4.

5. 5.

Taking action: A Workbook for Overcoming Depression./ Treating Depressed Children:

Therapist Manual for Taking Action. (1996) Stark K & Kendall P
“I’m so hopeless…I’ll never be good at
anything.”
Provide Positive Suggestions:
 I’m human
 I’m good at some things and not at others
 No one is good at everything
 I’ve been good at things in the past
 I’m not hopeless and here is the evidence
 Trigger

Ongoing Anxiety Physical Signs of Anxiety

(tense muscles/ breathing changes)

Anxious Behavior (avoidance, freeze, flight) Anxious Thoughts

Anxious Feeling (fear)

 Trigger

Decreased Anxiety Physical Signs of Anxiety

Strategies To Cope With Anxiety Eliminate Anxiety Thoughts

Anxious Feeling
 TRIGGER

Makes other person mad

Physical Signs of Anger

Angry Behaviour
Negative Thoughts

Feeling Angry
 TRIGGER

Other Person cooperates Physical Signs

Do 5-steps to Problem Solving: Positive Thoughts

Calm voice (“Stay Calm”, “Control your anger”,
or “you can work this out” )

Behaviour (Use deep breathing; Feeling

counting; squeezing lemons) Frustrated,
Mild Anger
 I often worry that I _________.
(fill in the blank)
 If this worry of mine was indeed true,
what does it mean to me and why does it
bother me so much?
 If what I just wrote was indeed true,
what does it mean to me and why does it
bother me so much?
 If what I just wrote was indeed true,
what does it mean to me and why does it
bother me so much?
 If what I just wrote was indeed true,
what does it mean to me and why does it
bother me so much?
 What's the worst thing that could
possibly happen? What do I fear most of
all?
 When I think of the worst thing that
could happen, do I really think that it's
likely to happen? If so, how could I learn
to cope with it?
 What do I (perhaps "secretly") get out of
thinking like this? How does it work to
my advantage?
 Persuade a Friend
Carry on a dialogue - in writing - with a friend.
Pretend that your friend has some of the same
worrisome beliefs that you do. Look back over the
things you wrote for questions 1-3. Pick out one of
those statements and write it down, as if your friend
just said it. Now skip a line, and write a response to
your friend's statement. In that response, be a
compassionate, rational, and realistic thinker. After
you write your response, skip a line and have your
friend reply. Maybe your friend is a bit stuck in
his/her thinking. Then skip a line, and respond
again to your friend. Keep this conversation going
for 10 lines or so.
Positive imagery antidotes

 confidence & strength

 safety and peacefulness

 love/caring
 I accept myself even though I __________
(do not use the word "am")

 write this sentence 10 times!

Psychodynamic
Theory
It sounds like you have had another bad week.
Coming to these sessions seems not to help. I
don’t seem to be able to do anything to help
you even though I can see how bad things are. I
was wondering if this disappointment was like
the disappointment you might have felt as a
child, when your parents were drinking and
ignoring you.
Optional for SOWK 201:
Click here for more info on
the Psychodynamic
Diagnostic Manual
 consciousness
 desire
 transference
Denial: You completely reject the thought or feeling.
 "I'm not angry with him!"

Suppression: You are vaguely aware of the thought or

feeling, but try to hide it.
 "I'm going to try to be nice to him."

Reaction Formation: You turn the feeling into its opposite.

 "I think he's really great!"
Projection: You think someone else has your thought or
feeling or assign an attribute to them that they do not
have.
 "That boss hates me."
"That colleague hates the boss."
Displacement: You redirect your feelings to another
target.
 "I hate that secretary."
Rationalization: You come up with various explanations
to justify the situation (while denying your feelings).
 "He's so critical because he's trying to help us do our
best."
Intellectualization: A type of rationalization, only more
intellectualized.
 "This situation reminds me of how Nietzsche said that anger
is ontological despair."
Undoing: You try to reverse or undo your feeling by DOING
something that indicates the opposite feeling. It may be an
"apology" for the feeling you find unacceptable within
yourself.
 "I think I'll give that boss a present."
Isolation of affect: You "think" the feeling but don't really feel it.
 "I guess I'm angry with him, sort of."
Regression: You revert to an old, usually
immature behavior to ventilate your
feeling.
 "Let's goof off and shoot spitballs at
people!"
Sublimation: You redirect the feeling into
a socially productive activity.
 "I'm going to write a poem about
anger."
Click here for Hanna Levenson
performing psychodynamic
therapy with a male client - 6
minute clip
Solution-
Focused
 What I don’t want What I do want

When things go wrong When things go right

Beyond my control Within my control

I’m stuck I’m getting somewhere

More troubles to come Positive possibilities

Lance Taylor
 Desired outcome

 Strengths

 Successes

 Exceptions

 Changes between sessions

 Achievement of change
 What do you want?
 When does that already happen a
little?
 What do you hope will be different?
 What’s the next step?
 Assumptions Tools

Change is inevitable Scaling

You have resources to Miracle Question

change

You are doing better Exceptions

than they are saying
• What do you want?
• When does that already happen a
little?
• What do you hope will be different?
• What’s the next step?
Click here to view a clip of
Solution-focused therapy session
- 5 minutes
Crisis Intervention
 What has happened?
 What are their perceptions,
feeling & thoughts about the
event?
 Who can support the client?
 Have they successfully handled
this before?
 Suicide & homicide assessment
Intentional self-harm includes intentional self-
inflicted injuries where an intent to die may not
be present.
• Quick, easy to use assessment forms:
http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-
measures#Personality
1) Rapid response by worker
2) Time limited
3) Specific focus on crisis (precipitating event and
its meaning to client)
4) Help client make decisions and take action
5) Contact with the client’s social network
Sheafor & Horejsi (2008)
 Death of loved one

 Divorce

 Loss

 Traumatic event

 Others
CLIENT

TIME
 Symptoms within 1 month of traumatic event
 Anxiety, numbing, reduced awareness of
surroundings, life is unreal, detached feeling,
difficulty concentrating, inability to remember
important details of the trauma
 Acute Distress Disorder symptoms plus:
 3 or more months after the event
 Flashbacks, recurring frightening dreams about the
event, extreme distress reactions when reminded of
the event
 Emotional support
 Communicate belief in client’s ability to cope
(hope)
 Ask questions to facilitate thinking
 Options
 Plan actions & anticipate consequences of
future actions with client
 May need to move from feelings to thinking
 Boil down problem
 Focus on present
 Explore options and alternatives
 Explore Social supports
 Review resources, internal and external
 Make a clear plan
 Ask client to summarize the plan
 Evaluation, termination, and affirmation
 State follow-up plan
McColdrick, M., & Gerson, R. (1985). Genograms in
family assessment. New York: Norton.
Minuchin, S., & Fishman, H. (1981). Techniques of
family therapy. Cambridge, MA: Harvard
University Press.
Sherman, R., & Fredman, N. (1986). Handbook of
structural techniques in marriage and family
therapy. New York: Brunner/Mazel.
Stuart, R. (1989). Helping couples change. New York:
Guildford Press.
Distress Centre,
Calgary 1990
 members are deceitful and destructive to one
another
A client comes in with the goal of dealing with
their private individual issue.
Using a Social
Work lens
(meta-
perspective):
 critical

 society based

 context-aware

 constructionist
Lambert, M. J., & Cattani-Thompson, K. (1996).
Current findings regarding the effectiveness of
counseling: Implications for practice. Journal of
Counseling and Development, 74, 601-608.
Greenberg & Mitchell (1983). Object relations in
psychoanalytic theory.
de Shazer, S. (1988). Clues: Investigating solutions in
brief therapy. W.W. Norton.
Sheafor & Horejsi (2008). Techniques and guidelines
for social work practice.
Crits-Christoph, P. (1998). Training in empirically validated
treatments: The Division 12 APA Task Force recommendations. In
K. S. Dobson & K. D. Craig (Eds.), Empirically supported therapies:
Best practice in professional psychology (pp. 3-25). Thousand Oaks,
CA: Sage.
Freeman, A. M., & Dattilio, F. M. (Ed.). (1992). Comprehensive casebook
of cognitive therapy. New York, NY: Plenum.
Salkovskis, P. M. (1996). Frontiers in cognitive therapy. New York, NY:
Guilford.
Burns, D. (1989). The feeling good handbook: Using the new mood therapy
in everyday life. New York, NY: William Morrow.
Greenberger, D., & Padesky, C. A. (1995). Mind over mood: A cognitive
therapy treatment manual for clients. New York, NY: Guilford.
Locke, Myers, et al (Eds.). The handbook of
counseling.Thousand Oaks, CA: Sage.
Dorfman, R. Paradigms of clinical social work.
Seligman, & Reichenberg (2009). Theories of counseling
and psychotherapy: systems, strategies, and skills.
Gurman, & Messer. Essential psychotherapies: theory
and practice.
O’Hare, T. Evidence-based practices for social workers.
Capuzzi, & Gross. Counseling and psychotherapy:
theories and interventions.