INTEGRATIVE

APPROACHES Session 5

TO Pauline Elwell
pauline.elwell@canterbury.ac.uk

COUNSELLING
AND THERAPY
 MODULE AIMS
oTo analyse and develop a practice-based understanding of these theories through
active engagement in skills practice throughout the module.
oTo engage critically with the approaches and to explore their suitability for
different populations of clients in different contexts.
oTo explore a range of challenging issues raised in counselling, including loss,
separation, bereavement, addiction, self-harm.
oTo apply and evaluate the application of advanced counselling and interpersonal
skills, including challenge, immediacy and use of silence. Critically
oTo evaluate the impact of the social and cultural context in which counselling takes
place and develop appropriate understanding of diversity and multicultural
approaches within the helping professions.
 MODULE
OUTCOMES
o Clearly explain an integrative approach to counselling in practice.
oAnalyse and critically evaluate Transactional Analysis to understand
communication and relationships within the helping encounter.
oAnalyse the integration and application of Transactional Analysis
(TA), Cognitive Behavioural Therapy (CBT) or Solution Focused
(Brief) Therapy (SFT or SFBT) in helping relationships, using an
integrative model.
oIdentify and apply counselling skills and approaches for working
with a range of challenging issues with due reflection upon the issues
of diversity and power within the helping interaction, recognising
developmental and learning needs.
CONTRACT
oRespect each other’s rights to their opinions/views oMobiles – on desks if necessary for dependents an/or

oAdopt a non-judgemental approach (if possible?) only use for session activities

oPunctuality – plan to arrive / start on time.

oShare if/when you feel safe to do so
oListening – giving space/not interrupting
oPositive/supportive learning environment
oTaking responsibility for the contract
oEngage fully in learning activities
oBehave assertively/positively
oConfidentiality (within the boundaries discussed at
oRespond respectfully
time of contract ) anonymity
oHow can we challenge when we feel that the
oEmbracing diversity
contract has not been adhered to?
 Congruence

CORE
CONDITIO Acceptance – Unconditional
Positive Regard
NS
Empathy
 THEORETICAL
APPROACHES
The majority of the mainstream approaches and theoretical models,
can be considered under one of four primary ‘umbrella’ headings:

o Psychodynamic Approaches
o Humanistic Approaches
o Cognitive-Behavioural Approaches
o Integrative or Pluralistic Approaches.
 INTEGRATIVE
APPROACH -
DEFINITIONS
Cognitive Person-
‘Integration covers a wide range of
perspectives, making it impossible to present a
Behavioural centred
unified set of theoretical assumptions in a way Therapy Therapy
that may be possible for purist approaches’

(Dryden and Reeves (2014)

‘the counsellor brings together elements from

different theories and models into a new theory Solution
Transactiona
or model’ (McLeod (1998) Focussed
l Analysis
Therapy
‘What is integrated is any knowledge that
helps me understand the client, her process,
myself and the therapy’ (Worsley, 2011)
ASSIGNMENT WRITING
WORKSHOP
Refining our writing:
How do we define the client’s presenting issue?
oResearching the presenting issue.

Integrative approaches
oHow does this fit within humanist/person centered?

Transactional Analysis
oHow am can this help when working with my client?
TRANSACTIONAL Further thinking
ANALYSIS
TRANSACTIONAL ANALYSIS
‘The study of the psychiatric aspects of specific transactions or sets of transactions
which take place between two or more particular individuals at any given time of
place’ (Bern, 1961: 12)

TA provides a shared language for exploring the interactions between the client and
other, an insight into the internal world through the external.

Aim is to support the client to gain a deeper understanding and awareness of their
own needs and ways of being, to resolve inner conflict and move towards self
actualisation and autonomy.
 HOW DOES TRANSACTIONAL ANALYSIS
‘HELP’ IN THE HELPING ENCOUNTER ?
Identification of the ego state from which a client is transacting can be made reliably through questioning
and observation
Counsellors are able to judge on an on-going basis whether clients are re-playing their childhood (Child),
accessing communication learned from parent or parental figures (Parent) or responding directly in the here
and now (Adult)
Identifying ego state functioning and patterns of relating gives valuable clues into how the client
experiences, self other and the world.
Counsellors who understand and can identify their own ego states, are able to monitor their responses to
clients - do not get drawn into games or ‘rubber banded’ back to historic interactions that are not responses
to the ‘here and now’.
Counsellors with this knowledge can help themselves and their clients to choose which response they want
to make (they are therefore in control of their communication).
The aim of TA is strengthen the Adult Ego State and Clients capacity to act accordingly in the ‘here and
now’.
 TA LIFE
POSITIONS
Children develop their life positions largely from
messages they receive around them.
Berne (1971) identified Life Positions, which
represent the fundamental value or belief that a
person places on himself and others.

1. I am Ok, You are OK

2. I am Not Ok, You are OK
3. I am OK, you are NOT Ok
4. I am not OK, You’re not ok

This then begins to inform our LIFE SCRIPT

-Justifies and informs decisions and behaviours
 SCRIPTS
A Life Plan -
formed in Childhood and is ‘justified’
by subsequent events – reality becomes viewed
and experienced through the lens of the script –
CIRCULAR

Scripts are shaped by Verbal and non verbal

‘messages’:
Modelling: Visible ways adults and peers behave.
Attributions: Being told 'you're just like...'
Suggestions: Hints and encouragement such as
'Always do your best'.
Injunctions and Permissions/ counter-injunctions:
Demands to not do or do things. ‘ Girls should be
gentle’ , ‘boys don’t cry’
HOW CAN WE USE SCRIPTS
TO HELP CLIENTS?
oUnderstand why individuals behaviour in certain ways
oMay help to explore moments of stress or reasons behind a
‘rubber band’ effect (going from one extreme to the other),
leading back to the earlier experience.
oAnalyse circular patterns of behaviour or thoughts. These
then serve to reinforce the original SCRIPT –Script Theory.
oHelps to explain the ‘pay off’ feeling - Every time a script is
confirmed there is some satisfaction ‘I was right I am
useless’.
oShift happens when the ADULT ego state is developed and
has enough resources to be able to meet this need, let go of
the old patterns without replaying the script.
STROKES
A Stroke according to Berne (1971) is a unit of recognition

Any transaction is an exchange of strokes

Fundamental unit of human interaction and action –

vital life force from infancy, throughout life

Strokes fulfil our psychological hungers for:

Stimulus: The need for physical and mental stimulus

Recognition – the need for acknowledgment from others

Structure – the need for structure in life

WHY MIGHT A CLIENT BE IN THIS
EGO STATE?
In your same groups, think about what factors might
contribute to a client’s ego state.
Social cues – how we relate to others, how
peers/friends behave in certain situations.
Historical context – Account of childhood, recollection
of ‘parent figures’, connections individuals makes
between past and how they are behaving now ‘it
reminds of…’ ‘my father used to …and now I….’
Cultural cues – values and beliefs about how
someone should behave, ‘you’re the man of the
house’
Remember, one cue is not sufficient to draw a
conclusion…………………………………………………………
REVISING TA

oWhat is TA?
oHow can it assist us in our practice as counsellors?
oHow can it assist greater insight for our clients?
oHow can knowledge of our own ego state inform
our work with clients?
 oUse of Paraphrasing
HOW DO oClients Language
WE oBuilding an alternative SF Picture/ vision

ENSURE oEvaluation and steps to success ‘how will we know if it is

working/ moving towards goal’
SFT IS
PERSON-
CENTRED
?
HOW DO WE
ENSURE CBT IS
PERSON-
CENTRED?
HOW DO WE ENSURE TA IS
PERSON-CENTRED?
o Questioning and reflecting back used to identify states.
o Counsellors are able to judge on an on-going basis whether clients are re-playing
their childhood (Child), accessing communication learned from parent or parental
figures (Parent) or responding directly in the here and now (Adult)
o Counsellors who understand and can identify their own ego states, are able to
monitor their responses to clients
o Counsellors with this knowledge can help themselves and their clients to choose
which response they want to make – client centered.
ASSIGNMENT

1. Case study- 2000 words (50%) Due: 13 th March 2pm

Analyse and critically evaluate a case study in relation to theory.

2. Reflective essay 2000 words (50%) Due: 17th April

Focussing on a particular area explaining and evaluating the most
appropriate approaches.
ASSIGNMENT 1

1. Case study- 2000 words (50%) Due: 13 th March 2pm

Analyse and critically evaluate a case study in relation to theory.
oBackground information
oPresenting issue
oProposed theoretical approach
oTechnique selected
oDiscussion
oConclusion
STUDENT SURVEYS
https://www.canterbury.ac.uk/our-students/ug-current/student-voice/uk-engagement-
survey
STUDENT REPS MEETING
Specifically:
1.Attendance: what are the barriers students are facing?

2.Module evaluations: this is an area where we are only finding between 1 and 5 students

per module completing these. We want to increase this as this is a key way we want to

work to improve the course. What are the barriers to completing the evaluations and

what can the course team do to support students with this.

More generally
3.What is going well?
4.What needs to be improved?
5.What do you want more of and what less of?