Assignment Code: MCFT-003 / TMA-3 / ASST-3 / 2022-23

Course Code: MCFT-003

Assignment Name: Counselling and Family Therapy: Basic Concepts and Theoretical Perspectives

Year: 2022 - 2023

Verification Status: Verified by Professor

Note: - (i) Answer all the questions in both sections.

(ii) Answers to questions of Section “A” should not exceed 300 words each.

Section A - Descriptive Questions (10x6=60 marks)

Q 1. Explain, with examples, the key principles for counselling.

Ans) Counselling helps clients with mental, emotional, and behavioural issues. Counselling fundamentals include:

Counselling is a collaborative process between the counsellor and the client or counselee. The client and counsellor must play complementary roles for the process to work. Counsellors and clients have different goals. The counsellor guides the person and builds a relationship.

To show they are listening, the counsellor repeats the client's words and nonverbal cues.

For example, the counsellor might say, "What I'm hearing you say is that you're feeling overwhelmed by your responsibilities."

The counsellor tries to understand and share the client's experiences.

For example, the counsellor might say, "I can imagine that must have been very difficult for you."

Counselling helps clients solve identified issues. The counsellor teaches the client how to solve the problem. Counselling helps clients apply their knowledge in new ways. The client may learn new skills or change unhelpful beliefs or behaviours.

The counsellor accepts the client without judgment, offering respect, understanding and compassion.

For example, the counsellor might say, "I respect your right to your own thoughts and feelings, no matter what they are."

Clients dominate counselling. Consider the client's wishes. The counsellor should never force, order, patronise, or act on behalf of the client and use only culturally sensitive interventions. She or he is like an expert guide. He or she determines if the client's destination is feasible. She or he helps the client find other routes, assess their difficulty, and decide on one. They help the client overcome issues.

The counsellor respects the client's privacy and protects their information.

For example, the counsellor might say, "What we discuss in here stays between us, unless there is a risk of harm to yourself or others."

The counsellor is genuine and authentic in their interactions with the client.

For example, the counsellor might share their own thoughts or feelings in a relevant context to build rapport with the client.

Q 2. Identify any of your beliefs that have been bothering you, and analyse it in terms of A, B,C,D,E, and F.

Ans) A (activating event) B (belief) - C (emotional and behavioural consequence)

D (disputing intervention) - E (effect) - F (new feeling)

A. Belief:

There is something wrong with me.

List of Problems: I am defective. I am no good. I am totally flawed. I am worthless. I am a bad person who cannot be fixed. I am a total failure, everything I do is wrong.

B. Absolute beliefs:

Common absolute beliefs include:

1. People may think they are weak or cannot handle life.

2. Mental health issues may be attributed to poor choices like drug use or unhealthy living.

3. They may feel helpless.

C. Emotional and Behavioural Consequence:

Common reactions and consequences:

1. Sadness, anxiety, hopelessness, and anger affect daily life and relationships.

2. Drugs and alcohol may help people cope, but they can become addicts.

3. Emotional stress can cause headaches, fatigue, and digestive issues.

4. People may withdraw from friends, family, and social activities, which can increase loneliness and emotional pain.

5. Daily tasks, work, school, and other responsibilities may be difficult.

D. Disputing Intervention:

Scientific method in counselling:

1. First, identify the client's untruths, such as "I'm a failure because I have a mental health problem."

2. Next, the client and therapist can find evidence against the irrational belief.

3. The therapist and client can then examine the evidence to find any gaps in the client's beliefs. This can show the client that their belief may be wrong.

4. After disproving the irrational belief, the client and therapist can brainstorm a solution.

5. Finally, test the new, more logical belief in the real world. The client can test the new belief to see if it improves their mood.

E. Effect:

Some of the most common effects: 

1. "Something is wrong with me" can make someone sad, anxious, hopeless, or angry, which can affect their daily life and relationships.

2. Daily tasks, work, school, and other responsibilities may be difficult.

3. Emotional stress can cause headaches, fatigue, and digestive issues.

4. Drugs and alcohol may help people cope, but they can become addicts.

5. People may withdraw from friends, family, and social activities, which can increase loneliness and emotional pain.

6. In extreme cases, people may consider suicide to end their suffering.

F. New Feeling:

A few feelings that can be helpful:

1. Kindness and understanding can eliminate self-criticism and negative self-talk.

2. Believing that things can improve and that you can solve your problems can boost your resilience and motivation.

3. Gratitude can distract you from negative thoughts.

4. Self-confidence can combat low self-esteem, which can lead to the belief that "something is wrong."

5. Accepting someone's emotions can help.

Q 3. What are the three counsellor attributes, according to Rogers, which create a growth promotion climate. Discuss, giving examples.

Ans) According to Carl Rogers, the founder of person-centered therapy, there are three core counsellor attributes that create a growth-promoting climate for clients: congruence, empathy, and unconditional positive regard.

Congruence: Congruence refers to the therapist's authenticity and genuineness. A congruent therapist is open, honest, and transparent in their interactions with clients, and they avoid presenting a false or idealized self. When a therapist is congruent, they create a safe and supportive environment that allows clients to be themselves and explore their thoughts and feelings without fear of judgment.

Example: A congruent therapist might share personal experiences or struggles that are relevant to the client's situation, helping to build rapport and trust.

Empathy: Empathy refers to the therapist's ability to understand and share the client's feelings and experiences. An empathetic therapist actively listens and tries to see the world from the client's perspective, which can help the client feel heard and validated.

Example: An empathetic therapist might reflect back what they are hearing from the client, helping the client feel understood and validated.

Unconditional Positive Regard: Unconditional positive regard refers to the therapist's accepting and non-judgmental attitude towards the client. A therapist with unconditional positive regard accepts the client for who they are, regardless of their thoughts, feelings, or behaviours. This creates a safe and supportive environment in which the client can feel free to express themselves without fear of criticism or rejection.

Example: An unconditional positive regard therapist might offer praise and encouragement, even in the face of the client's struggles, helping to build confidence and resilience.

Together, these three counsellor attributes can create a growth-promoting climate that supports clients in exploring and resolving their challenges and developing a greater sense of self-awareness and self-acceptance.

Q 4. Analyse any two restructuring techniques.

Ans) Cognitive behavioural therapy (CBT) uses a number of different "restructuring techniques" to help clients find and question negative thought patterns and beliefs. Reframing and disputing are two of the most common ways to change something.

1. Disputing: When someone disputes you, they are calling into question the validity of your negative beliefs and thoughts by investigating the evidence and asking questions. The purpose of disputing is to assist clients in recognising irrational beliefs and replacing them with beliefs that are better balanced and more accurate.

Example: A client who believes "I'm a failure" might use disputing to question this belief by examining past successes, exploring different perspectives, and looking for evidence that contradicts this belief.

2. Reframing: The act of reinterpreting a situation or experience in a more positive or constructive light is what is meant by the term "reframing." Reframing can help clients experience less anxiety, depression, and stress by allowing them to view events and experiences from a different perspective.

Example: A client who is feeling overwhelmed with work might use reframing to see their workload as an opportunity to grow and develop new skills, rather than as a source of stress and anxiety.

It is possible for disputing and reframing to be effective methods for assisting clients in overcoming negative thought patterns and improving both their mental health and overall well-being. However, it is essential to keep in mind that mastering these strategies may require a considerable amount of time and effort on the part of the individual, as well as the assistance of a qualified counsellor or therapist. In addition, it is essential to identify the strategy that is most successful for each specific client. This is because different individuals and circumstances may call for a greater or lesser degree of success from a variety of different methods.

Q 5. Describe the assumptions of strategic family therapy.

Ans) A form of talk therapy known as strategic family therapy focuses on resolving issues within the context of the interpersonal dynamics that exist within the family. It is predicated on a few key assumptions, which are as follows:

1. From each individual's point of view, a family can be considered functional if it meets certain criteria.

2. The importance of the social setting is emphasised, and at least two or three people are involved in the problems.

3. Parents always have more say in their children's lives than their children do, according to the functional power structure of their families.

4. The treatment focuses on the patient's symptoms. Symptoms are strategies that one person employs in order to cope with another.

5. The issues that have been brought up serve some purpose within the family.

6. The therapist takes on the role of being responsible for deciding how the therapy will be organised. It is not through gaining insight that change takes place; rather, it is through the family carrying out the directives of the therapist.

7. The focus is on the process rather than the content.

8. Many people believe that understanding family dysfunction requires having a firm grasp on the family life cycle. Families tend to become mired in one particular stage.

9. Families are systems that are governed by rules.

10. The here and now, rather than events of the past and their significance, are the focal points of attention. Expressions of emotion are discouraged in this environment. In most instances, a model of brief therapy is utilised.

In general, the assumptions of strategic family therapy highlight the significance of understanding and addressing issues within the context of family relationships, as well as the role that action and concrete solutions play in the process of bringing about change.

Q 6. How will you practise supportive counselling with a young adult suffering from mild depression?

Ans) By using the tool of education, I would provide the patient knowledge on how to cope and deal with both problems and long-term stress reactions. Also instil positive strategies, such as cultivating a support system of family and friends, relaxation exercises, or physical exercise would be given him to overcome his stress or mild depression. Besides, negative strategies, such as substance abuse, excessive sleep, or excessive activity, will have shown him so that choices may be made to avoid them.

As a counsellor, I will help the person learn about her or his depression, the illness's symptoms, course, and prognosis will be discussed with the patient. Once the patient is made to understand  and warning symptoms specific for a particular illness in his particular case, the patient can take steps to prevent psychological breakdown. Another tool I will use as a counsellor is to encourage patient to establish a healthy routine.

Then as a supportive counsellor I would help the patient overcome his sense of estrangement and isolation from the world through some type of social integration like may be a reconnection with family members. Above all I will give the patient materials and ideas that will help him construct a new sense of meaning in the world.

Some steps that I would follow as a supportive counsellor are:

1. Provide a non-judgmental space for the young adult to express himself.

2. Listen attentively and validate his feelings.

3. Help the patient express his feelings.

4. Help the young adult discover depression-management strategies.

5. Inform patient about depression, its causes, and treatments.

6. Help the patient set goals and create a self-care plan.

7. Help the young adult assess their social support and relationships.

8. Refer the young adult to other mental health professionals or community resources if needed.

9. Monitor and adjust the young adult's treatment plan as needed.

Section B - Short Answer Type Questions (40 marks)

1. Write short notes (in about 150 words each) on the following: (5x8=40 marks)

i) Resistance in family therapy

Ans) Resistance can be understood in the same way as any other pattern of how a family interacts. The word "resistance" refers to the unhealthy ways that families interact with each other that keep them from getting help. From the point of view of family systems, resistance is nothing more than a sign that the family isn't able to adapt to the current situation and work together to get help.

If the counsellor wants the whole family to go to counselling or psychotherapy, he or she will have to realise that the client is the most powerful person in the family. Once the counsellor or therapist knows why the family isn't in treatment, they can use the idea of "tracking" to find a way to talk to this powerful person directly and negotiate a treatment plan that person will agree to.

Thus, the key to eliminating the resistance to family therapy lies within the family's patterns of interaction; overcome the resistance in the interactional patterns and the family will come to counselling or family therapy.

ii) Denial and intrusiveness

Ans) Denial and Intrusiveness are two psychological responses that can occur after a person experiences a traumatic or stressful event.

1. Denial: Denial is a defence mechanism that allows a person to avoid or minimize the emotional impact of a traumatic event. This may involve denying that the event occurred, minimizing its impact, or avoiding thoughts and feelings related to the event.

2. Intrusiveness: Intrusiveness refers to the repetitive and unwanted re-experiencing of traumatic memories and emotions. This can include intrusive thoughts, memories, or flashbacks that are distressing and difficult to control.

Both denial and intrusiveness can have negative impacts on a person's mental health and well-being and can lead to the development of conditions such as Post-Traumatic Stress Disorder (PTSD). Treatment for trauma-related symptoms may include therapy, medication, and support from loved ones. It is important to seek help from a mental health professional if you are experiencing symptoms of trauma or stress.

iii) Assumptions of Psychodynamic Psychotherapy

Ans) Certain underlying assumptions and ways of helping people are what set psychodynamic approaches apart. These are what make psychodynamic approaches different from other kinds of therapy.

Psychodynamic approaches are based on certain assumptions as follows:

1) what people say and do has meaning, although it may be outside of conscious awareness;

2) there are patterns to one's behaviour.

3) these repetitive patterns can be discerned from the individual's life narrative, and observed in the therapeutic relationship; and

4) although these behaviours become fixed, they can change with insight and understanding.

Psychodynamic psychotherapy utilises seven types of interventions or techniques as given below:

1) A focus on affect and expression of the patient's emotions;

2) Exploration of the patient's attempts to avoid topics or engage in activities that hinder the progress of therapy.

3) Identification of patterns in the patient's actions, thoughts, feelings, experiences, and relationships.

4) An emphasis on past relationships.

5) A focus on interpersonal experiences.

6) An emphasis on the therapeutic relationship; and

7) An exploration of wishes, fantasies, and dreams.

iv) Strokes

Ans) Strokes are just as essential to human life as things like food, water, and a roof over our heads. A person will perish if these essential requirements aren't satisfied in their life. A person's mental health can be impacted by both positive and negative life experiences. The mind is favourably influenced in a beneficial way by positive experiences. Affection, warmth, appreciation, and acceptance are all positive characteristics that can be expressed through touch. These can be communicated verbally or in other ways, such as by smiling, making eye contact, touching, gesturing, or other similar actions.

A person's mental state is negatively impacted when they are subjected to unfavourable criticism. It is believed that having one of these is preferable to not having a stroke at all. Positive strokes can be given with or without conditions. Unconditional positive stroke makes a person feel important just because they exist. It has nothing to do with how or what they do.

v) PTSD

Ans) PTSD stands for Post-Traumatic Stress Disorder. It is a mental health condition that can occur after a person experiences or witnesses a traumatic event such as a natural disaster, combat, sexual or physical assault, or a serious accident.

The traumatic event is persistently re-experienced in one or more ways:

1. Recurrent and intrusive distressing recollections of the event including images, thoughts and perceptions;

2. Recurrent distressing dreams of the event.

3. Acting or feeling as if the traumatic event were recurring;

4. Intense psychological distress on exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event; and

5. Physiological reactivity on exposure to internal or external cues that symbolise an aspect of the traumatic event.

PTSD can have a significant impact on a person's daily life and can affect their relationships, work, and overall well-being. Treatment for PTSD may include therapy, medication, and support from loved ones. It is important to seek help from a mental health professional if you are experiencing symptoms of PTSD.

vi) Importance of psychoeducation

Ans) Psychoeducation is an important tool that aims to give the patient more power by giving them information that is backed by science. This helps the patient feel better about themselves and the treatment they are getting. So, it makes it easier for them to trust their doctor.

The people who are in need of assistance and their families should, as the most important objective of any and all therapeutic interventions, be given more control over their own lives. Patients need to have a fundamental comprehension of their condition, its history, and the treatments that are currently available in order for them to be able to deal with their illness to the best of their abilities. This will allow them to get the most out of the care that they receive. Without a different understanding of the illness, it is possible that there will not be enough insight, compliance, and improvement in coping to work with professionals in a way that's both effective and sustainable over the long term. assisting them and their families in their time of need.

vii) Types of social skills

Ans) Social skills are the abilities and skills that allow people to communicate, interact, and make friends with other people. Relationship skills are a very important part of having social skills. So, communication is an important part of being able to get along with other people. Communication involves both giving and getting information. Some of the parts of expressive communication are what you say, how you say it, and how fast you say it. It's also important to know when you have to talk and when you don't have to talk when you're expressing yourself.

Here are some common types of social skills:

1. Communication skills: The ability to effectively communicate thoughts, feelings, and ideas through verbal and nonverbal means.

2. Active listening skills: The ability to fully engage with the speaker, understand their message, and provide an appropriate response.

3. Empathy skills: The ability to understand and share the emotions of others.

4. Interpersonal skills: The ability to build and maintain positive relationships with others.

5. Adaptability skills: The ability to adjust to new and changing social situations and effectively navigate them.

viii) Common features of crisis

Ans) Crisis is when a person sees an event or situation as unbearable and hard, and their resources and ways of dealing with it are not enough. A crisis is a turning point or a situation that poses an immediate threat to a person or a group and needs to be dealt with right away to stop it from getting worse.

Here is a list of things that usually happen when a person is in a crisis:

1. A triggering event perceived as threatening,

2. Unexpected events,

3. Person experiences discomfort causing fear, tension, confusion,

4. Loss of daily routine,

5. Failure of usual coping methods to reduce impact of stress,

6. Uncertain future,

7. Continuation of distress (about 2 to 6 weeks), and

8. State of disequilibrium followed by rapid transition to an active state of crisis..