Krumboltz Expert 3.indd

Transcription

Instructor’s Manual
for
COGNITIVE-BEHAVIORAL
THERAPY
WITH
JOHN KRUMBOLTZ, PHD
from the series
PSYCHOTHERAPY WITH THE EXPERTS
with hosts
Jon Carlson, PsyD, EdD & Diane Kjos, PhD
by
Randall C. Wyatt, PhD
&
Eileen Flanagan, MA
COGNITIVE-BEHAVIORAL THERAPY WITH JOHN KRUMBOLTZ, PHD
The Instructor’s Manual accompanies the DVD Cognitive-Behavioral
Therapy with John Krumboltz, PhD (Institutional/Instructor’s
Version). Video available at www.psychotherapy.net.
Copyright © 2009, Psychotherapy.net, LLC. All rights reserved.
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Teaching and Training: Instructors, training directors and facilitators
using the Instructor’s Manual for the DVD Cognitive-Behavioral
Therapy with John Krumboltz, PhD may reproduce parts of this
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The DVD Cognitive-Behavioral Therapy with John Krumboltz, PhD
(Institutional/Instructor’s Version) is licensed for group training and
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courses or other means is prohibited without the prior written
permission of the publisher.
Wyatt, Randall C., PhD, & Flanagan, Eileen, MA
Instructor’s Manual for Cognitive-Behavioral Therapy with
John Krumboltz, PhD
Cover design by Sabine Grand
Order Information and Continuing Education Credits:
For information on ordering and obtaining continuing education
credits for this and other psychotherapy training videos, please visit us
at www.psychotherapy.net or call 800-577-4762.
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Instructor’s Manual for
COGNITIVE-BEHAVIORAL THERAPY
WITH JOHN KRUMBOLTZ, PHD
Table of Contents
Tips for Making the Best Use of the DVD
4
Krumboltz’s Approach to Cognitive-Behavioral Therapy
8
Krumboltz’s Reflections on the Session
9
Reaction Paper for Classes and Training
11
Suggestions for Further Readings, Websites and Videos
12
Discussion Questions
14
Complete Transcript
16
Krumboltz’s Approach
16
Psychotherapy Session
26
Group Discussion
49
Video Credits
69
Earn Continuing Education Credits for Watching Videos
70
About the Contributors
71
More Psychotherapy.net Videos
73
3
Tips for Making the Best Use of the DVD
1. USE THE TRANSCRIPTS
Make notes in the video Transcript for future reference; the next time
you show the video you will have them available. Highlight or notate
key moments in the video to better facilitate discussion during the
video and post-viewing.
2. DISCUSSION QUESTIONS
Pause the video at different points to elicit viewers’ observations
and reactions to the concepts presented. The Discussion Questions
provide ideas about key points that can stimulate rich discussions and
learning.
3. LET IT FLOW
Allow the session to play out some so viewers can appreciate the work
over time instead of stopping the video too often. It is best to watch
the video in its entirety since issues untouched in earlier parts often
play out later. Encourage viewers to voice their opinions; no therapy
is perfect! What do viewers think works and does not work in the
session? We learn as much from our mistakes as our successes and it is
crucial for students and therapists to develop the ability to effectively
critique this work as well as their own.
4. REFLECT ON KRUMBOLTZ’S REFLECTIONS
After showing the video, hand out copies of Krumboltz’s Reflections
on the Session, giving participants an opportunity to read
Krumboltz’s own summary of his intentions for the session and his
reflections on how it went.
5. SUGGEST READINGS TO ENRICH VIDEO MATERIAL
Assign readings from Suggestions for Further Readings and Websites
prior to viewing. You can also time the video to coincide with other
course or training materials on related topics.
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6. ASSIGN A REACTION PAPER
See suggestions in Reaction Paper section.
7. ROLE-PLAY IDEAS
After watching the video, organize participants into pairs. Assign
each pair to role-play a therapy session using Krumboltz’s CognitiveBehavioral Therapy approach. The clients may resemble the client in
the video, or you can create different scenarios, and you may have
players switch roles if time permits. As a basic instruction, suggest
to the therapists that they begin by establishing ground rules for the
session with the client. After clarifying the client’s concern, therapists
may want to problem-solve with the client to identify constructive
actions the client can take. Encourage therapists to focus on instilling
hope in the possibility of learning and change. See Krumboltz’s
Approach to Cognitive-Behavioral Therapy in this manual for a
brief review of how he works. After the role-plays, have the groups
come together to discuss the exercise. First have the clients share
their experiences and then have the therapists talk about what the
session was like for them. What did participants find exciting and/or
challenging about this way of working? Finally, open up a general
discussion on what participants learned about Cognitive-Behavioral
Therapy.
An alternative is to do this role-play in front of the whole group with
one therapist and one client; the entire group can observe, acting as
the advising team to the therapist. Before the end of the session, have
the therapist take a break, get feedback from the observation team,
and bring it back into the session with the client. Other observers
might jump in if the therapist gets stuck. Follow up with a discussion
that explores what participants found exciting and/or challenging
about this way of working.
8. WATCH THE SERIES
This video is one in a series portraying leading theories of
psychotherapy and their application. Each video in the series presents
a master therapist working with a real client who has real problems.
By showing several of the videos in this Experts series (See the More
5
Videos section for a complete list of the videos in the series),
you can expose viewers to a variety of styles and approaches,
allowing them an opportunity to see what fits best for them.
More Videos with this Client: In this video, Dr. Krumboltz
works with a client named Robin. Robin is featured as a client in
several other videos in this Experts series:
–Integrative Therapy with Allen E. Ivey, EdD;
–Mind-Body Therapy with Ernest Rossi, PhD;
–Person-Centered Therapy with Natalie Rogers; and
–Solution-Focused Therapy with Insoo Kim Berg, MSSW.
It can be particularly enlightening for viewers to watch some or
all of these five therapists work with the same client to see how
their styles, personalities and theoretical orientations play out
differently. If you have viewers write a Reaction Paper – see the
guidelines in this manual – you can ask them to address what
differences they notice in how Berg, Krumboltz, Rossi, Rogers
and Ivey work with Robin, and how these differences affect the
outcomes of the sessions.
Other videos in the series use different therapeutic models.
We can reflect upon the differences among these models by
exploring the following questions:
• How does the model explain the therapeutic process?
• What assumptions does the model imply
about the purpose of therapy?
• How is theory translated into practice in real-life situations?
• What is the role of the therapist?
• What outcomes are associated with successful therapy?
9. PERSPECTIVE ON VIDEOS AND THE
PERSONALITY OF THE THERAPIST
Psychotherapy portrayed in videos is less off-the-cuff than
therapy in practice. Therapists or clients in videos may be
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nervous, putting their best foot forward, or trying to show mistakes
and how to deal with them. Therapists may also move more quickly
than is typical in everyday practice to demonstrate a technique. The
personal style of a therapist is often as important as their techniques
and theories. Thus, while we can certainly pick up ideas from master
therapists, participants must make the best use of relevant theory,
technique and research that fits their own personal style and the needs
of their clients.
*A NOTE ON PRIVACY AND CONFIDENTIALITY
Because this video contains an actual therapy session, please take
care to protect the privacy and confidentiality of the client who has
courageously shared her personal life with us.
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Krumboltz’s Approach to
Cognitive-Behavioral Therapy
A leader in the practice of cognitive behavioral therapy, John
Krumboltz, PhD describes his work as a learning approach to
counseling. Whether the goal is learning to think, learning to feel, or
learning to act, Krumboltz advocates for an education based model.
In his counseling sessions, Krumboltz considers himself a coach and a
teacher. The therapeutic relationship provides hope, and supports the
client in formulating and accomplishing goals. Cognitive problemsolving techniques are an important aspect of the process. In the
course of the session the client will typically have the opportunity to
practice new attitudes and behavior. The counselor provides positive
reinforcement and helps the client devise tasks that will reinforce new
behavior and transfer these attitudes onto other aspects of experience.
Krumboltz finds this approach useful across cultures, and he applies
it effectively with individuals, groups, families and couples. For
Krumboltz, therapy is successful when clients change in the way they
want to change.
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Krumboltz’s Reflections on the Session
I think that the most important goal of counseling is to help clients
learn how to take the next action step in the real world toward dealing
effectively with their problem. Active listening is certainly important,
but it is not enough.
So in this case with Robin I had seven goals:
1. Let Robin know the local ground rules including the fact that we
were making a movie that could last no more than 40 minutes;
2. Discover Robin’s concern and let her know
that I understood her feelings about it;
3. Offer some hope that constructive action could be devised;
4. Allow her to propose potentially satisfactory solutions;
5. Provide a model of one way in which some action could be taken;
6. Have her actually practice the action in a role play; and
7. Get her to agree to try the proposed action in her real world.
I think the counselor should be of maximum help in the shortest
reasonable amount of time. She wanted to know how much history
of the problem I wanted to hear. I asked her to tell me what was going
on now. Every problem has a long history, but the crucial issue is what
can be done about it NOW.
Robin came to counseling alone. She could have brought her husband,
but she didn’t. She could have brought her mother-in-law, but she
didn’t. If other people had been included, I would have wanted to
solicit their views too, and the counseling might have taken a quite
different direction.
I believe people do what they think is the best thing to do at each
moment given all their circumstances. Even Robin’s mother-in-law
was doing what she thought was best, and I wanted Robin to see that
her mother-in-law’s behavior was understandable even though it was
not acceptable to Robin.
Cultural values are an important part of counseling. Robin wanted to
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operate independently without unwanted intrusions by her motherin-law. As one of the audience members pointed out, this view would
be unacceptable in other cultures where respect for one’s elders is
highly valued. However, Robin was my client. I accepted her values. If
I had not, I probably would not have been able to help her and would
have referred her to a more suitable counselor.
What would I have done differently now that I have had more time to
think about it? Not much, given the short time we had. I thought the
counseling session was reasonably successful. I only wish I had not
used the word “ugly” to describe the mother-in-law’s behavior. That
was too harsh a word. Now I think the word “inappropriate” would
have been better.
If I had been her regular counselor and could have seen her
subsequently, I would have asked her if she would be willing to email
me a brief report about the action she had agreed to take. And I would
have asked her to name the date and time by which I should expect
to receive her email. It is too easy to assume that counseling is over
when the client leaves the office, but the crucial action is still ahead.
Will the clients actually do what they have promised to do? Asking for
email reports increases the probability that they will actually take the
promised action.
What if the client does not fulfill a promise? My rule is never blame
the client. I would engage the client in a discussion about their
thinking. Maybe the task was too difficult. Maybe some other task
would be better. Maybe there are some questions that need to be
considered first. But still the bottom line is this: What can the client
try to do in the real world as a next step toward resolution of the
problem?
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Reaction Paper for Classes and Training
Video: Cognitive-Behavioral Therapy with John Krumboltz, PhD
• Assignment: Complete this reaction paper and
return it by the date noted by the facilitator.
• Suggestions for Viewers: Take notes on these questions
while viewing the video and complete the reaction paper
afterwards, or use the questions as a way to approach
the discussion. Respond to each question below.
• Length and Style: 2-4 pages double-spaced. Be brief and
concise. Do NOT provide a full synopsis of the video. This is
meant to be a brief reaction paper that you write soon after
watching the video—we want your ideas and reactions.
What to Write: Respond to the following questions in your
reaction paper:
1. Key points: What important points did you learn about CognitiveBehavioral Therapy? What stands out in how Krumboltz works?
2. What I found most helpful: What was most beneficial to you as a
therapist about the model presented? What tools or perspectives
did you find helpful and might you use in your own work?
What challenged you to think about something in a new way?
3. What does not make sense: What principles/techniques/
strategies did not make sense to you? Did anything push your
buttons or bring about a sense of resistance in you, or just not
fit with your own style of working? Explore these questions.
4. How I would do it differently: What might you have
done differently than Krumboltz in the therapy session
in the video? Be specific in what different approaches,
strategies and techniques you might have applied.
5. Other Questions/Reactions: What questions or
reactions did you have as you viewed the therapy in the
video? Other comments, thoughts or feelings?
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Suggestions for Further Readings,
Websites and Videos
BOOKS
Ellis, A. (2001). Overcoming destructive beliefs, feelings, and behaviors:
New directions for rational emotive behavior therapy. Amherst,
NY: Prometheus Books.
Krumboltz, J.D. & Levin, A. S. (2004). Luck is no accident: Making the
most of happenstance in your life and career. Atascadero, CA:
Impact Publishers.
Meichenbaum (2002). Cognitive behavior modification: An integrative
approach. New York, NY: Springer.
Reinecke, M.A. & Clark, D.A. (Eds) (2003). Cognitive therapy across
the lifespan: Evidence and practice. Cambridge, UK: Cambridge
University Press.
WEB RESOURCES
John Krumboltz’s web pages at Stanford University
www.stanford.edu/~jdk
www.stanford.edu/group/adolescent.ctr/Research/
krumboltz.html
Psychotherapy.net online interviews with Albert Ellis and Donald
Meichenbaum
www.psychotherapy.net
Association for Behavioral and Cognitive Therapies
www.aabt.org
National Association of Cognitive-Behavioral Therapists
www.nacbt.org
The British Association of Behavioural and Cognitive Psychotherapies
www.ocdaction.org.uk
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RELATED VIDEOS AVAILABLE AT
WWW.PSYCHOTHERAPY.NET
Mixed Anxiety and Depression: A Cognitive-Behavioral Approach
-Donald Meichenbaum, PhD
Cognitive-Behavioral Child Therapy
-Bruce Masek, PhD
Couples Therapy for Addiction: A Cognitive-Behavioral Approach
-Barbara S. McCrady, PhD
Integrative Therapy with Allen E. Ivey, EdD*
Mind-Body Therapy with Ernest Rossi, PhD*
Person-Centered Therapy with Natalie Rogers, PhD*
Solution-Focused Therapy with Insoo Kim Berg, MSSW*
* additional videos that feature the same client and
therapists from different theoretical orientations.
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Discussion Questions
Professors, training directors and facilitators may use a few or all of
these discussion questions keyed to certain elements of the video or
those issues most relevant to the viewers. On-screen minute markers
are noted to highlight related points in the video/transcript.
KRUMBOLTZ’S APPROACH
1. Learning Approach to Counseling: How do you relate to the
idea of the learning approach to counseling? In your clinical work,
do you consider yourself a coach and a teacher? Why or why
not? If not as a coach or teacher, how do you see your role?
THE PSYCHOTHERAPY SESSION
2. Understanding the Client: (2-2:2-9) Early in the session,
what do you notice Krumboltz doing to let Robin know
that he understands her problem? Do you think he is
successful? What do you think Krumboltz accomplishes
with this focus on understanding the problem?
4. Interesting Dilemma: (2-9) What is your response to
Krumboltz telling Robin she has an interesting dilemma?
How do you think his framing her dilemma as “interesting”
affects Robin and the work they do together? How is this
intervention consistent with Krumboltz’s learning approach?
5. Emotional Abuse: (2-28) What do you notice in yourself
when you observe Krumboltz telling Robin that she is
being emotionally abused by her mother-in-law? Do you
agree with Krumboltz’s assessment? Does his approach
seem to further the therapy or slow it down?
6. Role-Play: (2-30) How did Krumboltz’s role-play
interventions affect Robin’s therapy? For example, his choice
to exaggerate Robin’s mother-in-law when it is his turn
to play her part? What guides your use of role-plays?
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7. Interventions: Which of Krumboltz’s interventions in this
session seem most effective to you? What do you think of
the way he encouraged Robin to first reflect on a recent
experience before going into the history of the problem
(2-3)? Or, asking Robin why she thinks her mother-inlaw behaves as she does (2-9)? What about his approach to
problem-solving with Robin (2-20:2-30)? How might you have
intervened differently if you had been the therapist here?
8. Therapeutic Relationship: How would you characterize
the therapeutic relationship in this session? Do you
think Krumboltz developed a working alliance with
Robin? In what ways was the therapeutic relationship
significant in this particular course of therapy?
GROUP DISCUSSION
9. Values (3-37): What do you think of Krumboltz’s assertion that
all therapy is value laden and that the values of the counselor
come into play particularly around the issues of contract? In
thinking of this session, were there any moments where you
became aware of Krumboltz’s values? How do you see your
own values coming into the work you do with clients?
10.Uncomfortable Techniques (3-43): Krumboltz asserts that we have
to serve the public using the best techniques we know, even if they
are uncomfortable to us. How does that idea sit with you? What
do you think of his analogy comparing counseling to treating
a patient with appendicitis? What do you do when you find
yourself trying out clinical techniques that feel uncomfortable
to you? Does this seem like an ethical issue to you?
11.Personal Reaction: How would you feel about being
Krumboltz’s client? Do you believe he could create an alliance
with you and that the therapy would be effective? How so?
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Complete Transcript of
with John Krumboltz, PhD
Note to facilitators: You will find chapter markers on the DVD at fiveminute intervals so that you may easily skip to desired points in the video.
Throughout the transcript below, we indicate on-screen minute markers
that correspond with those that appear at the bottom right corner of the
DVD on screen. In the transcript of the psychotherapy session itself, use the
numbered entries to draw attention to desired points within the dialogue.
KRUMBOLTZ’S APPROACH
1–1
Carlson: I’m just wondering: What’s your sense of what cognitive
behavioral therapy is?
Kjos: I see it as a structured, systematic approach to therapy that’s
based on scientific principles. Basically the therapist applies his or her
scientific knowledge about human behavior to helping the client solve
a problem.
Carlson: Oh, okay. It’s my understanding that it’s based upon two
underlying beliefs, and the first is that a person is both a product
and a producer in their environment. And secondly, that if someone
can change their thoughts, or their cognitions, or their behavior, or
actions, then they can actually bring about a change in their life. How
does this relate to other theories?
Kjos: Well, I think it’s probably what you would call a cognitive
theory, although often when you watch a person work in this area,
you see them doing things that you would call person-centered as they
build the relationship with the client, because that’s a key part of it.
1–2
But the therapist acts in a way as a teacher, a coach, maybe an expert
in terms of how to accomplish the client’s goals, in some cases.
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Carlson: Well, let’s find out some more about cognitive behavioral
therapy from our guest, John Krumboltz. John? Welcome.
Dr. Krumboltz: Thank you.
Carlson: Thank you for joining us today.
Krumboltz: Thank you.
Kjos: John.
Krumboltz: Hi.
Carlson: John, can you tell us a bit about cognitive behavior therapy,
and just how it works?
Krumboltz: Well, first I should mention that cognitive behavior
therapy is not my favorite word in the world. It’s too much of a
mouthful to say, for one thing. And the other thing is that its, well, it
doesn’t describe the entirety of what we’re doing as well as a phrase
such as “a learning approach to counseling,” because learning, to me,
encompasses the entirety of what we are about. Learning to think,
learning to feel, and learning to act.
1–3
Carlson: So you’d see this cognitive behavioral approach, then, as a
learning-focused or a learning-centered approach.
Krumboltz: Absolutely.
Carlson: Um-hmm. How do you make an intervention and make it
work, though? What is the underlying principles of change, then, in
this learning model?
Krumboltz: The underlying principle of change is an educational
model. We are educating people. That’s what the… The counselor is
an educator. The metaphor that I think may be most useful is to sort
of think of yourself as a coach. What does a coach do? Suppose you
want to improve your golf strokes. So you go to a golf coach and you
say, “Help me.” Okay, well the coach doesn’t start off by giving you a
lecture about golfing or the history of golf.
1–4
The coach will say, “Let’s see you swing. What do you do? Starting
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with the way you are right now.” And then begins to help you figure
out ways to improve. “Why don’t you try standing this way? Why
don’t you grip the club this way? And experiment with some different
alternatives and see if it makes any difference in where the ball goes.”
See, it’s very much an educational model.
Carlson: So it sounds like the counselor observes and then provides
feedback?
Krumboltz: Uh, it doesn’t have to be the counselor who observes and
provides feedback. The client can observe and provide feedback. The
client can elicit observations and feedback from other people, too.
The counselor can also add to it, but is not the sole provider of such
guidance.
Kjos: The counselor, then, serves somewhat as an expert?
1–5
Krumboltz: Well, the counselor is an expert, but an expert in the
sense of helping the process. Not an expert in deciding what the goal
ought to be. I mean, if you said, “Oh, I’m not interested in improving
my golf game,” the coach is not going to teach you how to hold a golf
club.
Carlson: So you’re not going to manipulate or make somebody do
something that they don’t want to do.
Krumboltz: Well, of course not, of course not.
Kjos: How did this therapy get developed, or what was the process of
development of this approach?
Krumboltz: Well, you know, there is no one guru of the learning
approach to counseling. I think thousands of people have contributed
to it. But one could identify a few people who made some notable
contributions.
1–6
In a sense, Albert Ellis was one of the early proponents of an approach.
He called it Rational Emotive Therapy, but he clearly contributed an
important cognitive development. B.F. Skinner, of course, is a notable
proponent of a behavioral approach. I don’t know whether those two
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ever met. They may have. But I don’t think they ever cooperated on
doing anything. But lots of other people. Meichenbaum, of course, has
contributed a lot. Aaron Beck.
1–7
And thousands of other people have made contributions to our
understanding of how to help people by applying a learning
approach. So it has evolved over the decades until we sort of have an
accumulation of techniques that seem to be very effective in helping
people accomplish what they want to accomplish.
Kjos: How do these techniques or this theory as it has evolved apply to
the many different cultural types of clients that we now see, the sort of
multicultural characteristics?
Krumboltz: Well, you see, everybody from every culture learns. I
mean, that’s how they apply their culture is by learning. So the basic
principles apply to everybody. But the specifics of how you help
a person might be quite different depending upon their cultural
background.
1–8
See, now one feature of this learning approach is that we don’t deal
just with remediation of problems that already occurred but we also
do preventive work and developmental work. And one example of that
is a study that was done by Steven Schinke and Beverly Singer. They
were working with Native American adolescents on helping them
develop better nutrition habits and preventing them from starting
to smoke. They set up some groups; they arranged for indigenous
personnel to be the leaders of these groups and trained these leaders.
1–9
They used Native American folktales to illustrate the traditional
American Indian values of health, of pure mind, of pure body, of
pure spirit. They used models from the American Indian heroes who
illustrated the principles of good health. And so the technique of helping
people learn was tailored to the culture of the people who are trying to
learn, to maximize the learning that occurs. But the basic principle of
learning is still the same, no matter who you’re trying to help.
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Kjos: What about someone who sees themselves as being constrained
by external forces, such as racism or sexism?
1–10
Krumboltz: Everybody is constrained by external forces: racism,
sexism, ageism, regionalism. Part of the problem is to help people
figure out ways to cope with these. I mean, these are pressures that are
exerted from the outside, judgments that are made about you from
the outside, and everyone faces some of them. Now some people face a
lot more, and much more severe, as in the case of sexism and racism.
One needs to… And see, in a sense part of it is trying to overcome this
thing on a political front, but another part of it is how do you help
each individual deal with it in his or her own personal life? And again,
it’s a learning process. How are you going to learn to cope with this?
1–11
What do you do when someone makes a racist or sexist remark to
you, or tells a racist or sexist joke in your presence? What kind of a
response do you want to be able to make? Can you make it? Do you
need some practice in making it? And again, you design what would
be the best thing for that person to do.
Carlson: So you’d see these as learned behaviors and needing to learn
different responses…
Krumboltz: Exactly.
Carlson: …in this basic learning program. Is there a kind of client
that behavior therapy really works well with? Or maybe one that it
doesn’t work so well with?
Krumboltz: It works very well with anyone who is capable of learning.
We have had absolutely no success with people who are dead.
Kjos: What about couples, or groups, families?
1–12
Krumboltz: Couples, groups, families, absolutely. There has been lots
of good work done in group counseling. Lots of good preventive work.
Carlson: Is there research that points to the effectiveness of this
model, this learning or cognitive behavioral model?
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Krumboltz: There are mountains of research, mountains of research.
One of the best books that summarizes this, I think, is a book by
Frederick Kanfer and Arnold Goldstein called Helping People Change.
I find it very useful because it not only summarizes the research but it
writes it up in a way that enables people to actually apply it. and gives
examples of how it can be applied in practice.
1–13
Carlson: One of the things that I’ve been really interested in, and I’d
be remiss if I didn’t get a chance to ask you this question. Early in your
career you were identified as a behavioral counselor, and you wrote
books and articles and actually even participated in a famous debate
in which you took the behavioral counseling point of view and you
debated C.H. Patterson, the famous client-centered theorist. How did
you make that transition from this strictly behavioral approach to this
more of a learning or cognitive behavioral approach?
Krumboltz: Well, in my history I’ve tried out lots of different
approaches. Originally I was fascinated with Sigmund Freud, and I
thought psychoanalysis was the answer to every problem. And I used
to provide interpretations about how anal retentive some of my friends
were. And then I got trained in what was then called nondirective
counseling—Carl Rogers—now called client-centered or personcentered counseling. And you know, for awhile I thought, well, that
was the answer. And then I got hired as a high school counselor and I
tried to apply client-centered counseling…
1–14
Carlson: Hmm, I bet that was interesting.
Krumboltz: …in a high school setting. That was disaster city. It
was clearly not doing any good. Of course, I thought it was my fault
because I wasn’t doing it well enough, but now I think it’s simply
insufficient. I mean, good ideas, helpful ideas, but insufficient by itself
to do everything that needed to be done. And you know, then I moved
to a psychometric approach and failed that for awhile, and then sort of
a self-understanding approach, and a phenomenological approach.
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1–15
And then I got intrigued with B.F. Skinner and I thought¬ that the
behavioral approach would have a great deal to offer because of its
specificity of goals, specificity of techniques for accomplishing goals.
That was good, and so it was true that I was sort of identified as a
behavioral counselor for a number of years. And my feeling is that
I still am. I mean, but the reason that I prefer a little broader way of
thinking about it now is because the phenomenon of human behavior
is so complex that the behavioral approach by itself did not really
encompass enough of the thinking process of human beings: the way
in which we process information, the way we solve problems. And
that there’s a lot to be added by looking at human behavior through a
cognitive lens as well as the behavioral lens.
1–16
So it’s not that I have switched. It is that I have broadened my view to
take into account the complexity of human behavior.
Carlson: It’s interesting that you mentioned when you were the high
school counselor you felt that you didn’t do it right, this personcentered or client-centered approach, and I noticed in a book that
you wrote called Behavioral Counseling that you talked about the
client-centered concepts of developing a relationship, and you devoted
one paragraph to that in this entire text and really said that it was an
important thing for a counselor to do, and then really went on to talk
more about the behavioral change. How important is that in your
approach, this notion of creating a relationship?
1–17
Krumboltz: Well, it’s very important, it’s very important. The reason
that we didn’t devote more than a paragraph to it was because, at
the time, there were people devoting books and books and books to
it, and it didn’t seem necessary to repeat what everybody else was
saying, because we wanted to add something new, but at the same time
acknowledge the importance of really understanding where the person
is coming from. So it was not in any way intended to diminish the
importance of it. It was just, let’s spend the few pages that we have to
devote to this topic to something that hasn’t been said before.
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Carlson: Kind of on a different stage of therapy, the first stage maybe
being the relationship. The first step.
1–18
Krumboltz: Well yeah, see, I think that, in any counseling, that you
have to begin by finding out where the client is. What is the problem?
What are you concerned about? And you have to indicate to the
client that you understand where the client is. And the client has to
know, “Oh, my counselor understands me. Phew, what a relief. I feel
understood.” I mean, I think that is a very essential beginning point.
But, you see, some people might say, “Well, that’s enough,” you see. I
don’t think that’s enough. That’s where you start, but now how are you
going to help this person take steps to accomplish their goal?
Carlson: So the conditions aren’t sufficient for change. You have to go
beyond that.
Krumboltz: Oh, absolutely.
Kjos: Making a change, what would you say to a student who would be
interested in pursuing a career in this area? What future do you see in
cognitive behavior?
1–19
Krumboltz: Oh, I see a big future. Interesting question, Diane. I guess
I’d want to say, “Do you want to be a guru? Do you want to be seen
as omniscient? Somewhat mysterious? Sort of like the Wizard of Oz?
Sort of manipulating things behind the scenes and projecting this big
image of omniscience? If that’s what you want then you’d better go
somewhere else, because cognitive behavioral approach, the learning
approach, is not mysterious. It is very sensible. It’s very down to earth.
There’s no mumbo-jumbo to it. You’re helping people learn. You’re
a coach, you’re a mentor, you’re an educator. If you don’t like that
view of it, well, why don’t you go into something where there’s more
mumbo-jumbo. Read Rorschach cards or tea leaves.
1–20
So that’d be a way of sort of screening out people who want to be the
omniscient guru. But then they might say, “Well, what kind of people
do you want?” Well, I’d say, uh, “Are you interested in helping people
23
prevent problems from occurring?” For example, we have, on the
Stanford campus, a program in sexual assault prevention. Now the
way it used to be done was, women who were concerned about this
would take courses in how to ward off sexual assault. Don’t go to these
places. Don’t dress in this way. Be sure you say this or that.
1–21
But a bigger way of looking at the problem is to say, “Why does this
behavior occur anyway? Who are the people who perpetrate it?” So
Stanford University has sort of a sexual assault training program. And
it’s not just the women who get trained, but the men, also. So there’s
an… And there are policy statements made about how this is totally
unacceptable behavior and the people who perpetrate it will be dealt
with severely. Announcements from the administration.
Carlson: So changing the whole system.
Krumboltz: Changing the whole system.
Carlson: Okay.
Krumboltz: You see? Now to me that’s a cognitive behavioral
approach. It’s educating the whole community about a problem and
preventing it from happening rather than waiting for it to happen and
then dealing with the victims.
Carlson: Next we’re going to watch you work with a young woman
in counseling. What were your goals in working with this person as a
cognitive behavioral therapist?
1–22
Krumboltz: Well, uh, I knew that we only had one interview that
was to be 40 minutes long, and so, in the first interview, and in this
case the only interview, I wanted first of all to make sure that we
understood what the ground rules were. I wanted to make sure that
we all recognized that we were making a movie, that we had only 40
minutes to make it, and that this movie would be seen by thousands
of people. I wanted to make it sort of on the public record what the
ground rules were. And see, I think in any first interview you want to
somewhat, sometime, somewhere, make clear what the ground rules
were.
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1–23
And then the second thing I wanted to accomplish was to make sure
that she knew that I understood her problem. And the third thing I
like to do is to offer hope, hope that something can be done. That it
is not hopeless. That it’s possible to make progress toward solving the
problem, if indeed I think it is, and for the most part I always do.
Carlson: So ground rules, clear goals. We want to develop some
understanding of the problem. Instill some hope or encouragement.
1–24
Krumboltz: Yes, and the fourth thing is to have some sort of a task to
be done, some sort of action to be taken, so that when the client leaves,
there is something to be done. All counseling does not occur in an
interview setting. In fact, some of the most important activities occur
outside of the interview setting.
Carlson: And the task would be a behavioral task, or a thinking task?
Krumboltz: It could be. It could be a behavioral task, it could be a
thinking task, it could be a monitoring task. It could be, you know,
keeping a record of how often you do such and such.
Carlson: Okay.
Kjos: What kinds of things should we watch for in this video?
Anything in particular that we should be watching for as we’re
watching the video, a segment of the interview?
Krumboltz: Well, you might watch it and see whether what I have just
said is what I did.
Kjos: Okay, okay.
Krumboltz: And there may be some other things, too. There may be
some other things that you…
Carlson: Would you like our viewers to particularly pay attention
to, then, the way that you structure the counseling session? You
develop understanding of the problem, instill some kind of hope and
encouragement, and then let the counselee leave with a specific task
that she’s going to be working on?
25
1–25
Krumboltz: Yes, and in this particular case, we also practiced the task
right here in the counseling session.
Carlson: So there was another step in there that might ensure the
likelihood that the task would be carried out by a rehearsal?
Krumboltz: By a rehearsal of it if possible, in the counseling session,
yes.
Carlson: I can’t wait to see this.
Krumboltz: Let’s go.
Kjos: Okay. Thank you.
PSYCHOTHERAPY SESSION
Krumboltz 1: Robin, you and I have just met, and uh, we, are here
making a film, and we have camera people around and three cameras
going, and, uh, this film is going to be seen by thousands of people
in the years ahead and, uh, the ground rules here are that you and I
have 40 minutes to work together, and we are going to see if we can
accomplish whatever we can accomplish in 40 minutes.
Robin -1: Okay.
Krumboltz–2: And I am looking forward to doing that with you. And,
uh, I understand that you have something on your mind, and I would
like to know what it is.
2–2
Robin–2: Well, I guess, I’m having trouble in, uh, relationships are
complicated with people. Um, but I am having specific problems right
now with my in-laws, and I know that that’s common, that everybody,
you know, you always hear all the mother-in-law jokes and things like
that, but, um, uh, I’m having some real difficulty knowing what my
boundaries are, how much should I give, how far should I bend, uh,
how much should I really care, should I let it bother me, should I not?
Um …
Krumboltz–3: It does bother you, though.
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Robin–3: It does.
Krumboltz–4: Yeah. Okay.
Robin–4: It very much does.
Krumboltz–5: I, I hear that. I hear that.
Robin–5: Um. My husband is an only child, and for a long time
everything that my mother-in-law said I took personally. Now I
know it’s just, it’s because who her son married, it has nothing to
do personally, but accepting that is extremely difficult for me. Um.
Anything she says, anything she does, I still take personally, even
though I shouldn’t.
Krumboltz–6: What do you mean you shouldn’t? Why shouldn’t you
take it personally?
Robin–6: Because it’s not against me personally. It’s against the person
that married her husband.
Krumboltz–7: Yeah, but you are that person.
Robin–7: Or her son.
Krumboltz–8: You are that person.
Robin–8: Yeah, but …
Krumboltz–9: And so, tell me more about the specifics of this. What,
what exactly, um, happens?
2–3
Robin–9: Well, I mean, I could start from the very, I mean, there is so
much history between us. Um, I don’t know how far to go back, um …
Krumboltz–10: Well, why don’t we not go back too far. Why don’t we
start with more recent.
Robin–10: Okay.
Krumboltz–11: What’s the most recent thing that’s happened?
Robin–11: The most recent thing was this past weekend. (What had
led up to the point was, um, I have a son who is 14 months old. When
he was born, I really thought that this would be a time for his parents
to become more involved in our lives and want to have some thing to
27
do with their grandchild. They never showed any interest whatsoever.
Um, they live locally where I do, and they only visited maybe 5 times
within that year. That was very disturbing to me. Um, this past
weekend they came down for a visit completely unexpected. I was not
prepared. I don’t like surprises.
2–4
Um, my husband immediately dropped all our plans and catered to
everything that they did, and the fact that the holidays are approaching,
I’ve already made my holiday plans. Normally we don’t do anything
with them because they don’t want to be involved with us. Well, all of
a sudden now , they want my husband to go to Tennessee with them
to visit their family for Thanksgiving, and, um, I wasn’t invited and
neither was my son.
Krumboltz–12: Oh my! Mmmm.
Robin–12: So, um …
Krumboltz–13: That hurts.
2–5
Robin–13: It hurts, but I mean, I know that it causes some conflict with
my husband and I, but my husband’s not one of those ones to stand and
tell his mother, you know, don’t, don’t say anything against her, blah,
blah, blah. Because he knows that she doesn’t come around much. But
the ridicule that she gives me, she also gives to him. But he’s been raised
in that type of environment, so he can ignore it. He doesn’t let it bother
him.
Krumboltz–14: Tell me about this ridicule.
Robin–14: Um, well, I’ve been told that I’m not good enough for her
son, that I don’t take care of him enough, um …
Krumboltz–15: Told to your face?
Robin–15: Yes.
Krumboltz–16: Uh-huh. In just those words, “You’re not good enough
for my son”?
Robin–16: Yeah. When I, um, when we were planning our wedding, I
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wanted to include her and offered her, you know, if she had anything
she wanted, and she said “No, I’m sorry I just can’t, I can’t be involved
in it because I don’t think you’re good enough for my son. You don’t,
you don’t treat him the way you should.”
Krumboltz–17: Hmm!
Robin–17: I mean …
Krumboltz–18: Hmm! Wow, that is really cruel.
2–6
Robin–18: Well, she’s the only woman I’ve ever encountered that can’t
like me. I think I have one of those personalities that I’ve never met a
stranger …
Krumboltz–19: Yes, I, I sense that about you, too. I mean, you have a
very friendly,
outgoing nature, and I image everyone you meet would just love you.
Robin–19: Uh-huh. And she’s the only one that doesn’t. And that
hurts so much and I…
Krumboltz–20: Of course.
Robin–20: I can’t gain her approval. They’re, they’re, I mean, I’ve
tried. Um, I’ve tried to kill her with kindness, you know, remembering
her birthday, holidays, things like that. I’ve, I’ve tried it all.
Krumboltz–21: Uh-huh, and what happens when you do that. I mean,
you remember her birthday–what does she say when you…
Robin–21: She talks specifically to my husband, Ed, and says, “Oh,
thank you for that card”, or “Oh, thank you for that gift. You picked
it out so well”, and my husband will immediately say, “Well what did
you get? I don’t know what you got because Robin bought it,” you
know, that type of thing. But she never acknowledges.
Krumboltz–22: She won’t acknowledge that you did it.
2–7
Robin–22: No, no. Everything comes from her son. But yet, before
I came along, he never did anything for his parents. You know, but,
29
that’s…
Krumboltz–23: I can, I can see that would be very, very difficult to
take.
Robin–23: It is. And it’s a relationship that’s, that for most people
is difficult anyway, but I guess when I, when I look at my son and
know that someday if he decides to marry, I’m going to be a motherin-law, and I think to myself, no way am I going to even think about
mistreating, you know …
Krumboltz–24: Your, your daughter-in-law.
Robin–24: Yeah. Just because it’s almost inhumane.
Krumboltz–25: It is not almost inhumane. It is inhumane. It is, it is.
2–8
Robin–25: But I don’t want, I mean, it has, it has caused problems
in the past with, with my husband. Now, we’ve basically come to
terms that, when they come around, we try to just be friendly and,
you know, and then if they don’t come around, that’s okay too. Uh,
but, and it doesn’t cause problems, but yet the underlying current is
still there, you know, because it, one time I did confront her that I
didn’t feel part of the family. Uh, it, it doesn’t register with her. It goes
in one ear and out the other. I mean, she immediately changes the
subject. So, there, there is nothing I can do or say to her to get her to
understand. It’s something that I have to learn to accept how to do
that and still keep my sanity. It’s like …
2–9
Krumboltz–26: Uh-huh. Uh-huh. Well, that’s, that’s an interesting
dilemma that you are in right now. Let’s, let’s, so, let’s kind of
concentrate a little bit on how you might work on this. Your motherin-law is not going to change.
Robin–26: No. The only person who can change is me.
Krumboltz–27: That’s right. That’s right, the only person who can
change is you.
Robin–27: Uh-huh.
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Krumboltz–28: Your husband probably cannot change.
Robin–28: Nope.
Krumboltz–29: And, so you and I have this rare opportunity right
now to see if we can’t think of a way to deal with this situation so that
you will not feel so devastated when you get these cuts.
Robin–29: Uh-huh. Yeah.
Krumboltz–30: So, let’s, let’s, let’s first, uh, kind of think now, why,
why do you suppose your mother-in-law does this? I mean, can you,
can you put yourself in her shoes for a moment and…
Robin–30 : Yeah, I’ve taken her son away.
2–10
Krumboltz–31: Yes, you have. Her only son.
Robin–31: Her only son, yeah.
Krumboltz–32: And you, Robin, have stolen her only son. And your
husband loves you maybe even more than he loves …
Robin–32: Her.
Krumboltz–33: His mother.
Robin–33: Uh-huh, uh-huh, yeah. The, the, it goes without saying
there is an intimacy between a husband and wife that is not with a
parent, uh, uh, that’s why I sometimes think that she’s got a problem
because she, she had an unhealthy relationship to begin with, with her
son. She was very possessive with him.
Krumboltz–34: Oh, she, oh, she was.
Robin–34: Yeah.
Krumboltz–35: Uh-huh. And now her possessiveness is really
challenged by your presence.
Robin–35: Uh-huh. Definitely.
2–11
Krumboltz–36: She must feel absolutely threatened.
Robin–36: I think she does.
31
Krumboltz–37: At a, at a very deep level she is, she is, uh, so insecure
in, her, uh, herself that, that she sees what is, to anybody else a normal
happy marriage, as a threat to her.
Robin–37: Uh-huh, uh-huh. But see she feels insecure, so how she
responds is to make me insecure.
Krumboltz–38: Exactly, exactly. That’s … well, what a wonderful way
to do it. What a wonderful …
Robin–38: She succeeds very well.
2–12
Krumboltz–39: Well, I hear that. She’s, she’s a master at this art
of making you feel bad. But she is doing it because she herself is
threatened by the loss, what she perceives, as the loss of a son. Now,
it’s, it’s a sick way to look at it. I mean, a normal healthy individual
would say, “Oh, how wonderful. Now, not only do I have a son, but
I have a daughter and a grandson, and wonderful. What a terrific
pleasure to have our family increase so delightfully.”
Robin–39: Right.
Krumboltz–40: That would be a healthy way to look at it.
Robin–40: Right, and she doesn’t.
Krumboltz–41: She’s not a healthy, she’s not a healthy person.
Robin–41: No.
Krumboltz–42: And the more you try to cater to her, the more you try
to please her, what’s going to happen?
2–13
Robin–42: It doesn’t affect her. It just makes me more frustrated
because I feel that I can’t accomplish anything.
Krumboltz–43: Uh-huh. Exactly, exactly. And do you think that she
might even know that at some level?
Robin–43: Her? No. No, not her. I don’t think so.
Krumboltz–44: You don’t think she even knows that?
Robin–44: No, I’ll be honest. I don’t think she smart enough to
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understand any of that.
Krumboltz–45: Yeah. But at an emotional level. Intellectually, she
probably doesn’t.
Robin–45: Emotional level she knows she can get to me.
Krumboltz–46: Yeah, exactly.
Robin–46: Yeah.
Krumboltz–47: Exactly. And if she gets to you enough, I’m, I’m
looking at this from her point of view now, or let’s you and I both look
at it from her point of view. She gets to you enough at her emotional
level, may be she can …
Robin–47: Get Ed back.
Krumboltz–48: Get him back.
Robin–48: Yeah.
Krumboltz–49: Get him away from you.
2–14
Robin–49: Uh-huh. Oh, she’s tried.
Krumboltz–50: She has? What do you mean?
Robin–50: Uh, we had, we were building a new home. And we sold
our home. We had to find a, temporary housing for six weeks. Uh, my
parents could not hold the two of us. His mother refused to let me live
with them for six weeks. So, we just went ahead and decided and went
our separate ways. I stayed with my parents, and he stayed with his
parents for six weeks, and, it, it took us probably three months after
that six weeks for us to come to terms with what had happened.
Krumboltz–51: Uh-huh. I can see … Now, can, can you and your
husband talk about this situation.
Robin–51: Uh-huh, very, very well.
Krumboltz–52: And what is his, what is his attitude about it?
2–15
Robin–52: He tries to tell me, and this is what bothers me the most,
33
he says that she and I are a lot alike, and that’s why we can’t see eye to
eye on a lot of things, that we, in other words, we both want the best
for him. He, he really believes that his mother wants the best for him,
and that’s okay if that’s what he wants to believe. Uh, but he thinks
that I just need to let whatever she says go in one ear and out the other
because that’s what he’s done. She will put him down, and it doesn’t
even register with him as a put-down.
Krumboltz–53: What, what does she say to him that puts him down?
Robin–53: Uh, that he’s overweight. That he’s lazy. He’s too picky
about his house, Uh…
Krumboltz–54: Uh-huh. Does she, does she ever praise him? Does she
ever…
Robin–54: Never.
Krumboltz–55: Never.
Robin–55: Never.
Krumboltz–56: Has she ever praised you?
2–16
Robin–56: Never. Well, she did one time. On my wedding day, she
told me that I looked very beautiful. That was it. That’s the only
compliment I’ve ever received. You know, so, when you get them,
you remember them. But, she, she, it’s, it’s sort of like, you know,
my mother told me if you don’t have anything nice to say, don’t say
anything at all. Well, she’ll say. She’ll speak her mind.
Krumboltz–57: She is just the other way around.
Robin–57: Uh-huh.
Krumboltz–58: If she has something bad to say, she’ll say it. If she has
some thing good to say…
Robin–58: She won’t.
Krumboltz–59: She won’t say a word.
Robin–59: Uh-huh.
Krumboltz–60: Uh-huh. So, you are in this dilemma of, uh, of, of
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really being all alone in this situation. Because your, your husband
doesn’t quite understand…
2–17
Robin–60: No, he’s a lot like my father-in-law. My father-in-law told
me the same thing when I tried to talk to him, that that’s just the way
she is. You just accept her the way she is. Uh, he never says anything. I
mean, he’s got a heart of gold. He would do anything and everything
for us. But he will never disagree with her.
Krumboltz–61: He won’t confront her.
Robin–61: No, never.
Krumboltz–62: And, and, your, your husband doesn’t confront her.
Robin–62: No. Never. So, so, my situation is, you know, to what extent
do I try to have a relationship with them for the sake of my son? That’s
his grandmother, but yet, eventually, he is going to know and be able
to see that there is a difference in her, and he is going to see that.
Krumboltz–63: Oh, of course he will.
2–18
Robin–63: Uh, at what point do you, do you say, we are only going to
allow certain things to happen, or, we are only going to get together
occasionally or, you know. The one thing that I have said, regardless,
is that if she wants to have anything to do with my son, I will be
included. That’s just a given.
Krumboltz–64: Good for you.
Robin–64: Just because it’s my son. You know, I went through the
nine months, and I went through the labor and…
Krumboltz–65: Exactly.
Robin–65: You want to enjoy him, you’ll enjoy him with me.
Krumboltz–66: That’s good, that’s good. So you, you have asserted
yourself in that way.
Robin–66: Uh-huh.
Krumboltz–67: By making your boundaries clear, right?
35
Robin–67: Yeah, because when I really thought that there might be
a change in her when, when he was born, she would call and ask how
her boy was, referring to my son, and I just laid the law down. I said he
is your grandson. He’s my son, he’s your grandson.
Krumboltz–68: Good for you.
Robin–68: Yeah, but I didn’t feel comfortable doing that.
Krumboltz–69: Well, but good for you. You did it.
2–19
Robin–69: No, but, I don’t like, because to me that’s almost being, uh,
rude.
Krumboltz–70: Uh, well, yes, but you… I, I, I, for anybody else, I can
understand. That would be sort of, yeah, kind of rude. Because you,
you know, someone else might have meant something different by it,
or a slip of the tongue or something. But you knew full well what she
was saying.
Robin–70: Oh yeah.
Krumboltz–71: You knew full well, and you confronted her on it.
Robin–71: Yeah, but I didn’t like it.
2–20
Krumboltz–72: Well, but you did it. You did it. Yeah, I think, I think
that the thing that maybe we could do for a few minutes right here
is to think about what are the alternatives that, uh, you face here. I
mean, let’s, let’s just kind of list the possible things that you could do
in this situation, okay? I’m sure you’ve thought about this a lot, so why
don’t you just kind of list what they are.
Robin–72: The one that I’d love to do is just no relationship with them
at all. But I know that’s not possible.
Krumboltz–73: Okay, let’s list that. That’s, that’s the first alternative.
Okay. If you don’t mind, I’ll just make a few notes here.
Robin–73: Okay.
Krumboltz – 74: Of these things. Okay, first thing is just, no
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relationship at all.
Robin–74: Uh, the second would be setting the ground rules. If she
calls me, it has to be at my convenience. It has to be, you know, okay
with me. In other words, no dropping by unexpectedly. Planned,
planned visits.
Krumboltz–75: All right, so you would set the ground rules. Planned
visits only where you have agreed to it in advance.
Robin–75: Right.
Krumboltz–76: All right.
Robin–76: You know, like a phone call.
Krumboltz–77: Yeah, a phone call.
2–21
Robin–77: Or just let things go the way they are. I mean, uh…
Krumboltz–78: The way they are? That’s a third alternative. Just let
things go the way they are, huh?
Robin–78: Uh-huh.
Krumboltz–79: Okay, which means that they’d pop over whenever
they feel like it?
Robin–79: Uh-huh, yeah. We used to live in the same town, and they
used to do that very frequently, and I put a stop to that, too.
Krumboltz–80: Oh you did?
Robin–80: I just told her, I said, and sometimes you have to be very
rude and crude with her. But I just told her. She, she used to do it a lot
right after we got married. And I didn’t appreciate it, because I’m one
of those people that if I know somebody’s coming over, I’d like the
house to be at least presentable. Uh, and finally, I just told her, well,
you know, we are a young couple, we might be doing something, so I
would appreciate it if you would call before you came over. Because we
had given her a key.
2–22
My husband thought she should have a key, and she would just help
37
herself right on in. In other words, there was no respect of our home.
Krumboltz–81: Hmm. Does she still have a key?
Robin–81: Nope.
Krumboltz–82: Ha, ha! The way you said that indicates that you must
have done something.
Robin–82: Yeah, well, we moved. That was one of the reasons why
we moved was mainly to isolate ourselves a little bit. We put 30 miles
between our parents.
Krumboltz–83: Oh, okay.
Robin–83: just to give us a little bit more, uh…
Krumboltz–84: a little more distance.
Robin–84: Uh-huh. That helped a lot.
Krumboltz–85: Okay, all right, all right.
Robin–85: That has helped a lot.
Krumboltz–86: Good.
Robin–86: Uh, I’m trying to think if there is anything else.
Krumboltz–87: Well, okay, having no relationship at all is one. Setting
some ground rules is the second. Leaving things as is, is the third. Um,
okay. Anything else that you’ve thought of?
2–23
Robin–87: Well, one thing that I would love to happen but it will
never happen is for my husband to lay the law down.
Krumboltz–88: Uh-huh, uh-huh. Okay. But, but since your husband
is not here to talk to us, we can’t control his …
Robin–88: And he’s not going to.
Krumboltz–89: And you know he’s not going to anyway, uh, but, but
one thing that it does suggest is that you could have a heart-to-heart
talk with him about this.
Robin–89: Uh-huh. Which I have.
Krumboltz–90: Which you have had, but you are afraid that would
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never do any good anyway.
2–24
Robin–90: Yeah, it, it probably wouldn’t. Uh, uh, well, you know, one
of the things, another thing that bothers her, and I don’t, I thought
about it a lot, I have a large family. My family is very involved with
me and my son. You know, big extended family. She has always been
intimidated by that also. So, I mean, like a couple of, like, when my
son had his first birthday, I invited all the family. They came, gave him
his gift, he opened up his gift. When he had finished opening up that
gift, they left. She wouldn’t stay with the rest of the family for the rest
of the party.
Krumboltz–91: Oh, she left early.
Robin–91: Yeah.
Krumboltz–92 After she had done her thing?
Robin–92: Uh huh. Yeah. But yet they came over the next day when
nobody else was there.
Krumboltz–93: Ahh, interesting.
2–25
Robin–93: So, I, I sometimes think, okay, she’s intimidated by my
family. Maybe I need to make sure that she has her own time. That if
I do have a family event, that I do one thing for my side of the family
and one thing for his side, which his side is only his parents. But that’s
more work for me. But yet it caters to her.
Krumboltz–94: It does, doesn’t it?
Robin–94: Uh-huh.
Krumboltz–95: It does. You know, what, what occurs to me is, uh,
maybe there is a way of using your family as a, a, a buffer. That is, uh,
uh, the only time that you, you have certain, say, family gatherings,
uh, his family and your family come at the same time. Now she’s not
going to like that.
Robin–95: Right, right
39
2–26
Krumboltz–96: We already know that. Okay. But, that’s the family
gathering time. And if you had some sort of a ground rule that, that
she only came over when it was agreeable with you, then you could
control when she appeared. And, and if you wanted to, I mean, just,
just to list another alternative here, you could say, we are not having a
family get together until next month, the 29th of next month, and, uh,
so we are going to invite you and your husband and my family over
then. And we certainly hope that you will be able to come.
Robin–96: Well, then I’d never see them.
Krumboltz–97: Well, uh, does that bother you?
Robin–97: Uh, yes. But it doesn’t bother me as much as it bothers me
to see that my husband then doesn’t get to see his parents. See, I guess
that’s why regardless of what a horrible person she is to me and really
is to my husband, my husband still loves her because he’s her son.
Krumboltz–98: That’s right.
2–27
Robin–98: And I have to be respectful of his feelings. And I, I couldn’t
do that.
Krumboltz–99: Okay.
Robin–99: Uh, because I would hate it if he ever limited me to when I
could see my mother. See, that’s where we are drawing the fine lines, is
where, I mean, cause …
Krumboltz–100: But now, wait a minute. You are not limiting him as
to when he can see his mother. I mean, he can go see his mother any
time.
Robin–100: No, no, no, see, he never goes to see his mother. His
mother comes to see him. That’s where…
Krumboltz–101: Well, but, he could go see his mother.
Robin–101: That’s true. He could.
Krumboltz–102: He could.
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Robin–102: Then it still frees me. I just don’t want to end up being
the, whatever decision I decide to make, I just don’t want to turn out
to be the bad guy.
2–28
Krumboltz–103: I hear you. That’s right. No, you don’t want to be the
bad guy. But you also don’t want to be abused.
Robin–103: Right.
Krumboltz–104: You are being emotionally abused right now.
Robin–104: Right.
Krumboltz–105: By her.
Robin–105: Uh-huh. Uh-huh. Yeah. But the, it’s so hard. My parents
taught me so much to give other people respect. And it’s hard to, uh…
sometimes I don’t feel like I’m an adult, uh, that I’m still a child and
that I still have to respect her. It ‘s hard to stand up on my own two
feet a lot.
2–29
Krumboltz–106: I hear you, I hear you. Uh, but, now, we’ve actually
sort of talked about, uh, five alternatives now. Let’s just see if we could
quickly just try out uh, uh, uh, a narrowing down. One alternative is
no relationship at all, and you’ve already said, that’ s not going to, so
we cross off number one. Okay, possibility number two is setting some
ground rules for planned visits. That’s a possibility.
Robin–106: That’s a possibility.
Krumboltz–107: Okay. And number three is leaving things as is.
Robin–107: And that’s not…
Krumboltz–108: No, that’s not a possibility. And number four is
persuading your husband to change his behavior. And you think that’s
really impossible.
Robin–108: To confront this. Yeah.
Krumboltz–109: And alternative number five is using your own
family as sort of a buffer and having them over at the same time you
41
have her over.
Robin–109: Uh-huh. That’s… I would probably use a combination of
those two.
2–30
Krumboltz–110: Of, of those two? Okay, okay. Now, what, what, so
let’s, let’ s for a minute then go with these two possibilities. Uh, setting
the ground rules for planned visits, and, and, which could include
your family if you decided to do it that way. You wouldn’t have to
every time.
Robin–110: Right.
Krumboltz–111: I mean, it’s always your choice.
Robin–111: Right.
Krumboltz–112: Okay. Now, would you find it hard, I mean, I sense
you would find it hard, to set up these ground rules.
Robin–112: Oh, yeah.
Krumboltz–113: Uh, what, what would be the ground rules that you
would like to set up?
Robin–113: Well, probably one of the, the biggest one is that they call
beforehand.
2–31
Krumboltz–114: Okay. Let’s just work, let’s just work with that one for
a minute. Let’s , let’s, let’s have a little fun here together. Let’s, uh, l et’s
see. Why don’t you be your mother-in-law for a minute. Try, try to put
yourself in her role. I am going to try to be you for a minute.
Robin–114: Okay.
Krumboltz–115: And I’m going to try, I’m going to try to see if I can’t
talk to
your mother-in-law in a way that might be helpful. And you try to be
your mother-in-law. You got it?
Robin–115: Yeah.
Krumboltz–116: Now, how do you address her?
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Robin–116: Dori.
Krumboltz–117: Dori, okay. Now, let’s, uh, shall we make this on the
phone, or shall we make it in person?
Robin–117: On the phone.
Krumboltz–118: All right, on the phone.
Robin–118: I’m more confident. “Hello?”
Krumboltz–121: Uh, Dori, how are you feeling today?
2–32
Robin–121: Oh, it’s been another one of those days.
Krumboltz–122: Yeah, yeah? Not so good, huh?
Robin–122: No, I’m down on my back again.
Krumboltz–123: Oh, that’s too bad, that’s too bad. Dori, listen, there
is something I want to talk to you about.
Robin–123: Uh huh.
Krumboltz–124: And, uh, it’s kind of hard for me to, to say, but, uh,
it’s really quite important for me to, uh, to be able to discuss this with
you.
Krumboltz–125: Uh, one of the things that my husband and I need to
do is to, is to be able to plan our time together. And, uh it’s sometimes
hard for us to do this, uh, when we have guests that, who drop in
unexpectedly, and, and I was wondering if you would be willing, uh,
when you are thinking about coming over, uh, to call us in advance
and see whether or not it is a convenient time, or, or see if we couldn’t
negotiate a good time for us to get together.
2–33
It would really be a much more helpful way for it to happen. Do you
think that we could do it that way?
Robin–125: Am I a guest?
Krumboltz–126: Well, in our house you certainly are a guest. And we
43
would like you to be a welcome guest when it’s mutually convenient.
Robin–126 : Well, I, I can’t believe you just feel that way.
Krumboltz–127: Well, Dori, it is the way I feel. I’m being very honest
with you. And it’s hard for me to say this to you, uh, but, it, it really is
important to me that we have control of our own time and that we can
talk to each other in advance so that we can plan mutually convenient
times to get together.
Robin–127: Well, if that’s the way you want it.
Krumboltz–128: Well, it is the way I want it, and, uh, so I hope you
understand.
Robin–128: Bye.
Krumboltz–129: Great. That’s wonderful. Thanks Dori.
Robin–129: Mm hum.
Krumboltz–130: Talk to you later.
2–34
Robin–130: Bye. That’s exactly how she’d be.
Krumboltz–131: Terrific. All right. Now, what, what, uh, uh, let’s, let’s
re verse the process. You be you, and I will be your mother-in-law. I’m
probably going to be more ugly than your mother-in-law is. Just to
give you a hard time.
Robin–131: (laughter) Okay.
Krumboltz–132: Okay?
Robin–132: All right.
Krumboltz–133: All right, so, call me up.
Robin–133: Ring, ring, ring, ring, ring.
Krumboltz–134: Hello?
Robin–134: Dori?
Krumboltz–135: Yeah, yeah. Who’s this?
Robin–135: This is Robin.
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Krumboltz–136: Robin who?
Robin–136: Your daughter-in-law.
Krumboltz–137: Oh, my daughter-in-law?
Robin–137: Yeah, you know the one that’s married to Ed?
Krumboltz–138: Oh, oh, oh, uh, oh yeah. Oh, Ed, oh yeah. Hi. Yeah,
what’s up?
Robin–138: Well, uh, I wanted to talk to you. Wondered if you had a
minute.
2–35
Krumboltz–139: Well, I’m pretty busy right now. My back’s paining
me, and I’m awfully busy. I don’t really have too much time to talk to
you.
Robin–139: Well, you know this is really important, and Ed wanted
me to give you a call.
Krumboltz–140: Oh, well, if Ed wanted it, then what is it?
Robin–140: Well, we’ve been talking, and you know, family time’s real
important to us, and you know, with Ed putting in all the extra hours
and stuff, we very seldom get to see one another, and weekends are
our only time, and it, it just seems like you’re coming over, you know,
quite often, and you sometimes forget to, uh, give us a call to let us
know you’re coming.
Krumboltz–141: Well, so, so what. I mean, what am I some kind of a
guest or something?
2–36
Robin–141: Well, yeah, in essence you are, you know. Because we
make plans and we want to do stuff, and when you come over, it
just sort of messes up our whole schedule, and I was just wondering
if you could possibly start giving us a call. That way we can make
arrangements to make sure that we’re free and, could spend some time
with you then.
Krumboltz–142: Well, I am totally offended. I think this is just a
terrible way to treat one’s mother-in-law. It’s just awful. I mean, just,
45
I, I, I told you before, that you are just not good enough for Ed. I just
think it’s awful that you treat me this way. I just, I just can’t believe
that you would call me up and say something so cruel and rude as you
just said.
Robin–142: Well, you know, Ed and I talked about it, and he was in
agreement with me, but he just didn’t feel comfortable calling you. I
said that I would call because he doesn’t have much time.
Krumboltz–143: Well! I just, I just, I just can’t believe that you would
say this. I just, I just am really shocked. And,uh, good-bye.
Robin–143: (Laughter)
Krumboltz–144: All right, now I was, I was maybe worse than she
would have been.
Krumboltz–145: You think so?
Robin–145: Yeah.
2–37
Krumboltz–146: Yeah, yeah, okay. Good, okay. So, now, now that I
was just as bad, that’s just probably the worst it could be, right?
Robin–146: Uh-huh.
Krumboltz–147: So, how do you feel now?
Robin–147: I’d be like, I would feel like, that I probably ruint [sic] it.
Krumboltz–148: You probably what?
Robin–148: That I ruined it.
Krumboltz–149: Ruined … ?
Robin–149: Ruined it.
Krumboltz–150: Ruined what?
Robin–150: Ruint [sic] it. That, that’s the southern word. That they
probably wouldn’t have anything to do with it and it’s probably going
to all come back in my face, and Ed’s going to say that I hurt his
mother ‘s feelings and, uh, I shouldn’t have done that. Even though
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we had talked about it. He can sometimes, she’ll sometimes turn it
around to say that I said something different than what I actually
did. Which is one reason why if I confront her, I like to do it over the
phone, but I like to have Ed listening on the other end.
Krumboltz–151: Oh, that would be good, wouldn’t it?
2–38
Robin–151: Yeah. So that he hears the whole conversation to know …
Krumboltz–152: That would be good. That would be good. And now
he wouldn’t say a word, then?
Robin–152: No.
Krumboltz–153: He wouldn’t say a word?
Robin–153: No.
Krumboltz–154: But he would hear everything?
Robin–154: Right.
Krumboltz–155: And you would have talked with Ed in advance so
that he knew that it was a planned conversation?
Robin–155: Right, right, yeah.
Krumboltz–156: And, and so if she did come back and twist it around
on you, which I’m sure she will, he at least would know.
Robin–156: Right.
Krumboltz–157: You know, you know, one of the things that
sometimes is a good idea on these kinds of things is to tape record the
conversation.
Krumboltz–158: And then you and Ed can play it back when she
begins to distort it, and say…
Robin–158: Oh, that’s a good idea. That’s a really good idea.
2–39
Krumboltz–159: Yeah, yeah. What really took place here? And you
can get little, little, uh, devices from places like Radio Shack that you
47
can attach to your phone and hook it up to a tape recorder and tape,
tape both sides of the conversation just clear as a bell.
Krumboltz–160: And then you will have evidence in your pocket.
Robin–160: Yes.
Krumboltz–161: Ever after. Exactly what happened.
Robin–161: Yes. Uh-huh. That’s a, that’s a really good idea. Never
thought about that.
Krumboltz–162: Well, what do you think about it? Do you think you
could do something like that?
Robin–162: You mean far as going ahead and calling her and setting
the ground rules?
Krumboltz–163: Yeah.
Robin–163: Yeah. I would probably discuss them with my husband
and make sure that he was in agreement. He doesn’t necessarily have
to be the one to call her and tell her because that’s not what he is going
to do.
Krumboltz–164: That’s not it, that’s not it.
2–40
Robin–164: But if he was in agreement with them, yeah, I could
probably give her a call and just say you know, we’ve talked about it,
you know and we understand that you do want to have something to
do with us, but it, it’s difficult for us.
Krumboltz–165: Uh-huh, uh-huh. I think you can do it. I mean you
just did it with me, and I was, I was more ugly than even your motherin-law would be. And you did, you did a perfect job. A super job.
Robin–165: Well, see, I always try to pass the buck and say that it was
Ed’s idea.
Krumboltz–166: That’s all right. But it is going to be Ed’s idea. It’s
going to be Ed’s and your idea. Because you are going to agree on it in
advance. He, he just doesn’t want to do it himself.
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Robin–166: Right.
Krumboltz–167: But he would support you in doing it. And it’s clear
to me that you know how to do it. Because you just did it right here. I
want you to try to do it, I think you can do it. And I think, I think that
once she gets over the shock of it, she will shape up. She’ll never, she’ll
never approve of you.
2–41
Don’t ever hope that that’s going to happen, but she will respect you
because you are not kow-towing to her bully tactics.
Krumboltz–168: She will respect you.
Robin–168: Well, that’s probably all I want.
Krumboltz–169: Yup.
Robin–169: Yeah, that’s true. That’s very true.
Krumboltz–170: I think you can do it.
Robin–170: I’ll try.
Krumboltz–171: All right! Let’s do it! And I think our time is up for
right now.
Robin–171: Good, good.
Krumboltz–172: Okay?
Robin–172: Mmmmm
GROUP DISCUSSION
3–1
Carlson: John, I was very impressed with this interview. Is this a
typical example of what cognitive behavioral therapy is like?
Krumboltz: Hard to answer whether it’s typical. I think it represents
fairly a way in which it is done, yeah.
Carlson: If we were to look at this video, how did the theory work in
terms of the way that you operated with this client?
49
Krumboltz: Well, the way I looked at it was that Robin needed some
help in learning how to deal with this dilemma that she was faced
with. She didn’t know exactly what to do, how to deal with it. We had
to consider with her, we had to run through some cognitive processes
of problem-solving, one of which is to list alternatives.
3–2
After we sort of understood what the problem was, we had to list some
alternative solutions that might work, and we did so, and then we
narrowed them down to a couple that she was willing to try. But she
still didn’t know quite know how to do it, so I wanted to give her some
practice. So what she needed to learn to do was to do it. So we did that
in two ways: First I… We role-played in one way, where she was the
mother-in-law and I was doing her part, and then we did it the other
way where she could do it herself and I was the mother-in-law. And so
she got some practice both ways—really some modeling the first way
and then some practice the second way—and then I wanted to give her
some positive reinforcement for her success because she did a super
job. And I wanted to let her know about that. And then I wanted her to
generalize this practice that we did in the session with what she would
do on the outside.
3–3
So I would say the theory was applied rather consistently.
Kjos: So sort of step-by-step as you had talked about it earlier.
Krumboltz: Uh, it seemed to work very well.
Carlson: Very clearly, learning was at the root of this intervention.
Carlson: I was impressed with the number of techniques that you
used, and I went through my notes and I looked at this and I saw
techniques and skills such as empathy and respect, reinforcement
and encouragement and support. You were using restatement and
reframing. You placed the locus of control directly on the client. You
used a little bit of logical persuasion and you overstated the obvious.
You used problem-solving procedures and role-playing, and even
got a commitment to change at the end. You used many, many of the
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techniques. I expected to see more of an emphasis, though, on logic
and reason, kind of like Aaron Beck might, or Albert Ellis did, and
you passed up opportunities, such as talking about “shoulds” or that
she was not good enough.
3–4
Can you explain your thinking, what was going on, or how you might
differ from these people?
Krumboltz: Well, I didn’t feel it was necessary to give her a lecture on
the “shoulds.” She didn’t need that. I did respond to it.
Carlson: It sounds like that’s almost disrespectful, from your point of
view, to give somebody a lecture.
Krumboltz: Well, if it would have done any good, I might have done
it. I like to be very results-oriented. I want to do what helps the client,
not simply adhere to some theory. A theory is just a template, just
a filter for kind of helping you think where you’re going. It’s not a
command. It’s not a set of orders that you have to follow.
3–5
It’s just designed to be kind of a helpful reminder of where you’re
going.
Kjos: One of the other things that you did that I was fascinated by was
what we kind of call a Columbo technique, where you’d sort of start
and then you’d back off, and she’d have to finish it. And that worked
very well with her, so that you would sort of imply that there must be
at least one more alternative and she’d come up with it. And that was a
neat way that you used that, and it worked well with Robin, I thought.
Krumboltz: I think you’re right, Diane. I think one of the most useful
techniques in counseling is silence. A well-timed silence can be very
effective if… Because what it does is put the ball in the court of the
client.
3–6
Carlson: This is especially effective with a client like Robin, who is
more dependent and maybe a little bit more submissive. How would
you work with a client who had a different personality structure?
51
Maybe somebody who was more resistant, or maybe even mandated,
who didn’t even want to be here?
Krumboltz: Those circumstances could change things drastically. I
probably wouldn’t be able to do it the same way with a resistive client
as I was able to do it with Robin, who was so cooperative. Might be a
totally different way to approach it.
Carlson: Would it work with somebody who maybe didn’t want to
learn?
3–7
Krumboltz: Would it work with someone who didn’t want to learn?
Well, I’m not sure that there’s anyone who doesn’t want to learn, but
there may be some people who don’t want to learn what I want to
teach. We would first have to arrive at some contract, some sort of
agreement of what it was that we were trying to achieve.
Kjos: Some basis of understanding.
Krumboltz: Some basis of understanding of why we were both there,
and if we couldn’t arrive at a contract, why, we couldn’t make any
progress.
Carlson: So it might not work if you couldn’t come to an agreement.
Krumboltz: Well, absolutely. If a person doesn’t want counseling, you
can’t force them to undergo a process that they are refusing to do. This
is still a free country, thank goodness.
Carlson: So if somebody were mandated to come to see you by the
court system and really didn’t want help, you might just accept that
fact and…
Krumboltz: No, no, I think what I would say was, “Look, let’s face
facts here. You’re here because if you don’t come here, you’re going to
spend time in jail. I know that and you know that. Now the question
is, do you want to work together on this situation?”
3–8
Carlson: Um-hmm.
Krumboltz: If the guy says, “No, I don’t. Screw you.” Okay, that takes
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care of it. Go back to jail.
Carlson: Okay.
Krumboltz: But if he says, “Yeah, as long as I’m here, let’s deal with
it.” Okay, then we can start getting down to brass tacks and start to
deal with it. But we’ve got to have that initial agreement.
Kjos: Somebody said that the counselor is not mandated. The client is.
Carlson: Yeah. Okay. Well, why don’t we bring our audience in to our
discussion period and maybe begin with some specific questions about
the interview that we just saw.
Audience Member #1: I’d like to go back to your original question,
Jon. Before you got into the cognitive process you really dealt with the
affective domain and the kinds of concerns that she was having. And
I was wondering if that’s a typical kind of preparation to get into the
cognitive awareness.
3–9
Krumboltz: Well, absolutely. I think the first thing that has to happen
is I have to understand what the problem is. And I have to let her know
that I understand what the problem is. And I can’t do anything before
that. So I’m not sure that I would separate the affective from the
cognitive. I think the affective and the cognitive permeated the entire
process. But in a sense I first was doing this understanding before I
could know how to begin a different type of intervention.
Audience Member #2: I thought you did a really nice job of conveying
your understanding and your warmth toward the client, and I thought
that the problem that she stated in the beginning was that she needed
to not take it personally, what her mother-in-law was saying and
doing.
3–10
And I thought that wasn’t addressed very much. You got almost to it
at the end. And I think that what you conveyed was, by taking the side
of…her view of her mother-in-law, a win-lose situation rather than
creating a win-win situation.
Krumboltz: See, I don’t think that she was put in a win-lose situation
53
at all. I think this approach puts her in a win-win situation because
I think it gives her a technique for asserting herself and gaining the
respect of her mother-in-law. You see, the technique of catering to her
mother-in-law, she’s tried, for a long time, and it did not work. She
made that very clear.
3–11
But what I did try to do, along the line that you’ve suggested, was
to try to get her to put herself in her mother-in-law’s shoes. And see
that this mother-in-law is a very insecure, inadequate, unhealthy
individual. So I didn’t want Robin to feel that she, Robin, was the
bad guy or should be feeling bad because of the kinds of treatment
she was getting, because it was actually the doings of this rather
sick individual who was in fear of losing her son. So in a sense I was
trying to get her to see a bigger picture, with the hope that that might
contribute toward… So even when they do get together, she’s still
going to get these insults. So it was an effort to sort of buffer her so
when she gets them, she’s says, “Oh well, this is the response of this
rather inadequate human being, and too bad, but ah…” So in that
sense I think I did address her concern in that way.
3–12
But I didn’t want to just say, I didn’t want… See, I was not willing to
accept her initial premise that what I need to do is learn to accept this
bad treatment.
Carlson: So you changed her thinking…
Krumboltz: I…I…I… I don’t know if I changed her thinking. She
changed her thinking. But I was unwilling to agree, you know: “Yes,
you’re going to be treated badly and you should learn to accept that.”
That’s not my goal at all. I wasn’t willing to buy that, see? So once
again, we had to make a contract. We had to agree on something to do.
And we figured out something to do, and she seemed to like it. And
she did it.
Audience Member #3: John, I just want to get into how you think and
conceptualize. Do you consciously, in your mind, think about positive
reinforcement, negative reinforcement, even punishment, when you’re
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processing a case? This would be helpful, I think, for those of us that
are training, because these are important basics. Can you kind of
share with us how you conceptualize and think in these terms? Or do
you?
3–13
Krumboltz: Well, I do use those terms in my thinking, yes, but
I’m not sure that I am…I don’t think I do it quite…in going to the
abstraction and then to the specific. I don’t think, “Now it’s time for a
positive reinforcement statement.” No, I don’t do anything like that. If
I think that, uh, you know, if Robin did something really effective and
good, I spontaneously say, “Wow, that was good. That was great. You
did it. Nice going.” Those are positive, reinforcing statements. They
come from the heart. But I know that they’re positively reinforcing.
They’re, uh…I want her to be encouraged and supported for doing
them.
3–14
But they’re not contrived in any sense. So I don’t know if I’m
addressing your question. I know that I’m doing it. But they come
from the heart.
Audience Member #3: But you would say that in teaching people
this technique in your work, that they should have some awareness of
how…
Krumboltz: Oh, absolutely, absolutely. I mean, I think counselors
need to be aware of what they are doing and what they are saying
while they are being genuine with their client.
Audience Member #4: John, at what point in the counseling process
would you help Robin with identifying who owns the problem?
3–15
Krumboltz: Well, in a sense, Robin—we were fortunate here because
I think Robin knew full well who owned the problem. She said so
herself. She said, “It’s up to me. I can’t change my mother-in-law, I
can’t change my husband,” basically is what she said. So I had an easy
job of it there. See, some clients will say, “The reason I came to get
help from you is because I want my husband to behave differently.”
55
And at one point I said to her, “But your husband isn’t here now. So
we can’t help him change because he’s not here.” I could have said,
“Maybe you and your husband would like to come in together next
time and we can work on this, the three of us.” But you see, one of the
ground rules was that I’m only here now and we only have 40 minutes.
And so that’s part of the limitations, what we’re working with. But that
would have been an alternative way to go.
Audience Member #5: I very much respect the piece of work you did,
and I think it was appropriate in these limits, but I was concerned
about some ways that, if this were continued work, and she will
continue work, that it set up some barriers to some work that needs to
be done: specifically, that you helped her label her mother-in-law and
even her husband, at one point, as unchangeable.
3–16
Not just not changeable here, since they’re not here. You helped…
you fed into perceiving the situation as good guy, bad guy, and the
mother’s the bad guy. And my sense is that she has a lot of ways she
is like her mother-in-law, including projecting the problem, or the
badness, outside herself, and none of that stuff that you could do later
in role-play or empty chair is set up here.
3–17
Krumboltz: Well, interesting point. There are a lot of things that
could have been done, in addition to what was done. We had 40
minutes to work. My judgment was that we needed to make some
progress now. We needed to do something constructive now. So it was
the first step. And remember in the tape, she started to say, “Well, one
of the things that would help would be if she would call in advance.”
Now I cut her off at that point. I didn’t say, “Well, what’s another thing
that you want to do, and what’s a third thing, and a fourth thing?” I
cut her off because… I said, “Let’s just work on this one thing now,
and see if we can make some progress on it. And if we can, then we
can work on these other things later.”
Audience Member #6: I think the presenting problem here was
with the in-laws and the upcoming holidays. In terms of cognitive
behavioral therapy, what specifically did you feel needed to be learned
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or unlearned in regard to this presenting problem?
3–18
Krumboltz: Yes, she talked about the holidays and the fact that her
husband was invited to go to Tennessee, and she and her son were not
invited. And we didn’t deal with that problem at all. I didn’t quite see
that as the presenting problem. It was not the problem that she chose
to focus on for this session. It could have been, but we focused on how
she could confront her mother-in-law about these surprise visits. That
was the thing we focused on. This other problem is a good one, too. I
don’t know what she’s going to do about the holidays. I hope she has a
chance to talk to you. I mean, it’s another dilemma.
3–19
Audience Member #7: I was wondering about helping a person who
comes from another culture like I do, where we have an extended
family system, and the family dynamic is very different. As I was
listening to her and you supporting her, or reinforcing her, treat the
mother-in-law like a guest. This would be extremely offensive and
hurting in my culture, because my way is your way, too. We have our
way, not my way or your way. And this is a very deeply ingrained belief
system and value system we have in our culture. How would you deal
with a client who comes from that family dynamic?
3–20
Krumboltz: Ah, see, that’s a great question. This very clearly was an
American problem in an American setting. In another culture, where
the extended family values are much more important, or even in this
country, where extended family values are much more important,
there would be other considerations. See, but my job was to help
Robin figure out what to do in her situation, with her mother-in-law,
in the state of Illinois, in the United States of America this year, right
now.
Audience Member #7: Can I respond to that?
Krumboltz: Yes.
Audience Member #7: I think even in an American family, the mother
would feel offended to be treated like a guest by her own son.
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3–21
Krumboltz: Well, you know, being treated like a guest is really not
such a bad thing. I mean, guests are often treated better than family
members in many homes. And, you see, under normal circumstances,
this is not a thing you would say to your mother-in-law or your
mother or anybody else. But these are not normal circumstances.
Robin was being emotionally abused, and had been for a long time.
And it was getting intolerable for her. And she needed to figure out
some action that she needed to take. She felt it was rude. I mean, she
said so herself. So it’s not that different here than it is from where
you come from. She felt it too. And yet she felt it was necessary to do
because of the certain circumstances that exist right here, now.
Audience Member #4: John, do you feel this form of therapy sort
of reinforces the quick fix mentality that our society seems to be
permeated with presently?
3–22
Krumboltz: Does it…oh, boy, I don’t know. But yeah, there’s
something about a quick fix that…It sounds like you’re against
quick fixes. You see, I’m not against quick fixes if they work. I think
the quicker the fix, the better, if it’s a good fix. I don’t believe in
extending…I don’t believe in having long-term therapy just because
it’s long-term. I mean, as far as I’m concerned, the shorter we can do
it, the better. The only reason we want it to go longer is because it
takes longer in order to accomplish our goals. If we can do it in one
session, let’s do it in one session. If it takes three, let’s do it in three.
But the shorter, the better. So I’m not against a quick fix. Um, it’s only
if the quick fix is a bad fix, then we’re in trouble. But in this particular
case, I don’t think it was a bad fix. I think it was taking steps toward a
good fix.
3–23
Carlson: The research literature, John, talks about psychodynamic
approaches as yielding long-term changes and says cognitive
behavioral really do provide quick fixes. What do cognitive behavioral
therapists do to make sure the treatment is adhered to, that there
won’t be a relapse over time?
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Krumboltz: Well, several things. One is that the process by which it
takes place can be made explicit. So you help a person learn how to
confront, and you give them support, for example, in doing it. See, I
would hope that Robin learned some—will learn, by her experience—
some skills.
Carlson: So the skills would be transferable.
3–24
Krumboltz: The skills would be transferable to other situations.
Sometimes it takes longer. I mean, Robin was a very quick learner.
Some people take a lot longer to acquire some of these skills. Some
people are much more trouble than Robin. I mean, Robin is a pretty
together person, so it didn’t take very long with her. I think there is
some obligation to follow through and follow up and make sure that
these learnings stick. It takes a little cooperation on the part of the
client with the counselor to follow through on that.
Carlson: Especially if the research is true for cognitive behavioral
work, that the gains are lost over time.
Krumboltz: Well, I don’t think that there’s any evidence that that’s
true at all. I’m sorry, I don’t agree with that. And I don’t agree that
long-term therapy is better than short-term therapy.
Carlson: The research that I was referring to is research out of the
University of Washington that Neil Jacobson has done, in which he’s
shown that there is a 50 percent relapse rate after two years.
3–25
Krumboltz: Relapse in what?
Carlson: That the clients are performing at the same levels that they
were at pre-treatment after having undergone successful treatment.
Krumboltz: Well, that may be in…He’s been doing work in marriage
therapy.
Carlson: That’s behavioral and cognitive behavioral and marital
therapy.
Krumboltz: Yeah, yeah, well, if that’s the case, then the question,
59
see…One of the absolute advantages of a cognitive behavioral
approach is that it is self-correcting. That if whatever technique
Jacobson is using is not working, and he’s getting this relapse rate, and
he’s not happy with it, he might say, “Well, hmm, I wonder why? What
am I doing wrong? How could I change my procedures? What can I do
better? Let’s do…let’s try something different and do another research
study and see if it works any better.
3–26
So, we’re constantly trying to improve the process. Cognitive
behavioral approach does not have a set formula for accomplishing
anything or everything, at all. It’s constantly being improved
by people trying new things, doing research on it, adding to the
literature. Ten years from now we’ll know a lot better how to do it
than we know today.
Carlson: It’s a research-based approach, though…
Carlson: …so that you keep using this empirical data to refine
techniques and intervention strategies?
Krumboltz: Absolutely. We are results-oriented. We want to help
people improve, and we want to do it as quickly and as easily as
possible. And we want to keep learning how to do it better and better.
Audience Member #8: So how do you know then if counseling is
successful?
3–27
Krumboltz: We know that counseling is successful if the client
changes in ways that the client wants to change. So sometimes it takes
some reports from the client. Sometimes it’s self-reports, sometimes
it’s observations from other people, sometimes it’s various kinds of
assessments, psychometric assessment instruments. But there are lots
of ways to observe whether people have changed in the way they want
to change.
Audience Member #8: John, long ago in another life, when you were a
behaviorist, I had a chance to see you run a group, and I’m wondering
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if Robin were in a group and you were the facilitator, how you might
have dealt with her differently, or the same, or how you would use the
group to deal with Robin?
3–28
Krumboltz: I’m a firm believer in group counseling. I think it’s a very
effective way to help people, and a very efficient way. If Robin were in
a group of people who also had mother-in-law problems, let us say,
or marital problems, what I would want to do is to use the group as
a sounding board and as a feedback mechanism, so that members of
the group could say things to her perhaps even more frankly than I
did about what they saw going on and how they had done it in their
family. It would be a sharing of ideas for how other people handle
this similar situation. And there’s something about…I think it would
help…The other thing about group therapy that I like is it helps people
feel not so lonely. To some extent, Robin may have felt she was all
alone in this problem that she had, and the group would alleviate that
problem because she’s not alone.
3–29
Everybody knows what it’s like to have problems with in-laws. So I’m
much in favor of the group approach. I’m glad you mentioned that.
Carlson: We certainly want to open up questions to the general theory
now as well as specifically on the video.
Audience Member #9: John, getting back to people not being alone.
Obviously Robin was not alone in her problems, but also not alone
in dealing with the problem. Clearly, the husband was going to be
an integral part of the solution to this problem. Now she, at the end,
brought him in, saying, you know, “We have talked about this. I’ve
talked to Ed about this,” and when they did the role-playing, making
it clear that he was involved. Now if she hadn’t brought that up, when
would you have brought the idea of bringing him into consulting on
the solution to the problem, and in similar cases where you have an
adolescent who may be describing a very different situation at home,
when do you bring the other parties involved in solving the problem?
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3–30
Krumboltz: You mean, when do I bring them into the counseling
situation, or when do I bring them into, I mean bring them the
office where we talk about it? Or you mean bring them into the
conversation.
Audience Member #9: Not necessarily, but even bringing the person,
saying, you know, “This is a good solution but there are other people
involved, Would you consider…When are you going to talk to Ed
about the solution?”
Krumboltz: Oh.
Audience Member #9: You know, either way. Either bringing them in
or at least getting the person to say, you know, “You’re not alone in this
situation. There are other people that need to be involved.”
Krumboltz: I see. Oh, absolutely, and it’s a good point. I think I
definitely would have, in this case, if she had not made it clear that she
did talk with her husband about this and that they were agreed that
something like this needed to be done, I would have, uh…I would
have suggested…In fact, maybe the role play would have been, how is
she going to talk with Ed, rather than how is she going to talk with her
mother-in-law.
3–31
That might have been a necessary precursor to what we did.
Audience Member #9: Okay. Uh, following up on another question,
getting back to dealing with an adolescent. I understand the need to
empathize and relate to the presenting problem that the person has.
However, in adolescence they may describe a situation or a parent’s
overbearing in an artificial way and exaggerated manner. And going
along and confirming that may cause more difficulties and hinder
the solution to the problem, and may mask some other possible
alternatives. When do you confront their description of the situation
as to whether that is an actual, accurate description?
3–32
Krumboltz: Well, I think you’ve put your finger on a really serious
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problem. And that is that, uh, in dealing with adolescents, and of
course many adults are still adolescents at heart, what you get is a onesided picture of what’s going on. And if we were to, uh…in the case
of Robin, if we were to have the mother-in-law present, we might get
a quite different story about what’s going on here. And if Robin and
the mother-in-law had come in together to work on this, I would have
worked in a completely different style. I would have wanted to find
out, well, what’s the mother-in-law’s position on this? How does she
feel about this? But the mother-in-law was not here, so I had to deal
with what existed. Now you’re talking about adolescents. My wife,
Betty, is a middle school counselor, and she sees, uh, she deals with
these adolescents and their parents and the teachers and the principals
and the school psychologists.
3–33
And she sees these problems from many different points of view, and
she sees how these kids will distort a story. And if the kid goes to a
psychiatrist and tells the psychiatrist the story, the psychiatrist—and
that’s all the psychiatrist knows—the psychiatrist is likely to take some
actions that are not optimal and healthy. I think it is often necessary
to get people together who are sharing some stake in the problem. I
think family systems approach is very useful when it gets together the
people who are involved and who have to interact with each other and
interrelate. And the therapist can be in the middle of it and see what’s
going on. So that’s another reason why group counseling is helpful.
3–34
That’s why I think marital counseling is optimally helpful when both
members of the couple are present, not just one. So I am all in favor
of getting all the stakeholders involved, if you can. But sometimes you
can’t. And then you have to do what you can with what you have.
Audience Member #1: Just one comment about what you just
suggested. I would also like to add the possibility of parents and
teachers distorting the position. It’s not just the teenagers.
Krumboltz: Very good point. In a sense, everybody distorts the
situation. Everybody sees it from their own point of view.
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Audience Member #1: Their own truth.
Krumboltz: They do.
Audience Member #4: But as a follow up to that, what would be easier
to work with, then, a population of adolescents whose belief system
isn’t that long in the making, or the adults in the system whose belief
system may in fact be generations in the making?
Krumboltz: What’s your answer to that one?
Audience Member #4: I prefer the adolescents.
3–35
Audience Member #5: It seems to me that one way we can open up
that both the systems work and the intrapersonal work is to not make
statements that confirm their good/bad or black/white thinking, and
that’s what I was trying to indicate. You did it very well when you were
talking about, “Well, the husband isn’t here right now so we can’t work
on that piece.” But when you were talking about the mother-in-law,
you almost label her a demon.
Krumboltz: Well, maybe I did, maybe I did. Maybe I went a little bit
too far on that. I’ll consider that as a very legitimate consideration
here. I was trying to be empathic with her and how she was seeing the
situation. But at the same time, I was trying to get her to see that the
mother-in-law was that way for very good reasons at an emotional
level.
3–36
Audience Member #5: She’s…
Krumboltz: But…
Audience Member #5: I’m sorry.
Krumboltz: But you’re right. I mean, I did kind of paint it in rather
dichotomous terms.
Audience Member #5: Her recognition, or your recognition that she
felt abused, if it were handled at a feeling level, leads to, “So you need
some better boundaries.” So that the total direction seemed to be
right, but I would have kept it, this is her subjective experience. She
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feels abused.
Krumboltz: Well, it’s possible that… The totality of the situation as
she described it was not just that she felt abused. I felt that she was
abused. And I said so. And I might have been wrong.
Carlson: So you entered her world.
3–37
Krumboltz: But it wasn’t reflective of her view of it, but it seemed to
me that the whole thing held together and made sense that way. But I
take your suggestion with respect. I appreciate it.
Audience Member #3: I’m impressed by the fact that you take that
position on it. I think that’s a good modeling for other counselors and
it’s greatly appreciated. And I guess this is something that we’re getting
into. Allegedly behavioral therapy is supposed to be “value-neutral” or
“value-free.” And I’m just wondering. Do you buy into that, and what
would your value base be for when you provide therapy services?
3–38
Krumboltz: I do not buy into that at all. All counseling is value-laden,
from beginning to end, and we might as well face it. My values…
The values of the counselor come in when you agree to what the
contract is. What are we going to accomplish here? And maybe other
counselors would not have agreed to the same things that I agreed
to. But it’s a contract. It’s a contract, an agreement. And it takes two
people to arrive at that agreement. And once it’s agreed to, then we
work on it together.
Audience Member #10: She mentioned several times that she had
spoken with her husband, that her husband supported her, but yet I
kept getting the feeling that, although the husband said he supported
her, she still felt very alone when confronting the mother-in-law. At
what point would a cognitive behaviorist address this issue, if at all,
and how would they go about doing that?
3–39
Krumboltz: Now address the issue of what?
Audience Member #10: Being alone and unsupported; out there by
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herself.
Krumboltz: I could have said that. I could have said the—I don’t
know if I did. I guess not—I could have said, “You feel very much
alone in this situation.” And I think that would have been an accurate
reflection of probably how she did feel. Because, you know, she did
say that the husband was supportive of her but he wasn’t willing to do
anything. It sounded to me as if the husband was intimidated by his
own mother. But he was willing to, you know, apparently to listen on
the phone to the whole process.
3–40
Kjos: And you had said that you had made a choice not to deal with
her talking to her husband about supporting her versus calling the
mother-in-law. I think that was sort of one of those choices one makes
in a session: which way do we go?
Audience Member #1: John, I’d like to ask a theoretical question.
Going back somewhat to Jon Carlson’s question in reference to
research. One of the elements of mischief in some of the research
is that one solution does not necessarily apply to another situation.
What do you do in terms of transferring generalization of learning
experience for the client?
Krumboltz: Well, in this particular case, we didn’t really address it
explicitly. But sometimes, more often sometimes in career counseling,
we’ll talk about, you know, “Let’s take a look at the process that you
went through to arrive at this decision. Now, you’re going to probably
be making many career decisions in the years ahead.
3–41
What have you learned from this that you might want to use again
if you need to make another decision?” And get the client to kind
of verbalize the process that we went through. There, that’s a way of
trying to promote some generalization.
Audience Member #4: John, given that cognitive behavioral therapy
is a more directive teaching kind of model, would there be a student
profile that might best fit this model in the teaching arena, as far as
training counselors?
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Krumboltz: Uh, a student profile? You mean, a…
Audience Member #4: A type of student who might adhere well to
that kind of approach.
3–42
Krumboltz: Well there’s a premise in your question here that I want to
challenge. You see, I don’t think that counseling techniques should be
adhered to on the grounds that they are comfortable for the counselor.
I think counseling techniques are used because they are helpful to
the client. You see, I would want to be, I would want to be training
counselors who would be maximally helpful to their clientele. And it
might be that initially, they might feel a little bit uncomfortable trying
out some techniques. I don’t really know why. I mean, I don’t think
these are particularly uncomfortable techniques. But let’s say they
are. So part of the training program is to help them learn how to do
these techniques effectively, but not to say, “Oh, well, you’re not very
comfortable using positive reinforcement, so you don’t have to do that.
3–43
You just go ahead and do your whatever thing.” No, that’s not the
way. This is a profession. Our job is to serve the public, and we have
to serve the public using the best techniques we know how. You know,
what if a doctor, you go to a doctor and say, and you yell and you’ve
got appendicitis, and he says, “You know, I’m not really comfortable
with operations. I think what I’ll do is I’ll give you some aspirin. Well,
I’m really comfortable giving aspirin. That’s what I’ll give you.”
Audience Member #4: I know that doctor.
Krumboltz: No, no. We’ve got to use the best techniques we know
how.
Carlson: John, we’re nearing the end of our time. Are there any
comments or any concluding remarks that you might want to make
for our audience?
3–44
Krumboltz: Well, yes. I just want to say one thing, and that is that,
you know, we have to be very careful about all of these theories that
67
we throw around. You know, there’s a tendency to, uh, somehow deify
these theories and make them more important than they really are.
You know, a theory is just a simplification. It’s a way of looking…I
mean, human life is so complicated that we can’t understand it.
We can’t understand it. So a crutch that we go to is a theory, a way
of sort of…Well, if I can’t…If I can just kind of put my finger on a
few labels, it would help me get hold of it. So okay, here are a few
labels that we can use to kind of put it in order. But when we do that
we are simplifying it, oversimplifying it. And so, we ought to keep
remembering that it’s an oversimplification that we’re using, and that
real life is much more complicated, and we should never forget that.
And therefore…
3–45
See, one of the advantages of the cognitive behavioral approach is that
it is perfectly willing to steal techniques from anybody. No limit, no
limit. The question is, does it work? Does it help the client? That’s the
important thing. That’s what we’re all about.
Carlson: Well thank you, John. We all learned a lot about cognitive
behavioral therapy and appreciate you being with us today.
Kjos: Thank you.
Krumboltz: My pleasure.
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Video Credits
SPECIAL THANKS TO:
The clients Gina, Juan, Robin and Phil for their time and the courage
to share their personal stories so that others may learn.
Barbara Milton, Project Coordinator, for her dedication to the success
of this project.
Faculty and students in the Psychology and Counseling division of
the College of the Education at Governors State University for their
participation.
Addison Woodward, Chair, Division of Psychology and Counseling
for his support, participation and encouragement.
Leon Zalewski, former Dean, and Larry Freeman, Acting Dean,
College of Education for their support and encouragement.
A very special thank you to Ray Short, Editor, Allyn & Bacon, for his
courage and vision.
A production of Communications Services,
Governors State University
Video copyright © 1997, Allyn & Bacon
DVD released by Psychotherapy.net, 2009;
VHS version by Allyn & Bacon, 1997.
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70
Psychotherapy.net
About the Contributors
VIDEO PARTICIPANTS
John Krumboltz, PhD, Featured Therapist, is Professor of Education
and Psychology at Stanford University with a specialty in counseling
psychology. He helps counselors learn how to help their clients take
actions to create more satisfying lives for themselves. His research
covers tracing the roots of academic, career, and personal problems,
as well as studying the emotional outcomes of learning experiences,
and the use of multimedia in simulating occupational activities. Dr.
Krumboltz is also a leader in the theory of career counseling. His
social learning theory postulates that career transitions result from an
uncountable number of learning experiences made possible by both
planned and unplanned encounters with the people, institutions and
events in each person’s particular environment.
Dr. Krumboltz is a Fellow of the American Psychological Association
and the American Association for the Advancement of Science. He
has received a Guggenheim Fellowship and spent a year as a Fellow at
the Center for Advanced Studies in the Behavioral Sciences. On three
occasions he has received the Outstanding Research Award from the
American Personnel and Guidance Association. In 1990 the American
Psychological Association’s Division of Counseling Psychology gave
him the Leona Tyler Award, the nation’s foremost award in the field of
counseling psychology.
Dr. Krumboltz is co-author of Luck Is No Accident: Making the Most
of Happenstance in Your Life and Career and Changing Children’s
Behavior.
Jon Carlson, PsyD, EdD, Host, is Professor of Psychology and
Counseling at Governors State University and a practicing clinical
psychologist. He has authored 40 books, 150 journal articles, and
developed over 200 videos featuring leading experts in psychotherapy,
substance abuse treatment, and parenting and couples education.
71
Diane Kjos, PhD, Host, now retired, was a professor at Governors
State University in Illinois for twenty-two years, and past-President
of both the Illinois Counseling Association and the National Career
Development Association. She is co-author, with John Carlson, of
two textbooks, Theories of Family Therapy, and Becoming an Effective
Therapist, and co-host of the video series Psychotherapy with the
Experts, Family Therapy with the Experts, and Brief Therapy Inside-out.
MANUAL AUTHORS
Randall C. Wyatt, PhD, is Director of Professional Training at the
California School of Professional Psychology, San Francisco at Alliant
International University and a practicing psychologist in Oakland,
California.
Eileen M. Flanagan, MA, LMFT, is a practicing psychotherapist
practice with offices in Oakland and San Francisco, California.
Email: [email protected].
72
Psychotherapy.net
More Psychotherapy.net Videos
New videos are added frequently. Visit us at www.psychotherapy.net or call
(800) 577-4762 for more information.
The Ackerman Institute
Constance Ahrons
Ellyn Bader & Dan Wile
Insoo Kim Berg
Stephanie Brown
James Bugental
Tian Dayton
Albert Ellis
George De Leon
Pamela Dunne
George J. DuPaul &
Gary Stoner
Bruce Ecker
John Edwards
Stephen Feldman
Couples and Infertility
Gender Differences in Depression
Making Divorce Work
Couples Therapy: An Introduction
“I’d hear laughter”
Irreconcilable Differences
Treating Alcoholism in Psychotherapy
(2-DVD series)
Existential-Humanistic Psychotherapy in
Action
James Bugental: Live Case Consultation
Healing Childhood Abuse through
Psychodrama
Trauma and the Body
Coping with the Suicide of a Loved One
Rational Emotive Behavior Therapy for
Addictions
The Therapeutic Community (3-DVD set)
Exploring Narradrama
Assessing ADHD in the Schools
Classroom Interventions for ADHD
Down Every Year: A Demonstration of Depth
Oriented Brief Therapy
Tools and Techniques for Family Therapy
Legal and Ethical Issues for Mental Health
Professionals
Arthur Freeman
Cognitive Therapy for Depression
Linda Gask
The Glendon Association
Suicide and Self-Harm
Invisible Child Abuse
Sex, Love and Intimate Relationships
Voices About Relationships
Voices of Suicide
The Psychological Residuals of Slavery
The Angry Couple
Coming Out
Kenneth V. Hardy
Susan Heitler
Karin Heller &
Bill Domonkos
Harville Hendrix
Harville Hendrix on the Healing Relationship
73
Evan Imber-Black
Arnold Lazarus
Steve Lerner
Ronald Levant
Hanna Levenson
Marco J. D. Maida
Rollo May
Monica McGoldrick
Donald Meichenbaum
Scott Miller
Jacob Moreno
Zerka T. Moreno
Rod Mullen
Frank Ochberg
George Papageorge
Erving Polster
Ron Scott (Producer)
Martin Seligman
Lenore Walker
Irvin Yalom
Harry Wexler
Family Secrets
Arnold Lazarus: Live Case Consultation
She’s Leaving Me
Effective Psychotherapy with Men
Time-Limited Dynamic Psychotherapy
Jacob Levy Moreno: His Life and His Muses
Rollo May on Existential Psychotherapy
The Legacy of Unresolved Loss
Mixed Anxiety and Depression:
What Works in Psychotherapy
Moreno Movies (4-DVD series)
The Zerka T. Moreno Series (3-DVD series)
Encounter Groups for Addictions
(3-DVD set)
Explaining PTSD
PTSD and Veterans
The Counting Method
Connecting with Our Kids
Psychotherapy with the Unmotivated Patient
Psychotherapy with Gay, Lesbian and
Bisexual Clients (7-DVD series)
Positive Psychology and Psychotherapy
The Abused Woman
The Gift of Therapy
Irvin Yalom: Live Case Consultation
Understanding Group Psychotherapy
(3-DVD series)
Therapeutic Communities in Prisons
COUPLES THERAPY WITH THE EXPERTS SERIES
Jon Carlson & Mary Arnold Culture-Sensitive Therapy
Pat Love
Image Therapy
Sue Johnson
Emotionally Focused Couples Therapy
Gus Napier
Experiential Therapy
Richard C. Schwartz
Couples Therapy
Internal Family Systems Therapy
BRIEF THERAPY FOR ADDICTIONS SERIES
Bruce S. Liese
G. Alan Marlatt
74
Cognitive Therapy for Addictions
Harm Reduction Therapy for Addictions
Psychotherapy.net
Barbara S. McCrady
William R. Miller
John C. Norcross
Robert E. Wubbolding
Joan Ellen Zweben
Couples Therapy for Addictions
Motivational Interviewing
Stages of Change for Addictions
Reality Therapy for Addictions
Integrating Therapy with 12-Step Programs
CHILD THERAPY WITH THE EXPERTS SERIES
Jon Carlson
Janet Sasson Edgette
Gerald Koocher
Terry Kottman
Stephen Madigan
Bruce Masek
John J. Murphy
Violet Oaklander
David Scharff
Anin Utigaard
Adlerian Parent Consultation
Adolescent Family Therapy
Psychotherapy with Medically Ill Children
Adlerian Play Therapy
Narrative Therapy with Children
Cognitive-Behavioral Child Therapy
Solution-Focused Child Therapy
Gestalt Therapy with Children
Object Relations Child Therapy
Person-Centered Child Therapy
Reality Therapy with Children
PSYCHOTHERAPY WITH THE EXPERTS SERIES
Insoo Kim Berg
James Bugental
Jon Carlson
Mary Goulding
Kenneth V. Hardy
Allen Ivey
Jeffrey Kottler
Arnold Lazarus
Donald Meichenbaum
Natalie Rogers
Ernest Rossi
Jill Savege Scharff
Lenore Walker
Solution Focused Therapy
Existential-Humanistic Psychotherapy
Adlerian Therapy
Transactional Analysis
Family Systems Therapy
Integrative Therapy
Integrative Counseling
Multimodal Therapy
Person-Centered Expressive Arts Therapy
Mind-Body Therapy
Object Relations Therapy
Feminist Therapy
Reality Therapy
75
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Krumboltz Expert 3.indd

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