MODULE SEVEN

Counseling Theories and

Rehabilitation

Counseling

Module 7

The contents of this module were developed under a grant from the U.S. Department of

Education. However, those contents do not necessarily represent the policy of the U.S.

Department of Education, and you should not assume endorsement by the Federal

Government.

Technical Assistance and Continuing Education (TACE) Region 8

University of Northern Colorado

Greeley, CO 80639

These materials were developed with funds from the U.S. Department of Education. The

TACE is funded through a cooperative agreement between the U.S. Department of

Education and the University of Northern Colorado, award number H264A30003-97.

NOTE: Funding for TACE 8 ended on December 31, 2014. Materials can be used freely for

their intended purposes.

The University of Northern Colorado is an Equal Opportunity/Affirmative Action

Institution.

Revised AP Date: Spring 2011

Modul

e Seven: Counseling Theories and Rehabilitation Counseling

Table of Contents

How to Use the Learning Modules .......................................................................... 3

Rationale, Goal, Learning Objectives, Topics Covered ............................................. 6

Counseling Theories and Rehabilitation Counseling ................................................. 8

Selecting a Counseling Theory .......................................................................11

Theories of Counseling and Psychotherapy ............................................................ 13

Psychoanalytic Approaches ................................................................................... 14

Psychoanalytic Theory - Sigmund Freud ........................................................ 14

Individual Psychology - Alfred Adler ............................................................... 17

Existential-Humanistic Approaches ........................................................................ 18

Person-Centered Therapy - Carl Rogers ........................................................ 18

Gesalt Therapy - Fritz Perls.......................................................................... 20

Cognitive-Behavioral Approaches........................................................................... 21

Behavioral Approaches ................................................................................. 22

Cognitive Approaches................................................................................... 23

Rational Approaches .................................................................................... 26

Trait-Factor Counseling - Edmund G. Williamson .......................................... 26

Rational-Emotive Therapy (RET) - Albert Ellis .............................................. 29

Reality Therapy - William Glasser ................................................................. 30

Module

Seven: Counseling Theories and Rehabilitation Counseling

Eclectic Approaches ............................................................................................. 32

Multimodal Therapy - Arnold Lazarus ............................................................ 32

Adaptive Counseling and Therapy (ACT) ...................................................... 33

Brief Therapy ............................................................................................... 35

Summary ............................................................................................................. 37

Case Studies........................................................................................................ 38

Case Study Considerations ................................................................................... 39

References............................................................................................................ 41

Suggested Reading List ........................................................................................ 48

How to Use the Learning Modules

The learning modules are designed to provide rehabilitation personnel with relevant,

applicable knowledge pertaining to the rehabilitation process. The ultimate goal is to

assure that all rehabilitation personnel are adequately trained and prepared to provide

high quality rehabilitation services to people with disabilities.

These modules can be utilized in a variety of ways: new counselor training (individual

study or with supervisor mentoring); professional development or refresher for

current rehabilitation professionals; or CRC study guides.

Module S

even: Counseling Theories and Rehabilitation Counseling

Each module contains the following: 1) Rationale, 2) Goal, 3) Learning Objectives

and Topics Covered, 4) Learning Materials, 5) Case Studies, 6) References, 7)

Mastery Test, and 8) Evaluation.

Steps for Successful Completion:

Content for "Steps for Successful Completion" has been deleted as this section is no longer

relevant with the conclusion of TACE 8 cooperative agreement between U.S. Department of

Education and the University of Northern Colorado.

Proceed to page 6.

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e Seven: Counseling Theories and Rehabilitation Counseling

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e Seven: Counseling Theories and Rehabilitation Counseling

ationale

The practice of vocational rehabilitation counseling requires knowledge and

competency in a variety of areas including counseling theory and practice. An

understanding of the major theories of counseling and their application to vocational

rehabilitation is important for vocational rehabilitation counselors as counseling theory

provides a lens through which to view rehabilitation consumers and their needs.

Goal

• To provide an overview of major counseling theories and their applications to

vocational rehabilitation.

Module Seven: Counseling Theories and Rehabilitation Counseling

Learning Objectives

• To understand how counseling theory guides counseling practice.

• To gain introductory level knowledge of some of the major counseling theories

and schools of thought.

• To be able to evaluate the appropriateness of various counseling approaches

for use in the vocational rehabilitation setting.

Topics Covered

• The role of counseling theory in counseling practice.

• An overview of major counseling theories from psychodynamic, existential-

humanistic, and cognitive-behavioral approaches and their applications to

vocational rehabilitation counseling.

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e Seven: Counseling Theories and Rehabilitation Counseling

Counseling Theories and Rehabilitation Counseling

Rehabilitation counseling has been described as a process where the counselor works

collaboratively with the client to understand existing problems, barriers, and potentials

in order to facilitate the client’s effective use of personal and environmental resources

for career, personal, social, and community adjustment following disability (Patterson,

Szymanski, & Parker, 2005). In carrying out this multifaceted process, rehabilitation

counselors must be prepared to assist individuals in adapting to the environment, to

assist environments, including employer settings, in accommodating the needs of the

individual, and to work toward the full participation of individuals in all aspects of

society, with a particular focus on career aspirations (Patterson, Szymanski, & Parker,

2005).

Rubin & Roessler (2008) states that over the years, the fundamental role,

functions, and skill competencies of the rehabilitation counselor have evolved and

expanded. However, regardless of their employment setting and specific client

population served, most rehabilitation counselors assess client needs, work with the

client to develop goals and individualized plans to meet identified needs, and provide

or arrange for the services and interventions (e.g., psychological, medical, social,

behavioral) needed by the client, including job placement and follow-up services

(Rubin & Roessler, 2008). Counseling skills are an essential component of all

activities throughout the individualized vocational rehabilitation process. Specialized

knowledge of disabilities, environmental factors that interact with disabilities, resources

for assisting persons with disabilities, as well as vocational knowledge and

assessment skills required, all serve to differentiate the rehabilitation counselor from

social workers, other types of counselors, and other rehabilitation practitioners in

Module Seven: Counseling Theories and Rehabilitation Counseling

today’s service delivery environments (Patterson, Szymanski, & Parker, 2005);

The Commission on Rehabilitation Counselor Certification (2011) identifies the official

scope of practice statement for rehabilitation counseling as follows:

Rehabilitation counseling is a systematic process which assists persons with physical,

mental, developmental, cognitive, and emotional disabilities to achieve their personal,

career, and independent living goals in the most integrated setting possible through

the application of the counseling process. The counseling process involves

communication, goal setting, and beneficial growth or change through self-advocacy,

psychological, vocational, social, and behavioral interventions. The specific techniques

and modalities utilized within this rehabilitation counseling process may include, but

are not limited to:

• assessment and appraisal

• diagnosis and treatment planning

• career (vocational) counseling

• individual and group counseling treatment intervention facilitating adjustments

to the medical and psychosocial impact of disability

• case management, referral, and service coordination

• program evaluation and research

• interventions to remove environmental, employment, and attitudinal barriers

• consultation services among multiple parties and regulatory systems

Module Seven: Counseling Theories and Rehabilitation Counseling

• job analysis, job development, and placement services, including assistance

with employment and job accommodations.

• the provision of consultation about and access to rehabilitation technology.

It is important to note that the interventions used in vocational rehabilitation counseling

are intended to facilitate obtaining the client’s end goal of successful vocational

placement. According to Parker, Hansmann, Thomas and Thoreeson (2005) the

ultimate goal of rehabilitation (the independent, effective, and full functioning of

clients) is predicated upon, and intimately linked to, intensive counseling by a skilled,

professional rehabilitation counselor.

The importance of a professional counseling relationship to rehabilitation is in the

amelioration of handicaps created from the cumulative impact of psychosocial and

physical barriers on persons with disabilities. The internalization of such barriers by

persons with disabilities may lead directly to negative self-appraisal and severe

psychological difficulties. Consequently, the primary task of rehabilitation counseling

is the removal of such barriers, whether inflicted by oneself or by society (Parker et

al., 2005)

It is not the task of the vocational rehabilitation counselor to diagnose

psychopathology or to provide intensive psychotherapy for psychological problems.

However, it is the challenge of the rehabilitation counselor to create an atmosphere in

which clients feel free to express feelings such as shame, anger, frustration, or

sadness that may accompany the experience of having a disability or that arise from

confronting barriers associated with the disability. To successfully accomplish the

challenge of developing a professional counseling relationship with the client that will

Module Seven: Counseling Theories and Rehabilitation Counseling

help the client to overcome barriers to employment and independence, the

rehabilitation counselor should have knowledge of counseling theories and the ability

to apply them appropriately in the rehabilitation counseling setting. Although

knowledge of counseling theories and skills are essential, it is important to note again

that the majority of vocational rehabilitation counselors do not have adequate training

or skills to provide in depth psychotherapy to clients. It is also not appropriate for

vocational rehabilitation counselors to assume this role in the time limited, goal

focused arena of vocational rehabilitation counseling.

Selecting a Counseling Theory

Counseling theory guides counseling practice. Counseling theories serve as road

maps during the course of counseling. The theory one chooses should influence the

counseling process, anticipate potential barriers or problems, provide a framework for

understanding client development, needs, individual circumstances, and provide tools

for reaching client goals. Many counseling theories exist. In considering suitable

counseling approaches, the rehabilitation counselor may wish to consider the following

questions:

1. Does the theory being considered organize and integrate knowledge and help to

answer questions in such a way as to make possible a systematic consumer

description from which prediction and explanation concerning the consumer can be

derived (Patterson & Watkins, 1997)? Does the theory help counselors determine

where to focus their attention (Hall & Gardner, 1997)? Is the theory useful in terms

of how effectively it can generate verifiable predictions about a client (Parker et al.,

2005)? Does it enable the counselor to develop hypotheses regarding consumer

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behavior that the counselor has not yet observed (Parker et al., 2005)?

2. “What are the underlying philosophical notions of the theory? How does the

theory view human nature? Is this view congruent with the counselor’s own beliefs?”

(Thomas et al., 1992, p. 214). How well developed and empirically verified are the

theoretical bases of the approach (Thomas et al., 1992)? “How well does the theory

describe and explain the development of normal and abnormal behavior and the

dynamics of behavior change?” (Thomas et al., 1992, p. 214).

3. “What range and type of clients can feasibly be served by the approach? What

limits are imposed by such factors as the client’s presenting problems, intellectual

functioning, verbal expressivity, or therapeutic expectations?” (Thomas et al., 1992,

p. 214). Rehabilitation counselors are generally expected to work with consumers

possessing a wide range of characteristics, and the counselor’s approach must be

flexible enough to deal with consumer variability (Thomas et al., 1992).

4. “What demands does a selected approach place upon the counselor with respect

to training, experience, personality attributes, verbal ability, and values?” (Thomas et

al.,1992, p. 214).

5. “What are the explicit or implicit goals of counseling? In many employment

contexts, counselors are expected to limit their function to a narrower role than

prescribed by a given approach. What is the impact of this restriction?” (Thomas et

al., 1992, p. 214). When an agency’s goals for its clients are defined as job

development and placement, counseling approaches that stress goals of personality

integration may be inappropriate (Thomas et al., 1992).

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6. “What specific techniques are used to achieve the goals of the theoretical

approach? Counseling techniques must also be considered in terms of the demands

placed on the counselor and the client, the appropriateness for the agency context,

the costs relative to the benefits obtained, and other practical constraints” (Thomas et

al., 1992, pp. 214- 215). Many counseling approaches are inappropriate for the

rehabilitation setting due to the training or time required to implement the approach.

Is the selected approach (a) congruent with the counselor’s basic philosophy

and theoretical orientation; (b) consistent with his or her training and personality; (c)

applicable to the consumers of the agency; (d) accountable in terms of the benefits

accrued; and (e) in general, does it work well with the specific rehabilitation context

(Thomas et al., 1992)? It is the responsibility of the counselor to apply his or her

training, experience, and professional judgment to select an approach that best suits

their unique responsibilities (Thomas et al., 1992).

Theories of Counseling and Psychotherapy

In search for a vantage point from which to view the rehabilitation client, the counselor

has the option of selecting from a variety of counseling approaches. These

approaches are frequently categorized under one of three major theoretical positions:

psychodynamic, existential-humanistic, and cognitive-behavioral. Under each of

these three categories several major theories exist, for instance, most noted under

psychodynamic theories are the psychoanalytic theories of Sigmund Freud, Carl Jung,

and Alfred Adler, the Ego Psychology of Erikson and Brenner; the Interpersonal

Theory of Sullivan and Fromm-Reichmann, the Object Relations theories of Klein,

Fairbairn, and Kernberg, and the Self-Psychology of Kohut. Existential-Humanistic

theories are represented by the Person Centered theory of Carl Rogers, the

Existential Psychology of Rollo May, the Logo Therapy of Viktor Frankl, the Gestalt

Therapy of Frederick Perls, and the concept of Self-actualization from Abraham

Maslow.

Included under the major Cognitive-Behavioral theories are the Operant

Conditioning of B. F. Skinner, the Cognitive Psychology of Albert Bandura, Reciprocal

Inhibition of Joseph Wolpe, Social Learning approach of Julian B. Rotter, Rational-

Emotive therapy of Albert Ellis, Reinforcement Theory of John Dollard and Neal Miller,

and the Cognitive-Behavior Modification of Donald Herbert Meichenbaum. The list of

theories and theorists is far from comprehensive. Summaries of the major counseling

theories and their application to rehabilitation counseling, as well as a discussion of

eclectic approaches, are included in this module. For a more thorough description and

understanding of various theories of counseling and personality, the reader is

encouraged to consult a counseling theory textbook or the original works of individual

theorists.

Psychoanalytic Approaches

Psychoanalytic Theory-Sigmund Freud

Historically, Sigmund Freud is considered to be the founder of psychoanalysis and

psychoanalytic therapy (Bongar & Beutler, 1995). Freud’s psychoanalytic theory was

the first of the three major schools of psychology (Corey, 2009).

According to Corey (2009), the primary contributions of psychoanalytic theory

and practice include:

(1) An individual’s mental life can be understood, and the insights into human nature

can be applied to alleviate some human suffering. (2) Human behavior is often

governed by unconscious factors. (3) Early childhood development has a profound

effect on adult functioning. (4) This theory has provided a meaningful framework for

understanding the ways in which an individual attempts to cope with anxiety by

postulating mechanisms to avoid becoming engulfed in anxiety. (5) The

psychoanalytic approach offers ways of tapping the unconscious through the analysis

of dreams, resistances, and transferences (p. 10).

The psychoanalytic approach provides a conceptual basis for understanding

unconscious dynamics, the importance of early development as related to present

difficulties, anxiety and ego defenses as a way of coping, and the nature of

transference (Corey, 2009).

Application in Vocational Rehabilitation

Many aspects of psychoanalytic theory have applications in rehabilitation counseling.

Cook (1992) suggested that psychoanalytic conceptualizations of the ego defenses

(e.g., A. Freud, 1936; S. Freud, 1923/1961) are particularly useful in understanding

the impact of disability on the individual. Cook (1992) listed four defense

mechanisms, which are frequently mentioned in the literature on adjustment to

physical disability: repression, projection, reaction formation, and regression.

Repression refers to forgetting subject matter that is traumatic or anxiety provoking or

pushing away unacceptable thoughts, feelings, or memories (Corey, 2009).

Projection refers to the process of attributing to another those traits that are

unacceptable to oneself. Reaction formation involves behaving in ways that are

directly opposite to unconscious wishes or actual feelings. Regression is reverting

back to an earlier phase of development where the demands on the individual were

not as great. Cubbage & Thomas (1989) include denial, compensation,

displacement, sublimation, restriction of the ego, and rationalization. By recognizing

the role that defense mechanisms play in adjustment to disability, rehabilitation

counselors are in a better position to understand the client’s behavior and level of

coping.

Psychoanalytic theory was one of the first theories to recognize the importance

of early childhood experience in personality development. According to Corey

(2009), psychoanalytic theory provides counselors with conceptual tools for

understanding trends in development, key developmental tasks characteristic of the

various stages of growth, normal and abnormal personal and social functioning, plus

critical needs of the individual.

Psychoanalytic theorists offer little specific direction to the counselor who is

involved primarily in the resolution of vocational and educational problems. Thomas

et al. (1992) suggest that for modern analysts and person-centered therapists, a goal

of therapy for people with disabilities would be to strengthen the cohesiveness of the

self and to improve self-esteem. A further contribution of psychoanalytic theory to

rehabilitation practice is the recognition that early life experiences and child-rearing

practices may have considerable impact on later development and behavior.

Due to the intensive training required for the practitioners and the length of

time of traditional treatment, psychoanalysis is not appropriate for use by rehabilitation

counselors. Knowledge of psychoanalytic theory, however, can be useful for better

understanding the client seeking rehabilitation services.

Individual Psychology - Alfred Adler

Adlerian theory examines “lifestyle”, seen as the pattern of dimly conscious

beliefs and goals, an unconscious or vaguely conscious, cognitive “map” that guides

the person through life, influences interactions with others, and impacts how the

person measures their own self-worth (Rule, 2005). Adler’s early theory of organ

inferiority expressed the idea that a congenital or acquired defect or weakness in the

body impacts behavior and personality. Adler believed that all behavior is purposive

and goal directed (Sweeney, 1981).

In Adlerian theory, it is believed that attitude changes result in behavioral

changes. Thus the goal is to encourage situational, attitude, and/or behavior

changes which free the individual to function more fully as a self-determining, creative

and responsible equal within his or her environment (Sweeney, 1981).

A primary contribution of Adler is a holistic view of the individual that takes into

account genetic, environmental, and social influences in understanding personality

development (Sweeney, 1981). Adler’s positive view of human beings as well as his

use of psychoanalytic theory and technique may be viewed as a bridge to both

existential-humanistic approaches and some cognitive-behavioral approaches.

Application in Vocational Rehabilitation

Rule (2005) suggests that much of Adler’s work is applicable to vocational

rehabilitation counseling and addressing the psychological aspects of disability. The

concept of “lifestyle” is particularly relevant to counseling with individuals going

Module Seven: Counseling Theories and Rehabilitation Counseling

through adjustment to disability. Rule (2005) states that the lifestyle approach of

adjustment to disability respects the personalized meaning of the disability to the

individual because lifestyle assessment attempts to identify the individual’s general

expectations of self, others, and life. Additionally, its goal-directed focus helps the

individual to move from where they are to where they want to be. Adler’s concepts of

striving for superiority and organ inferiority may also be helpful in attempting to

understand the impact of a physical or mental disability on the life and behavior of the

individual.

Existential-Humanistic Approaches

Existential-humanistic approaches to counseling and psychotherapy are based on an

existential philosophy of the human condition and on the encounter between the client

and the therapist in which one attempts to wrestle with existential issues such as

freedom and responsibility, meaning and meaninglessness, guilt, anxiety, suffering,

and death (Corey, 2009). The focus of existentialism is on the individual’s most

immediate experience, his or her existence and the experiencing of this existence

(Patterson, 1980). Bongar & Buelter (1995) say that “Existential-humanistic

psychotherapy is an effort to increase clients’ access to their power to guide their

lives, to find more satisfactions they deeply seek, and to avoid some of the pitfalls

lying within themselves” (p. 118).

Person-Centered Therapy - Carl Rogers

The Person-Centered view of humans is positive; humans have an inclination toward

becoming fully functioning. In the context of the therapeutic relationship the client

experiences feelings that were previously denied to awareness. “The client actualizes

Module Seven: Counseling Theories and Rehabilitation Counseling

potential and moves toward increased awareness, spontaneity, trust in self, and inner

directedness” (Corey, 2009, p. 186).

The Person-Centered view holds that the client has the potential for becoming

aware of problems and has the ability to solve them. This approach perceives mental

health as a congruence of ideal self and real self. Maladjustment is the result of a

discrepancy between what one wants to be and what one is. It is believed that the

qualities of the therapist, including genuineness, warmth, accurate empathy, respect,

permissiveness, and the communication of these attitudes to the client are critical to

the therapeutic process. The client uses the therapeutic relationship for translating

self-learnings to other relationships (Corey, 2009).

The unique contributions of the Person-Centered approach include the

expectation that the client will take an active stance and assume responsibility for his

or her own therapy and the emphasis on the therapeutic relationship in which the

therapist demonstrates empathy, congruence, and positive regard. The person-

centered therapy approach “challenged the role of the traditional therapist who

commonly used techniques of diagnosis, probing, and interpretation and challenged

the view of the therapist as expert” (Corey, 2009, p. 210).

Application in Vocational Rehabilitation

The Rogerian concepts have since been incorporated into almost all therapeutic

approaches and are certainly applicable to the vocational rehabilitation counselor-

client relationship. With increasing emphasis on client informed choice, the Rogerian

philosophy that promotes faith in the client’s ability to make choices and to achieve

their full potential is certainly congruent with recent trends in VR settings. Since

Module Seven: Counseling Theories and Rehabilitation Counseling

person-centered therapy is based on the assumption of the human capacity for self-

actualization and the ability to perceive situational events and internal stimuli, and to

represent the perceptions in symbolic form, a limitation of person-centered therapy in

the rehabilitation setting may be in work with clients with limited intelligence or verbal

ability, and clients with severe psychosis (Thomas et al., 1992).

Gestalt Therapy - Fritz Perls

According to Gestalt theory, individuals strive for wholeness and integration of

thinking, feeling, and behaving. “The view is anti-deterministic; in that the person is

seen to have the capacity to recognize how earlier influences are related to present

difficulties” (Corey, 2009, p. 186).

The focus of Gestalt therapy is on the ‘what’ and ‘how’ of experiencing in the

here-and-now to help the client accept his or her polarities. Key concepts of the

Gestalt approach include personal responsibility, unfinished business, avoiding,

experiencing, and awareness of the now. “It is an experiential therapy that stresses

feelings and the influence of unfinished business on contemporary personality

development” (Corey, 2009, p. 188).

The techniques used in Gestalt therapy include confrontation, dialogue with

polarities, role-playing, staying with feelings, reaching and impasse, and reliving and

re-experiencing unfinished business in the forms of resentment and guilt.

Confrontation is often used to call attention to discrepancies. “How” and “what”

questions are often used (Corey, 2009, p. 204).

Application in Vocational Rehabilitation

Module Seven: Counseling Theories and Rehabilitation Counseling

According to Thomas et al. (1992), Gestalt therapy has been used with a variety of

client populations including people diagnosed as having alcoholism, emotional

disturbance, and mental retardation. Because Gestalt therapy is useful for consumers

who have difficulty with distorted or limiting self-images, it may be particularly

efficacious for persons living with physical disabilities. Gestalt therapy, however,

involves a dynamic and active role on the part of the therapist, a higher level of risk

taking with clients, the use of unconventional techniques not accepted by some

agencies, and extensive training in order to be recognized as a Gestalt therapist, thus

making Gestalt therapy impractical for most rehabilitation counselors (Thomas et al.,

1992).

Cognitive- Behavioral Approaches

Included under the category of Cognitive-Behavioral approaches to counseling and

psychotherapy are essentially three sub-groups of theories that will be covered in this

module: behavioral or social learning, cognitive-behavioral, and rational approaches.

In contrast to the humanistic approaches, which focus on client feelings, experiencing,

and awareness, cognitive or rational approaches emphasize a logical and intellectual

solution to human problems. The distinction between the three sub-groups lies

primarily in the extent each one focuses on the behavioral versus the cognitive

component in therapy and the difference between these therapies with regard to the

view of the nature of reality presented.

In rational forms of cognitive therapy, pathology or distress in the individual is

seen as the product of faulty thinking or perception of a stable and knowable reality

(Dobson & Shaw, 1995). For cognitive therapists, reality is a constructed entity that

rests more on the nature of the knower, thus pathology is the result of the meaning

Module Seven: Counseling Theories and Rehabilitation Counseling

that the knower has made of their reality rather than the nature of reality itself

(Dobson & Shaw, 1995).

Behavioral Approaches

“Behavioral strategies focus on changing operationally defined, observable, and

measurable behavior rather than feelings, attitudes, or beliefs. Humans are shaped

and determined by socio-cultural conditioning. The view is basically deterministic, in

that behavior is seen as the product of learning and conditioning” (Corey, 2009, p.

186).

The focus of behavioral approaches is an overt behavior, precision in

specifying goals of treatment, development of specific treatment plans, and objective

evaluation of therapy outcomes. Therapy is based on the principles of learning

theory. Behavioral theorists hold that normal behavior is learned through

reinforcement and imitation and that abnormal behavior is the result of faulty learning.

Behavioral therapy stresses present behavior and has little concern for past history

and origins of disorders (Corey, 2009).

The behavioral therapist is active and directive and functions as a teacher or

trainer in helping the client learn more effective behavior. The client must be active in

the process and experiment with new behaviors. The primary therapeutic techniques

are systematic desensitization, implosive therapy, assertive training, aversion therapy,

and operant conditioning.

Application to Vocational Rehabilitation

Module Seven: Counseling Theories and Rehabilitation Counseling

According to Thomas et al., (1992),

“The behavioral approach appears to be applicable to a wide range of

rehabilitation settings and clientele. No categories of clients are

arbitrarily excluded. Presenting problems of substantial numbers of

rehabilitation clients (e.g., absence of job seeking and maintaining

skills, inappropriate social behaviors, fears related to changing

vocations) are amenable to behavioral counseling. Counselors would

require special training in the application of techniques based on the

learning theory model, as well as training in the skills of problem

identification and goal formulation. Techniques that require cooperation

of others, such as maintaining reinforcement contingencies, may set

some limits on application” (p. 230).

Other techniques that may be used in the rehabilitation setting include

contracting, assertiveness training, and reinforcement counseling. Behavior

techniques are an effective alternative for consumers whose disabilities have created

a deficiency in cognitive functioning.

Cognitive Approaches

Cognitive therapy (CT) arose out of the recognition and belief that “... individuals not

only respond to their environments but are also the architects of those environments”

(Meichenbaum, 1995, p. 141).

The theory is based on information processing, which refers to the way clients

synthesize, organize, and process data to develop plans of action. In CT, such

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distortions are translated into hypothesis to be tested by clients outside of therapy.

Cognitive approaches emerged from the behavioral tradition and share with

behaviorism a focus on empirical demonstration of outcomes, as well as behavior

change (Dobson & Shaw, 1995). Cognitive therapies expand on behavioral models

to include recognition of the effect of thoughts on feelings. A number of therapeutic

models exist along the broad continuum of cognitive-behavioral therapies. Thomas et

al., (1992) summarize the basic philosophy of cognitive approaches to counseling:

CT is based on the theory of personality that holds that how one thinks

largely determines how one feels and behaves (Beck & Weishaar,

1989). It is based on the observation that dysfunctional, automatic

thoughts that are exaggerated, distorted, mistaken, or unrealistic play a

dominant role in psychopathology.

CT assumes that humans respond primarily to the cognitive

representation of their environment rather than to the environment per

se. Most learning is cognitively mediated, and thoughts, feelings, and

behaviors are all causally interactive. Therefore, clients with severe

physical disabilities may erroneously internalize the thought that they

are at fault when environmental barriers preclude their working in a job

to which they aspire” (p. 232).

“The cognitive model of psychopathology predicts that patients who suffer from

a given disorder likely have cognitive schemas (often expressed as attitudes towards

the self) that serve as vulnerability factors for the negative seen in STOP

specific situations” (Dobson & Shaw, 1995, p.161). Identification and modification of

Module Seven: Counseling Theories and Rehabilitation Counseling

maladaptive thinking by breaking the pattern of negative, automatic thoughts is key to

the therapy process.

Cognitive therapy requires the modification of maladaptive beliefs. Thus, the

basic approach of the cognitive therapist is to disrupt the cycle that perpetuates a

client’s depression. One technique is to develop alternative adaptive responses for

dysfunctional thoughts. Maladaptive thoughts can also be handled through such

techniques as “thought stopping,” “scheduled worrying,” replacement of these thoughts

with more adaptive ones, and the development of plans for preventing or handling

anticipated problems.

Three additional techniques to elicit behavior change are:

1. Decatastrophizing or the what if technique (Beck & Emery, 2005) which helps

clients prepare for dreaded consequences;

2. Reattribution techniques, which refer to the identification of ways for clients to

test automatic thoughts and assumptions by considering alternative causes for events

(e.g., I cannot work because of a lack of transportation.);

3. Redefining in which the client is taught to move from an external to an internal

focus, for example, by shifting from “I am lonely and unlovable” to “I need to reach out

to people and be caring” (Beck & Weishaar, 1989).

The cognitive therapist is active in the early stages and becomes less active in

the later stages of therapy serving more as an adviser and less as a teacher.

Therapy is terminated when the client is able to employ appropriate coping skills and

Module Seven: Counseling Theories and Rehabilitation Counseling

perspectives outside of therapy.

Application in Vocational Rehabilitation

Opinions about the applicability of cognitive therapies in rehabilitation counseling are

mixed. On the one hand, CT can be useful in treating depression, anxiety, low self-

esteem, and in helping a client to re-frame the way in which they perceive their

situation. On the other hand, CT is not appropriate for individuals with low intelligence

or severe thought disorders (Thomas et al., 1992). Counselors who wish to use CT

should receive specific training in the techniques beyond that usually incorporated in

most formal counselor education programs. In many cases, referral of carefully

screened clients to professional psychotherapists for cognitive therapy is appropriate.

Rational Approaches

The primary difference between cognitive and rational approaches is in the view of

reality of each perspective. Rational approaches rest on the assumption that there is

an external, stable world that can be known through accurate experience and

cognition. The client’s difficulties rest in an inaccurate or distorted perspective of

reality. Rational therapists confront the cognitive distortions of their clients.

Trait-Factor Counseling - Edmund G. Williamson

One rational approach, also known as the Minnesota approach, is Trait-Factor

counseling. This approach was developed from an essentially vocational counseling

base, emphasizing problems of educational and vocational adjustment (Patterson,

1980). The Minnesota approach, as developed by Williamson, is concerned with the

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assessment of occupational aptitudes and abilities and the requirements of a full

range of various occupations from unskilled to skilled.

A basic assumption of the trait-factor approach is that each individual is born

with the potential for both good and evil. The individual strives to develop his or her

full potential, which may be viewed as excellence in all aspects of human

development. However, according to this approach, the individual needs others to

realize his or her fullest potential. Development is more likely to be fostered by

rational processes than by affective or intuitive capacities.

The basic assumptions related to trait-factor counseling include:

1. Major traits of the individual are measurable and can be used to match an

individual to a vocation or job.

2. Information derived from the individual in testing and diagnostic interviewing can

be used in decision making concerning vocational and general life adjustment.

3. Information derived from the individual must be considered in light of demands

made in the environment.

4. A major task in counseling is the systematic synthesis of information so that

reasonable predictions can be made about the individual’s “fit” with the job and other

important dimensions of the environment (Thomas et al, 1992, p.224).

Considerable stress is placed on social enlightenment, self-understanding, and

self-direction, rather than on autonomous individuation. “The client is expected to be

Module Seven: Counseling Theories and Rehabilitation Counseling

a responsible member of society and to conform to its mores and values” (Thomas et

al., 1992, p. 224).

According to Patterson (1980), in Trait-Factor counseling the counselor

engages in a tutorial role with the client, assisting the client in obtaining data or

providing necessary information, presenting and discussing options, and attempting to

aid the client to reach the best solution. At the same time, attention to emotions and

a positive relationship between the counselor and client are both necessary to achieve

optimal client adjustment.

Application in Vocational Rehabilitation

Trait-factor counseling appears to parallel most closely in the practice of a majority of

rehabilitation counselors, particularly those in state agencies. A major counselor

requirement is the ability to interpret psychological test results and to understand the

merits and liabilities of psychological measurement. Goals of counseling are generally

congruent with the broader goals of rehabilitation. The techniques of analysis

(comprehensive assessment), synthesis, diagnosis, prognosis, counseling, and follow

up are usually well within the repertoire of skills of most rehabilitation counselors, and

deemed appropriate in most settings.

Some counselors, however, have difficulty in accepting the philosophical

underpinnings of this approach. Moreover, the emphasis on the use of psychometric

tests and other assessment techniques could be a significant disadvantage of the

trait-factor approach given the questionable validity of many of these techniques when

applied to people with disabilities (Thomas et al., 1992). It is also important to note

that “person environment theories are excellent for the identification and generation of

Module Seven: Counseling Theories and Rehabilitation Counseling

alternatives for consideration, but they must not be used in isolation of considering the

impact of the disability or job accommodation. Tailor these theories to the situation at

hand” (Szymanski, Enright, Hershenson, & Ettinger, 2003, p. 97).

Rational-Emotive Therapy (RET) - Albert Ellis

The Rational-Emotive Therapy of Albert Ellis represents a radical departure from more

traditional approaches to counseling and psychotherapy. More aligned with cognitive-

behavioral therapies, RET stresses thinking, judging, deciding, analyzing, and doing

(Corey, 2009). It is highly didactic, very directive, and concerned more with cognitive

processes rather than feelings. RET is based on the Rational-Emotive Therapy

paradigm, also called the A-B-C paradigm, that says: “When a highly charged

emotional consequence C follows a significant Activating Event (A), A may be seem

to, but does not actually, cause C. Instead, emotional consequences are largely

created by B, the individual’s ‘belief system’ (Ellis, 2011, p. 196).” It is the person’s

irrational beliefs about an event rather than the actual event that causes distress.

RET assumes that irrational beliefs can be challenged and changed resulting in a

change in the person’s emotional state.

Humans have an innate potential for rational thinking. Irrational thinking is

acquired by learning, usually at an early age and perpetuated throughout life.

Perception, thinking, and emoting are independent and occur simultaneously.

Irrational beliefs, when they cause emotional disturbance, are primarily faulty and/or

negative self-statements. These irrational beliefs may be supplanted and thus

overcome by inducing the individual to verbalize positive self-verbalizations. “Therapy

is cognitive/behavior/action oriented and stresses thinking, judging, analyzing, doing,

and re-deciding. The model is didactic-directive. Therapy is a process of

Module Seven: Counseling Theories and Rehabilitation Counseling

reeducation” (Corey, 2009, p. 186).

“The therapist functions as a teacher, and the client as a student. A personal

relationship between the client and therapist is not essential (Corey, 2009, p. 200).”

RET uses many diverse procedures such as teaching, reading, “homework

assignments,” and applying logical scientific method for problem solving. Techniques

are designed to engage the client in a critical evaluation of a particular philosophy of

life. “The therapist interprets, questions, probes, challenges, and confronts the client

(Corey, 2009, p. 204).” The main contribution of RET is that it points out the

necessity of practice and doing to actually change problem behavior (Corey, 2009).

Application in Vocational Rehabilitation

In regard to the application of RET to the rehabilitation setting, Thomas et al. (1992)

state the following:

Applicability of RET to rehabilitation settings is limited in several

ways. RET is probably not feasible for individuals who have low

intelligence or severe thought disorders. It does not appear appropriate

for educational and vocational decision making, but may be effective

when low self-esteem, poor social skills, or lack of acceptance of

disability interfere with rehabilitation (p. 227).

Reality Therapy - William Glasser

Reality therapy was developed by Glasser (1984), who described reality therapy as

“being applicable to individuals with any sort of psychological problem....It focuses on

Module Seven: Counseling Theories and Rehabilitation Counseling

the present and upon getting people to understand that they choose essentially all

their actions in an attempt to fulfill basic needs....The therapist’s task is to lead them

toward....more responsible choices” (Glasser, 1984, p. 320). According to reality

therapy theory, individuals can develop either a “success identity” or a “failure

identity.” Reality therapy rejects the medical model and concept of mental illness by

focusing on what can be done now, and rejecting the past. “Value judgments and

moral responsibility are stressed, and mental health is equated with acceptance of

responsibility (Corey, 2009, p. 189).”

A primary goal of reality therapy is guiding the client toward learning realistic

and responsible behavior and developing a “success identity.” “This is accomplished

by assisting the client in making value judgments about behavior and in deciding on a

plan of action for change (Corey, 2009, p. 192).”

After the client decides on specific changes desired, plans are formulated, a

commitment to follow through is established, and results are evaluated. In Reality

Therapy, insight and attitude change are not deemed crucial (Corey, 2009). “Reality

therapy is basically an active, directive, didactic therapy. It often uses a contract,

and, when the contract is fulfilled, therapy is terminated. This approach can be

supportive and confrontational (Corey, 2009, p. 205).”

Application in Vocational Rehabilitation

Thomas et al. (1992) comment on the use of reality therapy in vocational

rehabilitation counseling saying:

Reality therapy has not been widely used in rehabilitation settings, but

Module Seven: Counseling Theories and Rehabilitation Counseling

does appear to have potential value for those with “responsibility”

problems, for example, the public offender and the overly dependent

client. Although the basic tenets have been thoroughly documented,

little research has been conducted to verify the utility of reality therapy

(p. 228).

Eclectic Approaches

The eclectic approach represents attempts to develop systems of counseling based on

all salient scientific data and philosophical treatises on human behavior. It recognizes

that no one approach is appropriate for use with all clients, or all types of problems.

Essentially, the eclectic counselor uses techniques derived from a variety of

theoretical systems, providing that these techniques can be logically integrated and

are philosophically congruent.

Arguments persist against eclecticism as a legitimate counseling approach.

Antagonists to eclecticism say that an eclectic approach represents a failure to commit

to a counseling theory and can lead to counselor confusion and inconsistency when

counseling models and techniques are mixed and matched (Thomas et al., 1992). At

the same time, the strengths of eclecticism include the recognition that no one theory

can adequately explain all of human behavior or personality formation, no one set of

therapy techniques is effective for all clients, and both clients and therapists differ in

personality, ability, and temperament. A description of three eclectic counseling

approaches follows.

Multimodal Therapy - Arnold Lazarus

Module Seven: Counseling Theories and Rehabilitation Counseling

Lazarus (1989) developed multimodal therapy to systematize the choice of

counseling techniques borrowed from a variety of theories and approaches. He

adhered to technical eclecticism, the selection of techniques based on client need

rather than utilizing techniques particular to one theoretical orientation. “Lazarus

conceptualized client functioning as organized around seven categories of functioning,

denoted by the acronym, BASIC-ID, where B=behaviors, A=affective processes,

S=sensations, I=images, C=cognitions, I=interpersonal relationships, and D=drugs,

biological functioning, nutrition, and exercise” (Thomas et al., 1992, p. 234). The

BASIC-ID paradigm provides a systematic, organizational structure for counselors

using an eclectic approach to meet the varying needs of clients in a time efficient

manner.

Systematic Eclecticism - Beutler

Beutler (1983) proposed a theoretical system derived from research and practice that

differs from technical eclecticism. His model utilizes theoretical eclecticism, or the

systematic integration of basic principles from a variety of theoretical perspectives.

Beutler’s approach emphasizes obtaining a counselor-client match based on

therapist characteristics, client characteristics, and treatment variables (Mahalik,

1990). Beutler viewed counseling as a process of persuasion in which counselors

influence clients to undergo certain changes according to client needs.

Adaptive Counseling and Therapy (ACT)

Howard, Nance, and Myers (1986) developed a theory referred to as adaptive

counseling and therapy (ACT). ACT posits four levels of counselor readiness and

Module Seven: Counseling Theories and Rehabilitation Counseling

four styles of leadership. Thomas et al. (1992) provide the following description of

ACT:

The four levels of readiness are a) low readiness, b) low-moderate readiness,

c) high-moderate readiness, and d) high readiness. The four styles of direction and

support (leadership) are a) telling-high direction, low support; b) teaching- high

direction, high support; c) supporting-low direction, high support; and d) delegating-

high direction, low support.

Howard juxtaposed the four levels of direction and four levels of support

to form a 4x4 matrix containing 16 cells. Each cell represents a

combination of one level of direction with one level of support. In each

cell, Howard placed a major theory of counseling and its major

advocates. For example, in the cell for low direction and low support,

Howard placed Freudian psychoanalysis. In the cell for low direction but

high support, he placed Rogerian, person-centered therapy. Thus ACT

is more an aid to conceptualizing the relationships among theories than

it is an integrative approach (p. 235).

Application in Vocational Rehabilitation

As in the practice of traditional counseling, eclecticism applied to vocational

rehabilitation counseling involves drawing upon both theoretical concepts and

techniques from various counseling approaches based on the needs and

characteristics of the client, the personal style of the vocational rehabilitation

counselor, and the resources and limitations of the rehabilitation agency setting.

Since the very nature of the vocational rehabilitation process dictates that treatment is

Module Seven: Counseling Theories and Rehabilitation Counseling

to be time-limited and goal focused, with emphasis on obtaining vocational objectives,

most counseling approaches must be modified to fit the vocational rehabilitation

process. “The fundamental goal of rehabilitation counseling-to empower persons with

disabilities to achieve their highest personal, social, and work potential-may be best

accomplished through the use of an eclectic, integrative model of counseling” (Parker,

Hansmann, Thomas, & Thoreson, 2005, p. 143).

Some of the counseling approaches most frequently utilized in eclectic practice

include the following: the Person-Centered therapy of Rogers with its emphasis on the

client-therapist relationship and client self-directedness; the Trait-Factor counseling of

Williamson with its direct application to vocational exploration and choice; behavioral

approaches that include emphasis on contracts and the modification of behaviors that

interfere with obtaining and maintaining employment; the Individual Psychology of

Adler with its goal directed, holistic approach to the individual, including the life style

concept; the psychoanalytic theory of Freud with the understanding of the role of

defense mechanisms; and the Multimodal therapy of Lazarus which focuses on

specific client needs.

Brief Therapy

Brief therapy has proliferated into a dominant form of therapy. Almost all of the major

forms of psychotherapy have developed a model of brief therapy to fit their

philosophical point of view (Street & Downey, 1996). There is brief behavioral

therapy (Primac, 1993), brief psychodynamic therapy (Della Selva, 2004; Garfield,

1998), and brief systemic family therapy (Quick, 2008; Street & Downey, 1996) just

to name a few. In fact, Herink (1980) estimates that with all the variations, there are

approximately 250 different proposed models of brief therapy.

Module Seven: Counseling Theories and Rehabilitation Counseling

There are three components that are common to almost all models of brief

therapy: 1) the focus is selected, and is problem specific, 2) there are time limits, and

3) tasks are employed (Wells & Phelps, 1990). These primary components are

complimentary to the overriding goals of rehabilitation and if employed, will facilitate

the rehabilitation process.

Problem Specific

Brief therapy is treatment with a focus (Quick, 2008), that is directly related to the

goals that the consumer has set (Rudolph, 1999). By utilizing a brief counseling

approach in rehabilitation, the focus is on increasing the functioning of the consumer

in respect to a specific problem.

Time Limits

Time limits in brief therapy are relative to the model one is implementing, from one

(Talmon, 1993) to 72 sessions (Budman, Demby, Soldz, & Merry, 1996). There has

been little agreement on the length of brief therapy (Garrison, 1972), but the length of

time is less relevant than the quality of the experience (Mahoney, 1997). Time limits

may play less of a role in the active rehabilitation process. The areas where time

limits may be more applicable are in on-going support and post employment services.

Task Performance

The performance of therapeutic tasks is central to the treatment process (Rudolph,

Module Seven: Counseling Theories and Rehabilitation Counseling

1999). In order for the consumer to acquire skills, gain insight, or learn coping, an

opportunity to learn must be made available. The learning process is inherent within

the task performance. Tasks also assist the consumer in taking responsibility for the

rehabilitation process, and gaining confidence and esteem through successful

completion of those tasks. Strategic tasks should be used by the counselor to assist

the consumer in accomplishing the goals that have been set.

Because these components of problem focus, time limits, and employing tasks

are common across all forms of brief therapy, and facilitate the overriding goals of

rehabilitation, they help to improve the quality of service rendered by the rehabilitation

counselor. These principles can be applied to diverse populations of consumers, and

can be used with individuals that have physical and/or psychological disabilities.

Brief therapy has even proven effective with severe populations, such as those who

have personality disorders (Donovan, 1989; Garfield, 1998; Winston, Pollack,

McCullough, Flegenheimer, Kestenbaum, & Trujillo, 1991). These common

components can facilitate all phases of rehabilitation (i.e. assessment, skill

development, and follow up services). By utilizing the basic components of brief

therapy, it is the consumer that sets the goals for treatment. The power differential

often present in traditional therapies is alleviated (Street & Downey, 1996), and the

counselor takes on a collaborative role, rather than a coercive one. This type of equal

therapeutic relationship empowers the consumer throughout the rehabilitation process.

Summary

This module has provided a very brief overview of some of the major theories of

personality and counseling. (Theories specific to vocational rehabilitation, career,

and/or guidance counseling were not covered since they will be discussed in other

Module Seven: Counseling Theories and Rehabilitation Counseling

modules.) The content of this module is intended to stimulate thinking about how you,

as a vocational rehabilitation counselor, conceptualize the consumers you serve and

the dilemmas that they face. The way you view consumers will definitely influence

how you work with them.

Case Studies

Identify the key issues that you would want to address as the counselor, the

counseling approach or approaches that would be most appropriate and why.

Case 1

Susan is a 25 year old female with mild mental retardation and problems with impulse

control. She worked briefly in a local grocery store but was dismissed due to behavior

problems. Her intellectual capacity is limited, although you suspect that she is

capable of handling the type of work that she was doing if her problematic behaviors

are under control.

Case 2

Michael is a 47 year old, white, male with an impressive vocational history. He had

worked as a corporate executive in the computer industry. Recently he had a

cerebral vascular accident (CVA) as a result of chronically high blood pressure. The

stroke left him paralyzed on his left side. He is also having difficulty with his speech.

Module Seven: Counseling Theories and Rehabilitation Counseling

He is currently undergoing physical, occupational, and speech therapy. Despite his

speech difficulties, he articulates to you his profound sense of loss around his

physical impairments, his inability to return to his job, and the resulting sense of

meaninglessness and despair that he is experiencing.

Case Study Considerations

Case 1

1. Some of the issues in Susan’s case include: the specific behavioral problems that

are interfering with successful vocational placement, the source of the behavioral

problems (e.g., level of motivation to work, level of social skills, knowledge about

appropriate work behaviors), the degree of mental impairment, and the

appropriateness of the vocational placement in terms of level of challenge,

supervision, and abilities needed to fulfill job requirements.

2. Counseling approaches that might be most appropriate for work with Susan may

include cognitive-behavioral therapies, especially more behaviorally oriented

techniques that would focus on eliminating problematic behaviors or eclectic

therapies that could address behavior, psych-social, and motivational issues. You

may have thought of additional approaches. If so, are they appropriate in terms of the

client’s specific needs, limitations, and characteristics?

Case 2

1. In Michael’s situation there are several issues you may have identified. Some of

Module Seven: Counseling Theories and Rehabilitation Counseling

the most important to consider include the degree of Michael’s despair and sense of

meaninglessness, which could be indicative of serious depression; grief over his

losses; coping skills, rehabilitation and vocational options; current functioning and

prognosis for degree of recovery from the stroke; and realistic vocational objectives.

2. In terms of counseling approaches, it is important to note again that vocational

rehabilitation counselors are not intended to serve as psychotherapists. It may be

most appropriate to refer Michael for counseling regarding emotional issues. Yet, it

would also be appropriate to address Michael’s existential concerns, especially his

sense of meaninglessness which is connected to the loss of his career. Existential-

humanistic approaches may be very appropriate and helpful. Likewise, Cognitive

therapies that focus on altering self-defeating thoughts and looking realistically at his

situation and the possibilities for his future may also be useful. You may have

identified other approaches that could be used for Michael.

References

Beck, A. T. And Weishaar, M. (1989).

Cognitive therapy

. In A. Freeman, K. Simon, L.

E. Beutler, and H. Arkowitz (Eds.), Comprehensive handbook of cognitive

therapy (pp. 21-36). New York: Plenum.

Beck, A. T., & Emery, G. (2005).

Cognitive therapy of anxiety and phobic disorders.

Philadelphia: Center for Cognitive Therapy.

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979).

Cognitive therapy of

depression.

New York: Guilford Press.

Beutler, L. E. (1983).

Eclectic psychotherapy: A systemic approach.

New York:

Pergamon.

Budman, S.H., Demby, A., Soldz, S., & Merry, J., (1996).

Time-limited Group

psychotherapy for patients with personality disorders: Outcomes and dropouts

International Journal of Group Psychotherapy, 46(3), 357-377.

Commission on Rehabilitation Counseling Certification. (2011).

http://www.crccertification.com/

Cook, D. (1992).

Psychosocial impact of disability.

In R. M. Parker and E. M.

Szymanski (Eds.), Rehabilitation counseling: Basics and beyond (2nd ed.).

(pp. 249-272). Austin, Texas: Pro-Ed.

Corey, G. (1977).

Theory and practice of counseling and psychotherapy.

Monterey, California: Brooks/Cole Publishing Company.

Cubbage, M. E., & Thomas, K. R. (1989).

Freud and disability.

Rehabilitation

Psychology, 34, pp. 161-173.

Della Selva, P.C. (2004).

Intensive short-term dynamic psychotherapy: Theory and

technique.

New York, NY: John Wiley & Sons, Inc.

Dobson, K. S., & Shaw, B. F. (1995).

Cognitive therapies in practice.

In B. Bongar &

L. E. Beutler (Eds.), Comprehensive textbook of psychotherapy theory

and practice. New York: Oxford University Press.

Dollard, J., & Miller, N. E. (1950).

Personality and psychotherapy.

New York:

McGraw-Hill.

Donovan, J.M. (1989). Brief dynamic psychotherapy:

Characterologic intervention and

the physical position of the patient.

Psychiatry, 52(4), 446-461.

Ellis, A. (2011).

Rational-emotive therapy.

In R. Corsini (Ed.), Current

psychotherapies, (3rd rd., pp. 196-238). Itasca, IL: F.E. Peacock.

Freud, S. (1963)

A general introduction to psychoanalysis.

New York: Liveright.

Garfield, S.L. (1998).

The practice of brief psychotherapy.

Elmsford, NY:

Pergamon Press, Inc.

Garrison, R.K. (1972).

The measurement of change in self concept and personal

adjustment as the result of brief career development counseling sessions.

Unpublished doctoral dissertation, University of Northern Colorado.

Glasser, W. (1965).

Reality therapy.

New York: Harper and Row.

Glasser, W. (1969).

Schools without failure.

New York: Harper and Row.

Glasser, W. (1984)

Reality therapy.

In R. Corsini (Ed.), Current psychotherapies,

(3rd ed., pp. 320-353). Itasca, IL: F.E. Peacock.

Hall, C. S., & Lindsey, G. (1987).

Theories of personality (4th ed.).

New York:

Wiley.

Herink, R. (Ed.). (1980).

The psychotherapy handbook.

New York: New American

Library.

Howard, G. S., Nance, D. W., & Myers, P. (1986)

Adaptive counseling and

therapy: An integrative, eclectic model.

The Counseling Psychologist, 15,

pp. 371-447.

Jenkins, W., Patterson, J. B., & Szymanski, E. M. (1992),

Philosophical, historic, and

legislative aspects of the rehabilitation counseling profession.

In R. M. Parker

and E. M. Szymanski (Eds.), Rehabilitation counseling: Basics and

beyond. (2nd ed.). (pp. 1-41). Austin, Texas: Pro-Ed.

Lazarus, A. A. (1989).

The practice of multimodal therapy.

Baltimore: The Johns

Hopkins University Press.

Leahy, M. J. (1996). Panel:

The functional role of the vocational rehabilitation

counselor.

In R. N. Pacinelli and D. W. Dew (Eds.), Proceedings of 1996

Conference: Redirecting Vocational Rehabilitation: Responsibilities of

Rehabilitation Education, pp. 27-31. Washington University: Regional

Rehabilitation Continuing Education Program.

Mahalik, J. (1990).

Systematic eclectic models.

The Counseling Psychologist, 16,

pp. 655-679.

Mahoney, M.J. (1997).

Brief moments and enduring effects: Reflections on time and

timing in psychotherapy.

In W.J. Matthews & J.H. Edgette (Eds.), Current

thinking and research in brief therapy: Vol. 1. Solutions, Strategies, Narratives.

New York, NY: Brunner/Mazel Publishers.

Meichenbaum, D. H. (1995). Cognitive-behavioral therapy in historical perspective. In

B. M. Bongar & L. E. Beutler (Eds.),

Comprehensive textbook of

psychotherapy: Theory and

practice. New York: Oxford.

Parker, R.M., Hansmann, S., Thomas, K.R., and Thoreson, R.W. (2005).

Rehabilitation counseling theories. In R.M. Parker, E.M. Szymanski, and J.B

Patterson (Eds.), Rehabilitation Counseling: Basics and Beyond. Austin,

Texas: Pro-Ed.

Patterson, C. H. (1980).

Theories of counseling and psychotherapy. (3rd ed.).

New

York: Harper & Row Publishers.

Patterson, C. H. (1986).

Theories of counseling and psychotherapy.

Pacific Grove,

CA: Brooks/Cole.

Patterson, J.B., Szymanski, E.M., Parker, R.M. (2005) Rehabilitation counseling:

The profession. In R.M. Parker, E.M. Szymanski, and J.B Patterson (Eds.),

Rehabilitation Counseling: Basics and Beyond. Austin, Texas: Pro-Ed.

Perls, F., Hefferline, R. F., & Goodman, P. (1951).

Gestalt therapy.

New York: Julian.

Perls, F. (1969).

Gestalt therapy verbatim.

Lafayette, CA: Real People.

Primac, D.W. (1993). Measuring

change in a brief therapy of a compulsive

personality.

Psychological Reports, 72(1), 309-310.

Quick, E.K. (2008).

Doing what works in brief therapy: A strategic solution

focused approach.

San Diego, CA: Academic Press Inc.

Rogers, C. R., Gedlin, E. T., Kissler, D. J., & Trumax, C. B. (Eds.). (1967).

The

therapeutic relationship and its impact: A study of psychotherapy with

schizophrenics.

Madison, WI: University of Wisconsin Press.

Rotter, J. B. (1954).

Social learning and clinical psychology.

Englewood Cliffs, NJ:

Prentice-Hall.

Rubin S.E. and Roessler, R. T. (2008). Foundations of the vocational rehabilitation

process. Austin, Texas: Pro-Ed

Rudolph, B.A. (1999).

Brief collaborative therapy: A practical guide for practitioners.

Westport, CT: Praeger Publishers.

Rule, W. R. (1984).

Lifestyle counseling for adjustment to disability.

Rockville,

Maryland: Aspen Systems Corporation.

Street, E. & Downey, J. (1996).

Brief therapeutic consultations: An approach to

systemic counselling.

Chichester England: John Wiley & Sons.

Sweeney, T. J. (1981).

Adlerian Counseling: Proven Concepts and Strategies, (2nd

ed.).

Muncie, Indiana: Accelerated Development Inc.

Szymanski, E., Enright, M. S., Hershenson, D. B., & Ettinger, J. M. (2003).

Career

development theories, constructs, and research: Implications for people with

disabilities.

In E. M. Szymanski and R. M. Parker (Eds.), Work and disability

ed.) (pp. 91-153). Austin, Texas: Pro-Ed.

Talmon, M. (1993).

Terapyah bi-fegishah ahat.

Tel Aviv: Motiv, Hotsaah la-or Devir

Katsman.

Thomas, Thoreson, Butler, & Parker (1992).

Theoretical foundations of rehabilitation

counseling.

In R. M. Parker and E. M. Szymanski (Eds.), Rehabilitation

counseling: Basics and beyond (2nd ed.) (pp. 207 - 247). Austin, Texas:

Pro-Ed.

Wells, R.A. & Phelps, P.A. (1990).

The brief psychotherapies: A selective

overview

. In R.A. Wells & V.J. Giannetti (Eds.), Handbook of the brief

psychotherapies (pp. 3-25). New York, NY: Plenum Press.

Winston, A., Pollack, J., McCullough, L., Flegenheimer, W., Kestenbaum, R., &

Trujillo, M. (1991).

Brief Psychotherapy of Personality Disorders.

The

Journal of Nervous and Mental Disease, 179(4), 188-193.

Wolpe, J. (1958).

Psychotherapy and reciprocal inhibition.

Stanford, CA: Stanford

University Press.

Wolpe, J. (1969).

The practice of behavior therapy.

New York: Pergmon.