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Wikipedia-Article "Counseling"

Psychotherapy is a set of techniques intended to improve mental health, emotional or behavioral issues in individuals, who are often called "clients". These issues often make it hard for people to manage their lives and achieve their goals. Psychotherapy is aimed at these problems, and solves them via a number of different approaches and techniques; commonly psychotherapy involves a therapist and client(s), who discuss their issues in an effort to discover what they are and how they can manage them. Because sensitive topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect patient privacy and client confidentiality. See therapeutic frame for more.

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General description

Given that psychotherapy is a kind of treatment restricted mostly to verbal exchanges, practitioners do not have to be medically qualified. In most countries, however, psychotherapists must be trained, certified and licensed with a range of different licensing schemes and qualification requirements in place around the world. Psychotherapists may be psychologists, social workers, trained nurses, psychiatrists, psychoanalysts, or professionals of other mental health disciplines. Psychiatrists' training focuses on the prescription of medicines, with some training in psychotherapy. Psychologists have special training in mental health assessment and research in addition to psychotherapy. Social workers have special training in mental health assessment and treatment as well as linking patients to community and institutional resources.

Recent trends in drug development to treat chemical imbalances have led to a more wide spread use of pharmaceuticals in conjunction with psychotherapy by medically qualified mental health nurse practitioners, psychiatrists, and in some states prescribing psychologists . While having benefits for patients with ailments such as bipolar disorder, impulse problems, schizophrenia and obsessive compulsive disorder, drugs of late have begun to be used as a 'quick fix' and are gaining less favor in the therapeutic community.[1][2]

There are at least five main systems of psychotherapy:

For an idea of the range of different kinds of psychotherapies, see the list of psychotherapies.
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History

For a comprehensive view of the different kinds of psychotherapies, see the List of psychotherapies.
For a view of the development of psychotherapy see the Timeline of Psychotherapy history

Most psychotherapies are either direct descendants of psychoanalysis, or their founders started out in areas of psychoanalysis before developing their own theories. Therefore, when describing the history of psychotherapy, most traditionally start with Freud.

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Psychoanalysis

Although there are some bodies of thought in psychology without Sigmund Freud in their legacy, most can be traced back to his work starting in the 1880s in Vienna. Trained as a neurologist, Freud began noticing neurological problems in patients that had no discernible biological basis. Seeing blindness, paralysis and anorexia with no apparent physical cause, he looked towards the mind for answers. Finding some evidence that those who were mentally ill could exhibit physical symptoms, he discovered colleagues and teachers who were equally perplexed and interested in such matters like Josef Breuer and Jean-Martin Charcot.

Freud opened up a private practice in 1886 until 1896 that mostly treated women who showed symptoms of hysteria (which, at that time, was very loosely defined). Using such techniques as dream interpretation, free association, transference and analysis of the id, ego and superego, his colleagues developed a system of psychotherapy termed 'psychoanalysis'. Students and colleagues of his such as Alfred Adler, Otto Rank and Carl Jung became psychoanalysts themselves, and formed their own differentiating systems of psychotherapy. These were all later termed under a more broad label of 'psychodynamic', meaning anything that involved the psyche's conscious/unconscious influence on external relationships and the self. Psychodynamic psychotherapy and psychoanalysis are considered to be particularly effective at treating certain mental disorders, such as personality disorders and mood disorders.

Current psychodynamic approaches continue to develop and change. Contemporary Freudian approaches usually retain Freud's emphasis on sexuality, aggression, and mental conflict, and often prefer insight-oriented, uncovering psychotherapy to more supportive techniques. Contemporary Freudians, for the most part, continue to believe that psychotherapy is most effective when it leads to increased self-knowledge on the part of the patient. Other current psychodynamic approaches -such as object-relational and self-psychological approaches- prefer techniques designed to change the patient's habitual patterns of living by building an especially authentic or supportive relationship with the analyst that is believed to help the patient learn new ways of relating to others and to life in general.

The psychoanalytic community has recently begun to put extensive effort into researching the efficacy and process of psychoanalytic treatment.

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Cognitive

As psychoanalysis and its influence spread throughout the world in the early 1900s, other ideas were brewing. Aaron T. Beck, following schooling at Brown University and Yale Medical School developed his own form of psychotherapy known as cognitive therapy in the 1940s. Similarly Albert Ellis, a student at Columbia University developed Rational Emotive Behavior Therapy (REBT). The spectrum that soon became cognitive therapy involves some common features. These included short, structured and present focused therapy aimed at changing a person's distorted thinking. Being oriented towards symptom-relief, collaborative empiricism and modifying peoples core beliefs, this is often the preferred method of treatment for depression, substance abuse, anxiety disorders, eating disorders and phobias. This method of treatment is known for having been more extensively researched than most other types of psychotherapy.

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Humanistic

Another body of thought in psychotherapy started in the 1950s with Carl Rogers. Rogers, who went to Columbia University just like Albert Ellis, earned a PhD while simultaneously becoming interested in existentialism, the works of Abraham Maslow and his hierarchy of human needs. By the early 1930s he had finished his doctoral work and had brought Person centered psychotherapy into mainstream focus. Rogers' basic tenets were unconditional positive regard, genuineness, and empathic understanding, with each demonstrated by the counselor. According to Rogers, these tenets were both necessary and sufficient to create a relationship conducive to enhancing the client's psychological well being, by enabling the client to fully experience themselves. Inspired by Rogers, others followed his mode of thinking like Fritz and Laura Perls in the creation of Gestalt therapy. Later these fields of psychotherapy would become what is known as humanistic psychotherapy today.

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Behavioral

The rudiments of behavioral counseling begin in the 1920's, however it's comprehensive form did not emerge until the 1950's and 1960's. The primary contributors were Joseph Wolpe in South Africa, M.B. Shipiro and Hans Eyseneck in Britain, and B.F. Skinner in the United States.

Behavioral counseling approaches rely on principles of operant conditioning, classical conditioning and social learning theory. Behaviorism is often based on the philosophy of behaviorism. According to behaviorism, counseling should only focus on behaviors that are observable and measurable, rather than cognitions. Note that B. F. Skinner was awarded Humanist of the Year Award in 1972 by the American Humanist Association, indicating that behavioral counseling is considered compatible with humanistic philosophy as well (Epstein, 1997).

The behavioral counselor may use operant conditioning techniques contingency contracts, self-management, shaping, behavioral momentum, token economies, response cost, and biofeedback. For social learning theory techniques, counselors may use modeling, behavior practice groups, and role playing. Often classical conditioning techniques are the treatment of choice for phobias and fetishes, and include techniques of systematic desensitization, flooding, counterconditioning, and aversive conditioning. Sometimes hypnosis is used to achieve relaxation as well.

Additionally, behavioral counseling has been effective in treating eating disorders. Behavioral counseling is the most scientifically validated approach because of its emphasis measurable and observable results. Increasingly, counselors and researchers are incorporating behavior modification techniques with other approaches (eclectic or multimodal approaches), and develop behavioral definitions to measure psychological constructs such as depression, anxiety or anger (Thompson, Rudolph, & Henderson, 2004).


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Brief counseling

Also see: Brief therapy

Brief Counseling can make use of any of the above psychotherapeutic approaches, but it also may involve specific techniques that have been shown to provide rapid relief for large numbers of people. Among these approaches are Narrative Therapy and Solution-focused Therapy. These practices help clients to identify those occasions when their stated problem(s) are less dominant in their lives.

Typically brief counseling can take from one to five sessions. Employee Assistance Programs are geared to provide brief assessments and interventions that often fulfill the clients' needs in just a few sessions. It is also not unusual for a community mental health center to offer Brief Counseling to all new clients in order to encourage greater self-reliance and to discourage dependence on a therapist. In such a context, self-help groups also play a role in aiding ongoing improvements in functioning.

Well-known writers/practitioners of brief counseling techniques are Bill O'Hanlon, Insoo Kim Berg, Michael White, Jeffrey Guterman, and Steve de Shazer.

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Schools and approaches

Psychoanalysis was the earliest form of psychotherapy, but many other theories and techniques are also now used by psychotherapists, psychologists, psychiatrists, personal growth facilitators and social workers. Techniques for group therapy have been developed.

While behaviour is often a target of the work, many approaches value working with feelings and thoughts. This is especially true of the psychodynamic schools of psychotherapy, which today include Jungian therapy and Psychodrama as well as the psychoanalytic schools. Other approaches focus on the link between the mind and body and try to access deeper levels of the psyche through manipulation of the physical body. Examples are Rolfing, Pulsing and postural integration.

A distinction can also be made between those psychotherapies that employ a medical model and those that employ a humanistic model. In the medical model the client is seen as unwell and the therapist employs their skill to help them back to health. In the humanistic model the therapist facilitates learning in the individual and the clients own natural process draws them to a fuller understanding of themselves. An example would be gestalt therapy.

Some psychodynamic practitioners distinguish between more uncovering and more supportive psychotherapy. Uncovering psychotherapy emphasizes facilitating clients' insight into the roots of their difficulties. The best-known example of an uncovering psychotherapy is classical psychoanalysis. Supportive psychotherapy, by contrast, stresses strengthening clients' defenses and often providing encouragement and advice. Depending on the client's personality, a more supportive or more uncovering approach may be optimal. Most psychotherapists utilize a combination of uncovering and supportive approaches.

Cognitive behavioural therapy is particularly common where the mode of psychotherapy is dictated by the demands of insurance companies who wish to see a financially limited commitment.

A computer program called ELIZA has been built to perform an automated and extremely simplified version of Rogerian psychotherapy.

There is considerable controversy over which form of psychotherapy is most effective, and more specifically, which types of therapy are optimal for treating which sorts of problems. Psychotherapy outcome research -in which the effectiveness of psychotherapy is measured by questionnaires given to patients before, during, and after treatment- has had difficulty distinguishing between the different types of therapy. Many psychotherapists believe that the nuances of psychotherapy cannot be captured by this type of research, and prefer to rely on their own clinical experiences and conceptual arguments to support the type of treatment they practice.


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Therapeutic Relationship

Research has shown that the quality of the relationship between the therapist and the client has a greater influence on client outcomes than the specific type of psychotherapy used by the therapist (this was first suggested by Saul Rosenzweig in 1936). Accordingly, most contemporary schools of psychotherapy focus on the healing power of the therapeutic relationship.

This research is extensively discussed (with many references) in The Heart and Soul of Change: What Works in Therapy, Mark A. Hubble, Barry L. Duncan, Scott D. Miller (Eds), American Psychological Association (1999) ISBN 155798557X (quotes in this section are from this book) and in "The great psychotherapy debate" by Bruce Wampold (2001).

A literature review by M. J. Lambert (1992) estimated that 40% of client changes are due to extratherapeutic influences, 30% are due to the quality of the therapeutic relationship, 15% are due to expectancy (placebo) effects, and 15% are due to specific techniques. Extratherapeutic influences include client motivation and the severity of the problem:

For example, a withdrawn, alcoholic client, who is "dragged into therapy" by his or her spouse, possesses poor motivation for therapy, regards mental health professionals with suspicion, and harbors hostility toward others, is not nearly as likely to find relief as the client who is eager to discover how he or she has contributed to a failing marriage and expresses determination to make personal changes.

In one study, some highly motivated clients showed measurable improvement before their first session with the therapist, suggesting that just making the appointment can be an indicator of readiness to change. Tallman and Bohart note that:

[O]utside of therapy people rarely have a friend who will truly listen to them for more than 20 minutes (Stiles, 1995)... Further, friends and relatives often are involved in the problem and therefore do not provide a "safe outside perspective" which may be required. Nonetheless, as noted above, people often solve their problems by talking to friends, relatives, co-workers, religious leaders, or some other confidant in their lives, or by thinking and exploring themselves.

Rosenzweig, S. (1936). Some implicit common factors in diverse methods in psychotherapy. Journal of Orthopsychiatry, 6, 412-415

Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldfried (Eds), Handbook of Psychotherapy Integration (pp. 94-129)

Stiles, W. B. (1995). Disclosure as a speech act: Is it psychotherapeutic to disclose? In J. E. Pennebaker (Ed.), Emotion, Disclosure, and Health (pp. 71-92).

Tallman, Karen, and Arthur C. Bohart (1999). The Client as a Common Factor: Clients as self-healers. In Hubble, Duncan, Miller (Eds), The Heart and Soul of Change (pp. 91-131)

Asay, Ted P., and Michael J. Lambert (1999). The Empirical Case for the Common Factors in Therapy: Quantitative Findings. In Hubble, Duncan, Miller (Eds), The Heart and Soul of Change (pp. 23-55)

Wampold, B. E. (2001). The great psychotherapy debate. New Jersey: Lawrence Erlbaum.

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Criticism

Critics of psychotherapy suggest that the passage of time contributes significantly to psycho-social healing. After a difficult personal event, the friendly support of friends, peers, and family members; clergical contacts; and personal reading, research, and independent coping are all likely contributors to improvement should the person have those resources at hand. Contemporary use of simple questionnaires to report on personal function and feeling cannot be easily isolated from a variety of other valuable, more accessible, and less expensive tools that have been in place long before psychotherapy or psycho-active pharmaceuticals.

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See also

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Related lists


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References

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Psychodynamic schools

  • Anthony Bateman, Dennis Brown, Jonathan Pedder Introduction to Psychotherapy: An Outline of Psychodynamic Principles and Practice; Routledge; ISBN 0415205697; June 2000
  • Bateman, A. & Holmes J. Introduction to Psychoanalysis: Contemporary Theory and Practice; Routledge; ISBN 0415107393; 1995
  • Ellenberger, Henri F., The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry, Basic Books 1970
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Humanistic schools

  • John Rowan; Ordinary Ecstasy: Brunner-Routledge; ISBN 0415236320; March 2001
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General

  • Thomson, C.L, Rudolph L.B., & Henderson, D. (2004). Counseling children. (6th ed.). Belmont, CA: Brooks/Cole Thompson.
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Behavioral

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External links

This article is based on the article "Counseling" from Wikipedia - the free encyclopedia created and edited by online user community. This article is distributed under the terms of GNU Free Documentation License. Here you find the list of authors of this article. The article can only edited within Wikipedia. Edit this article in Wikipedia.

Wikipedia-Article "Management [2]"

Manager redirects to here. For use in sports, see coach (sport).
Enterprise management redirects to here. For use in computer networks, see Network management or Systems management

"Management" (from Old French ménagement "the art of conducting, directing", from Latin manu agere "to lead by the hand") characterises the process of leading and directing all or part of an organization, often a business, through the deployment and manipulation of resources (human, financial, material, intellectual or intangible). Early twentieth-century management writer Mary Parker Follett defined management as "the art of getting things done through people."

One can also think of management functionally, as the action of measuring a quantity on a regular basis and of adjusting some initial plan, and as the actions taken to reach one's intended goal. This applies even in situations where planning does not take place. From this perspective, there are five management functions: Planning, Organizing, Leading, Co-ordinating and Controlling.

Management is also called "Business Administration", and schools that teach management are usually called "Business Schools". The term "management" may also be used to describe the slate of managers of an organization, for example of a corporation. A governing body is a term used to describe a group formed to manage an organization, such as a sports league.

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Historical development

Some writers trace the development of management thought back to Sumerian traders and ancient Egyptian pyramid builders. Slave-owners through the centuries faced the problems of exploiting/motivating a dependent but sometimes recalcitrant workforce, but many pre-industrial enterprises, given their small scale, did not feel compelled to face the issues of management systematically. But innovations such as the spread of Hindu-Arabic numerals (5th to 15th centuries) and the codification of double-entry book-keeping (1494) provided tools for management assessment, planning and control.

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19th century

Modern management as a discipline began as an off-shoot of economics in the 19th century. Classical economists such as Adam Smith and John Stuart Mill provided a theoretical background to resource allocation, production, and pricing issues. About the same time, innovators like Eli Whitney, James Watt, and Matthew Boulton developed technical production elements such as standardization, quality control procedures, cost accounting, interchangeability of parts, and work planning.

By the middle of the 19th century, Robert Owen, Henry Poor, and M. Laughlin and others introduced the human element with theories of worker training, motivation, organizational structure and span of control. Compare the analyses of Karl Marx and of Friedrich Engels.

By the late 19th century, marginal economists Alfred Marshall and Leon Walras and others introduced a new layer of complexity to the theoretical underpinings of management. Joseph Wharton offered the first tertiary-level course in management in 1881.

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20th century

By about 1900 we find managers trying to place their theories on a thoroughly scientific basis. Examples include Henry Towne's Science of management in the 1890s, Frederick Winslow Taylor's Scientific management (1911), Frank and Lillian Gilbreth's Applied motion study (1917), and Henry L. Gantt's charts (1910s). J. Duncan wrote the first college management text book in 1911.

The first comprehensive theories of management appeared around 1920. People like Henri Fayol and Alexander Church described the various branches of management and their inter-relationships. In the early 20th century, people like Ordwat Tead, Walter Scott and J. Mooney applied the principles of psychology to management, while other writers, such as Elton Mayo, Mary Parker Follett, Chester Barnard, Max Weber, Rensis Likert, and Chris Argyris approached the phenomenon of management from a sociological perspective.

Peter Drucker wrote one of the earliest books on applied management: Concept of the Corporation (published in 1946). It resulted from Alfred Sloan (chairman of General Motors until 1956) commissioning a study of the organisation. Drucker has gone on to write 32 books, many in the same vein.

H. Dodge, Ronald Fisher, and Thorton C. Fry introduced statistical techniques into management. In the 1940s, Patrick Blackett combined these statistical theories with microeconomic theory and gave birth to the science of operations research. Operations research, sometimes known as "management science", attempts to take a scientific approach to solving management problems, particularly in the areas of logistics and operations.

Some of the more recent developments include the theory of constraints, Management by objectives, reengineering, and various information technology driven theories such as agile software development.

As the general recognition of managers as a class solidified during the 20th century and gave perceived practitioners of management a certain amount of prestige, so the way opened for popularised systems of management ideas to peddle their wares. In this context many management fads may have had more to do with pop psychology than with scientific management theory.

Towards the end of the 20th century, business management came to consist of six separate branches, namely:

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21st century

In the 21st century we find it increasingly difficult to subdivide management into functional categories in this way. More and more processes simultaneously involve several categories. Instead, we tend to think in terms of the various processes, tasks, and objects subject to management. A list of some of the areas of management can be found later in this article.

It is also the case that many of the assumptions made by management have been under attack from business ethics, critical management studies, and anti-corporate activism.

One consequence is that workplace democracy has become both more common, and more advocated, in some places distributing all management functions among the workers, each of whom takes on a portion of the work. However, these models predate any current political issue, and may be more natural than command hierarchy. All management is to some degree democratic in that there must be majority support of workers for the management in the long term, or they leave to find other work, or go on strike. Hence management is becoming less about command-and-control, and more about facilitation and support of collaborative activity, utilizing principles such as those of human interaction management to deal with the complexities of human interaction.

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Nature of the work

In for-profit work, the primary function of management is satisfy a range of stakeholders. This typically involves making a profit (for the shareholders), creating valued products at a reasonable cost (for customers), and providing rewarding employment opportunities (for employees). In nonprofit work it is also important to keep the faith of donors. In most models of management, shareholders vote for the board of directors, and that board then hires senior management. Some organizations are experimenting with other methods of selecting or reviewing managers senior managers (such as employee voting models) but this is very rare.

In the public sector of countries constituted as representative democracies, politicians are elected to public office. They hire many managers and administrators, and in some countries like the United States a great many people lose jobs when a new President comes into office. 2500 people serve "at the pleasure of the President" including all the top US government executives.

Public, private and voluntary sectors place different demands on managers, but all must retain the faith of those who select them (if they wish to retain their jobs), retain the faith of those people that fund the organization, and retain the faith of those who work for the organization. If they fail to convince employees that they are better off staying than leaving, the organization will be forced into a downward spiral of hiring, training, firing, and recruiting.

Management also has a responsibility to innovate and improve the functioning of the organization.

In all but the smallest organizations, achieving these objectives involves a division of management labour. People specialize in a limited range of functions so as to more quickly gain competence and expertice. Even in employee managed workplaces such as a Wobbly Shop, where managers are elected, or where latitude of action is sharply restricted by collective bargaining or unions, managers still take on roughly the same functions and job descriptions as in a more traditional command hierarchy.

Chief executive officer (CEO) - The CEO is ultimately responsible for the success or failure of the business. He or she provides overall strategic direction for the firm, often with the assistance of a team of vice presidents. Strategic management decisions like what products to market, what market segments to target, what functions to outsource, what business model to employ, and what geographical areas to operate in are the responsibility of the CEO. The CEO is accountable to the board of directors. Typically a CEO will delegate many responsibilities to one or more executive vice presidents.

In small firms, the owner, president, or chief executive officer typically assume many roles and responsibilities.

Vice president, Marketing - An executive vice president of marketing might direct overall marketing strategies, advertising, promotions, sales, product management, pricing, and public relations policies. The direct reports of the EVP oversee advertising and promotion. In a small firm, they may serve as a liaison between the firm and the advertising or promotion agency to which many advertising or promotional functions are contracted out. In larger firms, advertising managers oversee in-house account, creative, and media services departments.

Marketing managers - Marketing managers develop the firm's detailed marketing plans and procedures. With the help of subordinates, including product development managers and market research managers, they determine the demand for products and services offered by the firm and its competitors. In addition, they identify potential markets—for example, business firms, wholesalers, retailers, government, or the general public. Marketing managers develop pricing strategy with an eye towards maximizing the firm's share of the market and its profits while ensuring that the customers are satisfied. In collaboration with sales, product development, and other managers, they monitor trends that indicate the need for new products and services and oversee product development. Marketing managers work with advertising and promotion managers to promote the firm's products and services and to attract potential users.

Promotions managers - Promotions managers supervise sales promotion specialists. They direct promotion programs that combine advertising with purchase incentives to increase sales. In an effort to establish closer contact with purchasers—dealers, distributors, or consumers—promotion programs may involve direct mail, telemarketing, television or radio advertising, catalogs, exhibits, inserts in newspapers, Internet advertisements or Web sites, instore displays or product endorsements, and special events. Purchase incentives may include discounts, samples, gifts, rebates, coupons, sweepstakes, and contests.

Public relations managers - Public relations managers supervise public relations specialists. These managers direct publicity programs to a targeted public. They often specialize in a specific area, such as crisis management or in a specific industry, such as healthcare. They use every available communication medium in their effort to maintain the support of the specific group upon whom their organizations success depends, such as consumers, stockholders, or the general public. For example, public relations managers may clarify or justify the firms point of view on health or environmental issues to community or special interest groups.

They also evaluate advertising and promotion programs for compatibility with public relations efforts and serve as the eyes and ears of top management. They observe social, economic, and political trends that might ultimately affect the firm and make recommendations to enhance the firm's image based on those trends.

They may also may confer with labor relations managers to produce internal company communications—such as newsletters about employee-management relations—and with financial managers to produce company reports. They assist company executives in drafting speeches, arranging interviews, and maintaining other forms of public contact; oversee company archives; and respond to information requests. In addition, some handle special events such as sponsorship of races, parties introducing new products, or other activities the firm supports in order to gain public attention through the press without advertising directly.

Sales managers - Sales managers direct the firm's sales program. They assign sales territories, set goals, and establish training programs for the sales representatives. Managers advise the sales representatives on ways to improve their sales performance. In large, multiproduct firms, they oversee regional and local sales managers and their subordinates. Sales managers maintain contact with dealers and distributors. They analyze sales statistics gathered by their staffs to determine sales potential and inventory requirements and monitor the preferences of customers. Such information is vital to develop products and maximize profits.

Account executive - The account executive manages the account services department, assesses the need for advertising, and, in advertising agencies, maintains the accounts of clients.

Creative director - The creative services department develops the subject matter and presentation of advertising. The creative director oversees the copy chief, art director, and associated staff.

Media director - The media director oversees planning groups that select the communication media—for example, radio, television, newspapers, magazines, Internet, or outdoor signs—to disseminate the advertising.

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Areas of management

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See also

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Lists

This article is based on the article "Management [2]" from Wikipedia - the free encyclopedia created and edited by online user community. This article is distributed under the terms of GNU Free Documentation License. Here you find the list of authors of this article. The article can only edited within Wikipedia. Edit this article in Wikipedia.