40 Developmental Counselling Therapy, the four developmental orientations in DCT

M. Priya

Introduction

Developmental counselling therapy is meant for how clients make meaning and understanding their own world and many theories of development are metaphorical basis (Ivey et al., 2005). Ivey proposed the theory in which the clients perceive their experiences with relation to one of four cognitive-emotional styles. i.e. sensorimotor (SM), Concrete (CO), formal operational (FO) and dialectic approach system (DS). The clients relate to the primary world and present as fully in a particular style and describe their issues accordingly. On the other hand, they may be unable to process in any particular style (Barrio-Minton & Myers, 2008).

DCT can be applied to variety of mental issues including anxiety, depression and spiritual bypass. DCT has been also used with children, adolescents in difficult situation. The world health organisation (WHO) has estimated around 100 million people worldwide suffer from mental illness in case of health, occupation, relationships, violence, injury or death. Mental health counsellors are taking up challenges to find the ways to treat these disorders to overcome the problem. Relapse is commonly termed as a return to use of a substance after a period of abstinence from use (Moss & Cook, 2012). Relapse usually occurs for 40% to 60% of those treated for chemical dependency (Fisher & Harrison, 2005). Brooks and McHenry (2009) stated that “relapsing clients normally have a multitude of issues that can combine to disruption their recovery efforts”. It is thus important to work to better understand the phenomenon of relapse and explore interventions that prevent it.

Objectives:

• To know what is DCT
• To be aware of different types of DCT

Cognitive Development of Children

Piaget (1952) proposed a theory of cognitive development and explained how children construct knowledge and how this process changes over period of time. He assumed that children by their own try to make sense of their world including physical and social phenomena. In critical points in their development, new ways of thinking and constructing knowledge appears.

Developmental counseling and therapy (DCT) developed by Allen Ivey for understanding and helping individual based on the theories for bringing uniqueness, human growth and development, family and environmental systems, wellness, multicultural awareness, counseling and therapy, and change. DCT can be described as an integrative metatheory that integrates other theories and counseling approaches in a methodical manner. It provides a means for counselors to assess their clients accurately and choose interventions most likely to assure successful counseling outcomes.

Human Developmental Nature

Every individual will change over their lifespan. Individual life experiences combine to create an exclusive life story for them. That story gives them assurance as how they make sense of their life experiences, situations and transitions. How to face challenges, how to deal with the changes of each life stages becomes part of their life story.

Normal Development

Basic to the DCT model is a betterment approach and a search for what is moral and right in individual client development. Every change have some transitions, yet even normal changes can create difficulties. Many individuals are often confused when a transition creates conflicting emotions such as happiness and sorrow. This is distinctive because with every transition, some innovative and desired things are gained, and some things are lost as well. For example, the birth of a new child is a joy to parents and sometimes it is also a burden to some people as it creates major life changes.

Developmental Challenges

The life changes and challenges create stresses. Sometimes these stresses are severe and extreme. Some traditional concept this would be considered as the basis of personality disorders. From a developmental perspective, responses to disturbance are normal processes of trying to make sense of one’s life experiences and to become strong. Counsellors by viewing distress responses as developmentally normal, they are able to focus on understanding the client rather than identifying a problem. This basic rapport and understanding is helpful for promoting a positive, proactive view of clients.

The Developmental Counseling and Therapy Model Philosophical Foundations

DCT is stranded in multiple theories and in the ethical writings of Plato and the research and applications of Piaget. Both proposed four levels and styles of thinking.

Plato style

Plato explained the transition to enlightenment. A slave, chained in the dark with only candles for light, sees shadows on the walls. The slave creates stories to explain the shadows. After the slave emerges from the cave the true meaning of the shadows becomes clear. Upon returning to the cave, the shadows no longer have the same meaning. This constitutes a permanent change in perspectives and in ways of thinking. It is impossible to return to earlier stages of thinking. A “blind spot” has been removed.

Piaget style

He studied cognitive development of children and proposed four consecutive stages in the development of thought processes. These stages are linear, hierarchical and also qualitatively different. In the sensory motor stage, every infant who experiences the world through the five senses, such as taste, touch, hearing, smell, and vision. The preoperational child begins to develop mental images to represent things that are not physically present. Young children, ages 7 to 11, begin to develop a concrete understanding of the world which allows children to think logically rather than magically to explain events. Adolescents when they enter the final stage of development are able to understand abstract concepts. They can imagine future events and think about and hypothesize consequences without needing to take action.

Four Cognitive-Emotional-Developmental Styles

The DCT model is based in a symbolic interpretation of the theories of Plato and Piaget. These theories suggest different ways of thinking and the development of thought processes.

In DCT, four cognitive-emotional-developmental styles (CED) are defined, these are

1. The sensorimotor
2. Concrete
3. Formal
4. dialectic systemic CED styles

(https://psychology.iresearchnet.com/counseling-psychology/counseling-therapy/developmental counseling-and-therapy/)

Each styles has a different way of processing information. Any individual can function in one style or sometimes in multiple ways.These styles are not mutually exclusive and any individual can function in more than one style at the same time in a situation.

These four DCT styles could be blend in a cyclical model and run from one to another. It is also has chance to move between the styles in a nonlinear manner. All the four styles help individuals to understand their world and their experience in different way. All are important and essential ways of understanding their own experiences. The inability to function in any of the style is referred to as a “Developmental block” and these blocks can be overcome through counseling.

Sensorimotor Cognitive-Emotional-Developmental Style

Sensorimotor functioning is based on individual sensory experience. This works with what one sees, hears, and feels. Hence all of one’s experiences in life have a physical component and are physically embedded in one’s body. Any experiences carry a body memory and that memory may be experienced as an image or thought process.

People feelings are expressed in images which reflect conscious or unconscious thoughts. Sometimes they are not conscious of the feelings and they themselves question about their behaviours. To locate one’s feelings it is evidence of late sensorimotor functioning. Sometimes they are unable to experience the feelings and that could be a developmental block.

Concrete Cognitive-Emotional-Developmental Style

The concrete CED style is based on linear sequences of events based on logic. The early and late concrete thinking characterised by specific details of events and if-then thinking. If an individual forget to tell or missed out to tell important details in telling a story may have an early concrete block. Someone who is overly concrete may be able to provide many examples of overwhelming life situations. This is also a block, but in the late concrete style, this occurs when a person cannot understand relationships among actions. If the individual cannot anticipate outcomes, then he apt to keep repeating the same mistakes.

Formal Cognitive-Emotional-Developmental Style

Abstract thinking signifies formal operational thinking. In the DCT model, formal thinking defines having the ability to be self-reflective and analytical which allows an individual to see his or her patterns of feelings, emotions and behaviors. Here an individual can recognise cause and effect of a situation.

In the early formal CED style, individual become aware of their repeating patterns but they do not understand how those patterns cause in the difficulties they experience. In the late formal style, individuals begin to understand the patterns and its meaning in their lives.

Dialectic Systemic Cognitive-Emotional-Developmental Style

The first three orientations in the DCT model encompass internal aspects of functioning. The fourth style, dialectic, necessitates that individuals move beyond an egocentric view to see themselves as part of multiple interacting systems. In the dialectic style, individuals “think about thinking.” Individual cognitive complexity allows them to view themselves and their patterns based in family, gender, and cultural impacts. They also can recognize the views of others as separate and distinct from their own. This act helps the individuals to recognize how multiple systems, individually and collectively, have affected their development and continue to affect their relationships, growth, development, daily functioning, and holistic wellness.

A block in the early dialectic style is reflected in an inability to understand how patterns developed. They may spend so much time thinking about other alternatives, or who might be affected by what they do, that taking concrete action becomes difficult. They may be unable to understand the influence of one or more systems in their lives and may reject those systems as a significance. (https://psychology.iresearchnet.com/counseling-psychology/counseling-therapy/developmental-counseling-and-therapy/)

Assessing Cognitive Styles

Ivey developed the Standard Cognitive Developmental Interview (SCDI) to enable investigation and movement through the four cognitive styles. The aim of this assessment interview is to determine how well clients function in each of the four cognitive-emotional-developmental styles. This SCDI is always situation specific and could be focused on one particular issue. Whenever multiple issues arise, successful completion of the interview depends on the counsellors ability and client to maintain a focus rather than pursue multiple possible concerns.

In the process of interview, it is essential that counselors “stay out of the client’s way” by focusing on the client’s structures of meaning. This requires the use of basic microcounseling skills such as attending, listening, paraphrasing, summarizing, questioning, and encouraging. These skills are applied within four sequences of questions corresponding to the four DCT cognitive-emotional-developmental styles.

Assessing the Sensorimotor Cognitive-Emotional-Developmental Style

The questions are proposed to make the image present and experienced or felt in the here-and-now of the session. The following questions are asked and considerable reflection and exploration of the client’s responses is desired before moving to each new question:

• What are you hearing?
• What are you seeing?
• What are you feeling?
• Can you locate that feeling in your body or any part of your body?

   If the client responds positively then his feelings an assessment of full functioning in the sensorimotor style may be made.

If the client is unable to express what he or she is feeling in response to the image, a sensorimotor block may be present at that point of view. The presence of such a block may inhibit successful completion of the remaining portions of the interview as the embedding of the feeling is of singular importance.

Assessing the Concrete Cognitive-Emotional-Developmental Style

The aim of the concrete questioning sequence is to normalize how well the client is able to process an issue in a linear and detailed manner. The transition to this questioning sequence occurs immediately after the embedding of a feeling of a person. It begins with a summary of the sensorimotor image, a reflection of the embedded feeling, and the question “Was there another time you felt the same way?” This question stimulates the client to determine a second example of a time when the first feeling occurred. To explore this second example, the following questions are posed:

• Can you tell me specifically what has happened to you?
• What happened just before that incident?
• What did you do when that happened?

The counselor listens for details and for evidence of logical and if-then thinking. This questioning sequence moves the client away from present sensory experience in preparation for a more reflective style.

If a client is highly concrete and able to offer many details, multiple stories often emerge. It can be a challenge to keep this type of client focused on one story and one sequence of events. Reflecting back to the embedded feeling may be helpful. Once the concrete processing has been completed, two examples have been provided in which the same embedded feeling was predominant.

Assessing the Formal Cognitive-Emotional-Developmental Style

Here the goal is to support the client in identifying patterns and repeating patterns by asking questions such as the following:

• What similarities do you see in these two (or more) experiences?
• Does this kind of thing (feeling, behavior, thought) happen a lot for you when (the situation happens)?
• What are you saying to yourself when this happens?
• How is your way of reacting to each situation similar?

Assessing the Dialectic Systemic Cognitive-Emotional-Developmental Style

When patterns are identified and the meaning of the patterns has been explored, the dialectic questioning sequence may be initiated. This sequence usually begins with a summary of the first (sensorimotor image), second (concrete situation), and third (reflection on patterns) sections of the interview. This transition is somewhat more awkward than in the earlier parts of the interview. Here the first three sections are internally focused. The dialectic perspective requires that clients reflect on their situation from the perspective of others and from the lens of multiple interacting systems. For example, how are the client’s reactions to his or her situation different, or not different, when interacting with family members, with coworkers in a work setting, with friends and neighbors, or during interactions with members of a social club or religious institution. During this sequence, the counselor elicits the client’s perspectives on how others might view the situation and what others might say in response to the client’s concerns.

The questions are more difficult and the flow less fluid, as the client is challenged to think in new ways. Questions that may be asked in this part of the interview include:

• How do you think this pattern developed (in your family or current living arrangements)?
• Does this pattern happen in your family at all?
• How did you learn this way of thinking and acting in your (family)?
• What rule are you using when you think/act/feel this way?

Treatment Planning Using the DCT Model

The DCT assessment interview is also called as a therapeutic experience that begins the change process. Identification of the rule is tantamount to an “a-ha!” experience in which the client learns the reasons underlying automatic behaviors, or blind spots. Authorization to change occurs in concert with the commitment to continue exploration in counseling. Constant with a philosophy of wellness, clients are encouraged to make positive lifestyle choices to improve their quality of life through personal traits such as sense of humor, sense of control, self-esteem, and rational beliefs may become the focus of wellness efforts, which are holistic and affect the total person, much as integrative counseling models address the needs of the whole person at a particular point in time.

The main advantages of integrative counseling models are that they bring together assessments, interventions, and multiple theoretical approaches. What is unique about DCT is the structured manner in which the model is presented. This structure allows for virtually all counseling theories and methods to be integrated in a purposeful manner so that clinicians may use assessment results to select interventions most likely to be successful with a particular client in response to a given presenting issue. Examples of the preferred interventions based on the four styles are as follows:

• Sensorimotor: bodywork (acupuncture, massage, yoga); catharsis; exercise (walking, jogging); focusing on emotions in the here-and-now; Gestalt interventions; guided imagery; medication; meditation; psychodynamic free association; relaxation training
• Concrete: here assertiveness training; behavioral counts and charts; brief therapy; cognitive automatic thoughts charts; crisis intervention; decision and problem solving; desensitization and establishment of anxiety hierarchies; narratives and story telling; psychoeducational skills training; reality therapy; Rational Emotive Behavior Therapy; thought stopping
• Formal: this is an Adlerian therapy; bibliotherapy; cognitive therapy; dream analysis; logotherapy; narratives and reflecting on stories; person-centered therapy; psychodynamic therapies; Rational Emotive Behavior Therapy
• Dialectic Systemic: this can be used during advocacy for social justice; community genograms; community or neighborhood action; consciousness raising groups; family dream analysis; family genograms; feminist therapy; multicultural counseling and therapy; self-help groups.

DCT Applications and Research

DCT can be used successfully with children, adolescents, and adults of all age groups. It is effective and applicable for a wide range of client populations and issues, and is useful for teaching counseling skills and for supervision in the procurement of those skills.

(https://psychology.iresearchnet.com/counseling-psychology/counseling-therapy/developmental-counseling-and-therapy/)

References:

1. Pal,O.B (2011). Guidance and Counselling, APH Publishing Corporation, New Delhi.
2. Narayana Rao. S (2008). Counselling and Guidance, Tata Mc Graw-Hill Publishing Company Ltd, New Delhi.
3. Hamrin, S.A., B.P. Paulsen (1950). Counselling Adolescents. Chicago, Science Research Associates.
4. Stefflre, B.P., King and F.Leafgren (1962). Characteristics of counsellors judged by their peers, Journal of counselling psychology, 335-340