Reality Therapy provides a framework for evaluating needs, wants, actions, thoughts, feelings and physiological perceptions. It is concerned with personal responsibility and commitment and, although the emphasis is on the present, planning for successful experiences and growth is also a key component.
Counsellors who practice reality therapy provide a warm caring environment in which clients tell their stories, explore their emotions, examine their lifestyles and work through their present circumstances.
Supporting clients through loss and significant life changes with reality therapy involves four important and often interrelated components:
- Exploration of wants, needs, perceptions and emotions
- Exploration of past and present total behaviours
- Evaluation of present behaviours, lifestyles and situations, and deciding whether or not to change.
- Making plans for change that are simple, attainable, specific and measurable These plans focus on doing rather than not doing, are immediate and controlled by the planner
Reality Therapy provides an empowering and educational experience for clients. It is a positive approach to counselling that allows people to make significant life changes and transitions that go far beyond the counselling experience.
EMDR psychotherapy is an information processing therapy and uses an eight phase approach to address the experiential contributors of a wide range of pathologies. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health.
During treatment various procedures and protocols are used to address the entire clinical picture. One of the procedural elements is “dual stimulation” using either bilateral eye movements, tones or taps.
During the reprocessing phases the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external stimulus. During that time, clients generally experience the emergence of insight, changes in memories, or new associations.
The clinician assists the client to focus on appropriate material before initiation of each subsequent set.
Eight Phases of Treatment
Phase One is a history taking session during which the therapist assesses the client’s readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
The therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.
Phases Three through Six
A target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist’s fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client.
Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens.
After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client’s report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged.
This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing.
When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements.
After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
The therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
Re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures.
Neurofeedback utilizes EEG (electro-encephalograph) technology to both assess and address imbalances in the brain. Using EEG equipment, the clinician “listens” to the electrical brain wave activity across the brain and helps to identify where the brain may be over- or under-investing its energy (assessment).
Following assessment, a treatment program is then applied which provides the client with information (feedback) which encourages the brain to correct the issues that may be contributing to behavioural or lifestyle difficulties.
What is Neurofeedback for?
Neurofeedback has been applied to just about any human issue that is, in part, related to an over-active, under-active, or unstable neurological system (brain). Common issues to which neurofeedback is applied include:
- Attention Deficit & Hyperactivity Disorder
- Chronic Anxiety
- Sleep Disorder
- Panic Disorder
- Learning Disability
- Fetal Alcohol Syndrome
- Impulse Control Issues
- Migraine headaches
The process is entirely painless. The client is seated comfortably and attached to 6 wire sensors; three on each side of his/her head and ears. The sensors are held onto the ear and scalp by a gel-like paste. The sensors carry the EEG information from the brain to the computer. There are no needles or intrusive procedures.
In front of the client is a computer screen, which will display images and project sound/music. It is often described as resembling an interactive computer game. The clinician has an additional computer screen, which displays the EEG output.
The client’s task is simply: to be aware of the visual and musical feedback and work with the clinician to influence the feedback. It is simply a process of allowing the brain to become aware of its behaviour and to allow the brain to re-train itself with the help of feedback into its responses and habits.
How Long Does It Take?
A single neurofeedback session typically takes about 1 hour. It is recommended that sessions take place twice per week for the first 4 – 6 weeks. Generally, some notable improvement is notable within the first 8 sessions.
Can Neurofeedback Do Harm?
To date, the only documented side effect of neurofeedback is occasional fatigue. Neurofeedback tends to be quite calming for most clients and occasionally that is experienced as fatigue directly following a session.