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Colloquium for the profession of clinical psychology and educational psychology

Written Exam - General guidelines

The written exam (one hour) is composed of a series of common questions for both subspecialties, and a
series of specific questions for each subspecialty. The domains of knowledge to be covered are:

A- For all candidates:

THE MAIN THEORIES OF HUMAN DEVELOPMENT

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1- Freud's Psychosexual Developmental Theory - One of the best-known grand theories of child
development

Personality develops through a series of 5 stages in which the pleasure-seeking energies (libido) of
the id are focused on certain erogenous areas. This psychosexual energy (libido) is the driving
force behind behavior.
Personality is mostly established by the age of 5 and early experiences play a large role in personality
development and continue to influence behavior later in life.
During each stage, the child encounters conflicts that play a significant role in the course of
development.
Failure to resolve the conflicts of a particular stage and progress through that stage can result in a
fixation at that point in development, which could have an influence on adult behavior.
If these psychosexual stages are completed successfully, a healthy personality is the result.

The Oral Stage

Birth to 1 year
Primary focus of the libido: mouth – tasting, sucking
Primary conflict: weaning process – child must become less dependent on caretakers.
Oral fixation results in issues of dependency or aggression, and can be expressed in problems with
drinking, eating, smoking, nail biting.

The Anal Stage

1 to 3 years
Primary focus of the libido: controlling the bladder and bowel movements.
Primary conflict: toilet training – child has to learn to control bodily needs.
Positive experiences serve as the basis to become a competent, productive, and creative adult.
Inappropriate parental approaches to toilet training:
Too lenient – anal-expulsive personality could develop (messy, wasteful, or destructive).
Too strict or early – anal-retentive personality could develop (stringent, orderly, rigid, and obsessive).

The Phallic Stage

3 to 6 years
Primary focus of the libido: genitals.
Discovery of the differences between M & F
Boys start viewing fathers as a rival for the mother’s affections. Oedipus complex – desire to possess
the mother and replace the father; but also, fear of punishment by the father (castration anxiety).
Penis envy in the case of girls – as opposed to Electra complex. Eventually, child begins to identify
with the same-sex parent as a means to vicariously possess the other parent. Penis envy, however,
never fully resolved and all women remain somewhat fixated on this stage. (see Karen Horney’s
rebuke with womb envy).

The Latent Period

6 to puberty
Sexual feelings are inactive
Superego continues to develop while the id’s energies are suppressed.
Children develop social skills, values and relationships with peers and adults outside the family.
Development of ego and superego contribute to this period of calm.
Sexual energy is still present but is sublimated into intellectual pursuits and social interactions.
Important period for the development of social and communication skills and self-confidence.
Fixation at this stage can result in immaturity and inability to form fulfilling relationships as an adult.
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The Genital Stage

Puberty to death
Erogenous zone: maturing sexual interests
With the onset of puberty, the libido becomes active once again. Strong sexual interest in the
opposite sex.
Shift of focus from individual needs to interest in the welfare of others.
If other stages completed successfully, the individual is well-balanced, warm, and caring.
Goal is to establish a balance between the various life areas.
Ego and Superego fully formed and functioning at this point: younger children ruled by the id (requires
immediate satisfaction of most basic needs and wants); teens in the genital stage are able to balance
most basic urges against the need to conform to the demands of reality and social norms.
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2- Erikson's 8-Stage Psychosocial Developmental Theory

Ego psychologist
Social interaction & experience as driving force in development (as opposed to sexual
interest)
In each of the 8 stages, people experience a conflict that serves as a turning point in
development.
These conflicts are centered on either developing a psychological quality or failing to develop that
quality
Successfully managing the challenges of each stage leads to the emergence of a lifelong
psychological virtue.

Psychosocial Stages Summary Chart

Stage 1: Infancy (birth to 18 months)

Basic Conflict: Trust vs. Mistrust

Important Events: Feeding

Outcome: During the first stage of psychosocial development, children develop a sense of trust when
caregivers provide reliability, care, and affection. A lack of this will lead to mistrust.

Stage 2: Early Childhood (2 to 3 years)

Basic Conflict: Autonomy vs. Shame and Doubt

Important Events: Toilet Training

Outcome: Children need to develop a sense of personal control over physical skills and a sense of
independence. Toilet training plays an important role in helping children develop this sense of autonomy.
Children who struggle and who are shamed for their accidents may be left without a sense of personal
control. Success during this stage of psychosocial development leads to feelings of autonomy, failure
results in feelings of shame and doubt.

Stage 3: Preschool (3 to 5 years)

Basic Conflict: Initiative vs. Guilt

Important Events: Exploration

Outcome: Children need to begin asserting control and power over the environment. Success in this
stage leads to a sense of purpose. Children who try to exert too much power experience disapproval,
resulting in a sense of guilt.

Stage: School Age (6 to 11 years)

Basic Conflict: Industry vs. Inferiority

Important Events: School

Outcome: Children need to cope with new social and academic demands. Success leads to a sense of
competence, while failure results in feelings of inferiority.

Stage: Adolescence (12 to 18 years)

Basic Conflict: Identity vs. Role Confusion
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Important Events: Social Relationships

Outcome: Teens need to develop a sense of self and personal identity. Success leads to an ability to
stay true to yourself, while failure leads to role confusion and a weak sense of self.

Stage: Young Adulthood (19 to 40 years)

Basic Conflict: Intimacy vs. Isolation

Important Events: Relationships

Outcome: Young adults need to form intimate, loving relationships with other people. Success leads to
strong relationships, while failure results in loneliness and isolation.

Stage: Middle Adulthood (40 to 65 years)

Basic Conflict: Generativity vs. Stagnation

Important Events: Work and Parenthood

Outcome: Adults need to create or nurture things that will outlast them, often by having children or
creating a positive change that benefits other people. Success leads to feelings of usefulness and
accomplishment, while failure results in shallow involvement in the world.

Stage: Maturity(65 to death)

Basic Conflict: Ego Integrity vs. Despair

Important Events: Reflection on life

Outcome: Erikson's theory differed from many others because it addressed development throughout the
entire lifespan, including old age. Older adults need to look back on life and feel a sense of fulfillment.
Success at this stage leads to feelings of wisdom, while failure results in regret, bitterness, and despair.
At this stage, people reflect back on the events of their lives and take stock. Those who look back on a
life they feel was well-lived will feel satisfied and ready to face the end of their lives with a sense of
peace. Those who look back and only feel regret will instead feel fearful that their lives will end without
accomplishing the things they feel they should have.
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3- Behavioral Child Development Theories (Watson, Pavlov, Skinner)

Belief that psychology needs to focus only on observable and quantifiable behaviors.
All human behavior can be described in terms of environmental influences.
Development is a reaction to rewards, punishments, stimuli and reinforcement.
No consideration to internal thoughts & feelings. Focus purely on how experience shapes who we
are.
Learning occurs purely through processes of association and reinforcement. Two important types
of learning in this approach to development:
Classical conditioning: learning by pairing a naturally occurring stimulus with a
previously neutral stimulus
Operant conditioning utilizes reinforcement & punishment to modify behaviors.
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4- Piaget's Cognitive Developmental Theory (Piaget)

Concerned with the development of a person’s thought processes and how these thought
processes influence how we understand & interact with the world.

Children think differently than adults.

Piaget’s cognitive theory of development seeks to describe & explain the development of thought
processes & mental states.

Also, looks at how these thought processes influence the way we understand and interact with
the world.

Piaget’s theory of cognitive development accounts for the steps and sequence of children’s
intellectual development – 4 stages:

The sensorimotor stage: between birth & 2 years.

Knowledge of the world is limited to sensory motors & motor activities.
Behaviors are limited to simple motor responses to sensory stimuli.

The preoperational stage: between 2 & 6 years

Child learns to use language
No yet understanding of concrete logic
Cannot mentally manipulate information
Unable to take the point of view of other people.

The concrete operational stage; between 7 & 11 years

Children gain a better understanding of mental operations
Begin thinking logically about concrete events
Have difficulty understanding abstract or hypothetical concepts.

The formal operation stage: between 12 & adulthood

People develop the ability to think about abstract concepts.
Skills such as logical thought, deductive reasoning, & systematic planning emerge.
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5- Bowlby's Attachment Theory

One of the earliest theories of social development.

Early relationships with caregivers play a major role in child development and continue to
influence social relationships throughout life.
Children are born with an innate need to form attachment.
Attachments aid in survival by ensuring that the child receives care and protection. Both children
and caregivers engage in behaviors designed to ensure proximity. Children strive to stay close
and connected to their caregivers who in turn provide safe haven and a secure base for
exploration.
Attachment styles:
Consistent support and care --- development of a secure attachment style
Less reliable care --- development of ambivalent, avoidant, or disorganized attachment style.
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6- Bandura's Social Learning Theory

Life would be incredibly difficult & dangerous if you had to learn everything you know from
personal experience.
Observation, imitation, & modeling play a primary role in learning process.

Combination of elements from behavioral theories, which suggest that all behaviors are
learned through conditioning, and cognitive theories, which take into account psychological
influences such as attention and memory.
Addition of social element – people learning new information & behaviors by watching other
people.

3 core concepts of social learning theory:

People can learn through observation

Internal mental states & motivation – internal reward, such as pride, satisfaction & a
sense of accomplishments - are an essential part of the learning process
Just because something has been learned does not mean it will result in a change in a
behavior

How does observational learning happen ? - 4 steps:

Attention
Retention
Reproduction
Motivation (reinforcement & punishment)
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7- Vygotsky's Sociocultural Theory

Children are born with biological constraints on their minds.

Each culture, however, provides tools of intellectual adaptation - these tools allow to use basic
mental abilities in a way that is adaptive to the culture in which they live.

Children learn actively & through hands on experiences. Parents, caregivers, peers and the
culture at large are responsible for developing higher order functions.

Learning is an inherently social process. Though interacting with others, learning becomes
integrated into an individual’s understanding of the world.

The zone of proximal development: the gap between what a person can do with help and what
they can do on their own
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B- For the candidates in clinical psychology:

1- PSYCHOPATHOLOGY: CLASSIFICATIONS OF PSYCHIATRIC DISORDERS

The DSM uses a multi-axial system of classification, i.e. that diagnoses are made on several
different axes or dimensions:
1. Axis I records the patient’s primary diagnosis
2. Axis II records long-standing personality problems or mental retardation
3. Axis III records any medical conditions that might affect the patient psychologically
4. Axis IV records any significant psychosocial or environmental problems experienced by
the patient
5. Axis V records an assessment of the patient’s level of functioning

Anxiety Disorders

Generalized Anxiety Disorder

Specific Phobia
Panic Disorder & Agoraphobia
Obsessive-compulsive Disorder
Post-traumatic Stress Disorder

Roots of Anxiety Disorders

Biological factors: Genetic predispositions; differing sensitivity; neurotransmitters – disturbances

in neural circuits that use the neurotransmitters GABA & serotonin; brain damage

Conditioning & learning also play a role in anxiety disorders

Evolutionary predisposition (conditioned fears to certain objects & situations associated to ancient
dangers (snakes & heights).

Observational learning

Cognitive factors: people with certain styles of thinking are more susceptible to anxiety disorders
than others

Personality traits: the personality trait of neuroticism

SSRIs & Anxiety Disorders: selective serotonin reuptake inhibitors are a class of drug commonly
used to treat anxiety disorders.

Mood Disorders

Marked disturbances in emotional state, which affect thinking, physical symptoms, social
relationships, & behavior.

2 basic types:

Unipolar: at the depressive end of the continuum

Bipolar: at both ends of the continuum

Dysthymic Disorder: depressed mood for a majority of days over at least two years.
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Major depressive disorder: at least 1 major depressive episode (at least 2 weeks experiencing
some or all of the following symptoms:

Constant sadness or irritability

Loss of interest in almost all activities
Changed sleeping or eating patterns
Low energy
Feelings of worthlessness or guilt
Difficulty concentrating
Recurrent thoughts about suicide

Bipolar Disorders: involve at least one distinct period when a person exhibits manic symptoms,
involving any or all of the following:

Irritability
Feeling of being high
Decreased need for sleep
Inflated self-esteem or grandiosity
Fast & pressured speech
Agitation
Increased interest in pleasurable activities that have the potential for harmful
consequences

People with bipolar disorders usually also experience major depressive episodes.

Etiology of Mood Disorders:

Biological influences:

Genetic predisposition
Neurotransmitters norepinephrine & serotonin are involved in mood disorders
Brain structure: smaller hippocampus and amygdala in the brain, perhaps
because of an excess of the stress hormone cortisol

Cognitive factors:
Learned helplessness
Self-blame
Low self-esteem
Rumination

Interpersonal factors:
Lack of social network
Loss of an important relationship

Environmental stressors

Eating Disorders

Problematic eating patterns

Extreme concerns about body weight
Inappropriate behaviors aimed at controlling body weight

Anorexia Nervosa
Refusal to maintain a body weight in the normal range
Intense fear about gaining weight
Highly distorted body image
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Amenorrhea

Bulimia Nervosa
Habitual binge eating and unhealthy efforts to control body weight, including
vomiting, fasting, excessive exercise, use of laxatives, diuretics
Body weight kept in the normal range
Evaluation of self, according to body weight & shape

Etiology of Eating Disorders

Biological factors

Personality factors
AN: tend to be obsessive, rigid, neurotic, & emotionally inhibited
BN: tend to be impulsive & oversensitive & have a poor self-esteem

Cultural factors (high value of thinness in industrial countries)

Family influences: insufficient autonomy; mothers who emphasize too much

emphasis on body weight

Cognitive factors:
Distortions of thinking: rigidity (all-or-none terms)

Onset of AN often associated with stressful events (leaving home for college)

Somatoform Disorders

Real physical symptoms that cannot be fully explained by a medical condition, the effects
of a drug, or another mental disorder.
They do not fake symptoms or produce symptoms intentionally.

3 common Somatoform Disorders:

Somatization disorder:
Formally called hysteria.
Wide variety of physical symptoms (pain, gastrointestinal, sexual…)

Conversion Disorder:
Symptoms affect voluntary functioning or sensory functioning.

Hypochondriasis:
Preoccupied with fears that they have a serious disease, fears that are
based on misinterpretations of physical symptoms. They are not
delusional and can acknowledge that their worries may be excessive.

Etiology of Somatoforms Disorders:

Personality – histrionic personality traits

Cognitive factors – pay too much attention to bodily sensations; make
catastrophic conclusions when experiencing minor symptoms; distorted ideas
about good health, and expect healthy people to be free of any symptoms &
discomfort
Learning: reinforced for being sick (attention, sympathy, avoidance of work &
family challenges).
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Substance-Related Disorders –

Substance abuse:
Maladaptive pattern of drug use that results in repeated negative consequences
such as legal, social, work-related, or school-related problems.
Use in situations of possible physical danger

Substance dependence or addiction:

Continuing to use despite physical or psychological costs.
May make several unsuccessful attempts to give up
May develop tolerance (gradual need for more and more)
May develop withdrawal symptoms (sweating, nausea, muscle pain, shakiness
and irritability).

Etiology of Substance-Dependence

Interaction of biology & environment

Biological influences:

There may be a genetic predisposition to the type of alcoholism that begins in

adolescence and is associated with impulsive, antisocial, & criminal behavior.
Many genes may interact to play a role in other types of alcoholism.

Environmental influences: cultural norms, social policy, variation in symptoms,

reasons of drug use.

Schizophrenia

A psychotic disorder – loss of contact with reality, sometimes with delusions or hallucinations.
Wide range of symptoms:

Positive Symptoms - involve the presence of altered behaviors:

Delusions (false beliefs strongly held despite contradictory evidence)

Hallucinations (sensory or perceptual experiences that happen without external
stimulus – auditory most common)
Disorganized speech (word salad, words & sentences strung together in an
incoherent way)
Disorganized behavior (inappropriate gestures or laughter, agitated pacing or
unpredictable violence).

Negative symptoms – involve an absence or reduction of normal behavior

Emotional flatness
Social withdrawal
Spare or uninflected speech
Lack of motivation

Subtypes of Schizophrenia (4)

Paranoid type:
Marked delusions or hallucinations & relatively normal cognitive & emotional
functioning
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Delusions are usually persecutory (belief that one is being oppressed, pursued,
or harassed in some way); grandiose (belief that one is very important or
famous), or both.

Disorganized type:

Characterized by disorganized behavior, disorganized speech, & emotional

flatness or inappropriateness

Catatonic type:

Characterized by unnatural movement patterns such as rigid, unmoving posture

or continual, purposeless movements, or by unnatural speech patterns such as
absence of speech or parroting of other people’s speech.

Undifferentiated type:

Diagnosis given to a patient that does not meet criteria for paranoid,
disorganized, or catatonic schizophrenia

Etiology of Schizophrenia

Biological factors: genes, neurotransmitters, and brain anomalies play a role in

the onset of schizophrenia

Genetic predisposition: substantial evidence

Neurotransmitters: overabundance of the neurotransmitter dopamine in
the brain, or both serotonin & dopamine. Perhaps glutamate
Brain structure – leading to inability to filter out irrelevant information
leading to being overwhelmed by stimuli
Brain injury

Stress

Dissociative Disorders

Characterized by disturbances in consciousness, memory, identity, and perception

Dissociative Amnesia

Inability to remember important personal information, usually about something

traumatic or painful

Dissociative Fugue

Suddenly leaving home, disappearing unexpectedly. Do not remember their past

& are confused about their identity. May assume entirely new identities.

Dissociative Identity Disorder (formerly ‘multiple personality disorder)

Certain aspects of identity, consciousness, and memory are not integrated.

Cannot remember important personal information and have 2 or more identities
or personality states that control their behavior.

Etiology of Dissociated Disorders

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Severe stress plays a role in the onset of dissociative disorders.

Personality Disorders

Stable patterns of experience and behavior that differ noticeably from patterns that are
considered normal by a person’s culture.
Symptoms remain the same across different situations and manifest by early adulthood.
They cause distress or make it difficult to function normally in society.

Schizoid personality disorder – social withdrawal & restricted expression of emotions

Borderline personality disorder: impulsive behavior & unstable relationships, emotions

& self-image

Histrionic personality disorder: attention-seeking behaviors and shallow emotions

Narcissistic personality disorder: an exaggerated sense of importance, a strong desire

to be admired, and a lack of empathy

Avoidant personality disorder: social withdrawal, low self-esteem, and extreme

sensitivity to negative evaluation

Antisocial personality disorder: (formerly sociopathy or psychopathy)

Lack of respect for other people’s rights, feelings, and needs, beginning by age fifteen.
Deceitful & manipulative & tend to break the law frequently
Often lack empathy & remorse but can be superficially charming
Behavior often aggressive, impulsive, reckless & irresponsible
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Kohlberg’s stages of moral development

Kohlberg identified three levels of moral reasoning: pre-conventional, conventional, and post-
conventional. Each level is associated with increasingly complex stages of moral development.

Level 1: Preconventional

Throughout the preconventional level, a child’s sense of morality is externally controlled. Children accept
and believe the rules of authority figures, such as parents and teachers. A child with pre-conventional
morality has not yet adopted or internalized society’s conventions regarding what is right or wrong, but
instead focuses largely on external consequences that certain actions may bring.

Stage 1: Obedience-and-Punishment Orientation

Stage 1 focuses on the child’s desire to obey rules and avoid being punished. For example, an action is
perceived as morally wrong because the perpetrator is punished; the worse the punishment for the act is,
the more “bad” the act is perceived to be.

Stage 2: Instrumental Orientation

Stage 2 expresses the “what’s in it for me?” position, in which right behavior is defined by whatever the
individual believes to be in their best interest. Stage two reasoning shows a limited interest in the needs
of others, only to the point where it might further the individual’s own interests. As a result, concern for
others is not based on loyalty or intrinsic respect, but rather a “you scratch my back, and I’ll scratch yours”
mentality. An example would be when a child is asked by his parents to do a chore. The child asks
“what’s in it for me?” and the parents offer the child an incentive by giving him an allowance.

Level 2: Conventional

Throughout the conventional level, a child’s sense of morality is tied to personal and societal
relationships. Children continue to accept the rules of authority figures, but this is now due to their belief
that this is necessary to ensure positive relationships and societal order. Adherence to rules and
conventions is somewhat rigid during these stages, and a rule’s appropriateness or fairness is seldom
questioned.

Stage 3: Good Boy, Nice Girl Orientation

In stage 3, children want the approval of others and act in ways to avoid disapproval. Emphasis is placed
on good behavior and people being “nice” to others.

Stage 4: Law-and-Order Orientation

In stage 4, the child blindly accepts rules and convention because of their importance in maintaining a
functioning society. Rules are seen as being the same for everyone, and obeying rules by doing what one
is “supposed” to do is seen as valuable and important. Moral reasoning in stage four is beyond the need
for individual approval exhibited in stage three. If one person violates a law, perhaps everyone would—
thus there is an obligation and a duty to uphold laws and rules. Most active members of society remain at
stage four, where morality is still predominantly dictated by an outside force.

Level 3: Postconventional

Throughout the postconventional level, a person’s sense of morality is defined in terms of more abstract
principles and values. People now believe that some laws are unjust and should be changed or
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eliminated. This level is marked by a growing realization that individuals are separate entities from society
and that individuals may disobey rules inconsistent with their own principles. Post-conventional moralists
live by their own ethical principles—principles that typically include such basic human rights as life, liberty,
and justice—and view rules as useful but changeable mechanisms, rather than absolute dictates that
must be obeyed without question. Because post-conventional individuals elevate their own moral
evaluation of a situation over social conventions, their behavior, especially at stage six, can sometimes be
confused with that of those at the pre-conventional level. Some theorists have speculated that many
people may never reach this level of abstract moral reasoning.

Stage 5: Social-Contract Orientation

In stage 5, the world is viewed as holding different opinions, rights, and values. Such perspectives should
be mutually respected as unique to each person or community. Laws are regarded as social contracts
rather than rigid edicts. Those that do not promote the general welfare should be changed when
necessary to meet the greatest good for the greatest number of people. This is achieved through majority
decision and inevitable compromise. Democratic government is theoretically based on stage five
reasoning.

Stage 6: Universal-Ethical-Principal Orientation

In stage 6, moral reasoning is based on abstract reasoning using universal ethical principles. Generally,
the chosen principles are abstract rather than concrete and focus on ideas such as equality, dignity, or
respect. Laws are valid only insofar as they are grounded in justice, and a commitment to justice carries
with it an obligation to disobey unjust laws. People choose the ethical principles they want to follow, and if
they violate those principles, they feel guilty. In this way, the individual acts because it is morally right to
do so (and not because he or she wants to avoid punishment), it is in their best interest, it is expected, it
is legal, or it is previously agreed upon. Although Kohlberg insisted that stage six exists, he found it
difficult to identify individuals who consistently operated at that level.
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2- THE MAIN APPROACHES IN PSYCHOTHERAPY

(APA)

Different approaches to psychotherapy

Psychologists generally draw on one or more theories of psychotherapy.

A theory of psychotherapy acts as a roadmap for psychologists: It guides them through the
process of understanding clients and their problems and developing solutions.
Approaches to psychotherapy fall into five broad categories:
• Psychoanalysis and psychodynamic therapies. This approach focuses on changing problematic
behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations.
Psychoanalytically oriented therapies are characterized by a close working partnership between
therapist and patient. Patients learn about themselves by exploring their interactions in the
therapeutic relationship. While psychoanalysis is closely identified with Sigmund Freud, it has
been extended and modified since his early formulations.
• Behavior therapy. This approach focuses on learning's role in developing both normal and
abnormal behaviors.
o Ivan Pavlov made important contributions to behavior therapy by discovering classical
conditioning, or associative learning. Pavlov's famous dogs, for example, began drooling when
they heard their dinner bell, because they associated the sound with food.
o "Desensitizing" is classical conditioning in action: A therapist might help a client with a phobia
through repeated exposure to whatever it is that causes anxiety.
o Another important thinker was E.L. Thorndike, who discovered operant conditioning. This
type of learning relies on rewards and punishments to shape people's behavior.
o Several variations have developed since behavior therapy's emergence in the 1950s. One
variation is cognitive-behavioral therapy, which focuses on both thoughts and behaviors.
• Cognitive therapy. Cognitive therapy emphasizes what people think rather than what they do.
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o Cognitive therapists believe that it's dysfunctional thinking that leads to dysfunctional emotions
or behaviors. By changing their thoughts, people can change how they feel and what they do.
o Major figures in cognitive therapy include Albert Ellis and Aaron Beck.
• Humanistic therapy. This approach emphasizes people's capacity to make rational choices and
develop to their maximum potential. Concern and respect for others are also important themes.
o Humanistic philosophers like Jean-Paul Sartre, Martin Buber and Søren
Kierkegaard influenced this type of therapy.
o Three types of humanistic therapy are especially influential. Client-centered therapy rejects
the idea of therapists as authorities on their clients' inner experiences. Instead, therapists help
clients change by emphasizing their concern, care and interest.
o Gestalt therapy emphasizes what it calls "organismic holism," the importance of being aware
of the here and now and accepting responsibility for yourself.
o Existential therapy focuses on free will, self-determination and the search for meaning.
• Integrative or holistic therapy. Many therapists don't tie themselves to any one approach.
Instead, they blend elements from different approaches and tailor their treatment according to
each client's needs.