1. Therapy in Africa: Combined model of Western and African perspectives to therapy - including that of reconstruction, re-institution and healing the wounds left
by colonialism, neo-colonialism, and damaging political systems; rehabilitation of the self and a family in distress (as emphasised in most Western practices) BUT
also the renewal of the battered and denigrated (although also sometimes very limiting) cultural traditions and contexts in Africa; Includes examining the clients
sociohistorical context – not just them as individuals (as opposed to Western individualist values)
2. Goals of psychotherapy in Africa: Change or counter faulty/negative/unrealistic beliefs, attitudes, values, expectations, worldview, prejudices and negative
myths of Africans about themselves, their world, and others. Re-examine the misdirected goals and expectations towards which most people strive in today’s
Africa. Challenge the behavioural strategies, most of them destructive in the long run, that many people in Africa construct to achieve the inordinate goals that
organise their lives. Explore and reflect on the negative consequences of people’s behaviours in today’s Africa. Re-educate the society and halt the avoidable
psychological damages brought about by society. Redress and rehabilitate the colonial damage inflicted not only on the landscape and economy of Africa but
also on the psychological world of the entire African peoples. This will entail purging aspects of cultural history that bear the traces of self-hatred instilled on us
by our negative colonial past and all of the other disabling consequences of our colonial and post-colonial experience.
3. Multiculturally competent: Become aware of your own biases, values, cultural norms and expectations. Attempt to understand the world from your client’s
vantage point. Gain a knowledge of the dynamics of oppression, racism, discrimination and stereotyping. Study the historical background, traditions and
values of your client and be open to learning from them. Expand your vantage point to explore your client’s ways of life that are different from your own.
4. Types of Ethics: Mandatory ethics - minimum level of professional practice. Aspirational (ideal) ethics - highest standards of thinking and conduct. Positive
ethics - approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble: tries to do more
than just keep the professional out of legal or disciplinary trouble with the HPCSA. First do no harm. Then do good; respect autonomy of others, be just, fair
and faithful
5. Informed consent (signed document! Especially for legal guardians to sign for minors). Clients need enough information about the counselling process to make
informed choices. Educate clients about their rights and responsibilities. Address privacy issues with clients, including the implications of using technology to
communicate. Informed consent empowers clients and helps to build trust with them.
6. The limits of confidentiality – confidentiality can be trumped: When the Client poses a danger to self or others. Clients who are children/minors, dependent
adults, or older adults are victims of abuse. Client needs to be hospitalised. Information is made an issue in a court action. Client requests a release of record
7. Evidence-Based Therapy: (see right)
8. African psychotherapy: African traditional thought informs the lived experiences of African
people in all aspects of their lives and aims to ensure moral behaviour so that they can
become umuntu. Illness, disharmony and/or disequilibrium indicate that the process of
becoming umuntu is being disturbed. Healing is sought to correct this. God is considered
the source, energy and strength. Rituals enable stability and harmony.
9. The African worldview is built on the following tenets: the interconnectedness and
interdependence of all beings; the spiritual nature of human beings; the communal self
(which is relational, or dialogical, in nature); the validity of affective knowledge; the
oneness of mind, body and spirit; value of interpersonal relationships
1. The structure of personality: The Psyche has three parts: Id (Pleasure principle) Ego (Reality principle) Superego (Moral principle). The ego is pressured by the
id, the superego and reality, and serves as a go-between that tries to satisfy all these forces. When the ego cannot cope, anxiety develops. We use defense
mechanisms to deal with anxiety.
2. Anxiety: Feeling of dread resulting from repressed feelings, memories and desires. Develops out of conflict among the id, ego and superego to control psychic
energy. Three types of anxiety: Reality anxiety, Neurotic anxiety, Moral anxiety
3. Ego-defense mechanisms: Are normal behaviours that operate on an unconscious level and tend to deny or distort reality. Help the individual cope with anxiety
and prevent the ego from being overwhelmed. Have adaptive value if they do not become a style of life to avoid facing reality
4. The therapeutic process: The goal is to make the unconscious conscious and strengthen the ego so behaviour is based on reality. The blank screen approach
fosters transference. Achieving insight into problems and increasing awareness of ways to change helps clients gain control over their lives. Pushing the
client too rapidly or offering ill-timed interpretations will render the process ineffective.
5. Psychoanalytic phenomena and techniques
a. Transference occurs when the client reacts to the therapist as they did to an earlier significant other (projections).
b. Countertransference is the reaction of the therapist toward the client that may interfere with objectivity.
c. Resistance is anything that works against the progress of therapy and prevents the production of unconscious material. Therapist helps clients become aware
of reasons for their resistance so they can deal with them.
d. Maintaining the analytic framework: Therapist uses procedural and stylistic factors (e.g. analyst’s relative anonymity, consistency of meetings).
e. Free association: Client reports immediately without censoring any feelings or thoughts.
f. Interpretation: Therapist points out, explains and teaches the meanings of whatever is revealed.
g. Dream analysis: During sleep, the person’s defences are lowered and repressed feelings, thoughts, desires, etc. come to the surface through the dream
material. However, it is disguised - uncovering of the disguised meaning through the understanding symbols. Two levels of content: manifest and latent.
Manifest = more acceptable content, as it appears to the dreamer. Latent = hidden, symbolic, unconscious material.
6. Application to group counselling: Group work provides a rich framework for working through transference feelings. The group becomes a microcosm of
members’ everyday lives. Projections onto the leader and members are clues to unresolved intrapsychic conflicts that can be identified, explored and worked
through in the group.
7. Contributions of psychoanalytic approach . Helps therapists understand: Human behaviour from a psychosexual perspective, which can be a powerful
framework when paired with the psychosocial perspective. That unfinished business can be worked through to provide a new ending to events that have
restricted clients emotionally. The value of concepts such as unconscious motivation, the influence of early development, transference, countertransference and
resistance. How the overuse of ego defences keep clients from functioning effectively
8. Limitations of psychoanalytic approach: may not be appropriate for all cultures or socioeconomic groups. Deterministic focus does not emphasise current
maladaptive behaviours. Generally minimises role of the environment. Requires subjective interpretation. Relies heavily on client fantasy. Lengthy treatment
may not be practical or affordable for many clients
9. Strengths from a multicultural perspective: Erikson made significant contributions to how social and cultural factors affect people in many cultures over the life
span. This approach promotes intensive psychotherapy for therapists, which gives them insight into their countertransference, including biases and prejudices.
10. Limitations from a multicultural perspective: Based on upper- and middle-class values and may be cost prohibitive for many people; Cultural expectations may
lead clients to want more direction and structure from the professional; More concerned with long-term personality reconstruction than with short-term
problem solving; Fails to address social, cultural and political factors that oppress clients
1. Existential therapy: Asks deep questions about the nature of the human being and of anxiety, despair, grief, loneliness, and isolation; Deals centrally with the
questions of meaning, creativity and love. Common questions/sources of existential angst for clients: ‘Why am I here?’ ‘What do I want from life?’ ‘What gives
my life purpose?’ ‘Where is the source of meaning for me in life?’
2. Basic dimensions of the human condition that existential therapy stands for (What it means to be human):
a. The capacity for self-awareness: The greater our awareness, the greater our possibilities for freedom. Awareness is realising that: We are finite and time is
limited; We have the choice to act or not to act; Meaning is not automatic and we must seek it; We are subject to loneliness, meaninglessness, emptiness, guilt
and isolation.
b. The tension between freedom and responsibility: We do not choose the circumstances into which we are born, but we create our own destiny through our
choices. Freedom implies that we are responsible for our lives, for our actions, and for our failures to take action. Freedom and responsibility go hand in
hand; assuming responsibility is a basic condition for change.
c. The creation of an identity and establishing meaningful relationships: Identity is ‘the courage to be’ – we must trust ourselves to search within and find our
own answers. Our great fear is that we will discover that there is no core, no self.
d. Being existentially ‘alone’ helps us to discover our authentic self. Balancing aloneness and relatedness helps us develop a unique identity and live
authentically in the moment. At their best our relationships are based on our desire for fulfilment, not based on deprivation.
