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Q1. Explain the meaning and structure of interpersonal counselling. Describe the four basic interpersonal problem areas addressed by interpersonal counselling. 5+5

Ans. Meaning and Structure of Interpersonal Counselling Meaning: Interpersonal Counselling, or Interpersonal Psychotherapy (IPT), is a time-limited, focused psychotherapy that centers on the connection between a person’s mood (particularly depression) and their interpersonal relationships. It operates on the premise that our relationships affect how we feel, and how we feel affects our relationships. It was originally developed by Gerald Klerman and Myrna Weissman for the treatment of depression. IPT believes that psychological symptoms often arise in an interpersonal context and can be most effectively addressed within that same context. The goal is to reduce symptoms and improve the client’s interpersonal functioning. Structure: IPT is typically conducted over 12-16 weeks and is structured into three distinct phases: 1. The Initial Phase (Sessions 1-3): In this phase, the counsellor conducts a diagnostic evaluation, creates an interpersonal inventory of the client’s significant relationships, and links the client’s symptoms to an interpersonal context. The counsellor and client work collaboratively to identify one primary problem area that the therapy will focus on. This phase concludes with a therapeutic contract, clarifying the goals and expectations of the treatment. 2. The Middle Phase (Sessions 4-12): This is the main working phase of the therapy. The counsellor uses specific strategies to address the chosen problem area. For example, if the problem is a role dispute, sessions might focus on analyzing communication patterns, clarifying expectations, and role-playing. The counsellor helps the client to better manage relationships and improve communication skills. 3. The Termination Phase (Final 2-4 Sessions): In this final phase, progress is reviewed, and feelings about ending the therapy are discussed. The counsellor reinforces the skills the client has learned and helps develop a plan for handling future problems. The aim is to recognize the client’s sense of competence and prevent future relapse. The Four Basic Interpersonal Problem Areas Addressed by IPT: IPT focuses on one of four main interpersonal problem areas: 1. Interpersonal Role Disputes: This occurs when the client and a significant person in their life (e.g., spouse, family member, co-worker) have non-reciprocal expectations. These disputes can be at different stages: negotiation (where both parties understand their differing expectations), impasse (where negotiations have stalled), or dissolution (where the relationship is irreparably damaged). The goal of therapy is to identify the stage of the dispute and develop communication and problem-solving strategies to resolve it. 2. Interpersonal Role Transitions: This relates to life changes that affect a person’s social role, such as marriage, divorce, becoming a parent, retirement, or changing jobs. These transitions can be stressful as the person has to let go of an old role and adapt to the demands of a new one. The aim of therapy is to help the client mourn the loss of the old role, evaluate the opportunities and challenges of the new role, and develop the necessary social support and skills. 3. Complicated Grief: This occurs when the grieving process after the death of a loved one is stalled or becomes excessively prolonged. Unlike normal grief, complicated grief does not lessen with time and severely impairs the person’s ability to function. The goal of IPT is to facilitate the grieving process, help the client reorganize their relationship with the deceased, and encourage the development of other supportive relationships. 4. Interpersonal Deficits: This applies to individuals who have a long history of social isolation or inadequate and unfulfilling relationships. These clients often have difficulty initiating or sustaining relationships. The focus of therapy is on exploring past significant relationships, identifying recurring patterns in current relationships, and using the therapeutic relationship with the counsellor to practice new relationship skills.

Q2. Describe the stages in cognitive behaviour therapy and explain the irrational thought patterns. 0

Ans. Stages in Cognitive Behaviour Therapy (CBT) Cognitive Behaviour Therapy (CBT) is a structured, goal-oriented psychotherapy that teaches how to identify and change destructive thought patterns and behaviours to overcome psychological problems. Its stages are as follows: 1. Assessment and Appraisal: This is the initial phase where the therapist establishes a strong therapeutic alliance with the client. It involves gathering information about the client’s problems, symptoms, and history. Crucially, the therapist introduces the client to the cognitive model of CBT—the idea that our emotions and behaviours are influenced not by situations, but by our thoughts about those situations (Thoughts → Feelings → Behaviours). Specific, measurable goals are set in this stage. 2. Cognitive Conceptualization: In this stage, the therapist develops a hypothesis for understanding the client’s problems. This involves identifying the client’s Automatic Negative Thoughts (ANTs) , their underlying intermediate beliefs such as rules and attitudes, and their core beliefs about themselves, others, and the world. This conceptualization serves as a roadmap that explains how the client’s problems developed and are being maintained. 3. Skills Acquisition and Application: This is the core phase of CBT, where the client learns and practices various cognitive and behavioural techniques.

• Cognitive Skills: This includes identifying automatic thoughts, challenging them through cognitive restructuring (e.g., using Socratic questioning, thought records), and recognizing irrational thought patterns (cognitive distortions).
• Behavioural Skills: This includes behavioural activation (for depression), exposure therapy (for anxiety), relaxation techniques (deep breathing), and problem-solving skills.

4. Generalization and Maintenance:

As therapy progresses, the focus shifts to applying the learned skills to various situations and making them a part of daily life. The goal of this stage is for the client to become their own therapist.

Relapse prevention

is a key component, which involves preparing for future stressors and setbacks.

5. Termination:

In the final stage, the therapist and client review the progress made in therapy. They create a plan for the future and ensure the client is equipped to continue using their skills after therapy ends.

Irrational Thought Patterns (Cognitive Distortions)

Cognitive distortions are irrational, exaggerated thought patterns that maintain psychological distress, particularly depression and anxiety. Identifying and challenging them is a key part of CBT. Some common patterns are:

• All-or-Nothing Thinking: Seeing situations in only two categories, such as good or bad, success or failure. Example: “If I don’t get an ‘A’ on this exam, I’m a total failure.”
• Overgeneralization: Seeing a single negative event as a never-ending pattern of defeat. Example: After one bad date, thinking, “I’ll never have a relationship.”
• Mental Filter: Focusing on a single negative detail and ignoring everything else. Example: Receiving many positive comments on a presentation but dwelling on the one critical remark.
• Disqualifying the Positive: Rejecting positive experiences by insisting they “don’t count.” Example: Dismissing a compliment by saying, “They were just being nice.”
• Jumping to Conclusions: Making negative interpretations without any supporting evidence. Two types are: (a) Mind Reading: Assuming others are thinking negatively about you. (b) The Fortune Teller Error: Predicting that things will end badly.
• Magnification (Catastrophizing) or Minimization: Exaggerating the importance of your mistakes and shortcomings or minimizing your positive qualities.
• Emotional Reasoning: Assuming that your negative emotions reflect reality. “I feel it, therefore it must be true.” Example: “I feel like a loser, so I must be one.”
• “Should” Statements: Applying rigid rules to yourself or others with “I should,” “I must,” or “I shouldn’t.” This leads to feelings of guilt and frustration.
• Labeling and Mislabeling: An extreme form of overgeneralization. Attaching a negative global label to yourself or others based on one mistake. Example: Instead of “I made a mistake,” saying “I am a loser.”
• Personalization: Blaming yourself for a negative external event for which you were not primarily responsible.

Q3. Describe the approaches of family and explain the techniques of family therapy. 0

Ans. Approaches of Family Therapy Family therapy is based on the premise that an individual’s problems do not exist in isolation but are influenced by the patterns of interaction and relationships within the family system. The family is seen as an emotional unit, and the goal of therapy is to improve functioning within that unit. There are several major approaches: 1. Structural Family Therapy: Developed by Salvador Minuchin, this approach focuses on the family’s structure —that is, the consistent patterns of interaction among members. The therapist analyzes the family’s subsystems (e.g., spousal, parental), boundaries (clear, rigid, or diffuse), and hierarchies . The goal is to “restructure” the family by disrupting problematic patterns and establishing a healthier hierarchy and clearer boundaries. 2. Strategic Family Therapy: Associated with theorists like Jay Haley and Cloe Madanes, this approach is problem-focused and pragmatic. The therapist takes an active and directive role. The primary focus is on changing the interactional sequences that maintain the presenting problem. The goal is to change behaviour rather than to gain insight. It often uses specific tasks or “directives” for the family to complete between sessions. 3. Bowenian Family Systems Therapy: Murray Bowen developed this approach, which views the family as a multigenerational emotional unit. Key concepts include differentiation of self (autonomy from the family’s emotional pull), triangles (when a two-person system enlists a third person under stress), and multigenerational transmission processes. The goal of therapy is to help members increase their level of differentiation, making them less reactive to their family of origin’s emotional patterns. 4. Experiential Family Therapy: With pioneers like Carl Whitaker and Virginia Satir, this approach emphasizes emotional expression, authenticity, and individual growth within the family. Problems are seen as the result of suppressed emotions. The therapist acts as a coach or facilitator, creating experiential exercises to help family members express their true feelings and connect with each other more directly and honestly. Techniques of Family Therapy Therapists from different approaches use a variety of techniques to understand and change the family system:

• Genogram: Popularized in Bowenian therapy, this is a detailed family tree that maps relationships, major events, illnesses, and behavioural patterns across at least three generations. It helps families see the multigenerational influences on their current problems.
• Reframing: This is the technique of presenting a problem behaviour in a different, usually more positive or constructive, light. For example, a rebellious teenager might be reframed as “trying to establish their independence.” This is common in strategic and structural therapies.
• Enactment: A key technique in structural therapy, where the therapist asks the family to “enact” their conflict or interaction during the session. This allows the therapist to directly observe dysfunctional patterns and intervene in real-time, such as by establishing boundaries or redirecting communication.
• Circular Questioning: From the Milan systemic approach, this technique involves asking questions that highlight relationships and interactions among family members. Example: “When your mother is sad, what does your father do? And when he does that, what do you do?” It helps the family see how everyone contributes to and is affected by the problem.
• Paradoxical Injunction: A technique used in strategic therapy, where the therapist directs the family to continue the behaviour they want to change (prescribing the symptom). The aim is to disrupt the family’s pattern in such a way that they eventually give up the behaviour because they are no longer in control of it.
• Externalizing the Problem: A core technique of Narrative Therapy, in which the problem is separated from the person or family. The family is encouraged to unite against the problem. For example, asking “What is depression trying to make you do?” instead of “Why are you depressed?”

Q4. Explain Rogers’ client-centered counselling. 0

Ans. Carl Rogers’ client-centered counselling, also known as Person-Centered Therapy, is a non-directive approach based on humanistic psychology. It is founded on the belief that every individual has an innate tendency toward growth, health, and self-actualization . Rogers believed that people are inherently good and are capable of solving their own problems and reaching their full potential if they are provided with the right therapeutic environment. Core Philosophical Principles:

1. The Actualizing Tendency: This is an inherent motivation present in all living things to maintain and enhance their capabilities. Client-centered therapy aims to facilitate this tendency.
2. The Self-Concept: This includes the individual’s beliefs and perceptions about themselves (“Who am I?”). It consists of the real self (who the person actually is) and the ideal self (who the person wants to be). Psychological distress arises when there is a large incongruence between the real self and the ideal self.
3. Field of Experience: Each person exists in their own unique subjective reality, and their behaviour is an attempt to make sense of this reality. The counsellor must strive to understand the client’s world from their point of view.

The Role of the Therapist and the Three Core Conditions:

In client-centered therapy, the counsellor is not an expert who gives advice, but a facilitator who creates an environment in which the client can explore and grow. Rogers proposed that there are three “necessary and sufficient” conditions for positive change, which relate to the attitude of the counsellor:

1. Congruence or Genuineness:

This is the most important condition. It means the therapist is authentic, real, and transparent in the therapeutic relationship. There is no facade or inconsistency between the therapist’s inner experience and outer expression. This genuineness helps to build trust with the client.

2. Unconditional Positive Regard:

The therapist accepts the client completely and without any conditions. This means not judging or evaluating the client’s feelings, thoughts, and behaviours, even if the therapist does not agree with them. This non-judgmental acceptance creates a safe environment in which the client feels comfortable expressing their vulnerabilities and negative feelings.

3. Empathic Understanding:

The therapist strives to accurately understand the client’s internal frame of reference and communicates this understanding to the client. It is about feeling the client’s emotions

as if

they were your own, but without losing the “as if” quality. It is not simply repeating the client’s words, but reflecting the underlying feelings and meanings. This helps the client feel heard and understood.

Therapeutic Process and Techniques:

The process is non-directive, meaning the client leads the direction and pace of the session. The counsellor avoids diagnosing, interpreting, or giving advice. Instead, the main “techniques” are ways of communicating the three core conditions:

• Active Listening: Paying full attention to what the client is saying.
• Reflection of Feelings: Stating back the emotional content expressed by the client.
• Clarification: Asking questions to clarify the client’s statements.
• Summarizing: Briefly restating the main points and feelings discussed during a session.

Through this process, the client moves from a state of incongruence to greater congruence, becomes more self-accepting, and develops into a “fully functioning person” who is open to experience, trusts their own judgments, and lives creatively.

Q5. Describe the techniques for helping children with anxiety disorder. 6

Ans. Helping children with anxiety disorders involves a multi-faceted approach, often utilizing cognitive-behavioral techniques adapted for a younger audience. The goal is to teach children coping skills and gradually reduce their avoidance of feared situations. Key techniques include: 1. Psychoeducation: The first step is to explain anxiety to the child and their parents in an age-appropriate way. This can be done using metaphors like a “worry bully,” a “false alarm” in the brain, or a “worry bug.” This normalizes the child’s experience and demystifies the physical sensations of anxiety, making them feel less scary. 2. Cognitive Techniques (CBT): This involves helping children to identify their anxious thoughts (“what if” thoughts) and to challenge them. A popular model is the F.E.A.R. plan :

• F eeling Frightened? (Recognizing physical symptoms of anxiety)
• E xpecting Bad Things to Happen? (Identifying anxious thoughts)
• A ttitudes and Actions that can help (Developing coping self-talk and actions)
• R esults and Rewards (Reviewing progress and rewarding bravery)

Children learn to replace scary thoughts with more realistic “coping thoughts,” such as “I can handle this” or “It might not be so bad.”

3. Behavioral Techniques:

• Relaxation Training: Teaching children simple relaxation skills like “belly breathing” (diaphragmatic breathing), progressive muscle relaxation (tensing and releasing muscle groups), or guided imagery (imagining a safe, calm place).
• Exposure and Response Prevention (ERP): This is a crucial component. The child, with the therapist’s help, creates a “fear ladder” or exposure hierarchy, listing feared situations from least to most scary. The child then gradually confronts these situations one by one, starting with the easiest. The “response prevention” part means they refrain from using safety behaviours (like seeking reassurance). This teaches them that their fears are often unfounded and that they can manage their anxiety.

4. Parental Involvement:

Parents are trained to act as “anxiety coaches.” They learn to validate their child’s feelings without accommodating the anxiety (e.g., not letting the child avoid school). They are taught to praise brave behaviour and to model calm, confident responses to stress themselves. Play therapy, using dolls, puppets, or art, can also be a valuable tool for younger children to express and work through their fears non-verbally.

Q6. Discuss the approaches to integrative counselling. 6

Ans. Integrative counselling is a modern and flexible approach to psychotherapy that combines elements from different therapeutic schools of thought and practice. Rather than adhering rigidly to one single theory, an integrative counsellor tailors the therapy to the specific needs of the individual client. The core philosophy is that no single approach is superior in all situations. There are several recognized pathways or approaches to integration: 1. Technical Eclecticism: This is the most common form of integration. The therapist selects and uses techniques from various theoretical models that are deemed most effective for the client’s specific problem, without necessarily subscribing to the underlying theories of those models. The primary question is “What works?” For example, a therapist might use cognitive restructuring (from CBT) for a client’s negative thoughts and empty chair technique (from Gestalt therapy) to address unresolved feelings, based on what is clinically indicated. Arnold Lazarus’s Multimodal Therapy is a prime example of this approach. 2. Theoretical Integration: This approach is more ambitious than technical eclecticism. It aims to synthesize two or more theoretical models into a new, more comprehensive framework. It involves integrating the underlying theories, concepts, and assumptions, not just the techniques. A classic example is Cognitive Behavioural Therapy (CBT) itself, which integrated cognitive theory and behavioural theory. Another example is Dialectical Behavior Therapy (DBT), which integrates CBT principles with Zen Buddhist concepts of mindfulness and acceptance. 3. Assimilative Integration: In this approach, the therapist maintains a firm grounding in one primary theoretical orientation (e.g., person-centered, psychodynamic) but is willing to incorporate or “assimilate” techniques and perspectives from other approaches. The techniques are reinterpreted and used within the framework of the therapist’s core model. For instance, a person-centered therapist might use a behavioural technique like exposure, but would frame it as a way for the client to experience and overcome incongruence in a safe, accepting relationship. 4. Common Factors Approach: This approach posits that the effectiveness of therapy is not due to specific techniques but to the “common factors” shared by all effective therapies. These factors include the therapeutic alliance, empathy, providing a clear rationale for treatment, and client expectations (hope). A therapist using this approach focuses on cultivating these core relational and procedural elements, believing them to be the primary agents of change.

Q7. Explain the stress inoculation technique. 6

Ans. Stress Inoculation Training (SIT) is a cognitive-behavioral technique developed by Donald Meichenbaum. It is a psychological resilience-building program designed to help individuals cope with future stressful events. The name is a metaphor for a medical inoculation: just as a vaccine introduces a small dose of a virus to build immunity, SIT exposes individuals to manageable levels of stress in a controlled way to strengthen their coping skills and build psychological “antibodies.” The process is typically divided into three distinct phases: 1. Conceptualization / Education Phase: In this initial phase, the therapist and client work together to understand the nature of stress and the client’s specific stress responses. The client learns to break down their global stress into specific cognitive, emotional, and behavioral components. A key goal is to reconceptualize stress not as an overwhelming catastrophe, but as a “problem-to-be-solved.” The client is educated about how their thoughts and self-talk contribute to their stress experience. 2. Skills Acquisition and Rehearsal Phase: During this phase, the client learns and practices a wide range of coping skills to manage their stress. These skills are tailored to the individual and can include:

• Cognitive Skills: Learning to monitor and change negative self-talk into positive, coping self-statements (e.g., “I can handle this,” “One step at a time”). This includes cognitive restructuring and problem-solving.
• Behavioural Skills: Learning relaxation techniques such as deep breathing, progressive muscle relaxation, and guided imagery. Other skills might include time management, effective communication, and assertiveness.

These skills are rehearsed in the therapy session through discussion and role-playing.

3. Application and Follow-Through Phase:

In the final phase, the client applies the newly learned skills to progressively more stressful situations. This starts with imagined rehearsal (visualizing coping successfully with a stressor), moves to role-playing within the therapy session, and finally to graded in-vivo exposure (applying the skills in real-life stressful situations). This gradual application builds confidence and ensures the skills are well-practiced and integrated, thereby “inoculating” the client against future overwhelming stress.

Q8. Explain the three pathways of integrative approach in counselling practice. 6

Ans. The integrative approach in counselling involves blending concepts and techniques from different therapeutic schools to create a more personalized and effective treatment for each client. Instead of adhering to a single theory, the counsellor draws from a wider toolbox. There are three primary pathways or models for how this integration is practiced: 1. Technical Eclecticism:

• Focus: “What works?”
• Method: This is the most pragmatic pathway. The counsellor selects specific techniques from various therapeutic models based on their proven effectiveness for a particular client or problem, without necessarily buying into the entire theoretical framework behind each technique. The choice of technique is driven by research evidence and clinical experience.
• Example: A counsellor might use an ’empty chair’ technique from Gestalt therapy to help a client with unresolved grief, and also teach them relaxation exercises from Behaviourism to manage anxiety symptoms. The primary goal is effective problem-solving, not theoretical purity. Arnold Lazarus’s Multimodal Therapy is a classic example of this approach.

2. Theoretical Integration:

• Focus: “How do different theories fit together?”
• Method: This is a more complex pathway that aims to create a new, synthesized theoretical model by combining concepts from two or more existing theories. It goes beyond just borrowing techniques to merge the underlying principles and assumptions into a coherent whole.
• Example: Cognitive Behavioural Therapy (CBT) is a successful theoretical integration of cognitive theory (how thoughts affect feelings) and behaviour theory (how actions are learned). Another example is Dialectical Behaviour Therapy (DBT), which integrates cognitive-behavioural principles with Zen concepts of mindfulness and acceptance.

3. Assimilative Integration:

• Focus: “How can I enhance my primary approach?”
• Method: In this model, the counsellor has a firm grounding and commitment to one primary theoretical orientation (e.g., Person-Centered, Psychodynamic) but is open to incorporating or “assimilating” techniques from other models when they seem useful. These borrowed techniques are adapted to fit within the counsellor’s core theoretical framework.
• Example: A psychodynamic therapist, who primarily focuses on past experiences and unconscious processes, might incorporate mindfulness techniques (from DBT) to help a client manage overwhelming emotions in the present moment, viewing it as a tool to strengthen the ego’s coping capacity.

Q9. Explain informed consent and confidentiality. 6

Ans. Informed Consent Informed consent is a fundamental ethical and legal principle in counselling. It refers to the process of providing clients with sufficient information about the therapeutic process so they can make a voluntary and knowledgeable decision about whether to participate in it. It is not a one-time event but an ongoing dialogue throughout the therapy. Key components of informed consent typically include:

• The Nature of Therapy: Explaining the therapist’s theoretical approach (e.g., CBT, psychodynamic) and what the client can expect in sessions.
• Goals and Procedures: Discussing the potential goals of therapy and the methods that might be used.
• Risks and Benefits: Outlining the potential benefits (e.g., symptom reduction) and risks (e.g., temporary increase in distress as difficult topics are discussed).
• Fees and Policies: Clearly stating the cost per session, payment schedule, and cancellation policy.
• The Limits of Confidentiality: Explaining the specific situations where the therapist may be required to break confidentiality.
• Client’s Rights: Emphasizing that participation is voluntary and the client has the right to refuse or withdraw from treatment at any time.

The purpose of informed consent is to respect the client’s autonomy and empower them as an active participant in their own care.

Confidentiality

Confidentiality is the cornerstone of the therapeutic relationship. It is the counsellor’s ethical and legal obligation to protect the client’s privacy by not disclosing any information shared during therapy without the client’s explicit permission. This includes the client’s identity, the content of sessions, and any records.

Importance:

Confidentiality fosters a sense of trust and safety, which is essential for the client to feel comfortable being open and honest about sensitive and personal issues without fear of judgment or exposure.

Limits to Confidentiality:

Confidentiality is not absolute. Counsellors are legally and ethically mandated to breach confidentiality in specific circumstances, which must be explained to the client during the informed consent process. These limits typically include:

• Threat of Harm to Self or Others: If a client poses a serious and imminent risk of suicide or of harming an identifiable person (duty to warn/protect).
• Child or Elder Abuse: If the counsellor suspects abuse or neglect of a child, an elderly person, or a dependent adult.
• Court Order: If a judge legally orders the release of client records for a legal proceeding.

Balancing confidentiality with these legal duties is a critical responsibility for any counsellor.

Q10. Functional enuresis/encopresis. 3

Ans. Functional enuresis and functional encopresis are elimination disorders typically diagnosed in childhood. The term “functional” signifies that the issue is not caused by an underlying medical condition (such as a neurological or urological problem). Functional Enuresis: This is the repeated, involuntary or intentional, voiding of urine into bed or clothes. For a diagnosis, it must occur at least twice a week for three consecutive months or cause significant clinical distress or impairment in social or academic functioning. The child must have a chronological and developmental age of at least 5 years. It is most commonly treated with behavioural interventions, such as the bell-and-pad method (a bedwetting alarm that sounds when moisture is detected), which conditions the child to wake up to the sensation of a full bladder, combined with positive reinforcement for dry nights. Functional Encopresis: This is the repeated passage of feces into inappropriate places, such as clothing or on the floor, whether involuntary or intentional. A diagnosis requires this to happen at least once a month for a period of three months in a child who is at least 4 years old. It is often associated with chronic constipation, where liquid stool leaks around a hard, impacted mass (overflow incontinence). Treatment typically involves a multi-pronged approach: medical management to clear the bowel, dietary changes to promote regularity, and a behavioural program of scheduled toilet sits after meals to establish a regular bowel habit.

Q11. Selective mutism. 3

Ans. Selective Mutism is an anxiety disorder characterized by a child’s consistent failure to speak in specific social situations where there is an expectation for speaking (e.g., at school), despite speaking normally in other, more comfortable situations (e.g., at home). Key Diagnostic Criteria:

• The disturbance interferes with educational or occupational achievement or with social communication.
• The duration of the failure to speak is at least one month (not limited to the first month of school).
• The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required.
• The condition is not better explained by a communication disorder (like stuttering) and does not occur exclusively during the course of a disorder like autism spectrum disorder or schizophrenia.

It’s crucial to understand that the child is not being defiant or manipulative; they are genuinely too anxious to speak. Treatment focuses on reducing anxiety, not on forcing speech. Behavioural techniques like

stimulus fading

(gradually introducing the child to more people or new situations) and

shaping

(reinforcing all attempts at communication, from gesturing and whispering to eventual vocalization) are common and effective approaches.

Q12. Psychodrama. 3

Ans. Psychodrama is an action-based method of group psychotherapy developed by Jacob L. Moreno. In this approach, clients use spontaneous dramatization, role-playing, and dramatic self-presentation to explore and gain insight into their lives and problems. Instead of just talking about issues, participants act them out. The process involves several key elements:

• The Protagonist: The client whose personal problem is being explored.
• The Director: The therapist who guides the protagonist and other group members through the enactment.
• Auxiliary Egos: Other group members who take on the roles of significant people in the protagonist’s life (e.g., a parent, spouse, or boss).
• The Stage: A designated area where the action takes place.

Core techniques include

role reversal

(the protagonist plays the part of another person to gain their perspective),

the double

(an auxiliary stands behind the protagonist and voices unexpressed thoughts and feelings), and

the mirror

(the protagonist watches an auxiliary re-enact their behaviour). The goal is to achieve emotional release (catharsis), gain new insights into one’s behaviour and relationships, and practice new, more effective ways of being.