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Seligma, L., & Reichenberg, L. W. (2013). Theories of Counseling and Psychotherapy (4th ed.). Pearson.

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The fourth force came into existence in the beginning of the 21st century. Elements of the all three forces are intergrated into a comprehensive and holistic effort to understand people as fully as possible. Clinicians' awareness and understanding of components of individual identity such as gender, culture, age, race and sexual orientation facilitate development of positive theraputic relationships and effective treatment plans (Seligma & Reichenberg. 2013).

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Carl Roger's work led to the third force in the 1960's which was existential-humanistic psychotherapy. It emphasizes the importance of emotions and sensations and of people taking charge of and finding meaning in their own lives.  Among Carl, other contributed to this force such as Fritz Perls and Viktor Frankl (Seligma & Reichenberg. 2013).

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The second force was led by five theorists, B.F. Skinner, Albert Ellis, Aaron Beck, William Glasser and Donald Meichenbaum which is behavioral and cognitive theories and interventions. Behavioral treatments approaches was used in the 1970's which led to cognitive approaches in the 1980's then led to cognitive-behavioral approaches in the 1990's. Cognitive and behavioral treatment systems emphasizes the influence of thoughts and actions on emotions (Seligma & Reichenberg. 2013).

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The first force viewed past experiences as the source of people's present emotional difficulties and emphasizing unconscious processes and long term treatment, psychodynamic approaches provided a solid foundation for the field of psychotherapy (Seligma & Reichenberg. 2013).

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People had little understanding of emotional difficulties and mental disorder. Many People with severe symptoms were forcibly confined in institutions and exposed to largely ineffective treatments, while those with mild or moderate difficulties typically received no help.