Control Therapy Overview

Control Therapy
Helping individuals gain a positive sense of control in their lives

If you can keep you head when all about you are losing theirs . . . If you can stay calm and in control when those around you are panicking and losing control, then . . . clearly, you don't understand the situation!
(with apologies to Rudyard Kipling)
Start worrying . . . details to follow.
My grandma Nana's view of Life.

A Brief Overview

The material below begins with 1) an invitation for a moment of control-related self-reflection followed by 2) a two page overview of Control Therapy; 3) a few paragraph history of the roots of CT.

Further reading that provides an overview of Control Therapy, (in order of length!) includes a couple of pages in the Control Therapy Training Manual (FAQ #1 from lay public/client (p. 3), from students, trainees (pp.13-14); a four page summary in the Encyclopedia of Psychology (Wiley); a 15 page summary in Appendix 11 of the Control Therapy Training Manual; and a 250 page "Last Lecture" (as well as the book Control Therapy; and the Control Therapy Training Manual)—all available at no charge on this website.

AN INVITATION: A MOMENT OF CONTROL-RELATED SELF-REFLECTION: Before discussing what Control Therapy is, and in the spirit of self-exploration and self-reflection, a "psychology from the inside out," it may be helpful to take a moment or two to consider the following questions

  • Think of times when you have had a positive sense of control in your life.
  • What does a positive sense of control feel like? How do you "know" it? In your body? Your thoughts? Your feelings? Relationally?
  • What are ways you seek to gain and maintain a positive sense of control in your life? (Self as agent)
  • What are ways that others can help you to gain a sense of control in your life? (Other as agent, including, where appropriate, your beliefs about the nature of the universe).
  • Does a sense of control always involve making changes to meet your needs and desires (an assertive, change mode of control)? Can it sometimes involve learning to accept and be at peace and harmony with "what is" (a yielding, accepting mode of control)?
  • Do you feel you have too little control in your life? In which "domain(s)"? e.g., physically, cognitively, emotionally, interpersonally, at work?
  • Do you sometimes feel you are seeking, desiring, or actually have and are exerting too much control? Again, in which domain(s)?
  • Finally, for you, what would optimal control be like: in your mind, your body, interpersonally, at work?

 

The Principles and Practice of
CONTROL THERAPY

Issues of control face all humans. Control Therapy is based on the belief that all of us want to have a positive sense of control about our lives and that we feel happier and healthier when we do. Yet, each of us—client, student, teacher—also knows from first-hand experience that we receive assaults to our sense of control as we go through life. Some of these are the result of inevitable existential suffering inherent in being alive. Others are what we might call "unnecessary suffering" brought about by poor choices, lack of skillful responses to events, and/or not having learned appropriate cognitive, emotional and behavioral self-regulation strategies.

The reason individuals seek counseling is often because there are one or more areas of concern in their life where they feel things are not in as much control as they would like, or where they feel they (or others) are too controlling. And, despite their best efforts, those areas are causing them pain and suffering. These areas could include physical health, work, relationships, and personal issues, such as our habits, our feelings, and our thoughts.

Essentially, the principles and practice of Control Therapy rest upon a biopsycho¬social foundation and have three postulates: (1) All individuals desire a sense of control in their lives; one of our greatest human fears is losing control, and one of our strongest motivations is to have a degree of control over our lives; (2) we humans seek to gain or regain a sense of control by our actions, thoughts, emotions, and awareness. There are healthy and unhealthy (lower and higher) levels of control desires, goals, and strategies-- which individuals utilize to gain or regain that sense of control--; and (3) there are individual differences in people's Control Profiles—desire for control, sense of control, and the means (agency and modes) by which they seek to gain a sense of control.

CT is based on an educational model, and believes that although there is individual variation (postulate 3), each of us has the ability to

  • Learn to pause, reflect, consider and reconsider our thoughts, actions, and behavior
  • Learn to choose, if we wish, to interrupt and override reflexive cognitive, emotional, and behavioral impulses and sequences
  • Learn to create alternative ways of responding -- behaviorally, emotionally, and/or cognitively -- that we feel are more in our (and others') best interest, and which help us gain, or regain a positive sense of control.

The Two Phases of Control Therapy (CT). CT is based on the premise that all individuals seek to gain, maintain, and regain a positive sense of control in their lives personally, interpersonally, and in their views of the nature of the universe. CT further has shown that issues of personal control (e.g., desire for control, fear of losing control, power struggles) underlie most concerns brought to therapy.

Phase One of Control Therapy involves assessment of the client's control profile, helping the client become more aware of his/her area of concern and control dynamics; self-evaluation of the area of concern; and goal setting. This phase incorporates the use of a reliable and valid standardized multidimensional psychological assessment tool, the Shapiro Control Inventory (SCI) to provide a unique "Control Profile" for the client, showing sense of control in the general domain, in specific life areas, and in regards to motivation for change, desire for change, preferred style for gaining control: i.e., an assertive/change mode of control a positive/assertive mode of control which involves changing and altering a situation (and ourselves); a positive yielding/accepting mode of control in which a person learns to accept, yield, and develop a peace and harmony with "what is." Each of these ways to gain a sense of control can be accomplished by the use of self-efforts (self as agent) and/or by help from others (others as agent, including our beliefs about the nature of the universe).

Through assessment by a standardized test (the SCI), self-observation, listening to control speech, and examining control stories, clients are helped to recognize their control profiles, assaults to their sense of control, and what forces are shaping their lives, including personal (i.e., behavioral, cognitive, and emotional), interpersonal, and environmental). They then evaluate this information and choose a goal to help address their control related concerns. Several tools to help clients address challenges in goal setting, including decision making priorities, Control Mode Dialogue, are offered when needed to help refine and clarify client goals.

The second phase of Control Therapy: Matching Control Profile and goal to Control Enhancing Interventions Research has shown that there are individual differences in people's Control Profiles in terms of their preferred modes for facing this central issue of gaining and maintaining a sense of control; and that for a specific clinical problem, matching clinical control-enhancing interventions to the individual's Control Profile maximizes the opportunity for therapeutic success. Control Therapy has developed guidelines and principles, based on theory, research, and practice, on how to utilize and tailor to the individual client control-enhancing techniques involving a five step model for the assertive/change mode and for the yielding/accepting mode including:

  1. Desire for control
  2. Right and responsibility for control
  3. Self-efficacy beliefs
  4. Commitment and skills
  5. Success

By integrating theory, research and practice, Control Therapy addresses client's concerns through eight to twelve sessions designed to help individuals learn to gain or regain a psychological "sense of control" in the "intended direction" by the most skillful means possible. A systems model of feedback and evaluation of each of the components of Control Therapy to provide feedback and evaluation at each step. This systems model helps ensure the best possible working relationship between client and therapist with regard to assessment, goal setting, matching interventions to the client's control profile and goal, ensuring that teaching of interventions is most skillfully matched to a client's style, and to facilitate ongoing feedback during the therapeutic process to help maximize success. A competency based model for assessing student/therapeutic progress is also detailed to help facilitate student training in CT.

In summary, CT is a short term therapeutic approach that provides a systematic way assessing a person's control profile and assaults to their sense of control, and then determining when to use which types of control strategies with a specific client given that person's unique control profile and consistent with that person's particular counseling goals.

 

The Roots and History of CT

Historical comparison, contrast, integration. The roots of Control Therapy began in the early l970's with clinical research studies combining meditation and behavioral self-control for addictions and stress/anxiety management. This work culminated in an article which explored historically for the first time the similarities, differences and clinical applications of self-regulation strategies, both Western (e.g., behavior self-control, cognitive therapy) and Eastern (Zen Buddhism and Vipassana, mindfulness meditation) (American Psychologist, l976 ).

Modes of control. Exploring the goals and context of these eastern and western techniques led, in the late l970's, to the positing and conceptual development of four modes of control, including identifying a positive assertive/change mode of control, and a positive yielding/acceptance mode of control as important aspects of positive psychological health and well-being. The modes of control represented and embodied a way of understanding human control that was not culturally limited, but involved delineating positive assertive, positive yielding, negative assertive (overcontrol), and negative yielding (too little control, helpless passivity) responses to various situations, interactions, and encounters. This four quadrant model of control and self-control was developed which reflected characteristic cognitive and/or behavioral styles of responding to control-related issues (of Precision Nirvana, l978, Prentice Hall, Psychologia, l982) A Control Mode Dialogue, which addresses the two negative modes (negative assertive and negative yielding) was developed to help recognize, understand, and transform those modes into positive ones.

SCI Control Profile. A clinically useful, reliable and valid means of assessing the theory through a control profile for each individual (including desire for control, overall sense of control in the general and specific domain, agency of control, and modes of control) was created and tested. During the next decade a dozen reliability and validity studies with several thousand individuals were conducted, culminating in the publication of the SCI Inventory (Behaviordata, l992, SCI Manual, l994) including content analysis of psychotherapy speech samples, neurobiological correlates of the modes of control and sense of control using Positron Emission Tomography, and control profiles of normal and other populations: depression, generalized anxiety disorder, panic attacks, borderline personality, eating disorders (anorexia and bulimia); adult children of alcoholics, those at high risk for cardiovascular disease, type A individuals with myocardial infarction, and women with breast cancer.

Further theory, research, practice. The theory and postulates of Control Therapy were explored, and the research on control and psychological health, physical health, and relational health examined, including case studies using Control Therapy for generalized anxiety; for preventive health care: a case of lifestyle modification; and in couples therapy (Control Therapy, Wiley, l998). The Control Research Foundation was established in 2004. A website (controlresearch.net) established (2008) to gather this material and where the SCI can be taken online (The SCI has been translated into several languages—Chinese, Korean, Spanish, Hebrew, and the Chinese version is online at the website). A Control Therapy Training Manual (2009) was written; in 2013 a twenty year follow up of sense of control and modes of control and morbidity and mortality in breast cancer was published (Behavioral Medicine). Finally, in preparation for this Amendment, a template for a Control Therapy Syllabus (2014) and a template for a "Lecture on Control Therapy" (2014) were prepared. As of the writing of this Amendment to the Control Research Foundation Fund (August, 2014), there are now over forty years of history to this work.

Control as a common theme in human behavior. One of the advantages of the principles and practices of Control Therapy, which can easily be understood from listening to control speech in everyday life, and even by exploring briefly one's own control story (see questions at start of this Exhibit A), is that "control" is something involved in normal everyday life, conversation, and experience. Therefore, CT offers the client (and all of us) the opportunity to frame clinical concerns in non-pathologizing language. Further, control language provides a link between clinical disorders, normal psychological health, and positive well-being. Another important aspect is that the principles and practices of Control Therapy, with its biopsychosocial foundation, control related vision of positive health, and control enhancing interventions, can be easily adapted by other therapeutic approaches where control issues are relevant. Finally, CT can have application not just as "therapy" in clinical settings, but also in the educational classroom and in health care settings. Because CT essentially is an educational model, it has application to a wide range of people from therapy clients to students to patients and health-care providers it's in that it shows how all control related desires, goals, and strategies can be viewed along a continuum from less skillful (causing increased suffering to self and others) to more skillful, decreasing suffering and optimizing well-being in both self and others.

 

Additional Information

For more Frequently Asked Questions on Control Therapy (e.g., What is Unique about Control Therapy, Can Control Therapy Complement Other Psychotherapeutic Approaches), visit the FAQ section.