Theoretical Approaches to Counselling and Psychotherapy

Theoretical Approaches to Counselling & Psychotherapy Introduction to Therapeutic Approaches Personal integration as a framework for the professional education of counselors. When students are presented with a single theory and are expected to subscribe to it alone, their effectiveness will be limited when working with a diverse range of clients in the future. An undisciplined mixture of approaches, however, can be an excuse for failing to develop a sound rationale for systematically adhering to certain concepts and to the techniques that are extensions of them. It is easy to pick and choose fragments from the various therapies because they support our biases and preconceptions. Each therapeutic approach has useful dimensions for understanding human behavior. No theory is either "right" or "wrong"; each theory offers a unique contribution to understanding human behavior and has implications for counseling practice. Accepting the validity of one theory does not necessarily imply rejecting other approaches. There is a clear place for theoretical pluralism, especially in a society that is becoming increasingly diverse. More approaches have been developing methods that involve collaboration between therapist and client, making the therapeutic venture a shared responsibility. This collaborative relationship, coupled with teaching clients ways to use what they learn in therapy in their everyday lives, empowers clients to take an active stance in their world. It is imperative that clients be active, not only in their counseling sessions but in daily life as well. Homework, collaboratively designed by clients and therapists, can be a vehicle for assisting clients in putting into action what they are learning in therapy. A related assumption is that we can exercise increasing freedom to create our own future. Accepting personal responsibility does not imply that we can be anything we want to be. Social, environmental, cultural, and biological realities oftentimes limit our freedom of choice. Being able to choose must be considered in the sociopolitical contexts that exert pressure or create constraints; oppression is a reality that can restrict our ability to choose our future. We are also influenced by our social environment, and much of our behavior is a product of learning and conditioning. That being said, I believe an increased awareness of these contextual forces enables us to address these realities. It is crucial to learn how to cope with the external and internal forces that influence our decisions and behavior. We should challenge the assumption that therapy is exclusively aimed at "curing" psychological "ailments." Such focus on the medical model restricts therapeutic practice because it stresses deficits rather than strengths. Psychotherapy is a process of engagement between two people, both of whom are bound to change through the therapeutic venture. At its best, this is a collaborative process that involves both the therapist and the client in co-constructing solutions regarding life's tasks. Therapists are not in business to change clients, to give them quick advice, or to solve their problems for them. Instead, counselors facilitate healing through a process of genuine dialogue with their clients. The kind of person a therapist is remains the most critical factor affecting the client and promoting change. If practitioners possess wide knowledge, both theoretical and practical, yet lack human qualities of compassion, caring, good faith, honesty, presence, realness, and sensitivity, they are more like technicians. It is essential that counselors explore their own values, attitudes, and beliefs in depth and work to increase their own awareness. With respect to mastering the techniques of counseling and applying them appropriately and effectively, it is my belief that you are your own best technique. Your engagement with clients is useful in moving the therapeutic process along. It is impossible to separate the techniques you use from your personality and the relationship you have with your clients. Administering techniques to clients without regard for the relationship variables is ineffective. Counseling entails far more than becoming a skilled technician. It implies that you are able to establish and maintain a good working relationship with your clients, that you can draw on your own experiences and reactions, and that you can identify techniques suited to the needs of your clients. As a counselor, you need to remain open to your own personal development and to address any significant personal problems. The most powerful ways for you to teach your clients is by the behavior you model and by the ways you connect with them. Your personal characteristics are of primary importance in becoming a counselor, but it is not sufficient to be merely a good person with good intentions. To be effective, you also must have supervised experiences in counseling and sound knowledge of counseling theory and techniques. It is essential to be well grounded in the various theories of personality and to learn how they are related to theories of counseling. Differences between you and your client may require modification of certain aspects of the theories. Some practitioners make the mistake of relying on one type of intervention (supportive, confrontational, information giving) for most clients with whom they work. In reality, different clients may respond better to one type of intervention than to another. Even during the course of an individual's therapy, different interventions may be needed at various times. In developing an integrative perspective, it is essential to think holistically. To understand human functioning, it is imperative to account for the physical, emotional, mental, social, cultural, political, and spiritual dimensions. If any one of these facets of human experience is neglected, a theory is limited in explaining how we think, feel, and act. Overview of Contemporary Counseling Models Psychodynamic approaches: ● Psychoanalytic therapy is based largely on insight, unconscious motivation, and reconstruction of the personality. ○ ● The psychoanalytic model appears first because it has had a major influence on all of the formal systems of psychotherapy. Some of the therapeutic models are extensions of psychoanalysis, others are modifications of analytic concepts and procedures, and still others emerged as a reaction against psychoanalysis. Many theories of psychotherapy have borrowed and integrated principles and techniques from psychoanalytic approaches. Adlerian therapy differs from psychoanalytic theory in many respects, but it can broadly be considered an analytic perspective. ○ Adlerians focus on meaning, goals, purposeful behavior, conscious action, belonging, and social interest. Although Adlerian theory accounts for present behavior by studying childhood experiences, it does not focus on unconscious dynamics. Experiential and relationship-oriented therapies: ● Includes the existential approach, the person-centered approach, and Gestalt therapy ● The existential approach stresses a concern for what it means to be fully human. It suggests certain themes that are part of the human condition, such as freedom and responsibility, anxiety, guilt, awareness of being finite, creating meaning in the world, and shaping one's future by making active choices. ○ This approach is not a unified school of therapy with a clear theory and a systematic set of techniques. Rather, it is a philosophy of counseling that stresses the divergent methods of understanding the subjective world of the person. ● The person-centered approach, which is rooted in a humanistic philosophy, places emphasis on the basic attitudes of the therapist. It maintains that the quality of the client-therapist relationship is the prime determinant of the outcomes of the therapeutic process. ○ Philosophically, this approach assumes that clients have the capacity for self-direction without active intervention and direction on the therapist's part. ● Another experiential approach is Gestalt therapy, which offers a range of experiments to help clients gain awareness of what they are experiencing in the here and now that is, the present. ○ In contrast to person-centered therapists, Gestalt therapists tend to take an active role as they follow the leads provided by their clients. These approaches tend to emphasize emotion as a route to bringing about change, and in a sense, they can be considered emotion-focused therapies. Cognitive behavioral approaches: ● Sometimes known as the action-oriented therapies because they all emphasize translating insights into behavioral action. These approaches include: ○ Choice theory / reality therapy ○ Behavior therapy ○ Rational emotive behavior therapy ○ Cognitive therapy ● Reality therapy focuses on clients' current behavior and stresses developing clear plans for new behaviors. ● Like reality therapy, behavior therapy puts a premium on doing and on taking steps to make concrete changes. A current trend in behavior therapy is toward paying increased attention to cognitive factors as an important determinant of behavior. ● Rational emotive behavior therapy and cognitive therapy highlight the necessity of learning how to challenge inaccurate beliefs and automatic thoughts that lead to behavioral problems. ● These cognitive behavioral approaches are used to help people modify their inaccurate and self-defeating assumptions and to develop new patterns of acting. These general approach encompasses the systems and postmodern perspectives: ● Feminist therapy and family therapy are systems approaches, but they also share postmodern notions. The systems orientation stresses the importance of understanding individuals in the context of the surroundings that influence their development. To bring about individual change, it is essential to pay attention to how the individual's personality has been affected by gender-role socialization, culture, family, and other systems. ● The postmodern approaches include social constructionism, solution-focused brief therapy, narrative therapy, and motivational interviewing. These newer approaches challenge the basic assumptions of traditional approaches by assuming that there is no single truth and that reality is socially constructed through human interaction. Both