Contemporary Theory and Practice in Counseling and Psychotherapy

Howard E. A. Tinsley, Suzanne H. Lease, Noelle S. Giffin Wiersma

• Publisher: SAGE Publications, Inc
• Year: 2015
• ISBN:
  9781483324784
• Edition: 1
• Topic: Social Sciences
• Subtopic: Sociology
• Index: Social Sciences

This comprehensive, topically arranged text provides a contemporary account of counseling theories as practiced by internationally acclaimed experts in the field. Each chapter covers the way mindfulness, strengths-based positive psychology, and the common factors model is integrated into the theory. A special emphasis on evidence-based practice helps readers prepare for their work in the field.

Key Features

• The text focuses on how each theory presents a useful and effective basis for contemporary practice, providing students with the most up-to-date scholarship on current theories and how these theories guide the practice of today's counselors and psychotherapists.
• Chapters are written by internationally acclaimed experts offering a truly global and complete perspective of the field.
• Discussion of the pros and cons of each theoretical approach allows students to explore all sides of an approach, offering an opportunity for balanced, critical analysis of the material.
• Brief therapies or "manualized" approaches, developed in response to the limits imposed by insurance companies on the number of reimbursable therapy sessions per client, are addressed, as many theoretical approaches offer strategies for providing these therapies.
• Careful discussion in every chapter of the applicability of theories to a diverse client population allows readers to address the specific needs of a broader clientele while acknowledging gender, race, age, sexual orientation, religion, etc.
• Integrated coverage of and a separate chapter on evidence-based practice introduce students to what is becoming the expected standard for effectively working with clients.
• Lists of additional resources from expert contributors allow students to further explore the concepts presented.

Section 1 Contemporary Theory in Its Historical and Empirical Context

Chapter 1 Contemporary Approaches to Counseling and Psychotherapy

Howard E. A. Tinsley Western Washington University and Southern Illinois University Carbondale

Suzanne H. Lease University of Memphis

Noelle S. Giffin Wiersma Whitworth University

Abstract

The need for counseling and psychotherapy is great, both in the United States and internationally. Estimates of the percentage of adults having some form of mental illness or brain disorder range upward from 25%. Programs in medicine, psychology, education, and many other disciplines are training therapists to address this need using a variety of evidence-based approaches. In this chapter we document briefly the need for mental health services and explain the terminology that the volume contributors use to refer to service providers, service recipients, the conditions treated, and the services provided. We provide a brief outline of the stages in the therapy process. A growing body of meta-analysis research has demonstrated convincingly that a small number of common factors underlie the alternative approaches to therapy. We discuss those factors and the empirical research demonstrating their effectiveness. We conclude the chapter with a consideration of codes of ethical conduct that prescribe the obligations and responsibilities of all health service providers, regardless of their formal professional affiliation.

Key words

assessment/diagnosis, common factors model, dodo bird conjecture, dual relationship, duty to warn, ethics, facilitative conditions, mental illness, meta-analysis, termination

Introduction

As a reader of this book you are doubtless preparing for a career as a mental health professional or have a personal interest in the approaches used to help those in need of mental health services. We think that as you read this book you will be impressed, as are we, by the breadth and sophistication of the leading approaches to counseling and psychotherapy and the guidance they can provide therapists in understanding their clients. The theories described here have been tested, so therapists can have confidence that their use will be of genuine benefit to their clients. We asked our authors to describe the growing body of psychological research that informs these theories and documents their effectiveness.

There are numerous theoretical orientations and related therapeutic approaches. Estimates of the number of therapeutic approaches range from 200 (Imel, 2008) to more than 400 (Maclennan, 1996; Wedding & Corsini, 2013). Obviously, no text could cover all of them—nor should it! Contemporary Theory and Practice in Counseling and Psychotherapy provides comprehensive coverage of the significant theories in the field. Surveys of mental health service providers reveal that the theories covered in this volume are the mainstays of practicing therapists (Norcross, Hedges, & Castle, 2002; Norcross, Karpiak, & Santoro, 2005; Watkins, Lopez, Campbell, & Himmell, 1986). Newer, empirically supported approaches to therapy such as dialectical behavior therapy, coherence therapy, and narrative therapy are also included because of their demonstrated effectiveness. In aggregate, the theoretical approaches in Contemporary Theory cover the breadth and depth of clinical practice by mental health professionals.

Theories of counseling and psychotherapy are dynamic, evolving bodies of intellectual knowledge. Most of these theories have undergone critically important modifications in the past two decades to incorporate empirically supported elements brought to light by the contemporary emphasis on rigorous research. We’ve chosen internationally acclaimed experts to write about each of the theories. Thus, in addition to providing a brief historical context for each theory, our contributors provide an up-to-the-minute account of their theoretical approaches, based on their own expert research and practice. The focus of this book is on the contemporary practice of counseling and psychotherapy by experts.

Readers at the beginning of their professional training may be overwhelmed by the amount of knowledge they have to learn as they move through their programs. It may seem unclear how counseling theories help the people with whom they will work. Our belief is that theory provides the foundation for our work as counselors and psychotherapists. It is the “road map” we use in working with clients. Without theory to guide our work, we are more likely to “fly by the seat of our pants” in client sessions, never the ideal way to approach our clinical work. Our goal in editing this book is to provide readers with a series of road maps (as in an atlas, for those who remember paper maps, as opposed to GPS and smart devices).

The Need for Mental Health Services

The magnitude of the problems confronting mental health professionals, and indeed society, is sobering, and the demand for skilled mental health professionals is great. The stark conclusion from the National Institute of Mental Health (NIMH, 2012)— “Mental disorders are common in the United States”—captures the seriousness of the mental health problem in the United States. NIMH reports that 4.1% of the U.S. adult population suffered from a serious mental illness in 2012. The prevalence varied from 3.2% for males to 4.9% for females, it spiked to a high of 5.2% in the overall population between the ages of 26 and 49, and it ranged from a low of 1.8% among native Hawaiian and other Pacific islanders to a high of 8.1% among American Indians and Alaskan natives.

Unfortunately, those estimates may dramatically understate the problem. The results are based on data from respondents who completed the past-12-month version of the Structured Clinical Interview for the DSM-IV-TR Axis I Disorders (Research Version, Non-patient Edition). The assessment did not include diagnostic modules for adult attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders, schizophrenia, or other psychotic disorders (NIMH, 2012). Additionally, many individuals with mental health issues may never seek help from a counselor or therapist. Primary care has been called the “de facto” mental health (now frequently termed behavioral health) entry point for 70% of the population (Regier et al., 1993). Unfortunately, many primary care physicians report that they are unable to obtain outpatient mental health services for their patients (Cunningham, 2009).

The Centers for Disease Control and Prevention (2011) found that, in developed countries, mental disorders account for more disability than any other group of illnesses. Approximately 25% of U.S. adults have a mental illness, and nearly 50% of U.S. adults will develop at least one mental illness during their lifetimes (Rosenberg, 2013). These individuals come from all walks of life and represent all levels of society, including even the wealthiest of individuals. A source of great concern to many in the United States is the 2.3–3.5 million people who experience homelessness at some point during a given year (Urban Institute, 2000a, 2000b). Many of these people are troubled by psychological difficulties that interfere with their ability to obtain the resources needed for basic food and shelter. Serious mental illness is an important mental health problem in all segments of the U.S. population.

A Homeless Man in New York City

C. G. P. Grey

The problem of mental illness is not confined to the United States. The World Health Organization (2001) reported that some 450 million people worldwide suffer from some form of mental disorder or brain condition and that 25% meet the criteria...