Six Key Approaches to Counselling and Therapy

Richard Nelson-Jones

• Publisher: SAGE Publications Ltd
• Year: 2010
• ISBN:
  9781446244975
• Edition: 2
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

This updated and revised new edition of Six Key Approaches to Counselling and Therapy provides an accessible introduction to the theory and practice of six of the most popular contemporary therapeutic approaches from the three main schools of therapy practice:

- cognitive therapy and solution-focused therapy from the cognitive-behavioural school

- person-centred and Gestalt therapy from the humanistic school

- Freud?s psychoanalysis and Jung?s analytical therapy from the psychodynamic school.

Following a clearly-defined structure, each chapter describes the origin of the therapeutic approach, a biography of its originator, its theory and practice, discusses case material and further developments, and suggests further reading. Richard Nelson-Jones goes on to review and evaluate all the approaches in his concluding chapter.

This excellent textbook is a vital resource for students on introductory courses and those who are starting out on professional training.

1

Introducing Counselling and Therapy Approaches

I invite you on an intellectual, practical and personal journey through six of the most interesting and important approaches to contemporary counselling and therapy. Though you may not have thought about it this way, you already started your journey as a counselling theorist long ago as you developed ideas about what makes people tick. In this book, I aim to assist you to move further along the path towards developing your theory of human development and gaining practical knowledge about how to conduct counselling and therapy.

OVERVIEW OF COUNSELLING AND THERAPY APPROACHES

A useful distinction exists between schools of counselling and therapy and theoretical approaches to counselling and therapy. A theoretical approach presents a single position regarding the theory and practice of counselling and therapy. A school of counselling and therapy is a grouping of different theoretical approaches that are similar to one another in terms of certain important characteristics that distinguish them from theoretical approaches in other counselling and therapy schools.

Probably the three main schools influencing contemporary individual counselling and psychotherapy practice are the psychodynamic school, the humanistic school, and the cognitive-behaviour school. Sometimes the humanistic school incorporates existential therapeutic approaches and then can get the broader title of being the humanistic-existential school. A fourth school, the postmodern school, comprises some more recent approaches. Be careful not to exaggerate the differences between counselling and therapy schools, since there are similarities as well as differences among them. Box 1.1 briefly describes some distinguishing features of the psychodynamic, humanistic-existential, cognitive behaviour and postmodern schools.

BOX 1.1 FOUR COUNSELLING AND THERAPY SCHOOLS

The psychodynamic school

The term psychodynamic refers to the transfer of psychic or mental energy between the different structures and levels of consciousness within people’s minds. Psychodynamic approaches emphasize the importance of unconscious influences on how people function. Therapy aims to increase clients’ abilities to exercise greater conscious control over their lives. Analysis or interpretation of dreams can be a central part of therapy.

The humanistic school

The humanistic school is based on humanism, a system of values and beliefs that emphasizes the better qualities of humankind and people’s abilities to develop their human potential. Humanistic therapists emphasize enhancing clients’ abilities to experience their feelings and think and act in harmony with their underlying tendencies to actualize themselves as unique individuals.

The cognitive behaviour school

Traditional behaviour therapy focuses mainly on changing observable behaviours by means of providing different or rewarding consequences. The cognitive behaviour school broadens behaviour therapy to incorporate the contribution of how people think to creating, sustaining and changing their problems. In cognitive behaviour approaches, therapists assess clients and then intervene to help them to change specific ways of thinking and behaving that sustain their problems.

The postmodern school

The postmodern therapies adopt a social constructionist viewpoint, assuming that how people process and construct information about themselves and their world is central to their existence. Rather than conceptualizing progress as a departure from and rejection of the past, postmodernism draws on the past to serve the present. People’s experience of emotions depends on the names that they give to these emotions. People’s beliefs about their relationships affect how they interpret the reactions of others and how they respond to them. Personal behaviour results from these cognitive processes and is therefore open to change.

Box 1.2 introduces the theoretical approaches included in this book. So that readers can obtain a sense of the history of the development of ideas within counselling and therapy, I have included the dates of the originators of each approach. The descriptions provided in Box 1.2 reflect the position of the originators of the different positions, rather than developments within a theoretical approach stimulated by others.

BOX 1.2 SIX COUNSELLING AND THERAPY APPROACHES

Psychodynamic school

Classical psychoanalysis Originator: Sigmund Freud (1856–1939)

Pays great attention to unconscious factors related to infantile sexuality in the development of neurosis. Psychoanalysis, which may last for many years, emphasizes working through the transference, in which clients perceive their therapists as reincarnations of important figures from their childhoods, and the interpretation of dreams.

Analytical therapy Originator: Carl Jung (1875–1961)

Divides the unconscious into the personal unconscious and the collective unconscious, the latter being a storehouse of universal archetypes and primordial images. Therapy includes analysis of the transference, active imagination and dream analysis. Jung was particularly interested in working with clients in the second half of life.

Humanistic school

Person-centred therapy Originator: Carl Rogers (1902–87)

Lays great stress on the primacy of subjective experience and how clients can become out of touch with their organismic experiencing through introjecting others’ evaluations and treating them as if their own. Therapy emphasizes a relationship characterized by accurate empathy, respect and non-possessive warmth.

Gestalt therapy Originator: Fritz Perls (1893–1970)

Individuals become neurotic by losing touch with their senses and interfering with their capacity to make strong contact with their environments. Therapy emphasizes increasing clients’ awareness and vitality through awareness techniques, experiments, sympathy and frustration, and dreamwork.

Cognitive behaviour school

Cognitive therapy Originator: Aaron Beck (1921–)

Clients become distressed because they are faulty processors of information with a tendency to jump to unwarranted conclusions. Therapy consists of educating clients in how to test the reality of their thinking by interventions such as Socratic questioning and conducting real-life experiments.

Postmodern school

Solution-focused therapy Originators: Steve de Shazer (1940–2005) and Insoo Kim Berg (1934–2007)

Theories of causation are irrelevant to the process of achieving goals and resolving problems. The therapist is responsible for directing the conversation towards the client’s goals and acknowledging their difficulties. Specific uses of language and styles of questioning are used to encourage creativity and flexible thinking around the relevant issues.

So far I have presented the different schools and theoretical approaches as though they are separate. In reality, many counsellors and therapists regard themselves as working in either eclectic or integrative ways. A detailed discussion of eclecticism and integration is beyond the scope of this book. Suffice it for now to say that eclecticism is the practice of drawing from different counselling and therapy schools in formulating client problems and implementing treatment interventions. Integration refers to attempting to blend together theoretical concepts and/or practical interventions drawn from different counselling and therapy approaches into coherent and integrated wholes.

COUNSELLING AND PSYCHOTHERAPY

The word therapy is derived from the Greek word therapeia meaning healing. Literally psychotherapy means healing the mind or the soul. Nowadays, most commonly the meaning of psychotherapy is broadened to become healing the mind by psychological methods that are applied by suitably trained and qualified practitioners. However, as illustrated in this book, there are different approaches to therapy and, consequently, it is more accurate to speak of the psychotherapies rather than a uniform method of psychotherapy. Moreover, there are different goals for therapy including dealing with severe mental disorder, addressing specific anxieties and phobias, and helping people find meaning and purpose in their lives. Each of the different therapeutic approaches may be more suitable for attaining some goals than others.

Does counselling differ from psychotherapy? Attempts to differentiate between counselling and psychotherapy are never wholly successful. Both counselling and psychotherapy represent diverse rather than uniform knowledge and activities and both use the same theoretical models. In 2000, the British Association for Counselling acknowledged the similarity between counselling and psychotherapy by becoming the British Association for Counselling and Psychotherapy. In Australia, the Psychotherapy & Counselling Federation of Australia exists.

For the most part I use the terms therapy, therapist and client. Therapy refers both to the theoretical approach and to the process of helping clients. Therapist refers to the providers of therapy services to clients, be they psychoanalysts, psychiatrists, clinical psychologists, counselling psychologists, counsellors, social workers or other suitably trained and qualified persons. Client refers to the recipient of therapeutic services whether inside or outside of medical settings.

WHAT IS A COUNSELLING AND THERAPY THEORY?

A theory is a formulation of the underlying principles of certain observed phenomena that have been verified to some extent. A criterion of the power of a theory is the extent to which it generates predictions that are confirmed when relevant empirical data are collected. The more a theory receives confirmation or verification, the more accurate it is. Facts strengthen rather than replace theories.

FUNCTIONS OF COUNSELLING AND THERAPY THEORIES

What do counselling and therapy theories do? Why are they useful? Therapists cannot avoid being counselling and therapy theorists. All make assumptions about how clients become and stay the way they are and about change. Three of the main functions of counselling and therapy theories are: providing conceptual frameworks, providing languages, and generating research.

THEORIES AS CONCEPTUAL FRAMEWORKS

Therapists are decision makers. They continually make choices about how to think about clients’ behaviour, how to treat them, and how to respond on a moment-by-moment basis during therapy sessions. Theories provide therapists with concepts that allow them to think systematically about human development and the therapeutic process.

Counselling and therapy theoretical approaches may be viewed as possessing four main dimensions if they are to be stated adequately. In this context behaviour incorporates both observable behaviour and internal behaviour or thinking. The dimensions are:

1. a statement of the basic concepts or assumptions underlying the theory;
2. an explanation of the acquisition of helpful and unhelpful behaviour;
3. an explanation of the maintenance of helpful and unhelpful behaviour; and
4. an explanation of how to help clients change their behaviour and consolidate their gains when therapy ends.

When reading about the different counselling and therapy approaches, you may observe that many if not most have significant gaps in their conceptual frameworks. They are partial rather than complete or comprehensive theoretical statements. Arguably, some of the missing concepts in the theories are implicit rather than explicit. Theorists select for more thorough treatment those dimensions of a theory that they consider important.

THEORIES AS LANGUAGES

Swiss psychiatrist Carl Jung (1961) used to stress that, since all clients are different individuals, therapists require a different language for each client. Another function of theories is similar to that provided by languages. Languages are vocabularies and linguistic symbols that allow communication about phenomena. Like the major spoken languages of English, Spanish and Mandarin Chinese, the different theorists develop languages for the phenomena they wish to describe, for instance: cognitive, psychoanalytic or person-centred languages. Language can both unite and divide. It can encourage communication between people who speak the same language, but discourage communication if they do not. Each theoretical position has concepts described in unique language. However, the uniqueness of the language may mask common elements among theories, for example: the meaning of conditions of worth in person-centred therapy overlaps with that of super-ego in Freud’s psychoanalytic therapy, though you would not know this from the language!

The therapy process is a series of conversations requiring languages. In any therapeutic relationship there are...

Table of contents

• Cover Page
• Title
• Copyright
• Contents
• Preface
• Acknowledgements
• 1 Introducing counselling and therapy approaches
• 2 Freud’s psychoanalysis
• 3 Jung’s analytical therapy
• 4 Person-centred therapy
• 5 Gestalt therapy
• 6 Cognitive therapy
• 7 Solution-focused therapy
• 8 Evaluation, eclecticism and integration
• Glossary
• Name index
• Subject index