Psychotherapy is a process of engagement between two persons, both of whom are bound to change through the therapeutic venture (Corey, 2009, p.6). This collaborative process always requires the participation of both the therapist and the client in co-constructing solutions to concerns. In these relationships, counselors facilitate healing through a process of genuine dialogue with their clients. Counseling students can begin to forge a counseling style that matches their personality by familiarizing themselves with major approaches to therapeutic practice. By learning various major approaches to counseling and psychotherapy, one develops a balanced view of the major ideas of various theorists and therapists, and the practical techniques that are commonly employed by counselors who adhere to the various approaches.
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Therefore, it is very important when learning these approaches to keep an open mind and to critically consider both the unique contributions and the particular limitations of each therapeutic system presented in the learning process. Through personal integration, students are expected to learn various models; since, by subscribing to one model, students can limit their effectiveness in working with a diverse range of future clients. Hence, by embracing different models, students have a better sense of how to integrate concepts and techniques from different approaches when defining their synthesis and framework for counseling. For better outcomes, it is always good to remain open to incorporating diverse approaches in one’s synthesis.
Counseling and Psychotherapy Approaches
Counseling and psychotherapy interventions are primarily psychological. Major approaches include psychodynamic therapies (which are shaped by earlier works of Sigmund Freud) and the development of psychotherapy. These theories are based on the importance of unconscious conflicts in producing the symptoms and defenses of the patient. The goal of these therapies is to help patients to attain insight into the repressed conflicts, which are the source of difficulty; thus, psychoanalysis is a long-term therapy. The second is experiential therapies, which are patient-centered therapies shaped by the works of Carl Rogers.
During therapy, great emphasis is placed on the ability of the patient to change when the therapist is empathic and genuine and conveys non-possessive warmth (Day, 2008). The therapist is non-directive in the interaction with the patient and attempts to promote the growth potential of the patient. Gestalt therapy, existential approaches, and transpersonal approaches fall under this category.
Thirdly, cognitive-behavioral therapies combine cognitive therapies with behavioral therapies; indeed, they are best exemplified by the works of Aaron T. Beck. These therapies focus on changing dysfunctional attitudes into more realistic and positive ones, as well as providing new information-processing skills. Additionally, eclectic and integrative therapies emphasize psychotherapists’ failure to strictly adhere to one theoretical orientation or school but the use of any procedures that they deem will be helpful for the individual patient. The focus is on openness to the views of other approaches and attempts to integrate two or more different theoretical views or systems of psychotherapy. Eclecticism is one of the leading forces advocating for integration in psychotherapy.
Lastly, group, family, and marital therapy involve more than one patient because of the specific goals concerned. Outpatient groups have been used mainly for psychoneurotic problems such as smoking cessation, binge eating, weight loss, and other similar problems. Inpatient group therapy is mainly used in hospitals for some mental conditions. The next part of this paper will compare and contrast the works of Aaron Beck in cognitive behavior therapy and Freud’s psychoanalysis, and then shape a current own counseling approach.
Aaron Beck Cognitive Behavior Theory and Freud Psychoanalysis
Aaron Tempkin Beck developed an approach referred to as cognitive therapy (CT) from his research on depression between 1963 and 1967. According to the theory, one’s thoughts and beliefs (schema) shape one’s behavior and subsequent actions. Dysfunctional thinking is caused by dysfunctional thinking, and that thinking is influenced by our beliefs. For Beck, our beliefs decide the course of our actions, and positive results can be got if patients are persuaded to think positively and avoid negative thinking.
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Cognitive therapy perceives psychological problems as stemming from commonplace processes such as faulty thinking, making incorrect inferences based on inadequate or incorrect information, and failing to distinguish between fantasy and reality (Corey, 2009, p.287). This therapy is an insight-focused therapy that emphasizes recognizing and changing negative thoughts and maladaptive beliefs. Beck’s theory holds that “depressive cognition could be as a result of traumatic experience or incapability of adaptive coping skills; depressive people have a negative perception or belief about themselves and their environment” (Corey, 2009).
Beck formulated the negative cognitive triad made up of several dysfunctional schemas as discussed in the subsequent section of this paper. These include, “first, the depressed patients see themselves as inadequate, incapable of success and always as a victim of circumstances; secondly, the patient considers all past and present experiences through the kaleidoscope of negativity, constantly emphasizing on defeats, failures and a victim mentality; lastly, the depressed individual envisions the future, just as he interprets the past and present and sees only despair and hopelessness” (Hebert & Forman, 2010). These beliefs are mainly involved with negative aspects of life; thus, in treatment, Beck puts major emphasis on understanding and changing core beliefs by restructuring destructive thinking to bring positive changes in the patient.
Sigmund Freud, psychoanalytic theory largely emphasizes the workings of the unconscious mind. According to Freud, the patients are not aware of their unconscious processes, thus they may experience irrational pleasure-seeking or guilt. The conscious mind is what we are normally aware of on daily basis, which contributes only a small portion of our mind, while the unconscious mind is where most of one’s psychological processes take place, and is quite large. In therapy, the content of the unconscious mind should be understood and inferred. According to Freud, the human mind is divided into three parts that are referred to as the id, the ego, and the superego (Sigelman & Rider, 2009, p.55).
The id is what one is born with and it constantly seeks to avoid pain and to gain pleasure. It is influenced by the sex drive and desire to hurt oneself or another. The ego is only the part that fully controls the conscious and it tries to control the influences of the id while meeting its needs. The superego is shaped by a person’s morals that are learned in childhood and they always attempt to persuade the id to do the right thing.
Freud advocated that there exists a finite amount of energy distributed between the id, ego, and superego. For Freud, personality is shaped in five psychosexual stages: oral, anal, phallic, latent, and genital, each of which involves psychic conflicts that create the need for defense mechanisms and have lasting effects on personality (Sigelman & Rider, 2009, p.55). Psychological dysfunction occurs when there is an incorrect distribution of that energy.
Freud evaluated various mechanisms, which the ego uses to deal with anxiety and stress. Defense mechanisms are present in all individuals, but dysfunction occurs when one overuses one of the available mechanisms and when one is oblivious to these happenings of the unconscious mind. In therapy, the psychoanalytic therapist’s focus is to bring the patient’s unconsciousness into the realm of consciousness.
The therapist can achieve this in the following ways: first, by interpreting the dreams that the client reports. Secondly, through free association (speaking therapy), where the client is allowed to speak freely, while the therapist interprets the resistance and repressions to understand the unconscious. The last is through transference, which involves allowing the patient unknowingly to shift his feelings towards others onto the therapist. By transforming the unconscious into the conscious, the therapist assists the client to make life choices rather than being controlled by the unconscious defense mechanisms.
Of the two theories, Aaron Beck’s cognitive behavior theory is more attractive, while the psychoanalytic theory is least attractive. The major shortcoming of the psychoanalytic approach is that it lacks a clear focus and takes several years to complete. Cognitive therapy (CT) is insight-focused by emphasizing recognizing and changing negative thoughts and maladaptive beliefs and runs for a shorter period.
CT emphasizes on client’s learning to engage in realistic positive thinking, while psychoanalysis emphasizes making the unconscious conscious. CT is focused on present problems (suppressing symptoms) regardless of the client’s diagnosis, while psychoanalysis is a process that goes back to the past. Moreover, CT takes an educational approach that aims at resolving the client’s most pressing problems and teaching the client’s relapse prevention strategies, while psychoanalysis is a lengthy process aimed at self-realization that can lead to better therapy outcomes.
The two theories link because Beck was previously a psychoanalyst; thus, using Freud’s psychoanalysis, his understanding, and observations of schema, he developed the CT. additionally, the two therapies emphasize the therapeutic relationship between the therapist and the client. Lastly, the weakness of CT lies in the assumption that the most direct way to change dysfunctional emotions and behaviors is to modify inaccurate and dysfunctional thinking, while there may be other causes that cannot be addressed by this approach.
Current Counseling Approach
Given my personality, spirituality, and skills, I would like to employ an eclectic counseling approach. Studies reveal that eclectic counselors are trained in a wide variety of counseling approaches, thus they rationally and intuitively select an approach based on the needs of their clients (Meier & Davis, 2010). Being a happy and optimistic personality, I would be able to assist different clients using different approaches. For example, some clients or approaches require forming a friendly therapeutic relationship with the client first; thus, this will comfortably suit my personality. Other approaches require one to guide clients positively towards the defined goals, thus acting as an optimistic teacher.
Being a faithful Christian who is liberal, I would be able to embrace various approaches in handling Christians of different denominations and even non-religious people due to my liberal nature; thus, by embracing eclectic counseling, I would be able to serve clients better. Having dealt with various societal issues, NGOs, and entrepreneurship, I would easily adapt to an eclectic approach. Given that I am seeking dual licensure in clinical and school professional counseling, where I will work with people from different backgrounds socially, economically, and culturally, it is necessary to embrace this approach due to the ever-changing clients’ needs occasioned by this setup.
For example, in handling clients of substance abuse, they require different approaches depending on the individual case. Some clients might have abused hard drugs such as cocaine and heroin, thus, they will require a different approach from an alcoholic.
Corey, G. (2009). Theory and practice of counseling and psychotherapy. Belmont, CA: Cengage Learning.
Day, S.X. (2008). Theory and Design in Counseling and Psychotherapy 2nd Edition. Boston, MA: Houghton Mifflin.
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Hebert, J. D. & Forman, E.M. (2010). Acceptance and Mindfulness in Cognitive Behavior Therapy: Understanding and Applying the New Therapies. NJ: John Wiley & Sons, Inc.
Meier, S.C. & Davies, S.R. (2010). The Elements of Counseling. Belmont, CA: Cengage Learning.
Sigelman, C.K. & Rider, E.A. (2009). Life-span Human Development. Sixth edition. Belmont, CA: Cengage Learning.