Career Counseling a Holistic Approach Chapter 16 Edition 8
Psychoanalytic Approach; Behavioral Approach - Cognitive Behavioral Therapy (CBT), Rational Emotive Behavioral Therapy (REBT), Transactional Analysis (TA); Humanistic Approach - Person Centered Therapy, Gestalt Therapy, Existential Therapy; Other Contemporary Therapy - Adlerian Therapy/ Individual Psychology, Reality therapy, Family Systems Therapy, Feminist Therapy, Eye Movement Desensitization and Reprocessing (EMDR), Eclectic Counseling, Integrative Counseling, Group Therapy.
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CHAPTER - 6
COUNSELING APPROACHES
Topics Covered
Psychoanalytic Approach
Behavioral Approach
Cognitive Behavioral Therapy (CBT)
Rational Emotive Behavioral Therapy (REBT)
Transactional Analysis (TA)
Humanistic Approach
Person Centered Therapy
Gestalt Therapy
Existential Therapy
Other Contemporary Therapy
Adlerian Therapy/ Individual Psychology
Reality therapy
Family Systems Therapy
Feminist Therapy
Eye Movement Desensitization and Reprocessing (EMDR)
Eclectic Counseling
Integrative Counseling
Group Therapy
118 Counseling Approaches
PSYCHOANALYTIC APPROACH
Psychoanalytic approach is a type
of approach based upon the theories
of Sigmund Freud, who is
considered one of the forefathers of
psychology and the founder of
psychoanalysis. This therapy
explores how the unconscious mind
influences thoughts and behaviors,
with the aim of offering insight and
resolution to the person seeking
therapy. Psychoanalytic therapy
tends to look at experiences from
early childhood to see if these
events have affected the
individual's life, or potentially
contributed to current concerns.
Sigmund Freud
(May 6, 1856 –September 23, 1939)
This form of therapy is considered a longterm choice and can continue for weeks,
months or even years depending on the depth of the concern being explored. Differing
from several other therapy types, psychoanalytic therapy aims to make deepseated
changes in personality and emotional development.
Basic Philosophy: While each therapist will work in different ways according to the
needs of the individual seeking therapy, many work on the following assumptions
Human beings are basically determined by psychic energy and by early
experiences.
Unconscious motives and conflicts are central in present behavior.
Irrational forces are strong; the person is driven by sexual and aggressive
impulses.
Early development is of critical importance because later personality problems
have their roots in repressed childhood conflicts.
Key Concepts: Normal personality development is based on successful
resolution and integration of psychosexual stages of development. Faulty
personality development is the result of inadequate resolution of some specific stage.
Id, ego, and superego constitute the basis of personality structure. Anxiety is a result
of repression of basic conflicts. Unconscious processes are centrally related to current
behavior.
Essentials of Counseling 119
Developmental Stages
Oral stage is centered on the mouth as a source of pleasure.
Anal stage is centered on the anus and elimination as a source of pleasure.
Phallic stage is centered on the genitals and sexual identification as a source of pleasure.
Oedipus Complex is described as the process whereby a boy desires his mother and fears
castration from the father, in order to create an ally of the father, the male learns traditional male
roles.
Electra Complex is described a similar but less clearly resolved in the female child with her desire
for the father, competition with the mother; and thus, learns the traditional female roles.
Latency stage is a time of little sexual interest in Freud's developmental view. This stage is
characterized with peer activities, academic and social learning, and development of physical
skills.
Genital stage begins with the onset of puberty. If the other stages have been successfully
negotiated, the young person will take an interest in and establish sexual relationships.
Structure of Personality
The personality has three parts the id, the ego, and the superego.
The id is present at birth and is part of the unconscious. The id is the site of the pleasure principle,
the tendency of an individual to move toward pleasure and away from pain. The id does not have a
sense of right or wrong, is impulsive, and is not rational. It contains the most basic of human
instincts, drives, and genetic endowments.
The ego is the second system to develop and it functions primarily in the conscious mind and in
the preconscious mind. It serves as a moderator between the id and the superego, controlling
wishes and desires. The ego is the site of the reality principle, the ability to interact with the
outside world with appropriate goals and activities.
The superego sets the ideal standards and morals for the individual. The superego operates on the
moral principle which rewards the individual for following parental and societal dictates. Guilt is
produced when a person violates the ideal ego denying or ignoring the rules of the superego.
Ego Defense Mechanisms
Ego defense mechanisms were believed by Freud to protect the individual from being overwhelmed by
anxiety. He considered them normal and operating on the unconscious level.
Defense Description Example
Denial arguing against an anxiety
provoking stimuli by stating it
doesn't exist
denying that your physician's diagnosis of
cancer is correct and seeking a second opinion
Displacement taking out impulses on a less
threatening target
slamming a door instead of hitting as person,
yelling at your spouse after an argument with
your boss
Intellectualization avoiding unacceptable
emotions by focusing on the
intellectual aspects
focusing on the details of a funeral as opposed to
the sadness and grief
120 Counseling Approaches
Projection placing unacceptable impulses
in yourself onto someone else
when losing an argument, you state "You're just
Stupid"; homophobia
Rationalization supplying a logical or rational
reason as opposed to the real
reason
stating that you were fired because you didn't
kiss up the boss, when the real reason was your
poor performance
Reaction
Formation
taking the opposite belief
because the true belief causes
anxiety
having a bias against a particular race or culture
and then embracing that race or culture to the
extreme
Regression returning to a previous stage
of development
sitting in a corner and crying after hearing bad
news; throwing a temper tantrum when you
don't get your way
Repression pulling into the unconscious forgetting sexual abuse from your childhood due
to the trauma and anxiety
Sublimation acting out unacceptable
impulses in a socially
acceptable way
sublimating your aggressive impulses toward a
career as a boxer; becoming a surgeon because
of your desire to cut; lifting weights to release
'pent up' energy
Suppression pushing into the unconscious trying to forget something that causes you
anxiety
Ego defenses are not necessarily unhealthy as you can see by the examples above. In fact, the lack of
these defenses or the inability to use them effectively can often lead to problems in life. However, we
sometimes employ the defenses at the wrong time or overuse them, which can be equally destructive.
Role of the Counselor: To encourage the development of transference, giving the
client a sense of safety and acceptance. The client freely explores difficult material
and experiences from their past, gaining insight and working through unresolved
issues. The counselor is an expert, who interprets for the client.
Goals of Therapy
Helping the client bring into the conscious the unconscious.
Helping the client work through a developmental stage that was not resolved or
where the client became fixated.
To reconstruct the basic personality.
To assist clients in reliving earlier experiences and working through repressed
conflicts.
To achieve intellectual awareness.
Help the client adjustment to the demands of work, intimacy, and society.
Essentials of Counseling 121
Therapeutic Relationship: The analyst remains anonymous, and clients develop
projections toward him/her. Focus is on reducing the resistances that develop in
working with transference and on establishing more rational control. Clients undergo
longterm analysis, engage in free association, to uncover conflicts, and gain insight
by talking. The analyst makes interpretations to teach them the meaning of current
behavior as related to the past.
Techniques of Therapy: Interpretation, dream analysis, free association, analysis of
resistance, analysis of transference. All are designed to help clients gain access to
their unconscious conflicts, which leads to insight and eventual assimilation of new
material by the ego. Diagnosis and testing are often used. Questions are used to
develop a case history.
Free Association is a process where the client verbalizes any thoughts that may without censorship, no
matter how trivial the thoughts or feeling may be to the client.
Dream Analysis is a process where the client relates their dreams to the counselor. The counselor
interprets the obvious or manifest content and the hidden meanings or latent content.
Analysis of transference is a process where the client is encouraged to attribute to counselor those
issues that have caused difficulties with significant authority figures in their lives. The counselor helps
the client to gain insight by the conflicts and feelings expressed.
Analysis of resistance is a process where the counselor helps the client to gain insight into what causes
form the basis for a hesitation or halting of therapy.
Interpretation is a process where the counselor helps the client to gain insight into past and present
events.
Applications: Psychoanalytic therapy can be used by those with a specific emotional
concern as well as those who simply want to explore themselves. Understanding why
we are the way we are often brings with it a sense of wellbeing and a stronger sense
of self. As psychoanalytic therapy is considered one of the more longterm therapy
types, it is perhaps less useful for those seeking quick, solutionfocused therapies.
Psychoanalytic therapy is a gradual process that takes time; however the results can
be life changing.
Some believe due to the nature of the therapy, psychoanalytic work is better suited to
more general concerns such as anxiety, relationship difficulties, sexual issues or low
selfesteem. Phobias, social shyness and difficulties sleeping are further examples of
areas that could be addressed within psychoanalytic therapy. Critics have pointed out
that the therapy may not be as useful to those with more specific or obsessionbased
concerns such as obsessive compulsive behavior, as you may be too concerned by
your actions to participate fully.
122 Counseling Approaches
How does psychoanalytic therapy work?
Psychoanalytic therapy is insight driven and therefore looks to foster change by helping you to
understand your past and how events from your early life could be affecting you now. Sessions will
vary according to where you are in the course of your therapy, but much of the time will be spent
talking freely to your therapist in a safe, nonjudgmental environment. The psychoanalyst will listen to
your concerns and look out for patterns or certain events that may hold significance. In this type of
therapy it is believed that unconscious feelings and childhood events play a key role in mental distress.
As well as listening to you discuss your experiences; your therapist may use other techniques to help
identify potential causes for your concerns.
Such techniques may include
Free association: Free association involves you talking about whatever comes into your mind without
censoring or editing the flow of memories/ideas. Your therapist will encourage you to speak freely to
help you return to an earlier emotional state so they can better understand any recurrent patterns of
conflict you may be experiencing.
Therapeutic transference: Transference relates to the way you may be transferring thoughts or feelings
connected to influential figures in your life (for example your parents or siblings) onto your therapist.
While this may not happen in every case, if it does your therapist should discuss transference with you
to help you gain further insight into the way you deal with people in your daily life.
Interpretation: A key element of psychoanalytic therapy is interpreting and 'reading between the lines'.
While your therapist is likely to stay relatively quiet and allow you to talk freely, they will occasionally
interject with thoughts or interpretations of the topics you discuss. Your psychoanalyst may also ask
you about your dreams; Freud wrote a lot on the subject of dream analysis and believed that dreams
were important resources for understanding the unconscious.
Multiculturalism: Its focus on family dynamics is appropriate for working with
many minority groups. The therapist's formality appeals to clients who expect
professional distance. Notion of ego defense is helpful in understanding inner
dynamics and dealing with environmental stresses. Its focus on insight, intrapsychic
dynamics, and longterm treatment, though, is often not valued by clients who prefer
to learn coping skills for dealing with pressing daily concerns. Internal focus is often
in conflict with cultural values that stress an interpersonal and environmental focus.
Contributions: More than any other system, this approach has generated controversy
as well as exploration and has stimulated further thinking and development of
therapy. It has provided a detailed and comprehensive description of personality
structure and functioning. It has brought into prominence factors such as the
unconscious as a determinant of behavior and the role of trauma during the first 6
years of life. It has developed several techniques for tapping the unconscious. It has
shed light on the dynamics of transference and countertransference, resistance,
anxiety, and the mechanisms of ego defense.
Essentials of Counseling 123
Limitations
: Requires lengthy training for therapists and much time and expense for
clients. The model stresses biological and instinctive factors to the neglect of social,
cultural, and interpersonal ones. Its methods are not applicable for solving specific
problems of clients in lower socioeconomic classes and are not appropriate for many
ethnic and cultural groups. Many clients lack the degree of ego strength needed for
regressive and reconstructive therapy. It is inappropriate for the typical counseling setting.
Psychodynamic Psychotherapy/Counseling: This approach stresses the importance of the
unconscious and past experience in shaping current behavior. The client is encouraged to talk about
childhood relationships with parents and other significant people and the therapist focuses on the
client/therapist relationship (the dynamics) and in particular on the transference. Transference is when
the client projects onto the therapist feelings experienced in previous significant relationships. The
Psychodynamic approach is derived from Psychoanalysis but usually provides a quicker solution to
emotional problems.
Psycho-synthesis: Sometimes described as 'psychology of the soul'. It is the name given to a series of
actions that lead to a change or development which encourages personal growth by a bringing together
of the whole person the emotional, the mental, the physical and spiritual within a safe environment.
Psychosynthesis is useful for people seeking a new, more spiritually oriented vision of them.
BEHAVIORAL APPROACH: Cognitive Behavioral Therapy (CBT), Rational
Emotive Behavioral Therapy (REBT), Transactional Analysis (TA)
BEHAVIORAL APPROACH
As the name implies, this approach focuses on
behavior changing unwanted behaviors through
rewards, reinforcements, and desensitization. This
therapy is based on the belief that behavior is
learnt in response to past experience and can be
unlearnt, or reconditioned, without analyzing the
past to find the reason for the behavior. It works
well for compulsive and obsessive behavior, fears,
phobias and addictions. Someone whose fear of
germs leads to excessive washing, for example,
may be trained to relax and not wash his/her hands
after touching a public doorknob.
Burrhus Frederic (B. F.) Skinner
(March 20, 1904 August 18, 1990)
Behavioral therapy often involves the cooperation of others, especially family and
close friends, to reinforce a desired behavior.
Basic Philosophy: Behavior is the product of learning. We are both the product and
the producer of the environment. No set of unifying assumptions about behavior can
incorporate all the existing procedures in the behavioral field.
124 Counseling Approaches
Key Concepts: Focus is on overt behavior, precision in specifying goals of treatment,
development of specific treatment plans, and objective evaluation of therapy
outcomes. Therapy is based on the principles of learning theory. Normal behavior is
learned through reinforcement and imitation. Abnormal behavior is the result of faulty
learning. This approach stresses present behavior.
Role of the Counselor: Roles of the behavioral counselor are varies and include
being a consultant, a reinforcer, and a facilitator. The counselor is active and may
supervise other people in the client's environment to achieve the goals of therapy.
Counselors using social learning may model the desired behavior, while respondent
and operant conditioning counselors are more directive and prescriptive in their
approach to the therapy goals. Use of tests and diagnosis varied greatly among
behavioral counselors.
Goals of Therapy: Generally, to eliminate maladaptive behaviors and learn more
effective behaviors. To focus on factors influencing behavior and find what can be
done about problematic behavior. Clients have an active role in setting treatment
goals and evaluating how well these goals are being met.
Therapeutic Relationship: The therapist is active and directive and functions as a
teacher or trainer in helping clients learn more effective behavior. Clients must be
active in the process and experiment with new behaviors. Although a quality
client/therapist relationship is not viewed as sufficient to bring about change, a good
working relationship is essential for implementing behavioral procedures.
Techniques of Therapy: The main techniques are systematic desensitization,
relaxation methods, flooding, eye movement and desensitization reprocessing,
reinforcement techniques, modeling, cognitive restructuring, assertion and social
skills training, selfmanagement programs, behavioral rehearsal, coaching, and
various multimodal therapy techniques. Diagnosis or assessment is done at the outset
to determine a treatment plan. Questions are used, such as what, how, and when (but
not why). Contracts and homework assignments are also typically used.
Applications: A pragmatic approach based on empirical validation of results. Enjoys
wide applicability to individual, group, marital and family counseling. Some problems
to which the approach is well suited are phobic disorders, depression, sexual
disorders, children's behavioral disorders, stuttering, and prevention of cardiovascular
disease. Beyond clinical practice, its principles are applied in fields such as pediatrics,
stress management, behavioral medicine, education, and geriatrics.
Essentials of Counseling 125
Multiculturalism: Its focus on behavior, rather than on feelings, is compatible with
many cultures. Strengths include a collaborative relationship between counselor and
client in working toward mutually agreedon goals, continual assessment to determine
if the techniques are suited to clients' unique situation, assisting clients in learning
practical skills, an educational focus, and stress on selfmanagement strategies.
Counselors need to help clients assess the possible consequences of making
behavioral changes. Family members may not value clients newly acquired assertive
style, so clients must be taught how to cope with resistance by others.
Contributions: Emphasis is on assessment and evaluation techniques, thus providing
a basis for accountable practice. Specific problems are identified, and clients are kept
informed about progress toward their goals. The approach has demonstrated
effectiveness in many areas of human functioning. The roles of the therapist as
reinforcer, model, teacher, and consultant are explicit. The approach has undergone
extensive expansion, and research literature abounds. No longer is it a mechanistic
approach, for it now makes room for cognitive factors and encourages selfdirected
programs for behavioral change.
Limitations: Major criticisms are that it may change behavior but not feelings; that it
ignores the relational factors in therapy; that it does not provide insight; that it ignores
historical causes of present behavior; that it involves control and manipulation by the
therapist; and that it is limited in its capacity to address certain aspects of the human
condition. Many of these assertions are based on misconceptions, and behavior
therapists have addressed these charges. A basic limitation is that behavior change
cannot always be objectively assessed because of the difficulty in controlling
environmental variables.
COGNITIVE BEHAVIOR THERAPY (CBT)
A combination of cognitive and behavioral therapies, this
approach helps people change negative thought patterns,
beliefs, and behaviors so they can manage symptoms and
enjoy more productive, less stressful lives. Cognitive
behavioral therapy (CBT) was developed by Aaron T.
Beck, Albert Ellis, Maxie Maultsby, Michael Mahoney,
Donald Meichenbaum, David Burns, Michael Mahoney,
Marsha Linehan, Arthur Freeman, and others. Cognitive
behavior therapy is a type of psychotherapeutic treatment
that helps patients understand the thoughts and feelings
that influence behaviors.
Dr. Aaron Temkin Beck
(July 18, 1921 to present)
126 Counseling Approaches
CBT is commonly used to treat a wide range of disorders including phobias,
addictions, depression, and anxiety. Cognitive behavior therapy is generally short
term and focused on helping clients deal with a very specific problem. During the
course of treatment, people learn how to identify and change destructive or disturbing
thought patterns that have a negative influence on behavior.
Most cognitive behavioral therapies have the following characteristics
CBT is based on the Cognitive Model of Emotional Response. CBT is based on the
idea that our thoughts cause our feelings and behaviors, not external things, like
people, situations, and events. The benefit of this fact is that we can change the way
we think to feel/act better even if the situation does not change.
CBT is Briefer and Time-Limited. It is considered among the most rapid in terms of
results obtained. The average number of sessions clients receive (across all types of
problems and approaches to CBT) is only 16. Other forms of therapy, like
psychoanalysis, can take years. What enable CBT to be briefer are its highly
instructive nature and the fact that it makes use of homework assignments. CBT is
timelimited in that we help clients understand at the very beginning of the therapy
process that there will be a point when the formal therapy will end. The ending of the
formal therapy is a decision made by the therapist and client. Therefore, CBT is not
an openended, neverending process.
A sound therapeutic relationship is necessary for effective therapy, but not the focus.
Some forms of therapy assume that the main reason people get better in therapy is
because of the positive relationship between the therapist and client. Cognitive
behavioral therapists believe it is important to have a good, trusting relationship, but
that is not enough. CBT therapists believe that the clients change because they learn
how to think differently and they act on that learning. Therefore, CBT therapists focus
on teaching rational selfcounseling skills.
CBT is a collaborative effort between the therapist and the client. Cognitive
behavioral therapists seek to learn what their clients want out of life (their goals) and
then help their clients achieve those goals. The therapist's role is to listen, teach, and
encourage, while the client's roles is to express concerns, learn, and implement that
learning.
CBT is based on aspects of stoic philosophy. Not all approaches to CBT emphasize
stoicism. Rational Emotive Behavior Therapy, Rational Behavior Therapy, and
Rational Living Therapy emphasize aspects of stoicism. Beck's Cognitive Therapy is
not based on stoicism.
Essentials of Counseling 127
Cognitivebehavioral therapy does not tell people how they should feel. However,
most people seeking therapy do not want to feel they way they have been feeling. The
approaches that emphasize stoicism teach the benefits of feeling, at worst, calm when
confronted with undesirable situations. They also emphasize the fact that we have our
undesirable situations whether we are upset about them or not. If we are upset about
our problems, we have two problems the problem, and our upset about it. Most
people want to have the fewest number of problems possible. So when we learn how
to more calmly accept a personal problem, not only do we feel better, but we usually
put ourselves in a better position to make use of our intelligence, knowledge, energy,
and resources to resolve the problem.
CBT uses the Socratic Method. Cognitivebehavioral therapists want to gain a very
good understanding of their clients' concerns. That's why they often ask questions.
They also encourage their clients to ask questions of themselves, like, "How do I
really know that those people are laughing at me?" "Could they be laughing about
something else?"
CBT is structured and directive. Cognitivebehavioral therapists have a specific
agenda for each session. Specific techniques/concepts are taught during each session.
CBT focuses on the client's goals. We do not tell our clients what their goals should
be, or what they should tolerate. We are directive in the sense that we show our
clients how to think and behave in ways to obtain what they want. Therefore, CBT
therapists do not tell their clients what to do rather, they teach their clients how to
do.
CBT is based on an educational model. CBT is based on the scientifically supported
assumption that most emotional and behavioral reactions are learned. The goal of
therapy is to help clients unlearn their unwanted reactions and to learn a new way of
reacting. CBT has nothing to do with 'just talking'. People can just talk with anyone.
The educational emphasis of CBT has an additional benefit it leads to long term
results. When people understand how and why they are doing well, they know what to
do to continue doing well.
CBT theory and techniques rely on the Inductive Method. A central aspect of rational
thinking is that it is based on fact. Often, we upset ourselves about things when, in
fact, the situation isn't like we think it is. If we knew that, we would not waste our
time upsetting ourselves. Therefore, the inductive method encourages us to look at
our thoughts as being hypotheses or guesses that can be questioned and tested. If we
find that our hypotheses are incorrect (because we have new information), then we
can change our thinking to be in line with how the situation really is.
128 Counseling Approaches
Homework is a central feature of CBT. If when you attempted to learn your
multiplication tables you spent only one hour per week studying them, you might still
be wondering what 5 X 5 equals. You very likely spent a great deal of time at home
studying your multiplication tables, maybe with flashcards.
The same is the case with psychotherapy. Goal achievement (if obtained) could take a
very long time if all a person were only to think about the techniques and topics
taught was for one hour per week. That's why CBT therapists assign reading
assignments and encourage their clients to practice the techniques learned.
Basic Philosophy: Individuals tend to incorporate faulty thinking, which leads to
emotional and behavioral disturbances. Cognitions are the major determinants of how
we feel and act. Therapy is primarily oriented toward cognition and behavior, and it
stresses the role of thinking, deciding, questioning, doing, and redeciding. This is a
psychoeducational model, which emphasizes therapy as a learning process, including
acquiring and practicing new skills, learning new ways of thinking, and acquiring
more effective ways of coping with problems.
Key Concepts: Although psychological problems may be rooted in childhood, they
are perpetuated through reindoctrination in the now. A person's belief system is the
primary cause of disorders. Internal dialogue plays a central role in one's behavior.
Clients focus on examining faulty assumptions and misconceptions and on replacing
these with effective beliefs.
Goals of Therapy: To challenge clients to confront faulty beliefs with contradictory
evidence that they gather and evaluate. Helping clients seek out their dogmatic beliefs
and vigorously minimizing them. To become aware of automatic thoughts and to
change them.
Therapeutic Relationship: The therapist functions as a teacher and the client as a
student. The therapist is highly directive and teaches clients an ABC model of
changing their cognitions. The focus is on a collaborative relationship. Using a
Socratic dialogue, the therapist assists clients in identifying dysfunctional beliefs and
discovering alternative rules for living. The therapist promotes corrective experience
that lead to learning new skills. Clients gain insight into their problems and then must
actively practice changing selfdefeating thinking and acting.
Techniques of Therapy: Therapists use a variety of cognitive, emotive, and
behavioral techniques; diverse methods are tailored to suit individual clients. An
active, directive, timelimited, presentcentered, structured therapy. Some techniques
include engaging in Socratic dialogue, debating irrational beliefs, carrying out
Essentials of Counseling 129
homework assignments, gathering data on assumptions one has made, keeping a
record of activities, forming alternative interpretations, learning new coping skills,
changing one's language and thinking patterns, role playing, imagery, and confronting
faulty beliefs.
Applications: Has been widely applied to the treatment of depression, anxiety,
marital problems, stress management, skill training, substance abuse, assertion
training, eating disorders, panic attacks, performance anxiety, and social phobia. The
approach is especially useful for assisting people in modifying their cognitions. Many
selfhelp approaches utilize its principles. Can be applied to a wide range of client
populations with a variety of specific problems.
Who could benefit from CBT?
This type of therapy is particularly helpful for those with specific issues as it is very practical (rather
than insightbased) and looks at solutions. For this reason the therapy works well for those who
suffer from depression and/or anxiety
suffer from posttraumatic stress disorder (PTSD)
have an addiction
want to change their behavior
have anger issues
eating disorders, such as anorexia and bulimia
sleep problems, such as insomnia
panic disorder
have a phobia
suffer from obsessivecompulsive behavior (OCD).
In some cases CBT is used for those with longstanding health problems such as chronic pain or
irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS). While the therapy cannot cure
such physical ailments, it can help people cope emotionally with their condition and lower stress levels.
There is also up and coming interest in the use of CBT alongside medication to help those who suffer
from hallucinations and delusions.
Multiculturalism: The collaborative approach offers clients opportunities to express
their areas of concern. The psychoeducational dimensions are often useful in
exploring cultural conflicts and teaching new behavior. The emphasis on thinking (as
opposed to identifying and expressing feelings) is likely to be acceptable to many
clients. The focus on teaching and learning tends to avoid the stigma of mental illness.
Clients may value active and directive stance of therapist. Before too quickly
attempting to change the beliefs and actions of clients, it is essential for the therapists
to understand and respect their world. Some clients may have serious reservations
about questioning their basic cultural values and beliefs. Clients could become
dependent on the therapist for deciding what are appropriate ways to solve problems.
There may be a fine line between being directive and promoting dependence.
130 Counseling Approaches
Contributions: Major contributions include emphasis on a comprehensive and
eclectic therapeutic practice; numerous cognitive, emotive, and behavioral techniques;
openness to incorporating techniques from other approaches; and a methodology for
challenging and changing faulty thinking. Most forms can be integrated into other
mainstream therapies.
Limitations: Tends to play down emotions, does not focus on exploring the
unconscious or underlying conflicts, and sometimes does not give enough weight to
client's past.
When is CBT Used as a form of Therapy?
Scientific studies of CBT have demonstrated its usefulness for a wide variety of mental illnesses
including mood disorders, anxiety disorders, personality disorders, eating disorders, substance abuse
disorders, sleep disorders and psychotic disorders. Studies have shown that CBT actually changes brain
activity in people with mental illnesses who receive this treatment, suggesting that the brain is actually
improving its functioning as a result of engaging in this form of therapy.
CBT has been shown to be as useful as antidepressant medications for some individuals with
depression and may be superior in preventing relapse of symptoms. Patients receiving CBT for
depression are encouraged to schedule positive activities into their daily calendars in order to increase
the amount of pleasure they experience. In addition, depressed patients learn how to change
(restructure) negative thought patterns in order to interpret their environment in a less negatively
biased way. As regular sleep has been found to be very important in both depression and bipolar
disorder, therapists will also target sleeping patterns to improve and regulate sleep schedules with their
patients. Studies indicate that patients who receive CBT in addition to treatment with medication have
better outcomes than patients who do not receive CBT as an additional treatment.
CBT is also a useful treatment for anxiety disorders. Patients who experience persistent panic attacks
are encouraged to test out beliefs they have related to such attacks, which can include specific fears
related to bodily sensations, and to develop more realistic responses to their experiences. This is
beneficial in decreasing both the frequency and intensity of panic attacks. Patients who experience
obsessions and compulsions are guided to expose themselves to what they fear in a safe and controlled
therapeutic environment. Beliefs surrounding their fears (of contamination, illness, inflicting harm,
etc.) are identified and changed to decrease the anxiety connected with such fears.
The same is true for people with phobias, including phobias of animals or phobias of evaluation by
others (termed Social Anxiety Disorder). Those in treatment are exposed to what they fear and beliefs
that have served to maintain such fears are targeted for modification. CBT is often referred to as a "first
line treatment" in many anxiety disorders including generalized anxiety disorder, posttraumatic stress
disorder, panic disorder, and obsessivecompulsive disorder and specific phobias.
Over the past two decades, CBT for schizophrenia has received considerable attention in the United
Kingdom and elsewhere abroad. While this treatment continues to develop in the United States, the
results from studies in the United Kingdom and other countries have encouraged therapists in the US to
incorporate this treatment into their own practices. In this treatment, often referred to as cognitive
behavioral therapy for psychosis (CBTP), patients are encouraged to identify their own delusional or
paranoid beliefs and to explore how these beliefs negatively impact their lives.
Essentials of Counseling 131
Therapists will then help patients to engage in experiments to test these beliefs. Treatment focuses on
thought patterns that cause distress and also on developing more realistic interpretations of events.
Delusions are treated by developing an understanding of the kind of evidence that a person uses to
support their beliefs and encouraging them to recognize evidence that may have been overlooked,
evidence that does not support the belief. For example, a person who thinks that they are being
videotaped by aliens may feel less worried when their therapist helps them to discover that there are no
hidden cameras in the waiting room, or that a television remote does not contain any Alien technology
within it.
CBT's focus on thoughts and beliefs is applicable to a wide variety of symptoms. While the above
summary is certainly not comprehensive, it provides an overview of the principles of CBT and how
they apply to the treatment of various psychological illnesses. Because CBT has excellent scientific
data supporting its use in the clinical treatment of psychological illness, it has achieved wide popularity
both for therapists and patients alike. A growing number of psychologists, psychiatrists, social workers,
and psychiatric nurses have training in CBT.
RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
Rational emotive behavior therapy, also known as
REBT, is a type of cognitivebehavioral therapy.
It was first called Rational Therapy, later Rational
Emotive Therapy, then changed to Rational
Emotive Behavior Therapy. It was first introduced
in 1955 by Dr. Albert Ellis who had become
increasing frustrated with the ineffectiveness of
psychotherapy. Ellis drew from his knowledge of
philosophy and psychology to devise a method
which he believed was more directive, efficient,
and effective.
Dr. Albert Ellis
(September 27, 1913 – July 24, 2007)
Basic Philosophy: REBT is focused on helping clients change irrational beliefs. The
replacement of illogical and unrealistic ideas with more realistic and adaptive ones
through direct intervention and confrontation by the therapist.
Key Concepts: Ellis suggested that people mistakenly blame external events for
unhappiness. He argued, however, that it is our interpretation of these events that truly
lies at the heart of our psychological distress. To explain this process, Ellis developed
what he referred to as the ABC Model
A – Activating Event: Something happens in the environment around you.
B – Beliefs: You hold a belief about the event or situation.
C – Consequence: You have an emotional response to your belief.
132 Counseling Approaches
Role of the Counselor
Counselors are direct and active in their teaching and correcting the client's
cognitions.
Ellis believes that a good REBT counselor must be bright, knowledgeable,
empathetic, persistent, scientific, interested in helping others and use RET in their
personal lives (Ellis, 1980).
The counselor does not rely heavily on the DSMIV categories.
Goals of the Therapy
The primary goal is to help people live rational and productive lives.
REBT helps people see that it is their thoughts and beliefs about events that
creates difficulties, not the events or the situations.
It helps the client to understand that wishes and wants are not entitlements to be
demanded. Thinking that involves the words must, should, ought, have to, and
need are demands, not an expression of wants or desires.
RET helps clients stop catastrophizing when wants and desires are not met.
It stresses the appropriateness of the emotional response to the situation or event.
A situation or event need not elicit more of a response than is appropriate.
It assists people in changing selfdefeating behaviors or cognitions.
RET espouses acceptance and tolerance of self and of others in order to achieve
life goals.
Steps in Rational Emotive Behavior Therapy
The basic steps in Rational Emotive Behavior Therapy are
Identifying the underlying irrational thought patterns and beliefs. The very first step
in the process is to identify the irrational thoughts, feelings, and beliefs that lead to
psychological distress. In many cases, these irrational beliefs are reflected as
absolutes, as in I must, I should or I can't. According to Ellis, some of the most
common irrational beliefs include
Feeling excessively upset over other people's mistakes or misconduct.
Believing that you must be 100 percent competent and successful in everything to
be valued and worthwhile.
Believing that you will be happier if you avoid life's difficulties or challenges.
Feeling that you have no control over your own happiness; that your contentment
and joy are dependent upon external forces.
By holding such unyielding beliefs, it becomes almost impossible to respond to
situations in a psychologically healthy way. Possessing such rigid expectations of
Essentials of Counseling 133
ourselves and others only leads to disappointment, recrimination, regret, and
anxiety.
Challenging the irrational beliefs. Once these underlying feelings have been
identified, the next step is to challenge these mistaken beliefs. In order to do this, the
therapist must dispute these beliefs using very direct and even confrontational
methods. Ellis suggested that rather than simply being warm and supportive, the
therapist needs to be blunt, honest, and logical in order to push people toward
changing their thoughts and behaviors.
Gaining Insight and Recognizing Irrational Thought Patterns. Facing irrational
thought patterns can be difficult, especially because accepting these beliefs as
unhealthy is far from easy. Once the client has identified the problematic beliefs, the
process of actually changing these thoughts can be even more difficult.
It is also important to recognize that while rational emotive behavior therapy utilizes
cognitive strategies to help clients, it also focuses on emotions and behaviors as well.
In addition to identifying and disputing irrational beliefs, therapists and clients also
work together to target the emotional responses that accompany problematic thoughts.
Clients are also encouraged to change unwanted behaviors using such things as
meditation, journaling, and guided imagery.
Applications: REBT can be effective in the treatment of a range of psychological
disorders including anxiety disorders and phobias as well as specific behaviors such
as severe shyness and excessive approval seeking.
How does REBT work?
REBT's comprehensive approach works best for individuals desiring a scientific,
presentfocused, and active treatment for coping with life's difficulties, rather than
one which is mystical, historical, and largely passive. REBT is based on a few simple
principles having profound implications
You are responsible for your own emotions and actions.
Your harmful emotions and dysfunctional behaviors are the product of your
irrational thinking.
You can learn more realistic views and, with practice, make them a part of
you.
You'll experience a deeper acceptance of yourself and greater satisfactions in life
by developing a realitybased perspective.
REBT distinguishes clearly between two very different types of difficulties practical
problems and emotional problems. Your flawed behavior, unfair treatment by others,
and undesirable situations, represent practical problems. Regrettably, your human
134 Counseling Approaches
tendency is to upset yourself about these practical problems, thereby unnecessarily
creating a second order of problems emotional suffering.
REBT addresses the latter by helping you
Take responsibility for your distress. The first lesson in healthy emoting and
relating was stated by the Roman philosopher Epictetus more than 2000 years ago
only you can upset yourself about events the events themselves, no matter how
undesirable, can never upset you.
Recognize that neither another person, nor an adverse circumstance, can ever
disturb you only you can. No one else can get into your gut and churn it up.
Others can cause you physical pain by hitting you over the head with a baseball
bat, for example or can block your goals. But you create your own emotional
suffering, or selfdefeating behavioral patterns, about what others do or say.
Identify your 'musts'. Once you admit that you distort your own emotions and
actions, then determine precisely how. The culprit usually lies in one of the three
core 'musts'
Must # 1 (a demand on yourself): I 'must' do well and get approval, or else I'm
worthless. This demand causes anxiety, depression, and lack of assertiveness.
Must # 2 (a demand on others): You 'must' treat me reasonably, considerately,
and lovingly, or else you're no good. This must leads to resentment, hostility, and
violence.
Must # 3 (a demand on situations): Life 'must' be fair, easy, and hasslefree, or
else it's awful. This thinking is associated with hopelessness, procrastination, and
addictions.
Ascertain what you're demanding of yourself, of your significant others, or of
your circumstances. Not until you have discovered the 'must' can you then go on
effectively to reduce your distress.
Dispute your 'musts'. The only way you can ever remain disturbed about
adversity is by vigorously and persistently agreeing with one of these three
'musts'. Thus, once you've bared them, then relentlessly confront and question
your demands.
Begin by asking yourself What's the evidence for my 'must'? How is it true?
Where's it etched in stone? And then by seeing There's no evidence. My 'must'
is entirely false. It's not carved indelibly anywhere. Make your view 'must'free,
and then your emotions will heal.
Reinforce your preferences. Conclude, therefore
Preference 1: I strongly 'prefer' to do well and get approval, but even if I
fail, I will accept myself fully.
Essentials of Counseling 135
Preference 2: I strongly 'prefer' that you treat me reasonably, kindly, and
lovingly, but since I don't run the universe, and it's a part of your human
nature to err, I, then, cannot control you.
Preference 3: I strongly 'prefer' that life be fair, easy, and hasslefree, and
it's very frustrating that it isn't, but I can bear frustration and still considerably
enjoy life.
Assuming that you take the above suggestions to heart and thereby greatly reduce
your anxiety, hostility, depression, and addictions, what remains? Will you exist
robotlike, devoid of human feeling and motivation? Hardly! Without your turmoil,
you'll more easily experience love, involvement, and joy. And without your
addictions, you'll be freer to engage in the gratifying experiences of spontaneity,
commitment, and selfactualization. REBT will appeal to you if you relish quickly
taking control of your own life, rather than remaining dependent upon a therapist for
years. By giving you tools for identifying and overcoming the true source of your
difficulties, it will prepare you to act in many ways as your own therapist. And by
helping you to reinforce realistic, selfbenefitting beliefs, it will enable you to
eliminate present emotional and behavioral problems, and to avoid future ones.
TRANSACTIONAL ANALYSIS (TA)
The Transactional Analysis (TA) approach to
counseling belongs to the Psychoanalytical
School of therapy and was devised by Eric
Berne a Canadian psychiatrist in the late 1940's.
TA is a widely recognized form of modern
psychology that involves a set of practical
conceptual tools designed to promote personal
growth and change. It is considered a
fundamental therapy for wellbeing and for
helping individuals to reach their full potential
in all aspects of life. In counseling TA therapy is
very versatile, for it can be used in a wide range
of areas and incorporates key themes from
humanistic, integrative, psychoanalytical,
psychodynamic therapies.
Dr. Eric Berne
(May 10, 1910 – July 15, 1970)
Though it is commonly recognized as a brief and solutionfocused approach,
transactional analysis can also be applied as an effective longterm, indepth therapy.
136 Counseling Approaches
Basic Philosophy: TA has an optimistic view of human nature that believes that
people can change despite life's events and that is never too late to change one's life.
All decisions that are made in life can be redecided.
Some basic assumptions are
All people are important and their concerns are valid.
All people should be treated as equals and with respect.
With a few exceptions, all people have the ability to think as adults.
All people decide their own destiny and can make changes to it.
From these assumptions TA creates a form of therapy that is not only problem
oriented, but also goaloriented. It aims to free the client from maladaptive patterns of
behavior based on past thinking. In doing so, they will be able to choose a new
direction in life. In fact, the basic goal of transactional analysis is to help a client
make new decisions about their current behavior and change the direction their lives
are taking. In other words, a person will learn to write their own life story instead of
allowing it to be written for them.
Key Concepts: TA uses four major methods to analyze and predict behavior
1. Structural analysis looks at what is happening within the individual.
2. Transactional analysis looks at what is happening between two or more people.
3. Game analysis looks at transactions between individuals leading to negative
feelings.
4. Script analysis looks at the life plan the individual has chosen to follow.
Structural Analysis: TA is a dynamic theory at personality in the sense that uses the
concepts of psychic energy and the distribution of energy. The structure of personality
is based on the personality theory of parent, adult, child ego states. Eric Berne defines
the ego states on the patterns of feeling, thinking and behaving. Any individual in a
social grouping will exhibit one of these states. Structure analysis describes each
person in terms of three ego states Parent ego state contains the parental
admonishments and values with dos, shoulds, and oughts. Adult ego state contains the
objective, thinking, rational and logical ability to deal with reality. Child ego state is
the source of childlike behaviors and feelings.
Parent Ego State: This is a set of feelings, thinking and behavior that we have copied
from our parents and significant others. As we grow up we take in ideas, beliefs,
feelings and behaviors from our parents and caretakers. If we live in an extended
family then there are more people to learn and take in from. When we do this, it is
called introjecting. For example, we may notice that we are saying things just as our
father, mother, grandmother may have done, even though, consciously, we don't want
Essentials of Counseling 137
to. We do this as we have lived with this person so long that we automatically
reproduce certain things that were said to us, or treat others as we might have been
treated. Parental ego states are in two forms (a) Controlling/ Critical Parent which
is negative, unsupportive, critical. (b) Nurturing Parent which is supportive, helpful,
nurturing, comforting.
Adult Ego State: It is about direct
responses to the here and now. We
deal with things that are going on
today in ways that are not unhealthily
influenced by our past. It is about
being spontaneous and aware with the
capacity for intimacy. When in our
Adult we are able to see people as
they are, rather than what we project
onto them. We ask for information
rather than stay scared and rather than
make assumptions.
Taking the best from the past and using it appropriately in the present is an integration
of the positive aspects of both our 'Parent' and 'Child' ego states. So this can be
called the 'Integrating Adult'. Integrating means that we are constantly updating
ourselves through our every day experiences and using this to inform us.
Child Ego State: It is a set of behaviors, thoughts and feelings which are replayed
from our own childhood. Berne says we all carry within ourselves a little boy or a
little girl who feels, thinks, acts and responds just as we did when we were children. It
also contains creative intuitive capacities such as rebellion, compliance etc. TA has
identified three different forms of child ego state they are Natural/ Free child;
Adaptive child and Little professor.
Contamination Ego State: This
occurs when we talk as if
something is a fact or a reality
when really this is a belief.
Racism is an example of this.
The 'Integrating Adult' ego state
is contaminated in this case by
the 'Parent' ego state.
Parent
Contamination
Child
Contamination
Double
Contamination
(Parent & Child)
Parent Ego State
Behaviors, thoughts and feelings
copied from parents or parent figures
Adult Ego State
Behaviors, thoughts and feelings which
are direct responses to the here and now
Child Ego State
Behaviors, thoughts and feelings
replayed from childhood
138 Counseling Approaches
Both the Parent and Child ego states are constantly being updated. The 'Parent' and
'Child' ego states are echoes of the past. The 'Adult' ego state is a response to the
here and now when a person is grown up and using grown up responses.
Transactional Analysis: The three ego states can be used as a way of analyzing
transactions (communications) between people.
A transaction is a communication from A to B
and the response from B to A. Transactional
analysis helps the client to understand the three
distinct types of transactions. They are
complementary, crossed and ulterior.
Complementary transactions are characterized by
both people communicating from the same ego
state.
A complementary transaction occurs when a
message, sent from a specific ego state, gets the
predicted response from a specific ego state in the
other person.
Crossed transactions are characterized by both
people coming from different ego states and
resulting in an unexpected hurtful response. This
happens between two ego states when a message
sent from one person gets the unexpected
response. The lines between the two ego states
cross and communication breaks down.
Ulterior transactions are characterized by people
coming from different ego states, but the
responses appear to be from the same ego state. It
involves more than two ego states at the same
time. In this type of transaction two messages are
exchanged one in the social level and one in
psychological level. There are two types of
ulterior transaction. They are Duplex transaction
and Angular ulterior transaction.
Complementary Transaction
Crossed Transaction
Ulterior Transaction
Communication between people can be from one ego state to a different one or from
one ego state to the same ego state. Normally communication will be from one ego
state either to the same ego state or a different one. The person who first
communicates will expect a reply to be from a certain ego state. If communication is
from a different ego state to the expected one, then the communication may be
Essentials of Counseling 139
ineffective and the message may be lost, not received or disregarded by the person
receiving it. If communication is from 'Adult to Adult' then it is likely to be the most
effective communication for most of our communications.
There are three rules of communication' in TA
1st Rule of Communication: So long as transactions remain complementary,
communication can continue indefinitely.
2nd Rule of Communication: When a transaction is crossed, a break in
communication results, and one or both individuals will need to shift ego states in
order for the communication to be reestablished.
3rd Rule of Communication: The behavioral outcome of an ulterior transaction (one
where two messages are sent at the same time; one overt social and one covert
psychological) is determined at the psychological level and not at the social level.
Game Analysis: Games are learned patterns of behavior. And most people play a
small number of favorite games with a range of different people and in varying
intensities. A game is an ongoing series of transactions seemingly complementary,
covertly ulterior which leads to a well defined pay off. Pay off are usually negative
feelings like fear, anger, sadness for one or both the players. Game is defined as a
series of complementary transactions, progressing to a well defined predictable
outcome. Most of what happens in life is game. The client is encouraged to learn
more satisfying ways of structuring time and acquiring strokes.
'First Degree' games are played in social circles generally lead to mild upsets not
major traumas. 'Second Degree' games occur when the stakes may be higher. This
usually occurs in more intimate circles, and ends up with an even greater negative
payoff. 'Third Degree' games involve tissue damage and may end up in the jail,
hospital or morgue. Chris Davidson (2002) has argued that world politics can involve
'Fourth Degree' games where the outcomes involve whole communities, countries
or even the world.
Games vary in the length of time that passes while they are being played. Some can
take seconds or minutes while others take weeks months or even years. People play
games for these reasons
to structure time;
to acquire strokes;
to maintain the substitute feeling and the system of thinking, beliefs and actions
that go with it;
to confirm parental injunctions and further the life script;
to maintain the person's life position by 'proving' that self/others are not OK;
140 Counseling Approaches
to provide a high level of stroke exchange while blocking intimacy and
maintaining distance;
to make people predictable.
There are various ways to stop a game, including the use of different options than the
one automatically used. We can
Cross the transaction by responding from a different ego state than the one the
stimulus is designed to hook.
Pick up the ulterior rather than the social message; e.g. when a person says "I
can't do this, I'm useless". Rather than saying, "Let me do this for you", instead
say, "It sounds like you have a problem. What do you want me to do about it?"
(said from the Adult ego state)
The opening message to the game always entails a discount. There are further
discounts at each stage of the game. By detecting discounts we can identify game
invitations and defuse them with options. A discount is when we minimize,
maximize or ignore some aspect of a problem which would assist us in resolving
it. Such as saying in a whiny voice "This is too difficult for me to do", so we
automatically help them.
Replace the game strokes. Loss of strokes to the 'Child' ego state means a threat
to survival. We get a great many strokes from games, even if they are negative.
However, if we don't obtain sufficient positive strokes, or give ourselves positive
strokes, we will go for quantity rather than quality of strokes and play games to
get them. This loss of strokes is also a loss of excitement that the game has
generated.
Another way to think about this is to consider the game role we or the other person is
likely to take. One way to discover this is to ask the following questions (John James,
1973)
What keeps happening over and over again?
How does it start?
What happens next?
And then what happens?
How does it end?
How do feel after it ends?
We can then consider the reason we might have taken up a particular role, where we
might switch to, and then consider how to do things differently. We need to consider
what our own responsibility is in this if the situation is too violent for us to get
involved what options to we have? We could call for help; get others to come with us
Essentials of Counseling 141
to intervene and so on. We need to choose the appropriate assistance and take the
action required.
Script Analysis: Script analysis involves the plans that a person makes for their life.
Some of the common ones are
Never scripts result in a person who believes s/he is a never do well.
Until scripts result in the person who continues to wait until they can deserve the
reward.
Always scripts result in a person continuing without change.
After scripts result in anticipation of difficulty after a certain event.
Openended scripts result in lack of direction after a given time or event.
The ideal life script is one that is characterized by the "I am ok and you are ok".
"I'm OK You're OK" is probably the
bestknown expression of the purpose of
TA to establish and reinforce the position
that recognizes the value and worth of
every person. Transactional analysts
regard people as basically "OK" and thus
capable of change, growth, and healthy
interactions. As Berne set his Psychology
up, there are four life positions that a
person can hold and holding a particular
psychological position has profound
implications for how an individual
operationalizes his/her life. The positions
are stated as
The OK Corral (Franklin Ernst, 1971) Model
You are Okay with me
I am not OK
You are Ok
One Down Position
Get away from
Helpless
I am OK
You are Ok
Healthy Position
Get on with
Happy
I am not OK
You are not Ok
Hopeless Position
Get nowhere with
Hopeless
I am OK
You are not Ok
Oneup Position
Get rid of Angry
You are not Okay with me
I'm OK and you are OK. This is the healthiest position about life and it means that I feel good
about myself and that I feel good about others and their competence.
I'm OK and you are not OK. In this position I feel good about myself but I see others as damaged
or less than and it is usually not healthy.
I'm not OK and you are OK. In this position the person sees him/herself as the weak partner in
relationships as the others in life are definitely better than the self. The person who holds this
position will unconsciously accept abuse as OK.
I'm not OK and you are not OK. This is the worst position to be in as it means that I believe that I
am in a terrible state and the rest of the world is as bad.
Strokes: Strokes refer to compliments, acceptance and recognition, which are
influential in how people lead their lives. TA therapy recognizes that we are greatly
motivated by the reinforcement we get as children, and if this was dysfunctional, we
are likely to adopt dysfunctional patterns of living as we get older.
142 Counseling Approaches
Intimacy: Another motivation recognized in transactional analysis is intimacy.
Similarly to strokes, if the intimacy a child experiences is dysfunctional, then they
will learn that this type of intimacy is the best s/he can do to meet basic needs and
communicate with others. This can lead to the development of repetitive patterns of
behavior that can hinder a person's potential.
Redecision: This refers to an individual's capacity to redecide and make changes to
certain decisions made as a child that stem from unconscious scripts. Redecision
reflects the assumption of TA therapy that individuals have the potential to lead their
lives as they choose. This power is released after a redecision is made while a client
is in their childego state.
Contracts: Transactional analysis practice is based upon mutual contracting for
change. Transactional analysts view people as capable of deciding what they want for
their lives. Accordingly transactional analysis does its work on a contractual basis
between the client and the therapist, educator, or consultant. This helps to set
boundaries and realize expectations for both the client and the psychotherapist.
Ultimately, therapists will use these concepts in transactional analysis therapy to
promote structural rearrangement and deconfusion of a client's child egostate. They
will encourage clients to challenge their current beliefs and the way s/he uses their life
script. This will help them to better understand the direction and patterns of their life
for themselves, and this awareness can help them to make the decision to change their
behavior.
Role of the Counselor
In TA the counselor and the client work together to establish the specific goals of
therapy.
The counselor contracts with the client for the changes that they desire.
Counselors use their knowledge to address a concern introduced by the client
rather than telling the client what issues need to focus on.
Goals of the TA
The goal is to not only learn to adjust to life but to attain health and autonomy.
Through the gaining of autonomy the client can be more aware, intimate and
spontaneous living a life free of games and selfdefeating life scripts.
Techniques of TA: In addition to structural, transactional, game and script analysis,
TA counselors use other techniques. Some of these techniques are
Treatment contract which is a agreement between the counselor and the client about
what is to be accomplished and what responsibilities are agreed upon. Interrogation
Essentials of Counseling 143
involves forcing the client to answer from the adult ego state through a succession of
confrontive questions. Specification is identifying the ego state that is the source of
the transition. Confrontation is the process of pointing out inconsistencies.
Explanation is a process where the counselor teaches the Adult ego state of the client
a tenet of TA. Illustration is a story or example that is used to portray a point.
Confirmation is a technique where the counselor directs the client's attention to a
previously modified behavior that is reoccurring. Interpretation involves the
counselor explaining to the child ego state the reasons behind the client's behavior.
Crystallization occurs when the client realizes that game playing can be given up and
the client can enjoy the freedom of choice in behavior.
How Does TA Work?
Transactional Analysis (TA) is a tool to know yourself, to know how you relate to others, and to
discover how you have been living out a life plan based on unconscious relational patterns. These
unconscious organizing patterns that begin at birth. They are reinforced and elaborated during a
number of developmental ages. The results constitute a life 'script'. Change happens through the help
of your therapist in becoming aware of the previously unconscious 'script' patterns. The therapist can
then facilitate different outcomes so that you get what you want in life. TA offers many tools and
useful approaches for individual, couple, and group therapy. TA is based on the assumption that all
individuals can learn to trust themselves, think for themselves, make their own decisions and express
their feelings.
TA therapy is based on the theory that each person has three ego states parent, adult and child. These
are used along with other key transactional analysis concepts, tools and models to analyze how
individuals communicate and identify what interaction is needed for a better outcome. Throughout
therapy, the TA therapist will work directly on here and now problem solving behaviors, whilst helping
clients to develop daytoday tools for finding constructive creative solutions. The ultimate goal is to
ensure clients regain absolute autonomy over their lives. Eric Berne defines this autonomy as the
recovery of three vital human capacities spontaneity, awareness and intimacy.
Transactional analysis is a talking therapy and sessions are designed to explore an individual's
personality and how this has been shaped by experience particularly those stemming from childhood.
This is achieved through skilful questioning and the utilization of various models, techniques and tools.
Sessions can be carried out in the form of oneonone counseling, or with families, couples or groups.
The atmosphere that supports transactional analysis is nonjudgmental, secure and respectful, ensuring
that a positive relationship is forged between the therapist and client(s) in order to provide a model for
subsequent relationships and communication that are developed outside of therapy.
In this setting the therapist works collaboratively with the individual to identify what has gone wrong
in their communication and provide opportunities for them to change repetitive patterns that limit their
potential. TA therapists recognize that we all have the potential to live the life we want, rather than the
life we are programmed to live. Sometimes however this potential is hindered by repetitive patterns or
'unconscious scripts' that stem from childhood decisions and teachings.
144 Counseling Approaches
Applications: TA can help
Develop awareness, options and skills in daily life, through the enhancement of
your strengths and resources.
Improve on your communication skills and help with managing conflict and
difficult situations in your life.
Foster intimacy, spontaneity, and autonomy within yourself and your
relationships.
Think clearly and raise your emotional intelligence.
Develop new options and make better choices in your life.
Experience and live the life you deserve.
Transactional Analysis can be said to be an effective method in the process of
counseling. Recently its scope is increasing. Individuals especially the young adults
are the needy clients of this transactional analysis counseling, because present
generations carry different complex ego states. It enable the clients to identity the
sorts of relationship.
The term 'cognitivebehavioral therapy (CBT)' is a very general term for a classification of therapies
with similarities. There are several approaches to cognitivebehavioral therapy, including Rational
Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy,
and Dialectic Behavior Therapy.
Cognitive Therapy: This approach aims to identify and correct distorted thinking patterns that can
lead to feelings and behaviors that may be troublesome, selfdefeating, or even selfdestructive. The
goal is to replace such thinking with a more balanced view that, in turn, leads to more fulfilling and
productive behavior. Uses the power of the mind to influence behavior. It is based on the theory that
previous experiences can damage self image and this can affect attitude, emotions and ability to deal
with certain situations. It works by helping the client to identify, question and change poor mental
images of them, thus altering negative responses and behavior. It can help pessimistic or depressed
people to view things from a more optimistic perspective.
Cognitive Analytical Therapy: This combines Cognitive Therapy and Psychotherapy and encourages
clients to draw on their own ability to develop the skills to change destructive patterns of behavior.
Negative ways of thinking are explored in structured and directive ways, involving diarykeeping,
progress charts, etc.
Dialectical Behavioral Therapy: DBT was developed from cognitive behavior therapy (CBT). The
main aim of CBT is to change behavior, which is done by applying techniques with a focus on
problemsolving, such as homework, diary cards and behavioral analysis. However, some people felt
uncomfortable with the strong focus on change, and felt that their suffering and apparent loss of control
over their lives were not understood. This caused them to become frustrated and even to drop out of
treatment. Therapist sought to resolve this by the use of acceptance strategies. Acceptance strategies
are added to the process of CBT which means that the therapist explores with their clients an
acceptance that their behavior (e.g. selfharming, drinking, etc.), even though damaging in the long
term, may be the only way they have learned to deal with intense emotions; and which might have led
to positive short term benefits.
Essentials of Counseling 145
HUMANISTIC APPROACH: Person Centered Therapy, Gestalt Therapy,
Existential Therapy
In the 1960s and 1970s, there was a growing interest among counselors in a 'third
force' in therapy as an alternative to the psychoanalytic and behavioral approaches.
Under this heading fall the personcentered approach, Gestalt therapy and existential
therapy.
Humanistic psychology is concerned with human potential and the individual's
unique personal experience. Humanistic psychologists generally do not deny the
importance of many principles of behaviorism and psychoanalysis. They value the
awareness of antecedents to behavior as well as the importance of childhood
experiences and unconscious psychological processes. Humanistic psychologists
would argue, however, that humans are more than the collection of behaviors or
objects of unconscious forces. Therefore, humanistic psychology often is described as
holistic in the sense that it tends to be inclusive and accepting of various theoretical
traditions and therapeutic practices. The emphasis for many humanistic therapists is
the primacy of establishing a therapeutic relationship that is collaborative, accepting,
authentic, and honors the unique world in which the client lives. The humanistic
approach is also holistic in that it assumes interrelatedness between the client's
psychological, biological, social, and spiritual dimensions. Humanistic psychology
assumes that people have an innate capacity toward selfunderstanding and
psychological health.
Humanistic therapy helps individuals access and understand their feelings, gain a
sense of meaning in life, and reach selfactualization. The aim of humanistic therapy
is usually to help the client develop a stronger, healthier sense of self, also called self
actualization. It is also to help individuals access and understand their feelings to help
to gain a sense of meaning in life. Humanistic theory sees each individual's
personality as being composed of physical, intellectual, emotional, behavioral,
creative, and spiritual elements. In order to help the client reach selfactualization,
humanistic therapists help clients remove and replace the attitudes, behaviors, and
beliefs that do not produce a positive state of being, and integrate the various
components of their unique personalities so that each individual is more selfaware,
mature, and authentic.
Key points of humanistic therapy are
Empathic understanding of the client's frame of reference and subjective
experience.
Respect for the client's cultural values and freedom to exercise choice.
146 Counseling Approaches
Exploration of problems through an authentic and collaborative approach to help
the client develop insight, courage, and responsibility.
Exploration of goals and expectations, including articulation of what the client
wants to accomplish and hopes to gain from treatment.
Clarification of the helping role by defining the therapist's role but respecting the
self determination of the client.
Assessment and enhancement of client motivation both collaboratively and
authentically.
Negotiation of a contract by formally or informally asking, "Where do we go from
here"?
Demonstration of authenticity by setting a tone of genuine, authentic encounter.
In humanistic therapy, there are two widely practiced techniques gestalt therapy
(which focuses on thoughts and feelings 'here and now' instead of root causes) and
clientcentered therapy (which provides a supportive environment in which clients
can reestablish their true identity).
PERSON-CENTERED THERAPY
Personcentered therapy (PCT) is also known as
personcentered psychotherapy, personcentered
counseling, clientcentered therapy or Rogerian
psychotherapy. PCT is a humanistic approach that
deals with the ways in which individuals perceive
themselves consciously rather than how a
counselor can interpret their unconscious thoughts
or ideas. It is a nondirective form of talk therapy
that was developed by humanist psychologist Carl
Rogers during the 1940s and 1950s. Today, it is
one of the most widely used approaches in
psychotherapy.
Dr. Carl Ransom Rogers
(January 8, 1902 – February 4, 1987)
Clientcentered therapy provides a supportive environment in which clients can re
establish their true identity. The world that we live in is judgmental. And many of us
fear that if we shared with the world our true identity it would judge us relentlessly.
Experience with these judgments results in people establishing a public identity to
navigate the judgmental world. The ability to reestablish their true identity will help
the individual understand themselves as they truly are; which is important as people
suppress their feelings about issues because they are not supported, socially
acceptable, or lead to unwanted judgment. The task of reestablishing one's true
Essentials of Counseling 147
identity is not an easy task and the therapist must rely on the techniques of
unconditional positive regard and empathy. These two techniques are central to client
centered therapy because they build trust between the client and therapist by creating
a nonjudgmental and supportive environment for the client.
Contemporary personcentered therapy is the result of an evolutionary process that
continues to remain open to change and refinement. Rogers did not present the PCT
as a fixed and completed approach to therapy. The four developmental periods of the
approach are
1. In the first period, during the 1940s, Rogers developed what was known as
nondirective counseling as a reaction against the directive and traditional
psychoanalytic approaches to individual therapy. Roger's theory emphasized the
counselor's creation of a permissive and nondirective climate. Rogers also
challenged the validity of commonly accepted therapeutic procedures such as
advice, suggestion, direction, persuasion, teaching, diagnosis, and interpretation.
This was based on his conviction that diagnostic concepts and procedures were
inaccurate, prejudicial, and often misused. Nondirective counselors avoided
sharing a great deal about themselves with clients and instead focused mainly on
reflecting and clarifying the clients' verbal and nonverbal communications with
the aim of gaining insight into the feelings expressed by clients.
2. In the second period, during the 1950s, Rogers renamed his approach client
centered therapy to reflect its emphasis on the client rather than on directive
methods. This period focused on the phenomenological world of the client.
Rogers assumed that the best vantage point for understanding how people behave
was from their own internal frame of reference. He focused more explicitly on the
actualizing tendency as the basic motivational force that leads to client change.
3. The third period, beginning in the late 1950s and extending into the 1970s,
addressed the necessary and sufficient conditions of therapy. The process of
"becoming one's experience" is characterized by openness to experience, a trust
in one's experience, an internal locus of evaluation, and the willingness to be in
process. He was interested in how people best progress in psychotherapy, and he
studied the qualities of the clienttherapist relationship as a catalyst leading to
personality change. Clientcentered philosophy was applied to education and was
called studentcentered teaching. It was also applied to encounter groups, led by
laypersons in the 1960s.
4. The fourth phase, during the 1980s and 1990s, was marked by considerable
expansion to education, industry, groups, conflict resolution, and the search for
world peace. The theory became known as personcentered approach. This shift in
148 Counseling Approaches
terms reflected the broadening application of the approach. Areas of further
application include education, health care, crosscultural and interracial activity,
international relations, politics, and the achievement of worldpeace.
Basic Philosophy
Rogers viewed human nature as basically good.
He believed that if given the appropriate environment of acceptance, warmth and
empathy, the individual would move toward selfactualization.
Selfactualization is the motivation that makes the individual move toward
growth, meaning, and purpose.
It is considered a phenomenological psychology whereby the individual's
perception of reality is accepted as reality for the individual.
Personcentered is often referred to as a self theory, because of Rogers's emphasis
on the self being a result of the person's life experiences and the person's
awareness of comparisons to others as the same or different.
Rogers believed that most people were provided conditional acceptance as
children, which lead them to behave in ways that would assure their acceptance.
However, in their need for acceptance, the individual often behaved in ways that
were incongruent with the real self. Thus, the greater this incongruence between
the real self and the ideal self, the greater isolated and maladjusted the person
became.
Key Concepts: Rogers identified six key factors that stimulate growth within an
individual. He suggested that when these conditions are met, the person will gravitate
toward a constructive fulfillment of potential. According to Rogerian theory, the six
factors necessary for growth are
TherapistClient Psychological Contact: This first condition simply states that a
relationship between therapist and client must exist in order for the client to
achieve positive personal change. The following five factors are characteristics of
the therapistclient relationship, and they may vary by degree.
Client Incongruence or Vulnerability: A discrepancy between the client's self
image and actual experience leaves him/her vulnerable to fears and anxieties. The
client is often unaware of the incongruence.
Therapist Congruence or Genuineness: The therapist should be selfaware,
genuine, and congruent. This does not imply that the therapist be a picture of
perfection, but that s/he be true to him/herself within the therapeutic relationship.
Therapist Unconditional Positive Regard (UPR): The clients' experiences,
positive or negative, should be accepted by the therapist without any conditions or
Essentials of Counseling 149
judgment. In this way, the client can share experiences without fear of being
judged.
Therapist Empathy: The therapist demonstrates empathic understanding of the
clients' experiences and recognizes emotional experiences without getting
emotionally involved.
Client Perception: To some degree, the client perceives the therapist's
unconditional positive regard and empathic understanding. This is communicated
through the words and behaviors of the therapist.
Role of the Counselor
The counselor sets up an environment where the client is safe to explore any
aspect of the self. The counselor's job is to facilitate the exploration through a
special "I Thou" relationship of unconditional positive regard, empathy and
warmth.
The counselor uses psychological testing on a limited basis. The Qsort is
sometimes used in assessment by the person centered counselor. The Qsort gives
an indication of the incongruence between the perceived real self and ideal self.
Qsort: A series of 100 statements are written on cards. The statements are selfdescriptions, i.e. I am
capable, I am dependent, I am worthless. The client is asked to read and sort each of these statements
into nine piles from most like me to least like me. Then the stacks are recorded. The clientresorts the
cards into what they would like to be like.
The use of diagnostic categories is discouraged as incompatible with the
philosophical view of the individual as unique. Diagnosis places the counselor in a
position of authority and imposes a treatment plan.
Goals of Therapy: Person centered theory is directly concerned with the individual.
The counselor facilitates the client toward
Realistic selfperception;
Greater confidence and selfdirection;
Sense of positive worth;
Greater maturity, social skill, and adaptive behavior;
Better stress coping;
More fully functioning in all aspects of their lives.
Therapeutic Relationship: The relationship is of primary importance. The qualities
of the therapist, including genuineness, warmth, accurate empathy, respect, and non
judgmentalness and communication of these attitudes to clients are stressed. Clients
use this real relationship with the therapist to help them transfer their learning to other
relationships.
Rogers based his hypothesis of the 'necessary and sufficient conditions
for therapeutic personality change' on the quality of the relationship. Roger's
150 Counseling Approaches
hypothesis is as follows
Two persons are in psychological contact.
The first, or the client, is in a state of incongruence, being vulnerable or anxious.
The second person, or the therapist, is congruent or integrated in the relationship.
The therapist experiences unconditional positive regard for the client.
The therapist experiences an empathic, understanding of the client's internal
frame of reference and endeavors to communicate this experience to the client.
The communication to the client of the therapist's empathic understanding and
unconditional positive regard is to a minimal degree achieved.
Techniques of Therapy: This approach uses few techniques but stresses the attitude
of the therapist. Basic techniques include active listening and hearing, reflection of
feelings, clarification, and being there for the client. This model does not include
diagnostic testing, interpretation, taking a case history, or questioning or probing for
information. The techniques used in person centered therapy have changed over time.
Three periods of time in which different techniques were stressed
Nondirective Period (1940 1950): In this period of theory development, the
counselor focused on listening and creating a permissive atmosphere. The counselor
did not provide interventions, but communicated acceptance and clarification.
Reflective Period (1950 1957): During this period of time, counselors emphasized
being non judgmental of the client, while responding to the client's feelings and
reflecting the affect accurately.
Experiential Period (1957 1980): This is the period of the EWG Empathy, Warmth
and Genuineness. Empathy is the ability of the counselor to understand the emotions
of the client and correctly communicate this understanding. Warmth is also referred to
as acceptance and positive regard in person centered literature. Warmth is the ability
of the counselor to convey an unconditional acceptance of the client's personhood.
Genuineness or congruence is the ability to be who one really is without assuming
roles or facades.
The counselor helps the client through accurate reflections of feelings, keeping the
client focused on the concern, and clarification of feelings and information. The
counselor uses openended questions or phrases to help the clients gain insight into
experiences and necessary changes in their lives.
Applications: Has wide applicability to individual and group counseling. It is
especially well suited for the initial phases of crisis intervention work. Its principles
have been applied to marital and family therapy, community programs, administration
and management, and human relations training. It is a useful approach for teaching,
Essentials of Counseling 151
parent/child relations, and working with groups composed of people from diverse
cultural backgrounds. Today many people who are not practicing counseling use the
approach to help guide them through daytoday work and relationships.
Generally, personcentered counseling can help individuals of all ages with a range of
personal issues. It has been found particularly useful in helping individuals to
overcome specific problems such as depression, anxiety, personality disorders, eating
disorders and alcohol addictions. These issues can have significant impact on self
esteem, selfreliance and selfawareness, but personcentered therapy can help
individuals to reconnect with their inner self in order to transcend any limitations.
Multiculturalism: Focus is on breaking cultural barriers and facilitating open
dialogue among diverse cultural populations. Main strengths are respect for clients'
values, active listening, welcoming of differences, nonjudgmental attitude,
understanding, willingness to allow clients to determine what will be explored in
sessions, and prizing of cultural pluralism. Some of the core values of this approach
may not be congruent with the client's culture. Lack of counselor direction and
structure are unacceptable for clients who are seeking help and immediate answers
from a knowledgeable professional.
Contributions: Rogers had a major impact on the field of counseling and
psychotherapy. When he introduced his revolutionary ideas in the 1940s, he provided
a powerful and radical alternative to psychoanalysis and to the directive approaches
then practiced. Rogers was a pioneer in shifting the therapeutic focus from an
emphasis on technique and reliance on therapist authority to that of relationship. One
of Rogers's contributions to the field of psychotherapy was his willingness to state his
concepts as testable hypotheses and to submit them to research. He literally opened
the field to research. Personcentered therapy has demonstrated that therapist empathy
plays a vital role in facilitating constructive changes in the client
Research consistently demonstrates that therapist empathy is the most potent
predictor of client progress in therapy.
Empathy is an essential component of successful therapy in every therapeutic
modality.
Empathy is a basic component of emotional intelligence.
Client perception of therapist empathy, as opposed to that of external raters or
therapists, is mot predictive of positive client outcome.
Limitations: Possible danger from the therapist who remains passive and inactive,
limiting responses to reflection. Many clients feel a need for greater direction, more
structure, and more techniques. Clients in crisis may need more directive measures. It
152 Counseling Approaches
is difficult to translate the core conditions into actual practice in certain cultures.
Clients accustomed to indirect communication may not be comfortable with direct
expression of empathy or selfdisclosure on the therapist's part. Another limitation is
that this approach extols the value of an internal locus of evaluation. In some cases,
clients are likely to be highly influenced by societal expectations and not simply
motivated by their own personal preference.
Because the personcentered counselors place so much emphasis on genuineness and
on being led by the client, they do not place the same emphasis on boundaries of time
and technique as would psychodynamic therapists. They have very positive and
optimistic view of human nature. The philosophy that people are essentially good, and
that ultimately the individual knows what is right for them, is the essential ingredient
of successful person centered therapy as 'all about loving'.
GESTALT THERAPY
Gestalt Therapy was developed in the late
1940s by Fritz Perls (a Germanborn
psychiatrist) with his wife Laura Perls and
further influenced by the likes of Kurt Lewin
and Kurt Goldstein (Corsini & Wedding,
2000). It was developed as a revision to
psychoanalysis and focuses on an experiential
and humanistic approach rather than analysis
of the unconscious; which was one of the
main therapeutic tools at the time 'Gestalt
Therapy' was employed.
Friedrich (Frederick) Salomon Perls
[Better known as Fritz Perls]
(July 8, 1893 – March 14, 1970)
Gestalt Therapy rejects the dualities of mind and body, body and soul, thinking and
feeling, and feeling and action. According to Perls, people are not made up of separate
components, i.e., mind, body and soul; rather human beings function as a whole. In
doing so, one defines who one is (sense of self) by choice of responses to
environmental interactions (boundaries). The word 'Gestalt' (German origin) refers to
a "whole, configuration, integration, pattern or form" (Patterson, 1986). Gestalt
Therapy focuses on the whole of the client's experience, including feelings, thoughts
and actions. The client gains selfawareness in the 'here and now' (what is happening
from one moment to the next) by analyzing behavior and body language and talking
about bottled up feelings. In gestalt therapy, selfawareness is key to personal growth
and developing full potential. The approach recognizes that sometimes this self
awareness can become blocked by negative thought patterns and behavior that can
Essentials of Counseling 153
leave people feeling dissatisfied and unhappy. It is the aim of a gestalt therapist to
promote a nonjudgmental selfawareness that enables clients to develop a unique
perspective on life. By helping an individual to become more aware of how they
think, feel and act in the present moment, gestalt therapy provides insight into ways in
which s/he can alleviate their current issues and distress in order to aspire to their
maximum potential.
Basic Philosophy
The person strives for wholeness and integration of thinking, feeling, and
behaving.
Gestalt therapy is considered to be a hereandnow therapy focusing on awareness
with the belief that when one focuses on what they are and not what they wish to
become, they become selfactualized. The idea being that through self acceptance
one becomes selfactualized.
Individual naturally seeks to become an integrated whole, living productively.
Gestaltists are antideterministic because they believe that people have the ability
to change and become responsible.
Gestalt focuses on the client's own inner world of interpretation and assessment of
the present life situation.
Gestaltists believe that individuals emphasize intellectual experience, diminishing
the importance of emotions and senses, resulting in an inability to respond to the
situations or events in their life.
Gestaltists believe that thoughts, feelings, and reactions to past events or situations
can impede personal functioning and prevent hereandnow awareness.
The emphasis in on reality and not on embellished or imagined needs. The
individual recognizes their internal need and meets that need through
manipulation of the need and the environment.
Difficulty may arise in several ways
Loss of contact with the environment and its resources.
Loss of contact with self through over involvement with environment.
Fail to put aside unfinished business.
Loss the Gestalt resulting in fragmentation or scattering.
Experience conflict between what one should do and what one wants to do.
Experience difficulty with life's dichotomies, i.e., love/hate, pleasure/pain,
masculinity/femininity.
Key Concepts of Gestalt Therapy: Several key concepts underlie Gestalt Therapy,
many of which are similar to that of personcentered and existential therapy. The
following are the key concepts of Gestalt Therapy
154 Counseling Approaches
Wholeness and Integration: Wholeness refers to the whole person or the individual's
mind and body as a unit rather than as separate parts (Seligman, 2006). Integration
refers to how these parts fit together and how the individual integrates into the
environment. Often people who come to therapy do not have these parts fitting
together in their environment, Gestalt Therapy is about facilitating clients to integrate
themselves as whole persons and help restore balance in their environment.
Awareness: Awareness is one of the most important elements in Gestalt Therapy as it
is seen as a "hallmark of the healthy person and a goal of treatment" (Seligman,
2006). When individuals are 'aware', they are able to selfregulate in their
environment. There are two main causes lacking awareness (a) Preoccupation with
one's past, fantasies, flaws and strengths that the individual becomes unaware of the
whole picture, and (b) Low selfesteem. There are three ways people may achieve
awareness through therapy (i) Contact with the environment This is through
looking, listening, touching, talking, moving, smelling, and tasting. This enables the
individual to grow in his/her environment through reacting to the environment and
changing. (ii) Here and now This is the individual living in and being conscious at
the present moment rather than worrying about the past or the future.
(iii) Responsibility This refers to the individual taking responsibility for his/her own
life rather than blaming others.
Energy and Blocks to Energy: Gestalt Therapists often focus on where energy is in
the body, how it is used, and how it may be causing a blockage (Corey, 2005).
Blocked energy is a form of resistance, for example, tension in a part of the body, not
breathing deeply, or avoiding eye contact. Gestalt Therapy is about finding and
releasing the blockages that may be inhibiting awareness.
Growth Disorders: Growth disorders refer to emotional problems that are caused by
people who lack awareness and do not interact with their environment completely. In
doing so, people are unable to cope with the changes in their lives successfully and,
instead deal with the problems in a defensive manner (Seligman, 2006).
Unfinished Business: Unfinished business refers to people who do not finish things in
their lives and is often related to people with a 'growth disorder' (Seligman, 2006).
People with unfinished business often resent the past and because of this are unable to
focus on the here and now. One of the major goals of Gestalt Therapy is to help
people work through their unfinished business and bring about closure.
Role of the Counselor
Counselor creates an environment for the client to explore their needs in order to
grow.
Essentials of Counseling 155
Counselor is fully with the client in the hereandnow with intense personal
involvement and honesty.
Counselor helps the client to focus on blocking energy and to positively and
adaptively use that energy.
Counselor also helps the clients to discern life patterns.
Among the rules that counselor uses to help client
The principle of the now requires the counselor to use present tense.
"I and Thou" means that the client must address the person directly rather than
talk about them or to the counselor about them.
Making the client use the "I" instead of referring to own experiences in the
second (you) or third (it) person.
The use of an awareness continuum that focuses on how and what rather than
on why.
The counselor has the client convert questions into statements.
DSMIV categories and standardized assessment is not considered necessary
within this theory.
Goals of Therapy: To assist clients in gaining awareness of momenttomoment
experiencing and to expand the capacity to make choices. Aims not at analysis but at
integration.
Emphasis is on the hereandnow of the client's experience.
The client is encouraged to make choices based on the now as opposed to past.
Help the client resolve the past.
Assist the client to become congruent.
Help the client to reach maturity intellectually.
Help the client shed neuroses.
Therapeutic Relationship: Central importance is given to the I/Thou relationship
and the quality of the therapist's presence. The therapist's attitudes and behavior
counts more than the techniques used. The therapist does not interpret for the clients
but assists them in developing the means to make their own interpretations. Clients
identify and work on unfinished business from the past that interferes with current
functioning.
Techniques of the Therapy: Techniques in Gestalt therapy one of two forms, either
an exercise or an experiment. (1) Exercises include activities such as i. frustration
actions; ii. fantasy role playing; iii. Fantasy; and iv. Psychodrama. (2) Experiments
are unplanned creative interventions that grow out of the hereandnow interaction
between the client and the counselor.
156 Counseling Approaches
Dream works in Gestalt therapy consist of the client telling the dream and then
focusing their awareness on the dream from the perspective of each character or
element in the dream.
Empty chair is a process where the client addresses parts of the personality, as if it
were an entity sitting an empty chair. The client may switch perspectives by
switching chairs or may simply address the chair. The technique is contraindicated
for severely disturbed clients.
Confrontation is another of the Gestalt exercises that is very powerful. Basically,
the counselor calls attention to the incongruence between the client's
verbalizations and observed emotions or behaviors.
Making the rounds is a group exercise in which the client is instructed to say the
same sentence to each member of the group and then adding something personal
to each person.
"I take responsibility" is the phrase that follows each statement expressing
statements or perceptions that the client states. The process is to help the client to
integrate their internal perceptions and their behaviors.
Exaggeration is overdramatizing the client's gestures and movements to help
gain insight into their meaning.
May I feed you a sentence is the question that the counselor asks before giving the
client a more specific expression of what the counselor believes is the underlying
message of the client.
Applications: Ultimately, gestalt therapy is considered to help individuals gain a
better understanding of how their emotional and physical needs are connected. They
will learn that being aware of their internal self is key to understanding why they react
and behave in certain ways. This journey of selfdiscovery makes the approach
beneficial for individuals who can be guarded when it comes to their emotions, and
find it difficult to process why they feel and act the way they do. It can also provide
support and a safe space for individuals going through times of personal difficulty.
Gestalt therapy is considered particularly valuable for helping to treat a wide range of
psychological issues especially as it can be applied as a longterm therapy or as a
brief and focused approach. It has been found effective for managing tension, anxiety,
addiction, posttraumatic stress, depression and other psychological problems that can
prevent people from living life to the full. Gestalt Therapy is also effective in
counseling groups, couples, and families (Corsini & Wedding, 2000). Overall, people
who participate in gestalt therapy tend to feel more selfconfident, calm and at peace
with themselves.
Essentials of Counseling 157
Multiculturalism: Its focus on expressing oneself nonverbally is congruent with
those cultures that look beyond words for messages. Provides many experiments in
working with clients who have cultural injunctions against freely expressing feelings.
Can help to overcome language barrier with bilingual clients. Focus on bodily
expressions is a subtle way to help clients recognize their conflicts. Clients who have
been culturally conditioned to be emotionally reserved may not embrace Gestalt
experiments.
Contributions: Main contribution is an emphasis on direct experiencing and doing
rather than on merely talking about feelings. It provides a perspective on growth and
enhancement, not merely a treatment of disorders. It uses clients' behavior as the
basis for making them aware of inner creative potential. The approach to dreams is a
unique, creative tool to help clients discover basic conflicts. Therapy is viewed as an
existential encounter; it is processoriented, not techniqueoriented. It recognizes
nonverbal behavior as a key to understanding.
Limitations: For Gestalt Therapy to be effective, the therapist must have a high level
of personal development (Corey, 2005). Effectiveness of the confronting and
theatrical techniques of Gestalt Therapy is limited and has not been well established.
It has been considered to be a selfcentered approach which is concerned with just
individual development. Potential danger for therapists to abuse the power they have
with clients (Corey, 2005). Lacks a strong theoretical base. Deals only with the here
and now. Does not deal with diagnosis and testing.
How Does Gestalt Therapy Work?
Fundamentally, gestalt therapy works by teaching clients how to define what is truly being experienced
rather than what is merely an interpretation of the events. Those undertaking gestalt therapy will
explore all of their thoughts, feelings, behaviors, beliefs and values to develop awareness of how they
present themselves and respond to events in their environment. This gives them the opportunity to
identify choices, patterns of behavior and obstacles that are impacting their health and wellbeing, and
preventing them from reaching their full potential. The unfolding of this therapeutic process will
typically involve a range of expressive techniques and creative experiments developed collaboratively
between therapist and client. These will be appropriate for the client and their specific problems. Below
are some of the most common methods used
Role-play: Roleplay can help individuals to experience different feelings and emotions and better
understand how they present and organize themselves.
Empty Chair/ Open Chair Technique: The empty chair technique is a "method of facilitating the
roletaking dialogue between the patient and others or between parts of the patient's personality. It is
generally used in a group situation" (Patterson, 1986). Two chairs are placed facing each other one
represents the patient or one aspect of the patient's personality, and the other represents another person
or the opposing part of the personality. As the patient alternates the role, s/he sits in one or the other
chair.
158 Counseling Approaches
The therapist may simply observe as the dialogue progresses or may instruct the patient when to
change chairs, suggest sentences to say, call the patient's attention to what has been said, or ask the
patient to repeat or exaggerate words or actions. In the process, emotions and conflicts are evoked,
impasses may be brought about and resolved, and awareness and integration of polarities may develop
polarities or splits within the patient, between the patient and other persons, or between the patient's
wants and the social norms (Patterson, 1986).
Dialogue: A gestalt therapist will need to engage the client in meaningful and authentic dialogue in
order to guide them into a particular way of behaving or thinking. This may move beyond simple
discussion to more creative forms of expression such as dancing, singing or laughing.
Dreams: Dreams are used to bring about integration by the client. The focus of a client's dream is not
on the unconscious, rather on projections or aspects of the dreamer (Seligman, 2006). The therapist
would get clients to talk about their dream/s in terms of the significance of each role in the dream and
this allows clients to take responsibility for the dreams and increase awareness of their thoughts and
emotions.
Attention to Body Language: Throughout therapy, a gestalt therapist will concentrate on body
language, which is considered a subtle indicator of intense emotions. When specific body language is
noticed, the therapist may ask the client to exaggerate these movements or behaviors. This is thought to
intensify the emotion attached to the behavior and highlight an inner meaning. For example, a client
may be showing signs of clenched fists or frowning, to which the therapist may ask something along
the lines of "What are you saying with this movement?"
Gestalt Therapy deems that people cannot be considered as separate from their environment or from
interpersonal relations. The individual is seen as being selfregulating and is able to motivate oneself to
solve problems. Individuals are able to work towards growth and develop as their environments allow.
A psychologically healthy person is someone who is selfregulating through the changes in life and has
developed a sense of 'wholeness' between mind and body (Corsini & Wedding, 2000).
Use of Language: Gestalt Therapists choose language that will encourage change in the client. The
following are ways that this can be accomplished (Seligman, 2006)
Emphasis on statements rather than questions to highlight a collaborative clienttherapist
relationship.
'What' and 'How' questions (when questions are used) to keep the client in the present and
promote integration.
'I' statements are used to promote clients ownership of feelings rather than placing blame on
others.
The present tense is used so the focus is on the present rather than the past.
Encouraging responsibility for clients of their words, emotions, thoughts, and behaviors so they
recognize and accept what they are feeling.
Topdog - Underdog: A commonly utilized Gestalt technique is that of the topdogunderdog dialogue.
This technique is used when the therapist notices two opposing opinions/attitudes within the client. The
therapist encourages the client to distinguish between these two parts and play the role of each in a
dialogue between them (Patterson, 1986). The tyrannical 'topdog' demands that things be a particular
way whilst the 'underdog' plays the role of disobedient child. The individual becomes split between the
two sides struggling for control.
Essentials of Counseling 159
: Fantasy is used in Gestalt Therapy to increase clients' selfawareness of their thoughts and
emotions and to bring about closure to unfinished business (Seligman, 2006). Therapists use guided
imagery techniques (fantasy) to encourage clients to imagine situations such as what they would do in a
certain situation or by projecting themselves into different roles.
Body as a Vehicle of Communication: Gestalt Therapy sees that not only are thoughts and emotions
important to creating a feeling of 'wholeness' for the client, the physical sensations are also important.
Seligman (2006) has identified three strategies to help with focusing attention on the physical
sensations
Identification: Gestalt Therapists should be able to recognize physical signs of their clients. For
example, a client might be tapping their feet on the ground. The therapist may say "Become your
leg and give it a voice?" This creates awareness of the client's physical sensations and emotions.
Locating emotions in the body: Gestalt Therapists may ask clients where they are experiencing the
emotion in their body. For example, a client may say they are feeling nervous about something.
The therapist may ask where this is coming from in the body and the response from the client may
be that the feeling is butterflies in the stomach. This helps the client to bring about more awareness
into sensations and their emotions.
Repetition and exaggeration: If there is repetition such as the example of the client tapping their
feet on the ground, the therapist would get them to exaggerate the movement and talk about
feelings that come up. This in turn focuses on the emotion and should help to release the blocked
awareness.
Confusion: The technique of dealing with confusion of the client is about drawing attention to the
client's hesitation in talking about something unpleasant. The hesitation can be shown through
avoidance, blanking out, verbalism and fantasy (Patterson, 1986). By drawing attention to the
hesitation, it creates selfawareness for the client and allows the client to work through the issue.
Confrontation: In Gestalt Therapy, confrontation means 'to challenge or frustrate the client'. The
client is challenged with sensitivity and empathy on the part of the therapist to face the issues important
to them. It is an invaluable tool for bringing clients into clear awareness of their realities, when used
appropriately. However, confrontation is not a technique that can be used with all clients.
Gestalt therapy is a welldeveloped and wellgrounded theory with a myriad of tenets,
principles, concepts, and methods. Gestalt therapy is a sound science and a powerful
means for facilitating and nurturing the full functioning of the human person with the
potential of bringing about human healing, growth, and wholeness. It focuses on the
integration between the 'whole' person and his/her environment. This therapy sees a
healthy individual as being someone who has awareness in his/her life and lives in the
here and now rather than focusing on the past or future. Gestalt Therapy has a number
of successful techniques that are applicable in therapy today and may be utilized
across a broad spectrum of emotional issues.
EXISTENTIAL THERAPY
Existential psychotherapy arose spontaneously in the minds and works of a number of
psychologists and psychiatrists, namely Rollo May, Viktor Frankl, James Bugental,
160 Counseling Approaches
Friedrich Nietzsche, Soren Kierkegaard, JeanPaul Sartre, Irvin Yalom, Kirk
Schneider, Stephen Diamond, and Myrtle Heery in Europe in the 1940s and 1950s.
Existential psychotherapy uses a positive approach
that applauds human capacities while simultaneously
maintaining a genuine perception of the limitations of
the human being, human spirit, and human mind.
Existential therapy shares many similarities with
humanistic psychology, experiential psychotherapy,
depth psychotherapy, and relational psychotherapy.
Existential therapists believed drives in Freudian
psychology, conditioning in behaviorism, and
archetypes in Jungianism all had their own
significance. Existential psychotherapy is not a
specific technical approach that presents a new set of
rules for therapy. It asks deep questions about the
nature of the human being and the nature of anxiety,
despair, grief, loneliness, isolation, and anomie. It also
deals centrally with the questions of creativity and
love. Out of the understanding of the meaning of these
human experiences, existential psychotherapists have
devised methods of therapy that do not fall into the
common error of distorting human beings in the very
effort of trying to help them.
Rollo Reece May
(April 21, 1909 – October 22, 1994)
Dr. Viktor Emil Frankl
(March 26, 1905 – September 2, 1997)
Basic Philosophy
Existentialists believe that the individual writes their own life story by the choices
that they make.
Psychopathology is defined by existentialists as neglecting to make meaningful
choices and accentuating one's potential.
Anxiety is seen as the motivational force that helps the clients to reach their
potential. Conversely, anxiety is also seen as the paralyzing force that prevents
clients from reaching their full potential. Therefore, through awareness, this
anxiety can be helpful in living more fully.
Frankl shares that each person searches for meaning in life, and that while this
meaning may change, the meaning never ceases to be.
According to Frankl life's meaning can be discovered in three ways
i. by doing a deed (accomplishments or achievements),
ii. by experiencing a value (beauty, love, nature, and arts),
iii. by suffering (reconciling ourselves to fate).
Essentials of Counseling 161
Key Concepts: Humans are in a constant state of transition, emerging, evolving, and
becoming. Being a person implies that we are discovering and making sense of our
existence. Although the specific questions we raise vary in accordance with our
developmental stage in life, the fundamental themes do not vary who am I?; what
can I know?; what ought I to do?; what can I hope for?; where am I going? The basic
dimensions of the human condition include
1. The capacity for selfawareness;
2. Freedom and responsibility;
3. Creating one's identity and establishing meaningful relationships with others;
4. The search for meaning, purpose, values, and goals;
5. Anxiety as a condition of living; and
6. Awareness of death and nonbeing.
Capacity for SelfAwareness: As human beings, we can reflect and make choices
because we are capable of selfawareness. The greater our awareness, the greater our
possibilities for freedom. We have the potential to take action or not to act; inaction is
a decision. We choose our actions, and therefore we can partially create our own
destiny. Existential anxiety, which is basically a consciousness of our own freedom, is
an essential part of living; as we increase our awareness of the choices available to us,
we also increase our sense of responsibility for the consequences of these choices. We
are subject to loneliness, meaninglessness, emptiness, guilt, and isolation. We can
choose either to expand or to restrict our consciousness. Selfawareness is at the root
of most other human capacities, the decision to expand it is fundamental to human
growth.
Freedom and Responsibility: Even though we have no choice about being thrust into
the world, the manner in which we live and what we become are the results of our
choices. Because of the reality of this essential freedom, we must accept
responsibility for directing our lives. However, it is possible to avoid this
responsibility for directing our lives, or exhibiting 'bad faith'. We are constantly
confronted with the choice of what kind of person we are becoming, and to exist is
never to be finished with this kind of choosing. Existential guilt is being aware of
having evaded a commitment, or having chosen not to choose.
Striving for Identity and Relationship to Others: As human beings we strive for
discover or create a self that is our personal identity and we strive for connectedness
with others and with nature. Rather than trusting ourselves to search within and find
our own answers to the conflicts in our life, we sell out by becoming what others
expect of us. Our being becomes rooted in the expectations, answers, values, and
beliefs that come from the important people in our world.
162 Counseling Approaches
Search for Meaning: Some of the underlying conflicts that bring people into
counseling and therapy are centered in existential questions such as "Why am I
here? What do I want from life? What gives my life purpose? Where is the source of
meaning for me in life?" Existential therapy can provide the conceptual framework
for helping clients challenge the meaning in their lives. Questions that the therapist
might ask are "Do you like the direction of your life? Are you pleased about whom
you are and what you want for yourself, what are you doing to get some clarity?"
Anxiety as a Condition of Living: Existential anxiety is conceptualized as the
unavoidable result of being confronted with the 'givens of existence' death,
freedom, existential isolation, and meaninglessness. Existential therapists differentiate
between normal and neurotic anxiety, and they see anxiety as a potential source of
growth. Normal anxiety is an appropriate response to an event being faced. It can be
used as a motivation to change. Neurotic anxiety, in contrast, is out of proportion to
the situation. It is typically out of awareness, and it tends to immobilize the person.
Being psychologically healthy entails living with as little neurotic anxiety as possible,
while accepting and struggling with the unavoidable existential anxiety that is a part
of living. When we make a decision that involves reconstruction of our life, the
accompanying anxiety can be a signal that we are ready for personal change. Opening
up to new life means opening up to anxiety. Existential therapy helps clients come to
terms with the paradoxes of existence life and death, success and failure, freedom
and limitations, and certainty and doubt. Facing existential anxiety involves viewing
life as an adventure rather than hiding behind securities that seem to offer protection.
The therapist must guide clients in finding ways to deal with anxiety constructively.
The therapist can help clients recognize that learning how to tolerate ambiguity and
uncertainty and how to live without props can be a necessary phase in the journey
from dependence to autonomy. When a client becomes more selfconfident, the
anxiety that results from an expectation of catastrophe will decrease.
Awareness of Death and Nonbeing: Awareness of death is a basic human condition
that gives significance to living. It is necessary to think about death if we are to think
significantly about life. Death provides the motivation for us to live our lives fully and
take advantage of each opportunity to do something meaningful. If we realize we are
mortal, we know that we do not have an eternity to complete our projects and that
each present moment is crucial. Without being morbidly preoccupied by the ever
present threat of nonbeing, clients can develop a healthy awareness of death as a way
to evaluate how well they are living and what changes they want to make in their
lives.
Essentials of Counseling 163
Role of the Counselor
Each client is considered a unique relationship with the counselor focusing on
being authentic with the client and entering into a deep personal sharing
relationship.
The counselor models how to be authentic, to realize personal potential, and to
make decisions with emphasis on mutuality, wholeness and growth.
Existential counselors do not diagnosis, nor do they use assessment models like
the DSMIV.
Goals of Therapy: The goals of existential therapy are to enable people to
have the clients take responsibility for their life and life decisions.
develop selfawareness to promote potential, freedom, and commitment to better
life choices.
help the client develop an internal frame of reference, as opposed to the outward
one.
identify factors that block freedom.
successfully negotiate and come to terms with past, present and future crises.
become more truthful with themselves.
find clarity on what their purpose in life is and how they can learn from the past to
create something valuable and meaningful to live for.
understand themselves and others better and find ways of effectively
communicating and being with others.
Therapeutic Relationship: The therapist's main tasks are to accurately grasp clients,
being in the world and to establish a personal and authentic encounter with them. The
relationship is seen as critically important. Clients discover their own uniqueness in
the relationship with the therapist. The immediacy of the client/therapist relationship
and the authenticity of the hereandnow encounter are stressed. Both client and
therapist can be changed by the encounter.
Techniques of Therapy: Few techniques flow from this approach, because it stresses
understanding first and technique second. The therapist can borrow techniques from
other approaches and incorporate them in an existential framework. Diagnosis,
testing, and external measurements are not deemed important. The most common
technique used in existential counseling is the relationship with the client.
Confrontation is also used by existential counselors, when they challenge the clients
with their own responsibility for their lives.
Therapeutic Procedures: The therapy is a creative, evolving process of discovery
that can be conceptualized in three general phases.
164 Counseling Approaches
The initial phase, counselors assist clients in identifying and clarifying their
assumptions about the world. Clients are invited to define and question the ways
in which they perceive and make sense of their existence. The counselor teaches
them how to reflect on their own existence and to examine their role in creating
their problems in living.
The middle phase, clients are encouraged to more fully examine the source and
authority of their present value system. This leads to new insights and some
restructuring of their values and attitudes. Clients get a better idea of what kind of
life they consider worthy to live and develop a clearer sense of their internal
valuing process.
The final phase focuses on helping clients take what they are learning about
themselves and put it into action, to find ways of implementing their examined
and internalized values in a concrete way. Clients typically discover their
strengths and find ways to put them to the service of living a purposeful existence.
Applications: Existential therapy is especially appropriate for clients who are
struggling with developmental crises, doing grief work, confronting death, or facing a
significant decision. Some examples of these critical turning points that mark
passages from one stage of life into another are the struggle for identity in
adolescence, coping with possible disappointments in middle age, adjusting to
children leaving home, coping with failures in marriage and work, and dealing with
increased physical limitations as one ages. It can be useful for people who are on the
edge of existence, such as those who are dying, who are working through
developmental or situational crises, or who are starting a new phase of life. Can be
applied to both individual and group counseling, marital and family therapy, crisis
intervention, and community mental health work.
Multiculturalism: Focus is on understanding client's phenomenological world,
including cultural background. This approach leads to empowerment in an oppressive
society. It can help clients examine their options for change within the context of their
cultural realities, values of individuality, freedom, autonomy, and selfrealization,
often conflict with cultural values of collectivism, respect for tradition, deference to
authority, and interdependence. Some may be deterred by the absence of specific
techniques. Others will expect more focus on surviving in their world.
Contributions: Its major contribution is recognition of the need for a subjective
approach based on a complete view of the human condition. It calls attention to the
need for a philosophical statement on what it means to be a person. Stress on the
'I/Thou' relationship lessens the chances of dehumanizing therapy. It provides a
Essentials of Counseling 165
perspective for understanding anxiety, guilt, freedom, death, isolation, and
commitment.
Limitations: The existentialists can be criticized on the grounds that they are
excessively individualistic and they ignore the social factors that cause human
problems. If a counselor consistently tells certain disenfranchised clients that they
have a choice in making their lives better, they may feel patronized and
misunderstood. It is highly focused on the philosophical assumption of self
determination, which does not take into account the complex factors that many people
who have been oppressed must deal with. In many cultures it is not possible to talk
about the self and selfdetermination apart from the context of the social network and
environmental conditions. Another problem is the lack of direction that clients may
get from the counselor. Many clients expect a structured and problemoriented
approach to counseling that is not found in the existential approach, which places the
responsibility on the client for providing the direction of therapy.
Existential psychotherapy perceives the patient as an existing, immediate person, not
as a composite of drives, archetypes, or conditioning. Instinctual drives and history
are obviously present, but they come into existential therapy only as parts of the
living, struggling, feeling, thinking human being in unique conflicts and with hopes,
fears, and relationships. Existential therapy emphasizes that normal anxiety and guilt
are present in all of life and that only the neurotic forms of these need to be changed
in therapy. The person can be freed from neurotic anxiety and guilt only as s/he
recognizes normal anxiety and guilt at the same time. The original criticism of
existential therapy as 'too philosophical' has lessened as people recognize that all
effective psychotherapy has philosophical implications. Existential therapy is
concerned with the 'IAm' (being) experience, the culture (world) in which a patient
lives, the significance of time, and the aspect of consciousness called transcendence.
Existential therapy always sees the patient in the center of his/her own culture. Most
people's problems are now loneliness, isolation, and alienation. Our present age is one
of disintegration of cultural and historical mores, of love and marriage, the family, the
inherited religions, and so forth. This disintegration is the reason psychotherapy of all
sorts has burgeoned in the twentieth century; people cried for help for their
multitudinous problems. Thus, the existential emphasis on different aspects of the
world (environment, social world, and subjective world) will, in all likelihood,
become increasingly important. It is predicted that the existential approach in therapy
will then become more widely used.
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OTHER CONTEMPORARY THERAPY
ADLERIAN THERAPY/ INDIVIDUAL
PSYCHOLOGY
REALITY THERAPY
FAMILY SYSTEMS THERAPY
FEMINIST THERAPY
EMDR
ECLECTIC COUNSELING
INTEGRATIVE
COUNSELING
GROUP THERAPY
ADLERIAN THERAPY/ INDIVIDUAL PSYCHOLOGY
Adlerian Therapy, originated by Alfred Adler, is also
called individual psychology and focuses on creating a
therapeutic relationship that is cooperative,
encouraging and practical. Alfred Adler was a major
contributor to the development of the psychodynamic
approach to therapy. After 810 years of collaboration,
Freud and Adler parted company, with Freud taking
the position that Adler was a heretic who had deserted
him. Adler founded the Society for Individual
Psychology in 1912.
Alfred W. Adler
(February 7, 1870 May 28, 1937)
Other Freudian revisionists included Karen Horney, Erich Fromm, and Harry Stack
Sullivan (neoFreudians) agreed that social and cultural factors were of great
significance in shaping personality. They are called neoFreudian because they moved
away from Freud's biological and deterministic point of view toward Adler's social
psychological and goaloriented view of human nature. After Adler's death in 1937,
Rudolf Dreikurs was the most significant figure in bringing Adlerian psychology.
Dreikurs is credited with the idea of child guidance centers and training professionals
to work with a wide range of clients. Adlerian counselors help clients look at their
lifestyle and personal values to help them understand and question their usual patterns
of behavior and hidden goals. It is a learning process that assists the client to move
towards useful involvement and contribution to society.
Basic Philosophy
Adlerian concept of social interest is the individual's feeling of being part of a
whole, spanning the past, present, and the future. Adler believed that people were
mainly motivated toward this feeling of belonging. He did not believe that social
interest was innate but rather a result of social training.
Adler expressed that people strove to become successful and overcome the areas
that they perceived as inferior. He referred to this process of personal growth as
Essentials of Counseling 167
striving for perfection. Those who did not overcome feelings of inferiority
developed an inferiority complex. Those who overcompensated for feelings of
inferiority developed a superiority complex.
Adler believed that a person's conscious behavior, not their unconscious, was the
mainstay of personality development. Because of this concept, Adlerian theory
emphasizes personal responsibility for how the individual chooses to interpret and
adjust to life's events or situations.
Maladjustment is defined in Adlerian theory as choosing behavior resulting in a
lack of social interest or personal growth. Adler believed that misbehavior would
take place when the person had become discouraged or when positive attempts at
good behavior had failed to get the needed results. Encouragement to good
behavior was often the recommended antidote to misbehavior.
Another concept is that of teleology, which simply put means that a person is as
influenced by future goals as by past experiences.
Adlerian espoused the belief that the birth of each child changed the family
substantially. He thought that the birth order of the children in the family
influenced many aspects of their personality development. Briefly, characteristics
of these birth positions are
Oldest children are usually high achievers, parent pleasers, conforming, and are
well behaved. Second born children are more outgoing, less anxious, and less
constrained by rules than first born. They usually excel as what the first born does
not. Middle children have a feeling of being squeezed in and are concerned with
perceived unfair treatment. These children learn to excel in family politics and
negotiation. However, they can become very manipulative. This position also
tends to develop areas of success that are not enjoyed by their siblings. Youngest
child is the most apt at pleasing or entertaining the family. While they run the risk
of being spoiled, they are also the most apt at getting what they want through their
social skills and ability to please. They are often high achievers, because of the
role models of their older siblings.
Only children or children born seven or more years apart from siblings are more
like first born children. Children with no siblings often take on the characteristics
of their parents' birth order, as the parents are the only role models. While these
children may mature early and be high achievers, they may lack socialization
skills, expect pampering, and be selfish.
Adler saw the family as the basic socialization unit for the child. He believed that
children's interpretation of the events in their life was determined by the
interaction with family members before the age of five. The family interactions
168 Counseling Approaches
taught the children to perceive events and situations through certain subjective
evaluations of themselves and the environment. These perceptions that guided the
children's behavior were called fictions. Basic mistakes could be made based on
these fictions. Adlerians believe that some of those mistakes are (Mozak, 1984)
Overgeneralizing in which the individual believes that everything is the same
or alike.
False or impossible goals of security which leads the individual to try to please
everyone in seeking security and avoiding danger.
Misperception of life and life's demands which leads the individual to expect
more accommodation than is reasonable and to interpret their failure to get
accommodation as never getting any breaks.
Minimization or denial of one's worth results in the individual believing that
they cannot be successful in life.
Faulty values results in a 'me first' mentality with little or no regard for others.
Adler believed that life took courage or a willingness to take risks without
knowing the outcome. He believed that a person with a healthy life style
contributed to society, had meaningful work, and had intimate relationships. He
espoused cooperation between the genders as opposed to competition. He believed
that well adjusted people lived in an interdependent relationship with others in a
cooperative spirit.
Key Concepts: It stresses the unity of personality, the need to view people from their
subjective perspective, and the importance of life goals that give direction to
behavior. People are motivated by social interest and by finding goals to give life
meaning. Other key concepts are striving for significance and superiority, developing
a unique lifestyle, and understanding the family constellation. Therapy is a matter of
providing encouragement and assisting clients in changing their cognitive perspective.
Role of the Counselor
The counselor is as a diagnostician, teacher and model.
The counselor helps the client to explore conscious thoughts, beliefs and logic for
behaviors that are not in the client's best interest or social interest.
The counselor encourages the client to behave 'as if' the client were who they
wished to be and often provides the client with 'homework' assignments outside
the sessions.
Goals of Therapy
To challenge client's basic premises and life goals.
Essentials of Counseling 169
To offer encouragement so individuals can develop socially useful goals.
To develop the client's sense of belonging.
Therapeutic Relationship: The emphasis is on joint responsibility, mutually
determining goals, mutual trust and respect, and equality. A cooperative relationship
is manifested by a therapeutic contract. Focus is on identifying, exploring, and
disclosing mistaken goals and faulty assumptions within the person's lifestyle.
Techniques of Therapy: Adlerians pay more attention to the subjective experiences
of clients than to using techniques. Some techniques include gathering lifehistory
data (family constellation, early recollections, personal priorities), sharing
interpretations with clients, offering encouragement, and assisting clients in searching
for new possibilities.
Most commonly used are establishing rapport, defining style of life and helping
the client to gain insight.
Confrontation consists of challenging the client's private logic and behavior.
Asking 'the Question' consists of asking the client how their life would be
different if they were well. The question often asked to parents is what would be
the problem if this child were not the problem?
Encouragement consists of the counselor supporting the client by stating the belief
in the client's ability to take responsibility and change behavior.
Acting 'as if' consists of instructing the client to behave 'as if' there were no
problem or as the person that the client would like to be.
Spiting in the Client's soup means that the counselor points out the purpose of the
client's behavior. Afterward, the client may continue the behavior, but cannot do
so without being aware of their motivation for engaging in the behavior.
Catching oneself consist of helping the client learn to bring destructive behavior
into awareness and stop it.
Task setting consists of helping the client set shortterm goals leading toward the
attainment of longterm goals.
Therapeutic Procedures
Four phases not linear; and do not progress in rigid steps; can best be understood as a weaving that
leads to a tapestry
1. Establishing the proper therapeutic relationship.
2. Exploring the psychological dynamics operating in the client (an assessment).
3. Encouraging the development of selfunderstanding (insight into purpose).
4. Helping the client make new choices (reorientation and reeducation).
Establishing the Relationship: Working with clients is based on a sense of deep caring, involvement,
and friendship. Adlerian therapists seek to make persontoperson contact with clients rather than
170 Counseling Approaches
starting with 'the problem'. The initial focus should be on the person, not the problem. Therapists start
by helping clients become aware of their assets and strengths, rather than dealing continually with their
deficits and liabilities. A positive relationship is created by listening, responding, demonstrating respect
for clients' capacity to understand purpose and seek change, and exhibiting faith, hope and caring.
Adlerians pay more attention to the subjective experiences of the client than they do to using
techniques. They fit their techniques to the need of each client. During this phase, the main techniques
used are attending and listening with empathy, following the subjective experience of the client as
closely as possible, identifying and clarifying goals, and suggesting initial hunches about purpose in
client symptoms and actions. They attempt to access the core patterns in the client's life.
Exploring the Individual's Dynamics: The second phase consists of two interview forms the
subjective interview and the objective interview. In subjective interview the counselor helps the client
to tell their story as completely as possible. What the clients says will spark an interest in the counselor
and lead, to the next most significant question about the client. The Adlerian counselor is listening for
clues to the purposive aspects of the client's coping and approaches to life. The subjective interview
should extract patterns in the person's life, develop hypotheses about what works for the person, and
determine what accounts for the various concerns in the client's life. Adlerians end a subjective
interview with this question, "How would your life be different, and what would you do differently, if
you did not have this symptom or problem?" The objective interview (a) how problems in the client's
life began; (b) any precipitating events; (c) a medical history; (d) a social history; (e) the reasons the
client chose therapy at this time; (f) the person's coping with life tasks; (g) a lifestyle assessment.
The family constellation Factors such as cultural and familial values, genderrole expectations, and
the nature of interpersonal relationships are all influenced by a child's observation of the interactional
patterns within the family. Assessment includes an exploration of the client's family constellation,
including the client's evaluation of conditions that prevailed in the family when the person was a young
child, birth order, parental relationship, family values, and extended family and culture. Early
recollections Asking the client to provide their earliest memories, including the age of the person at
the time of the remembered events and the feelings or reactions associated with it. Early memories cast
light on the 'story of our life', because they represent metaphors for our current views. The counselor
might say "I would like to hear about your early memories. Think back to when you were very young,
as early as you can remember, and tell me something that happened one time". The counselor will then
ask "What part stands out to you? If you played the whole memory like a movie and stopped it at one
frame, what would be happening? Putting yourself in that moment, what are you feeling? What's your
reaction? Three memories are usually considered a minimum to assess a pattern. Personality priorities
people rely on a numberone priority, a first line of defense that they use as an immediate response to
perceived stress or difficulty (Kefir, 1981). Each priority involves a dominant behavior pattern with
supporting convictions that an individual uses to cope. (a) Superiority striving for significance
through leadership, or accomplishment; (b) Control looking for guarantees against ridicule a need
for complete mastery of situations; (c) Comfort wanting to avoid stress or pain at all costs; (d) Please
avoiding rejection by seeking constant approval and acceptance. Integration Integrated summaries of
the data are developed and presented to the client for discussion. Mosak (2000) common basic mistakes
(1) Overgeneralizations; (2) False or impossible goals; (3) Misperceptions of life and life's demands;
(4) Minimization or denial of one's basic worth; and (5) Faulty values.
Encouraging Selfunderstanding and Insight: Adlerians believe almost everything in human life has a
purpose. When speaking of insight, Adlerians are referring to an understanding of the motivations that
Essentials of Counseling 171
operate in a client's life a special form of awareness that facilitates a meaningful understanding within
the therapeutic relationship and acts as a foundation for change. Disclosure and welltimes
interpretations are techniques that facilitate the process of gaining insight. They are hunches or guesses
and they are often stated "It seems to me that . . ."; "Could it be that . . ." or "This is how it appears to
me . . ."
Helping with Reorientation: The actionoriented phase helping people discover new and more
functional alternatives. People need to be reoriented to the useful side of life. The useful side of life
involves a sense of belonging and being values, having an interest in others and their welfare, courage,
the acceptance of imperfection, confidence, a sense of humor, a willingness to contribute, and an
outgoing friendliness. Encouragement is the most distinctive Adlerian procedure and is central to all
phases of counseling and therapy. As a part of the encouragement process, Adlerians use a variety of
cognitive, behavioral, and experiential techniques to help clients identify and challenge selfdefeating
cognitions, generate perceptional alternatives, and make use of assets, strengths, and resources. Clients
are encouraged to 'as if' they were the people they want to be. Clients are asked to catch themselves in
the process of repeating old patterns. Commitment is an essential part of this process. Adlerian
practitioners focus on motivation modification more than behavior change and encourage clients to
make holistic changes on the useful side of living.
Applications: Because the approach is based on a growth model, it is applicable to
such varied spheres of life as child guidance, parent/child counseling, marital and
family therapy, individual counseling with all age groups, correctional and
rehabilitation counseling, group counseling, substance abuse programs, and brief
counseling. It is ideally suited to preventive care and alleviating a broad range of
conditions that interfere with growth.
Multiculturalism: Its focus on social interest, collectivism, pursuing meaning in life,
importance of family, goal orientation, and belonging is congruent with many
cultures. Focus on personinenvironment allows for cultural factors to be explored.
Some clients may view the counselor as an authority who will provide answers to
problems, which conflicts with the egalitarian, persontoperson spirit as a way to
reduce social distance.
Contributions: One of the first approaches to therapy that was humanistic, unified,
holistic, and goal oriented and that put an emphasis on social and psychological
factors. A key contribution is the influence that Adlerian concepts have had on other
systems and the integration of these concepts into various contemporary therapies.
Limitations: Weak in terms of precision, testability, and empirical validity. Few
attempts have been made to validate the basic concepts by scientific methods. Tends
to oversimplify some complex human problems and is based heavily on common
sense.
172 Counseling Approaches
REALITY THERAPY
Reality Therapy (RT) is based on a concept called 'Choice Theory' (originally called
Control Theory). RT is a particular approach in psychotherapy and counseling.
Reality therapy was developed by William Glasser, a psychiatrist in the 1960s.
Glasser believes that people who are behaving in
inappropriate ways do not need help to find a defense
for their behavior. Instead, they need help to
acknowledge their behavior as being inappropriate
and then to learn how to act in a more logical and
productive manner. Reality therapy attempts to help
people control the world around them more
effectively so that they are better able to satisfy their
needs. RT approach to counseling and problem
solving focuses on the hereandnow of the client and
how to create a better future, instead of concentrating
at length on the past.
Dr. William Glasser
(May 11, 1925 – August 23, 2013)
It emphasizes making decisions, and taking action and control of one's own life.
Typically, clients seek to discover what they really want and whether what they are
currently doing (how they are choosing to behave) is actually bringing them nearer to,
or further away from, that goal. Reality Therapy is a considered a cognitive
behavioral approach to therapy; that is, it focuses on facilitating the client to become
aware of, and if necessary, change, his/her thoughts and actions.
William Glasser maintains that people act on a conscious level and that they are not
driven by instincts and the unconscious. Glasser believes that there is a health/growth
forces in every person that seeks both physical and psychological health/growth. He
separates these into the old brain or primitive physical needs and into the new brain or
psychological needs. While the old brain contents itself with maintaining life, the new
brain seeks belonging, power, freedom and fun. Glasser believes that identity or a
healthy sense of self is necessary. A success identity comes from being loved and
accepted. A failure identity comes from not having needs for acceptance, love and
worth met. A person must experience identity before they can perform a task. Glasser
espouses two critical periods of development in children
Children ages 2 to 5 first learn socialization and learn to deal with frustrations and
disappointments. Children not getting support and love from their parents during
this critical time begin to establish a failure identity.
Essentials of Counseling 173
The second critical period is between 5 and 10 years or the early school years.
Children who have socialization or academic problems may establish a failure
identity.
Glasser suggests that human learning is a lifelong process; therefore, one can change
one's identity at any time in one's personal history by learning what needs to be
learned. Glasser believes that humans are selfdetermined. He believes that each
person has within themselves a picture or perception of themselves. Each person then
behaves in a way that is determined or controlled by this image of self so that the self
image can be maintained. This control theory has three parts 'B' is the behavior. 'C'
is the control, where a comparison is made between the desired image and the image
the behavior is producing. 'P' is the perception or the development of the image.
Basic Philosophy
Humans are selfdetermining.
Humans change when they determine their behavior is not getting them what they
want & when they believe they have choices of behaviors.
People choose total behavior, hence responsible for acting, thinking, feeling, and
psychological states.
Behavior is aimed to satisfy needs for survival, love and belonging, power,
freedom, and fun.
Acting and thinking are chosen behaviors (changing acting and thinking
influences feelings and physiological states).
Choice theory explains how people attempt to control their world and teaches
ways to satisfy needs and wants in effective manners.
Key Concepts: The basic focus is on what clients are doing and how to get them to
evaluate whether their present actions are working for them. People create their
feelings by the choices they make and by what they do. The approach rejects the
medical model, the notion of transference, the unconscious, and dwelling on one's
past. The key terms are
Autonomy state of accepting responsibility and taking control of self (life).
Commitment not skewing from the plan for change.
Choice Theory humans are internally motivated and have a purpose to control
behaviors; humans are selfdetermined and create own destiny (all elements of
behavior are interrelated).
Cycle of Counseling any means to create a positive environment in counseling,
based on personal involvement and procedures for change to occur.
Involvement counselor's interest in and caring for clients.
174 Counseling Approaches
Paining Behaviors people choose misery by developing symptoms (headache,
depression, anxiety) because at the time they seem to be the best behaviors to
execute for survival.
Perceived World the reality we experience and interpret.
Psychological Needs needs for belonging, power, freedom, and fun that drive
people and explain behaviors.
Quality World perceptions and images we have to fulfill our basic psychological
needs.
Responsibility satisfying personal needs while not interfering with people who
fulfill their needs.
SelfEvaluation clients' assessment of current behaviors in order to determine if
their behaviors are working and if behaviors are meeting their needs.
Total Behavior integrated components of doing, thinking, feeling, and
physiology.
WDEP System procedures that are applied to the practice of reality therapy
groups; strategies help clients identify their wants; determine direction behaviors
take them, selfevaluations, and designs plans for change. Where, W = wants,
explore wants, needs and perceptions; D = direction and doing, focus on what
clients are doing and the direction they are headed; E = evaluation, challenge
clients to evaluate their total behavior (continual basis); P = planning and
commitment, assist in the formulation of realistic plans and making commitment
to carry out plans.
Role of the Counselor
Counselor is a teacher and a model to the client.
Counselor creates an atmosphere of acceptance and warmth helping the client
focus on the control of displayed thoughts and actions.
Reality counselor used 'ing' verbs to help the clients describing their thoughts and
actions, i.e., angering, bullying, intimidating, excusing.
Focus of therapy is on the behavior that the client needs or wants to change and
how to change that behavior in a positive manner.
Reality therapy does not generally use formal assessment techniques or diagnostic
categories.
Goals of Therapy
Overall goal assist clients to better meet their needs for love, belonging, survival,
power, freedom, and fun.
Essentials of Counseling 175
Help clients gain psychological strength, accept personal responsibility, regain
control of lives.
Challenge clients to examine what they are doing, thinking, and feeling.
Help the client to develop a practical plan to accomplish their personal needs and
desires.
Counselor helps the client put the past behind and focus on the present and the
outcome of present behaviors.
To help people become more effective in meeting their needs.
Teach client to selfevaluate behaviors and determine what they want to change.
Therapeutic Relationship
Counselors are involved with clients from outset and create warm, supportive, and
challenging relationship (clients must know that counselors are for them).
Involvement with and concern for are conveyed throughout the counseling
process.
Once trust is established, counselors confront clients with reality and
consequences of their actions.
Counselors avoid criticism, accepting excuses, and giving up on clients.
Assist clients to continually assess effectiveness and appropriateness of their
behaviors.
Techniques of Therapy: Various techniques may be used to get clients to evaluate
what they are presently doing to see if they are willing to change. If they decide that
their present behavior is not effective, they develop a specific plan for change and
make a commitment to follow through. The main technique has three basic steps
Through involvement with the client, the counselor helps the client to see the
reality and understand how a behavior is unrealistic.
The counselor separates the client from the behavior and rejects the behavior
without rejecting the client.
The final step is to teach the client how to fulfill their needs realistically and
positively.
Glasser uses humor to point out absurdity without being sarcastic.
Glasser uses confrontation to help the client accept responsibility for behavior.
The eight steps that reality therapy uses to accomplish its goals and techniques
1. Establishing a relationship.
2. Focusing on present behavior.
3. Client evaluation of his/her behavior.
4. Developing a contract or plan of action.
176 Counseling Approaches
5. Getting a commitment from the client.
6. Not accepting excuses.
7. Allowing reasonable consequences but refusing to use punishment.
8. Refusing to give up on the client.
Glasser's final technique is "Never Give Up".
Applications: It has been applied to
Youth offenders (detention facilities);
Variety of behavioral problems;
Individual and group counseling & marital and family counseling;
Military;
Drug and alcohol clinics;
Teaching and administration;
Social work, crisis intervention, and management & community development.
Multiculturalism
Focus is on members, making own evaluation of behavior (including how they
respond to their culture).
Through personal assessment they can determine the degree to which their needs
and wants are being satisfied.
They can find a balance between retaining their own ethnic identity and
integrating some of the values and practices of the dominant society.
This approach stresses taking charge of one's own life, yet some clients hope to
change their external environment.
Counselor needs to appreciate the role of discrimination and racism and help
clients deal with social and political realities.
Respect difference in worldviews and cultural values.
Skillful questioning will help assess how ethnic minorities have acculturated.
Contributions
Shortterm approach with wide range of clients.
Due to the direct methods, it appeals to many clients who are often seen as
resistant to therapy.
Simple and clear concepts, can be used by parents, teachers, educators, nurses,
ministers, managers, consultants, supervisors, counselors and social workers.
Positive, actionoriented approach.
Accepting personal responsibility and gaining effective control.
People take charge of their lives.
Focus for what clients are willing to do in the present
Essentials of Counseling 177
Limitations
Discounts the therapeutic value of exploring the client's past, dreams, the
unconscious, early childhood experiences, and transference.
The approach is limited to less complex problems. It is a problemsolving therapy
that tends to discourage exploration of deeper emotional issues.
Direct questioning needs to be softened when working with ethnic minorities.
At times choice is not an option, discrimination and racism are reality.
Minority clients may be hesitant to state what they need.
FAMILY SYSTEMS THERAPY
A psychiatrist and theorician Murray Bowen
produced a remarkable new theory of human
behavior called 'Family Systems Theory', or
'Bowen Theory'. Family systems theory is also
referred to as couple therapy, family therapy, and
marriage therapy. This theory has the potential to
replace most of Freudian theory and to radically
change treatment approaches, not only in
psychiatry, but in all of medicine. Potential
applications of this therapy extend beyond the
human family to nonfamily groups, including
large organizations and society as a whole.
Dr. Murray Bowen
(January 31, 1913 – October 9, 1990)
Family therapy is a type of psychotherapy that works with families and couples. It
helps families or individuals within a family, understand and improve the way family
members interact with each other and resolve conflicts.
It emphasizes family
relationships as an important factor in psychological health. Family therapists tend to
focus on what goes between people; that is, on how patterns of interaction within the
family may foster or maintain the problem. A family therapist can be a member of
any number of health professions. They may be psychologists, psychiatrists, social
workers, nurses or simply people who have been trained in the use of one or more
types of family therapy. Family therapy can take many different forms with the
therapist using a variety of different approaches including supportive counseling,
cognitivebehavioral techniques, psychodynamic techniques, or what is known as a
systemic approach. Most practitioners are 'eclectic', using techniques from several
areas, depending upon the needs of the client.
Basic Philosophy
The family is viewed from an interactive and systemic perspective.
178 Counseling Approaches
Human functioning is governed by principles common to all life forms.
Human life is guided primarily by emotional, instinctive forces that can be
regulated to some extent by an individual's ability to think. Human emotional
forces and behavior are influenced by the interplay among instinctual, biological,
genetic, psychological, and sociological factors.
The family is a single emotional unit made up of interlocking relationships
existing over many generations.
An individual's behavior across the life span is best understood as being closely
related to the functioning of her/his family of origin.
When the individual is seen in her/his family context, we can move beyond
simplistic causeandeffect thinking to a more comprehensive understanding of
the multiple factors that interact across time to produce problems or symptoms.
People are able to modify their automatic, emotional responses by studying
patterns of automatic behavior in themselves and their family of origin, and
developing greater objectivity in their appraisal of situations and their felt
responses.
Clients are connected to a living system; a change in one part of the system will
result in a change in other parts.
Key Concepts
Focus is on communication patterns within a family, both verbal and nonverbal.
Problems in relationships are likely to be passed on from generation to generation.
Symptoms are viewed as ways of communicating with the aim of controlling
other family members.
Key concepts vary depending on specific orientation but include differentiation,
triangles, power coalitions, familyoforigin dynamics, functional versus
dysfunctional interaction patterns, family rules governing communication, and
dealing with hereandnow interactions.
The present is more important than exploring past experiences.
Goals of Therapy: Most approaches are aimed at helping family members gain
awareness of patterns of relationships that are not working well and create new ways
of interacting to relieve their distress. Some approaches focus on resolving the
specific problem that brings the family to therapy.
Therapeutic Relationship: The family therapist functions as a teacher, coach, model,
and consultant. The family learns ways to detect and solve problems that are keeping
members stuck, and it learns about patterns that have been transmitted from
generation to generation. Some approaches focus on the role of therapist as expert;
Essentials of Counseling 179
others concentrate on intensifying what is going on in the here and now of the family
session. All family therapists are concerned with the process of family interaction and
teaching patterns of communication.
Techniques of Therapy: There is a diversity of techniques, depending on the
particular theoretic orientation. Interventions may target behavior change, perceptual
change, or both. Techniques include using genograms, teaching, asking questions,
family sculpting, joining the family, tracking sequences, issuing directives, anchoring,
use of countertransference, family mapping, refraining, paradoxical interventions,
restructuring, enactments, and setting boundaries. Techniques may be experiential,
cognitive, or behavioral in nature. Most are designed to bring about change in a short
time.
Applications: Applications vary depending on the particular approach to family
therapy. Family therapy is frequently shortterm and may be used in addition to other
types of treatment, particularly for certain psychological disorders that require more
indepth treatment. Useful for dealing with
Marital distress;
Problems of communicating among family members;
Power struggles;
Parenting issues;
Crisis situations in the family;
Child & adolescent behavior;
Selfharm, drug, alcohol & other substance misuse;
Supporting family members through separation, mediation and divorce;
Emotional disorders including anxiety, depression, loss and grief;
Anorexia, bulimia and other eating disorders;
Supporting family members in stepfamily life;
Emotional abuse or violence;
Helping individuals attain their potential, and
Enhancing the overall functioning of the family.
Multiculturalism: Many ethnic and cultural groups place value on the role
of the extended family. Many family therapies deal with extended family members
and with support systems. Networking is a part of the process, which is congruent
with the values of many clients. There is a greater chance for individual change if
other family members are supportive. This approach offers ways of working
toward the health of the family unit and the welfare of each member. Some
approaches are based on value assumptions that are not congruent with the values of
180 Counseling Approaches
clients from other cultures. Concepts such as individuation, selfactualization,
selfdetermination, independence, and selfexpression may be foreign to some
clients. In some cultures, admitting problems within the family is shameful. The value
of keeping problems within the family may make it difficult to explore conflicts
openly.
Contributions: In all of the systemic approaches, neither the individual nor the
family is blames for a particular dysfunction. The family is empowered through the
process of identifying and exploring interactional patterns. Working with an entire
unit provides a new perspective on understanding and working through both
individual problems and relationship concerns. By exploring one's family of origin,
there are increased opportunities to resolve other relationship conflicts outside of the
family.
Limitations
Limitations include problems in being able to involve all the members of a family
in the therapy.
Members may be resistant to changing the structure of the system.
Therapists' selfknowledge and willingness to work on their own familyoforigin
issues is crucial, for the potential of countertransference is high.
It is essential that the therapist be well trained, receive quality supervision, and be
competent in assessing and treating individuals in a family context.
FEMINIST THERAPY
Feminist Therapy derived from radical women uniting for change in the 1960s during
the Feminist Movement. It was developed by a numbers of feminist therapists Jean
Baker Miller (1927 2006), Carol Gilligan (1936 ), Carolyn Enns (1946 ) and
others. Feminist therapy grew out of concerns that established therapies were not
helping women. Specific concerns of feminist therapists included gender bias and
stereotyping in therapy; blaming victims of physical abuse and sexual abuse; and the
assumption of a traditional nuclear family. In feminist therapy, gender is the primary
focus; therapists must understand and be sensitive to how psychological oppression
and socialization influences identity development. Feminist therapy also focuses on
women's empowerment; communication, assertiveness, selfesteem and helping
women discover how to break free from some of the traditional roles that they may
feel are hindering their growth and development.
Essentials of Counseling 181
Feminist therapy also focuses on making
gender issues transparent enough that women
are both empowered and changed by engaging
in actively understanding how certain issues
affect their behavior (Mahaney, 2007).
According to Corey (2008), feminist therapists
understand that the client and the therapist
are not equally yoked, but when the therapist
gives the client a sense of control they are best able to understand their situation. The
main goal of feminist therapy is not just to change the individual's situation or
mindset, but also to form a revolution that changes the way society views gender
issues.
Feminist therapy strives to prevent psychological distresses and inappropriate
behavior in both genders. Also, feminist therapy attempts to remedy the stereotypes
derived from the traditional views on gender which can affect one's identity.
Basic Philosophy
Feminists criticize many traditional theories to the degree that they are based on
genderbiased concepts and practices of being androcentric, gendercentric,
ethnocentric, heterosexist, and intrapsychic.
This therapy is genderfree, flexible, interactionist, and lifespanoriented.
Eight basis philosophies (separate views on social oppression to determine how to
transform society. Each philosophy focuses on diversity, gender issues, and
sexism) Liberal; Cultural; Radical; Socialist; Postmodern; Women of color;
Lesbian; and Global/International.
Gender is central focus; therapists must understand and be sensitive to how
psychological oppression and socialization influence identity development.
Key Concepts: Core principles that form the foundation for practice of feminist
therapy are the personal is political, the counseling relationship is egalitarian,
women's experiences are honored, definitions of distress and psychological illness are
reformulated, emphasis on gender equality, and commitment to confronting
oppression on any grounds.
Key Concepts
Androcentric theory a theory that uses maleoriented constructs to draw conclusions about human
nature.
Egalitarian relationship relationship where power is balanced.
182 Counseling Approaches
Ethnocentrism believing that one's cultural group is superior to others, other groups are based on
one's personal standards.
Gendercentrism two developmental paths for men and women.
Genderneutral theory explains the differences between men's and women's behavior in terms of
socialization.
Genderrole analysis helps clients understand the impact of genderrole expectations.
Genderrole intervention provides insight into ways how social issues affect problems.
Gender schema psychological associations, interpretations are based on perceptions about gender.
Heterosexism heterosexual orientation is normative and desirable; devalues same sex relationships.
Lifespan perspective human development is a lifelong process; personality patterns and behavior
changes occur at any time during development.
Personal is political client problems have social and political causes; therapists focus on helping
clients change behaviors and become active participants to transform society.
Power analysis emphasizes power differences between men and women in society; clients recognize
the different types of power they possess and power is exercised.
Reframing therapist changes the frame of reference for looking at behaviors; shift from intrapersonal
(blame the victim) stance to consideration of societal factors that contribute to one's problems.
Relabeling changing the label/evaluation that has been applied to clients' behaviors; shift is from
negative to positive evaluation.
Relationalcultural theory a perspective that suggests a woman's identity and selfconcept develop in
the context of relationships.
Selfinrelation women's sense of self is largely dependent on they connect with others.
White privilege invisible package of unearned assets White people enjoy are not offered to people of
color.
Societal genderrole messages influence how people view themselves and behave.
Ethnicity, sexual orientation, and class may be important factors.
Gender cannot be considered apart from other identity areas (race, ethnicity,
sexual orientation, etc.).
Problematic symptoms are viewed as coping/survival strategies.
Six interrelated principles
Personal is political;
Personal and social identities are interdependent;
Definitions of distress and mental illness are reformulated;
Use of integrated analysis of oppression;
Egalitarian relationship; and
Women's perspectives valued.
Goals of Therapy
To bring about transformation both in the individual client and in society.
Five specific goals are Equality; Balancing independence and interdependence;
Empowerment; Selfnurturance; and Valuing diversity.
Essentials of Counseling 183
For individual clients the goal is to assist them in recognizing, claiming, and using
their personal power to free themselves from the limitations of genderrole
socialization.
To confront all forms of institutional policies that discriminate on the basis of
gender.
Therapeutic Relationship
The therapeutic relationship is based on empowerment and equalizing power
(egalitarianism).
Therapists actively break down the hierarchy of power and reduce artificial
barriers by engaging in appropriate selfdisclosure and teaching clients about the
therapy process.
Structure of the relationship models how to responsibly identify and use power.
There is mutuality, clienttherapist authentic connection.
Therapist demystifies counseling; client is an active partner in assessment and
treatment.
Teach clients to recognize how they define themselves and how they relate to
others (genderrole expectations).
Techniques of Therapy: Although techniques from traditional approaches are used,
feminist practitioners tend to employ consciousnessraising techniques aimed at
helping clients recognize the impact of genderrole socialization on their lives. Other
techniques frequently used include genderrole analysis and intervention, power
analysis and intervention, bibliotherapy, journal writing, therapist selfdisclosure,
assertiveness training, reframing and relabeling, cognitive restructuring, identifying
and challenging untested beliefs, role playing, psychodramatic methods, group work,
and social action.
Applications: Principles and techniques can be applied to a range of therapeutic
modalities such as individual therapy, relationship counseling, family therapy, group
counseling, and community intervention. The approach can be applied to both women
and men with the goal of bringing about empowerment.
Multiculturalism: Both individual change and social transformation are the ultimate
goals of therapy. A key contribution is that both the women's movement and the
multicultural movement have called attention to the negative impact of discrimination
and oppression for both women and men. One criticism is that feminist therapy was
developed by White, middle class, heterosexual women. Based on the feminist
notions of collaborative relationships, selfdetermination, and empowerment,
therapists need to assess with their clients the price of making significant personal
184 Counseling Approaches
change. If this assessment is not made, clients in certain cultures may experience
isolation as a result of making life changes or of assuming a new role.
Contributions
Integrate concepts with other theories;
Genderfree, flexible, interactional, lifespanoriented;
Positive, egalitarian attitude toward women and men;
Confront patriarchal systems;
Emphasizes context of women's lives (not symptoms and behaviors);
Sensitizes counselors to gendered uses of power in relationships;
Battered women's shelters, rapecrisis centers, women's health and reproductive
health centers;
Establish policies to lessen discrimination of all types;
Feminist principles applied to supervision, teaching, consultation, ethics, research,
theory building, and the practice of psychotherapy;
Community building, authentic mutual empathic relationships, sense of social
awareness, and social change.
Limitations
No neutral stance because advocate for change in social structure.
Counselors may impose values on clients.
No decisionmaking for clients.
Feminist therapy is based on White, middle class, heterosexual women.
EMDR
(Eye Movement Desensitization and Reprocessing)
Eye Movement Desensitization and Reprocessing
(EMDR) is a comprehensive, integrative psychotherapy
approach. It contains elements of much effective
psychotherapy in structured protocols that are designed to
maximize treatment effects. These include
psychodynamic, cognitive behavioral, interpersonal,
experiential, and bodycentered therapies. Shapiro's
(2001) Adaptive Information Processing (AIP) model
posits that EMDR facilitates the accessing and processing
Dr. Francine Shapiro
(February 18, 1948 to present)
of traumatic memories and other adverse life experience to bring these to an adaptive
resolution. More than 20,000 practitioners have been trained to use EMDR since
psychologist Francine Shapiro developed the technique in 1989. EMDR appears to be
a safe therapy, with no negative side effects. After successful treatment with EMDR,
Essentials of Counseling 185
affective distress is relieved, negative beliefs are reformulated, and physiological
arousal is reduced.
What Is EMDR?
Eye Movement Desensitization and Reprocessing is a powerful counseling technique
which has been very successful in helping people who suffer from trauma, anxiety,
panic, disturbing memories, post traumatic stress and many other emotional problems.
Until recently, these conditions were difficult and timeconsuming to treat. EMDR is
considered a breakthrough technique because of its simplicity and the fact that it can
bring quick and lasting relief for most types of emotional distress.
EMDR uses a technique called bilateral stimulation, (using right/left eye movement,
or tactile stimulation), which repeatedly activates the opposite sides of the brain,
releasing emotional experiences that are "trapped" in the nervous system. This assists
the neurophysiological system (the basis of the mind/body connection) to free itself
of blockages and reconnect itself.
What Can You Expect From EMDR?
Although most research into EMDR has examined its use in people with PTSD (Post
Traumatic Stress Disorder), EMDR is also used to treat many other psychological
problems. They include
Injury or Loss of a Loved One
Car Accident or Work Related Accidents & Injuries
Witness of Violent Crimes/Post Traumatic Stress
Test Anxiety/Relational Anxiety
Trouble Sleeping/Worrying/Phobias/Fears
Low SelfEsteem/Bad Temper/Panic Attacks
Physical, Emotional, Verbal & Sexual Abuse/Rape
Natural Disasters/Fire/Childhood Trauma & Abuse
Depression/Anger/Sadness/Assault
Eating Disorders/Performance Anxiety
High Anxiety/Lack of Motivation
Memories of a Traumatic Experience
Fear of Being Alone
Unrealistic Feelings of Guilt and Shame
Difficulty in Trusting Others
Relationship Problems.
186 Counseling Approaches
The EMDR technique is most effective when used in conjunction with other
traditional methods of therapy in treating these and many other emotional disorders.
EMDR therapy can help clients replace their anxiety and fear with positive images,
emotions and thoughts.
Eight Phases of Treatment
EMDR psychotherapy is an information processing therapy and uses an eight
phase approach to address the experiential contributors of a wide range of
pathologies. It attends to the past experiences that have set the groundwork for
pathology, the current situations that trigger dysfunctional emotions, beliefs and
sensations, and the positive experience needed to enhance future adaptive behaviors
and psychological health.
Phase 1: History and Treatment Planning: Generally takes 12 sessions at the
beginning of therapy, and can continue throughout the therapy, especially if new
problems are revealed. In the first phase of EMDR treatment, the therapist takes a
thorough history of the client and develops a treatment plan. Client and therapist
identify possible targets for EMDR processing. These include recent distressing
events, current situations that elicit emotional disturbance, related historical incidents,
and the development of specific skills and behaviors that will be needed by the client
in future situations.
Initial EMDR processing may be directed to childhood events rather than to adult
onset stressors or the identified critical incident if the client had a problematic
childhood. Clients generally gain insight on their situations, the emotional distress
resolves and they start to change their behaviors. The length of treatment depends
upon the number of traumas and the age of the problem onset. Generally, those with
single event adult onset trauma can be successfully treated in less than 5 hours.
Multiple trauma victims may require a longer treatment time.
Phase 2: Preparation: For most clients this will take only 14 sessions. For others,
with a much traumatized background, or with certain diagnoses, a longer time may be
necessary. One of the primary goals of the preparation phase is to establish a
relationship of trust between the client and the therapist. During the second phase of
treatment, the therapist ensures that the client has several different ways of handling
emotional distress. The therapist may teach the client a variety of imagery and stress
reduction techniques the client can use during and between sessions. A goal of EMDR
is to produce rapid and effective change while the client maintains equilibrium during
and between sessions.
Essentials of Counseling 187
During the second phase of treatment, the therapist ensures that the client has
adequate methods of handling emotional distress and good coping skills, and that the
client is in a relatively stable state. If further stabilization is required, or if additional
skills are needed, therapy focuses on providing these. The client is then able to use
stress reducing techniques whenever necessary, during or between sessions.
Phase 3: Assessment: Used to access each target in a controlled and standardized
way so it can be effectively processed. Processing does not mean talking about it. For
a single trauma reprocessing is generally accomplished within 3 sessions. If it takes
longer, you should see some improvement within that amount of time. The clinician
identifies the aspects of the target to be processed. The first step is for the person to
select a specific picture or scene from the target event (which was identified during
Phase One) that best represents the memory. Then s/he chooses a statement that
expresses a negative selfbelief associated with the event. Even if s/he intellectually
knows that the statement is false, it is important that s/he focus on it. These negative
beliefs are actually verbalizations of the disturbing emotions that still exist. During
the Assessment Phase, the person identifies the negative emotions (fear, anger) and
physical sensations (tightness in the stomach, cold hands) s/he associates with the
target. The client also rates the disturbance using the 0 (no disturbance)to10 (the
worst feeling you ever had) Subjective Units of Disturbance (SUD) scale. Then, the
positive cognition should reflect what is actually appropriate in the present. At this
point, the therapist will ask the person to estimate how true s/he feels his/her positive
belief is using the 1to7 Validity of Cognition (VOC) scale.
Phases One through Three lay the groundwork for the comprehensive treatment and
reprocessing of the specific targeted events. Although the eye movements (or taps, or
tones) are used during the following three phases, they are only one component of a
complex therapy. The use of the stepbystep eightphase approach allows the
experienced, trained EMDR clinician to maximize the treatment effects for the client
in a logical and standardized fashion. It also allows both the client and the clinician to
monitor the progress during every treatment session.
Phase 4: Desensitization: This phase focuses on the client's disturbing emotions and
sensations as they are measured by the SUDs rating. This phase deals with all of the
person's responses (including other memories, insights and associations that may
arise) as the targeted event changes and its disturbing elements are resolved. This
phase gives the opportunity to identify and resolve similar events that may have
occurred and are associated with the target. That way, a client can actually surpass
his/her initial goals and heal beyond his/her expectations.
188 Counseling Approaches
During desensitization, the therapist leads the person in sets of eye movement (or
other forms of stimulation) with appropriate shifts and changes of focus until his/her
SUDscale levels are reduced to zero (or 1 or 2 if this is more appropriate). Starting
with the main target, the different associations to the memory are followed. For
instance, a person may start with a horrific event and soon have other associations to
it. The clinician will guide the client to a complete resolution of the target.
Phase 5: Installation: The goal is to concentrate on and increase the strength of the
positive belief that the person has identified to replace his/her original negative belief.
During this fifth phase of treatment, the goal is to accept the full truth of positive self
statement at a level of 7 (completely true). If the person is aware that s/he actually
needs to learn some new skill, such as selfdefense training, in order to be truly in
control of the situation, the validity of his/her positive belief will rise only to the
corresponding level, such as a 5 or 6 on the VOC scale.
Phase 6: Body Scan: After the positive cognition has been strengthened and
installed, the therapist will ask the person to bring the original target event to mind
and see if s/he notices any residual tension in his/her body. If so, these physical
sensations are then targeted for reprocessing. Evaluations of thousands of EMDR
sessions indicate that there is a physical response to unresolved thoughts. This finding
has been supported by independent studies of memory indicating that when a person
is negatively affected by trauma, information about the traumatic event is stored in
motoric (or body systems) memory, rather than narrative memory, and retains the
negative emotions and physical sensations of the original event. When that
information is processed, however, it can then move to narrative (or verbalizable)
memory and the body sensations and negative feelings associated with it disappear.
Therefore, an EMDR session is not considered successful until the client can bring up
the original target without feeling anybody tension. Positive selfbeliefs are important,
but they have to be believed on more than just an intellectual level.
Phase 7: Closure: Closure ensures that the person leaves at the end of each session
feeling better than at the beginning. If the processing of the traumatic target event is
not complete in a single session, the therapist will assist the person in using a variety
of selfcalming techniques in order to regain a sense of equilibrium. Throughout the
EMDR session, the client has been in control and it is important that the client
continue to feel in control outside the therapist's office. S/he is also briefed on what to
expect between sessions (some processing may continue, some new material may
arise), how to use a journal to record these experiences, and which techniques s/he
might use on his/her own to help him feel calmer.
Essentials of Counseling 189
Phase 8: Re-evaluation: Opens every new session, the therapist checks to make
sure that the positive results (low SUDs, high VOC, no body tension) have been
maintained, identifies any new areas that need treatment, and continues
reprocessing the additional targets. The next session begins with phase eight, re
evaluation of the previous work, and of progress since the previous session. EMDR
treatment ensures processing of all related historical events, current incidents that
elicit distress, and future scenarios that will require different responses. The overall
goal is produce the most comprehensive and profound treatment effects in the shortest
period of time, while simultaneously maintaining a stable client within a balanced
system.
After EMDR processing, clients generally report that the emotional distress related to
the memory has been eliminated, or greatly decreased, and that they have gained
important cognitive insights. Importantly, these emotional and cognitive changes
usually result in spontaneous behavioral and personal change, which are further
enhanced with standard EMDR procedures.
How Does EMDR Work?
The counselor works gently with the client and asks him/her to revisit the traumatic
moment or incident, recalling feelings surrounding the experience, as well as any
negative thoughts, feelings and memories. They then hold their fingers about eighteen
inches from the clients face and begins to move them back and forth like a windshield
wiper (this can also be accomplished through hand taping or alternating auditory
sounds). The client tracks the movements as if watching ping pong. The more
intensely the client focuses on the memory, the easier it becomes for the memory to
come to life. As quick and vibrant images arise during the therapy session, they are
processed by the eye movements, resulting in painful feelings being exchanged for
more peaceful, loving and resolved feelings.
Although a fairly new therapeutic technique, EMDR is meeting with much success all
across the county. EMDR is a natural process. The client and the therapist become
partners on a journey to help move traumatic and blocked energy. Together they work
to transcend and free up the energy, so the client can return to their natural grounded
state of being. The goal of this work is to help the client heal, so they can return to
their life in peace.
190 Counseling Approaches
ECLECTIC COUNSELING
As its name indicates, eclectic therapy is a therapeutic approach that incorporates a
variety of therapeutic principles and philosophies in order to create the ideal treatment
program to meet the specific needs of the patient or client. Instead of insisting upon
strict adherence to one particular approach or school of thought, eclectic therapists
employ elements from a range of therapeutic techniques, with the goal of establishing
a course that is personally tailored to the patient or client. After all, the key here is to
help the patient as quickly and as effectively as possible. Eclectic counseling is
defined as the synthesis and combination of directive and nondirective counseling. It
represents a middle status between the two extremes represented by the 'non
directive' technique on one hand and the 'directive' technique on the other. In eclectic
counseling, the counselor is neither too active as in the directive counseling nor too
passive as in the nondirective counseling. Counselor just follows the middle path
between these two. Thorne (1973) finds that it is possible for a counselor to alternate
between directive and nondirective methods even in the same interview without
disrupting the nondirective permissive relationship with the client. He selects the
techniques according to the requirements of the situation and the individual. The
counselor must be competent and proficient in the use of all available methods. The
validity of the results is determined by the skill with which any method is used. The
critical factor is not what method is used but rather the skill with which it is used.
In eclectic counseling, the needs of a person and his/her personality are studied by the
counselor. After this the counselor selects those techniques, which will be useful for
the person. The main techniques used are reassurance giving information, case
history, testing etc. In eclectic counseling the counselor first takes into consideration
the personality and need of the counselee. S/he selects the directive or nondirective
technique that seems to serve the purpose best. The counselor may start with the
directive technique. When the situation demands, s/he may switch over to the non
directive counseling and viceversa. An attempt is made to adjust the technique to the
requirements of the situation and the individual.
Assumptions of Eclectic Counseling
Passive methods must be used whenever possible.
Active methods are used only with specific indications.
In the early stages when the client is telling his/her stories passive methods are
used. It permits emotional release.
Complex methods are used only when simple methods fail.
All counseling should be client centered.
Essentials of Counseling 191
Client is given opportunity to resolve his/her problems indirectly.
Directive methods are used where cooperations of other persons are needed for
the solution.
Characteristics of Eclectic Counseling
Objective and coordinating methods are used.
In the beginning client active methods are used.
Counselor remains passive.
Importance is given to job efficiency and treatment.
Principle of low expenditure.
Professional efficiency and skill of counselors are must.
Based on the need of client, directive and nondirective methods are used.
Provide opportunity to client to find solutions to his/her problems himself/herself.
Hierarchy of Eclectic Practices: McBride and Martin (1990) advocate a hierarchy of
eclectic practices and discuss the importance of having a sound theoretical base as a
guide.
The lowest or first level of eclecticism is really syncretism a sloppy unsystematic
process of putting unrelated clinical concepts together. It is encouraged when
graduate students are urged to formulate their own theories of counseling without
first having experienced how tested models work.
The second level of eclecticism is traditional. It incorporates an orderly
combination of compatible features from diverse sources harmonious whole.
Theories are examined in greater depth.
On a third level, eclecticism is described as professional or theoretical or as
theoretical integration. This type requires that counselor master at least two
theories before trying to make any combinations.
A final level of eclecticism is called technical eclecticism. In this approach,
procedures from different theories are selected and used in treatment.
Steps in Eclectic Counseling: The leading exponent of the Eclectic counseling
Thorne (1973) suggested the following in the process
1. Diagnosis of the cause.
2. Analysis of the problem.
3. Preparation of a tentative plan for modifying factors.
4. Securing effective conditions for counseling.
5. Interviewing and stimulating the client to develop his/her own resources and to
assume its responsibility for trying new modes of adjustment.
6. Proper handling of any related problems which may contribute to adjustment.
192 Counseling Approaches
Applications: Any condition that can be treated via any type of therapy is capable of
being treated with eclectic therapy. Thus, individuals with addictions, substance abuse
disorders, eating disorders, behavior compulsions, mood disorders, and other forms of
emotional or psychological issues may be effectively treated by a therapist who
embraces the philosophy of eclectic therapy.
Contributions of Eclectic Counseling
This approach encourages counselors to use different types of strategies or
approaches with clients. With such diverse approaches, counselor's awareness of
techniques and treatments used would increase due to the past experiences.
Diverse treatments and techniques used provide counselors with more flexibility
as they have more options of treatments to choose from, which ultimately benefit
the clients.
Limitations of Eclectic Counseling
It is vague, opportunistic and superficial.
Directive and nondirective cannot be mixed.
In this, the question arises how much freedom should be given to the client? For
this there is nondefinite rule.
Counselors often do more harm than good if they have little or no understanding
about what is helping the client.
INTEGRATING COUNSELING
Integrative Therapy (IT) was developed in Paris at
the end of the 1960s by a group of clinicians and
researchers psychologists and physicians under
the direction of Professor Dr. Hilarion G. Petzold.
Integrative therapy or integrative counseling is a
combined approach to psychotherapy that brings
together different elements of specific therapies.
Integrative therapists take the view that there is no
single approach that can treat each client in all
situations. Each person needs to be considered as a
whole and counseling technique must be tailored to
their individual needs and personal circumstances.
Integrative counseling maintains the idea that there are many ways in which human
psychology can be explored and understood no one theory holds the answer. All
theories are considered to have value, even if their foundational principles contradict
Essentials of Counseling 193
each other hence the need to integrate them. The integrative approach also refers to
the infusion of a person's personality and needs integrating the affective, behavioral,
cognitive, and physiological systems within one person, as well as addressing social
and spiritual aspects. Essentially, integrative counselors are not only concerned with
what works, but why it works tailoring therapy to their clients and not the client to
the therapy.
Integrative Psychotherapy takes into account many views of human functioning. The
psychodynamic, clientcentered, behaviorist, cognitive, family therapy, Gestalt
therapy, bodypsychotherapies, object relations theories, psychoanalytic self
psychology, and transactional analysis approaches are all considered within a
dynamic systems perspective. Each provides a partial explanation of behavior and
each is enhanced when selectively integrated with other aspects of the therapist's
approach. The psychotherapy interventions used in Integrative Psychotherapy are
based on developmental research and theories describing the selfprotective defenses
used when there are interruptions in normal development. Psychotherapy integration
can be differentiated from an eclectic approach, in which a therapist chooses
interventions because they work, without looking for a theoretical basis for using the
technique. Eclectic practitioners are not bound by the theories or methodology of any
one particular school. Instead, they may use what they believe or feel or experience
tells them will work best, either in general, or to suit the immediate needs of
individual clients. In contrast, integrative psychotherapy attends to the relationship
between theory and technique. An eclectic therapist might experience a change in
his/her client after administering a particular technique and be satisfied with a
positive result. In contrast, an integrative therapist is curious about the 'why and how'
as well.
Aim of Integrative Therapy
Integrative counseling aims to promote healing and facilitate wholeness ensuring
that all levels of a person's being and functioning (psychological, physical and
emotional health) are maximized to their full potential. Clients must be committed
to selfexploration and open to identifying what factors in their life are
perpetuating problems, and/or are causing current concerns.
In particular, the integrative approach helps clients face each moment openly and
authentically without having formed an opinion, expectation or attitude
beforehand. This enables them to better focus on the fears and hurts that limit their
psychological freedom, and recognize specific triggers that may be causing
disruptive patterns of behavior.
194 Counseling Approaches
Through this awareness, integrative therapy helps to create a healthy alliance
between mind and body empowering clients to start setting goals and practicing
new behaviors that will enable them to move beyond their limitations and
discover greater life satisfaction. This will be worked towards alongside other
goals that are drawn into therapy through the integration of other approaches.
These will all be tailored to the client's personal limits and external constraints.
Integration of Approaches: The central premise of integrative counseling is that
there are many ways in which human functioning can be explored and understood.
This means integration can occur through a variety of modalities/systems of
perspective. These may include humanistic therapies; psychoanalytical and
psychodynamic therapies; and cognitive and behavioral therapies. Each approach
offers explanation and insight into human behavior, as well as a unique understanding
of key factors that will result in changes to behavior and other areas of functioning
such as cognition and emotions. These can be reinforced when selectively integrated
with other elements of therapy. For example, if an integrative therapist is working
with a client that has behavioral problems, they may want to start the therapy by
working on adjusting behavioral functioning and reducing symptoms. This may
involve applying cognitive behavioral techniques to help the client establish some
control over their functioning before moving on to the next stage of therapy (i.e.
working on improving, and gaining insight into the client's behaviors, emotions and
thoughts). In this stage, the therapist may employ psychoanalytic techniques that
recall childhood experiences and interpretation, dream analysis or analysis of
transference.
There are many approaches to integrating psychotherapeutic techniques. Those
approaches are as follows
Common Factors Approach: The advantage of a common factors approach is the
emphasis on therapeutic actions that have been demonstrated to be effective. The
disadvantage is that common factors may overlook specific techniques that have
been developed within particular theories. Common factors theory asserts it is
precisely the factors common to the most psychotherapy that make any psychotherapy
successful.
Technical Eclecticism: This approach is guided primarily by data that indicates what
has worked best for others in the past. The advantage of technical eclecticism is that it
encourages the use of diverse strategies without being hindered by theoretical
differences. A disadvantage is that there may not be a clear conceptual framework
describing how techniques drawn from divergent theories might fit together.
Essentials of Counseling 195
Theoretical Integration: This approach requires integrating theoretical concepts from
different approaches. These approaches may differ in their fundamental philosophy
about human behavior. While assimilative integration begins with a single theory and
brings together techniques from different approaches, theoretical integration tries to
bring together those theoretical approaches themselves and then develop a unified
theory.
Assimilative Integration: This mode of integration favors a firm grounding in any one
system of psychotherapy, but with a willingness to incorporate or assimilate,
perspectives or practices from other schools. The therapist has a commitment to one
theoretical approach, but also is willing to use techniques from other therapeutic
approaches.
Therapeutic Relationship: The attitude and presence of an integrative counselor is
another crucial element of integrative therapy. It is generally believed that the most
effective model requires the therapist to be nonjudgmental, interpersonal and intent
on establishing a supportive and cooperative relationship with their client. They must
also engage in deep, attentive listening without the presuppositions that can distort
understanding. The meaningful contract empowers clients helping them to explore
and recognize patterns of behavior that need to be addressed through change and the
setting of new goals. This aspect of integrative therapy is often referred to as the
personal integration of therapists they are committing themselves wholly to their
client and their exploration of self.
Benefits of Integrated Therapy: A key advantage of integrative counseling is its
flexibility and focus on the whole of an individual. The integration of different
approaches means therapy can be tailored to meet a variety of needs and concerns. It
can be particularly beneficial for those who want to overcome negative patterns of
behavior caused by anxieties, fears, phobias or any other mental health issue that is
greatly impacting life satisfaction (i.e. addictions, depression, past and current trauma,
bereavement and low selfesteem). It has also been found useful in improving daily
function in children with autism and learning difficulties. Often these problems can
affect the four dimensions of human functioning affective, behavioral, cognitive,
and physiological systems.
Due to the indepth exploration of issues and setting of goals, integrative counseling
typically requires a substantial investment of time on the part of the client. Therefore
it may not suit those who want a quick, solutionfocused approach to personal
development. The length of the therapy will depend on the client, the therapeutic
goals set and the types of issues that are being addressed.
196 Counseling Approaches
GROUP THERAPY
Group therapy or group psychotherapy is a form of
psychotherapy in which one or more therapists treat a small
group of clients together as a group. The founders of group
psychotherapy in the USA were Joseph H. Pratt, Trigant
Burrow and Paul Schilder. All three of them were active and
working at the East Coast in the first half of the 20th century.
After World War II, group psychotherapy was further
developed by Jacob L. Moreno, Samuel Slavson, Hyman
Spotnitz, Irvin Yalom, and Lou Ormont. Yalom's approach to
group therapy has been very influential not only in the USA
but across the world. Group psychotherapy helps people who
would like to improve their ability to cope with problems.
Group therapy focuses on interpersonal relationships and helps
individuals learn how to get along better with other people
under the guidance of a professional. Group psychotherapy
also provides a support network for specific problems or
challenges. A group therapist appropriately selects people
(usually 5 to 10) who would be helped by the group experience
and who can be learning partners for one another. In meetings,
people are encouraged to talk with each other in a spontaneous
and honest fashion. A professionally trained therapist, who
provides productive examination of the issues or concerns
affecting the individuals and the group, guides the discussion.
Groups can be as small as three or four people, but group
therapy sessions often involve around seven to twelve
individuals (although it is possible to have more participants).
The group typically meets once or twice each week for an hour
or two. During the session each member works to express their
own problems, feelings, ideas and reactions as freely and
honestly as possible. Accordingly, the group members have an
opportunity to learn not only about themselves and their own
issues, but also the value of helping other group members.
Joseph Hersey Pratt
(1872–1956)
Trigant Burrow
(18751950)
Paul Ferdinand
Schilder
(18861940)
Irvin David Yalom
(1931 – to date)
According to author Oded Manor in 'The Handbook of Psychotherapy', the minimum
number of group therapy sessions is usually around six but a full year of sessions is
more common. Manor also notes that these meetings may either be open or closed. In
Essentials of Counseling 197
open sessions, new participants are welcome to join at any time. In a closed group,
only a core group of members are invited to participate. In many cases, the group will
meet in a room where the chairs are arranged in a large circle so that each member
can see every other person in the group. A session might begin with members of the
group introducing themselves and sharing why they are in group therapy. Members
might also share their experiences and progress since the last meeting.
Group therapy is a powerful tool for growth and change. In group therapy, 510
individuals meet face to face to share their struggles and concerns with the facilitation
of 12 trained group therapists. The power in group therapy lies in the unique
opportunity to receive multiple perspectives, support, encouragement and feedback
from other individuals in a safe and confidential environment. These interpersonal
interactions can provide group members an opportunity to deepen their level of self
awareness and to learn how they relate to others. Group therapy can be a safe and
supportive place to experiment with new ideas and ways of being. For many
emotional concerns, personal struggles, and relationship issues that college students
face, group therapy is the most effective treatment modality. Because group therapy is
so effective, the Counseling Center offers a wide array of groups to address the needs
of our students. We feel confident that group therapy is one of the most effective and
beneficial treatments to address the common issues faced by our students, but we
understand that for many students, the idea of joining a therapy group can be
daunting. Although many students are initially intimidated and hesitant about
participating in group therapy, group members consistently describe group therapy as
a very helpful and positive experience.
Principles of Group Therapy: In the 'Theory and Practice of Group Psychotherapy',
Irvin D. Yalom (1995) outlines the key therapeutic principles that have been derived
from selfreports from individuals who have been involved in the group therapy
process
Instillation of hope: The group contains members at different stages of the
treatment process. Seeing people who are coping or recovering gives hope to
those at the beginning of the process.
Universality: Sharing an experience with a group helps people see that they are
not going through something alone. It also serves to remove a group member's
sense of isolation, validate their experiences, and raise selfesteem.
Imparting information: Group members can help each other by sharing
information.
198 Counseling Approaches
Altruism: Group members can share their strengths and help others in the group,
which can boost selfesteem and confidence.
Corrective recapitulation of the primary family group: The therapy group is much
like a family in some ways. Within the group, each member can explore how
childhood experiences contributed to personality and behaviors. They can also
learn to avoid behaviors that are destructive or unhelpful in real life.
Development of socialization techniques: The group setting is a great place to
practice new behaviors. The setting is safe and supportive, allowing group
members to experiment without the fear of failure.
Imitative behavior: Individuals can model the behavior of other members of the
group or observe and imitate the behavior of the therapist.
Interpersonal learning: By interacting with other people and receiving feedback
from the group and the therapist, members of the group can gain a greater
understanding of themselves.
Group cohesiveness: Because the group is united in a common goal, members
gain a sense of belonging and acceptance.
Catharsis: Sharing feelings and experiences with a group of people can help
relieve pain, guilt, or stress.
Existential factors: While working within a group offers support and guidance,
group therapy helps member realize that they are responsible for their own lives,
actions, and choices.
Goals of Group Therapy
Gain an understanding of personal problems and explore possible solutions.
Give and receive feedback and support.
Feel more connected to other students who are struggling with similar issues.
Practice communication skills in a safe group setting.
Learn more about how you come across to others.
Improve your ability to identify your feelings and express them.
Reduce social isolation.
Theories of Group Therapy: Following are the important group therapy models
Brief cognitive group therapy
Cognitivebehavioral group therapy
Strategic/interactional therapy
Brief group humanistic and existential therapies
Group psychodynamic therapy
Modified dynamic group therapy (MDGT)
Modified interactional group process (MIGP).
Essentials of Counseling 199
Brief Cognitive Group Therapy: Cognitive techniques work well in group therapy.
The group is taught the basics of the cognitive approach, then individual members
take turns presenting an event or situation that tempted them to abuse substances.
Other members assist the therapist in asking for more information about the client's
thoughts on the event and how it did or did not lead to substance abuse (or to negative
feelings that might have led to use). Finally, the group members provide the client
with alternative ways of viewing the situation.
Cognitive-Behavioral Group Therapy: The cognitivebehavioral approach focuses
the group's attention on selfdefeating beliefs, relying on group members to identify
such beliefs in each other. The therapist encourages group members to apply
behavioral techniques such as homework and visualization to help participants think,
feel, and behave differently.
Strategic/ Interactional Therapies: The strategic therapist uses techniques similar to
those used in family therapy to challenge each group member to examine ineffective
attempted solutions. The therapist encourages group members to evaluate and process
these attempted solutions and recognize when they are not working, then engages the
group in generating alternative solutions. The therapist also works, where appropriate,
to change group members' perceptions of problems and helps them understand what
is happening to them. Typically, the therapist guides the process, while members offer
suggestions and encouragement to each other as they identify and implement effective
solutions.
The principles of solutionfocused therapy are the same for group treatment as for
individual therapy. These include client goalsetting through the use of the 'miracle'
question, use of scaling questions to monitor progress, and identification of successful
strategies that work for each client. The therapist works to create a group culture and
dynamic that encourages and supports group members by affirming their successes.
At the same time, the therapist works to restrain client digressions ('war stories') and
personal attacks. The therapist tries to challenge group members all of whom, unlike
in family therapy, are seen as 'customers' to take action to create positive change.
Brief Group Humanistic and Existential Therapies: Several approaches fall within
this category. The transpersonal approach is useful in meditation, stress reduction, and
relaxation therapy groups and can be adapted for clients who have substance abuse
disorders. In dealing with issues of religion or spirituality, it is helpful to have other
people talk about their perspectives. In this way, past degrading or punitive
200 Counseling Approaches
experiences related to organized religion can be redefined in a more meaningful and
useful context.
Gestalt therapy in groups allows for more comprehensive integration in that each
group member can provide a piece of shared personal experience. Each group
member plays a role in creating the group, and all of their perceptions must be
taken into account in making a change. Roleplaying and dream analysis in groups
are practical and relevant exercises that can help clients come to terms with
themselves.
Group Psychodynamic Therapy: Group psychodynamic therapy enables the group
itself to become both the context and means of change through which its members
stimulate each other to support, strengthen, or change attitudes, feelings, relationships,
thinking, and behavior with the assistance of the therapist.
Modified Dynamic Group Therapy (MDGT): On the basis of psychodynamic
theory, a modified dynamic group therapy approach was defined for substance
abusing clients (Khantzian et al., 1990). Viewing substance abuse disorders as an
expression of ego dysfunction, affect dysregulation, failure of selfcare, and
dysfunctional interpersonal relationships, MDGT falls in the intermediate length of
timelimited group psychotherapy, with its basic structure defined by two meetings
per week over a 26week format. As a supportive, expressive group experience,
MDGT provides substanceabusing clients the opportunity to evaluate and change
their vulnerabilities in four primary areas: (1) accessing, tolerating, and regulating
feelings; (2) problems with relationships; (3) selfcare failures; and (4) selfesteem
deficits. Congruent with this understanding of the origins of substance abuse, MDGP
emphasizes safety, comfort, and control within the group context. Group facilitation is
defined primarily by the therapist's ability to engage and retain substance abusers in
treatment by providing structure, continuity, and activity in an empathic atmosphere.
Modified Interactional Group Process (MIGP): Timelimited MIGP is a synthesis
of the work of several theorists (Yalom, 1995). The features that distinguish MIGP
from a more traditional interactive process are the greater activity of the leader and
the sensitivity to the development of a safe atmosphere that allows group members to
examine relational issues without excessive emotional contagion. The atmosphere of
safety is greatly enhanced by the therapist's adherence to group agreements or group
norms and by the continued reinforcement of these agreements throughout the group
process. The importance of confidentiality, the group's accepting responsibility for
itself, and selfdisclosure are all supported by the facilitator. Procedural agreements,
including beginning and ending the group session on time and ensuring that each
Essentials of Counseling 201
member has a place within the circle, with any absences addressed, are part of the
development of the safe environment. In this process, the therapist helps the clients
recognize that they are the primary change agents. The group becomes a safe place
both to give and to receive support. Although traditionally substance abuse groups
tend to be confrontative, MIGP is far more supportive. This stems from the belief that
denial and other defense mechanisms become more rigid when a person is attacked.
Consequently, group members are encouraged to support one another and look for
areas of commonality rather than use more shamebased interactive styles that attempt
to 'break through denial'. MIGP focuses special attention in four areas of the client's
life: gratification and support, vulnerability of self, regulation of affect, and selfcare
(Flores and Mahon, 1993). These four areas receive particular attention because they
represent areas of vulnerability within the substanceabusing client that can easily
lead to relapse and undermine recovery.
Preferred Group Counseling Techniques/Strategies
Reflection Allow clients to understand fully each person's comments and how
they can relate to what they just stated.
Active Listening Allow clients to be very aware of their listening skills within a
group and how important they are. This allows the group to be more open with
each other when they know their group members are paying attention to their
feedback.
Clarification Allow clients to be very concrete with others in the group of
comments made.
Summarizing Allow clients to see the bigger picture of what was said in the
group by doing a recap of what was said. Provides comfort within group.
Linking Allow clients to see how their problems connect with others' in the
group and they have the same concerns.
Encouraging Allow clients to be more open with group and makes sharing
personal feelings more inviting.
Focus Allow counselor and clients to give attention to groups concerns.
Cutting Off Allow counselors to keep the group on topic and give everyone a
chance to share.
Drawing Out Allow counselor to bring forth quiet group members comments.
Rounds Allows each client to share within the group.
Dyads Allows clients to pair up with a partner and learn more about another
client.
Word or Phrase Round Allow clients to broaden their vocabulary when
describing how they felt about something within the group session.
202 Counseling Approaches
Comment Round Allow clients to share their personal comments about that
specific session.
Icebreakers Allow clients to warmup to group members when beginning group.
Modeling Allow clients to see counselor as a role model in group work and the
behaviors that can be applied to them personally.
Use of Eyes Allows counselor to have direct eye contact with group members
that are sharing. It will allow the counselor to draw out quiet members to speak.
Allow them to members that have lost interest in the topic.
Tone Setting Allow clients to establish a mood for their group. Rather it needs to
be a tone that is serious, social, supportive, and formal.
Use of Leader's Energy Allow clients to see the counselor excitement about their
new group, topic, and activities.
NonJudgmental Allow clients to see that this is a positive experience and not to
make anyone feel down.
Empathy Allow clients to convey to other group members that they understand
and will not make fun of anyone.
Applications of Group Therapy: Group therapy has proven to be very effective
for the treatment of depression and traumatic stress, such as posttraumatic stress
disorder (PTSD) and sexual abuse survivors. Clinical cases have shown that
the combination of both individual and group therapy is most beneficial for most
clients. Group therapy has proven effective in treating feelings of isolation,
difficulties with interpersonal relationships, aging, schizophrenia, bipolar disorder,
anorexia, alcohol dependency, death & other losses, and lifestyle issues within a
traditional culture.
Common Misconceptions about Group Therapy
I'll be forced to tell my deepest thoughts, feelings and secrets. You control what, how
much and when you share. Most people find that when they feel safe enough to share
what's troubling them, a group can be helpful and affirming. Even if you're not ready
to talk about something, listening to others can help. What they're saying may apply
to you.
Group therapy will take longer because I'll be sharing the time. Group therapy is
often more efficient than individual therapy for two reasons First, you can benefit
from the group, even when you're quiet and listening carefully. Second, group
members may bring up issues that strike a chord with you things you may not have
been aware of or brought up yourself.
Essentials of Counseling 203
Others in the group will verbally attack me. It's important for members to feel safe
and leaders will help develop that environment within the group. While feedback is
often hard to hear, groups can point out damaging behaviors in a respectful, gentle
way, so you can hear and use the insights. As trust grows, group members generally
experience feedback (and even confrontation) as a sign of caring.
I have trouble talking to people. I'll never be able to share in a group. Most people
are anxious about talking in a group, but this almost always fades quickly. People also
remember what it's like to be new to a group; you're likely to get a lot of support
when you do begin talking.
Group therapy is second-best. Group therapy is the most effective treatment approach
for many issues. When a group is recommended, it's because your therapist believes
it's the best way for you to be helped. S/he can discuss the reasons for the
recommendation with you.
Groups are confidential, meaning that what members disclose in sessions is not shared
outside of the group. The importance of confidentiality and concerns about are
reviewed with group members at the first meeting and every time a new member joins
a group. For getting the most benefit from group therapy should do the followings
Attend the group regularly;
Share your hopes and fears for participating in group;
Share with the group what you're struggling with;
Take some emotional risks in group;
Be direct and honest with your feelings in group;
Be willing to give and receive feedback;
Share your own experiences and ask others about theirs; and
Let the group know both positive and negative feelings that come up in group.
Contributions of Group Therapy
Group therapy allows people to receive the support and encouragement of the other
members of the group. People participating in the group can see that others are going
through the same thing, which can help them feel less alone.
Group members can serve as role models to other members of the group. By
observing someone successfully coping with a problem, other members of the group
can see that there is hope for recovery. As each person progresses, they can, in turn,
serve as a role model and support figure for others. This can help foster feelings of
success and accomplishment.
Group therapy is often very affordable. Instead of focusing on just one client at a
time, the therapist can devote his/her time to a much larger group of people.
204 Counseling Approaches
Group therapy offers a safe haven. The setting allows people to practice behaviors
and actions within the safety and security of the group.
By working in a group, the therapist can see first-hand how each person responds to
other people and behaves in social situations. Using this information, the therapist
can provide valuable feedback to each client.
Essentials of Counseling 205
References
Kabir, S.M.S. (2017). Essentials of Counseling. Abosar Prokashana Sangstha, ISBN:
9789848798225, Banglabazar, Dhaka1100.
Kabir, S.M.S. (2016). Basic Guidelines for Research: An Introductory Approach for
All Disciplines. Book Zone Publication, ISBN: 9789843395658,
Chittagong4203, Bangladesh.
Kabir, S.M.S., Mostafa, M.R., Chowdhury, A.H., & Salim, M.A.A. (2016).
Bangladesher Samajtattwa (Sociology of Bangladesh). Protik Publisher,
ISBN: 9789848794692, Dhaka1100.
Kabir, S.M.S. (2018). Psychological health challenges of the hilltracts region for
climate change in Bangladesh. Asian Journal of Psychiatry, Elsevier,34, 74–
77.
Kabir, S.M.S., Aziz, M.A., & Jahan, A.K.M.S. (2018). Women Empowerment and
Governance in Bangladesh. ANTYAJAA: Indian journal of Women and Social
Change,
SAGE Publications India Pvt. Ltd, 3(1), 112.
Alam, S.S. & Kabir, S.M.S. (2015). Classroom Management in Secondary Level:
Bangladesh Context. International Journal of Scientific and Research
Publications, 5(8), 14, ISSN 22503153, www.ijsrp.org.
Alam, S.S., Kabir, S.M.S., & Aktar, R. (2015). General Observation, Cognition,
Emotion, Social, Communication, Sensory Deficiency of Autistic Children.
Indian Journal of Health and Wellbeing, 6(7), 663666, ISSNp22295356,e
23213698.
Kabir, S.M.S. (2013). Positive Attitude Can Change Life. Journal of Chittagong
University Teachers' Association, 7, 5563.
Kabir, S.M.S. & Mahtab, N. (2013). Gender, Poverty and Governance Nexus:
Challenges and Strategies in Bangladesh. Empowerment a Journal of Women
for Women, Vol. 20, 1-12.
206 Counseling Approaches
Kabir, S.M.S. & Jahan, A.K.M.S. (2013). Household Decision Making Process of
Rural Women in Bangladesh. IOSR Journal of Humanities and Social Science
(IOSR-JHSS), ISSN: 2279-0845,Vol,10, Issue 6 (May. - Jun. 2013), 69-78.
ISSN (Online): 2279-0837;Impact Factor (JCC):1.589.
Jahan, A.K.M.S., Mannan, S.M., & Kabir, S.M.S. (2013). Designing a Plan for
Resource Sharing among the Selected Special Libraries in Bangladesh,
International Journal of Library Science and Research (IJLSR), ISSN 2250
2351, Vol. 3, Issue 3, Aug 2013, 1-20, ISSN: 23210079.
Kabir, S.M.S. & Jahan, I. (2009). Anxiety Level between Mothers of Premature Born
Babies and Those of Normal Born Babies. The Chittagong University Journal
of Biological Science, 4(1&2), 131-140.
Kabir, S.M.S., Amanullah, A.S.M., & Karim, S.F. (2008). Selfesteem and Life
Satisfaction of Public and Private Bank Managers. The Dhaka University
Journal of Psychology, 32, 9-20.
Kabir, S.M.S., Amanullah, A.S.M., Karim, S.F., & Shafiqul, I. (2008). Mental Health
and Selfesteem: Public Vs. Private University Students in Bangladesh.
Journal of Business and Technology, 3, 96-108 .
Kabir, S.M.S., Shahid, S.F.B., & Karim, S.F. (2007). Personality between
Housewives and Working Women in Bangladesh. The Dhaka University
Journal of Psychology, 31, 73-84 .
Kabir, S.M.S. & Karim, S.F. (2005). Influence of Type of Bank and Sex on Self
esteem, Life Satisfaction and Job Satisfaction. The Dhaka University Journal
of Psychology, 29, 4152.
Kabir, S.M.S. & Rashid, U.K. (2017). Interpersonal Values, Inferiority Complex, and
Psychological WellBeing of Teenage Students. Jagannath University Journal
of Life and Earth Sciences, 3(1&2),127135.
ResearchGate has not been able to resolve any citations for this publication.
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![Syed Muhammad Sajjad Kabir]()
This book introduces students to a number of research methods useful for academic and professional investigations of information practices, texts, and technologies. By examining the applications, strengths and major criticisms of methodologies drawn from both the qualitative and quantitative traditions, this book permits an understanding of the various decisions and steps involved in crafting (and executing) a research methodology, as well as a critically informed assessment of published research. The book describes an overview of the different approaches, considerations, and challenges involved in research. In addition to reviewing core human research methods such as interviews, observations, surveys, and experiments, it will explore methods used in critical analysis of texts and technologies. It will also discuss mixed method approaches, case studies, participatory and user-centered research, as well as research involving minors. While this book also touches upon statistics and their importance, it is not required a comprehensive knowledge of the subject. It is concluded with a section on experimental results and the ways in which experimental design and statistics can be used to ensure certain results. After completion of this book, the reader should understand why research methodology is important in scientific research, be the comfortable reading method and results in sections of journal articles, and understand a range of different research methods.
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![Syed Muhammad Sajjad Kabir]()
How many times have you heard a friend, co-worker, spouse or significant other say, "Think positive" when you are feeling depressed, angry, anxious, frustrated or just down-right negative? Usually, it's the last think you want to hear at the moment, but it could possibly be the best thing you could do for both your emotional and physical health! Positive attitude, positive thinking, and optimism are now known to be a root cause of many positive life benefits. Studies show positive people can experience an increased lifespan, lower rates of depression, lower levels of stress, greater resistance to the common cold, better overall well-being, reduced risk of death from cardiovascular disease and better-coping skills during times of hardship and stress. It seems people with a positive attitude simply live longer, happier, healthier, more successful lives… and who doesn't want that!!
This article is based on a research undertaken to promote and facilitate linkages between gender, poverty reduction and good governance at the local level. The 569 unions under study were included from Dhaka, Barisal, Chittagong, Khulna, Rajshahi, and Sylhet divisions. The research focused on analysis by combining feminist research techniques such as participant field observation, key informant interviews, focus group discussions and case studies of women's life history. The findings showed that most of the women were under the control of their husbands, and they were mere proxies. Women's voices in governance were not so far heard due to their under-representation and non-participation in institutional structures of decision-making. In governance, women still had limited and insufficient access to resources, public debate, and political decision-making processes.
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![Syed Muhammad Sajjad Kabir]()
All educators including students, teachers, researchers, practitioners or consumers of research from any disciplines even doctors, engineers or all other professionals can be benefited from this book. I have prepared this book from my graduate & post graduate lecture notes, ten years of teaching experiences in this fields, and different training programs (e.g. Research Methodology for Researcher, BARD, Comilla; Research Methodology, Center for Advanced Research, University of Dhaka; Research Concepts and Issues, ISS, Hague, Netherlands & North South University etc.). It will provide the readers with a basic framework for understanding and evaluating research studies. It will also provide knowledge of the various types of research designs used in research and the procedures for conducting research studies. This book will provide an opportunity for readers to establish or advance their understanding of research through the critical exploration of research language, ethics, and approaches. The book introduces the language of research, ethical principles and challenges, and the elements of the research process within quantitative, qualitative, and mixed methods approach. Readers will use these theoretical underpinnings to begin to critically review literature relevant to their field or interests and determine how research findings are useful in informing their understanding of their environment. This book has been written for beginners who are currently involved in research and are interested to apply qualitative and quantitative methods in their area of work. Throughout the book, the basic philosophy of applying qualitative and quantitative perspectives along with pertinent issues of qualitative and quantitative research methods and applicability of various instruments of gathering qualitative and quantitative data in systematic, scientific and ethical ways are discussed. Upon completion of this book, readers are expected to obtain a basic understanding of qualitative and quantitative research methods by realizing its importance and relevance to the field of research. It is anticipated that readers would learn to prepare a research concept note by using research methods. This book introduces students to a number of research methods useful for academic and professional investigations of information practices, texts and technologies. By examining the applications, strengths and major criticisms of methodologies drawn from both the qualitative and quantitative traditions, this book permits an understanding of the various decisions and steps involved in crafting (and executing) a research methodology, as well as a critically informed assessment of published research. The book describes an overview of the different approaches, considerations, and challenges involved in research. In addition to reviewing core human research methods such as interviews, observations, surveys, and experiments, it will explore methods used in critical analysis of texts and technologies. It will also discuss mixed method approaches, case studies, participatory and user-centered research, as well as research involving minors. While this book also touches upon statistics and their importance, it is not required a comprehensive knowledge of the subject. It is concluded with a section on experimental results and the ways in which experimental design and statistics can be used to ensure certain results. After completion of this book, the reader should understand why research methodology is important in scientific research, be the comfortable reading method and results from sections of journal articles, and understand a range of different research methods. After completion of the book, the readers should be able to… Understand some basic concepts of research and its methodologies; Identify appropriate research topics; Select and define appropriate research problem and parameters; Effectively conduct literature review; Identify the types of methods best suited for investigating different types of problems and questions; Select sampling methods and how representative samples are obtained; Identify the different research designs and their appropriate application to hypothesis testing; Describe quantitative, qualitative and mixed methods approaches to research; Explain the strengths and limitations of research designs used in different disciplines; Describe the principle of statistical significance; Effectively summarize and present data; Organize and conduct research in a more appropriate manner; Design a research proposal; Write a research report and thesis; Be aware of the ethical principles of research, ethical challenges and approval processes. The book focuses on the logic, principles and practices of modern science and how it is applied to understanding the nature of reality. Successful completion of this book will prepare the reader for graduate work and advanced experimental concepts and also enable at a minimum to become an informed consumer of science.
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- Nazmunnessa Mahtab
The study was conducted to identify whether elected women members have been able to effectively exercise their power and attain their desired goals. The study also attempted to address the issues relating to the capacity of women members to perform their duties, develop their interpersonal relationships, explore the areas for developing their roles, and overcome the limitations as well. The overall goal of the research was to promote and facilitate linkage between gender, poverty reduction and good governance at the local level. The number of Unions under study were included from the six divisions of the country, that is, Dhaka, Barisal, Chittagong, Khulna, Rajshahi, and Sylhet. From each of the division, at least six Upazilas were selected on a random basis and again from each selected Upazila, at least ten Unions were selected on a random basis. The research focused on analysis by combining feminist research techniques such as participant field observation, key informant interviews, focus group discussions, and case studies of women's life history. The findings showed that most of the women were under the control of their husbands and they were mere proxies. Women's voices in governance were not so far heard due to their under-representation and non-participation in institutional structures for decision making. Women's limited access to resources, public debate and political decision making was still insufficiently considered in governance. The exercise of political authority to a large extent influenced decisions and the political participation of women occupies a prominent position in governance.
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- Shabrina Shajeen Alam
The purpose of the present study was to assess the properly managed classroom in secondary level. 66 students from two schools were used as respondents for the above purpose. The finding of the experiment is that overall secondary classroom management in Bangladesh is at high risk due to some environmental and personal factors. Classrooms do not have adequate seats; necessary equipment and the classroom sizes are very high. A satisfying fact in our classrooms is that most of the students feel they have good relations with their peers. Necessary steps have to be taken to come out from the problems in the classroom management aspect of secondary education.
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The aim of this paper is to provide an overview of the deleterious effects of climate change on psychological health of the Hill-Tracts and government to deal with these adverse psychological health impacts. Although knowledge is still limited about the connections between climate change and psychological health, the evidence is indicating that impacts can be felt at both the individual and community levels, with psychological health outcomes ranging from psychological distress, depression, and anxiety, to increased addictions and suicide rates. Drawing from 125 in-depth interviews conducted between January 2015 and October 2016 with community members and local and regional health professionals, participants reported that climate change was negatively impacting psychological health and well-being. The results stated that climate change enhanced the possibility of an increased drug, family stress, alcohol use, amplified previous traumas, psychological health stressors, and were implicated in increased potential for suicide ideation of the Hill-Tracts region in Bangladesh. These exploratory findings indicate that climate change is becoming an additional psychological health stressor for Hill-Tracks' dwellers in Bangladesh.
- S S Alam
- S M S Kabir
- R Aktar
Alam, S.S., Kabir, S.M.S., & Aktar, R. (2015). General Observation, Cognition, Emotion, Social, Communication, Sensory Deficiency of Autistic Children.
Career Counseling a Holistic Approach Chapter 16 Edition 8
Source: https://www.researchgate.net/publication/325844296_COUNSELING_APPROACHES