This chapter serves as an introduction to theories of counseling and psychotherapy. Theories of counseling and psychotherapy are foundational to the practice of mental health professions. Professional counseling or psychotherapy is the process whereby a trained professional uses his or her knowledge of biology, psychology, personality, relationships, and social systems to change behaviors and to solve client problems. Counselors are highly educated professionals who are directed by ethical codes to help people in need. Psychotherapists, no matter what their professional affiliations, are bound by the ethical principles of beneficence and non-maleficence. Mental health is not just the absence of mental disorder. The American Psychiatric Association published its highly used Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM- 5), which provides a listing of mental disorders and the criteria used to diagnose them. It is a typology of mental disorder-mental illnesses viewed as within the person.
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This chapter introduces an approach that is unique to counseling theory, based on its focus on solutions rather than problems. It gives an example of a model that is based on social constructivism philosophy. Solution-Focused Brief Therapy (SFBT) represents a significant break with the underlying philosophy at the core of traditional psychologically oriented psychotherapy approaches. It also represents a unique philosophy that extends beyond that of classic social systems theory, which is at the base of the classic family therapy approaches. The goal of SFBT is the replacement of symptomatic or problem behaviors with functional and wanted healthy behaviors. SFBT can be accomplished as an individual psychotherapy, as couple counseling, or as family therapy. Research is beginning to show that SFBT has great potential and is a viable, efficient, and effective approach to treating mental health issues.
This chapter introduces a systemic-relational therapy that focuses on family structure. It provides a biographical summary of Salvador Minuchin, the founder and proponent of Structural Family Therapy. The chapter outlines the basic theory of the structural approach and provides guidance on application of the theory. Structural family therapy is unique among the systemic-relational therapies because of its emphasis on the structure of families as a focus of study and as a target of intervention. Minuchin worked from the assumption that individuals are not bound by mentality into set ways of reacting; rather, he views the individual as an “acting and reacting member of social groups”. Minuchin believed that the therapist must take a leadership role as he or she joins the family in therapy. Minuchin’s Structural Family Therapy has emerged as a major player among the predominant family counseling theories.
This chapter provides a biographical sketch of Fritz Perls, the founder of Gestalt therapy. It outlines the underlying philosophy and basic principles that guide the Gestalt therapist. The beginning of Gestalt Therapy is identified best by the writing of Perls’s classic work, Ego, Hunger, and Aggression, which was originally viewed as a revision of Freud’s Psychoanalysis. The target of Gestalt Therapy is the individual perceiver as he or she lives (flows through) life. The Gestalt therapist places more value in action than in words, in experience than in thoughts, in the living process of therapeutic interaction and the inner change resulting thereby than in influencing beliefs. Case management is the process of maintaining contact with the client while facilitating the interpersonal relationship consistent with Gestalt therapy principles. The interpersonal nature of Gestalt Therapy is a strength, from a practical, therapeutic standpoint, but it is also a theoretical weakness.
This chapter provides a biographical sketch of Carl Rogers, the creator of Person- Centered Therapy (PCT). The “self” and the “self- concept” are foundational constructs that reflect Rogers’s early ontology, the self as an identifiable aspect of individuality. Rogers’s exposition of the “necessary and sufficient conditions for therapeutic personality change” in 1957 is perhaps the best summary of his foundational theory of change. According to Rogers, the difference that one person makes in interaction with another person does not necessarily have to be consciously recognized, it can be subceived. The basic theory of person-centered therapy is that if the therapist is successful in conveying genuineness, unconditional positive regard, and empathy, then the client will respond with constructive changes in personality organization. The Client-Centered Therapist is basically viewed as a facilitator of growth and movement toward the process of full functioning.
This chapter provides an overview of Jay Haley’s approach, which has been called “strategic therapy” and also “problem-solving therapy”. Jay Haley is the founder of Strategic Problem Solving Therapy and a leader of the systemic-relational movement. Problem Solving Therapy focuses on counseling families of triads or larger system structures. The issue of dyadic relational structures was dealt with in his earlier work, entitled Strategies of Psychotherapy. The strategic therapist must be directive, tactical, relationally neutral, and be able to negotiate the terms of therapy so that problems become the evident focus of treatment. The ideal outcome of Strategic Problem Solving Therapy is problem resolution. The therapist, then, must be the consummate interpersonal technician. Assessment occurs throughout strategic therapy, as the therapist continually reassesses whether clients are responding to directives or not. Haley’s approach has become very popular and is regarded as one of the leading therapies among systemic-relational paradigm adherents.
This chapter presents the intricate work of Marsha Linehan that has shown much efficacy in treating a specific population of clients, as well as others. It lists basic tenets of Dialectical Behavior Therapy (DBT) and the basic concepts used in conceptualizing and addressing a client’s concerns. DBT is a skills-based approach first targeted toward and found through extensive research to be highly effective with those experiencing extreme emotional dysregulation patterns, suicidal ideation, and non-suicidal self-injury consistent with a diagnosis of Borderline Personality Disorder (BPD). DBT is derived from cognitive behavioral therapy (CBT) with modifications specifically added for treating emotional dysregulation and related behaviors. The DBT therapist is highly flexible and uses a dialectical approach. There are four procedures for eliciting change in DBT clients: contingency procedures, exposure-based procedures, cognitive modification, and the didactic strategy of skills training itself.
This chapter presents the groundbreaking work of Sigmund Freud as a way to introduce a theory that has influenced the mental health field significantly and pervasively. Psychoanalysis is the term used by Freud to represent his therapeutic model, a model that focuses on the internal workings of the individual self. He views the internal workings of the mind, the psyche, as organized but dynamic. Essentially, the psyche is composed of three major sections: the conscious, the preconscious, and the unconscious. The primary role of the therapist, beyond providing an atmosphere for full exploration of the client’s history, is to help to strengthen the client’s ego. The main goals of psychoanalysis are ego self- knowledge and ego strength. There are several techniques associated with psychoanalysis and some of the techniques consistent with psychoanalysis are: the cathartic method, free association, facilitating and interpreting transference and dream interpretation.
This chapter describes a therapeutic approach that is consistent with the social constructivism paradigm of mental health treatment. The social constructivism philosophy purports that people understand their experiences through the social consensual process, people together socially construct meaning of their shared experiences. Cognitive Consensual Therapy (CCT) is grounded on a social constructivist philosophy. Social constructivism is an intellectual movement in the humanities, art, and the social science that is part of a larger shift in philosophy from modernism. The target of counseling is the process of human interaction. The counselor role as a cognitive consensual therapist is that of facilitating interactions so that clients come to view and to understand different ways of acting and thinking. Treatment begins with the establishment of a professional relationship. The therapist should come across as a well-educated, experienced, confident, credentialed, and well-established professional.
This chapter introduces Narrative Therapy (NT) as a theory that aligns with the social constructivism paradigm of counseling and psychotherapy. It provides some historical context for the development of the theory and biographical sketches of Michael White and David Epston. A primary influence to NT was the work of Gregory Bateson and his illustration of the unique way in which humans make sense of the world. NT focuses on the stories individuals tell about the events in their lives. A story or narrative is a mental account or chronicle of a person’s experiences or life events. In NT, therapeutic conversation is seen as an artful science where client stories are laid out, examined, challenged, and expanded on interactively and collaboratively. Narrative therapists take a decentralized but influential position in therapy. The narrative therapist takes great care to create an environment of collaboration, respect, and acceptance.
This chapter provides a biographical sketch of Virginia Satir, the founder of conjoint family therapy. It describes Satir’s basic ideas about relationships and their importance to mental health. The chapter presents an overview of techniques and methods of conjoint family therapy and outlines the basic premises of a theory that crossed over into a more purely relational way of viewing counseling and psychotherapy. Conjoint Family Therapy is a process of facilitating effective communication in a relational context. The therapist acts as an official observer of family interaction and as a teacher of clear communication. Satir’s treatment program is one of adhering to several basic principles. First, it is assumed that positive changes result through the interpersonal process of therapy, which is a conclusion, primarily based on her humanistic attitude that people have honorable motives and that everyone is healable.
This chapter introduces a counseling theory that is highly focused on how people think both in problem formation and in problem solution. It provides a historical backdrop to the theory of Albert Ellis by providing a concise biography. The chapter presents the rational- emotive behavior therapy (REBT) model in workable form and outlines the basic techniques and case management methods. REBT is very focused on the individual client. Theoretically, attention is primarily on the way the individual thinks (cognitive primacy) with secondary but localized attention on how the individual feels and acts. The setting for REBT is the therapist’s office, usually informally arranged, so that the therapist and the client can sit without barriers between them. Ellis described rational- emotive therapy (RET) as a comprehensive cognitive- affective behavioral theory and practice of psychotherapy. Cognitive therapists view cognition as a much more complex process than the REBT adherents.
This chapter introduces a behavioral therapy as a psychological approach to treatment that assumes that mental health problems derive from external forces that impinge the individual. It focuses on the empirical works of two major researchers, Ivan P. Pavlov and Burrhus F. Skinner, who developed learning theories that have serious implications for the treatment of emotional concerns. The chapter addresses the cognitive behavioral therapy movement, both historically and practically. Cognitive behavioral therapy, or CBT, has taken the behavioral therapy movement the internal versus external locus of influence boundary. It addresses how cognition, which is an internal psychological process involving language and perception, can be associated with behavioral techniques to improve case conceptualization and to affect treatment outcomes positively. The Cognitive Behavioral Therapist will first and foremost address the cognition and will try to change the thoughts that are associated with problem behaviors.
Psychiatrists are primarily suited to working within the boundaries of organic medical propositions and tenets, meaning they are trained as medical professionals addressing physical health issues. Psychiatric Case Management, as a counseling approach can be used by psychiatrists. However, it can also be used by psychologists, mental health counselors, marital and family therapists, social workers, and other mental health professionals when there is involvement of a physician overseeing medical treatments. This chapter provides a broad view of psychiatric practice, and it describes many organic medical diagnostic and treatment approaches. It also addresses types of psychotherapy, approaches to treatment of specific mental disorders, and psychopharmacology. The chapter focuses on topics such as medical assessment, psychiatric interviewing, mental status assessment, psychiatric diagnosis, psychiatric report writing, and medication management. The counselor role in psychiatric case management is threefold: a counselor must be a monitor, educator, and problem solver.
This chapter describes the evolution of psychotherapy across paradigms and addresses the “common factors” movement in psychotherapy research. Mental health professional educators are faced with choosing to focus on theories, to focus on common factors primarily, or to do some combination of teaching theory and common factors as a means of preparing practitioners. Research is giving the field broad hints about how the common factors movement interfaces with theories of counseling and psychotherapy. The social constructivism movement would prioritize defining the “context” of research as important both in hypothesis generation and interpretation of results. Research should not be held as the final arbiter of truth claims about counseling and psychotherapy. The most important criterion in the assessment of psychotherapy may be the benefit to clients and to a society that values human freedom and dignity.
This chapter presents the emotion-focused work of Leslie Greenberg and Susan (Sue) Johnson, which has shown to be efficient in the treatment of couples’ distress and depression, and for helping clients deal with the aftereffects of trauma and abuse. It lists basic tenets of Emotion-Focused Therapy (EFT) theory and the basic concepts used in conceptualizing and addressing a client’s concerns. The chapter offers a dialogue on the theory, outlining the conversation between a student and a mentor on the significance of the theory for the mental health profession. According to Greenberg the interventions used in EFT are guided by the understanding of the emotion process, the principles of emotion intervention, and the descriptions of distinctive interventions for varying problem markers. A major goal of EFT is to create a therapeutic environment in which the client feels safe to fully experience emotions in order to engage in the process of transformation.
The Individual Psychology of Alfred Adler provides a rich theoretical foundation for what has developed into Adlerian psychotherapy. This chapter defines the basic tenets of Adler’s theory of personality and therapy. Adler’s theory is grounded on the idea that childhood experiences are crucial to the psychological development, and that children, who are by nature in an inferior position to parents and other adults, strive to achieve some sense of superiority. Adler ’s work represents a psychological theory that acknowledges the influence of social factors on the personality. In efforts toward understanding the lifestyle, Adler viewed humans’ unique approaches to life through the lenses of the life tasks. These tasks included: the work task, the social task, and the sexual task. Adler believed that encouragement, the act of promoting courage within someone else, was the cornerstone of therapy and could inspire clients toward growth, healthy adaptation, and functioning in life.