Counseling Theories
Unconditional Positive Regard (Nonpossessive Warmth):
This means that the counselor values and accepts the client regardless of issues he or she may struggle with at any given moment in life. Clients always enter counseling when they are troubled, and they face choices, which if the counselor allowed herself she could judge in one way or another. The counselor does not do this, but rather accepts the struggle ... and that the client must find the answer.
Empathy:
The counselor is truly committed to trying to understand the client's phenomenal world. If the counselor tries to understand that world, the process of doing so will help the client better understand herself. From that basis, in an environment free of judgement (i.e. unconditional positive regard), the client can honesty explore, and possibly change values, her view of herself, and beliefs about the world.
Genuineness (Congruence)
The Person-Centered Therapy relationship must always be an honest one. The counselor needs to hold the first two values, but also be real and true in the relationship. Individuals who cannot accept others (i.e. because of personal values and beliefs they hold rigidly and apply to all), or who will not listen and try to understand ... cannot do Person-Centered Therapy. The first two attitudes are false unless there is a real person behind them, and it is Very Natural for personal genuineness to sometimes be in conflict with efforts at empathy and maintaining the position of unconditional positive regard.
Maladjustment in Person-Centered Therapy is believed to result from values and beliefs introjected into the self-structure which are inconsistent with a natural organismic valuing process. These values come from parents, significant others, and society as a whole, and are uncritically taken in and accepted by the self, when in truth, some of them fit very poorly. Some of this is an inevitable part of socialization, but the introjects can get out of hand. The result is an individual who experiences incongruence between ideal self, self as perceived, and visceral aspects of their organism. They are not being true and adequately accepting of who and what they are, instead chasing after values and goals not truly their own, neglecting or being unaware of those which are.
Person-Centered Therapy believes people can review and revise values, beliefs, and their self-concepts if provided a therapeutic environment characterized by the three critical conditions discussed above. In an environment free of threat and counselor judgements of right or wrong (unconditional positive regard), they can explore themselves with relative safety. The counselor's efforts at understanding the client (empathy) are not an end in themselves, but rather a means toward helping the client develop their own empathy for self. With such empathy, the client can choose and subsequently move in directions right for them. But beyond the first two values, the Person-Centered Therapy relationship must also be an honest one (genuineness). In the absence of that, the other values can only be faked.
Actual counselor behavior centers around efforts to understand the client's problems and feelings rather than trying to solve the problem. The nondirective elaboration of the client's problems and concerns will help them resymbolize these in ways more conducive to growth and self-actualization. Advice and interpretations are avoided, and counselors respond with a great deal of active listening to both the content and feelings the client is expressing.
The ABC model of REBT holds that clients mistake the antecedent event (called A) for the source of their emotional and behavioral consequence (called C). Between the antecedent event (A) and their emotional and behavioral consequence (C) ... is their belief system (B). Their belief system (B) is the true cause of their emotional and behavioral consequence (C).
The significance of the above is that the counselor must explore the client's belief system (B) to help with the problematic emotional and behavioral consequences (C) that brought them into therapy. REBT holds that the "good life" is the rational life, and that irrational beliefs (faulty B) will invariably lead to unpleasant emotional and behavioral consequences (C). Life should be lived rationally, and that is the best and most desirable life that can be hoped for. Irrationality (faulty B) will always lead to emotional distress and behavioral dysfucntion, and the faulty belief system is what therapy must address.
Before discussing REBT specifics of irrational thinking there is a more fundamental aspect of REBT to explain. Albert Ellis stated that the root of irrational thinking is escalating what are our natural "preferences" into absoulte "musts" that we subsequently make ourselves miserable over when we do not have them. We tell ourselves we "cannot stand" something being the way it is and then experience a powerful negative emotion. The more rational approach is to reduce this "cannot stand" attitude to a level of preferring matters to be different, but tolerating that they are not.
There are actually 12 irrational ideas in REBT presented in a more professional manner than the original lay version presented here, but in the interest of time this version adequately presents the essence of the theory. One or more of these are the root of the unpleasant emotional and behavioral consequences clients describe and elaborate in therapy. The task of the RET therapist is to recognized them, to teach the client to recognize them, and to argue effectively for rational beliefs to replace irrational thoughts.
1. It is absolutely essential to be loved or approved of by every significant person in one's life.
2. To be worthwhile, a person must be competent, adequate, and achieving in everything attempted.
3. Some people are wicked, bad, and villainous and therefore should be blamed and punished.
4. It is terrible and a catastrophe whenever events do not occur as one hopes.
5. Unhappiness is the result of outside events, and therefore a person has no control over such despair.
6. Something potentially dangerous or harmful should be cause for great concern and should always be kept in mind.
7. Running away from difficulties and responsibilities is easier than facing them.
8. A person must depend on others and have someone stronger on whom to rely.
9. The past determines one's present behavior and thus it cannot be changed.
10. A person should be upset over the problems and difficulties of others.
11. There is always a right answer to every problem, and a failure to find this answer is a catastrophe.
The REBT practitioner must first recognize the specific irrational ideas that are the source of the clients distress, explain why this is so to the client, and then argue effectively against the irrational beliefs and toward adopting a rational point of view. Read the 11 irrational ideas carefully and you will notice that many would be desirable ... if they could only be true! For example, in #1 it would be GREAT if we could be liked by EVERYONE we encounter during our life, but this is simply at odds with the very nature of the world we live in. The process of therapy involves: (1) the counselor recognizing irrational beliefs, (2) pointing these out to the client, (3) arguing successfully against them, and (4) teaching the client to do this as an internal dialogue themselves. REBT also emphasizes "homework" assignments that help clients actualize the behavioral implications of rational thinking.
There is no single theorist at the front of this widely practiced approach to psychotherapy that is strongly grounded in scientific research. Donald Michenbaum, Aaron Beck, Albert Ellis and Albert Bandura have been major contributors to the approach, to name a few.
Cognitive-behavioral therapy holds that our thoughts influence our feelings and behaviors, and that therapy needs to work at correcting faulty cognitive processes. Cognitive-behavioral therapy is goal directed, structured, and time limited. The emphasis is on problem-solving and skill development. Positive results are usually expected within a relatively short period of time, and the approach frequently involves repeated skill practice and homework assignments. Cognitions are looked at from the perspective of what evidence supports them and whether they lead to functional or dysfunctional feelings and behavior. Cognitive reframing involves changing the meanings placed on events so that more reasonable emotional reactions and behaviors follow. Cognitive restructuring involves challenging dysfunctional automatic thoughts and replacing them with more functional thoughts.
Cognitive-behavior therapy is rapidly becoming the dominant form of psychotherapy because of its strong research focus and scientific base. Techniques are varied and the approach has incorporated many of the best aspects of other therapies, such as the relationship building and active listening of Person-Centered Therapy. It is the most common type of therapy practiced by clinical psychologists and other therapists grounded in scientific research.
Transactional Analysis has sometimes been called the "poor person's" psychoanalysis because of how straightforward it is and the apparent similarity of the Parent-Adult-Child to Freud's Superego-Ego-Id. It became popular in the late 1960's, teaching many people to better understand themselves using its constructs and terminology.
Structural Analysis
In this level of analysis, the individual learns to recognize thoughts and behaviors characteristic of the different ego states. A person might, for example, conclude they spend far too much time in their Parent ego state, and that is why they are so critical and judgmental with themselves and others.
Transactional Analysis
This is learning to recognize how one Adult-Parent-Child interacts with another Adult-Parent-Child. Transactions can be complementary (e.g., Adult to Adult, Parent to Child), crossed (e.g., Child to Adult) or ulterior (when more than one ego state is involved in sending a message to another).
Game Analysis
Transactional Analysis describes many different games (little social roles) that people play with one another that lead to bad feelings and emotional pain. Clients learn to identify what "games" they become involved in with others, and when they can recognize that they can possibly decide not to play.
Script Analysis
A life script is one of the major acts a person plays out in life. This is an advanced level of analysis and allows an individual to see how their approaches to living life are helpful or self-defeating.
"I'm O.K., You're O.K.
"I'm O.K., You're Not O.K.
"You're O.K., I'm not O.K."
"You're not O.K., I'm not O.K."
Only one of the above positions leads to healthy and truly satisfying interpersonal relationships.
Reality Therapy is a versatile, perhaps even eclectic approach, and it is therefore difficult to describe. It is reviewed very briefly here. The key concept is evaluating actions (behaviors) from the perspective of responsibility. Certain actions, or inactions, have very predictable consequences in different problem situations encounter over the course of life. Responsible choices lead to good results ... and irresponsible choices to poor results. The poor results from irresponsible choices result in negative situational and emotional consequences for the individual.
Reality Therapy emphasizes establishing a relationship with the client (in that sense it is very Person-Centered), focusing on present problems and behaviors (in that sense it is very Behavioral), and evaluating problems from the perspective of acting responsibly vs. irresponsibly (in that sense it is very Cognitive). Everyone faces many problems over the course of life. The best results come to individuals choosing responsible courses of actions.
Alfred Adler broke with Freud in 1911 over Freud's unyielding emphasis on the importance of early sexuality in human development. Adler held that social factors such as a "striving for superiority" were far more important. It is natural for the child to feel insecure and inferior, and a major driving force in personality development is to compensate for and escape these feeling of inferiority. While Freud held that it was the past that governed behavior, Adler held that it was the "finalism" people seek in the future (where they want to get in life). He called these goals "fictional finalism" because they exist in our ideas rather than reality.
Adler also placed an important emphasis on "social interest." Freud saw society and the individual at odds with one another, but Adler saw society and the individual as mutually supportive. He believed that it was natural, normal and healthy for people to be involved and concerned with one another, and that the absence of this was a sign of maladaptation in the individual.
The psychotherapy system that Adler developed is not constrained by techniques, such as classical psychoanalysis is by free association. Adlerian therapy seeks to help people actualize their goals in life (overcome their inferiority feelings) and is very supportive an encouraging. It is also, however, challenging and confronting on problematic lifestyles and goals. Adlerian therapists seek to establish empathy and build rapport with their clients, and to understand the "lifestyle" that guides their behavior in functional or dysfunctional ways.
Adlerian psychotherapy seeks to develop people who have high social interest, who are cooperative with others, and who have a decreased sense of inferiority. The approach assumes that most people in therapy feel relatively powerless and discouraged, so encouragement is a cornerstone of the therapeutic approach. Self-confidence and a conviction that one can cope with the problems presented by life are critical goals of the therapy. Its strong positive and forward moving nature makes it a excellent therapeutic approach for people struggling with a sense of failure in life.
