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COUNSELING PSYCHOLOGY

SHORT TUTORIALS

What is Counseling?

  • In a guidance programme, counseling is the centre of all information.
  • It is a sort of conversation between a trained (counselor) and untrained (client) individual to guide the untrained person towards a particular goal with the help of interviews.
  • Rogers: “counseling is a series of direct contacts with the individual which aim to offer him assistance in changing the attitudes and behaviour”.
  • Shotorm: “counseling as a self-adjustive process, which helps the client become more self-directive and self-responsible
  • Specialized, personalized and individualized service”.
  • Self-analysis, self-insight and self- direction.

 

Characteristics of counseling

  • To establish mutual understanding.
  • To help to know about oneself.
  • To help to plan appropriate steps.
  • To change the client behaviour or beliefs or levels of emotional distress or all these.
  • To make important life decisions.
  • To enhance an individual’s ability to cope with life situations
  • Problem oriented
  • Understanding and managing negative feelings.
  • To provide the information.

 

  • To gather relevant information.
  • Directive Counseling
  • Non-Directive Counseling
  • Eclectic counseling

Directive Counseling

  • It also called Prescriptive counseling, or Counselor centered counseling
  • Chief exponent –E.G Williamson
  • Counselor plays the major role in this method
  • It is based on the assumption that client cannot solve his own problems for lack of information and experience
  • The counselor help the counselee to make decision in keeping with the diagnosis
  • He tries to direct the thinking of the counselee by informing, explaining, interpreting and suggesting (Prescriptive counseling)  
  • It gives more important to Intellectual  aspects

Steps of Directive counseling

o   Analysis – understand the client

o   Synthesis – summarized and synthesized

o   Diagnosis – formulating conclusions

o   Prognosis – Predicting

o   Counseling– counselor direct the client

o   Follow up – keep watching

Non-directive Counseling

  • Chief Exponent –Carl R. Rogers
  • Also known as Client centered or permissive counseling
  • Counselor role is passive
  • Counselee take active part
  • He gains insight in to his problem with the help of the counselor
  •  The counselee is made aware of the fact that the counselor does not have the answers but the counseling situation does provide him to solve his problems himself.
  • The purpose of this method is to help the client grow toward maturity and adjustment, so that he can take the responsibility of solving his problems.

Directive

Non-Directive

Time saving

Time Consuming

Counselor is Active

Counselor is Passive

Emphasis on the problem

Emphasis on individual

Intellectual aspects

Emotional aspects

Counselor centered

Client Centered

Methodology is direct

Indirect

Solution of the problem is the primary goal

Independence and integration of the client is the primary goal

Solve immediate problems

Deals with self-analysis and new problems of adjustment may be taken care of

Use psychological assessment data

May not use psychological assessment

Help offered by counselor to take decisions

Client takes his own decisions

Steps of Non-Directive Counseling

By Carl Rogers

  1. Defining the problematic situation
  2. Free expression of feelings
  3. Development of Insight
  4. Classification of positive and negative feelings
  5. Termination of Counseling situation

Eclectic Counseling

  • Chief exponent – F.C Thorne
  • Neither counselor centered nor client centered; but a combination of both.
  • Here the counselor is neither too active as in directive counseling nor too passive as in non-directive counseling, but follows a middle course.
  • It is highly flexible

Freedom to choice and expression is open  to both the counselor and counselee

Counseling TypeKey Points
PsychodynamicFocused on how past experiences affect current problems
Concerned with unconscious drives and conflicting aspects of personality
Traditionally, the therapist takes the expert role
Interpersonal CounselingDiagnosis-focused
Concerned with interpersonal relationships
Therapist functions as a client’s ally
Client-centered TherapyHumanistic approach
Focused on realizing human potential
Supports client discovery
Counselor is empathetic, nonjudgmental & nondirective
Existential TherapyFocused on what it means to be alive
Non-symptom focused
Clients guided in discovering unfulfilled needs and realizing potential
Cognitive-behavioral TherapyFocused on how both thoughts and behaviors affect outcomes
Evidence-based, effective and highly versatile
Mindfulness-based CounselingFocused on feelings and thoughts in the moment, and without judgment
Includes CBT with a Buddhist-based mindfulness component
Highly versatile
Rational Emotive TherapyFocused on how faulty thinking relates to distress
The therapist is active and directive
Reality TherapyFocused on the present-day
Non-symptom focused
Promotes individual responsibility and taking control of one’s life
Counselor is positive and nonjudgmental
Constructionist TherapyFocused on how cultural influences and interpretations shape meanings
Strong interest in language
Client-driven, counselor acts as collaborator
Systemic TherapyFocused on how systems (e.g., school, work, family) affect underlying issues
Therapist collaborates with people across and within systems
Narrative TherapyFocused on the stories we tell ourselves about who we are
Counselor works collaboratively to create alternate stories
Creative TherapyFocused on the use of artistic expression as a cathartic release of positive feelings
Highly versatile—music and various art mediums may be used

Analytical

Excellent Communication

Patient

Passionate

Compassionate

Calm

Goal orientated

Leadership qualities

Interpersonal skills

Research skills

Understanding

Team person

Familiar with human behavior

Observant

Problem solving skills

Pragmatic

Philosophical

Realistic

Sensible

Rational

Logical

Judicious

Prudent

Perceptive

Education without guidance and counseling is not complete and the person is unable to develop his personality fully and thus unable to serve society by his talents and abilities

  1. GUIDANCE

› Skinner: “guidance is a process of helping young persons learn to adjust to self, to others and to circumstances”.

› JM Brewer: “Guidance as a process through which an individual is able to solve their problems and pursue a path suited to their abilities and aspirations”.

› Guidance is an educational service designed to help students make more effective use of the schools training programme

› Guidance refers to the process of assisting the individual:

o   To find out his needs,

o   Understand his problems,

o   Asses his potentialities

o   To formulate plans of action

o   To maximize his potential development and adjustment.

Nature and Characteristics

› It is a personal service

› Help and assistance to an individual to solve problems

› It is a planning for future

› It helps a person to decide where he wants to go, what he wants to do and how best he can reach goals

› It is promotion of growth of individual in self-direction

› Continues and dynamic

› Based on educational objectives

› It provide benefit both the individual and society

› For better future adjustment

› Overall these field- Educational, vocational and social

› Attainment of self-direction by an individual

› It is a process of learning, helping and effecting changes in an individual

› Process of assisting an individual to find his place

› It helps to establish an effective relationship between his total educational experiences and his personnel needs and potentialities

› It is a process of assisting to adjust

› It provides physical and mental health

› Well rounded social development

› Proper use of leisure time

› Mastery of fundamental school processes

› Guidance covers the whole extent of youth problems

› Appropriate social behavior

› Personal effectiveness in every day affairs

›  Assimilation of right values and attitudes

› Guidance is remedial. Orientation and developmental

› It is both generalized and specialized service

Need for guidance in school

› Total development of the student

› For educational career development

› To recognize and use one’s inner potential

› For adjustment in school and home

› To minimize the incidence of indiscipline

› To help exceptional children in their optimal development

› It is needed to satisfy needs of all type of learners

› To develop healthy and balanced personality

Type of guidance

  1. Personal guidance

According to Wilson, “personal guidance is the assistance given to an individual in his physical, emotional, social, moral and spiritual development and adjustment”.

Needs of Personal guidance

ü  For personal adjustment

ü  It is essential for developing individual competence

ü  It is needed for avoiding interpersonal tensions and conflict

ü  For family and vocational life

ü  It help in taking decision with regard to personal problems

ü  It brings happiness and satisfaction in the life of the individual

ü  For integrated and balanced personality

Process of Personal guidance

  1. Collection of data
  • Physical, mental, intellectual, social, emotional, and academic, personality, interest and aptitude etc. are collected by using appropriate tool.
  1. Diagnosis of the problem
  • Analyze the problem and identifying the causes of the problem
  1. Prognosis
  • Based on diagnosis, the future course of development of the problem is judged by counselor.
  • Detected possible causes, remedial measures etc.
  1. Rendering guidance
  • Establishing proper rapport, realize the main cause of the difficulty
  1. Follow-up 

Educational guidance

It is a process for helping an individual to plan a suitable educational programme and make progress in it.

Jones: “It is the assistance given to the pupils in their choices and adjustments with relation to schools, curriculum, courses and school life”. 

Need of Educational guidance

ü  Select right type of education

ü  Reduce examination anxiety

ü  For effective study habits

ü  For meaningful educational experience

ü  To reduce wastage and stagnation

ü  Overcome educational problems

ü  For selecting appropriate curricula and course

ü  Educational growth and development

Vocational guidance

› National Vocational Guidance Association (USA): “Vocational guidance as the process of assisting the individual to choose an occupation, prepare for it, enter upon and progressing in it”.

Need of Vocational guidance

ü  To assist student to make the best possible vocational choice

ü  Provide information about occupational opportunities

ü  Help student to understand the problem of unemployment and its cause

ü  For vocational adjustment

ü  For efficient use of Manpower and resources

ü  To develop the potentialities of youngsters to the optimum level

 

ü  For achieve vocational goal 

Guidance

Counseling

General

Specific

It is broader than counseling

Is a part of guidance

Usually given normal individual

Abnormal individual

Personal or impersonal

Always personal

Personal centered

Problem centered

Lifelong process

Its service terminated after the problem solved

 

  • Hadfield: “mental health is the full and harmonious functioning of the whole personality”.
  • WHO: “it is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stress of life, can work productively and is able to make a contribution to his or her community”.
  • Therefore mental health is the ability to adjust oneself with the various stressful situations of the environment.
  • A mentally health person lives a fuller, happier, harmonious and effective life.

Characteristics of mentally healthy person

  • Knowing self
  • Socially adaptable
  • Flexibility
  • Emotionally matured and stable
  • Intelligent
  • Harmony with socially proved goals
  • Real life
  • Insight his own conduct
  • Courage and tolerance
  • Sense of belongingness and loyalty
  • Good habits
  • Free from undesirable activities
  • Philosophy of life
  • Enthusiastic and reasonable
  • Well balanced work, rest and recreation

Factors affecting Mental Health

  • Hereditary factors
  • Physical health
  • Socio-cultural environment
  • Intelligence
  • Disorganized family environment
  • Habit training in childhood
  • School related factors
  • Influence of media

Mental Health in School

  • Emotional development
  • Social relationship
  • Teachers role
  • Potentialities and needs
  • Level of aspiration
  • Freedom to express
  • Avoidance unhealthy competition
  • Variety of interests
  • Teaching in human relations
  • Provision of sex and moral education
  • Method of teaching and curriculum
  • Guidance cell

Characteristics of Mentally Healthy teacher

  • Alertness, enthusiastic
  • Maintain pleasant interpersonal relationships
  • Recognition of one’s own mistakes
  • Patience, kindness, sympathy and fairness in dealing with students
  • Democracy and courtesy in relationship with pupil
  • Ability to use praise for work well done.
  • Pleasing personal appearance and manner
  • Consistent behaviour
  • Flexibility in opinion, beliefs and attitudes
  • A good sense of humor
  • Physical fitness and good health status.
  • Wide interest

 

  • American Psychiatric Association: “Mental hygiene consists of measures to reduce the incidence of mental illness through prevention and early treatment and to promote mental health”.
  • Encyclopedia Britannia: “mental hygiene as the science of maintaining mental health and preventing the development of psychosis, neurosis, or other mental disorders”.
  • It is the science, which deal with

ü  The prevention of mental illness,

ü  The preservation of mental health, and

ü  The care of mental illness.

Aims and Objectives

  • Mental hygiene provides an opportunity to the individual to realize and develop his potentialities to the maximum.
  • Harmonious development of physical, mental and spiritual capacities of the individual.
  • To develop positive attitude towards life
  • It is responsible for effective existence
  • It is to prevent mental disorders or illness.
  • Preserve the mental health of the individual in group.
  • It is to discover and utilize therapeutic measure to cure mental illness.
  • Rehabilitation of mentally disturbed

 

  • To deal social problems

 

  • By Dr. Sigmund Freud
  • Also known as Adjustment mechanism and Mental mechanism.
  • A defence mechanism is an unconscious psychological strategy adopted by the individual to tackle a frustrating situation.
  • It is a learned responses which develop unconsciously to meet a stress situation
  • It may be defined as any habitual method of overcoming blocks, reaching goals, satisfying motives and maintaining equilibrium.
  • A defence mechanism is a coping technique that reduces anxiety arising from unacceptable or potentially harmful impulses
  • Tension reduction activity
  • Every individual uses his own mechanism to maintain the balance of his personality in the society.
  • Defense mechanism helps the individual to preserve his self-concept and protects him from anxiety.
  • Comer (1992): “According to psychoanalytic theory, these are strategies developed by ego to control unacceptable id impulses and to avoid or reduce the anxiety”.
  • Morgan at al (2005): “unconscious strategies used to avoid anxiety, resolve conflict and enhance self-esteem”.
  • Is the unconscious strategy adopted by an individual to protect form ego, to minimize conflict, and to maintain repression.

Types of Defence Mechanism

  1. Aggression
  • It refers to forceful activity that can be in the form of either physical, verbal or symbolic or all three.
  • It arises from the frustration where individual attempts to hurt or destroy the source of frustration.
  • Extra punitive:- aggressive attitudes frustration to another person
  • Intra punitive: frustration to himself.
  1. Compensation

This is a mechanism in which an individual tries to balance or over-up his deficiency in one field by exhibiting his strength in another field.

Ex: a boy who fails in academic subjects may save his self-esteem by distinguishing himself in athletics, girls wore high-heeled shoes.

  1. Identification
  • It consists of adopting the feelings, attitudes and achievements of others as one’s own.
  • Here individual seeks satisfaction in associating himself in some way in the success of others.
  • Ex: children often identify themselves with their parents, film stars, cricket players or political leaders.
  1. Projection
  • Placing blame for one’s own actions or inadequacies on someone or else or circumstances-rather than accepting responsibility for their own actions.
  1. Rationalization
  • Use of a reasonable excuse or acceptable explanation for behavior.
  • It is a face saving devise by which the individual justifies his short-comings, failure and incompetence by giving false reasons.
  • kind of excuse making process.
  • Ex: a boy failed in maths make use of rationalization when he says the questions were out of syllabus.

Sour grapism:

  •  Something we cannot get becomes something we did not want anyway.
  • Here individual attempt to rationalize his external conditions rather than upon his own inability.
  • Ex: failure to qualify UGC test, one might say, was a blessing as there are lot of unemployed UGC Holders.

Sweet Lemonism:

  • This refers to the attitude that what is already achieved is better than something that is usually considered more desirable of others.]
  1. Negativism
  • Refuse to co-operate and exhibit rebellious behaviour doing the opposite of what is normally expected.
  • This mechanism by which an individual draws the attention of others.
  1. Withdrawal
  • It is the retreating from situations which cause difficulties or refusing to face problems to avoid the danger of failure and hence the possible frustration.
  1. Regression
  • It is the mechanism of escape from reality by returning to behaviour appropriate at an earlier age.
  • In this the individual returns to less mature level of development to save his ego.
  • Ex: an adolescent girl who has been frustrated in fulfilling her needs may cry like a child, an old man, by taking of the good  olden days.
  1. Repression
  • An individual forgers by pushing down into the unconscious any thoughts that arouse anxiety.
  • It is an unconscious process where in painful experience, shameful thoughts etc. are removed from conscious mind by pushing down them to unconscious mind.
  1. Sublimation
  • It involves a process of redirecting the socially unacceptable desires along desirable channels.
  • Frustrated sexual impulses are usually sublimated as creative effort in music, art and literature etc.

 

  • The word ‘Adjustment’ mean ‘to fit’, ‘make suitable’, ‘adapt’ etc.
  • Adjustment is the process through which a person tries to strike balance between his requirements (need, desires, and urges) and varying life situations.
  • Webster: “adjustment is the establishment of a satisfactory relationship, as representing harmony, conformance, adaptation or the like”.
  • C. V. Good: “Adjustment is the process of finding and adopting modes of behaviour suitable to the environment or the changes in the environment”.
  • Shaffer: “Adjustment is the process by which a living organism maintains a balance between its needs and the circumstances that influence the satisfaction of these needs”.
  • Adjustment is a process that helps a person to lead a happy and contented life while maintaining a balance between his needs and his capacity to fulfill them.

Nature of Adjustment

  • It is a continues process
  • Two-way process

Not only the process of fitting oneself into available circumstances but also the process of changing the circumstances to fit one’s needs.

  • It is the process of need reduction
  • It is an achievement
  • It beings happiness, efficiency and some degree of social feelings
  • It involves psychological and physiological problems.

Area of adjustment

  • Health and physical environment
  • Finance, living conditions and employment
  • Social and recreational activities
  • Sex and marriage
  • Social psychological relation
  • Personal psychological relations
  • Moral and religious
  • Home and family
  • Future – vocational and educational
  • Adjustment to school and college work
  • Curriculum and teaching.

Measurement of Adjustment

  • Testing techniques
  • Projective techniques
  • Inventory techniques
  • Sociometric techniques
  • Scaling techniques
  • Bell’s adjustment inventory by- Hungh M. Bell
  • Asthana’s Adjustment inventory – H.S. Asthana.

Characteristics of a Well-adjusted Person

  • Awareness of his own strength and limitation
  • Respecting himself and others
  • An adequate level of aspiration
  • Satisfaction of basic needs
  • Absence of a critical or fault-finding attitude
  • Flexibility in behavior
  • The capacity to deal with adverse circumstances.
  • A realistic perception of the world.
  • A feeling of case with his surroundings.
  • A balanced philosophy of life.

A counselor’s approach is a reflection of his/her training and coaching philosophy.

For example, a person trained in behaviorism will view a client’s behavior as a function of reward and punishment systems. The Behavioral Counselor will primarily focus on how behavior is impacted by environmental factors, as opposed to thoughts or unconscious motivations.

Counseling approaches and coaching styles also are differentiated by how therapists interact with clients. For example, Client-centered Counselors tend to focus on a client’s innate goodness and to use a nondirective style of interaction.

Generally speaking, counseling approaches are guided by theory and research—both of which inform the method of practice.

1. Psychodynamic Counseling

Psychodynamic counseling is probably the most well-known counseling approach.

Rooted in Freudian theory, this type of counseling involves building strong therapist-patient alliances.

The goal is to aid clients in developing the psychological tools needed to deal with complicated feelings and situations. Freud also was concerned with the impact of early experiences and unconscious drives on behavior. This focus is evident in the following quote:

The conscious mind may be compared to a fountain playing in the sun and falling back into the great subterranean pool of subconscious from which it rises

Sigmund Freud, Brainyquote.com

Some of the ways in which these drives are uncovered include dream interpretation, projective tests, hypnotism, and free association.

Historically, psychodynamic therapy was a lengthy process, but nowadays, it also is applied as a relatively short-term approach. Research has indicated effectiveness for both long- and short-term psychodynamic treatment for the treatment of psychiatric issues (e.g., Bögels, Wijts, & Oort et al., 2014; Knekt, Lindfors, & Härkänen, 2008; Leichsenring, Salzer, & Jaeger, 2009).

 

2. Interpersonal Counseling

Interpersonal counseling is a diagnosis-focused approach in which the client’s disorder is regarded as a medical illness that requires intervention (Markowitz & Weissman, 2004).

In this sense, any fault or self-blame is diminished for the client. The role of interpersonal relationships and attachment on mental health outcomes are also important targets for this type of counseling.

It is a time-limited approach during which clients learn that their psychological issues are linked to environmental stressors. Interpersonal counselors are supportive and compassionate, serving as client allies.

Such therapists suggest ways for clients to deal with situations in a way that promotes self-efficacy and reduced symptoms (Markowitz & Weissman, 2004). Based on clinical trials, Interpersonal Therapy has been effective for the treatment of psychiatric disorders, especially depression (Markowitz & Weissman, 2004).

 

3. Humanistic/Client-Centered Counseling

Humanistic counseling is based on the assumption that individuals already possess the qualities needed to flourish. This approach encourages curiosity, intuition, creativity, humility, empathy, and altruism (Giorgi, 2005; Robbins, 2008).

Humanistic Counseling was first developed by Carl Rogers, who later founded Client-centered Therapy—a humanistic counseling style that helps clients reach their full potential as human beings.

Client-centered Therapy promotes a safe climate in which the therapist is both empathetic and nonjudgmental. In this way, the client experiences a sense of acceptance, openness, and unconditional positive regard.

These ideas are beautifully articulated by Rogers, who noted that:

People are just as wonderful as sunsets if you let them be. When I look at a sunset, I don’t find myself saying, ‘Soften the orange a bit on the right-hand corner.’ I don’t try to control a sunset. I watch with awe as it unfolds.

Carl Rogers, Goodreads.com

Carl’s words also convey the importance of allowing the client to make his/her own discoveries rather than providing a lot of therapist direction. Therefore, with a client-centered counselor, the client usually does most of the talking. The therapist’s role is to guide clients in an accepting way—helping them to see the beauty within themselves.

 

4. Existential Therapy

Existentialism is a philosophy aimed at examining the question of human existence. It is often associated with 19th and 20th-century writers and philosophers such as Jean-Paul Sartre, Soren Kierkegaard, Albert Camus, and Friedrich Nietzsche.

Existential thinking is also inherent in ancient Greek philosophy going as far back as Socrates—469-399 BCE (Flynn, 2009).

Existential Therapy does not attempt to cure a person or diminish specific symptoms, but rather, it seeks to explore and question aspects of the human predicament (Corbett & Milton, 2011). The client is viewed as ever-changing and always in the process of becoming (Dryden, 2007).

The existential therapist operates from the client’s perspective to explore what it means to be alive. He/she works with the client to examine unfulfilled needs and potential; and how to make rational choices. While this counseling approach is still evolving, research has indicated significant reductions in anxiety and depression symptoms following short-term existential therapy (Rayner & Vitali, 2015).

 

5. Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy (CBT) is grounded in the assumption that “emotional disorders are maintained by cognitive factors, and that psychological treatment leads to changes in these factors through cognitive and behavioral techniques” (Hofmann & Smits, 2008, p. 621).

In other words, by combining both cognitive and behavioral approaches, CBT is focused on how thoughts AND behaviors dictate a person’s feelings in a given situation.

The following principles guide Cognitive-behavioral Therapy:

  1. Mental health disorders involve key learning and information processing mechanisms.

  2. Behaviors are better understood by exposing their true functions.

  3. New adaptive learning experiences can be used to substitute prior nonadaptive learning processes.

  4. Therapists use a scientific approach to therapy by creating hypotheses about patients’ cognitive and behavioral patterns; by intervening and observing outcomes; and by reframing original hypotheses as needed (Hazlett-Stevens & Craske, 2004).

A variety of different techniques and components may be included in CBT therapy, such as exposure, social skills training, cognitive restructuring, problem-solving training, journaling, and relaxation training—among others.

 

6. Mindfulness-based Counseling

Mindfulness-based Counseling is grounded in mindfulness philosophy which “refers to a process that leads to a mental state characterized by nonjudgmental awareness of the present moment experience, including one’s sensations, thoughts, bodily states, consciousness, and the environment while encouraging openness, curiosity, and acceptance” (Hofmann, Sawyer, & Witt et al., 2010, p. 169).

During mindfulness-based therapy, the client pays attention to his/her feelings and thoughts in the moment, and without judgment. Following Buddhist traditions, it is an openminded and accepting way of responding to thoughts (Kabat-Zinn, 2005).

Mindfulness-based counseling is an increasingly popular approach aimed at helping clients to increase relaxation while removing negative or stressful judgments. This technique helps to teach clients how to deal with emotional stressors reflectively instead of reflexively (Hofmann et al., 2010).

Different types of mindfulness meditation approaches may be applied as part of mindfulness counseling such as yoga, breathing meditation, sitting meditation, bodyscan, and soundscan.

Bodyscan involves attending to different parts of the body in a gradual format while tensing and then relaxing muscles. With soundscan, responses to sounds are adjusted such that their aversive impact is reduced. While mindfulness approaches are often added onto CBT and other forms of therapy, there is recent evidence supporting their unique benefit for the reduction of anxiety (Blanck, Perleth, & Heidenreich et al., 2018).

 

7. Rational Emotive Therapy

Albert Ellis developed Rational Emotive Therapy in the mid-1900s. It is a type of CBT in which a person’s distress is perceived as a function of irrational or faulty thinking.

The therapist works with the client to examine his/her cognitive appraisals of how an event may have created an outcome (Gonzalez, Nelson, Gutkin, et al., 2004). In other words, it is the client’s belief about a situation—rather than the situation itself, that is the focus of treatment.

Unlike Client-Centered Therapy, Ellis’s rational-emotive approach is active and directive, intending to help clients avoid self-defeating beliefs and ultimately to experience a more positive sense of wellbeing.

 

8. Reality Therapy

Reality Therapy was developed by William Glasser in the 1950s. Its principles stem from Alfred Adler’s ideas about the social context of human behavior (Wubbolding, 2010). It is based on Choice Theory, which focuses on the power of individuals to control their behaviors.

While not all aspects of life are within our power to change, human beings are always faced with opportunities to respond either rationally or responsibly—or the opposite thereof (Peterson, 2000).

Reality Therapy helps clients to establish greater control over their lives while enhancing the ability to build meaningful and effective relationships. It is a present-day, non-symptom-focused approach in which the counselor takes on a friendly, positive, and nonjudgmental stance.

Reality Therapy promotes individual responsibility for actions while helping clients make decisions that are in line with the visions they have for their lives (Peterson, 2000; Wubbolding, 2010).

 

9. Constructionist Therapy

Constructionist Therapy is concerned with the meanings humans construct regarding the world around them. Within this framework, qualities believed to be related to gender, race, and social class is shaped by cultural influences and human interpretation. (Sutherland & Strong, 2010). Constructionist therapy is thus concerned with power imbalances, as well as the importance of language (Munro, Knox, & Lowe, 2008).

More specifically, language is considered the avenue through which individuals create meaning about themselves and others. Language is viewed as constructive, involving various aspects of communication (e.g., questions, reflections, and interpretations), along with the invitation for “clients to develop specific constructions of their identities, problems, and relationships” (Sutherland & Strong, 2010, p. 257).

It is a client-driven process in which the client actively participates in discussions as to their problematic perceptions and constructions.

 

10. Systemic Therapy

Systemic Therapy underscores the influence of how patterns across systems (e.g., family, school, and employment) influence behaviors and psychological issues. A systemic approach, therefore, does not aim to treat a problem, so much as the system underlying it (Carlson & Lambie, 2012).

For example, Systemic Therapy is often used for family counseling, as it enables the identification of dysfunctional patterns of communication and other behaviors across family members. Family involvement (which may be cross-generational) entails having family members work with the therapist to develop healthier roles, interactions, and dynamics.

 

11. Narrative Therapy

Narrative therapy enables individuals to become experts in their own lives. Each of us has a story we tell ourselves about who we are as a person. Because we derive meaning from our stories, they shape and influence how we perceive and respond to the world around us.

By impacting our decisions, these narratives influence our ability to enjoy meaningful and satisfying experiences. The narrative counselor works collaboratively with the client to create alternate stories using a nonjudgmental, respectful approach (Morgan, 2000).

Ultimately, clients are guided in re-authoring their stories in a way that is more consistent with their life goals.

 

12. Creative Therapy

Creative Therapy involves the use of different art mediums aimed at improving mood and other aspects of wellbeing.

For example, Music Therapy consists of “the monitored use of music to promote clinical change” (Bulfone, Quattrin, & Zanotti et al., 2009, p. 238). Music therapy may be used in multiple ways, such as in combination with CBT or other types of therapy.

Performing music also may foster positive feelings that reduce stress and promote healing. The scientific literature indeed supports a link between music therapy and reduced psychological symptoms such as anxiety (e.g., de l’Etoile’ Etoile, 2002; Bibb, J., Castle, D. & Newton, 2015; Shirani Bidabadi & Mehryar, 2015).

Art Therapy is also used as a creative therapeutic tool. Engaging clients in art projects such as healthy image posters, collages, and clay modeling provides a method of self-expression that goes beyond words.

Artistic expression also supports the cathartic release of positive feelings (Curl, 2008), and aids counselors in applying other types of therapy (Chambala, 2008). Research indicates that art therapy is indeed useful for the reduction of anxiety and other psychological symptoms across multiple populations (e.g., Chandraiah, Ainlay, & Avent, 2012; Sandmire, Gorham, & Rankin et al., 2012).

To aid the reader in the main points of each of the above counseling types, they are outlined in the following table:

Any of the above counseling approaches may be applied for the treatment of anxiety and depression.

The choice of therapy depends upon various other factors, such as the client’s specific symptoms, personality traits, coexisting diagnoses, family dynamics, a preferred way of interacting with the therapist, and treatment goals.

Depression

Several types of counseling have been found useful for the treatment of depression, such as Behavioral Therapy, Cognitive Behavioral Therapy, Intrapersonal Therapy, and Mindfulness-based Cognitive Therapy (Jorm, Allen, & Morgan et al., 2013).

Behavioral Therapy for depression is a good fit for someone who needs help getting involved in activities and behaviors that are inconsistent with a depressed mood. The individual’s cognitions would not be the target of a behavioral intervention; rather, the client would be behaving his/her way out of depression.

On the other hand, a CBT approach would contain behavioral elements in addition to a focus on faulty beliefs and thought patterns contributing to depression. CBT is the most researched type of treatment for depression, with many studies supporting its efficacy (Jorm et al., 2013).

Mindfulness-based CBT combines CBT with the element of present-moment awareness of how ruminative or wandering thoughts relate to depressed thinking (Jorm et al., 2013). Interpersonal Counseling involves working with the client to identify aspects of interpersonal relationships that contribute to depressive symptoms.

Overall, there are several effective approaches for the treatment of depression, elements of which may be combined or modified to meet the client’s unique needs.

Anxiety

Anxiety treatment also may involve any of the above approaches; however, CBT is the most widely used approach for treating anxious symptomatology. CBT counselors working with anxious clients will tailor therapy to the individual needs of the client and make modifications based on his/her progress (Hazlett-Stevens & Craske, 2004).

Along with occurring in a variety of forms, CBT may include different components.

Exposure Therapy is a type of CBT that is commonly used for the treatment of anxiety disorders. This technique involves exposing the client to his/her feared object or situation. Such exposure is typically gradual, with the exposure beginning with less threatening stimuli and gradually working its way toward increasingly feared stimuli.

When systematic desensitization is used, gradual exposure also involves Relaxation Techniques as a way of pairing the feared stimulus with a state that is not compatible with anxiety.

Flooding Exposure involves having a client confront his/her fears in a nongradual format based on the idea that, without engaging in avoidance, the patient’s fear will become extinguished, i.e., stopped  (Abramowitz, Deacon, & Whiteside, 2019).

Exposure therapy also may include In Vivo Exposure (i.e., exposure to an actual feared object), Simulated Exposure (i.e., exposure to a proxy of a feared object), or Virtual Reality Exposure (i.e., exposure to a highly realistic virtual space).

In sum, CBT comes in many forms, but it is generally regarded as a highly effective approach for the treatment of anxiety (e.g., Butler, Chapman, & Forman et al., 2006; Deacon & Abramowitz, 2004).

All human beings experience loss of some sort; indeed, “suffering is part of the divine idea” (Henry Ward Beecher, Brainyquote.com).

Many of us also experience trauma, which is a deeply troubling and painful experience, such as involvement in a natural disaster, combat, personal violence, or the death of a child. Sometimes people can get through the various stages of grief and ultimately move forward with life after loss or trauma. But, often, it becomes too much to bear without clinical help.

While many of the counseling approaches noted above are applicable, methods that are especially appropriate for treating trauma and loss are outlined below.

CBT is frequently used to treat loss, as well as trauma resulting in post-traumatic stress disorder (PTSD). For example, Prolonged Exposure Therapy was designed for the treatment of PTSD.

With this approach, both repeated in-vivo and imaginal exposure are combined to enable the patient to experience trauma without the feared outcomes. This technique is considered by many clinicians as the best option for PTSD (Van Minnen, Harned, & Zoellner et al., 2012). Additionally, exposure that utilizes virtual reality headsets is also effective for the treatment of PTSD (Powers & Emmelkamp, 2008).

Interpersonal Therapy is an additional option for those dealing with trauma and loss. Interpersonal Therapy examines symptoms related to loss through the lens of personal relationships.

Bereaved clients undergoing Interpersonal Therapy also may be guided in establishing new relationships (Wyman-Chick, 2012). Although often used to treat depression, research also has indicated that Interpersonal Therapy is a practical approach for PTSD (Rafaeli & Markowitz, 2011).

A new approach for treating loss, trauma, and PTSD is Eye Movement Desensitization and Reprocessing (EMDR). EMDR is based on the idea that psychological distress is the product of traumatic events that have been inappropriately processed.

The EMDR approach involves stimulating the brain’s information processing system, while painful events are being recalled. Such stimulation may include eye movements, hand tapping, or listening to tones (Shapiro & Solomon, 2010). It is believed that the bilateral stimulation applied during EMDR enables the client to reprocess connections between memories and emotions.

Scientific research has indicated that the EMDR approach is valid for the treatment of PTSD (Shapiro & Solomon, 2010).

Attending Support Groups is another approach that has the added benefit of creating a place in which clients are supported by those who can genuinely empathize with their feelings. Feeling related to at this level is often comforting for those who have felt isolated in their grief.

Support groups are not for everyone, as they do require the ability to interact with multiple people about painful life experiences. But, for those who are ready and able to share in this way, they may enable participants to form deep bonds with others, as well as to benefit from multiple perspectives—as opposed to just that of one therapist.

Overall, these approaches only represent a few examples of counseling techniques designed to help people through stress, trauma, and loss. Various additional techniques are available (e.g., Spiritual Counseling, Hypnotherapy, Stress Inoculation Therapy, etc.) based on the client’s needs and preferences.

A couples counselor serves an unbiased observer of the issues impacting a couple’s relationship.

The counselor helps the clients to uncover underlying feelings such as mistrust, resentment, and pain. The couple will learn new ways of communicating and navigating areas in need of compromise.

There also may be situations in which a relationship is not salvageable (e.g., spousal abuse, serious substance use issues, etc.). In this case, the couples counselor may guide one or both clients toward the conclusion that the relationship is in such a state that counseling is not recommended.

Couples counselors have several counseling tools and styles with which to work. For example:

  • Drawing from Reality Therapy, the therapist might work with the couple regarding issues of power and control (Wubbolding, 2010).

  • Interpersonal Counseling with couples emphasizes the role of relationships in affecting psychological outcomes. Systemic Therapy with couples aims to enhance connectedness and build stronger relationships (Johnson & Best, 2003).

  • Narrative Counseling with couples guides clients toward improved relationships by acknowledging and adjusting their narratives (Besley, 2002).

  • Existential Counseling with couples supports clients in experiencing more purposeful and meaningful lives.

  • Finally, Client-centered Counseling with couples guides clients in discovering the sources of their relationship issues.

Other couples counseling approaches not previously described include Holistic Counseling and The Gottman Method. With Holistic Counseling, couples therapists address a client’s full range of experiences and the entire being (e.g., mind, body, emotional, spiritual, and psychological).

Gottman Method Couple’s Therapy is a science-based approach that enhances affection, respect, and admiration among couples. It takes place in three parts: The friendship system, the conflict management system, and the shared meaning system (Garanzini, Yee, and Gottman et al., 2017). Gottman Method Couples Therapy has been found to improve long-term relationship stability and satisfaction. (Gottman & Gottman, 2008).

Reality Therapy has been used among school counselors and educators in numerous schools worldwide (Mason & Duba, 2009).

With its emphasis on personal responsibility, Reality Therapy helps to empower students with the motivation to make decisions that are consistent with their goals (Mason & Duba, 2009).

Reality Therapy applies to a wide range of student levels and issues, including conduct problems among children and career development needs among college students.

Counselors use Reality Therapy by developing respectful and trustful bonds with students and serving as advocates to help them attain their goals and acquire a greater sense of self-esteem.

Effective educational applications of Reality Therapy have been reported for the treatment of:

  • Public speaking phobia (Harris, Kemmerling, & North, 2004),
  • Identity crises (Kakia, 2010), and
  • Bullying behavior (Madukwe, Echeme, & Njoku, 2016).

Reality Therapy also has been found to improve teacher happiness (Nematzadeh & Sary, 2014)—which is yet another way of improving positive student outcomes.

Additional examples of counseling techniques for students include the following:

 

Motivational Enhancement Therapy

A brief approach designed to help school counselors enhance student motivation.

Motivational Enhancement Therapy has been applied within school and university settings for the promotion of academic achievement (Oluwole & Olanrewaju, 2016); as well as for the reduction of drinking-related outcomes (LaChance, Ewing, & Bryan et al., 2009) and problematic gambling behavior (Petry, Weinstock, & Morasco et al., 2009).

An approach designed to improve student outcomes by addressing dynamics between individual, school, and family systems.

Systemic therapy has been applied in educational settings to reduce school refusal and anxiety (Schweitzer & Ochs, 2003), improve social and emotional learning (Oberle, Domitrovich, & Meyers et al., 2016), creating safer school environments (Hernández & Seem, 2004), and promoting family engagement in school (Davis & Lambie, 2005).

An approach designed to improve student outcomes by addressing dynamics between individual, school, and family systems.

Systemic therapy has been applied in educational settings to reduce school refusal and anxiety (Schweitzer & Ochs, 2003), improve social and emotional learning (Oberle, Domitrovich, & Meyers et al., 2016), creating safer school environments

  • Rational Emotive Therapy is a good choice if a client needs a directive therapist to help with irrational beliefs.
  • Existential Therapy is a good option for dealing with a sense of meaningless and lack of purpose.
  • CBT Exposure Therapy is an excellent choice for combatting phobias and PTSD.
Posttraumatic stress disorder (PTSD) – causes, symptoms, treatment & pathology
Obsessive compulsive disorder (OCD) – causes, symptoms & pathology
Somatic symptom disorder – causes, symptoms, diagnosis, treatment, pathology
Disruptive, impulse control, and conduct disorders
Tourette’s syndrome & tic disorders – definition, symptoms, diagnosis, treatment
Learning disability – definition, diagnosis, treatment, pathology
Cerebral palsy (CP) – causes, symptoms, diagnosis, treatment & pathology
Autism – causes, symptoms, diagnosis, treatment, pathology
Attention deficit hyperactivity disorder (ADHD/ADD) – causes, symptoms & pathology
Alzheimer’s disease – plaques, tangles, causes, symptoms & pathology
Parkinson’s disease – causes, symptoms, diagnosis, treatment & pathology
Schizophrenia – causes, symptoms, diagnosis, treatment & pathology
Bipolar disorder (depression & mania) – causes, symptoms, treatment & pathology
Clinician’s Corner: Tips on how to study smarter
Spaced repetition in learning theory
 
Memory palaces – learning science
Social Anxiety Disorder – causes, symptoms, diagnosis, treatment, pathology
Panic disorder – panic attacks, causes, symptoms, diagnosis, treatment & patholog