Theoretical Approaches to Counselling - Essay Example

Theoretical Approaches to Counselling- Comparing the Strengths and Limitations of two Counselling Approaches There are three dominant approaches to counseling, each with theoretical, practical and relational aspects. They are the person-centered, the psychodynamic and the cognitive-behavioral approaches. These approaches are used in the practice of mental health counselors who whether are teaching clinical skills in academic settings, providing on-site supervision for practicum and internship students, or serving as clinical supervisors for unlicensed or less experienced counselors. In the following paper I am going to describe two of the above mentioned approaches including person-centered counseling approach and psychodynamic approach. Strengths and limitations of both approaches are analyzed as well as the theoretical aspect is presented. Psychotherapy-driven supervision is illustrated for three theoretical approaches: humanistic-relationship oriented, cognitive-behavioral, and solution-focused. Person-centered counseling: theoretical aspect This approach is often referred to as Rogerian counseling after its founder Carl Rogers, who was convinced that human beings were essentially positive, forward-looking and realistic by nature. This type of humanistic counseling deals with the ways in which people perceive themselves consciously rather than having a counselor try to interpret unconscious thoughts or ideas. There are many different components and tools used in person-centered counseling, including active listening, genuineness, paraphrasing, and more. The real point is that the client already has the answers to the problems and the job of the counselor is to listen without making any judgements, without giving advice, and simply help the client feel accepted and understand their own feelings. The fundamental premise upon which Carl Rogers based his theory was that the individual has within himself the resources for self-understanding, for challenging and altering self-concepts, attitudes and behaviors. This he called the actualizing tendency, which Rogers believed was the motivating force driving all human beings to achieve wholeness. Factors that inhibit or obscure the individual's actualizing tendency include the development of a negative self-concept. Accordingly person-centered counseling endeavors to help the client to become what they are capable of becoming, though releasing the psyche's own self-regulating mechanisms or "the organismic self" When viewed from a humanistic perspective, nursing can be seen as the ability to struggle with another through "peak experiences related to health and suffering in which the participants in the nursing situation are and become in accordance with their human potential" (Paterson and Zderad 1976:7). Nursing theorist Rosemary Parse captures this concept of "potential" in her theory of "health as human becoming" (1998). The goal of the nurse living out the theory of human becoming is "true presence in bearing witness and being with others in their changing health patterns" (Parse 2001:231). In practice, person centred counselors are often criticized as being too "safe" and nondirective. Frequently the client wants more assistance, knowledge and direction. The concept that we all have what it takes to self-actualize means that in strict person centred counseling there are long gaps of silence where the therapist dutifully waits for "as long as it takes" for the "penny to drop". Many clients get annoyed with this delay, and others become disillusion with therapy generally. In some cases clients may decide they can not be helped. Many clients who have sought psychoanalysis from the author have previously had person centred therapy and become annoyed at what they perceive as the therapist being unhelpful. The standing joke is that all a person centered therapist ever says is "Well what do you think". Person-centred counselling is effective in assisting those clients who are already fairly self-aware, and have some ability to verbalise their feelings. These clients benefit from a caring environment and some support in healing themselves. Also where clients have been bombarded with negative comments, a caring person centred environment is very beneficial. Psychodynamic counseling: theoretical aspects This approach is pioneered by Sigmund Freud, whose method of psychoanalysis is seen as the starting point for all future work developed in the field of psychotherapy. Freud's theories and concepts have been modified and adapted over the years by a large number of theorists including Carl Jung, Melanie Klein and others. McLeod (1993) identifies three distinctive features of the psychodynamic approach: 1) That the client's difficulties have their ultimate origins in childhood experiences; 2) That the client may not have a conscious awareness of their true motives or impulses behind their behavior; 3) That the use of dream analysis, interpretation and transference in counseling may help the client to become more conscious. The psychodynamic counselor sees counseling as helping the person explore their relationships with others, and is achieved through the client becoming more aware of his / her internalised aspects of personality. As much of this mental activity is unconscious, the aim of counseling is to bring internalised conflict into conscious awareness and thus enable the person to deal more effectively with the demands of external reality. In the practice of counseling, the client can project onto the Counsellor main caretakers or significant figures in their lives such as Father, Mother etc. The Counsellor can use this 'projection' to help the client work through issues. Psychodynamic boundaries can be quite rigid. The Counsellor reveals nothing of themselves. The Counsellor reflects back to the client and uses interpretation of everything in and out of the session, for example, on the way to the room, the client may talk about the weather. The Counsellor might interpret this as anxiety and will bring this to the clients attention, or if the client is carrying many bags or is late, all this can be noted and interpreted. In other words the clients 'inner world' is interpreted from the way they greet you to the way they sit in the room. Strengths and limitations of both approaches Without a doubt, both approaches have strengths as well as weaknesses. The strengths that each theoretical approach brings to the counseling setting are echoed in the strengths they bring to the supervision environment. For example, the facilitative conditions of empathy, genuineness, and warmth combined with the belief in supervisees' natural tendencies to learn and grow are enduring contributions of the person-centered approach (Bernard & Goodyear, 2004). Likewise, strengths of psychodynamic approach was delineated by Bradley and Gould (2001). Major strengths mentioned for the psychodynamic approach include: the recognition of interpersonal dynamics in the supervisory and counseling relationships; the emphasis on the supervisory working alliance, described as the relational bond based on a sense of shared goals and tasks (Borden, 1979, 1983). For the person-centered approach, primary strengths include; the adaptability of such techniques as modeling, role-playing, feedback, reinforcement, individualized goal-setting; and evaluation for the purpose of teaching counseling skills; emphasis on collaborative goal setting, monitoring, and evaluation as well as the use of cognitive strategies for increasing counselors' awareness of their own thought processes that they bring to their therapeutic work with clients. In addition to strengths associated with specific theory-based approaches, it is worth noting what the approaches in general contribute positively to the supervision environment. Given that theories of psychotherapy are designed to promote growth and change in clients, it stands to reason that they could be similarly helpful in promoting growth and change in supervisees. Contributions of theory-based supervision approaches in general include the following: providing therapeutic relationship conditions, modeling counseling interventions, and providing a supervision environment that is isomorphic (i.e., equivalent in structure) (Thomas, 1994) to the counseling process (Bernard, 1992; Bernard & Goodyear, 2004; Bradley & Gould, 2001; Thomas, 1994). Moreover, given that counseling theories provide concepts for explaining human behavior and interventions for promoting positive change (Corey, 2005; Day, 2004), they offer useful guides for conceptualizing client situations, as well as choosing and implementing interventions. Transferring strengths from psychotherapy approaches into the supervision arena definitely has merit. However, the overarching criticism of these approaches centers around the rigid application of psychotherapy models within the context of supervision. This criticism translates into two primary concerns: minimizing the educational needs of supervisees and failing to monitor client progress and welfare. In her review, Bernard (1992) emphasized that a fundamental difference between supervision and therapy is that supervision is more educational (i.e., instructional and evaluative) than therapeutic. She added that this difference "will inevitably frustrate the psychotherapy-based supervisor" (p. 236). In a more recent discussion of psychotherapy-based approaches, Bernard and Goodyear (2004) cautioned: Supervisors who rely on this as their exclusive lens will miss important information about their supervisee's [sic] and about the range and impact of interventions they might use to help those supervisees. Often, this single lens also can lead supervisors to think in 'therapeutic' rather than educational ways about their supervisees. (p. 76) Furthermore, Davenport (1992) warned that ethical and legal considerations, including client safety, could be jeopardized when training needs are emphasized over skill assessment and monitoring of client cases. Criticisms of specific psychotherapy-based approaches are also worth noting. The biggest challenge for the person-centered model of supervision is the incompatibility of incorporating instruction and evaluation into a supervision environment that centers on providing the core therapeutic conditions (e.g., warmth, empathy, and unconditional positive regard) associated with this approach (Bernard, 1992). Less pointed descriptions of weaknesses of other psychotherapy-based models were offered by Bradley and Gould (2001). For the psychodynamic approach, a potential weakness is: overemphasis on supervisee personal insight; the possible blurring of supervision and counseling; limited role ascribed to affect and cognitions (seen as aspects of behavior) and the idea that motivations for behaviors were often ignored. For the person-centered approach, the potential shortcomings are: the lack of attention to feelings, unconscious processes, and insight. Watkins (1995) noted that psychotherapy-based models have remained virtually unchanged for decades. He argued further that the problems which arose from "building supervision theory directly out of psychotherapy theory (because supervisees are not clients) ... led to the emergence of alternate supervision paradigms" (p. 571), such as developmental and social role-based models. Similarly, Bernard (1992) concluded: "Making the pieces fit ... becomes an ongoing challenge for the psychotherapy-based supervisor" (p. 237). Perhaps in recognition of challenges and criticisms, more recent descriptions of psychotherapy-based models seem less rigid. Authors have been more willing to include supervision interventions that fall outside of the primary techniques used in the identified theoretical approach. For example, in their book on person-centered supervision, Tudor and Worrall (2004b) embraced the "formative or educative function of supervision" (p. 48) to develop supervisee skill and understanding as they pertain to clients and the therapeutic process. Emphasizing this point, they argued that this educative function "is entirely compatible with the person-centered approach and indeed is informed by the person-centered focus on the facilitation of learning" (pp. 48-49). Likewise, Coren (2001) argued that didactic teaching should be combined with clinical practice in the supervisory relationship when supervising and training clinicians to provide short-term psychodynamic therapy. In their description of solution-focused supervision, Presbury et al. (1999) acknowledged the need to address countertransference issues and supervisee behavior that could harm the client. Finally, Safran and Muran (2001) described an approach to supervision of cognitive psychotherapy which incorporated a relational perspective and experiential learning. While recent applications of the two approaches have begun to address their shortcomings and challenges, a gap remains between these models and alternative supervision paradigms which focus more directly on the process of supervision and the professional development of the supervisee. Conclusion In this paper I have reviewed two major approaches to counseling: person-centered and psychodynamic. Following the discussion we can conclude that two approaches have two different aims in counseling. Psychodynamic approach aims at bringing awareness of the inner emotional world of the client in order to improve their capacity to relate to others and to value themselves as they really are. Person-centered approach main objective is to release the client from the burden of trying to be who they are not, and to help them find choices for living with a greater sense of reality, in themselves and in their relationships. While psychodynamic approach is more practically based and is based on the statement that behavior ant thoughts are out of conscious control, the person centered approach is non directive and client led and reassures clients they are responsible for the way they feel and their actions. Both approaches have strengths and limitations that were described in this paper. Combining psychodynamic and person-centered approach allows each to complement the strengths of the other. Psychodynamic supervision advocates the blending of the best from both perspectives. Given that theories of psychotherapy have proven strategies for explaining human behavior and promoting change, their presence in supervision is essential to training new counselors. Likewise, person-centered practices attend specifically to the learning needs of the developing counselor. Integrating practices from both viewpoints allows supervisors to model and teach psychotherapeutic practices in a way that meets the unique learning needs of new counselors. REFERENCES Barlow, D. H. (Ed.) (2001). Clinical handbook of psychological disorders: A step-by-step treatment manual (3rd ed.). New York: Guilford. Berg, I. K. (1992). Family based services: A solution-focused approach (Rev. ed.). Milwaukee, WI: Brief Family Therapy Center Press. Bernard, J.M. (1979). Supervisor training: A discrimination model. Counselor Education and Supervision, 19, 60-68. Bernard, J. M. (1992). The challenges of psychotherapy-based supervision: Making the pieces fit. Counselor Education and Supervision, 31, 232-237. Bernard, J. M. (1997). The discrimination model. In C. E. Watkins, Jr. (Ed.), Handbook of psychotherapy supervision (pp. 310-327). New York: Wiley. Bernard, J. M., & Goodyear, R. K. (1992). Fundamentals of clinical supervision. Boston, MA: Allyn & Bacon. Bernard, J. M., & Goodyear, R. K. (1998). Fundamentals of clinical supervision (2nd ed.). Boston, MA: Allyn & Bacon. Bernard, J. M., & Goodyear, R. K. (2004). Fundamentals of clinical supervision (3rd ed.). Boston, MA: Allyn & Bacon. Bob, S. R. (1999). Narrative approaches to supervision and case formulation. Psychotherapy, 36, 146-153. Bradley, L. J., & Gould, L. J. (2001). Psychotherapy-based models of counselor supervision. In L. J. Bradley & N. Ladany (Eds.), Counselor supervision: Principles, process, and practice (3rd ed., pp. 147-180). Philadelphia, PA: Brunner-Routledge. Bradley, L. J., & Kottler, J. A. (2001). Overview of counselor supervision. In L. J. Bradley & N. Ladany (Eds.), Counselor supervision: Principles, process, and practice (3rd ed., pp. 3-27). Philadelphia, PA: Brunner-Routledge. Coren, A. (2001). Short-term psychotherapy: A psychodynamic approach. New York: Other Press. Corey, G. (2005). Theory and practice of counseling and psychotherapy (7th ed.). Belmont, CA: Brooks/Cole. Day, S. X. (2004). Theory and design in counseling and psychotherapy. Boston, MA: Lahaska Press. De Jong, P., & Berg, I. K. (2002). Interviewing for solutions (2nd ed.). Pacific Grove, CA: Brooks/Cole. Dobson, K. S. (Ed.) (2001). Handbook of cognitive-behavioral therapies. New York: Guilford Press. Frawley-O'Dea, M. G., & Sarnat, J. E. (2001). The supervisory relationship:A contemporary psychodynamic approach. New York: Guilford Press.Freeman, S. C. (1992). C. H. Patterson on client-centered supervision: An interview. Counselor Education and Supervision, 31, 219-226. Neufelt, S. A. (1994). Use of a manual to train supervisors. Counselor Education and Supervision, 33, 327-336. Pearson, Q. M. (2001). A case in clinical supervision: A framework for putting theory into practice. Journal of Mental Health Counseling, 23, 174-183. Pearson, Q. M. (2004). Getting the most out of clinical supervision: Strategies for mental health counseling students. Journal of Mental Health Counseling, 26, 361-373. Rogers, C. R. (1961). On becoming a person: A therapist's view of psychotherapy. Boston: Houghton Mifflin. Rosenbaum, M., & Ronen, T. (1998). Clinical supervision from the standpoint of cognitive-behavior therapy. Psychotherapy, 35, 220-230. Safran, J. D., & Muran, J. C. (2001). A relational approach to training and supervision in cognitive psychotherapy. Journal of Cognitive Psychotherapy: An International Quarterly, 15, 3-15. Schneider, K. J., Bugental, J. E T., & Pierson, J. E (Eds.). (2001). The handbook of humanistic psychology: Leading edges in theory, research, and practice. Thousand Oaks, CA: Sage. Stenack, R. J., & Dye, H. A. (1982). Behavioral descriptions of counseling supervision roles. Counselor Education and Supervision, 21, 295-304. Stoltenberg, C. D., McNeill, B., & Delworth, U. (1998). IDM supervision: An integrated developmental model for supervising counselors and therapists. San Francisco: Jossey-Bass. Thomas, F. N. (1994). Solution-oriented supervision: The coaxing of expertise. The Family Journal: Counseling and Therapy for Couples and Families, 2, 11-18. Tudor, K., & Worrall, M. (Eds.). (2004). Freedom to practice: Person-centred approaches to supervision. Herefordshire, UK: PCCS Books. Wilkins, P. (1995). A creative therapies model for the group supervision of counsellors. British Journal of Guidance and Counselling, 23, 245-257. Read More