Four Theories of Therapeutic Counseling: Methods, Treatment, and Goals, with Sensitivity to MulticulturalismWhen entering the field of counseling one of the most important decisions a new counselor will face, is how to decide what theory is best suited to his or her type of practice. While every counselor has their own preferred approach, sometimes the approach may have to be amended to fit the needs of a client. Sometimes a combination of theories may be implemented in a way that will be most beneficial to the treatment process. Regardless of the psychological theory or approach, all counselors must be sensitive to their client’s individuality and cultural heritage. In comparing four popular theories used in the counseling profession today, apparent similarities and differences will emerge.
Psychoanalytic Therapy
The method of psychoanalytic therapy was developed by Dr. Sigmund Feud. It focuses mainly on the client’s formative years and early childhood experiences. Freud believed when someone begins facing difficulties later in life, there is an unresolved conflict still present from childhood (Erford, 2018). When patients are treated using psychoanalysis, the counselor listens while the client delves into childhood traumas and experiences. It is very important for a counselor not only to listen to a patient, but to observe as well. According to an article by Salman Akhtar, “Analytic listening, for Freud, was not restricted to the patients spoken words. It also included paying attention to his silences, and the non-verbal cues he offered” (Akhtar 2012). It is also very important for counselors to be aware of the non-verbal cues they are sending to the client. Eye contact, vocal tone, and body positioning are three main ways to indicate to the client that the counselor is engaged and interested during the session (Erford 2018).
The goal of the therapy is for the client to bring their unconscious memories into the conscious and deal with the situation that is causing the conflict. Sometimes a counselor may have the client talk about recurring dreams in order to analyze them and find a specific pattern or meaning. The client who would best be helped by this type of therapy is an adult having problems that seem to stem from a childhood experience, or an adult who is having relationship issues with a parent.
There is some criticism of this type of therapy; mainly because it is so lengthy and time consuming. Sensitivity to multiculturalism is also an issue in this type of counseling. Some cultures still consider women to be inferior to men. There are also some aspects of the theory that are very offensive to women, such as the concept of penis envy. These ideas have mostly been discredited and abolished (Erford 2018). This approach shares some similarities with Family Systems therapy and Person-centered therapy regarding examination of past issues, especially parental and family influences in early childhood. It differs from cognitive behavioral therapy in that it mainly deals with past issues and does not seek timely resolution of the problem.
`Cognitive Behavioral Therapy (CBT)
The main goal of CBT is to bring about changes in behavior through cognitive restructuring (Erford 2018). It is based on the premise that a client can learn to recognize negative thought patterns and replace them with healthier, more constructive ones. Thought stopping is also considered to be a very effective form of treatment. Clients who best fit the criteria for this type of therapy are those who suffer from cognitive distortions or faulty thinking (Erford 2018). They may be magnifying or minimizing a problem, or they may be catastrophizing future events. The problems occur when clients adopt patterns of thinking that are outside the norm. It is very important for the counselor to understand that “normal” can have different meanings for everyone and it is especially important to consider this within a multicultural context. According to an article in the Journal of Social and Psychological Sciences by Sophia Mello, “Patient’s emotional experiences, although supposedly ‘distorted’ are meaningful and intelligible’ (Mello 2018). She also states that “they convey a message about the patient’s perception and emotional experience at any given time (Mello 2018). The cognitive behavioral approach is different from the others in that it is very action oriented and focuses on more immediate results. It must be noted however that some clients may take longer than others to effectively employ the techniques used in this type of therapy (Erford 2018).
Person Centered Therapy
The theory of person-centered therapy was developed by Carl Rogers. The premise that Roger’s used for his theory is that all individuals have the need for high self-regard (Erford 2108). The counselor must be honest and sincere and approach the client in a completely nonjudgmental way to help the client open up and discuss the problem. Developing empathy is very important in the person-centered approach. Characteristics of clients most likely to receive this type of therapy are those who have experienced unhealthy social influences during the process of self-actualizing (Erford). Sometimes this is because the client faced conflict during this period while seeking approval from others. The goal of this therapy is for the client to grow and adjust to his or her social environment, while achieving independence and self-realization (Erford 2018). “The benefits of person-centered ways of working with clients may include increased social skills, reality contact, and reduction in psychopathological symptoms” (Traynor et.al. 2011). This method is similar to cognitive behavioral therapy and psychoanalytic theory in that it helps the client to examine thoughts about how a past event may be causing the current issue. This approach could be especially effective for clients from other cultures because they need to feel that the counselor has empathy and accepts them unconditionally.
Family Systems Therapy
This approach is best suited to adults who are having problems associated to repeating behaviors learned within the family unit. The client may be having a problem identifying as an individual or may be repeating actions learned from their parents that have been passed down generationally. Some types of treatment may include family education, “I” coaching, and differentiation of self (Erford 2018). Goals would be to identify and resolve negative patterns within the family unit. Identifying cultural beliefs and values is very important in this type of therapy. If the client is holding negative cultural conceptions, it may lead to a negative self-perception as well (Erford 2018). This approach is similar to person-centered therapy in searching for past negative influences. It differs from the other methods of therapy in that the entire family is involved in the counseling process rather than an individual client.
My Methods of Choice
Upon examining these four theories I believe my personal approach would primarily consist of CBT integrated with person-centered therapy. I believe most clients would like to see their issues resolved as quickly as possible, and CBT is the most action oriented. Cognitive distortions such as all or nothing thinking, catastrophizing, maximizing, and minimizing can be addressed quickly by thought stopping and cognitive restructuring (Erford 2018). Clients who feel they are making progress and being helped, are more likely to keep appointments and view the counseling process as a positive experience. My professional goals as a counselor would be to remain nonjudgmental and show empathy for my clients, while providing them with a peaceful, non-threatening environment. I feel this could be best accomplished by integrating person-centered therapy with the CBT approach.
Multiculturalism
The person-centered approach is also very effective when dealing with multiculturalism. It is important for the client to not only be heard, but to be understood as an individual as well. Much more can and should be done to deal with the issues of language barriers. More qualified interpreters should be available in clinical settings. “Counselors must develop a range of skills to allow them to address the needs of persons in culturally different populations” (Brady-Amoon 2011). This would help to avoid miscommunication that could have serious negative consequences. In quoting from an article by Peggy Brady-Amoon, “Becoming a culturally competent counselor is a lifelong process that takes place over the course of one’s career (Brady-Amoon 2011).
Conclusion
In conclusion, all four methods of counseling are valuable to the profession. Each of them is unique in its approach and has merit when used in the proper setting. Regardless of the preferred method of approach it is extremely important to keep the client’s individuality in mind. There is no better way to celebrate the diversity in our country than being able to help people from a myriad of cultural, ethnic and religious backgrounds to lead more meaningful and fulfilling lives.
References
Akhtar, S. (2012). Psychoanalytic Listening: Methods, Limits, and Innovations. London: Routledge. Retrieved from: http://databases.pennhighlands.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=489987&site=ehost=live&live&scope=siteBrady-Amoon, P. (2011) Humanism, Feminism, and Multiculturalism: Essential Elements of Social justice in Counseling, Education, and Advocacy. Journal of Humanistic Counseling, 50(2), 135-148. Retrieved from http://databases.pennhighlands.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=69613436&site=ehost-live&scope=site
Erford, B. T. (2018). Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations. NY NY: Pearson.
Mello, S. (2018). Does Cognitive Behavioral Therapy Need to Rediscover Its Existential Soul? Journal of Social and psychological Sciences 11(1), 1-9. Retrieved from http://databases.pennhighlands.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=129286367&site=ehost-live&scope=siteTraynor, W., Elliot, R., & Cooper, M. (2011) Helpful factors and outcomes in person centered therapy with clients who experience psychotic processes: therapists’ perspectives. Person Centered and Experimental Psychotherapies, 10(2), 89-104. https://doi.org.databases.pennhighlands.edu/10.10 80/147 79757.2011.576557
