Chapter 13: Understanding Theories Of Counselling In Practice Flashcards
Why does a counsellor need to understand theories of counselling in practice?
Counsellors need to be able to explain what they are doing and why, and use the skills and techniques that are consistent with their model for understanding the clients issues. It is not helpful if the counsellor is confused or sends out mixed messages about how counselling works or what they expect of the client.
When we are trying to understand clients issues, theory provides a potential framework for looking at what has “gone wrong“ and this in turn informs us how the counsellor might work with a client
As well as giving you a framework for understanding what went wrong, your theoretical model will also determine how you work with clients in the counselling process. This is evident in the nature of the counselling relationship, the goals and intentions of therapy, and the skills and techniques used by the counsellor
Describe how to put psychodynamic counselling into practice
Psychodynamic theory is focussed on how the clients past history impacts on the present. Most of the consequences of this early experience are acted out unconsciously, and therefore the aim of psychodynamic counselling is to bring past, unresolved issues or traumas into awareness in order to shed light on them and help the client change things in the present.
Includes integrating learning or working through aspects of a key developmental stage that the client did not successfully negotiate.
The psychodynamic counsellor aims to be neutral and keeps a certain aloofness or professional distance. The idea is that by not giving anything away about themselves, the therapist becomes in effect a “blank screen“ onto which the client will unconsciously “transfer“ thoughts, attitudes, and feelings which actually belong to past relationships with significant others – transference. The therapist can then interpret what is being transferred unconsciously onto them to help the client better understand themselves, their history, and their patterns of relating.
What are three skills and techniques that psychodynamic counsellors use to make the unconscious conscious?
Working with resistance and defense mechanisms – the counselor will notice how the client is defending themselves from uncomfortable thoughts and feelings or what defense mechanisms the client is using both in the room and in their life and will bring these into the clients awareness
Free Association – the counsellor will invite the client to say whatever comes into their mind as a way of seeing what unconscious material slips out without the client realizing it. The counsellor will then interpret this or invite the client to reflect on it
Dreams and fantasies – the counsellor will encourage the client to describe their dreams and fantasies because these less-guarded expressions of what is going on in the clients unconscious can reveal truths of which they are unaware
What is one criticism of the psychodynamic way of working?
That insight does not necessarily lead to change
Describe how to put cognitive-behavioral therapy counselling into practice
CBT aims to change self-defeating thoughts and unhelpful behaviors. The counsellor does not focus on past events or childhood development but focusses instead on the clients current negative thoughts and behaviors. They will see these as learned behaviours that can be unlearned. The therapists task is to identify, challenge, and work with the client to change irrational thoughts and behaviours to ones that will enable them to function more effectively. Essentially, CBT counsellors work at problem-solving by teaching new ways of thinking and behaving.
The relationship is more like a teacher-pupil relationship. The CBT counsellor takes a lead by assessing the problem and agreeing a specific treatment plan with the client aimed at achieving the desired change in thinking and/or behavior. The counsellor will use different tools, techniques, and prescribed homework tasks to facilitate this change. It is important that the client knows what they want to change for the therapy to work, which is why goalsetting is an important part of contracting in CBT work.
What are some specific techniques and skills that cognitive-behavioral counsellors use to help the client work towards change?
Challenging irrational beliefs and automatic thoughts
“Thought stopping“ to break old patterns of thinking
Experimenting with different ways of thinking and behaving
Using different measures and scales to track progress and change
Engaging in homework assignments, such as keeping a thought diary or practising new ways of behaving
What is one criticism of the CBT way of working?
It does not focus on the client-counselor relationship itself. Counsellors work on the basis that a “working alliance“ is sufficient, but this leaves little scope for exploring the dynamics of what is happening between the counsellor and client, including dealing with issues such as transference
Describe how to put person-centered counselling into practice
The person-centered view of what goes wrong is that the increasing tension between a persons organismic self and their self-concept – which has been formed from the conditions of worth imposed by others – leads to ever increasing internal this harmony. Rogers called this tension and split between the organismic self and the self-concept “being in a state of incongruence“: i. other words, not in harmony. The person becomes increasingly unable to trust and rely on their own internal valuing process and unable to fulfill their potential or self-actualize. The counselor does not use mental health terminology, preferring instead to use the clients own language for describing what ails them.
Focusses on creating an environment where a client would realize their potential and grow as a whole person. Rogers also believed that the client was the expert on their own life, and as such rejected the use of techniques that put the therapist in the role of an expert on the clients life.
Rogers believed that the relationship between client and counsellor was the key factor in how therapy works. Roger saw the therapists role as offering a relationship that was not conditional in anyway. The person-centered relationship is more like unconditional love
What are the three core conditions according to Rogers that were necessary and sufficient for change to occur?
Empathy, congruence, and unconditional positive regard
According to Rogers, this core condition is when the counsellor is able to put themselves so much inside the private world of the client that they can clarify thoughts and feelings or hidden and denied parts of the client that they themselves are barely aware of. The counsellor is able to feel and sense the clients world so accurately and sensitively that they can then translate that experience back to the client. As the client experiences being understood, they are able to understand themselves and get back in touch with their organismic self
Empathy
According to Rogers, this core condition is also called genuineness or realness. This means that the counsellor commits to being real in the relationship. Rather than “doing“ something as an expert, the person-centered counsellor will offer themselves as they are not in a professional role. Because it is the direct opposite of the state in which clients come to counseling, in a state of incongruence, if the counsellor is congruent, it helps the client to be real too. It is a powerful message which says it’s OK to be yourself and be real
Congruence
According to Rogers, this third core condition is where the counsellor displays unconditionality towards the client to counteract the conditions of worth that the client has grown up with. Means fully accepting the client and their individual experience of the world
Unconditional positive regard
What is one criticism of the person-centered way of working?
The core conditions are “necessary“ but not “sufficient“
Provide a summary of the key points of psychodynamic counseling, CBT counseling, and person-centered counselling in practice
Psychodynamic counseling:
- Works with the client to bring unconscious processes into conscious awareness
- takes a neutral stance in the client-counselor relationship to encourage transference
- works with transference and counter-transference to give the client insight which enables them to change
CBT counseling:
- works with a client to challenge irrational believes and to establish beliefs that are based on reality
- establishes a relationship that is like that of a teacher and pupil
- uses techniques and homework to facilitate change towards identified goals – client plays an active role
Person-centered counselling:
- works with a client to recognize the conditions of worth that have affected their self-concept
- builds a therapeutic relationship based on the core conditions which counteract the conditions of worth
- trusts the client to find their own answers in the process of change
When counsellors use a model of counselling which is made up of understanding and skills from more than one approach. It is the combination of different elements to form a new whole
Integrative counselling
