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Theoretical Approaches
Counselling or psychotherapy training?
BACP does not feel it is possible to make a generally accepted distinction between counselling and psychotherapy. There are well founded traditions which use the terms interchangeably and others which distinguish between them. If there are differences, then they relate more to the individual psychotherapist's or counsellor's training and interests and to the setting in which they work, rather than to any intrinsic difference in the two activities. A psychotherapist working in a hospital is likely to be more concerned with severe psychological disorders than with the wider range of problems about which it is appropriate to consult a counsellor. In private practice, however, a psychotherapist is more likely to accept clients whose need is less severe. Similarly, in private practice a counsellor's work will overlap with that of a psychotherapist. Those counsellors, however, who work for voluntary agencies or in educational settings such as schools and colleges usually concentrate more on the 'everyday' problems and difficulties of life than on the more severe psychological disorders. Many are qualified to offer therapeutic work which in any other context would be called psychotherapy.
Both counsellors and psychotherapists work from a variety of theoretical approaches with their clients. These approaches range from the type of psychoanalysis originally practiced by Sigmund Freud (and later developed into other forms of analytical psychotherapy by his pupils) through to humanistic psychotherapy - based on personal growth and self development - to the behavioural therapies used for dealing with specific phobias and anxieties.
The following is an alphabetical list of the commonly used theoretical approaches with a brief description of their meanings:
Adlerian Therapy
This is sometimes called individual psychology and uses the personality theory and system of counselling originated by Alfred Adler. Rather than psychoanalysis, Adler placed greater emphasis on infantile experiences of power and powerlessness and the goal-orientation of human behaviour. He created the terms "inferiority complex" and "superiority complex".
Behavioural Therapy
This therapy is based on the belief that behaviour is learnt in response to past experience and can be unlearnt, or reconditioned, without analysing the past to find the reason for the behaviour. It works well for compulsive and obsessive behaviour, fears, phobias and addictions.
Brief Therapy (see also Solution Focused Brief Therapy)
This uses the Cognitive Behavioural approach with a small, planned number of sessions and possibly a single follow-up session after some time has elapsed.
Cognitive Analytical Therapy
This combines Cognitive Therapy with Psychotherapy and encourages clients to draw on their own resources to develop skills to change destructive patterns of behaviour. Negative ways of thinking are explored and treatment is structured and directive involving diary-keeping, progress charts etc.
Cognitive Behavioural Therapy
This combines cognitive and behavioural techniques. Clients are taught ways to change thoughts and expectations and relaxation techniques are used. It has been effective for stress-related ailments, phobias, obsessions, eating disorders and (at the same time as drug treatment) major depression.
Cognitive Therapy
This approach uses the power of the mind to influence behaviour. It is based on the theory that previous experiences can adversely affect self-perception and condition attitude, emotions and ability to deal with certain situations. It works by helping the client to identify, question and change self-denigrating thoughts, thus altering habitual responses and behaviour. It can help pessimistic or depressed people to view things from a more optimistic perspective.
Eclectic Counselling
An eclectic counsellor will select what is applicable to the client from a range of theories, methods and practices. Justification is based on the theory that there is no proof that any one theoretical approach works better than all others for a specific problem.
Existential Counselling
Existentialists believe that life has no essential (given) meaning: any meaning has to be found or created. Existential counselling involves making sense of life through a personal world view and includes a willingness to face one's life and life problems.
Family Therapy
This is used to treat a family system rather than individual members of the family. A form of systemic therapy, it requires specifically trained counsellors.
Gestalt Therapy
The name is derived from the German for "organised whole". Developed by Fritz Perls, it is based on his belief that the human response to experiences is summed up in a person's thoughts, feeling and actions. The client gains self-awareness by analysing behaviour and body language and giving expression to repressed feelings. Treatment often includes acting out scenarios and dream recall.
Humanistic Psychotherapy
This embraces techniques coming from the "personal growth movement" and encourages people to explore their feelings and take responsibility for their thoughts and actions. Emphasis is on the self-development and achieving highest potential rather than dysfunctional behaviour. "Client-Centred" or "Non-Directive" approach is often used and the therapy can be described as "holistic". The client's creative instincts may be used to explore and resolve personal issues.
Integrative Counselling
This is when several distinct models of counselling and psychotherapy are used together in a converging way rather than in seperate pieces.
Jungian
Carl Jung was the originator of Analytical Psychology; a disciple of Sigmund Freud and a pioneer of psychoanalysis.
Neuro-Linguistic Programming (NLP)
NLP combines cognitive behavioural and humanistic therapies with hypnotherapy. It works on the theory that life experiences, from birth onwards, programme the way a person sees the world. The practitioner helps the client to discover how he (or she) has learnt to think or feel so that he can take control of his actions. The client is taught how to change speech and body language in order to communicate better and bring about personal change.
Person-Centred Counselling
Devised by Carl Rogers and also called "client centred" or "Rogerian" counselling, this is based on the assumption that an individual (client) seeking help in the resolution of a problem he or she is experiencing, can enter into a relationship with another individual (counsellor) who is sufficiently accepting and permissive to allow the client to freely express emotions and feelings. This will enable the client to come to terms with negative feelings, which may have caused emotional problems and develop inner resource. The objective is for the client to become able to perceive himself as a person, with power and freedom to change, rather than an object.
Primal Therapy
This is based on the theory that supressed birth or infancy traumas can resurface as neuroses. The therapy takes the client back to the "primal scene" where trauma can be re-experienced as an emotional cleansing.
Psychoanalysis
This is based on the work of Sigmund Freud, who believed that the unacceptable thoughts of early childhood are banished to the unconscious mind but continue to influence thoughts, emotions and behaviour. "Repressed" feelings can surface later as conflicts, depression etc or through dreams or creative activities. The analyst seeks to interpret and make acceptable to the client's conscious mind, troublesome feelings and relationships from the past. "Transference" onto the analyst, of feelings about figures in the client's life, is encouraged. This type of therapy is often used by clients suffering high levels of stress and can be a lengthy and intensive process.
Psychodynamic Psychotherapy/Counselling
This approach stresses the importance of the unconscious and past experience in determining current behaviour. The client is encouraged to talk about childhood relationships with parents and other significant people and the therapist focuses on the client/therapist relationship (the dynamics) and in particular on the transference. Transference is when the client projects onto the therapist feelings experienced in previous significant relationships. The psychodynamic approach is derived from psychoanalysis but usually provides a quicker solution to emotional problems.
Psychosynthesis
Sometimes described as "psychology of the soul", psychosynthesis aims to integrate or "synthesise" the level of consciousness at which thoughts and emotions are experienced, with a higher, spiritual level of consciousness. Painting, movement and other techniques can be used to recognise and value different facets of the personality. Psychosynthesis is useful for people seeking a new, more spiritually oriented vision of themselves.
Re-Birthing
In this approach, emotional or physical traumas during birth are said to create feelings of seperation and fear in later life. Breathing techniques are used to release tension whilst the client re-experiences traumatic emotions. A skilled practitioner is essential.
Solution-Focused Brief Therapy
This promotes positive change rather than dwelling on past problems. Clients are encouraged to focus positively on what they do well and to set goals and work out how to achieve them. As little as 3 or 4 sessions may be beneficial.
Systemic Therapies
These are therapies which have, as their aim, a change in the transactional pattern of members of the system. It can be used as the generic term for family therapy and marital therapy.
Transpersonal Therapy
This describes any form of counselling or therapy which places emphasis on spirituality, human potential or heightened consciousness. It includes psychosynthesis.