Counseling Models
Choosing a therapist to fit your needs can become a confusing experience. You probably will hear some "counselor-eze"–the language of the counseling field–with which you are not familiar. Don't worry, you are in the majority. Please remember: ALWAYS ASK QUESTIONS WHEN YOU DO NOT UNDERSTAND. You have some important decisions to make, and it is important to make informed decisions! Christians need to be aware of the different approaches their therapist may use in their counseling. Likewise, pastors need to have some idea of the counseling models used by the therapists to whom they refer their members. This pamphlet is not meant to be an introductory course to psychological theory. Rather, it is intended to serve as a quick reference guide.
Counseling models have something to offer when used by a trained therapist. Some theoretical approaches work better than others, depending on your psychological or relationship needs. Some therapists have integrated several counseling models into their personal approach to counseling.
Traditional Counseling Models
Psychoanalytic: This model follows the teachings of Sigmund Freud. The emphasis is on the client's childhood experiences and relationships with the parents, and on the client's psychosexual development. Psychoanalysis seeks to uncover the secrets of the human psyche hidden in the unconscious mind. Psychoanalysts attempt to develop a relationship of transference with their clients, in which the clients relate to their analysts just as they did to their parents in childhood. During this process the client's defense mechanisms are identified and replaced with healthy behavior patterns. Psychoanalysis usually takes many years to complete with 1-3 sessions every week.Psychodynamic: This model does not follow Freud's idea of psychosexual development. However, stages of social development over the life span are still important in this model. Lifetime experiences are examined and defense mechanisms are identified. The client is helped in learning appropriate decision-making skills and behaviors. Psychodynamic therapy often involves long term therapy, but not as long as psychoanalysis.The psychoanalytic and psychodynamic approaches propose that our childhood experiences can strongly influence our reactions in the present without our even realizing it. This does not mean that our present behaviors are the fault of our parents, nor that our past determines our future. However, it does provide us with information necessary and helpful for changing the negative influences of our past.Client-centered or Rogerian: Carl Rogers believed that reality for the individual is the sum total of one's experiences and perceptions over a lifetime. According to Rogers, the goal of achieving one's potential can be attained in counseling provided that the therapist provides an atmosphere of genuineness, unconditional acceptance, and empathy. The counselors are non-directive in that they refrain from sharing their own beliefs, values, or opinions with the client. They offer neither approval nor judgment of the client's decisions. This also is long-term therapy.Cognitive: The basic concept of this model is that our feelings and behaviors are the result of the way we think. The cognitive therapist seeks to help the client identify cognitive distortions, irrational beliefs, or negative self-talk. The therapist helps the client replace these faulty thought processes with reality-based thinking, so that the client experiences healthy emotions and relationships. Cognitive therapy tends to be didactic in nature, directive in approach, and collaborative in process.Behavioral: This model is very "scientific" in nature in that the counselor and client only work on what can be observed and measured. A problem behavior is observed; a plan for changing it is implemented; progress is measured and reported. Behaviorists believe that individuals are shaped by their environment. Some behaviorists believe that we learn through conditioning. Others believe that we can learn by observing the behaviors of others and the consequences of those behaviors. In either case, the theory is that, if the antecedent or the consequence of the client's behavior is changed, then the behavior of the client will be changed as well.Cognitive-Behavioral: This approach is a blend of cognitive therapy and behavioral therapy. The client's thought processes are identified as well as the antecedents and consequences of the client's behavior. The clients are helped to make healthy changes in both their way of thinking and their behaviors. All three–cognitive, behavioral, and cognitive-behavioral–models are considered to be short-term therapy (i.e., 3-6 months, possibly more).Family Systems: This model views problems as belonging to the family rather than to any one individual. Each family member both influences and is influenced by the other members of the immediate family and the extended family. Sub-systems are identified within the family. Family of origin issues are studied. Genograms are used to chart behavior patterns and experiences across several generations of the extended family. Even though there may be a focus client, the entire family is involved in therapy, so that dysfunctional family interaction patterns can be changed. Family systems therapy is directive, collaborative, and medium-term (6-12 months, or more).Adlerian or S.T.E.P.: Adlerian therapy is the basis for the Systematic Training in Effective Parenting or S.T.E.P. program. It is believed that no two siblings have the same family experiences due to their different psychological positions in the family constellation. Mutual respect within the family is a primary goal of therapy. The family atmosphere is identified, along with the goals of the child's misbehavior. Parents are taught to modify their reactions to their children's misbehavior, to encourage and nurture appropriate behaviors, and to use logical and natural consequences to discipline their children. Therapy is short/medium-term.Both Family Systems and Adlerian family counseling offer many benefits in dealing with problems within the family context. No individual lives in a vacuum. Having an understanding of the family dynamics provides insight into the individual's view of himself or herself. Twelve-Step: This model is used by many self-help groups (e.g., Alcoholics Anonymous) and by most substance abuse treatment programs. The 12 steps of recovery begin with an admission of being powerless over one's addiction and a turning to a higher power of one's own choosing for help. The steps proceed through making an inventory of all wrongs, making amends for those wrongs, and helping others work through the 12 steps. Individuals are encouraged to take "one day at a time." Self-help groups do not involve a professional therapist, while treatment programs and therapy groups are led by a therapist. Length of participation is up to each individual–some attend group meetings for the rest of their lives.Medical Model: This model sees all mental disorders as being biological in nature; therefore, the primary treatment is medication. When medication is deemed necessary, it often is best to consult with a psychiatrist, because they have been trained in the prescribing and monitoring of psychotropic medications. Therapy often is used in conjunction with medical treatment. In fact, research shows that a combination of medication and therapy often produce the best results for the more severe disorders.Eclectic: This means that the therapist is choosing from several theoretical models as the basis for their approach to counseling. However, usually there is one theoretical model that forms a foundation upon which certain aspects of the other theories are added. Usually eclectic counselors practice short or medium-term therapy.Eye Movement Desensitization and Reprocessing: EMDR is often used with trauma victims. It is based on the neurophysiological hypothesis of "Accelerated Information Processing". It is suggested that we have an innate physiological processing system in our brain that normally processes disturbing input in an adaptive manner. A trauma interrupts this adaptive information process and the traumatic memories are stored in an isolated neuro network that cannot connect with the other more adaptive neuro networks. The use of directed eye movements together with cognitive reprocessing unblocks the traumatic information so that it can connect with adaptive thought processes, resulting in emotional relief and healing from the traumatic memories.Solution-Focused: This is more a framework for therapy than a theory or model. It is adaptable to brief therapy (3-6 sessions or more). A problem is identified in terms of behaviors. Exceptions to the problem behavior in the client's life are identified as providing opportunities for change. A goal for counseling is explored. A solution plan is chosen that uses the client's present strengths and resources. The focus is on what changes can be made; emphasis is on the reality of the present.ConclusionIt is important to be sure that your spiritual needs as a Christian will be served and/or respected in therapy. It is important that your therapist explain the theoretical approach that will be used in counseling. The more information you have, the better prepared you are in making decisions throughout your therapy experience. Remember that in all things God's Word is the final authority to which all else, including counseling models, must submit.
Counseling models have something to offer when used by a trained therapist. Some theoretical approaches work better than others, depending on your psychological or relationship needs. Some therapists have integrated several counseling models into their personal approach to counseling.
Traditional Counseling Models
Psychoanalytic: This model follows the teachings of Sigmund Freud. The emphasis is on the client's childhood experiences and relationships with the parents, and on the client's psychosexual development. Psychoanalysis seeks to uncover the secrets of the human psyche hidden in the unconscious mind. Psychoanalysts attempt to develop a relationship of transference with their clients, in which the clients relate to their analysts just as they did to their parents in childhood. During this process the client's defense mechanisms are identified and replaced with healthy behavior patterns. Psychoanalysis usually takes many years to complete with 1-3 sessions every week.Psychodynamic: This model does not follow Freud's idea of psychosexual development. However, stages of social development over the life span are still important in this model. Lifetime experiences are examined and defense mechanisms are identified. The client is helped in learning appropriate decision-making skills and behaviors. Psychodynamic therapy often involves long term therapy, but not as long as psychoanalysis.The psychoanalytic and psychodynamic approaches propose that our childhood experiences can strongly influence our reactions in the present without our even realizing it. This does not mean that our present behaviors are the fault of our parents, nor that our past determines our future. However, it does provide us with information necessary and helpful for changing the negative influences of our past.Client-centered or Rogerian: Carl Rogers believed that reality for the individual is the sum total of one's experiences and perceptions over a lifetime. According to Rogers, the goal of achieving one's potential can be attained in counseling provided that the therapist provides an atmosphere of genuineness, unconditional acceptance, and empathy. The counselors are non-directive in that they refrain from sharing their own beliefs, values, or opinions with the client. They offer neither approval nor judgment of the client's decisions. This also is long-term therapy.Cognitive: The basic concept of this model is that our feelings and behaviors are the result of the way we think. The cognitive therapist seeks to help the client identify cognitive distortions, irrational beliefs, or negative self-talk. The therapist helps the client replace these faulty thought processes with reality-based thinking, so that the client experiences healthy emotions and relationships. Cognitive therapy tends to be didactic in nature, directive in approach, and collaborative in process.Behavioral: This model is very "scientific" in nature in that the counselor and client only work on what can be observed and measured. A problem behavior is observed; a plan for changing it is implemented; progress is measured and reported. Behaviorists believe that individuals are shaped by their environment. Some behaviorists believe that we learn through conditioning. Others believe that we can learn by observing the behaviors of others and the consequences of those behaviors. In either case, the theory is that, if the antecedent or the consequence of the client's behavior is changed, then the behavior of the client will be changed as well.Cognitive-Behavioral: This approach is a blend of cognitive therapy and behavioral therapy. The client's thought processes are identified as well as the antecedents and consequences of the client's behavior. The clients are helped to make healthy changes in both their way of thinking and their behaviors. All three–cognitive, behavioral, and cognitive-behavioral–models are considered to be short-term therapy (i.e., 3-6 months, possibly more).Family Systems: This model views problems as belonging to the family rather than to any one individual. Each family member both influences and is influenced by the other members of the immediate family and the extended family. Sub-systems are identified within the family. Family of origin issues are studied. Genograms are used to chart behavior patterns and experiences across several generations of the extended family. Even though there may be a focus client, the entire family is involved in therapy, so that dysfunctional family interaction patterns can be changed. Family systems therapy is directive, collaborative, and medium-term (6-12 months, or more).Adlerian or S.T.E.P.: Adlerian therapy is the basis for the Systematic Training in Effective Parenting or S.T.E.P. program. It is believed that no two siblings have the same family experiences due to their different psychological positions in the family constellation. Mutual respect within the family is a primary goal of therapy. The family atmosphere is identified, along with the goals of the child's misbehavior. Parents are taught to modify their reactions to their children's misbehavior, to encourage and nurture appropriate behaviors, and to use logical and natural consequences to discipline their children. Therapy is short/medium-term.Both Family Systems and Adlerian family counseling offer many benefits in dealing with problems within the family context. No individual lives in a vacuum. Having an understanding of the family dynamics provides insight into the individual's view of himself or herself. Twelve-Step: This model is used by many self-help groups (e.g., Alcoholics Anonymous) and by most substance abuse treatment programs. The 12 steps of recovery begin with an admission of being powerless over one's addiction and a turning to a higher power of one's own choosing for help. The steps proceed through making an inventory of all wrongs, making amends for those wrongs, and helping others work through the 12 steps. Individuals are encouraged to take "one day at a time." Self-help groups do not involve a professional therapist, while treatment programs and therapy groups are led by a therapist. Length of participation is up to each individual–some attend group meetings for the rest of their lives.Medical Model: This model sees all mental disorders as being biological in nature; therefore, the primary treatment is medication. When medication is deemed necessary, it often is best to consult with a psychiatrist, because they have been trained in the prescribing and monitoring of psychotropic medications. Therapy often is used in conjunction with medical treatment. In fact, research shows that a combination of medication and therapy often produce the best results for the more severe disorders.Eclectic: This means that the therapist is choosing from several theoretical models as the basis for their approach to counseling. However, usually there is one theoretical model that forms a foundation upon which certain aspects of the other theories are added. Usually eclectic counselors practice short or medium-term therapy.Eye Movement Desensitization and Reprocessing: EMDR is often used with trauma victims. It is based on the neurophysiological hypothesis of "Accelerated Information Processing". It is suggested that we have an innate physiological processing system in our brain that normally processes disturbing input in an adaptive manner. A trauma interrupts this adaptive information process and the traumatic memories are stored in an isolated neuro network that cannot connect with the other more adaptive neuro networks. The use of directed eye movements together with cognitive reprocessing unblocks the traumatic information so that it can connect with adaptive thought processes, resulting in emotional relief and healing from the traumatic memories.Solution-Focused: This is more a framework for therapy than a theory or model. It is adaptable to brief therapy (3-6 sessions or more). A problem is identified in terms of behaviors. Exceptions to the problem behavior in the client's life are identified as providing opportunities for change. A goal for counseling is explored. A solution plan is chosen that uses the client's present strengths and resources. The focus is on what changes can be made; emphasis is on the reality of the present.ConclusionIt is important to be sure that your spiritual needs as a Christian will be served and/or respected in therapy. It is important that your therapist explain the theoretical approach that will be used in counseling. The more information you have, the better prepared you are in making decisions throughout your therapy experience. Remember that in all things God's Word is the final authority to which all else, including counseling models, must submit.
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