What are the concepts of counseling

Video Transcript

Counseling: Definition

When you think about mental health counseling do you imagine a long couch and a silent doctor writing notes on his clipboard? This may have been true in the psychoanalysis days of the well-known Dr. Sigmund Freud, but today it actually isn’t. Counseling, often referred to as therapy, involves helping a client work through emotional and psychological issues of varying severity. It’s developed significantly through research and treatment experience by counseling psychologists and psychiatrists. Treatment methods and techniques have been developed through more recent counseling theories.

Counseling has many varied definitions through the field of psychology, but a few standards are constant. Essentially, counseling is the following:

• Performed by licensed, certified mental health counselors
• Confidential
• A profession with a range of specialties within the field
• Often done in an outpatient clinic or private practice
• Available for families, couples, and groups of people that share symptoms
• Based on scientific theories
• A personal and confidential experience
• For people with mental health problems
• For people without mental health problems
• For people with stress, anger, pain, grief, or other emotional issues
• For people who just need someone safe to talk to
• A developing science
• Sometimes supported with art, nature, or pet therapy
• Good for children, adults, the elderly, the disabled. . . everyone!

It’s also extremely important to note that counseling does not:

• Mean a client is ”crazy”
• Involve judgment on the clients actions
• Provide a quick fix
• Involve the therapist giving you answers
• Have anything to do with ”shrinking” anything!
• Need to go on forever
• Give out your personal information without your consent

Counseling Theories & Therapies

Since the time of Freud, psychologists have developed many theories about how best to approach helping others in counseling. Most of these theories are based on a combination of the views of the psychologist that created them and generally accepted psychological theories.

Some of the major counseling theories and techniques today are listed here:

1. Psychoanalytic theories and psychoanalysis
2. Cognitive-behavioral therapy
3. Existential therapy
4. Person-centered therapy

Now let’s cover these in a bit more detail.

As you saw, Sigmund Freud’s psychoanalytic theories of counseling are still used today! These theories have evolved significantly since the time of Freud but are still used in the counseling setting. Psychoanalytic therapy often focuses on childhood memories, unconscious thoughts and feelings, and exploring a client’s resistances to therapy.

On the other hand, cognitive-behavioral therapy is one of the most widely used therapies today. This theory is based on the idea that all problematic behaviors are learned, and thoughts and behaviors can be modified in counseling therapy. Therapists using cognitive-behavioral theories are goal-oriented and work with the client to modify behaviors that are causing emotional difficulty and problems for the client.

Counseling using existential therapy, though, focuses on the client’s personal experiences and personal thoughts on the meaning of life. Therapists using existential theories believe in a client’s freedom to choose their own lifestyle free from anxiety.

And, finally, we have person-centered therapy. Also called humanistic therapy, this person-centered method is easy to remember because it focuses on the uniqueness of every client. Because every client is unique, person-centered therapists may use other theories and therapies when they apply to the client’s situation. Person-centered therapy emphasizes that humans are naturally good, positive, and trustworthy. Due to this view, these therapists focus on self-exploration with their clients.

Licensed therapists are required to know these and all the other theories of counseling. Most counselors today use a combination of many types of therapy. However, due to the limitations that many insurance companies place on the amount of counseling sessions for insurance clients, cognitive-behavioral therapy is very popular. Cognitive-behavioral therapy can focus on specific, short-term behavioral goals.

Client Perspective

Let’s pretend we are a counseling client. We show up for our appointment on time and are brought into a comfortable room that often looks like a living room. The first session includes paperwork and a confidentiality agreement. Then it’s time to get to work.

Counselors often use the term ”work” as therapy is very tough when a client is dedicated to getting better. The first session will start with the therapist getting to know us and the issues that brought us to therapy. Then the work begins! We are expected to be open and honest as the relationship with the counselor becomes comfortable. The counselor will also help us think critically about our feelings and behaviors. The therapist often takes notes and we may as well. Some counseling sessions may focus on specific events, while others may try to delve deeper into why an emotion or behavior happens and how the client would like to change. These sessions run about an hour, and clients most often need to return for numerous sessions.

The length of counseling therapy varies with the client. Some clients are limited by the number of sessions an insurance company allows (usually between six and ten sessions.) Other insurance companies are more flexible, or the client can pay their own fees for therapy. In these cases, counseling may last as long as is needed and desired by the client.

The client is always free to leave therapy whenever they want, and many people test out counselors for a good-fit. For counseling to be most effective, the client needs to feel comfortable with the therapist. Since all therapists and clients are different, a switch can be made by the client or recommended by the therapist.

Counselor/Therapist Perspective

No matter what theories the counselor uses, there are some characteristics that all good counselors share. The best counselors share the following traits:

• They are able to listen deeply.
• They like helping people.
• They have emotional maturity.
• They have empathy and understanding.
• They have overall warmth.
• The express insightfulness.
• They’re comfortable with difficult issues and emotions.
• They’re non-judgmental.

As you can see, it’s very important for people who want to be counselors to be very warm, understanding, and nurturing by nature. Every person is unique, their circumstances are all different, and their needs and troubles vary. People who go into the field of counseling like helping people and have learned to be comfortable with any and all people and all issues that a client could bring to their counseling sessions.

Lesson Summary

All right, let’s take a moment to review what we’ve learned. When you’re finished watching the video, you should be able to:

• Explain what counseling is
• Discuss some major counseling theories
• Describe common counseling techniques
• Analyze how the client impacts the counseling session

As we learned, counseling, often referred to as therapy, involves helping a client work through emotional and psychological issues of varying severity, and that there are several different techniques. We learned that the main types of therapy include the following:

1. Psychoanalytic therapy, which often focuses on childhood memories, unconscious thoughts and feelings and exploring a client’s resistances to therapy.
2. Cognitive-behavioral therapy, which is based on the idea that all problematic behaviors are learned and thoughts and behaviors can be modified in counseling therapy.
3. Existential therapy, which focuses on the client’s personal experiences and personal thoughts on the meaning of life.
4. Humanistic therapy, also known as person-centered therapy, is a person-centered method and is easy to remember because it focuses on the uniqueness of every client.

No one perspective or methodology is a one-size-fits-all. But implementing the different perspectives, where and when are appropriate, is the best way to be an effective counselor.

KEY CONCEPTS OF COUNSELING WITH DIVERSE CLIENTS

Becoming a counselor who is competent in diversity and social justice means learning to view self, others, and the world in new ways. The process of stepping outside one’s life experience to understand and interact differently with others is inherently difficult. Counseling theories assist counselors in this process by providing a framework for understanding clients and their concerns, defining the counseling relationship, suggesting the goals and overall process of counseling, and describing interventions and strategies to achieve these goals. Although no comprehensive counseling theories exist that address all aspects of diversity, we review in this section a range of useful theories, concepts, and suggestions for understanding and working with diverse clients.

According to Constantine (2001), counselors need to be able to understand diverse clients and their concerns in terms of sociocultural and systemic factors to adequately treat them. However, most traditional counseling theories do not account for these factors and contain culturally determined assumptions about behavior that tend to skew judgments of abnormality toward diverse clients (Sue & Sue, 2008). Fortunately, the diversity, multicultural, and social justice counseling literature provide theories and concepts that help integrate sociocultural and systemic factors into the understanding of diverse clients and their concerns. The following sections describe three such concepts: the oppression model, social identity development, and worldview.

Understanding Diverse Clients Through the Oppression Model

Both multicultural and social justice counseling perspectives stress the importance of understanding clients and their concerns in terms of the systems in which they develop and live. This type of understanding allows counselors to see themselves, their clients, and the counseling relationship as part of societal systems; envision external barriers to client wellbeing; and implement systemic interventions such as advocacy. One way to conceptualize societal systems is through the oppression model (Bell, 2007).

Social identity groups are a collection of people who share physical, cultural, or social characteristics within one of the categories of social identity. The common social identity group categories included in discussions of diversity are race, ethnicity, gender, sexual orientation, class, disability, age, and religion (Hardiman & Jackson, 2007). According to the oppression model, within each identity group category, specific identity groups are valued more highly and, consequently, have more power than other groups. Social identity groups with more power are known as dominant or agent groups. Currently in the United States, agent groups include Whites, heterosexuals, males, the “able-bodied,” the upper class, and young or middle-aged adults (Hardiman & Jackson, 2007). Social identity groups that have less power are known as target groups and include, but are not limited to, people of color; gay, lesbian, bisexual, or transgender people; females; people with disabilities; the working class or poor; and older adults or the very young (Hardiman & Jackson, 2007).

Oppression begins with agent groups systematically devaluing the values, beliefs, and experiences of target groups. A multileveled socialization process that occurs both overtly and covertly perpetuates this devaluation. Many social and psychological processes contribute to the devaluation process, but the basic dynamics can be understood through examining the roles of stereotypes, prejudice, discrimination, and privilege.

Stereoh/pes are negative generalizations about social identity groups and group members. Stereotypes allow people to selectively attend to negative group attributes, which may or may not exist, and form simplistic, negative views that deny the complexity of human identity. Consequently, many prejudices are based on stereotypes. Prejudices are judgments of social identity groups or group members made without adequate information or contact (T. Smith & Kehe, 2004). Prejudices serve individual and group psychological needs by contrasting with another group or by justifying unequal treatment of other groups. This, the active form of prejudice, is called discrimination.

Discrimination is behavior by one social identity group that causes harm to members of other social identity groups (T. Smith & Kehe, 2004). Discrimination can take several forms. Individual and institutional discrimination result from the actions of individuals and institutions and are intended to discriminate against target social identity groups and individuals. Structural discrimination results from policies and practices that unintentionally discriminate against target social identity groups.

Related to structural discrimination is privilege, which is defined as unearned access to resources that is readily available to members of agent groups (T. Smith & Kehe, 2004). Because of their access to resources and power, members of agent groups can function without understanding the needs of target groups and group members and are, consequently, blinded to their own privilege and to the experiences of target groups and group members. Thus, privilege is much more difficult to identify and eradicate than overt discrimination.

Unfortunately, privilege, because of its association with agents in decision-making positions, its ability to blind agents to the needs and experiences of target groups and group members, and its invisibility, allows for the creation of policies, laws, organizations, and institutions that are discriminatory. These structures continue to socialize generations of agents to privilege while socializing targets to oppression, powerlessness, and discrimination.

The material, emotional, and relational results of oppression are very relevant to the counseling process. Clients may lack access to resources such as basic human needs and education and suffer discriminatory treatment by banks, law enforcement, and employers. The experience of being oppressed profoundly affects how target groups and individuals view themselves and others. The emotional results of oppression include internalized oppression, learned helplessness, and functional paranoia (Sue & Sue, 2008). Additionally, the relational results of oppression may manifest in the therapeutic relationship as mistrust and anger (Helms & Cook, 1999).

The oppression model gives counselors a basic framework to understand the large and small systems in which counselors and clients function, understand agent and target client experiences, and understand themselves as people who have also developed within these systems. The oppression model also reminds practitioners to be vigilant for oppression, discrimination, and privilege and to assume that all dominant culture systems may have some oppressive aspects.