Psychoanalytic counseling is based on Sigmund Freud's theories and explores how the unconscious mind influences thoughts and behaviors. The goal is to provide insight and resolution by examining early childhood experiences that may have contributed to current issues. Psychoanalytic counseling aims to create deep, long-term personality changes through techniques like free association, dream analysis, and interpretation of transference and resistance in therapy. It can be used to address concerns like anxiety, low self-esteem, relationship issues, and is a gradual process of gaining self-understanding.
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1. COUNSELING APPROACHES
Psychoanalytic Approach
Behavioral Approach
Cognitive Behavioral Therapy (CBT)
Rational Emotive Behavioral Therapy (REBT) Transactional
Analysis (TA)
Humanistic Approach
Person Centered Therapy
Gestalt Therapy Existential Therapy
Other Contemporary Therapy
Adlerian Therapy/ Individual Psychology
Reality therapy
Family Systems Therapy Feminist Therapy
Eye Movement Desensitization and Reprocessing (EMDR) Eclectic
Counseling
Integrative Counseling Group Therapy
2. PSYCHOANALYTIC APPROACH
Psychoanalytic approach is a type of approach based upon the theories of Sigmund Freud, who
is considered one of the forefathers of psychology and the founder of psychoanalysis. This
therapy explores how the unconscious mind influences thoughts and behaviors, with the aim of
offering insight and resolution to the person seeking. therapy. Psychoanalytic therapy tends to
look at experiences from early childhood to see if these events have affected the individual’s
life, or potentially contributed to current concerns.
Sigmund Freud
(May 6, 1856 –September 23, 1939)
This form of therapy is considered a longterm choice and can continue for weeks, months or even years depending on the
depth of the concern being explored. Differing from several other therapy types, psychoanalytic therapy aims to make
deepseated changes in personality and emotional development.
Basic Philosophy: While each therapist will work in different ways according to the needs of the individual seeking
therapy, many work on the following assumptions
Human beings are basically determined by psychic energy and by early experiences.
Unconscious motives and conflicts are central in present behavior.
Irrational forces are strong; the person is driven by sexual and aggressive impulses.
Early development is of critical importance because later personality problems
have their roots in repressed childhood conflicts.
Key Concepts: Normal personality development is based on successful resolution and integration of psychosexual
stages of development. Faulty personality development is the result of inadequate resolution of some specific stage. Id,
ego, and superego constitute the basis of personality structure. Anxiety is a result of repression of basic conflicts.
Unconscious processes are centrally related to current behavior.
3. Essentials of Counseling
Developmental Stages
Oral stage is centered on the mouth as a source of pleasure.
Anal stage is centered on the anus and elimination as a source of pleasure.
Phallic stage is centered on the genitals and sexual identification as a source of pleasure.
Oedipus Complex is described as the process whereby a boy desires his mother and fears castration from the father, in order to create an ally of the father, the male learns
traditional male roles.
Electra Complex is described a similar but less clearly resolved in the female child with her desire for the father, competition with the mother; and thus, learns the traditional
female roles.
Latency stage is a time of little sexual interest in Freud’s developmental view. This stage is characterized with peer activities, academic and social learning, and development
of physical skills.
Genital stage begins with the onset of puberty. If the other stages have been successfully negotiated, the young person will take an interest in and establish sexual
relationships.
Structure of Personality
The personality has three parts the id, the ego, and the superego.
The id is present at birth and is part of the unconscious. The id is the site of the pleasure principle, the tendency of an individual to move toward pleasure and away from pain.
The id does not have a
sense of right or wrong, is impulsive, and is not rational. It contains the most basic of human instincts, drives, and genetic endowments.
The ego is the second system to develop and it functions primarily in the conscious mind and in the preconscious mind. It serves as a moderator between the id and the
superego, controlling wishes and desires. The ego is the site of the reality principle, the ability to interact with the outside world with appropriate goals and activities.
The superego sets the ideal standards and morals for the individual. The superego operates on the
moral principle which rewards the individual for following parental and societal dictates. Guilt is produced when a person violates the ideal ego denying or ignoring the rules
of the superego. Ego Defense Mechanisms
Ego defense mechanisms were believed by Freud to protect the individual from being overwhelmed by anxiety. He considered them
normal and operating on the unconscious level.
Defense Description Example
Denial arguing against an anxiety provoking
stimuli by stating it doesn’t exist
denying that your physician’s diagnosis of cancer is correct and
seeking a second opinion
Displacement taking out impulses on a less
threatening target
slamming a door instead of hitting as person, yelling at your
spouse after an argument with your boss
Intellectualization avoiding unacceptable emotions by
focusing on the intellectual aspects
focusing on the details of a funeral as opposed to the sadness and
grief
4. 120 Counseling Approaches
Projection placing unacceptable impulses in yourself onto someone else when losing an argument, you state “You’re just Stupid”; homophobia
Rationalization supplying a logical or rational reason as opposed to the real reason stating that you were fired because you didn’t kiss up the boss, when the real reason was your poor performance
Reaction Formation taking the opposite belief because the true belief causes anxiety having a bias against a particular race or culture and then embracing that race or culture to the extreme
Regression returning to a previous stage of development sitting in a corner and crying after hearing bad news; throwing a temper tantrum when you don’t get your way
Repression pulling into the unconscious forgetting sexual abuse from your childhood due to the trauma and anxiety
Sublimation acting out unacceptable impulses in a socially acceptable way sublimating your aggressive impulses toward a career as a boxer; becoming a surgeon because of your desire to cut; lifting weights to release ‘pent up’
energy
Suppression pushing into the unconscious trying to forget something that causes you anxiety
Ego defenses are not necessarily unhealthy as you can see by the examples above. In fact, the lack of
these defenses or the inability to use them effectively can often lead to problems in life. However, we sometimes employ the defenses at the wrong time or overuse them, which can be equally destructive.
Role of the Counselor: To encourage the development of transference, giving the client a sense of safety and acceptance. The client freely explores difficult material and experiences from their past, gaining insight and working through unresolved issues. The counselor is an expert, who interprets for the client.
Goals of Therapy
Helping the client bring into the conscious the unconscious.
Helping the client work through a developmental stage that was not resolved or where the client became fixated.
To reconstruct the basic personality.
To assist clients in reliving earlier experiences and working through repressed conflicts.
To achieve intellectual awareness.
Help the client adjustment to the demands of work, intimacy, and society.
5. Essentials of Counseling 121
Therapeutic Relationship: The analyst remains anonymous, and clients develop
projections toward him/her. Focus is on reducing the resistances that develop in
working with transference and on establishing more rational control. Clients undergo
longterm analysis, engage in free association, to uncover conflicts, and gain insight
by talking. The analyst makes interpretations to teach them the meaning of current
behavior as related to the past.
Techniques of Therapy: Interpretation, dream analysis, free association, analysis of
resistance, analysis of transference. All are designed to help clients gain access to
their unconscious conflicts, which leads to insight and eventual assimilation of new
material by the ego. Diagnosis and testing are often used. Questions are used to
develop a case history.
Free Association is a process where the client verbalizes any thoughts that may without censorship, no
matter how trivial the thoughts or feeling may be to the client.
Dream Analysis is a process where the client relates their dreams to the counselor. The counselor
interprets the obvious or manifest content and the hidden meanings or latent content.
Analysis of transference is a process where the client is encouraged to attribute to counselor those
issues that have caused difficulties with significant authority figures in their lives. The counselor helps
the client to gain insight by the conflicts and feelings expressed.
Analysis of resistance is a process where the counselor helps the client to gain insight into what causes
form the basis for a hesitation or halting of therapy.
Interpretation is a process where the counselor helps the client to gain insight into past and present
events.
Applications: Psychoanalytic therapy can be used by those with a specific emotional
concern as well as those who simply want to explore themselves. Understanding why
we are the way we are often brings with it a sense of wellbeing and a stronger sense
of self. As psychoanalytic therapy is considered one of the more longterm therapy
types, it is perhaps less useful for those seeking quick, solutionfocused therapies.
Psychoanalytic therapy is a gradual process that takes time; however the results can
be life changing.
Some believe due to the nature of the therapy, psychoanalytic work is better suited to
more general concerns such as anxiety, relationship difficulties, sexual issues or low
selfesteem. Phobias, social shyness and difficulties sleeping are further examples of
areas that could be addressed within psychoanalytic therapy. Critics have pointed out
that the therapy may not be as useful to those with more specific or obsessionbased
concerns such as obsessive compulsive behavior, as you may be too concerned by
your actions to participate fully.
6. 122 Counseling Approaches
How does psychoanalytic therapy work?
Psychoanalytic therapy is insight driven and therefore looks to foster change by helping you to
understand your past and how events from your early life could be affecting you now. Sessions will
vary according to where you are in the course of your therapy, but much of the time will be spent
talking freely to your therapist in a safe, nonjudgmental environment. The psychoanalyst will listen to
your concerns and look out for patterns or certain events that may hold significance. In this type of
therapy it is believed that unconscious feelings and childhood events play a key role in mental distress.
As well as listening to you discuss your experiences; your therapist may use other techniques to help
identify potential causes for your concerns.
Such techniques may include
Free association: Free association involves you talking about whatever comes into your mind without
censoring or editing the flow of memories/ideas. Your therapist will encourage you to speak freely to
help you return to an earlier emotional state so they can better understand any recurrent patterns of
conflict you may be experiencing.
Therapeutic transference: Transference relates to the way you may be transferring thoughts or feelings
connected to influential figures in your life (for example your parents or siblings) onto your therapist.
While this may not happen in every case, if it does your therapist should discuss transference with you
to help you gain further insight into the way you deal with people in your daily life.
Interpretation: A key element of psychoanalytic therapy is interpreting and ‘reading between the lines’.
While your therapist is likely to stay relatively quiet and allow you to talk freely, they will occasionally
interject with thoughts or interpretations of the topics you discuss. Your psychoanalyst may also ask
you about your dreams; Freud wrote a lot on the subject of dream analysis and believed that dreams
were important resources for understanding the unconscious.
Multiculturalism: Its focus on family dynamics is appropriate for working with
many minority groups. The therapist’s formality appeals to clients who expect
professional distance. Notion of ego defense is helpful in understanding inner
dynamics and dealing with environmental stresses. Its focus on insight, intrapsychic
dynamics, and longterm treatment, though, is often not valued by clients who prefer
to learn coping skills for dealing with pressing daily concerns. Internal focus is often
in conflict with cultural values that stress an interpersonal and environmental focus.
Contributions: More than any other system, this approach has generated controversy
as well as exploration and has stimulated further thinking and development of
therapy. It has provided a detailed and comprehensive description of personality
structure and functioning. It has brought into prominence factors such as the
unconscious as a determinant of behavior and the role of trauma during the first 6
years of life. It has developed several techniques for tapping the unconscious. It has
shed light on the dynamics of transference and countertransference, resistance,
anxiety, and the mechanisms of ego defense.
7. Essentials of Counseling 123
Limitations: Requires lengthy training for therapists and much time and expense for
clients. The model stresses biological and instinctive factors to the neglect of social,
cultural, and interpersonal ones. Its methods are not applicable for solving specific
problems of clients in lower socioeconomic classes and are not appropriate for many
ethnic and cultural groups. Many clients lack the degree of ego strength needed for
regressive and reconstructive therapy. It is inappropriate for the typical counseling setting.
Psychodynamic Psychotherapy/Counseling: This approach stresses the importance of the
unconscious and past experience in shaping current behavior. 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.
Psycho-synthesis: Sometimes described as ‘psychology of the soul’. It is the name given to a series of
actions that lead to a change or development which encourages personal growth by a bringing together
of the whole person the emotional, the mental, the physical and spiritual within a safe environment.
Psychosynthesis is useful for people seeking a new, more spiritually oriented vision of them.
BEHAVIORAL APPROACH: Cognitive Behavioral Therapy (CBT), Rational
Emotive Behavioral Therapy (REBT), Transactional Analysis (TA)
BEHAVIORAL APPROACH
As the name implies, this approach focuses on
behavior changing unwanted behaviors through
rewards, reinforcements, and desensitization. This
therapy is based on the belief that behavior is
learnt in response to past experience and can be
unlearnt, or reconditioned, without analyzing the
past to find the reason for the behavior. It works
well for compulsive and obsessive behavior, fears,
phobias and addictions. Someone whose fear of
germs leads to excessive washing, for example,
may be trained to relax and not wash his/her hands
after touching a public doorknob.
Burrhus Frederic (B. F.) Skinner
(March 20, 1904 August 18, 1990)
Behavioral therapy often involves the cooperation of others, especially family and
close friends, to reinforce a desired behavior.
Basic Philosophy: Behavior is the product of learning. We are both the product and
the producer of the environment. No set of unifying assumptions about behavior can
incorporate all the existing procedures in the behavioral field.
8. 124 Counseling Approaches
Key Concepts: Focus is on overt behavior, precision in specifying goals of treatment,
development of specific treatment plans, and objective evaluation of therapy
outcomes. Therapy is based on the principles of learning theory. Normal behavior is
learned through reinforcement and imitation. Abnormal behavior is the result of faulty
learning. This approach stresses present behavior.
Role of the Counselor: Roles of the behavioral counselor are varies and include
being a consultant, a reinforcer, and a facilitator. The counselor is active and may
supervise other people in the client’s environment to achieve the goals of therapy.
Counselors using social learning may model the desired behavior, while respondent
and operant conditioning counselors are more directive and prescriptive in their
approach to the therapy goals. Use of tests and diagnosis varied greatly among
behavioral counselors.
Goals of Therapy: Generally, to eliminate maladaptive behaviors and learn more
effective behaviors. To focus on factors influencing behavior and find what can be
done about problematic behavior. Clients have an active role in setting treatment
goals and evaluating how well these goals are being met.
Therapeutic Relationship: The therapist is active and directive and functions as a
teacher or trainer in helping clients learn more effective behavior. Clients must be
active in the process and experiment with new behaviors. Although a quality
client/therapist relationship is not viewed as sufficient to bring about change, a good
working relationship is essential for implementing behavioral procedures.
Techniques of Therapy: The main techniques are systematic desensitization,
relaxation methods, flooding, eye movement and desensitization reprocessing,
reinforcement techniques, modeling, cognitive restructuring, assertion and social
skills training, selfmanagement programs, behavioral rehearsal, coaching, and
various multimodal therapy techniques. Diagnosis or assessment is done at the outset
to determine a treatment plan. Questions are used, such as what, how, and when (but
not why). Contracts and homework assignments are also typically used.
Applications: A pragmatic approach based on empirical validation of results. Enjoys
wide applicability to individual, group, marital and family counseling. Some problems
to which the approach is well suited are phobic disorders, depression, sexual
disorders, children’s behavioral disorders, stuttering, and prevention of cardiovascular
disease. Beyond clinical practice, its principles are applied in fields such as pediatrics,
stress management, behavioral medicine, education, and geriatrics.
9. Essentials of Counseling 125
Multiculturalism: Its focus on behavior, rather than on feelings, is compatible with
many cultures. Strengths include a collaborative relationship between counselor and
client in working toward mutually agreedon goals, continual assessment to determine
if the techniques are suited to clients’ unique situation, assisting clients in learning
practical skills, an educational focus, and stress on selfmanagement strategies.
Counselors need to help clients assess the possible consequences of making
behavioral changes. Family members may not value clients newly acquired assertive
style, so clients must be taught how to cope with resistance by others.
Contributions: Emphasis is on assessment and evaluation techniques, thus providing
a basis for accountable practice. Specific problems are identified, and clients are kept
informed about progress toward their goals. The approach has demonstrated
effectiveness in many areas of human functioning. The roles of the therapist as
reinforcer, model, teacher, and consultant are explicit. The approach has undergone
extensive expansion, and research literature abounds. No longer is it a mechanistic
approach, for it now makes room for cognitive factors and encourages selfdirected
programs for behavioral change.
Limitations: Major criticisms are that it may change behavior but not feelings; that it
ignores the relational factors in therapy; that it does not provide insight; that it ignores
historical causes of present behavior; that it involves control and manipulation by the
therapist; and that it is limited in its capacity to address certain aspects of the human
condition. Many of these assertions are based on misconceptions, and behavior
therapists have addressed these charges. A basic limitation is that behavior change
cannot always be objectively assessed because of the difficulty in controlling
environmental variables.
COGNITIVE BEHAVIOR THERAPY (CBT)
A combination of cognitive and behavioral therapies, this
approach helps people change negative thought patterns,
beliefs, and behaviors so they can manage symptoms and
enjoy more productive, less stressful lives. Cognitive
behavioral therapy (CBT) was developed by Aaron T.
Beck, Albert Ellis, Maxie Maultsby, Michael Mahoney,
Donald Meichenbaum, David Burns, Michael Mahoney,
Marsha Linehan, Arthur Freeman, and others. Cognitive
behavior therapy is a type of psychotherapeutic treatment
that helps patients understand the thoughts and feelings
that influence behaviors.
Dr. Aaron Temkin Beck
(July 18, 1921 to present)
10. 126 Counseling Approaches
CBT is commonly used to treat a wide range of disorders including phobias,
addictions, depression, and anxiety. Cognitive behavior therapy is generally short
term and focused on helping clients deal with a very specific problem. During the
course of treatment, people learn how to identify and change destructive or disturbing
thought patterns that have a negative influence on behavior.
Most cognitive behavioral therapies have the following characteristics
CBT is based on the Cognitive Model of Emotional Response. CBT is based on the
idea that our thoughts cause our feelings and behaviors, not external things, like
people, situations, and events. The benefit of this fact is that we can change the way
we think to feel/act better even if the situation does not change.
CBT is Briefer and Time-Limited. It is considered among the most rapid in terms of
results obtained. The average number of sessions clients receive (across all types of
problems and approaches to CBT) is only 16. Other forms of therapy, like
psychoanalysis, can take years. What enable CBT to be briefer are its highly
instructive nature and the fact that it makes use of homework assignments. CBT is
timelimited in that we help clients understand at the very beginning of the therapy
process that there will be a point when the formal therapy will end. The ending of the
formal therapy is a decision made by the therapist and client. Therefore, CBT is not
an openended, neverending process.
A sound therapeutic relationship is necessary for effective therapy, but not the focus.
Some forms of therapy assume that the main reason people get better in therapy is
because of the positive relationship between the therapist and client. Cognitive
behavioral therapists believe it is important to have a good, trusting relationship, but
that is not enough. CBT therapists believe that the clients change because they learn
how to think differently and they act on that learning. Therefore, CBT therapists focus
on teaching rational selfcounseling skills.
CBT is a collaborative effort between the therapist and the client. Cognitive
behavioral therapists seek to learn what their clients want out of life (their goals) and
then help their clients achieve those goals. The therapist’s role is to listen, teach, and
encourage, while the client’s roles is to express concerns, learn, and implement that
learning.
CBT is based on aspects of stoic philosophy. Not all approaches to CBT emphasize
stoicism. Rational Emotive Behavior Therapy, Rational Behavior Therapy, and
Rational Living Therapy emphasize aspects of stoicism. Beck’s Cognitive Therapy is
not based on stoicism.
11. Essentials of Counseling 127
Cognitivebehavioral therapy does not tell people how they should feel. However, most people seeking therapy do not
want to feel they way they have been feeling. The approaches that emphasize stoicism teach the benefits of feeling, at
worst, calm when confronted with undesirable situations. They also emphasize the fact that we have our undesirable
situations whether we are upset about them or not. If we are upset about our problems, we have two problems the
problem, and our upset about it. Most people want to have the fewest number of problems possible. So when we
learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a
better position to make use of our intelligence, knowledge, energy, and resources to resolve the problem.
CBT uses the Socratic Method. Cognitivebehavioral therapists want to gain a very good understanding of their
clients’ concerns. That’s why they often ask questions. They also encourage their clients to ask questions of
themselves, like, “How do I really know that those people are laughing at me?” “Could they be laughing about
something else?”
CBT is structured and directive. Cognitivebehavioral therapists have a specific agenda for each session. Specific
techniques/concepts are taught during each session. CBT focuses on the client’s goals. We do not tell our clients what
their goals should be, or what they should tolerate. We are directive in the sense that we show our clients how to
think and behave in ways to obtain what they want. Therefore, CBT therapists do not tell their clients what to do
rather, they teach their clients how to do.
CBT is based on an educational model. CBT is based on the scientifically supported assumption that most emotional
and behavioral reactions are learned. The goal of therapy is to help clients unlearn their unwanted reactions and to
learn a new way of reacting. CBT has nothing to do with ‘just talking’. People can just talk with anyone. The
educational emphasis of CBT has an additional benefit it leads to long term results. When people understand how
and why they are doing well, they know what to do to continue doing well.
CBT theory and techniques rely on the Inductive Method. A central aspect of rational thinking is that it is based on
fact. Often, we upset ourselves about things when, in fact, the situation isn’t like we think it is. If we knew that,
we would not waste our time upsetting ourselves. Therefore, the inductive method encourages us to look at our
thoughts as being hypotheses or guesses that can be questioned and tested. If we find that our hypotheses are
incorrect (because we have new information), then we can change our thinking to be in line with how the situation
really is.
12. 128 Counseling Approaches
Homework is a central feature of CBT. If when you attempted to learn your multiplication tables you spent only one
hour per week studying them, you might still be wondering what 5 X 5 equals. You very likely spent a great deal of
time at home studying your multiplication tables, maybe with flashcards.
The same is the case with psychotherapy. Goal achievement (if obtained) could take a very long time if all a person
were only to think about the techniques and topics taught was for one hour per week. That’s why CBT therapists
assign reading assignments and encourage their clients to practice the techniques learned.
Basic Philosophy: Individuals tend to incorporate faulty thinking, which leads to emotional and behavioral
disturbances. Cognitions are the major determinants of how we feel and act. Therapy is primarily oriented toward
cognition and behavior, and it stresses the role of thinking, deciding, questioning, doing, and redeciding. This is a
psychoeducational model, which emphasizes therapy as a learning process, including acquiring and practicing new
skills, learning new ways of thinking, and acquiring more effective ways of coping with problems.
Key Concepts: Although psychological problems may be rooted in childhood, they are perpetuated through
reindoctrination in the now. A person’s belief system is the primary cause of disorders. Internal dialogue plays a
central role in one’s behavior. Clients focus on examining faulty assumptions and misconceptions and on replacing
these with effective beliefs.
Goals of Therapy: To challenge clients to confront faulty beliefs with contradictory evidence that they gather and
evaluate. Helping clients seek out their dogmatic beliefs and vigorously minimizing them. To become aware of
automatic thoughts and to change them.
Therapeutic Relationship: The therapist functions as a teacher and the client as a student. The therapist is highly
directive and teaches clients an ABC model of changing their cognitions. The focus is on a collaborative relationship.
Using a Socratic dialogue, the therapist assists clients in identifying dysfunctional beliefs and discovering alternative
rules for living. The therapist promotes corrective experience that lead to learning new skills. Clients gain insight into
their problems and then must actively practice changing selfdefeating thinking and acting.
Techniques of Therapy: Therapists use a variety of cognitive, emotive, and behavioral techniques; diverse methods
are tailored to suit individual clients. An active, directive, timelimited, presentcentered, structured therapy. Some
techniques include engaging in Socratic dialogue, debating irrational beliefs, carrying out
13. Essentials of Counseling 129
homework assignments, gathering data on assumptions one has made, keeping a
record of activities, forming alternative interpretations, learning new coping skills,
changing one’s language and thinking patterns, role playing, imagery, and confronting
faulty beliefs.
Applications: Has been widely applied to the treatment of depression, anxiety,
marital problems, stress management, skill training, substance abuse, assertion
training, eating disorders, panic attacks, performance anxiety, and social phobia. The
approach is especially useful for assisting people in modifying their cognitions. Many
selfhelp approaches utilize its principles. Can be applied to a wide range of client
populations with a variety of specific problems.
Who could benefit from CBT?
This type of therapy is particularly helpful for those with specific issues as it is very practical (rather
than insightbased) and looks at solutions. For this reason the therapy works well for those who
suffer from depression and/or anxiety
suffer from posttraumatic stress disorder (PTSD)
have an addiction
want to change their behavior
have anger issues
eating disorders, such as anorexia and bulimia
sleep problems, such as insomnia
panic disorder
have a phobia
suffer from obsessivecompulsive behavior (OCD).
In some cases CBT is used for those with longstanding health problems such as chronic pain or
irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS). While the therapy cannot cure
such physical ailments, it can help people cope emotionally with their condition and lower stress levels.
There is also up and coming interest in the use of CBT alongside medication to help those who suffer
from hallucinations and delusions.
Multiculturalism: The collaborative approach offers clients opportunities to express
their areas of concern. The psychoeducational dimensions are often useful in
exploring cultural conflicts and teaching new behavior. The emphasis on thinking (as
opposed to identifying and expressing feelings) is likely to be acceptable to many
clients. The focus on teaching and learning tends to avoid the stigma of mental illness.
Clients may value active and directive stance of therapist. Before too quickly
attempting to change the beliefs and actions of clients, it is essential for the therapists
to understand and respect their world. Some clients may have serious reservations
about questioning their basic cultural values and beliefs. Clients could become
dependent on the therapist for deciding what are appropriate ways to solve problems.
There may be a fine line between being directive and promoting dependence.
14. 130 Counseling Approaches
Contributions: Major contributions include emphasis on a comprehensive and
eclectic therapeutic practice; numerous cognitive, emotive, and behavioral techniques;
openness to incorporating techniques from other approaches; and a methodology for
challenging and changing faulty thinking. Most forms can be integrated into other
mainstream therapies.
Limitations: Tends to play down emotions, does not focus on exploring the
unconscious or underlying conflicts, and sometimes does not give enough weight to
client’s past.
When is CBT Used as a form of Therapy?
Scientific studies of CBT have demonstrated its usefulness for a wide variety of mental illnesses
including mood disorders, anxiety disorders, personality disorders, eating disorders, substance abuse
disorders, sleep disorders and psychotic disorders. Studies have shown that CBT actually changes brain
activity in people with mental illnesses who receive this treatment, suggesting that the brain is actually
improving its functioning as a result of engaging in this form of therapy.
CBT has been shown to be as useful as antidepressant medications for some individuals with
depression and may be superior in preventing relapse of symptoms. Patients receiving CBT for
depression are encouraged to schedule positive activities into their daily calendars in order to increase
the amount of pleasure they experience. In addition, depressed patients learn how to change
(restructure) negative thought patterns in order to interpret their environment in a less negatively
biased way. As regular sleep has been found to be very important in both depression and bipolar
disorder, therapists will also target sleeping patterns to improve and regulate sleep schedules with their
patients. Studies indicate that patients who receive CBT in addition to treatment with medication have
better outcomes than patients who do not receive CBT as an additional treatment.
CBT is also a useful treatment for anxiety disorders. Patients who experience persistent panic attacks
are encouraged to test out beliefs they have related to such attacks, which can include specific fears
related to bodily sensations, and to develop more realistic responses to their experiences. This is
beneficial in decreasing both the frequency and intensity of panic attacks. Patients who experience
obsessions and compulsions are guided to expose themselves to what they fear in a safe and controlled
therapeutic environment. Beliefs surrounding their fears (of contamination, illness, inflicting harm,
etc.) are identified and changed to decrease the anxiety connected with such fears.
The same is true for people with phobias, including phobias of animals or phobias of evaluation by
others (termed Social Anxiety Disorder). Those in treatment are exposed to what they fear and beliefs
that have served to maintain such fears are targeted for modification. CBT is often referred to as a “first
line treatment” in many anxiety disorders including generalized anxiety disorder, posttraumatic stress
disorder, panic disorder, and obsessivecompulsive disorder and specific phobias.
Over the past two decades, CBT for schizophrenia has received considerable attention in the United
Kingdom and elsewhere abroad. While this treatment continues to develop in the United States, the
results from studies in the United Kingdom and other countries have encouraged therapists in the US to
incorporate this treatment into their own practices. In this treatment, often referred to as cognitive
behavioral therapy for psychosis (CBTP), patients are encouraged to identify their own delusional or
paranoid beliefs and to explore how these beliefs negatively impact their lives.
15. Essentials of Counseling 131
Therapists will then help patients to engage in experiments to test these beliefs. Treatment focuses on
thought patterns that cause distress and also on developing more realistic interpretations of events.
Delusions are treated by developing an understanding of the kind of evidence that a person uses to
support their beliefs and encouraging them to recognize evidence that may have been overlooked,
evidence that does not support the belief. For example, a person who thinks that they are being
videotaped by aliens may feel less worried when their therapist helps them to discover that there are no
hidden cameras in the waiting room, or that a television remote does not contain any Alien technology
within it.
CBT’s focus on thoughts and beliefs is applicable to a wide variety of symptoms. While the above
summary is certainly not comprehensive, it provides an overview of the principles of CBT and how
they apply to the treatment of various psychological illnesses. Because CBT has excellent scientific
data supporting its use in the clinical treatment of psychological illness, it has achieved wide popularity
both for therapists and patients alike. A growing number of psychologists, psychiatrists, social workers,
and psychiatric nurses have training in CBT.
RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)
Rational emotive behavior therapy, also known as
REBT, is a type of cognitivebehavioral therapy.
It was first called Rational Therapy, later Rational
Emotive Therapy, then changed to Rational
Emotive Behavior Therapy. It was first introduced
in 1955 by Dr. Albert Ellis who had become
increasing frustrated with the ineffectiveness of
psychotherapy. Ellis drew from his knowledge of
philosophy and psychology to devise a method
which he believed was more directive, efficient,
and effective.
Dr. Albert Ellis
(September 27, 1913 – July 24, 2007)
Basic Philosophy: REBT is focused on helping clients change irrational beliefs. The
replacement of illogical and unrealistic ideas with more realistic and adaptive ones
through direct intervention and confrontation by the therapist.
Key Concepts: Ellis suggested that people mistakenly blame external events for
unhappiness. He argued, however, that it is our interpretation of these events that truly
lies at the heart of our psychological distress. To explain this process, Ellis developed
what he referred to as the ABC Model
A – Activating Event: Something happens in the environment around you.
B – Beliefs: You hold a belief about the event or situation.
C – Consequence: You have an emotional response to your belief.
16. 132 Counseling Approaches
Role of the Counselor
Counselors are direct and active in their teaching and correcting the client’s
cognitions.
Ellis believes that a good REBT counselor must be bright, knowledgeable,
empathetic, persistent, scientific, interested in helping others and use RET in their
personal lives (Ellis, 1980).
The counselor does not rely heavily on the DSMIV categories.
Goals of the Therapy
The primary goal is to help people live rational and productive lives.
REBT helps people see that it is their thoughts and beliefs about events that
creates difficulties, not the events or the situations.
It helps the client to understand that wishes and wants are not entitlements to be
demanded. Thinking that involves the words must, should, ought, have to, and
need are demands, not an expression of wants or desires.
RET helps clients stop catastrophizing when wants and desires are not met.
It stresses the appropriateness of the emotional response to the situation or event.
A situation or event need not elicit more of a response than is appropriate.
It assists people in changing selfdefeating behaviors or cognitions.
RET espouses acceptance and tolerance of self and of others in order to achieve
life goals.
Steps in Rational Emotive Behavior Therapy
The basic steps in Rational Emotive Behavior Therapy are
Identifying the underlying irrational thought patterns and beliefs. The very first step
in the process is to identify the irrational thoughts, feelings, and beliefs that lead to
psychological distress. In many cases, these irrational beliefs are reflected as
absolutes, as in I must, I should or I can’t. According to Ellis, some of the most
common irrational beliefs include
Feeling excessively upset over other people’s mistakes or misconduct.
Believing that you must be 100 percent competent and successful in everything to
be valued and worthwhile.
Believing that you will be happier if you avoid life’s difficulties or challenges.
Feeling that you have no control over your own happiness; that your contentment
and joy are dependent upon external forces.
By holding such unyielding beliefs, it becomes almost impossible to respond to
situations in a psychologically healthy way. Possessing such rigid expectations of
17. Essentials of Counseling 133
ourselves and others only leads to disappointment, recrimination, regret, and
anxiety.
Challenging the irrational beliefs. Once these underlying feelings have been
identified, the next step is to challenge these mistaken beliefs. In order to do this, the
therapist must dispute these beliefs using very direct and even confrontational
methods. Ellis suggested that rather than simply being warm and supportive, the
therapist needs to be blunt, honest, and logical in order to push people toward
changing their thoughts and behaviors.
Gaining Insight and Recognizing Irrational Thought Patterns. Facing irrational
thought patterns can be difficult, especially because accepting these beliefs as
unhealthy is far from easy. Once the client has identified the problematic beliefs, the
process of actually changing these thoughts can be even more difficult.
It is also important to recognize that while rational emotive behavior therapy utilizes
cognitive strategies to help clients, it also focuses on emotions and behaviors as well.
In addition to identifying and disputing irrational beliefs, therapists and clients also
work together to target the emotional responses that accompany problematic thoughts.
Clients are also encouraged to change unwanted behaviors using such things as
meditation, journaling, and guided imagery.
Applications: REBT can be effective in the treatment of a range of psychological
disorders including anxiety disorders and phobias as well as specific behaviors such
as severe shyness and excessive approval seeking.
How does REBT work?
REBT’s comprehensive approach works best for individuals desiring a scientific,
presentfocused, and active treatment for coping with life’s difficulties, rather than
one which is mystical, historical, and largely passive. REBT is based on a few simple
principles having profound implications
You are responsible for your own emotions and actions.
Your harmful emotions and dysfunctional behaviors are the product of your
irrational thinking.
You can learn more realistic views and, with practice, make them a part of
you.
You’ll experience a deeper acceptance of yourself and greater satisfactions in life
by developing a realitybased perspective.
REBT distinguishes clearly between two very different types of difficulties practical
problems and emotional problems. Your flawed behavior, unfair treatment by others,
and undesirable situations, represent practical problems. Regrettably, your human
18. 134 Counseling Approaches
tendency is to upset yourself about these practical problems, thereby unnecessarily
creating a second order of problems emotional suffering.
REBT addresses the latter by helping you
Take responsibility for your distress. The first lesson in healthy emoting and
relating was stated by the Roman philosopher Epictetus more than 2000 years ago
- only you can upset yourself about events the events themselves, no matter how
undesirable, can never upset you.
Recognize that neither another person, nor an adverse circumstance, can ever
disturb you only you can. No one else can get into your gut and churn it up.
Others can cause you physical pain by hitting you over the head with a baseball
bat, for example or can block your goals. But you create your own emotional
suffering, or selfdefeating behavioral patterns, about what others do or say.
Identify your ‘musts’. Once you admit that you distort your own emotions and
actions, then determine precisely how. The culprit usually lies in one of the three
core ‘musts’
Must # 1 (a demand on yourself): I ‘must’ do well and get approval, or else I’m
worthless. This demand causes anxiety, depression, and lack of assertiveness.
Must # 2 (a demand on others): You ‘must’ treat me reasonably, considerately,
and lovingly, or else you’re no good. This must leads to resentment, hostility, and
violence.
Must # 3 (a demand on situations): Life ‘must’ be fair, easy, and hasslefree, or
else it’s awful. This thinking is associated with hopelessness, procrastination, and
addictions.
Ascertain what you’re demanding of yourself, of your significant others, or of
your circumstances. Not until you have discovered the ‘must’ can you then go on
effectively to reduce your distress.
Dispute your ‘musts’. The only way you can ever remain disturbed about
adversity is by vigorously and persistently agreeing with one of these three
‘musts’. Thus, once you’ve bared them, then relentlessly confront and question
your demands.
Begin by asking yourself What’s the evidence for my ‘must’? How is it true?
Where’s it etched in stone? And then by seeing There’s no evidence. My ‘must’
is entirely false. It’s not carved indelibly anywhere. Make your view ‘must’free,
and then your emotions will heal.
Reinforce your preferences. Conclude, therefore
Preference 1: I strongly ‘prefer’ to do well and get approval, but even if I fail,
I will accept myself fully.
19. Essentials of Counseling 135
Preference 2: I strongly ‘prefer’ that you treat me reasonably, kindly, and
lovingly, but since I don’t run the universe, and it’s a part of your human
nature to err, I, then, cannot control you.
Preference 3: I strongly ‘prefer’ that life be fair, easy, and hasslefree, and it’s
very frustrating that it isn't, but I can bear frustration and still considerably
enjoy life.
Assuming that you take the above suggestions to heart and thereby greatly reduce
your anxiety, hostility, depression, and addictions, what remains? Will you exist
robotlike, devoid of human feeling and motivation? Hardly! Without your turmoil,
you’ll more easily experience love, involvement, and joy. And without your
addictions, you’ll be freer to engage in the gratifying experiences of spontaneity,
commitment, and selfactualization. REBT will appeal to you if you relish quickly
taking control of your own life, rather than remaining dependent upon a therapist for
years. By giving you tools for identifying and overcoming the true source of your
difficulties, it will prepare you to act in many ways as your own therapist. And by
helping you to reinforce realistic, selfbenefitting beliefs, it will enable you to
eliminate present emotional and behavioral problems, and to avoid future ones.
TRANSACTIONAL ANALYSIS (TA)
Dr. Eric Berne
(May 10, 1910 – July 15, 1970)
The Transactional Analysis (TA) approach to
counseling belongs to the Psychoanalytical
School of therapy and was devised by Eric
Berne a Canadian psychiatrist in the late 1940’s.
TA is a widely recognized form of modern
psychology that involves a set of practical
conceptual tools designed to promote personal
growth and change. It is considered a
fundamental therapy for wellbeing and for
helping individuals to reach their full potential
in all aspects of life. In counseling TA therapy is
very versatile, for it can be used in a wide range
of areas and incorporates key themes from
humanistic, integrative, psychoanalytical,
psychodynamic therapies.
Though it is commonly recognized as a brief and solutionfocused approach,
transactional analysis can also be applied as an effective longterm, indepth therapy.
20. 136 Counseling Approaches
Basic Philosophy: TA has an optimistic view of human nature that believes that
people can change despite life’s events and that is never too late to change one’s life.
All decisions that are made in life can be redecided.
Some basic assumptions are
All people are important and their concerns are valid.
All people should be treated as equals and with respect.
With a few exceptions, all people have the ability to think as adults.
All people decide their own destiny and can make changes to it.
From these assumptions TA creates a form of therapy that is not only problem
oriented, but also goaloriented. It aims to free the client from maladaptive patterns of
behavior based on past thinking. In doing so, they will be able to choose a new
direction in life. In fact, the basic goal of transactional analysis is to help a client
make new decisions about their current behavior and change the direction their lives
are taking. In other words, a person will learn to write their own life story instead of
allowing it to be written for them.
Key Concepts: TA uses four major methods to analyze and predict behavior
1. Structural analysis looks at what is happening within the individual.
2. Transactional analysis looks at what is happening between two or more people.
3. Game analysis looks at transactions between individuals leading to negative
feelings.
4. Script analysis looks at the life plan the individual has chosen to follow.
Structural Analysis: TA is a dynamic theory at personality in the sense that uses the
concepts of psychic energy and the distribution of energy. The structure of personality
is based on the personality theory of parent, adult, child ego states. Eric Berne defines
the ego states on the patterns of feeling, thinking and behaving. Any individual in a
social grouping will exhibit one of these states. Structure analysis describes each
person in terms of three ego states Parent ego state contains the parental
admonishments and values with dos, shoulds, and oughts. Adult ego state contains the
objective, thinking, rational and logical ability to deal with reality. Child ego state is
the source of childlike behaviors and feelings.
Parent Ego State: This is a set of feelings, thinking and behavior that we have copied
from our parents and significant others. As we grow up we take in ideas, beliefs,
feelings and behaviors from our parents and caretakers. If we live in an extended
family then there are more people to learn and take in from. When we do this, it is
called introjecting. For example, we may notice that we are saying things just as our
father, mother, grandmother may have done, even though, consciously, we don’t want
21. Essentials of Counseling 137
to. We do this as we have lived with this person so long that we automatically
reproduce certain things that were said to us, or treat others as we might have been
treated. Parental ego states are in two forms (a) Controlling/ Critical Parent which is
negative, unsupportive, critical. (b) Nurturing Parent which is supportive, helpful,
nurturing, comforting.
Adult Ego State: It is about direct
responses to the here and now. We
deal with things that are going on
today in ways that are not unhealthily
influenced by our past. It is about
being spontaneous and aware with the
capacity for intimacy. When in our
Adult we are able to see people as
they are, rather than what we project
onto them. We ask for information
rather than stay scared and rather than
make assumptions.
Taking the best from the past and using it appropriately in the present is an integration
of the positive aspects of both our ‘Parent’ and ‘Child’ ego states. So this can be
called the ‘Integrating Adult’. Integrating means that we are constantly updating
ourselves through our every day experiences and using this to inform us.
Child Ego State: It is a set of behaviors, thoughts and feelings which are replayed
from our own childhood. Berne says we all carry within ourselves a little boy or a
little girl who feels, thinks, acts and responds just as we did when we were children. It
also contains creative intuitive capacities such as rebellion, compliance etc. TA has
identified three different forms of child ego state they are Natural/ Free child;
Adaptive child and Little professor.
Contamination Ego State: This
occurs when we talk as if
something is a fact or a reality
when really this is a belief.
Racism is an example of this.
The ‘Integrating Adult’ ego state
is contaminated in this case by
the ‘Parent’ ego state.
Parent
Contamination
Child
Contamination
Double
Contamination
(Parent & Child)
Parent Ego State
Behaviors, thoughts and feelings
copied from parents or parent figures
Adult Ego State
Behaviors, thoughts and feelings which
are direct responses to the here and now
Child Ego State
Behaviors, thoughts and feelings
replayed from childhood
22. 138 Counseling Approaches
Both the Parent and Child ego states are constantly being updated. The ‘Parent’ and
‘Child’ ego states are echoes of the past. The ‘Adult’ ego state is a response to the
here and now when a person is grown up and using grown up responses.
Transactional Analysis: The three ego states can be used as a way of analyzing
transactions (communications) between people.
A transaction is a communication from A to B
and the response from B to A. Transactional
analysis helps the client to understand the three
distinct types of transactions. They are
complementary, crossed and ulterior.
Complementary transactions are characterized by
both people communicating from the same ego
state. A complementary transaction occurs when a
message, sent from a specific ego state, gets the
predicted response from a specific ego state in the
other person.
Crossed transactions are characterized by both
people coming from different ego states and
resulting in an unexpected hurtful response. This
happens between two ego states when a message
sent from one person gets the unexpected
response. The lines between the two ego states
cross and communication breaks down.
Ulterior transactions are characterized by people
coming from different ego states, but the
responses appear to be from the same ego state. It
involves more than two ego states at the same
time. In this type of transaction two messages are
exchanged one in the social level and one in
psychological level. There are two types of
ulterior transaction. They are Duplex transaction
and Angular ulterior transaction.
Complementary Transaction
Crossed Transaction
Ulterior Transaction
Communication between people can be from one ego state to a different one or from
one ego state to the same ego state. Normally communication will be from one ego
state either to the same ego state or a different one. The person who first
communicates will expect a reply to be from a certain ego state. If communication is
from a different ego state to the expected one, then the communication may be
23. Essentials of Counseling 139
ineffective and the message may be lost, not received or disregarded by the person
receiving it. If communication is from ‘Adult to Adult’ then it is likely to be the most
effective communication for most of our communications.
There are three rules of communication’ in TA
1st Rule of Communication: So long as transactions remain complementary,
communication can continue indefinitely.
2nd Rule of Communication: When a transaction is crossed, a break in
communication results, and one or both individuals will need to shift ego states in
order for the communication to be reestablished.
3rd Rule of Communication: The behavioral outcome of an ulterior transaction (one
where two messages are sent at the same time; one overt social and one covert
psychological) is determined at the psychological level and not at the social level.
Game Analysis: Games are learned patterns of behavior. And most people play a
small number of favorite games with a range of different people and in varying
intensities. A game is an ongoing series of transactions seemingly complementary,
covertly ulterior which leads to a well defined pay off. Pay off are usually negative
feelings like fear, anger, sadness for one or both the players. Game is defined as a
series of complementary transactions, progressing to a well defined predictable
outcome. Most of what happens in life is game. The client is encouraged to learn
more satisfying ways of structuring time and acquiring strokes.
‘First Degree’ games are played in social circles generally lead to mild upsets not
major traumas. ‘Second Degree’ games occur when the stakes may be higher. This
usually occurs in more intimate circles, and ends up with an even greater negative
payoff. ‘Third Degree’ games involve tissue damage and may end up in the jail,
hospital or morgue. Chris Davidson (2002) has argued that world politics can involve
‘Fourth Degree’ games where the outcomes involve whole communities, countries
or even the world.
Games vary in the length of time that passes while they are being played. Some can
take seconds or minutes while others take weeks months or even years. People play
games for these reasons
to structure time;
to acquire strokes;
to maintain the substitute feeling and the system of thinking, beliefs and actions
that go with it;
to confirm parental injunctions and further the life script;
to maintain the person’s life position by ‘proving’ that self/others are not OK;
24. 140 Counseling Approaches
to provide a high level of stroke exchange while blocking intimacy and
maintaining distance;
to make people predictable.
There are various ways to stop a game, including the use of different options than the
one automatically used. We can
Cross the transaction by responding from a different ego state than the one the
stimulus is designed to hook.
Pick up the ulterior rather than the social message; e.g. when a person says “I
can’t do this, I’m useless”. Rather than saying, “Let me do this for you”, instead
say, “It sounds like you have a problem. What do you want me to do about it?”
(said from the Adult ego state)
The opening message to the game always entails a discount. There are further
discounts at each stage of the game. By detecting discounts we can identify game
invitations and defuse them with options. A discount is when we minimize,
maximize or ignore some aspect of a problem which would assist us in resolving
it. Such as saying in a whiny voice “This is too difficult for me to do”, so we
automatically help them.
Replace the game strokes. Loss of strokes to the ‘Child’ ego state means a threat
to survival. We get a great many strokes from games, even if they are negative.
However, if we don’t obtain sufficient positive strokes, or give ourselves positive
strokes, we will go for quantity rather than quality of strokes and play games to
get them. This loss of strokes is also a loss of excitement that the game has
generated.
Another way to think about this is to consider the game role we or the other person is
likely to take. One way to discover this is to ask the following questions (John James,
1973)
What keeps happening over and over again?
How does it start?
What happens next?
And then what happens?
How does it end?
How do feel after it ends?
We can then consider the reason we might have taken up a particular role, where we
might switch to, and then consider how to do things differently. We need to consider
what our own responsibility is in this if the situation is too violent for us to get
involved what options to we have? We could call for help; get others to come with us
25. Essentials of Counseling 141
to intervene and so on. We need to choose the appropriate assistance and take the
action required.
Script Analysis: Script analysis involves the plans that a person makes for their life.
Some of the common ones are
Never scripts result in a person who believes s/he is a never do well.
Until scripts result in the person who continues to wait until they can deserve the
reward.
Always scripts result in a person continuing without change.
After scripts result in anticipation of difficulty after a certain event.
Openended scripts result in lack of direction after a given time or event.
The ideal life script is one that is characterized by the “I am ok and you are ok”.
“I’m OK You’re OK” is probably the
bestknown expression of the purpose of
TA to establish and reinforce the position
that recognizes the value and worth of
every person. Transactional analysts
regard people as basically “OK” and thus
capable of change, growth, and healthy
interactions. As Berne set his Psychology
up, there are four life positions that a
person can hold and holding a particular
psychological position has profound
implications for how an individual
operationalizes his/her life. The positions
are stated as
The OK Corral (Franklin Ernst, 1971) Model
You are Okay with me
I am not OK
You are Ok
One Down Position
Get away from
Helpless
I am OK
You are Ok
Healthy Position
Get on with
Happy
I am not OK
You are not Ok
I am OK
You are not Ok
Hopeless Position Oneup Position
Get nowhere with
Hopeless
Get rid of Angry
You are not Okay with me
I’m OK and you are OK. This is the healthiest position about life and it means that I feel good
about myself and that I feel good about others and their competence.
I’m OK and you are not OK. In this position I feel good about myself but I see others as damaged
or less than and it is usually not healthy.
I’m not OK and you are OK. In this position the person sees him/herself as the weak partner in
relationships as the others in life are definitely better than the self. The person who holds this
position will unconsciously accept abuse as OK.
I’m not OK and you are not OK. This is the worst position to be in as it means that I believe that I
am in a terrible state and the rest of the world is as bad.
Strokes: Strokes refer to compliments, acceptance and recognition, which are
influential in how people lead their lives. TA therapy recognizes that we are greatly
motivated by the reinforcement we get as children, and if this was dysfunctional, we
are likely to adopt dysfunctional patterns of living as we get older.
I
am
not
Okay
with
me
I
am
Okay
with
me
26. 142 Counseling Approaches
Intimacy: Another motivation recognized in transactional analysis is intimacy.
Similarly to strokes, if the intimacy a child experiences is dysfunctional, then they
will learn that this type of intimacy is the best s/he can do to meet basic needs and
communicate with others. This can lead to the development of repetitive patterns of
behavior that can hinder a person’s potential.
Redecision: This refers to an individual’s capacity to redecide and make changes to
certain decisions made as a child that stem from unconscious scripts. Redecision
reflects the assumption of TA therapy that individuals have the potential to lead their
lives as they choose. This power is released after a redecision is made while a client
is in their childego state.
Contracts: Transactional analysis practice is based upon mutual contracting for
change. Transactional analysts view people as capable of deciding what they want for
their lives. Accordingly transactional analysis does its work on a contractual basis
between the client and the therapist, educator, or consultant. This helps to set
boundaries and realize expectations for both the client and the psychotherapist.
Ultimately, therapists will use these concepts in transactional analysis therapy to
promote structural rearrangement and deconfusion of a client’s child egostate. They
will encourage clients to challenge their current beliefs and the way s/he uses their life
script. This will help them to better understand the direction and patterns of their life
for themselves, and this awareness can help them to make the decision to change their
behavior.
Role of the Counselor
In TA the counselor and the client work together to establish the specific goals of
therapy.
The counselor contracts with the client for the changes that they desire.
Counselors use their knowledge to address a concern introduced by the client
rather than telling the client what issues need to focus on.
Goals of the TA
The goal is to not only learn to adjust to life but to attain health and autonomy.
Through the gaining of autonomy the client can be more aware, intimate and
spontaneous living a life free of games and selfdefeating life scripts.
Techniques of TA: In addition to structural, transactional, game and script analysis,
TA counselors use other techniques. Some of these techniques are
Treatment contract which is a agreement between the counselor and the client about
what is to be accomplished and what responsibilities are agreed upon. Interrogation
27. Essentials of Counseling 143
involves forcing the client to answer from the adult ego state through a succession of
confrontive questions. Specification is identifying the ego state that is the source of
the transition. Confrontation is the process of pointing out inconsistencies.
Explanation is a process where the counselor teaches the Adult ego state of the client
a tenet of TA. Illustration is a story or example that is used to portray a point.
Confirmation is a technique where the counselor directs the client’s attention to a
previously modified behavior that is reoccurring. Interpretation involves the
counselor explaining to the child ego state the reasons behind the client’s behavior.
Crystallization occurs when the client realizes that game playing can be given up and
the client can enjoy the freedom of choice in behavior.
How Does TA Work?
Transactional Analysis (TA) is a tool to know yourself, to know how you relate to others, and to
discover how you have been living out a life plan based on unconscious relational patterns. These
unconscious organizing patterns that begin at birth. They are reinforced and elaborated during a
number of developmental ages. The results constitute a life ‘script’. Change happens through the help
of your therapist in becoming aware of the previously unconscious ‘script’ patterns. The therapist can
then facilitate different outcomes so that you get what you want in life. TA offers many tools and
useful approaches for individual, couple, and group therapy. TA is based on the assumption that all
individuals can learn to trust themselves, think for themselves, make their own decisions and express
their feelings.
TA therapy is based on the theory that each person has three ego states parent, adult and child. These
are used along with other key transactional analysis concepts, tools and models to analyze how
individuals communicate and identify what interaction is needed for a better outcome. Throughout
therapy, the TA therapist will work directly on here and now problem solving behaviors, whilst helping
clients to develop daytoday tools for finding constructive creative solutions. The ultimate goal is to
ensure clients regain absolute autonomy over their lives. Eric Berne defines this autonomy as the
recovery of three vital human capacities spontaneity, awareness and intimacy.
Transactional analysis is a talking therapy and sessions are designed to explore an individual’s
personality and how this has been shaped by experience particularly those stemming from childhood.
This is achieved through skilful questioning and the utilization of various models, techniques and tools.
Sessions can be carried out in the form of oneonone counseling, or with families, couples or groups.
The atmosphere that supports transactional analysis is nonjudgmental, secure and respectful, ensuring
that a positive relationship is forged between the therapist and client(s) in order to provide a model for
subsequent relationships and communication that are developed outside of therapy.
In this setting the therapist works collaboratively with the individual to identify what has gone wrong
in their communication and provide opportunities for them to change repetitive patterns that limit their
potential. TA therapists recognize that we all have the potential to live the life we want, rather than the
life we are programmed to live. Sometimes however this potential is hindered by repetitive patterns or
‘unconscious scripts’ that stem from childhood decisions and teachings.
28. 144 Counseling Approaches
Applications: TA can help
Develop awareness, options and skills in daily life, through the enhancement of
your strengths and resources.
Improve on your communication skills and help with managing conflict and
difficult situations in your life.
Foster intimacy, spontaneity, and autonomy within yourself and your
relationships.
Think clearly and raise your emotional intelligence.
Develop new options and make better choices in your life.
Experience and live the life you deserve.
Transactional Analysis can be said to be an effective method in the process of
counseling. Recently its scope is increasing. Individuals especially the young adults
are the needy clients of this transactional analysis counseling, because present
generations carry different complex ego states. It enable the clients to identity the
sorts of relationship.
The term ‘cognitivebehavioral therapy (CBT)’ is a very general term for a classification of therapies
with similarities. There are several approaches to cognitivebehavioral therapy, including Rational
Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy,
and Dialectic Behavior Therapy.
Cognitive Therapy: This approach aims to identify and correct distorted thinking patterns that can
lead to feelings and behaviors that may be troublesome, selfdefeating, or even selfdestructive. The goal
is to replace such thinking with a more balanced view that, in turn, leads to more fulfilling and
productive behavior. Uses the power of the mind to influence behavior. It is based on the theory that
previous experiences can damage self image and this can affect attitude, emotions and ability to deal
with certain situations. It works by helping the client to identify, question and change poor mental
images of them, thus altering negative responses and behavior. It can help pessimistic or depressed
people to view things from a more optimistic perspective.
Cognitive Analytical Therapy: This combines Cognitive Therapy and Psychotherapy and encourages
clients to draw on their own ability to develop the skills to change destructive patterns of behavior.
Negative ways of thinking are explored in structured and directive ways, involving diarykeeping,
progress charts, etc.
Dialectical Behavioral Therapy: DBT was developed from cognitive behavior therapy (CBT). The
main aim of CBT is to change behavior, which is done by applying techniques with a focus on
problemsolving, such as homework, diary cards and behavioral analysis. However, some people felt
uncomfortable with the strong focus on change, and felt that their suffering and apparent loss of control
over their lives were not understood. This caused them to become frustrated and even to drop out of
treatment. Therapist sought to resolve this by the use of acceptance strategies. Acceptance strategies
are added to the process of CBT which means that the therapist explores with their clients an
acceptance that their behavior (e.g. selfharming, drinking, etc.), even though damaging in the long
term, may be the only way they have learned to deal with intense emotions; and which might have led
to positive short term benefits.
29. Essentials of Counseling 145
HUMANISTIC APPROACH: Person Centered Therapy, Gestalt Therapy,
Existential Therapy
In the 1960s and 1970s, there was a growing interest among counselors in a ‘third
force’ in therapy as an alternative to the psychoanalytic and behavioral approaches.
Under this heading fall the personcentered approach, Gestalt therapy and existential
therapy.
Humanistic psychology is concerned with human potential and the individual’s
unique personal experience. Humanistic psychologists generally do not deny the
importance of many principles of behaviorism and psychoanalysis. They value the
awareness of antecedents to behavior as well as the importance of childhood
experiences and unconscious psychological processes. Humanistic psychologists
would argue, however, that humans are more than the collection of behaviors or
objects of unconscious forces. Therefore, humanistic psychology often is described as
holistic in the sense that it tends to be inclusive and accepting of various theoretical
traditions and therapeutic practices. The emphasis for many humanistic therapists is
the primacy of establishing a therapeutic relationship that is collaborative, accepting,
authentic, and honors the unique world in which the client lives. The humanistic
approach is also holistic in that it assumes interrelatedness between the client’s
psychological, biological, social, and spiritual dimensions. Humanistic psychology
assumes that people have an innate capacity toward selfunderstanding and
psychological health.
Humanistic therapy helps individuals access and understand their feelings, gain a
sense of meaning in life, and reach selfactualization. The aim of humanistic therapy
is usually to help the client develop a stronger, healthier sense of self, also called self
actualization. It is also to help individuals access and understand their feelings to help
to gain a sense of meaning in life. Humanistic theory sees each individual’s
personality as being composed of physical, intellectual, emotional, behavioral,
creative, and spiritual elements. In order to help the client reach selfactualization,
humanistic therapists help clients remove and replace the attitudes, behaviors, and
beliefs that do not produce a positive state of being, and integrate the various
components of their unique personalities so that each individual is more selfaware,
mature, and authentic.
Key points of humanistic therapy are
Empathic understanding of the client’s frame of reference and subjective
experience.
Respect for the client’s cultural values and freedom to exercise choice.
30. 146 Counseling Approaches
Exploration of problems through an authentic and collaborative approach to help
the client develop insight, courage, and responsibility.
Exploration of goals and expectations, including articulation of what the client
wants to accomplish and hopes to gain from treatment.
Clarification of the helping role by defining the therapist’s role but respecting the
self determination of the client.
Assessment and enhancement of client motivation both collaboratively and
authentically.
Negotiation of a contract by formally or informally asking, “Where do we go from
here”?
Demonstration of authenticity by setting a tone of genuine, authentic encounter.
In humanistic therapy, there are two widely practiced techniques gestalt therapy
(which focuses on thoughts and feelings ‘here and now’ instead of root causes) and
clientcentered therapy (which provides a supportive environment in which clients
can reestablish their true identity).
PERSON-CENTERED THERAPY
Personcentered therapy (PCT) is also known as
personcentered psychotherapy, personcentered
counseling, clientcentered therapy or Rogerian
psychotherapy. PCT is a humanistic approach that
deals with the ways in which individuals perceive
themselves consciously rather than how a
counselor can interpret their unconscious thoughts
or ideas. It is a nondirective form of talk therapy
that was developed by humanist psychologist Carl
Rogers during the 1940s and 1950s. Today, it is
one of the most widely used approaches in
psychotherapy.
Dr. Carl Ransom Rogers
(January 8, 1902 – February 4, 1987)
Clientcentered therapy provides a supportive environment in which clients can re
establish their true identity. The world that we live in is judgmental. And many of us
fear that if we shared with the world our true identity it would judge us relentlessly.
Experience with these judgments results in people establishing a public identity to
navigate the judgmental world. The ability to reestablish their true identity will help
the individual understand themselves as they truly are; which is important as people
suppress their feelings about issues because they are not supported, socially
acceptable, or lead to unwanted judgment. The task of reestablishing one’s true
31. Essentials of Counseling 147
identity is not an easy task and the therapist must rely on the techniques of
unconditional positive regard and empathy. These two techniques are central to client
centered therapy because they build trust between the client and therapist by creating
a nonjudgmental and supportive environment for the client.
Contemporary personcentered therapy is the result of an evolutionary process that
continues to remain open to change and refinement. Rogers did not present the PCT
as a fixed and completed approach to therapy. The four developmental periods of the
approach are
1. In the first period, during the 1940s, Rogers developed what was known as
nondirective counseling as a reaction against the directive and traditional
psychoanalytic approaches to individual therapy. Roger’s theory emphasized the
counselor’s creation of a permissive and nondirective climate. Rogers also
challenged the validity of commonly accepted therapeutic procedures such as
advice, suggestion, direction, persuasion, teaching, diagnosis, and interpretation.
This was based on his conviction that diagnostic concepts and procedures were
inaccurate, prejudicial, and often misused. Nondirective counselors avoided
sharing a great deal about themselves with clients and instead focused mainly on
reflecting and clarifying the clients’ verbal and nonverbal communications with
the aim of gaining insight into the feelings expressed by clients.
2. In the second period, during the 1950s, Rogers renamed his approach client
centered therapy to reflect its emphasis on the client rather than on directive
methods. This period focused on the phenomenological world of the client.
Rogers assumed that the best vantage point for understanding how people behave
was from their own internal frame of reference. He focused more explicitly on the
actualizing tendency as the basic motivational force that leads to client change.
3. The third period, beginning in the late 1950s and extending into the 1970s,
addressed the necessary and sufficient conditions of therapy. The process of
“becoming one’s experience” is characterized by openness to experience, a trust
in one’s experience, an internal locus of evaluation, and the willingness to be in
process. He was interested in how people best progress in psychotherapy, and he
studied the qualities of the clienttherapist relationship as a catalyst leading to
personality change. Clientcentered philosophy was applied to education and was
called studentcentered teaching. It was also applied to encounter groups, led by
laypersons in the 1960s.
4. The fourth phase, during the 1980s and 1990s, was marked by considerable
expansion to education, industry, groups, conflict resolution, and the search for
world peace. The theory became known as personcentered approach. This shift in
32. 148 Counseling Approaches
terms reflected the broadening application of the approach. Areas of further
application include education, health care, crosscultural and interracial activity,
international relations, politics, and the achievement of worldpeace.
Basic Philosophy
Rogers viewed human nature as basically good.
He believed that if given the appropriate environment of acceptance, warmth and
empathy, the individual would move toward selfactualization.
Selfactualization is the motivation that makes the individual move toward
growth, meaning, and purpose.
It is considered a phenomenological psychology whereby the individual’s
perception of reality is accepted as reality for the individual.
Personcentered is often referred to as a self theory, because of Rogers’s emphasis
on the self being a result of the person’s life experiences and the person’s
awareness of comparisons to others as the same or different.
Rogers believed that most people were provided conditional acceptance as
children, which lead them to behave in ways that would assure their acceptance.
However, in their need for acceptance, the individual often behaved in ways that
were incongruent with the real self. Thus, the greater this incongruence between
the real self and the ideal self, the greater isolated and maladjusted the person
became.
Key Concepts: Rogers identified six key factors that stimulate growth within an
individual. He suggested that when these conditions are met, the person will gravitate
toward a constructive fulfillment of potential. According to Rogerian theory, the six
factors necessary for growth are
TherapistClient Psychological Contact: This first condition simply states that a
relationship between therapist and client must exist in order for the client to
achieve positive personal change. The following five factors are characteristics of
the therapistclient relationship, and they may vary by degree.
Client Incongruence or Vulnerability: A discrepancy between the client’s self
image and actual experience leaves him/her vulnerable to fears and anxieties. The
client is often unaware of the incongruence.
Therapist Congruence or Genuineness: The therapist should be selfaware,
genuine, and congruent. This does not imply that the therapist be a picture of
perfection, but that s/he be true to him/herself within the therapeutic relationship.
Therapist Unconditional Positive Regard (UPR): The clients’ experiences,
positive or negative, should be accepted by the therapist without any conditions or
33. Essentials of Counseling 149
judgment. In this way, the client can share experiences without fear of being
judged.
Therapist Empathy: The therapist demonstrates empathic understanding of the
clients’ experiences and recognizes emotional experiences without getting
emotionally involved.
Client Perception: To some degree, the client perceives the therapist’s
unconditional positive regard and empathic understanding. This is communicated
through the words and behaviors of the therapist.
Role of the Counselor
The counselor sets up an environment where the client is safe to explore any
aspect of the self. The counselor’s job is to facilitate the exploration through a
special “I Thou” relationship of unconditional positive regard, empathy and
warmth.
The counselor uses psychological testing on a limited basis. The Qsort is
sometimes used in assessment by the person centered counselor. The Qsort gives
an indication of the incongruence between the perceived real self and ideal self.
Qsort: A series of 100 statements are written on cards. The statements are selfdescriptions, i.e. I am
capable, I am dependent, I am worthless. The client is asked to read and sort each of these statements
into nine piles from most like me to least like me. Then the stacks are recorded. The clientresorts the
cards into what they would like to be like.
The use of diagnostic categories is discouraged as incompatible with the
philosophical view of the individual as unique. Diagnosis places the counselor in a
position of authority and imposes a treatment plan.
Goals of Therapy: Person centered theory is directly concerned with the individual.
The counselor facilitates the client toward
Realistic selfperception;
Greater confidence and selfdirection;
Sense of positive worth;
Greater maturity, social skill, and adaptive behavior;
Better stress coping;
More fully functioning in all aspects of their lives.
Therapeutic Relationship: The relationship is of primary importance. The qualities
of the therapist, including genuineness, warmth, accurate empathy, respect, and non
judgmentalness and communication of these attitudes to clients are stressed. Clients
use this real relationship with the therapist to help them transfer their learning to other
relationships. Rogers based his hypothesis of the ‘necessary and sufficient conditions
for therapeutic personality change’ on the quality of the relationship. Roger’s
34. 150 Counseling Approaches
hypothesis is as follows
Two persons are in psychological contact.
The first, or the client, is in a state of incongruence, being vulnerable or anxious.
The second person, or the therapist, is congruent or integrated in the relationship.
The therapist experiences unconditional positive regard for the client.
The therapist experiences an empathic, understanding of the client’s internal
frame of reference and endeavors to communicate this experience to the client.
The communication to the client of the therapist’s empathic understanding and
unconditional positive regard is to a minimal degree achieved.
Techniques of Therapy: This approach uses few techniques but stresses the attitude
of the therapist. Basic techniques include active listening and hearing, reflection of
feelings, clarification, and being there for the client. This model does not include
diagnostic testing, interpretation, taking a case history, or questioning or probing for
information. The techniques used in person centered therapy have changed over time.
Three periods of time in which different techniques were stressed
Nondirective Period (1940 1950): In this period of theory development, the
counselor focused on listening and creating a permissive atmosphere. The counselor
did not provide interventions, but communicated acceptance and clarification.
Reflective Period (1950 1957): During this period of time, counselors emphasized
being non judgmental of the client, while responding to the client’s feelings and
reflecting the affect accurately.
Experiential Period (1957 1980): This is the period of the EWG Empathy, Warmth
and Genuineness. Empathy is the ability of the counselor to understand the emotions
of the client and correctly communicate this understanding. Warmth is also referred to
as acceptance and positive regard in person centered literature. Warmth is the ability
of the counselor to convey an unconditional acceptance of the client’s personhood.
Genuineness or congruence is the ability to be who one really is without assuming
roles or facades.
The counselor helps the client through accurate reflections of feelings, keeping the
client focused on the concern, and clarification of feelings and information. The
counselor uses openended questions or phrases to help the clients gain insight into
experiences and necessary changes in their lives.
Applications: Has wide applicability to individual and group counseling. It is
especially well suited for the initial phases of crisis intervention work. Its principles
have been applied to marital and family therapy, community programs, administration
and management, and human relations training. It is a useful approach for teaching,
35. Essentials of Counseling 151
parent/child relations, and working with groups composed of people from diverse
cultural backgrounds. Today many people who are not practicing counseling use the
approach to help guide them through daytoday work and relationships.
Generally, personcentered counseling can help individuals of all ages with a range of
personal issues. It has been found particularly useful in helping individuals to
overcome specific problems such as depression, anxiety, personality disorders, eating
disorders and alcohol addictions. These issues can have significant impact on self
esteem, selfreliance and selfawareness, but personcentered therapy can help
individuals to reconnect with their inner self in order to transcend any limitations.
Multiculturalism: Focus is on breaking cultural barriers and facilitating open
dialogue among diverse cultural populations. Main strengths are respect for clients’
values, active listening, welcoming of differences, nonjudgmental attitude,
understanding, willingness to allow clients to determine what will be explored in
sessions, and prizing of cultural pluralism. Some of the core values of this approach
may not be congruent with the client’s culture. Lack of counselor direction and
structure are unacceptable for clients who are seeking help and immediate answers
from a knowledgeable professional.
Contributions: Rogers had a major impact on the field of counseling and
psychotherapy. When he introduced his revolutionary ideas in the 1940s, he provided
a powerful and radical alternative to psychoanalysis and to the directive approaches
then practiced. Rogers was a pioneer in shifting the therapeutic focus from an
emphasis on technique and reliance on therapist authority to that of relationship. One
of Rogers’s contributions to the field of psychotherapy was his willingness to state his
concepts as testable hypotheses and to submit them to research. He literally opened
the field to research. Personcentered therapy has demonstrated that therapist empathy
plays a vital role in facilitating constructive changes in the client
Research consistently demonstrates that therapist empathy is the most potent
predictor of client progress in therapy.
Empathy is an essential component of successful therapy in every therapeutic
modality.
Empathy is a basic component of emotional intelligence.
Client perception of therapist empathy, as opposed to that of external raters or
therapists, is mot predictive of positive client outcome.
Limitations: Possible danger from the therapist who remains passive and inactive,
limiting responses to reflection. Many clients feel a need for greater direction, more
structure, and more techniques. Clients in crisis may need more directive measures. It
36. 152 Counseling Approaches
is difficult to translate the core conditions into actual practice in certain cultures.
Clients accustomed to indirect communication may not be comfortable with direct
expression of empathy or selfdisclosure on the therapist’s part. Another limitation is
that this approach extols the value of an internal locus of evaluation. In some cases,
clients are likely to be highly influenced by societal expectations and not simply
motivated by their own personal preference.
Because the personcentered counselors place so much emphasis on genuineness and
on being led by the client, they do not place the same emphasis on boundaries of time
and technique as would psychodynamic therapists. They have very positive and
optimistic view of human nature. The philosophy that people are essentially good, and
that ultimately the individual knows what is right for them, is the essential ingredient
of successful person centered therapy as ‘all about loving’.
GESTALT THERAPY
Gestalt Therapy was developed in the late
1940s by Fritz Perls (a Germanborn
psychiatrist) with his wife Laura Perls and
further influenced by the likes of Kurt Lewin
and Kurt Goldstein (Corsini & Wedding,
2000). It was developed as a revision to
psychoanalysis and focuses on an experiential
and humanistic approach rather than analysis
of the unconscious; which was one of the
main therapeutic tools at the time ‘Gestalt
Therapy’ was employed.
Friedrich (Frederick) Salomon Perls
[Better known as Fritz Perls]
(July 8, 1893 – March 14, 1970)
Gestalt Therapy rejects the dualities of mind and body, body and soul, thinking and
feeling, and feeling and action. According to Perls, people are not made up of separate
components, i.e., mind, body and soul; rather human beings function as a whole. In
doing so, one defines who one is (sense of self) by choice of responses to
environmental interactions (boundaries). The word ‘Gestalt’ (German origin) refers to
a “whole, configuration, integration, pattern or form” (Patterson, 1986). Gestalt
Therapy focuses on the whole of the client’s experience, including feelings, thoughts
and actions. The client gains selfawareness in the ‘here and now’ (what is happening
from one moment to the next) by analyzing behavior and body language and talking
about bottled up feelings. In gestalt therapy, selfawareness is key to personal growth
and developing full potential. The approach recognizes that sometimes this self
awareness can become blocked by negative thought patterns and behavior that can
37. Essentials of Counseling 153
leave people feeling dissatisfied and unhappy. It is the aim of a gestalt therapist to
promote a nonjudgmental selfawareness that enables clients to develop a unique
perspective on life. By helping an individual to become more aware of how they
think, feel and act in the present moment, gestalt therapy provides insight into ways in
which s/he can alleviate their current issues and distress in order to aspire to their
maximum potential.
Basic Philosophy
The person strives for wholeness and integration of thinking, feeling, and
behaving.
Gestalt therapy is considered to be a hereandnow therapy focusing on awareness
with the belief that when one focuses on what they are and not what they wish to
become, they become selfactualized. The idea being that through self acceptance
one becomes selfactualized.
Individual naturally seeks to become an integrated whole, living productively.
Gestaltists are antideterministic because they believe that people have the ability
to change and become responsible.
Gestalt focuses on the client’s own inner world of interpretation and assessment of
the present life situation.
Gestaltists believe that individuals emphasize intellectual experience, diminishing
the importance of emotions and senses, resulting in an inability to respond to the
situations or events in their life.
Gestaltists believe that thoughts, feelings, and reactions to past events or situations
can impede personal functioning and prevent hereandnow awareness.
The emphasis in on reality and not on embellished or imagined needs. The
individual recognizes their internal need and meets that need through
manipulation of the need and the environment.
Difficulty may arise in several ways
Loss of contact with the environment and its resources.
Loss of contact with self through over involvement with environment.
Fail to put aside unfinished business.
Loss the Gestalt resulting in fragmentation or scattering.
Experience conflict between what one should do and what one wants to do.
Experience difficulty with life’s dichotomies, i.e., love/hate, pleasure/pain,
masculinity/femininity.
Key Concepts of Gestalt Therapy: Several key concepts underlie Gestalt Therapy,
many of which are similar to that of personcentered and existential therapy. The
following are the key concepts of Gestalt Therapy
38. 154 Counseling Approaches
Wholeness and Integration: Wholeness refers to the whole person or the individual’s
mind and body as a unit rather than as separate parts (Seligman, 2006). Integration
refers to how these parts fit together and how the individual integrates into the
environment. Often people who come to therapy do not have these parts fitting
together in their environment, Gestalt Therapy is about facilitating clients to integrate
themselves as whole persons and help restore balance in their environment.
Awareness: Awareness is one of the most important elements in Gestalt Therapy as it
is seen as a “hallmark of the healthy person and a goal of treatment” (Seligman,
2006). When individuals are ‘aware’, they are able to selfregulate in their
environment. There are two main causes lacking awareness (a) Preoccupation with
one’s past, fantasies, flaws and strengths that the individual becomes unaware of the
whole picture, and (b) Low selfesteem. There are three ways people may achieve
awareness through therapy (i) Contact with the environment This is through looking,
listening, touching, talking, moving, smelling, and tasting. This enables the individual
to grow in his/her environment through reacting to the environment and changing. (ii)
Here and now This is the individual living in and being conscious at the present
moment rather than worrying about the past or the future.
(iii) Responsibility This refers to the individual taking responsibility for his/her own
life rather than blaming others.
Energy and Blocks to Energy: Gestalt Therapists often focus on where energy is in
the body, how it is used, and how it may be causing a blockage (Corey, 2005).
Blocked energy is a form of resistance, for example, tension in a part of the body, not
breathing deeply, or avoiding eye contact. Gestalt Therapy is about finding and
releasing the blockages that may be inhibiting awareness.
Growth Disorders: Growth disorders refer to emotional problems that are caused by
people who lack awareness and do not interact with their environment completely. In
doing so, people are unable to cope with the changes in their lives successfully and,
instead deal with the problems in a defensive manner (Seligman, 2006).
Unfinished Business: Unfinished business refers to people who do not finish things in
their lives and is often related to people with a ‘growth disorder’ (Seligman, 2006).
People with unfinished business often resent the past and because of this are unable to
focus on the here and now. One of the major goals of Gestalt Therapy is to help
people work through their unfinished business and bring about closure.
Role of the Counselor
Counselor creates an environment for the client to explore their needs in order to
grow.
39. Essentials of Counseling 155
Counselor is fully with the client in the hereandnow with intense personal
involvement and honesty.
Counselor helps the client to focus on blocking energy and to positively and
adaptively use that energy.
Counselor also helps the clients to discern life patterns.
Among the rules that counselor uses to help client
The principle of the now requires the counselor to use present tense.
“I and Thou” means that the client must address the person directly rather than
talk about them or to the counselor about them.
Making the client use the “I” instead of referring to own experiences in the
second (you) or third (it) person.
The use of an awareness continuum that focuses on how and what rather than
on why.
The counselor has the client convert questions into statements.
DSMIV categories and standardized assessment is not considered necessary
within this theory.
Goals of Therapy: To assist clients in gaining awareness of momenttomoment
experiencing and to expand the capacity to make choices. Aims not at analysis but at
integration.
Emphasis is on the hereandnow of the client’s experience.
The client is encouraged to make choices based on the now as opposed to past.
Help the client resolve the past.
Assist the client to become congruent.
Help the client to reach maturity intellectually.
Help the client shed neuroses.
Therapeutic Relationship: Central importance is given to the I/Thou relationship
and the quality of the therapist’s presence. The therapist’s attitudes and behavior
counts more than the techniques used. The therapist does not interpret for the clients
but assists them in developing the means to make their own interpretations. Clients
identify and work on unfinished business from the past that interferes with current
functioning.
Techniques of the Therapy: Techniques in Gestalt therapy one of two forms, either
an exercise or an experiment. (1) Exercises include activities such as i. frustration
actions; ii. fantasy role playing; iii. Fantasy; and iv. Psychodrama. (2) Experiments
are unplanned creative interventions that grow out of the hereandnow interaction
between the client and the counselor.