Approaches to Counselling
There are 3 main approaches to counselling and psychotherapy, and as I trained integratively, I use elements of all these approaches. I always pay attention to the relationship between my client and me, tailoring my approach to suit the specific needs of each individual client.
The Psychodynamic approach, evolved from psychoanalytic theory, is the oldest with an emphasis on bringing the unconscious into consciousness so gaining greater self-knowledge. It is usually long-term work, often over a number of years, and in the case of psychoanalysis with several sessions each week. It delves into the past to discover the origins of our behavioural patterns and belief systems. Carl Jung, Alfred Adler, Otto Rank and Melanie Klein are all widely recognised for further developing the concept and application of psychodynamics.
Psychodynamic therapy focuses on unconscious thought processes which manifest themselves in a client’s behaviour. The approach seeks to increase a client’s self-awareness and understanding of how the past has influenced present thoughts and behaviours, by exploring their unconscious patterns. Clients are encouraged to explore unresolved issues and conflicts, and to talk about important people and relationships in their life. Transference (when clients transfer feelings they have toward important people in their life onto the therapist) is encouraged during sessions. Compared to psychoanalytic therapy, psychodynamic therapy seeks to provide a quicker solution for more immediate problems.
The Humanistic approach includes Person-Centred, Gestalt, TA (Transactional Analysis), and Existential. The Humanistic approach sits between the Psychodynamic and Behavioural approaches and can embrace elements of both. This model tends to be shorter term than Psychodynamic, but tends to be longer than the brevity of CBT. Therapists usually have a more interactive and equal relationship with their clients than psychodynamic therapists, and less of the purely teaching relationship of a CBT practitioner. Although Humanistic therapists consider it important to look at past experiences in order to understand the origins of behaviour patterns and belief systems, the main thrust is to help a client feel sufficiently empowered that they can take better control of their situation and therefore life.
The model works in 3 stages:
1. To understand the origin of the problem
2. To explore ways of addressing that problem
3. To put the planned solutions into effect
The Behavioural approach covers CBT (Cognitive-Behavioural Therapy) and REBT (Rational-Emotive Behaviour Therapy). Acceptance and Commitment Therapy (ACT) is contextual CBT that uses acceptance and mindfulness strategies, together with commitment and behaviour change strategies, to increase psychological flexibility.
These approaches are the youngest of the three and are different from the first two in that they focus on the here and now and do not investigate the causes.
It is brief therapy with the aim of helping clients unlearn their negative/unhelpful reactions to situations and learn new ways of reacting. Understanding how a client came by their belief system is not considered and consequently the longer-term effectiveness of CBT is often questioned. However, elements of CBT can be very effective in short or longer term therapy, and I tend to use some of these tools alongside considering the underlying causes of thoughts, feelings and behaviours.