Novice Counseling Theory
Introduction
Counseling and psychotherapy are fields thatare more art than science. Practitioners design their theories and select techniques from a palette of choices in an effort to help people become authentic and fully formed beings. Just as artists bring a unique approach to their craft, therapists bring a unique approach to their practice. Each therapist relies on their own beliefs about what drives humans and what may come to interfere with their functioning. As therapists perfect their craft, they may find themselves drawing ideas and techniques from others; ones that seem to fit with their schema of what makes people whole and how to help “broken” people reconstruct themselves into stronger more confident beings. From my long history of work in education with children aged 6-12, I had come to form my own beliefs about what caused problems in their functioning, and I had also developed a backpack of strategies to assist them. As I have recently been exposed to more formal counseling theory and a cache of new knowledge, I have somewhat revised my thinking and am developing a new approach.
Assumptions
People come into the world with a somewhat clean slate. I say somewhat due to the fact that one cannot discount the biological genetic programming that is a part of one’s being. Those genetics, in some cases, predispose individuals to the susceptibility of various types of mental illness such as: depression, bipolar disorder or schizophrenia. Whether or not a person comes to develop these disorders can be affected largely by other factors: environmental, sociological, personal, cognitive and emotional. This thinking is supported by the beliefs of Rational Emotive Behavioral therapists among others. Albert Ellis wrote that, “certain severe mental disturbances are partly inherited and have strong biological components. For example, schizophrenia is illustrative of biological limitations (Ellis, As cited in Scharf, 2012, p. 336).
The environment in which a child is raised also contributes greatly to his or her personality development. Freud recognized this with his beliefs about how traumatic early events are relegated to one’s subconscious. Adler and Beck both theorized that children’s personalities are formed from early childhood events that contribute to their belief systems. Rollo May believed that an individual’s development of authenticity and awareness is related to childhood experiences and how they are parented (Scharf, 2012).
Social and political factors cannot be discounted in evaluating the conditions in which one’s young experiences are formed and the opportunities that are provided to develop one’s potential. Societal conditions that allow oppression, poverty and both gender and power differences create situations that affect how an individual develops. Feminist therapists believe that it is in childhood that gender schemas develop and that parents can encourage the development of healthier schemas such as those that foster individual differences or cultural relativism (Scharf, 2012).
All of a child’s significant experiences affect the feelings and beliefs that he or she develops, but the relationships with parents and siblings appear to matter the most. Many theorists discuss the importance of developing independence. Psychoanalysts apply object relations psychology to the analysis of mother-child relationships in an effort to learn how children separate from their mother and experience individuation. Winnicott (As cited in Scharf, 2012) proposed the importance of the parental environment in fostering this process and that mothers should strive not to be perfect, but “good enough” to gradually encourage independence. Adler (As cited in Scharf, 2012), when discussing social interests, believed its development is influenced by the parent-child relationship and is taught in the mother-child bond. He believed other relationships such as the father-child and parental relationships also impacted a child’s social development. Parental neglect or pampering thwarts both a child’s social development and self-confidence. He also believed that birth order and sibling relationships played a role. Ellis and Beck (As cited in Scharf, 2012) believed that parents interactions with children contributed to the beliefs and cognitions that they developed. Thus, my belief that early childhood experiences contribute significantly to a personality development, belief systems and independence is well supported.
Healthy childhood experiences that occur in a nurturing supportive environment with a lack of genetic interference will produce a fully functioning, responsible, authentic individual. Phrases such as to thine own self be true or you are the captain of your own ship sum up my philosophy of a healthy individual. One of my strongest beliefs is that healthy individuals are able to think independently and value this freedom. They are able to make choices of their own volition independent of what others think and take responsibility for the consequences of their choices. They are able to tolerate bumps in the road or mistakes they may make and learn from them. They have the ability to pick themselves up, dust themselves off and start again. I share the belief that many factors contribute to the development of this type of individual.
Goals:
My goal as a therapist would be to help my clients to feel more in touch with themselves, to develop awareness and to be authentic. According to Kobasa and Maddi (As cited in Scharf, 2012) authentic individuals are their own persons; they are able to have genuine intimate relationships; they are concerned about societal institutions and they are flexible and open to change. I would like to help people be comfortable with the existential theme of freedom, choice and responsibility. Healthy persons would view freedom as their opportunity to confront undesired behaviors and change. They would accept responsibility for their current behaviors, identify self causes and not blame others. They would take the time to search for their wishes and then garner the will to decide what changes they want to make (Scharf, 2012).
I would work with my clients to help them develop goals for themselves. One way to do this would be to have them describe how they see themselves. What behaviors, attitudes and feelings define them? Next, I would have them describe the type of person they would like to be, or talk about the characteristics of someone they admire and want to be more like. Inherent in setting these goals, would be to make sure the client is describing the person that he or she would like to be, not what he or she thinks others (such as a parent or a spouse) want to see . One way to accomplish this might be to use the empty chair technique where the client can talk about the person they want to be and then sit in the other chair and play the part of someone who is leading them to act differently. They could use this approach to help them to identify behaviors that they would like to change which would become their goals.
The client’s choosing is a first step toward responsibility. Taking responsibility for the choice helps the client set expectations for themselves. As they make progress toward the goals, their needs are fulfilled and they should experience gratification leading to an increase in confidence and self-worth.
Therapeutic Relationship:
Although the goals and underlying philosophy are existential in nature, my client therapist relationship will be more reflective of a cognitive-behavioral approach. If I believe a healthy personality stems from independence and responsibility, then my client should assume some responsibility for his or her role in therapy. The relationship will function as a collaborative partnership with the client identifying areas that they would like to improve or change. If this is too difficult for them, then I will supply techniques or activities to help them.
While I believe that self-regard and a person’s esteem are important to develop the strength to make changes, that self-regard must come from the person’s growing confidence in his or her flexibility and openness to change and also from the ability to make tough decisions. In my opinion, unconditional regard can come across as a bit phony. I do think it is important for a client to know that you believe in them and their ability to improve, but that belief should be based on a foundation of trust, mutual respect and honest appraisal.
Therapeutic Process/Techniques
Despite the fact that my assumptions denote difficulties arising from childhood experiences, those issues will not play a role in the therapeutic process. Techniques from psychoanalysis such as resistance and transference have no bearing on client progress in my practice. Neither do assessment techniques such as free association or dream interpretation. While I agree with some of the underlying causal assumptions of psychoanalysts (especially those of early childhood influences), it is the practical here and now techniques of behavioral and cognitive therapists that, in my opinion, get the job done.
My therapeutic process will be one that rallies an individual’s feelings to activate desires to change. Selection and acceptance of a process to achieve the change and then happily living with the results completes the script. This is driven by my belief that people inherently have the ability to overcome their difficulties and control their own destiny regardless of how they began in life. Even though it takes courage, they have the freedom to choose a different path and reconstruct their story; something feminist therapy would uphold.
The process would take place in the here and now with little regard of the past experiences that may have contributed to current problems. The first sessions would consist of interviews about the client’s current life and areas with which the client was dissatisfied. During this time, rapport would be developed and a climate of mutual trust and appreciation would be constructed. Careful attention would be paid to the cultural and social-political situation of the client. If the client was of a culture other than mine, I would be cautious in proceeding very far without researching cultural norms or behaviors that could influence the direction of therapy and the techniques we would use. If the client’s current situation hinted of cultural, gender or power issues, I would again do some researching into advocacy resources that may be useful in helping him or her to achieve a full healing experience.
Another factor for which I would listen with a keen ear is environmental influence. If the person’s behaviors only occur in certain contexts or with certain family members or others, then a family systems approach may be the most appropriate therapy to consider.
In our sessions together, the client and I would fashion an idea of what type of person he or she would like to be which would help to identify the behaviors likely to change. The behaviors selected for change would be discussed and described in specific observable terms. If the client needed further assistance in identifying where they are now and behaviors they would like to change, tools such as scales, questionnaires and inventories would be utilized to gather assessment information.
The next step in therapy would be to prioritize the behaviors that the client wishes to change. Careful attention would be given to each one individually. Depending on the behaviors to be altered different techniques could be applied. If the client has irrational thoughts, specific techniques could dispute these. The client could be taught to do a cost/benefit analysis, use problem-solving to find suitable options for behaviors, use coping self-statements, participate in role-plays, use forceful statements or self-dialogue or even attempt a shame-attacking exercise. As the therapist of a client with cognitive distortions, I would use Socratic questioning techniques to help clients restructure their negative thoughts. We could also work together to challenge absolute and all-or-nothing thinking, label distortions or decatastrophize the thinking through a series of what-if questions. Clients that wished to become less anxious and face situations with resolve and determination would be exposed to techniques such as systematic desensitization which involves relaxation, establishing hierarchies and desensitizing activities. Imaginal flooding and in vivo procedures, as well as different types of modeling are other options to employ if my client’s behaviors were related to anxiety.
Critical to the success of many of the techniques mentioned above that are devised to bring about changes in cognition and behavior is the idea of practice and homework. My client would practice in sessions with me through role playing and participant observation as well as at home on their own. Also critical to the success of these techniques is the continual gathering of feedback. Thus, each session would begin with the client reporting back on the success of the homework activities. From there together we would decide whether they are ready to move on to work on the next behavior, or whether more practice or an alternate technique is needed.
Eventually, the client should begin to take ownership and responsibility for the behaviors being encouraged through the techniques. When the feedback indicates they are feeling in control of the person they have chosen to become, a termination plan would be devised. Inherent in the plan would be methods for dealing with setbacks and any re-emergence of the extinguished behaviors.
Lastly, if the therapy techniques do not appear to be creating comfort and helping my client to move forth in a healthier direction, and I believe that we have worked collaboratively in a trusting relationship to design a solid treatment plan, then I would definitely recommend that he or she see a physician for a possible medical intervention. This would be a last step, but I do believe that some behaviors are driven by genetic and biological causes that are activated by environmental or emotional triggers and may need a pharmaceutical component in addition to therapy techniques.
Conclusion
My approach to therapy is a kaleidoscope of many different theories bound together by the concepts of choice, independence and responsibility. While clients may initially struggle with being responsible for behaviors they are choosing and the decisions that drive their behavior, through a trusting and collaborative therapeutic relationship they can learn to regain the control to use that freedom of choice to make changes for a healthier and more authentic life.
References
Scharf, R. S. (2012). Theories of psychotherapy and counseling: Concepts and cases, 5th edition. California: Brooks/Cole.