Therapy offered to clients
This is a guide contains the type of services offered by EAC Accredited Members and brief details of what may be expected from each kind of therapy listed below.
Explanation of therapy approaches
Counsellors work from a variety of Modalities with their clients. These modalities range from Humanistic Counselling (based on personal growth and self-development) to the Behavioural Counselling used for dealing with specific phobias and anxieties. However there is evidence that the relationship between the counsellor and the client is more important than the approach the therapist uses.
The following is an alphabetical list of common modalities with a brief description of their meanings:
Adlerian Counselling Therapy
Adlerian Therapy, originated by Alfred Adler, is also called personal psychology and focuses on creating a therapeutic relationship that is co-operative, encouraging and practical. Adlerian counsellors help clients look at their lifestyle and personal values to help them understand and question their usual patterns of behaviour and hidden goals. It is a learning process that assists the client to move towards useful involvement and contribution to society.
A counsellor will seek to set goals with a client in relation to the issues a client needs to work on. There is a need to find false assumptions and mistaken goals.
Using listening skills the counsellor will show empathy and compassion toward the client while helping them to overcome feelings of inferiority cure faulty motivation.
Although displaying empathy a counsellor will also confront the client by using their distorted thinking and behaviour to help them to reframe their thinking.
Behavioural Counselling Therapy
This therapy is based on the belief that behaviour is learnt in response to experience and can be unlearned, or reconditioned, without analysing the past to find the reason for the behaviour. It works well for compulsive and obsessive behaviour, fears, phobias and addictions.
Behaviour therapy/counselling is used to help clients acquire new coping skills, improve communication, or learn to break maladaptive habits and overcome self-defeating emotional conflicts. The behavioural therapist/counsellor focuses on interpreting the clientâs behaviour, emphasizing a collaborative and positive relationship with the client and values the use of objectivity to assess and understand the client.
Brief Counselling (see Solution Focused Brief Counselling)Therapy
Brief Therapy is not just a condensed version of any other sort of therapy but it does come from a different starting point to other therapies. The counsellor will organise brief therapy around a set number of counselling sessions (usually 6) and those sessions are entirely focused on building solutions and not solving problems.
The counsellor will listen attentively to the client picking up clues about how the client views things. They help the client build a vision of how a preferred future would look like, then plan to help the client reach it. Goals are set as markers and quite often the client will be asked to do some work at home in preparation for the next session.
Client Centred Counselling (see Person-Centred Counselling)Therapy
Developed during the 40’s and 50’s by Carl Rogers, client centred therapy is a non-directive form of talk therapy. It is not one of the widest used forms of therapy. Rogers emphasised the term client and not patient, as a patient usually is one who is sick and is seeking a cure.
It is essential that the therapist who uses this modality creates a non-threatening environment for the client, one that is comfortable and certainly non-judgemental. Although it is widely used recent studies have indicated that perhaps it is not as effective as it was once thought to be. The three qualities suggested by Rogers; genuineness, unconditional positive regard and emphatic understanding, in themselves are all beneficial. However those recent studies mentioned earlier suggest that these factors alone are not enough to give a long-lasting change to the client’s life.
Cognitive Analytical Therapy
Cognitive Analytic Therapy (CAT) was initially developed in the United Kingdom by Anthony Ryle with the aim of providing effective and affordable psychological techniques which could be realistically provided in a resource constrained public health system. It is distinctive due to its integration of cognitive therapy and analytic practice and its collaborative nature involving the patient very actively in the understanding of their disorder. Its techniques create a very user-friendly and effective information based therapy.
Bringing together parts of cognitive therapies and psychoanalytical approaches, it focuses on understanding what a person brings to the therapy by way of target problems and the history of the deep-seated patterns that underlie them. In other words the therapist uses CAT to look at the way the client thinks, feels and acts. It is a programme tailored to the clients individual needs and helps them discover their own manageable behavioural goals in order to bring about change. The therapy recognises that people are far more than their identified problems, helping a client to see what appears to go wrong as well as setting their manageable goals.
- A client could present themselves having been given a label for their condition by a health worker such as depression; anxiety or borderline personality disorder.
- The client could recognise that they suffer from large amounts of stress or perhaps they self-harm.
- The may have problems with eating disorders or substance abuse.
- They may have physical symptoms that affect the way they believe that they can have close relationships.
- They may be suffering following a broken relationship
- They may have already tried different types of therapy in their effort to find an answer.
The counsellor/psychotherapist will try to work with the client to identify any chain of events, thoughts, motivations that explain how a problem is established and maintained.
In essence Cognitive Analytic Therapy is all about finding out exactly what a client’s problems are, how they were established, how they influence their everyday life, both in work situations and through their civil relationships. The counsellor tries to help the client to think differently about themselves and the choices they make day-to-day to get the best out of life.
Cognitive Behavioural Therapy
Cognitive behavioral therapy (CBT) is a form of counselling, originally designed to treat depression, but is now used for a number of mental disorders. Current problems are solved by changing unhelpful thinking. The name refers to therapy based upon a combination of basic behavioural and cognitive principles. Most therapists use a mixture of cognitive and behavioural therapy when working with patients dealing with anxiety or depression. By acknowledging that some thoughts and feelings cannot be controlled by rational thought, because they come from environmental prior conditioning and other external and internal motivations. CBT is “problem focused”, that is looking at specific problems whereas the client will be asked to select specific strategies to help address those problems with action orientated therapy. The psychoanalytic approach would look for unconscious meaning behind the clients thoughts and feelings and using this base would diagnose the client. On the other hand behaviorist counsellors believe that disorders such as depression, have to do with the relationship between a feared stimulus and an avoidance response, resulting in a conditioned fear. The two theories were combined to create what is now known as cognitive behavioral therapy.
CBT is effective for a variety of conditions, including mood, anxiety, personality, eating, addiction, dependence and psychotic disorders. Many CBT treatment programs have been evaluated for symptom-based diagnoses and been favoured over approaches such as psychodynamic treatments.
Use of the term CBT may refer to different interventions, including “self-instructions (e.g. distraction, imagery, motivational self-talk), relaxation and/or biofeedback, development of adaptive coping strategies (e.g. minimizing negative or self-defeating thoughts), changing maladaptive beliefs about pain, and goal setting”. Treatment is sometimes manualized, with brief, direct, and time-limited treatments for individual psychological disorders that are specific technique-driven. CBT is used in both individual and group settings, and the techniques are often adapted for self-help applications
Uses the power of the mind to influence behaviour. 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 themselves, thus altering negative responses and behaviour. It can help pessimistic or depressed people to view things from a more optimistic perspective.
Dialectical Behavioural Therapy
DBT was developed from cognitive behaviour therapy (CBT).The main aim of CBT is to change behaviour, which is done by applying techniques with a focus on problem-solving, such as homework, diary cards and behavioural 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. Adding Acceptance strategies to the process of CBT; which means that the therapist explores with their clients an acceptance that their behaviour (e.g. self-harming, 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.
Eclectic Therapy, or wide-ranging therapy, is an approach that uses a variety of principles and approaches, it is more flexible allowing the counsellor to adapt and create a programme
that will meet the needs of the client.. So instead of sticking to rigid schools of thought as found in other therapies it approaches the practice of using the elements from a range of therapeutic techniques that is tailored for the client.
Because of this flexibility it demands that the counsellor has a firm understanding of the therapies being used.
John M. Grohol, PsyD, described eclectic therapy in the following terms:
“Eclectics use techniques â¦ from all schools of therapy. They may have a favorite theory or therapeutic technique that they tend to use more often or fall back on, but they are willing and often use all that are available to them. After all, the key here is to help the patient as quickly and as effectively as possible”.
A counsellor will use either eclectic therapy or integrative therapy as stated above the eclectic counsellor will draw on a number of theories to tailor the therapy to the clients needs. For example they may use in the first stage (the exploration stage) Person centred therapy; the second stage or the insight stage the therapist could use psychoanalytical therapy whereas the last stage the action stage the counsellor could use behavioural therapy.
Integrative approaches highlight both core components of effective therapy and specific techniques designed to target clients’ particular areas of concern. This approach can be described as an integration of common factors and technical eclecticism.
What is the difference between eclectic and integrative counselling?
The differences are very subtle An integrative counsellor uses a fusion of one or more types of therapy. Although there may be more than one type of therapy in the mix there will be a consistent theoretical basis and standard of practice. In other words different counsellors could use the a specific integrative approach but they would use the same practice method applied in a similar manner.
The eclectic therapist uses techniques from a variety of therapies, put together to best serve each individual client. The approaches for clients with similar backgrounds could be completely different and each practitioner may have very different ways of providing the treatment.
Eye movement desensitization and reprocessing (EMDR) is a form of counselling/psychotherapy that was developed to resolve symptoms resulting from disturbing and unresolved life experiences.
EMDR is thought to imitate the psychological state that we enter into when in rapid eye movement (REM) sleep. Studies show that when in REM sleep we are able to make new associations between things very rapidly – EMDR may be tapping into this high-speed processing mode that we all have but often can’t access. The theory is that EMDR works directly with memory networks and enhances information processing by creating associations between the distressing memory and more adaptive information in other memory networks.
Family Counselling Therapy
This is used to treat a family system and not each member of the family. A form of Systemic Therapy, it requires specifically trained counsellors. Family counselling benefits the whole family by helping everyone to say how they are feeling. Family counselling can help reduce conflict which means fewer rows at home and can help everyone cope better with their situation.
The name is derived from the German for “organized whole”. Developed by Fritz Perls, it focuses on the client’s experience, including feelings, thoughts and actions. The client gains self-awareness in the `here and now’ by analysing behaviour and body language and talking about bottled up feelings. This approach often includes acting out scenarios and dream recall.
Gestalt theory is also about relationship. We cannot actually exist just as a separate ‘self’ in physical form. We are constantly interacting with our environment – we breath in air, we take in food and water. Our mood is affected by the weather, by a smell, a sound. From the earliest days in the womb our development is shaped by our interaction with our environments – the nutrients in our mother’s blood, drugs or toxins that pass through the placenta, stress hormones that effect how our body develops to handle stress etc. Then from birth we learn behaviours from interacting with those around us – we learn that it is safe or not safe to be us, we learn that crying will bring comfort or bring pain, we learn that anger is acceptable, or not acceptable. From all these inputs we construct our sense of self. Although this sense of self is developed in early childhood it can be altered in later life such as a negative self-image can be changed by exposing the client to a positive environment.
Humanistic Counselling Therapy
Coming from the “personal growth movement” this approach encourages people to think about their feelings and take responsibility for their thoughts and actions. Emphasis is on self-development and achieving highest potential. “Client-Centred” or “Non-Directive” approach is often used and the therapy can be described as “holistic” or looking at the person as a whole. The client’s creative instincts may be used to explore and resolve personal issues.
Counsellors who work with clients in a humanistic way provide support so that the client can freely explore their whole life experience, and not singular blocks. Particular attention is paid to combining the past, present and future, instead of concentrating on one specific area, problem or issue.
Integrative Counselling embraces an attitude towards the practice of counselling that affirms the inherent value of each individual. It is a unifying therapy that responds appropriately and effectively to the person at the affective, behavioural, cognitive, and physiological levels of functioning, and addresses as well the spiritual dimension of life.
Jungian analysis is the form of therapy developed by Carl Gustav Jung, one of the leading pioneers of modern depth psychology. From the Jungian viewpoint, analysis is essentially a dialogue between two people – the analyst and the analysand. Its aim is to help the analysand get in touch with their own inner sources of healing and growth, and thus to arrive at each answer and solutions.
Because Jungian analysis is adapted to the needs and goals of the person, it may in practice be any number of things: short-term counseling on a specific problem; sympathetic support through a difficult period; help in resolving conflicts and eliminating symptoms; guidance in developing creative potentials or discovering new life possibilities
Mindfulness is a specific way of intentionally paying attention. One negative thought can lead to a chain reaction of negative thoughts. This approach encourages people to be aware of each thought, enabling the first negative thought to be âcaught’ so that is seen as just a âthought’ and not a fact. This breaks the chain reaction of negative thoughts giving a mental âspace’ where the person can re-centre themselves in the present. Mindfulness-based therapists can work with individuals and groups and will usually integrate mindfulness into another modality, in which they are already trained. Mindfulness is likely to appeal to therapists who have developed a long-term meditation practice.
Neuro-Linguistic Programming (NLP)
NLP is not generally seen as model of therapy that is used on its own. It is usually an extra way of working within the more general therapeutic approach in which therapists are trained. NLP sees a world of excellence where people can be helped to create their own choice and flexibility. Based on a number of operating principles such as âHuman behaviour is purposeful’; âwe either already have all the resources we need or we can create them’; âModelling successful performance leads to excellence; if one person can do it, it is possible to model it and teach it to others’, NLP means finding out how someone does something well and then repeating the process with a goal of âexcellence for all’.
Devised by Carl Rogers and also called “Client-Centred” or “Rogerian” counselling, this is based on the assumption that a client seeking help in the resolution of a problem they are experiencing, can enter into a relationship with a counsellor who is sufficiently accepting and permissive to allow the client to freely express any emotions and feelings. This will enable the client to come to terms with negative feelings, which may have caused emotional problems, and develop inner resources. The aim is for the client to become able to see himself as a person, with the power and freedom to change, and not as an object.
In using Psychodynamic Counselling the counsellor will attempt to bring to the surface the clients true feelings to enable them to understand them. The theory is that everyone has an unconscious mind and quite often the feelings that are held there are too painful to be faced or confronted. The client will have built defences to protect themselves keeping these emotions deeply buried.
This modality of counselling believes that these inbuilt defences have gone wrong and are causing the client more harm than good. The counsellor in listening to the client will try to understand and get the client to uncover these deep-seated feelings so that they together can unravel them, the theory assumes that once the client begins to unravel one of their deep-seated feelings they will not be as painful as they believed and change can take place.
In psychosynthesis, the term Self is used to describe not the individualâs personality, but his or her innermost core of being â a core that holds and reflects universal spiritual values such a love, joy, empathy and compassion. It is Self which strives to awaken and to manifest as we grow, calling us to realise our true natures and to conduct our lives according to principles of integration and harmonisation. Psychosynthesis is an amalgamation of the works of Freud’s model of repression and the collective unconscious of Jung, by the Italian psychiatrist Assagioli.
Relationship counselling enables the parties in a relationship to recognise repeating patterns of distress and to understand and manage troublesome differences that they are experiencing. The relationship involved may be between, such as, members of a family (see also Family Therapy) or a couple, or work colleagues.
Relationship counselling can offer a couple time and space to reflect on their patterns of behaviour and to help them understand why they feel and respond the way they do. It can help them face past relational experiences which may be unresolved and which may be re-playing in their current relationship. At times, it is our learning in our own early family and childhood which may be getting in the way of our current intimate relationships.
Transpersonal Counselling is a form of counselling which looks at the entire person. The process is one of integration of the various parts of the self into a whole, reducing inner conflict and increasing the sense of fullness, meaning and purpose in life. Talking, thinking and meaning-making have an important place in the counselling journey, just as feeling, direct perception and state-travel do. Whilst the work moves beyond the personal, it also includes the personal as a valid and meaningful part of the wholeâ¦