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Table 1 Overview of Contemporary Counseling Models
Psychodynamic Approaches
Psychoanalytic Therapy

Founder: Sigmund Freud
...

Attention is given to the events of the first 6 years of
life as determinants of the later development of
personality
...

Key Figure: Following Adler, Rudolf Dreikurs is
credited with popularizing this approach in the
United States
...

Key concepts are used in most other current
therapies
...

Reacting against the tendency to view therapy as a
system of well-defined techniques, this model
stresses building therapy on the basic conditions of
human existence, such as choice, the freedom and
responsibility to shape one’s life, and selfdetermination
...


Person-Centered Therapy

Founder: Carl Rogers
...

This approach was developed during the 1940s as a
nondirective reaction against psychoanalysis
...

Gestalt Therapy

Founders: Fritz and Laura Perls
...

An experiential therapy stressing awareness and
integration; it grew as a reaction against analytic
therapy
...


Cognitive Behavioral Approaches
Behavior Therapy

Key figures: B
...
Skinner, Arnold Lazarus, and
Albert Bandura
...

Results are subject to continual experimentation
...


Cognitive Behavior Therapy

Key figure: A
...
Beck founded cognitive therapy
...

Judith Beck continues to develop CBT
...


Rational Emotive Behavior Therapy

Key figure: Albert Ellis founded rational emotive
behavior therapy
...


Reality Therapy

Founder: William Glasser
...

This short-term approach is based on choice theory
and focuses on the client assuming responsibility in
the present
...

Systems and Postmodern Approaches
Feminist Therapy

This approach grew out of the efforts of many
women, a few of whom are Jean Baker Miller,
Carolyn Zerbe Enns, Oliva Espin, and Laura Brown
...

Focusing on the constraints imposed by the
sociopolitical status to which women have been
relegated, this approach explores women’s identity
development, self-concept, goals and aspirations,
and emotional well-being
...

Steve de Shazer and Insoo Kim Berg are the cofounders of solution-focused brief therapy
...

Social constructionism, solution-focused brief
therapy, and narrative therapy all assume that there
is no single truth; rather, it is believed that reality is
socially constructed through human interaction
...


Family Systems Therapy

A number of significant figures have been pioneers
of the family systems approach, including Alfred
Adler, Murray Bowen, Virginia Satir, Carl
Whitaker, Salvador Minuchin, Jay Haley, and Cloé
Madanes
...


Table 2 The Basic Philosophies
Psychodynamic Approaches
Psychoanalytic Therapy

Human beings are basically determined by psychic
energy and by early experiences
...

Early development is of critical importance because
later personality problems have their roots in
repressed childhood conflicts
...
Emphasis is on the
individual’s positive capacities to live in society
cooperatively
...
Each person at an
early age creates a unique style of life, which tends
to remain relatively constant throughout life
...


Person-Centered Therapy

Positive view of people; we have an inclination
toward becoming fully functioning
...

The client moves toward increased awareness,
spontaneity, trust in self, and innerdirectedness
...


Some key concepts include contact with self and
others, contact boundaries, and awareness
...

As an experiential approach, it is grounded in the
here and now and emphasizes awareness, personal
choice, and responsibility
...

We are both the product and the producer of the
environment
...
Contemporary
behavior therapy has branched out in many
directions
...

Cognitions are the major determinants of how we
feel and act
...

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
...

Psychological problems are the result of our
resisting the control by others or of our attempt to
control others
...


Systems and Postmodern Approaches
Feminist Therapy

Feminists criticize many traditional theories to the
degree that they are based on gender-biased
concepts, such as being androcentric, gendercentric,
ethnocentric, heterosexist, and intrapsychic
...

Gender and power are at the heart of feminist
therapy
...


Postmodern Approaches

Based on the premise that there are multiple realities
and multiple truths, postmodern therapies reject the
idea that reality is external and can be grasped
...

The postmodern approaches avoid pathologizing
clients, take a dim view of diagnosis, avoid
searching for underlying causes of problems, and
place a high value on discovering clients’ strengths
and resources
...


Family Systems Therapy

The family is viewed from an interactive and
systemic perspective
...

The family provides the context for understanding
how individuals function in relationship to others
and how they behave
...
An
individual’s dysfunctional behavior grows out of the
interactional unit of the family and out of larger
systems as well
...

Faulty personality development is the result of
inadequate resolution of some specific stage
...

Unconscious processes are centrally related to
current behavior
...

People are motivated by social interest and by
finding goals to give life meaning
...
Therapy is a
matter of providing encouragement and assisting
clients in changing their cognitive perspective and
behavior
...

Interest is on the present and on what one is
becoming
...


Person-Centered Therapy

The client has the potential to become aware of
problems and the means to resolve them
...

Mental health is a congruence of ideal
self and real self
...

In therapy attention is given to the present moment
and on experiencing and expressing feelings
...

Key concepts include holism, fi gure-formation
process, awareness, unfi nished business and
avoidance, contact, and energy
...

Present behavior is given attention
...

Normal behavior is learned through reinforcement
and imitation
...


Cognitive Behavior Therapy

Although psychological problems may be rooted in
childhood, they are reinforced by present ways of
thinking
...

Internal dialogue plays a central role in one’s
behavior
...


Reality Therapy

The basic focus is on what clients are doing and how
to get them to evaluate whether their present actions
are working for them
...


The approach rejects the medical model, the notion
of transference, the unconscious, and dwelling on
one’s past
...


Postmodern Approaches

Therapy tends to be brief and addresses the present
and the future
...

The emphasis is on externalizing the problem and
looking for exceptions to the problem
...

By identifying instances when the problem
did not exist, clients can create new meanings for
themselves and fashion a new life story
...

Problems in relationships are likely to
be passed on from generation to generation
...

The present is more important than exploring past
experiences
...

To reconstruct the basic personality
...

To achieve intellectual and emotional awareness
...

To offer encouragement so individuals can develop
socially useful goals and increase social interest
...


Experiential and Relationship-Oriented Therapies
Existential Therapy

To help people see that they are free and to become
aware of their possibilities
...

To identify factors that block freedom
...

To enable them to move toward openness, greater
trust in self, willingness to be a process, and
increased spontaneity and aliveness
...

To become more self-directed
...

To foster integration of the self
...

To identify factors that influence behavior and find
out what can be done about problematic behavior
...


Cognitive Behavior Therapy

To teach clients to confront faulty beliefs with
contradictory evidence that they gather and evaluate
...
To become aware of automatic
thoughts and to change them
...

To enable clients to get reconnected with the people
they have chosen to put into their quality worlds and
teach clients choice theory
...

To assist clients in recognizing, claiming, and using
their personal power to free themselves from the
limitations of gender-role socialization
...


Postmodern Approaches

To change the way clients view problems and what
they can do about these concerns
...

To help clients create a self-identity grounded

on competence and resourcefulness so they can
resolve present and future concerns
...

Family Systems Therapy

To help family members gain awareness of patterns
of relationships that are not working well and to
create new ways of interacting
...

Focus is on reducing the resistances that develop in
working with transference and on establishing more
rational control
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The analyst makes interpretations to teach clients the
meaning of current behavior as it relates to the past
...


Adlerian / Individual Therapy

The emphasis is on joint responsibility, on mutually
determining goals, on mutual trust and respect, and
on equality
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Experiential and Relationship-Oriented Therapies
Existential Therapy

The therapist’s main tasks are to accurately grasp
clients’ being in the world and to establish a
personal and authentic encounter with them
...

Both client and therapist can be changed by the
encounter
...

The qualities of the therapist, including genuineness,
warmth, accurate empathy, respect, and
nonjudgmentalness—and communication of these
attitudes to clients—are stressed
...

Gestalt Therapy

Central importance is given to the I/Thou
relationship and the quality of the therapist’s
presence
...

The therapist does not interpret for clients but
assists them in developing the means to make their
own interpretations
...


Cognitive Behavioral Approaches
Behavior Therapy

The therapist is active and directive and functions
as a teacher or mentor in helping clients learn
more effective behavior
...

Although a quality client–therapist relationship is
not viewed as sufficient to bring about change, it is
considered essential for implementing behavioral
procedures
...

The therapist is highly directive and teaches
clients an A-B-C model of changing their
cognitions
...
Using a Socratic dialogue, the therapist
assists clients in identifying dysfunctional beliefs
and discovering alternative rules for
living
...

Clients gain insight into their problems and then
must actively practice changing self-defeating
thinking and acting
...

Therapists are then able to engage clients in an
evaluation of all their relationships with respect to
what they want and how effective they are in getting
this
...

The therapist is a client’s advocate, as long as the
client is willing to attempt to behave responsibly
...

Therapists actively break down the hierarchy of
power and reduce artificial barriers by engaging in
appropriate self-disclosure and teaching clients
about the therapy process
...


Postmodern Approaches

Therapy is a collaborative partnership
...

Therapists use questioning dialogue to help clients
free themselves from their problem-saturated stories
and create new life-affirming stories
...

Clients are encouraged to explore their strengths and
to create solutions that will lead to a richer future
...


Family Systems Therapy

The family therapist functions as a teacher, coach,
model, and consultant
...

Some approaches focus on the role of therapist as
expert; others concentrate on intensifying what is
going on in the here and now of the family session
...


Table 6 Techniques of Therapy
Psychodynamic Approaches
Psychoanalytic Therapy

The key techniques are interpretation, dream
analysis, free association, analysis of resistance,
analysis of transference, and countertransference
...


Adlerian / Individual Therapy

Adlerians pay more attention to the subjective
experiences of clients than to using techniques
...


Experiential and Relationship-Oriented Therapies
Existential Therapy

Few techniques flow from this approach because it
stresses understanding first and technique second
...

Diagnosis, testing, and external measurements are
not deemed important
...


Person-Centered Therapy

This approach uses few techniques but stresses the
attitudes of the therapist and a “way of being
...


This model does not include diagnostic testing,
interpretation, taking a case history, or questioning
or probing for information
...

Experiments are co-created by therapist and client
through an I/Thou dialogue
...

Formal diagnosis and testing are not a required part
of therapy
...

Diagnosis or assessment is done at the outset to
determine a treatment plan
...

Contracts and homework assignments are also
typically used
...

This is an active, directive, time-limited, presentcentered, psychoeducational, structured therapy
...

Reality Therapy

This is an active, directive, and didactic therapy
...

Various techniques may be used to get clients to
evaluate what they are presently doing to see if they
are willing to change
...


Systems and Postmodern Approaches
Feminist Therapy

Although techniques from traditional approaches are
used, feminist practitioners tend to employ
consciousness raising techniques aimed at helping
clients recognize the impact of gender-role
socialization on their lives
...


Postmodern Approaches

In solution-focused therapy the main technique
involves change-talk, with emphasis on times in a
client’s life when the problem was not a problem
...
In narrative therapy, specific
techniques include listening to a client’s problem
saturated story without getting stuck, externalizing
and naming the problem, externalizing
conversations, and discovering clues to competence
...

Family Systems Therapy

A variety of techniques may be used, depending on
the particular theoretical orientation of the therapist
...
Techniques may be experiential,
cognitive, or behavioral in nature
...


Table 7 Limitations in Multicultural Counseling
Psychodynamic Approaches
Psychoanalytic Therapy

Its focus on insight, intrapsychic dynamics, and
long-term treatment is often not valued by clients
who prefer to learn coping skills for dealing with
pressing daily concerns
...


Adlerian / Individual Therapy

This approach uses a detailed interview about one’s
family background; this can conflict with cultures
that have injunctions against disclosing family
matters
...


Experiential and Relationship-Oriented Therapies
Existential Therapy

Values of individuality, freedom, autonomy, and
self-realization often confl ict with cultural values of
collectivism, respect for tradition, deference to
authority, and interdependence
...

Others will expect more focus on surviving in their
world
...

Lack of counselor direction and structure are
unacceptable for clients who are seeking help and
immediate answers from a knowledgeable
professional
...
Some may not see how “being aware
of present experiencing” will lead to solving their
problems
...
Counselors
need to help clients assess the possible consequences
of making behavioral changes
...

Some clients
may have serious reservations about questioning
their basic cultural values and beliefs
...


Reality Therapy

This approach stresses taking charge of one’s own
life, yet some clients are more interested in changing
their external environment
...


Systems and Postmodern Approaches
Feminist Therapy

This model has been criticized for its bias toward the
values of White, middle-class, heterosexual women,
which are not applicable to many other groups of
women nor to men
...


Postmodern Approaches

Some clients come to therapy wanting to talk about
their problems and may be put off by the insistence
on talking about exceptions to their problems
...
Certain
clients may doubt the helpfulness of a therapist who
assumes a “not-knowing” position
...

The family is empowered through the process of
identifying and exploring interactional patterns
...

By exploring one’s family of origin, there are
increased opportunities to resolve other conflicts in
systems outside of the family

Table 8 Contributions to Multicultural Counseling
Psychodynamic Approaches
Psychoanalytic Therapy

Its focus on family dynamics is appropriate for
working with many cultural groups
...
Notion of ego defense is helpful in
understanding inner dynamics and dealing with
environmental stresses
...
Focus
on person-in-the-environment allows for cultural
factors to be explored
...
This approach leads to empowerment
in an oppressive society
...
The existential
approach is particularly suited to counseling diverse
clients because of the philosophical foundation that
emphasizes the human condition
...

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 cultural pluralism
...
Provides many experiments in
working with clients who have cultural injunctions
against freely expressing feelings
...

Focus on bodily expressions is a subtle way to help
clients recognize their conflicts
...
Strengths include a
collaborative relationship between counselor and
client in working toward mutually agreed-upon
goals, continual assessment to determine if the
techniques are suited to clients’ unique situations,
assisting clients in learning practical skills, an
educational focus, and stress on self-management
strategies
...
The psychoeducational dimensions are
often useful in exploring cultural conflicts and
teaching new behavior
...
The focus
on teaching and learning tends to avoid the stigma of
mental illness
...


Reality Therapy

Focus is on clients making their own evaluation of
behavior (including how they respond to their
culture)
...
They can find a balance between
retaining their own ethnic identity and integrating
some of the values and practices of the
dominant society
...
A key contribution is that both the
women’s movement and the multicultural movement
have called attention to the negative impact of
discrimination and oppression for both women and
men
...


Postmodern Approaches

Focus is on the social and cultural context of
behavior
...
Therapists do not
make assumptions about people and honor each
client’s unique story and cultural background
...
Therapy becomes a process of
liberation from oppressive cultural values and
enables clients to become active agents of
their destinies
...
Many
ethnic and cultural groups place value on the role of
the extended family
...
Networking is a part of the process, which
is congruent with the values of many clients
...
This approach
offers ways of working toward the health of the
family unit and the welfare of each member
...

Analytic therapy is not recommended for selfcentered and impulsive individuals or for people
with psychotic disorders
...


Adlerian / Individual Therapy

Because the approach is based on a growth model, it
is applicable to such varied spheres of life as child
guidance, parent–child counseling, marital and
family therapy, individual counseling with all age
groups, correctional and rehabilitation counseling,
group counseling, substance abuse programs, and
brief counseling
...


Experiential and Relationship-Oriented Therapies
Existential Therapy

This approach is especially suited to people facing a
developmental crisis or a transition in life and for
those with existential concerns (making choices,
dealing with freedom and responsibility, coping with
guilt and anxiety, making sense of life, and finding
values) or those seeking personal enhancement
...


Person-Centered Therapy

This approach is especially suited to people facing a
developmental crisis or a transition in life and for
those with existential concerns (making choices,
dealing with freedom and responsibility, coping with
guilt and anxiety, making sense of life, and fi nding

values) or those seeking personal enhancement
...

Gestalt Therapy

Addresses a wide range of problems and
populations: crisis intervention, treatment of a range
of psychosomatic disorders, couples and family
therapy, awareness training of mental health
professionals, behavior problems in children, and
teaching and learning
...
The methods are
powerful catalysts for opening up feelings and
getting clients into contact with their presentcentered experience
...
Enjoys wide applicability to individual,
group, couples, and family counseling
...
Beyond
clinical practice, its principles are applied in fi elds
such as pediatrics, stress management, behavioral
medicine, education, and geriatrics
...
CBT is especially useful for
assisting people in modifying their cognitions
...
CBT can
be applied to a wide range of client populations with
a variety of specifi c problems
...
It has been applied to individual
counseling with a wide range of clients, group
counseling, working with youthful law offenders,
and couples and family therapy
...


Systems and Postmodern Approaches
Feminist Therapy

Principles and techniques can be applied to a range
of therapeutic modalities such as individual therapy,
relationship counseling, family therapy, group
counseling, and community intervention
...


Postmodern Approaches

Solution-focused therapy is well suited for people
with adjustment disorders and for problems of
anxiety and depression
...
These
approaches can be applied to working with children,
adolescents, adults, couples, families, and the
community in a wide variety of settings
...


Family Systems Therapy

Useful for dealing with marital distress, problems of
communicating among family members, power
struggles, crisis situations in the family, helping
individuals attain their potential, and enhancing the
overall functioning of the family
...
It has provided a detailed and
comprehensive description of personality structure
and functioning
...
It has developed several techniques for
tapping the unconscious and shed light on the
dynamics of transference and countertransference,
resistance, anxiety, and the mechanisms of ego
defense
...
This is one of the fi rst
approaches to therapy that was humanistic, unified,
holistic, and goal-oriented and that put an emphasis
on social and psychological factors
...
It calls attention to the need
for a philosophical statement on what it means to be
a person
...
It provides a
perspective for understanding anxiety, guilt,
freedom, death, isolation, and commitment
...
This
unique approach has been subjected to empirical
testing, and as a result both theory and methods have

been modified
...
People without
advanced training can benefit by translating the
therapeutic conditions to both their personal and
professional lives
...
It is a
foundation for building a trusting relationship,
applicable to all therapies
...
It uses clients’
behavior as the basis for making them aware of their
inner creative potential
...
Therapy is viewed as an existential
encounter; it is process-oriented, not techniqueoriented
...


Cognitive Behavioral Approaches
Behavior Therapy

Emphasis is on assessment and evaluation
techniques, thus providing a basis for accountable
practice
...
The approach has demonstrated effectiveness
in many areas of human functioning
...
The approach has undergone
extensive expansion, and research literature
abounds
...


Cognitive Behavior Therapy

Major contributions include emphasis on a
comprehensive and eclectic therapeutic practice;
numerous cognitive, emotive, and behavioral
techniques; an openness to incorporating techniques
from other approaches; and a methodology for

challenging and changing faulty thinking
...
REBT makes full use of action-oriented
homework, various psychoeducational methods, and
keeping records of progress
...


Reality Therapy

This is a positive approach with an action
orientation that relies on simple and clear concepts
that are easily grasped in many helping professions
...
Due to
the direct methods, it appeals to many clients who
are often seen as resistant to therapy
...


Systems and Postmodern Approaches
Feminist Therapy

The feminist perspective is responsible for
encouraging increasing numbers of women to
question gender stereotypes and to reject limited
views of what a woman is expected to be
...
The unified feminist voice brought
attention to the extent and implications of child
abuse, incest, rape, sexual harassment, and domestic
violence
...


Postmodern Approaches

The brevity of these approaches fi t well with the
limitations imposed by a managed care structure
...
Clients
are not blamed for their problems but are helped to
understand how they might relate in more satisfying
ways to such problems
...

Family Systems Therapy

From a systemic perspective, neither the individual
nor the family is blamed for a particular dysfunction
...

Working with an entire unit provides a new
perspective on understanding and working through
both individual problems and relationship concerns
...
The model stresses
biological and instinctual factors to the neglect of
social, cultural, and interpersonal ones
...
Many clients lack
the degree of ego strength needed for regressive and
reconstructive therapy
...


Adlerian / Individual Therapy

Weak in terms of precision, testability, and
empirical validity
...

Tends to oversimplify some complex human
problems and is based heavily on common sense
...

Lacks a systematic statement of principles and
practices of therapy
...


Person-Centered Therapy

Possible danger from the therapist who remains
passive and inactive, limiting responses to
reflection
...

Clients in crisis may need more directive measures
...


Gestalt Therapy

Techniques lead to intense emotional expression; if
these feelings are not explored and if cognitive work

is not done, clients are likely to be left unfinished
and will not have a sense of integration of their
learning
...

Cognitive Behavioral Approaches
Behavior Therapy

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 by the therapist; and that it is
limited in its capacity to address certain aspects of
the human condition
...

REBT, being a confrontational therapy, might lead
to premature termination
...


Reality Therapy

Discounts the therapeutic value of exploration of the
client’s past, dreams, the unconscious, early
childhood experiences, and transference
...
It is a
problem-solving therapy that tends to discourage
exploration of deeper emotional issues
...
Therapists need
to keep in mind that clients are their own best

experts, which means it is up to them to decide
which values to live by
...
Some critics
contend that these approaches endorse cheerleading
and an overly positive perspective
...
Because some of the solution-focused
techniques are relatively easy to learn, practitioners
may use these interventions in a mechanical way or
implement these techniques without a sound
rationale
...

Some family members may be resistant to changing
the structure of the system
...
It is essential that the
therapist be well trained, receive quality supervision,
and be competent in assessing and treating
individuals in a family context

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