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Methods, Models and Approaches to Counselling and Psychotherapy

Counselling and Psychotherapy form an important part of Psychological Therapies, they fall into three main categories.

Behavioural, Humanistic, Psychoanalytical and Psychodynamic Therapies

1. Behavioural Therapies focus on cognitions and behaviours. Behavioural Therapies are based on the way you think (cognitive) and/or the way you behave. These therapies recognise that it is possible to change or recondition our thoughts or behaviour to overcome specific problems.

2. Psychoanalytical and Psychodynamic Therapies focus on the unconscious relationship patterns that evolved from childhood. Psychoanalytical and Psychodynamic Therapies are based on an individual's unconscious thoughts and perceptions that have developed throughout their childhood, and how these affect their current behaviour and thoughts. Humanistic therapies - focusing on self-development in the 'here and now'.

3. Humanistic Therapies focus on self-development, growth and responsibilities. They seek to help individuals recognise their strengths, creativity and choice in the 'here and now'.

Many professional Counsellors and Psychotherapists also practice 'Integrative' therapy, where they blend specific types of techniques. Other practitioners use an 'Eclectic' approach, taking elements of several different models and combining them. Different approaches can be used in the Counselling and Psychotherapy process depending on the client's need. An assessment of the client's problem area should be made and the appropriate approach can be implemented.

Counselling and Psychotherapy Approaches

Adlerian Therapy originated by Alfred Adler, focuses on creating a therapeutic relationship that is cooperative, encouraging and practical. Adlerian counsellors help clients explore their unique ’lifestyle’ and ’private logic’ (their core beliefs about self, others and the world) to increase understanding of and challenge habitual patterns of behaviour and hidden goals. It is an educative process of dialogue, insight, encouragement, re-orientation and enablement towards useful involvement in and contribution to society.

Behavioural Therapy is based on the belief that behaviour is learnt in response to past experience and can be unlearnt, or reconditioned, without analysing the past to find the reason for the behaviour.

Brief Therapy uses the cognitive behavioural approach with a small, planned number of sessions and possibly a single follow-up session after some time has elapsed.

Cognitive Analytical Therapy combines cognitive therapy and psychotherapy. It encourages clients to draw on their own resources to develop the skills to change destructive patterns of behaviour. Negative ways of thinking are explored and treatment is structured and directive involving diary-keeping, progress charts, etc.

Cognitive Therapy uses the power of the mind to influence behaviour. It is based on the theory that previous experiences can adversely affect self-perception so will condition attitude, emotions and ability to deal with certain situations. It works by helping the client to identify, question and change self-denigrating thoughts, thus altering habitual responses and behaviour. Cognitive Analytical Therapy (CAT) combines cognitive therapy and exploratory psychotherapy. It encourages clients to draw on their own resources to develop the skills to change destructive patterns of behaviour. Negative ways of thinking are explored and treatment is structured and directive.

Cognitive Behavioural Therapy (CBT) combines cognitive and behavioural techniques. Clients are taught ways to change thoughts and expectations and relaxation techniques may be used.

Dialectical Behaviour Therapy (DBT) is based on cognitive behavioural therapy. It's specially adapted for people who feel emotions very intensely such as clients who self harm, who are suicidal and for eating disorders, substance misuse and bipolar disorder. Dialectical means trying to understand how two things that seem opposite could both be true, for e.g.accepting yourself and changing your behaviour may feel contradictory. DBT aims to help you understand and accept your feelings, learn skills to manage them and become able to make positive changes.

Eclectic Counselling involves selecting what is applicable to the client from a range of theories, methods and practices. Justification is based on the theory that there is no proof that anyone theoretical approach works better than all others for a specific problem.

Eye Movement Desensitisation and Reprocessing (EMDR) involves stimulation of either lobe of the brain by using eye movements which it is believed replicates what appears to happen in REM sleep, allowing natural processing of traumatic events or disturbing memories to take place. It is particularly useful for Post Traumatic Stress Disorder.

Existential Counselling is based on the belief that life has no essential (given) meaning: any meaning has to be found or created. Existential Counselling involves making sense of life through a personal worldview and includes a willingness to face one’s life and life problems.

Gestalt Therapy is derived from the German for "organised whole". It is based on the belief that the human response to experiences is summed up in a person's thoughts, feelings and actions. The client gains self-awareness by analysing behaviour and body language and giving expression to repressed feelings. Treatment often includes acting out scenarios and dream recall.

Human Givens Therapy encompasses all effective approaches to helping people and whatever has accrued because of ideology. It is truly holistic, scientific and practical.

Humanistic Psychotherapy embraces techniques coming from the "personal growth movement" and encourages people to explore their feelings and take responsibility for their thoughts and actions. Emphasis is on self-development and achieving the highest potential rather than dysfunctional behaviour. "Client-centred" or "non-directive" approach is often used and the therapy can be described as "holistic". The client’s creative instincts may be used to explore and resolve personal issues.

Integrative Counselling is when several distinct models of Counselling and Psychotherapy are used together in a converging way, rather than separately. Many counsellors use one core theoretical model of counselling but draw on techniques and styles from other approaches when appropriate.

Neuro-Linguistic Programming (NLP) is described as ’the Psychology of excellence’ and sees a world of excellence where people can be facilitated in creating their own choice and flexibility. Presuppositions are used as the basic operating principles, some examples being ’Human behaviour is purposeful’, ’we either already have all the resources we need or we can create them’, ’Modelling successful performance leads to excellence. If one person can do it it is possible to model it and teach it to others. In NLP, modelling means finding out how someone does something. The core of NLP is the process of replicating excellence with a goal of ’excellence for all’.

Person-Centred Counselling is based on the assumption that an individual (client), seeking help in the resolution of a problem, can enter into a relationship with another individual (counsellor) who is sufficiently accepting and permissive to allow the client to freely express emotions. This will enable the client to come to terms with negative feelings which may have caused emotional problems, and develop inner resources.

Primal Therapy is based on the theory that suppressed birth or infancy traumas can resurface as neuroses. The therapy takes the client back to the "primal scene" where trauma can be re-experienced as an emotional cleansing.

Psychoanalysis focuses on the work of Sigmund Freud, who believed that the unacceptable thoughts of early childhood are banished to the unconscious mind but continue to influence thoughts, emotions and behaviour. "Repressed" feelings can surface later as conflicts, depression, etc or through dreams or creative activities. The analyst seeks to interpret and make acceptable to the client’s conscious mind, troublesome feelings and relationships from the past. "Transference" onto the analyst, of feelings about figures in the client’s life, is encouraged. This type of therapy is often used by clients suffering from high levels of distress and can be a lengthy and intensive process.

Psychodynamic Counselling or Psychotherapy stresses the importance of the unconscious and past experience in determining current behaviour. The client is encouraged to talk about childhood relationships with parents and other significant people, the therapist focuses on the client/therapist relationship (the dynamics). The psychodynamic approach is derived from psychoanalysis but usually provides a quicker solution to emotional problems.

Psychosynthesis & Transpersonal is sometimes described as "psychology of the soul" and aims to integrate or synthesise the level of consciousness at which thoughts and emotions are experienced with a higher, spiritual level of consciousness. Painting, movement and other techniques can be used to recognise and value different facets of the personality. It can be useful for people seeking a more spiritually oriented vision of themselves.

Re-birthing is based on the theory that emotional or physical traumas during birth create feelings of separation or fear in later life. Breathing techniques are used to release tension whilst the client re-experiences traumatic emotions.

Solution-focused Brief Therapy promotes positive change rather than dwelling on past problems. Clients are encouraged to focus positively on what they do well and to set goals and work out how to achieve them. As little as 3 or 4 sessions may be beneficial.

Systemic Therapies are therapies that have, as their aim, a change in the transactional pattern of members. It can be used as the generic term for family therapy and marital therapy.

Transactional Analysis (TA) is based on the belief that everyone has a child, adult and parent self within them and within each social interaction, one self-predominates. By recognising these roles, a client can choose which one to adopt and so change behaviour. This form of therapy has produced the term "inner child" used to describe unfulfilled needs from childhood.

Transpersonal Therapy describes any form of Counselling or Psychotherapy which places emphasis on spirituality, human potential or heightened consciousness. It includes psychosynthesis.