Marie Maynard Morgan (MA) Counselling, Psychotherapy & Supervision
'Immediacy' is the ability to use a situation
to invite each and every individual client
to look at what is going on in their
very unique and idiosyncratic life,
to identify and process potential triggers
from past and present relationships.
It can feel unfamiliar in the present tense
and yet is the most powerful skill
in counselling to help clients make sense
of their life, to challenge choice and
Explanation of Counselling & Psychotherapy Approaches
Adlerian Therapy (Individual Psychology)
Adlerian Therapy, originated by Alfred Adler, 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. A learning process, which assists the client to move towards useful involvement and contribution to society.
This therapy based on the belief that behaviour is learnt in response to experience and can be unlearnt, or reconditioned, without analyzing the past to find the reason for the behaviour. It works well for compulsive and obsessive behaviour, fears, phobias and addictions.
Cognitive Analytical Therapy
This combines Cognitive Therapy and Psychotherapy and encourages clients to draw on their own ability to develop the skills to change destructive patterns of behaviour. Negative ways of thinking explored or monitored in a structured and directive ways, involving diary keeping, progress charts, etc.
Cognitive Behavioural Therapy
This combines Cognitive and Behavioural techniques. Client's works through ways to change thoughts and expectations, relaxation techniques are used. It has been effective for stress-related ailments, phobias, obsessions, eating disorders and (at the same time as drug treatment) major depression.
Dialectical Behavioural Therapy (CBT and Acceptance Strategies)
DBT developed from cognitive behaviour therapy (CBT). The main aim of CBT is to change behaviour, by applying techniques with a focus on problem solving, such as homework, diary cards and behavioural analysis. However, the strong focus on change, meant that some people felt uncomfortable and that suffering and apparent loss of control over their lives, not understood. This caused them to become frustrated and even to drop out of treatment. Therapists sought to resolve this by the use of acceptance strategies. Acceptance Strategies add to the process of CBT which means that the therapist can explore 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. Client also attends group sessions with the same face-to-face therapist.
Eclectic Counselling (Integrative)
An Eclectic counsellor will select from a number of different approaches appropriate to the client's needs. Based on the theory that there is no proof that any one theoretical approach works better than all others for a specific problem.
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy developed to resolve symptoms resulting from disturbing and unresolved life experiences.
EMDR tries to imitate the psychological state that we enter into when in rapid eye movement (REM) sleep. Studies have shown that when in REM sleep we are able to make new associations between things very rapidly. EMDR may be tapping into high speed-processing mode that we all have but often cannot 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 Therapy (Systemic Therapy)
This is a form of treatment for a family system rather than individual members of the family. A form of, Systemic Therapy it requires specifically trained counsellors.
The name derived from the German for "organized whole". Developed by Fritz Perls, it focuses on the whole of 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.
Humanistic Therapy (Personal Growth)
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 person as a whole. The client's creative instincts may be used to explore and resolve personal issues.
"Induces hypnotic state in client to increase motivation or alter behavior patterns: Consults with client to determine nature of problem. Prepares client to enter hypnotic state by explaining how hypnosis works and what client will experience. Tests subject to determine degree of physical and emotional suggestibility. Induces hypnotic state in client, using individualized methods and techniques of hypnosis based on interpretation of test results and analysis of client's problem. May train client in self-hypnosis conditioning."
Integrative Therapy (Eclectic)
This is when several distinct models of counselling and psychotherapy are used together.
Carl Jung was the originator of Analytical Psychology; a disciple of Sigmund Freud and a pioneer of Psychoanalysis.
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 'caught' so that is seen as just a 'thought' and not a fact.
This breaks the chain reaction of negative thoughts giving a mental 'space' in which people can re-center themselves, in the present.
Mindfulness-based therapists can work with individuals and groups and will usually integrate mindfulness into another therapy or modality. Mindfulness is likely to appeal to therapists who have developed a meditation practice.
Neuro-Linguistic Programming (NLP)
NLP not generally seen as model of therapy, used on its own. It is usually an additional way of working within the more general therapeutic approach in which therapists trained.
NLP sees a world of excellence where people helped to create their own choice and flexibility. Based on a number of operating principles, such as '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'. NLP means finding out how someone does something well and then repeating the process with a goal of 'excellence for all'.
Person-Centred Therapy (Client-Centred or Rogerian)
Devised by Carl Rogers and is called 'Client-Centred' or 'Rogerian' counselling. 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 objective is for the client to become able to see himself as a person, with the power and freedom to change, rather than as an object.
Primal Therapy is not a model of therapy used on its own. It is usually an additional way of working within the more general therapeutic approach in which therapists trained.
Based on the theory, that buried birth or infancy distress can resurface as neuroses. The therapy takes the client back to the "primal scene" where trauma re-experienced as an emotional cleansing.
This is based 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 for clients suffering high levels of distress and can be a lengthy and intensive process.
This approach stresses the importance of the unconscious and past experience in shaping current behaviour. The client is encouraged to talk about childhood relationships with parents and other significant people and the therapist focuses on the client/therapist relationship (the dynamics) and in particular on the transference.
Transference is when the client projects onto the therapist feelings experienced in previous significant relationships.
The Psychodynamic approach from Psychoanalysis but usually provides a quicker solution to emotional problems.
Psychosynthesis (Psychology of the Soul)
Sometimes, described as 'psychology of the soul'. It is the name given to a series of actions that lead to a change or development which encourages personal growth by a bringing together of the whole person. The emotional, the mental, the physical and spiritual within a safe environment. Psychosynthesis is useful for people seeking a new, more spiritually oriented vision of them.
Not a model of therapy used on it's own. It is usually an additional way of working within the more general therapeutic approach.
In this approach, 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. A skilled practitioner is essential.
REBT (Rational Emotive Behavioural Therapy) (example of SAD)
A form of cognitive-behavioral therapy (CBT), it is effective in reducing certain types of emotional distress. The basic premise of REBT is to understand the events in our lives do not cause us to become upset, but rather it is actually the beliefs we hold about those life events.
We all desire happiness in our lives, whether that entails finding a career we enjoy, having a circle of friends, enriching our education and knowledge, or having enough leisure time. Sometimes in life, we block attaining goals to happiness, if we respond in a way that is unhealthy or unhelpful. How we react is our choice; if we choose unhealthy and unhelpful responses, then will we experience emotional consequences such as depression, anxiety, or anger.
Once underlying feelings have been identified, the next step is to challenge these mistaken beliefs. In order to do this, the therapist must dispute these beliefs using very direct and even confrontational methods. Rather than simply being warm and supportive, the therapist needs to be blunt, honest, and logical in order to push people toward changing their thoughts and behaviors.
One of the key concepts in REBT is the ABC Model.
A = Activating Event (something happens)
B = Belief (about the event)
C = Consequence (emotional reaction to the belief)
According to REBT, your reaction (C) is the result of your belief (B) and not caused directly by the event (A).
Consider an example with someone who suffers from social anxiety disorder (SAD):
A = Someone looks at you with a frown.
B = You believe that the person doesn't like you or that you have done something to displease the person.
C = You feel anxious and badly about yourself.
If you are not sure that your reactions are caused by your belief instead of the event, consider how a change in your belief can lead to a change in the consequence.
A = Someone looks at you with a frown.
B = You believe the person is having a bad day.
C = You feel bad for the person.
REBT also states that the beliefs that we hold that upset us are generally a variation on the following three commonly held irrational beliefs:
I must do well and win the approval of others or I am worthless.
Other people must treat me fairly or they deserve to be punished.
I must get what I want when I want it, and not get what I don't want, and I can't stand it if I don't.
The first belief leads to feelings of anxiety, depression, guilt and shame, the second leads to anger, violence and passive aggression, and the third leads to feeling sorry for oneself.
It is easy to see that people who suffer with SAD generally hold beliefs similar to the first one.
In order to reduce emotional distress, you must work on changing your irrational and inflexible beliefs. The goal is to adopt new flexible beliefs that lead to healthy behaviors and emotions.
The fourth part of the ABC Model refers to challenging your existing beliefs through a series of questions, the process of 'disputing' your irrational beliefs.
Relationship Therapy (Family or Group)
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, for example, members of a family (see also Family Therapy) or a couple, or group of work colleagues.
Solution-Focused (Brief Therapy)
This 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. Between 6-8 sessions may be beneficial.
These are the therapies, which have, as their aim, a change in the transactional pattern of members of a system. It can also be used as a generic term for either family therapy, or marital therapy.
This describes any form of counselling or therapy, which places emphasis on spirituality, human potential or heightened consciousness. It includes Psychosynthesis.