Orleans, V. & Scoyoc, S. (2009). A Short Introduction to Counselling Psychology. London: SAGE. Kapitel 1-6
The great focus that counselling psychology lies on research activity of the practitioner is something that divides it from counselling and psychotherapy.
Areas of knowledge that is important for a professional in counselling psychology:
– Psychological knowledge; the mind, personality, social and cultural context, development through life, psychopathology, testing and pharmacology.
– Psychotherapeutic approaches; three great approaches; psychoanalytical-psychodynamic, cognitive-behaviourism and humanistic-existential approach. They have a different view of the human, factors that help development and factors like predispose for psychological disorders. They have a different view on human motivation and they are embedded in different theories of change and the therapists role is different in the different approaches compared to the method.
• Psychoanalytical approach; medical model, the therapist as an expert and scientist. Unconsciousness, personality as an inner conflict, defence mechanisms. Therapeutic techniques like transference and counter transference, free association. Adler; individual psychology, holistic nature of the person. Jung; analytical psychology, collective unconscious. Hartmann; ego-psychology. Klein; developmental scheme, projective identification, object-relation. Bowlby; attachment theory. Berne; transactional analysis psychotherapy. Lacan; structural-linguistic paradigm. Kohut; self psychology, self-object transference, mirroring, intersubjective theory.
Psychodynamic consists every schools and has the goal to make the unconscious conscious and thereby give the client insight, bigger attention and heightened control, choice and decisions. Lately it have been learned that the therapist can not just be a blank screen, but has to be an active part of the interaction.
• Cognitive-behavioural tradition; has a scientific bases for the profession, is objective, has only place for what can be observed, learning and conditioning. Radical behaviourism, operant conditioning, there is a different between reflexes and operant (learned) behaviour. Lazarus and Wolpe; behaviouristic approach to a therapeutic setting; maladjusted/well adjusted, behaviouristic vs. person-focused. Lazarus; cognitive-behaviouristic therapy, multimodal therapy. Bandura; social learning theory, perception and expectations in the learning process. Kelly; personal construct theory, opposed to the medical model. Ellis; grandfather of CBT, focuses on thinking, action and outcome, rational-emotive therapy -> rational emotive behavioural therapy. Human as constructivists in their perception of meaning in a situation. Human motivation, look for happiness, biological tendency to become irrational and disturbed. Beck; father of CBT, studied depression, automatic negative thoughts, generalizing quality, focused on the person themselves, their world and the future. Approach based on an exploration of the cognitive elements of the depressed person’s world, underlying beliefs and assumptions. Dichotome thinking. Becks depression inventory (BDI). Development; personality can have a meaning, schema, different problems and lengths of therapy, positive psychology.
• Humanistic-existential tradition; reaction against the two other traditions, key figures; Maslow, Rogers. Focuses on ordinariness of the human being in a world, everyday concerns of life and death, hope, love, relation, being and meaning. Holistic perspective on the person in the process with phenomenological experiences and authentic dialog.
Person-centred therapy; Carl Rogers, actualizing tendency; grow towards health. To be seen, understood, accepted and validated in a relational context promotes this process. The person grows through seven stages towards health and congruence. In therapy the focus is on relational circumstances, acceptance and support and it is a here and now therapy.
Gestalt approach; Fritz Perls, a holistic approach of intrapsychic processes, the body, biological processes and behaviour. The organismic self-regulation, focus on attention, phenomenology and presently contact, mindfulness and two-chair work.
Existential psychotherapy; inspired by philosophic ideas by Kierkegaard and Nietzsche of self-determination, agency and action, existential and ethical dilemmas. May and Yalom developed the existential psychotherapy as a dynamic approach of death, freedom, existential isolation and meaninglessness. The approach is authentic, in good faith, adjacent and responsible and it is a choice, phenomenological focus, deep perspective on human challenges and it is a opponent to the medical model.
Transpersonal psychotherapy; some human experiences can not be explained from a reductionist approach. This approach takes the focus away from the ego and acknowledges a wider connectedness. Jung; collective unconscious. Assagioli; psycho synthesis, Buddhist philosophy, perspective on the in between.
Research and therapeutic outcome: tension between research and practice, difference between efficacy (science) and effectiveness (practice), political influenced, research is often interdisciplinary in counselling psychology, for the most part the effect of psychotherapy is investigated. Efficacy of psychotherapy compared to control – criticised, but positive effects have been found, effect size 0.80, randomised controlled trail, reductionist, manualised treatment, fixed sessions, follow-up, who defines evidence?
Practice-based research; shortage of on fixed durations, active shopping by the client, focus on general function, rather than symptoms and the existent of multiple problems. USA survey, based on reports from consumers of therapy, found that treatment is effective, there is no difference between approaches, long-term therapy gives better results than short-term therapy, at short-term therapy the GP is as effective as the therapist.
The dodo bird verdict; every approach gives good results – active expectations be the client, therapeutic alliance and empathy promotes outcome, conclusion; we must investigate common factors, emotional relationship, socially sanctioned role of the therapist, power to engender hope, therapist qualities, training, therapeutic alliance, the clients emotional experience and support factors, learning factors and action factors.
Reflexivity and ethics: reflexivity, focus on moral dimensions of research, consideration of processes through which text is co-constructed and the necessity for new approaches to communicate research findings. Pointing at an investigation of own values and thoughts. Knowledge is created by social constructions, therefore ethical directions must be made to challenging situations with humans as the focus.
Counselling psychology is unique with its ability to contain of all these tensions. The tendency is to use eclecticism and integrative rather than grand theories.