Three schools of counselling psychology

    Most criticisms aimed at psychoanalysis are because it lacks empirical evidence and is not seen as falsifiable (Popper, 1986). It also criticised on the grounds that is phallocentric. It is also argued that the theory is not generalisable because Freud’s ideas were based on a demographically restricted sample of individuals

    The humanistic school offers therapies such as the person centred approach (Rogers, 1902) and reality therapy amongst others.  He believed that humans have an actualising tendency to achieve their full potential. It emphasises the role of over socialisation in preventing people to perceive themselves and their environment properly, and consequently not being able to self actualise. Through experience with clients, he found that each person’s reality is different, depending on their perceptions and experiences. He called this perception a person’s ‘internal frame of reference’. When perceptions become maladaptive, therapy aims to focus on each individuals’ world to help them live more fully, using the core conditions of congruence, unconditional positive regard and empathy.

    Rogers believed that experiences are valued as positive or negative according to whether they maintain their actualising tendency. Through interaction with others, a self concept develops. This self concept/regard needs to be positively regarded from others. This leads to selective perception of experiences so that they fall in accord with the individuals’ conditions of worth. Experiences which don’t agree are distorted and aren’t put into the self structure. This causes incongruence and psychological maladjustment. For congruence to occur, all experiences must be assimilated with other concepts of the self. Counselling aims to recognise incongruous experiences, whilst showing empathy and unconditional positive regard.

    One fundamental argument against person-centred counselling is that providing the core conditions such as empathy is a technique that all good therapists do, not just person centred therapists. They then apply their other methods to improve client’s health, without just providing a comfortable relationship.

    Cognitive-behavioural therapy belongs to the behaviourism school. It states that behaviour is learnt through conditioning and modelling and maladaptive behaviour is treated by learning adaptive behaviours. Cognitive-behavioural therapy can be divided into three main types of therapy; cognitive therapy, (Beck, 1960) behaviour therapy (Watson 1920) and rational-emotive-behaviour therapy, also called REBT (Ellis, 1950).

    REBT was one of the first forms of  (Ellis, 1953). He believed that humans are prone to prevent their own happiness and growth by creating irrational beliefs of ‘shoulds’, ‘musts’ and ‘oughts’. Ellis demonstrated his point using a framework of A, B, C, D and E. A refers to an activating event causing distress (such as trauma). B stands for our belief system, and C stands for the consequences of our beliefs. Therefore, if a teenager reacts to family arguments with the irrational beliefs (B) that they are the cause of the upset, they will go on to think themselves as unworthy and useless (C). Sometimes, when they think of the results of the consequence (C), it can cause another activating event (A) and this creates a cycle which the individual cannot see a way out of. The therapist however, aims to dispute these irrational beliefs (D) and replace them with rational beliefs. They can then enjoy the psychological benefits (E).

    The therapist will do this by using empathy and unconditional positive regard, but also by quickly identifying an unrealistic belief and testing it. By using activities and homework, the client can gain more rational ways of thinking, by discovering that they have a choice of how to react to an event, and therefore a choice of how to feel. (Ellis (2003)

    Although humans are born with a capability to grow, they also have innate tendencies to self defeat, as well as learning ways from our environment. He also suggested that a healthy part of personality development is looking to significant others for approval and wanting to be in social relationships. However, if a person can only accept themselves if others do, it can create emotional disturbance (Ellis and Harper (1997)

    Empirical evidence of Freud’s theories are rare. Most of Freud’s observations were done in the therapy setting, thus lacked a control group, and the necessary components for an experiment. Also, they went unrecorded (Colby, 1960). However, in support of these observations, Shevrin (1986) suggested that both clinical and extra clinical methods should be looked at.

    Raskin (1974) found that person-centred therapy is higher on levels of empathy than other therapies, whilst Bergin and Garfield (1971) found that the relationship of outcome to the measurement of the core conditions was positive. Patterson (1984) however, questioned the strength of these conclusions. Bozarth (1998) reviewed outcome studies and found that effective counselling is mostly based upon the therapist and client’s relationship and the clients’ willingness and resources.

    The evidence gathered so far on REBT is impressive. Numerous studies have been conducted with positive results. Keller et al (2000) conducted a large scale study and found that a higher level of response was found when cognitive behaviour therapy and anti depressants were used together rather than separately. Also, the depression report shows that cognitive behavioural therapy has a 50% success rate. Hajzler and Bernard (1991) gained evidence showing REBT can be used as a preventative measure. They found that when children are given normal education with regular classes or REBT they learn to live more happily. It seems specifically helpful with special kinds of clients such as schoolchildren (Jaycox et al, 1995). However, Mahoney (1974) argues “Experimental research evaluating the efficacy of (REBT) has been sparse, methodologically poor, and summarily modest in its implications”. Also, it must only be used with clients who are suitable, otherwise it may be counterproductive.

    The counselling approaches can be compared and contrasted on certain areas. With regards to views on human nature, Maslow (1971) suggested that psychoanalysis is pessimistic in believing that humans have to repress negative instincts rather than develop positive ones. Also, REBT suggests we are irrational. The only theory which looks at human nature positively is client centred therapy which stresses human potential for growth and actualisation. Maslow argued that therapy should be about cultivating human potential as well as overcoming destructive tendencies.

    Also, with regards to therapy characteristics, some contrasts can be made. Psychoanalysis focuses on the past affecting the present and the therapist is detached and acts as a teacher. Therapy can last several years and so is expensive. However, person-centred therapy focuses on the present and the therapist is caring and warm. Therapy duration is decided by the client and they achieve their own insight. In addition, cognitive-behavioural therapy also focuses on the present, the therapist is a teacher and the therapist-client relationship isn’t important.

    Even though there are relentless problems with evaluating therapeutic approaches because there are countless variables, research continues to attempt to validate and improve on existing theories. Currently, none of the therapies offer better results consistently than any other. However, evidence is beginning to show that certain types of distress are better addressed by a particular approach.

References

Acton, S (1997) ‘Psychoanalysis: Freud's Revolutionary Approach to Human Personality’ Available from:  (Accessed 15th January 2007)

Corsini, R and Wedding, D, ‘Current Psychotherapies’ (seventh edition), Wadsworth, 2005

Mulhauser, G, ‘Counselling Resource Centre’ Available from:  (Accessed 15th January 2007)

Nelson-Jones, R, (1982) ‘Theory and practice of counselling psychology’ London, Cassell Educational Limited

Patterson, C, (1986) ‘Theories of counselling and psychotherapy’ (fourth edition) New York, HarperCollins,

Wikimedia Foundation 2006 ‘Client centred therapy’ Available from:  (accessed 15th January 2007)

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