Types of Counseling Used in Therapy Sessions

For people who haven’t been trained as counselors, the therapeutic process can seem a little magical: a client begins sessions with a counselor, opens up about all of his problems, and a few months later, begins to see a dramatic improvement in his relationships, his work, and his general life experience.

That’s kind of a «best case» scenario—and it’s also the plot of Good Will Hunting. Improved life satisfaction is one of the goals of counseling, and the longer clients attend their counseling sessions, the more likely they are to see improvement in their lives. But how does that self-improvement happen? What techniques do counselors use in their interactions with clients? We’ll take a little of the mystery out of it for you, and discuss some of the «therapeutic tools» that counselors have at their disposal. And, after all that, we’ll discuss the most powerful—and the most basic and overlooked—therapeutic tool that is available to every counselor in every field. Let’s start at the beginning of the alphabet and work our way down. Common Counseling Techniques and Interventions Cognitive Behavioral Therapy (CBT): CBT is a very popular therapeutic model, and it is used by a very high percentage of counselors.

It can get a little complex, but the basic idea behind CBT is that our thoughts and our interpretations determine the emotions that we feel. Many people use a consistently negative pattern of thinking that includes overgeneralizing, magnifying negatives, minimizing positives, and «catastrophizing,» and those patterns lead to a painful emotional experience. A counselor who uses CBT will help patients find self-defeating or non-constructive thought patterns, and teach the client how to use more positive or helpful thought patterns. CBT is an effective strategy, and the research shows that it produces positive results quickly—which is excellent, especially for clients who do not have unlimited therapy sessions as part of their health care coverage. Dialectical Behavior Therapy (DBT): Often used for people who suffer from «behavioral instability» (ie, people with certain personality disorders, such as Borderline Personality Disorder), DBT is used to help clients learn self-control and emotional regulation.

DBT is very useful for people who have difficulty interacting with others. e-Therapy / Online Therapy: Online therapy is not so much a counseling technique or philosophy, as much as it is a new way to practice as a counselor. Therapists and clients use high-definition webcams to hold online therapy sessions over a private and secure connection. Online therapy can be a good starting point for people with certain conditions (such as agoraphobia), but it’s an inefficient tool for other types of counseling, such as group therapy or family counseling. Eclectic Approach: In reality, most therapists use an «eclectic approach,» wherein the practitioner uses different counseling techniques for different clients, and takes «bits and pieces» of each counseling philosophy and uses them as necessary. For example, a counselor using an eclectic approach may interact with a client using the positive-thinking elements of CBT, but also use some of the self-control elements from DBT.

Evidence-Based Treatment (EBT), also called Evidence-Based Practice (EBP): EBT/EBP refers to any therapy technique that has been tested by researchers, and has shown effectiveness in treating clients. For instance, a research team might find that when counselors have depressed clients engage in an activity they enjoy for twenty minutes every day, their feelings of depression decrease by 60%. That technique—having clients do a pleasant activity for twenty minutes a day—would be called «evidence-based practice,» because there is research that affirms that the technique is effective.

Both CBT and DBT are evidence-based treatments. Exposure Response Therapy (ERP): ERP is useful for adults and children who suffer from anxiety and obsessive-compulsive disorder (OCD). Basically, a counselor using ERP will expose the client to the situation that produces anxiety, but s/he will do so slowly, and over a long period of time. The treatment sounds very simple, but there are many factors that must be considered, and improvement is carefully charted. Faith-Based Counseling: Faith-based counseling is any therapeutic intervention that includes the client’s spiritual belief system into the therapeutic process. Any other technique can be used, and faith-based counseling is often used in conjunction with CBT, ERP, and so on. «Faith-based» can refer to any belief system. Family Systems Therapy: A number of psychologists and mental health philosophers have contributed to the basic ideas of family therapy (including Dr. Murray Bowen), but in general, family systems therapy refers to a process whereby a therapist observes how family members interact with each other, and then works with the family to build new communication techniques and new ways of solving problems. Gestalt Therapy: Gestalt therapy helps clients become more aware of the emotions they are feeling, and teaches clients to articulate their emotional experience to the counselor.

The counselor then provides feedback, with the aim that the client will develop maturity and insight. Humanistic Therapy: Often seen as one of the more «fun» therapeutic techniques, humanistic therapy espouses the idea that people deepen their maturity and develop emotionally through creativity, play, humor, and psychological growth. Humanistic therapy isn’t as widely embraced as it once was, but many therapists are embracing the humanistic ideas via Positive Psychology (see below). Imago Therapy: Imago therapy is a very interesting form of relationship intervention, and it focuses on the power struggles that are often present in close relationships. People in imago therapy are taught how to loosen power struggles and focus on shared respect, love, and commitment. Mindfulness Therapy: Mindfulness therapy has its roots in meditation, and embracing the present moment.

Clients are taught to «observe» their thoughts, and allow difficult, depressing, or anxiety-producing thoughts to pass, without reacting emotionally to them. Mindfulness therapy can be a very powerful intervention, and is especially effective with clients who suffer from anxiety. The goal to «be here now,» and not be regretful of the past or fearful of the future, is a central idea of mindfulness therapy. Motivational Interviewing: The counseling technique is used to inspire clients to change self-destructive behaviors (such as problem drinking or drug abuse). Sometimes, clients come to therapy, but they don’t want to change their self-destructive behavior. The therapy sessions may be court-ordered, or the client may be showing up because a spouse or parent is putting pressure on them. An intervention using motivational interviewing is structured so that the client will develop the desire to change their lives for the better.

The technique reviews the negative impact of the behavior on the client’s life, and uses goal-setting as a method of helping the client desist self-harming behaviors. Play Therapy: Primary used with children, play therapy is an effective way to help children verbalize their feelings, understand their emotions, and develop positive interaction styles. Because children do not always have the communication skills or cognitive development to discuss problems, play therapy can be a very useful intervention, and play therapists are extensively trained to help children learn coping skills and positive ways of expressing their emotions. Positive Psychology: One of the newer interventions on the list, positive psychology was developed by a researcher at the University of Pennsylvania in the 1990s. The premise of positive psychology is that counselors spend too much time focus on the negative aspects of a client’s life, and do not spend enough time teaching them skills to enjoy life. A positive psychology intervention will include techniques that help clients find work they enjoy, deepen their personal relationships, and view life using an optimistic thought pattern.

Psychodrama: A group therapy or family therapy technique where different people are given different roles to play, so that group members will develop a deeper understanding of the people they interact with. In an effective psychodrama, group members will gain a deeper understanding of the pressures, challenges, and difficulties that other group members face, and develop more compassion and respect for one another. Psychotherapy, aka Psychodynamic Counseling: A therapy philosophy that focuses on a person’s subconscious, and how that person’s childhood and personal history impact their feelings, thoughts, and actions. Psychotherapeutic approaches can be very effective, and are an effective source of insight for clients, but they can be difficult to coordinate, and can also be very time-consuming. Psychodynamic counseling is difficult to use when clients have a limited number of sessions they can afford.

The Most Effective—and Most Basic—Counseling Technique While it sounds simple, the most effective (and sometimes the most difficult) technique a counselor uses is active listening. The counselor provides a safe space for the client, where everything that is said is confidential, and nothing that is said is judged. Clients are free to speak their minds and be completely honest about their fears, this hopes, and their regrets. For many people, that alone is a very healing experience. And, believe it or not, active listening is not easy. It is a technique counselors spend a lot of time practicing. Very often, a client’s experience or concerns will be shocking, or truly upsetting. But a counselor must maintain an atmosphere of nonjudgment and empathy. That can be difficult, and the tact involved in active listening is a learned skill. Therapeutic Interventions—Final Thoughts This is not a complete list—there are dozens of other therapeutic techniques, and researchers are continually developing new methods.

But the ideas above a good start, and will hopefully give you an idea of the tools that therapists use to interact with their clients. If you have any questions, please leave us a comment below, and we’ll try to answer it.

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