Foundations of Mental Health Counseling – Professional Development Project

I need this back by Thursday January 25, 2018 at 2pm.

I’m in the state of Georgia

My journey into counseling is based on my mom being diagnosed with mental illness when I was five years old. Me being in foster care and living with different family members and experiencing every form of abuse from the age of 5 until 18. I had anger issues and I was passive aggressive. I used comedy as a way to take the focus off me but it was mostly in school towards those who offended me. As an adult I went through a process of forgiving which lead me to wanting to help others.

PC 6106 Foundations of Mental Health Counseling

Required Assignment 1: (200 pts)

Description of RA 1:

Professional Development Project

In this assignment, you will develop a professional development plan and submit a 6-7 page reflection on the process.

Professional Development Project

Students will (1) interview a licensed professional counselor (i.e., not a social worker, marriage and family therapist, psychologist, case manager) currently practicing in the field about their position, responsibilities, credentials, training, involvement in the profession, specialty area, job market, self-care strategies, and advice to you as a counselor-in-training; (2) explore the ACA website, in terms of benefits, structure and content; and (3) identify licensing requirements (e.g., exams, hours, training) for the state in which you plan to acquire your license (i.e., contact the state/review the website) and certifications you plan to acquire (e.g., Registered Play Therapist, Nationally Certified Counselor); (4) describe your journey into counseling (“Why Am I Here?”).

The professional development project reflection paper should be 6-7 double-spaced pages: (a) summarize interview (including interviewee demographic contact information) and what you learned about the profession from the interview(2 pgs.), (b) review benefits of ACA membership (1/2-1 pg.), (c) summarize the licensure requirements in your state and create a plan and timeline for acquiring your professional counseling license and any additional certifications (2 pgs.), and (d) describe your unique path to the decision to becoming a counselor (“Why Am I Here”) (2 pgs.).

Your final product will be a 6-7 page Word document written in APA format. Your paper should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, and punctuation.

RA 1 Grading Criteria

CACREP Core Standards: 2.F.1.d; 2.F.1.f; 2.F.1.h;

CMHC Standards: 5.C.2.a; 5.C.2.k

Assignment Components

Proficient

Max Points

Select a licensed professional counselor

Selected a licensed professional counselor, described interviewee’s professional background and rationale for selecting interviewee.

/12 pts.

Interview a licensed professional counselor

Gathered information about interviewee’s position, responsibilities, credentials, training, involvement in the profession, specialty area, job market, self-care strategies, and advice to counselors-in-training. Demonstrated meaningful reflection on interview experience and described relevance to experience as a counselor-in-training.

/60 pts

Explore the ACA website, in terms of benefits, structure and content

Reviewed and described purpose of ACA and benefits of ACA membership.

/24 pts

Identify licensing requirements and certifications

Created a plan for acquiring professional counseling license using current licensure board requirements and cited appropriately; included timeline with projected dates for completion of process. Described specialty areas of interest, additional training required and certification process.

/32 pts.

Why Am I Here? (reflection)

Described personal journey into the field of counseling. Included: First time the student considered counseling as a career, how life experiences prepared the student to become a counselor, attributes possessed that will make the student an effective counselor, etc.

Must include two sources from peer-reviewed journals, cited correctly, and included in a reference list.

/48 pts

Academic Writing

Write in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources (i.e. APA); and display accurate spelling, grammar, and punctuation.

Written in a clear, concise, and organized manner; demonstrated ethical scholarship in appropriate and accurate representation and attribution of sources; and displayed accurate spelling, grammar, and punctuation. Use of scholarly sources aligns with specified assignment requirements.

/24 pts

Total

/ 200 pts.

The Place of Techniques and Evaluation in Counseling

Drawing on Techniques from Various Approaches

Techniques of Therapy

Applications of the Approaches

Contributions to Multicultural Counseling

Limitations in Multicultural Counseling

Contributions of the Approaches

Overview of Contemporary Counseling Models

Ego-Defense Mechanisms

Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages

The Basic Philosophies

Key Concepts

Goals of Therapy

The Therapeutic Relationship

Limitations of the Approaches

The Place of Techniques and Evaluation in Counseling

Drawing on Techniques from Various Approaches

Techniques of Therapy

					Psychoanalytic therapy	The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference, and countertransference. Techniques are designed to help clients gain access to their unconscious conflicts, which leads to insight and eventual assimilation of new material by the ego.
					Adlerian therapy	Adlerians pay more attention to the subjective experiences of clients than to using techniques. Some techniques include gathering life-history data (family constellation, early recollections, personal priorities), sharing interpretations with clients, offering encouragement, and assisting clients in searching for new possibilities.
					Existential therapy	Few techniques flow from this approach because it stresses understanding first and technique second. The therapist can borrow techniques from other approaches and incorporate them in an existential framework. Diagnosis, testing, and external measurements are not deemed important. Issues addressed are freedom and responsibility, isolation and relationships, meaning and meaninglessness, living and dying.
					Person-centered therapy	This approach uses few techniques but stresses the attitudes of the therapist and a “way of being.” Therapists strive for active listening, reflection of feelings, clarification, “being there” for the client, and focusing on the moment-to-moment experiencing of the client. This model does not include diagnostic testing, interpretation, taking a case history, or questioning or probing for information.
					Gestalt therapy	A wide range of experiments are designed to intensify experiencing and to integrate conflicting feelings. Experiments are co-created by therapist and client through an I/Thou dialogue. Therapists have latitude to creatively invent their own experiments. Formal diagnosis and testing are not a required part of therapy.
					Behavior therapy	The main techniques are reinforcement, shaping, modeling, systematic desensitization, relaxation methods, flooding, eye movement and desensitization reprocessing, cognitive restructuring, social skills training, self-management programs, mindfulness and acceptance methods, behavioral rehearsal, and coaching. Diagnosis or assessment is done at the outset to determine a treatment plan. Questions concentrate on “what,” “how,” and “when” (but not “why”). Contracts and homework assignments are also typically used.
					Cognitive behavior therapy	Therapists use a variety of cognitive, emotive, and behavioral techniques; diverse methods are tailored to suit individual clients. This is an active, directive, time-limited, present-centered, psychoeducational, structured therapy. Some techniques include engaging in Socratic dialogue, collaborative empiricism, debating irrational beliefs, carrying out homework assignments, gathering data on assumptions one has made, keeping a record of activities, forming alternative interpretations, learning new coping skills, changing one’s language and thinking patterns, role playing, imagery, confronting faulty beliefs, self-instructional training, and stress inoculation training.
					Choice theory/ Reality therapy	This is an active, directive, and didactic therapy. Skillful questioning is a central technique used for the duration of the therapy process. Various techniques may be used to get clients to evaluate what they are presently doing to see if they are willing to change. If clients decide that their present behavior is not effective, they develop a specific plan for change and make a commitment to follow through.
					Feminist therapy	Although techniques from traditional approaches are used, feminist practitioners tend to employ consciousness-raising techniques aimed at helping clients recognize the impact of gender-role socialization on their lives. Other techniques frequently used include gender-role analysis and intervention, power analysis and intervention, demystifying therapy, bibliotherapy, journal writing, therapist self-disclosure, assertiveness training, reframing and relabeling, cognitive restructuring, identifying and challenging untested beliefs, role playing, psychodramatic methods, group work, and social action.
					Postmodern approaches	In solution-focused therapy the main technique involves change-talk, with emphasis on times in a client’s life when the problem was not a problem. Other techniques include creative use of questioning, the miracle question, and scaling questions, which assist clients in developing alternative stories. In narrative therapy, specific techniques include listening to a client’s problem-saturated story without getting stuck, externalizing and naming the problem, externalizing conversations, and discovering clues to competence. Narrative therapists often write letters to clients and assist them in finding an audience that will support their changes and new stories.
					Family systems therapy	A variety of techniques may be used, depending on the particular theoretical orientation of the therapist. Some techniques include genograms, teaching, asking questions, joining the family, tracking sequences, family mapping, reframing, restructuring, enactments, and setting boundaries. Techniques may be experiential, cognitive, or behavioral in nature. Most are designed to bring about change in a short time.

Techniques of Therapy

Applications of the Approaches

Psychoanalytic therapy

Adlerian therapy

Existential therapy

Person-centered therapy

Gestalt therapy

Behavior therapy

Cognitive behavior therapy

Choice theory/ Reality therapy

Feminist therapy

Postmodern approaches

Family systems therapy

Candidates for analytic therapy include professionals who want to become therapists, people who have had intensive therapy and want to go further, and those who are in psychological pain. Analytic therapy is not recommended for self-centered and impulsive individuals or for people with psychotic disorders. Techniques can be applied to individual and group therapy.

Because the approach is based on a growth model, it is applicable to such varied spheres of life as child guidance, parent–child counseling, marital and family therapy, individual counseling with all age groups, correctional and rehabilitation counseling, group counseling, substance abuse programs, and brief counseling. It is ideally suited to preventive care and alleviating a broad range of conditions that interfere with growth.

This approach is especially suited to people facing a developmental crisis or a transition in life and for those with existential concerns (making choices, dealing with freedom and responsibility, coping with guilt and anxiety, making sense of life, and finding values) or those seeking personal enhancement. The approach can be applied to both individual and group counseling, and to couples and family therapy, crisis intervention, and community mental health work.

Has wide applicability to individual and group counseling. It is especially well suited for the initial phases of crisis intervention work. Its principles have been applied to couples and family therapy, community programs, administration and management, and human relations training. It is a useful approach for teaching, parent–child relations, and for working with groups of people from diverse cultural backgrounds.

Addresses a wide range of problems and populations: crisis intervention, treatment of a range of psychosomatic disorders, couples and family therapy, awareness training of mental health professionals, behavior problems in children, and teaching and learning. It is well suited to both individual and group counseling. The methods are powerful catalysts for opening up feelings and getting clients into contact with their present-centered experience.

A pragmatic approach based on empirical validation of results. Enjoys wide applicability to individual, group, couples, and family counseling. Some problems to which the approach is well suited are phobic disorders, depression, trauma, sexual disorders, children’s behavioral disorders, stuttering, and prevention of cardiovascular disease. Beyond clinical practice, its principles are applied in fields such as pediatrics, stress management, behavioral medicine, education, and geriatrics.

Has been widely applied to treatment of depression, anxiety, relationship problems, stress management, skill training, substance abuse, assertion training, eating disorders, panic attacks, performance anxiety, and social phobias. CBT is especially useful for assisting people in modifying their cognitions. Many self-help approaches utilize its principles. CBT can be applied to a wide range of client populations with a variety of specific problems.

Geared to teaching people ways of using choice theory in everyday living to increase effective behaviors. It has been applied to individual counseling with a wide range of clients, group counseling, working with youthful law offenders, and couples and family therapy. In some instances it is well suited to brief therapy and crisis intervention.

Principles and techniques can be applied to a range of therapeutic modalities such as individual therapy, relationship counseling, family therapy, group counseling, and community intervention. The approach can be applied to both women and men with the goal of bringing about empowerment.

Solution-focused therapy is well suited for people with adjustment disorders and for problems of anxiety and depression. Narrative therapy is now being used for a broad range of human difficulties including eating disorders, family distress, depression, and relationship concerns. These approaches can be applied to working with children, adolescents, adults, couples, families, and the community in a wide variety of settings. Both solution-focused and narrative approaches lend themselves to group counseling and to school counseling.

Useful for dealing with marital distress, problems of communicating among family members, power struggles, crisis situations in the family, helping individuals attain their potential, and enhancing the overall functioning of the family.

Applications of the Approaches

Contributions to Multicultural Counseling

Psychoanalytic therapy

Adlerian therapy

Existential therapy

Person-centered therapy

Gestalt therapy

Behavior therapy

Cognitive behavior therapy

Choice theory/ Reality therapy

Feminist therapy

Postmodern approaches

Family systems therapy

Its focus on family dynamics is appropriate for working with many cultural groups. The therapist’s formality appeals to clients who expect professional distance. Notion of ego defense is helpful in understanding inner dynamics and dealing with environmental stresses.

Its focus on social interest, helping others, collectivism, pursuing meaning in life, importance of family, goal orientation, and belonging is congruent with the values of many cultures. Focus on person-in-the-environment allows for cultural factors to be explored.

Focus is on understanding client’s phenomenological world, including cultural background. This approach leads to empowerment in an oppressive society. Existential therapy can help clients examine their options for change within the context of their cultural realities. The existential approach is particularly suited to counseling diverse clients because of the philosophical foundation that emphasizes the human condition.

Focus is on breaking cultural barriers and facilitating open dialogue among diverse cultural populations. Main strengths are respect for clients’ values, active listening, welcoming of differences, nonjudgmental attitude, understanding, willingness to allow clients to determine what will be explored in sessions, and prizing cultural pluralism.

Its focus on expressing oneself nonverbally is congruent with those cultures that look beyond words for messages. Provides many experiments in working with clients who have cultural injunctions against freely expressing feelings. Can help to overcome language barrier with bilingual clients.

Focus on bodily expressions is a subtle way to help clients recognize their conflicts.

Focus on behavior, rather than on feelings, is compatible with many cultures. Strengths include a collaborative relationship between counselor and client in working toward mutually agreed-upon goals, continual assessment to determine if the techniques are suited to clients’ unique situations, assisting clients in learning practical skills, an educational focus, and stress on self-management strategies.

Focus is on a collaborative approach that offers clients opportunities to express their areas of concern. The psychoeducational dimensions are often useful in exploring cultural conflicts and teaching new behavior. The emphasis on thinking (as opposed to identifying and expressing feelings) is likely to be acceptable to many clients. The focus on teaching and learning tends to avoid the stigma of mental illness. Clients are likely to value the active and directive stance of the therapist.

Focus is on clients making their own evaluation of behavior (including how they respond to their culture). Through personal assessment clients can determine the degree to which their needs and wants are being satisfied. They can find a balance between retaining their own ethnic identity and integrating some of the values and practices of the dominant society.

Focus is on both individual change and social transformation. A key contribution is that both the women’s movement and the multicultural movement have called attention to the negative impact of discrimination and oppression for both women and men. Emphasizes the influence of expected cultural roles and explores client’s satisfaction with and knowledge of these roles.

Focus is on the social and cultural context of behavior. Stories that are being authored in the therapy office need to be anchored in the social world in which the client lives. Therapists do not make assumptions about people and honor each client’s unique story and cultural background. Therapists take an active role in challenging social and cultural injustices that lead to oppression of certain groups. Therapy becomes a process of liberation from oppressive cultural values and enables clients to become active agents of their destinies.

Focus is on the family or community system. Many ethnic and cultural groups place value on the role of the extended family. Many family therapies deal with extended family members and with support systems. Networking is a part of the process, which is congruent with the values of many clients. There is a greater chance for individual change if other family members are supportive. This approach offers ways of working toward the health of the family unit and the welfare of each member.

Contributions to Multicultural Counseling

Limitations in Multicultural Counseling

Psychoanalytic therapy

Adlerian therapy

Existential therapy

Person-centered therapy

Gestalt therapy

Behavior therapy

Cognitive behavior therapy

Choice theory/ Reality therapy

Feminist therapy

Postmodern approaches

Family systems therapy

Its focus on insight, intrapsychic dynamics, and long-term treatment is often not valued by clients who prefer to learn coping skills for dealing with pressing daily concerns. Internal focus is often in conflict with cultural values that stress an interpersonal and environmental focus.

This approach’s detailed interview about one’s family background can conflict with cultures that have injunctions against disclosing family matters. Some clients may view the counselor as an authority who will provide answers to problems, which conflicts with the egalitarian, person-to person spirit as a way to reduce social distance.

Values of individuality, freedom, autonomy, and self-realization often conflict with cultural values of collectivism, respect for tradition, deference to authority, and interdependence. Some may be deterred by the absence of specific techniques. Others will expect more focus on surviving in their world.

Some of the core values of this approach may not be congruent with the client’s culture. Lack of counselor direction and structure are unacceptable for clients who are seeking help and immediate answers from a knowledgeable professional.

Clients who have been culturally conditioned to be emotionally reserved may not embrace Gestalt experiments. Some may not see how “being aware of present experiencing” will lead to solving their problems.

Family members may not value clients’ newly acquired assertive style, so clients must be taught how to cope with resistance by others. Counselors need to help clients assess the possible consequences of making behavioral changes.

Before too quickly attempting to change the beliefs and actions of clients, it is essential for the therapist to understand and respect their world. Some clients may have serious reservations about questioning their basic cultural values and beliefs. Clients could become dependent on the therapist choosing appropriate ways to solve problems.

This approach stresses taking charge of one’s own life, yet some clients are more interested in changing their external environment. Counselors need to appreciate the role of discrimination and racism and help clients deal with social and political realities.

This model has been criticized for its bias toward the values of White, middle-class, heterosexual women, which are not applicable to many other groups of women nor to men. Therapists need to assess with their clients the price of making significant personal change, which may result in isolation from extended family as clients assume new roles and make life changes.

Some clients come to therapy wanting to talk about their problems and may be put off by the insistence on talking about exceptions to their problems. Clients may view the therapist as an expert and be reluctant to view themselves as experts. Certain clients may doubt the helpfulness of a therapist who assumes a “not-knowing” position.

Family therapy rests on value assumptions that are not congruent with the values of clients from some cultures. Western concepts such as individuation, self-actualization, self-determination, independence, and self-expression may be foreign to some clients. In some cultures, admitting problems within the family is shameful. The value of “keeping problems within the family” may make it difficult to explore conflicts openly.

Contributions of the Approaches

Psychoanalytic therapy

Adlerian therapy

Existential therapy

Person-centered therapy

Gestalt therapy

Behavior therapy

Cognitive behavior therapy

Choice theory/ Reality therapy

Feminist therapy

Postmodern approaches

Family systems therapy

More than any other system, this approach has generated controversy as well as exploration and has stimulated further thinking and development of therapy. It has provided a detailed and comprehensive description of personality structure and functioning. It has brought into prominence factors such as the unconscious as a determinant of behavior and the role of trauma during the first six years of life. It has developed several techniques for tapping the unconscious and shed light on the dynamics of transference and countertransference, resistance, anxiety, and the mechanisms of ego defense.

A key contribution is the influence that Adlerian concepts have had on other systems and the integration of these concepts into various contemporary therapies. This is one of the first approaches to therapy that was humanistic, unified, holistic, and goal-oriented and that put an emphasis on social and psychological factors.

Its major contribution is recognition of the need for a subjective approach based on a complete view of the human condition. It calls attention to the need for a philosophical statement on what it means to be a person. Stress on the I/Thou relationship lessens the chances of dehumanizing therapy. It provides a perspective for understanding anxiety, guilt, freedom, death, isolation, and commitment.

Clients take an active stance and assume responsibility for the direction of therapy. This unique approach has been subjected to empirical testing, and as a result both theory and methods have been modified. It is an open system. People without advanced training can benefit by translating the therapeutic conditions to both their personal and professional lives. Basic concepts are straightforward and easy to grasp and apply. It is a foundation for building a trusting relationship, applicable to all therapies.

The emphasis on direct experiencing and doing rather than on merely talking about feelings provides a perspective on growth and enhancement, not merely a treatment of disorders. It uses clients’ behavior as the basis for making them aware of their inner creative potential. The approach to dreams is a unique, creative tool to help clients discover basic conflicts. Therapy is viewed as an existential encounter; it is process-oriented, not technique-oriented. It recognizes nonverbal behavior as a key to understanding.

Emphasis is on assessment and evaluation techniques, thus providing a basis for accountable practice. Specific problems are identified, and clients are kept informed about progress toward their goals. The approach has demonstrated effectiveness in many areas of human functioning. The roles of the therapist as reinforcer, model, teacher, and consultant are explicit. The approach has undergone extensive expansion, and research literature abounds. No longer is it a mechanistic approach, for it now makes room for cognitive factors and encourages self-directed programs for behavioral change.

Major contributions include emphasis on a comprehensive therapeutic practice; numerous cognitive, emotive, and behavioral techniques; an openness to incorporating techniques from other approaches; and a methodology for challenging and changing faulty or negative thinking. Most forms can be integrated into other mainstream therapies. REBT makes full use of action oriented homework, various psychoeducational methods, and keeping records of progress. CT is a structured therapy that has a good track record for treating depression and anxiety in a short time. Strengths-based CBT is a form of positive psychology that addresses the resources within the client for change.

This is a positive approach with an action orientation that relies on simple and clear concepts that are easily grasped in many helping professions. It can be used by teachers, nurses, ministers, educators, social workers, and counselors. Due to the direct methods, it appeals to many clients who are often seen as resistant to therapy. It is a short-term approach that can be applied to a diverse population, and it has been a significant force in challenging the medical model of therapy.

The feminist perspective is responsible for encouraging increasing numbers of women to question gender stereotypes and to reject limited views of what a woman is expected to be. It is paving the way for gender-sensitive practice and bringing attention to the gendered uses of power in relationships. The unified feminist voice brought attention to the extent and implications of child abuse, incest, rape, sexual harassment, and domestic violence. Feminist principles and interventions can be incorporated in other therapy approaches.

The brevity of these approaches fit well with the limitations imposed by a managed care structure. The emphasis on client strengths and competence appeals to clients who want to create solutions and revise their life stories in a positive direction. Clients are not blamed for their problems but are helped to understand how they might relate in more satisfying ways to such problems. A strength of these approaches is the question format that invites clients to view themselves in new and more effective ways.

From a systemic perspective, neither the individual nor the family is blamed for a particular dysfunction. The family is empowered through the process of identifying and exploring interactional patterns. Working with an entire unit provides a new perspective on understanding and working through both individual problems and relationship concerns. By exploring one’s family of origin, there are increased opportunities to resolve other conflicts in systems outside of the family

Contributions of the Approaches

Limitations of the Approaches

Psychoanalytic therapy

Adlerian therapy

Existential therapy

Person-centered therapy

Gestalt therapy

Behavior therapy

Cognitive behavior therapy

Requires lengthy training for therapists and much time and expense for clients. The model stresses biological and instinctual factors to the neglect of social, cultural, and interpersonal ones. Its methods are less applicable for solving specific daily life problems of clients and may not be appropriate for some ethnic and cultural groups. Many clients lack the degree of ego strength needed for regressive and reconstructive therapy. It may be inappropriate for certain counseling settings.

Weak in terms of precision, testability, and empirical validity. Few attempts have been made to validate the basic concepts by scientific methods. Tends to oversimplify some complex human problems and is based heavily on common sense.

Many basic concepts are fuzzy and ill-defined, making its general framework abstract at times. Lacks a systematic statement of principles and practices of therapy. Has limited applicability to lower functioning and nonverbal clients and to clients in extreme crisis who need direction.

Possible danger from the therapist who remains passive and inactive, limiting responses to reflection. Many clients feel a need for greater direction, more structure, and more techniques. Clients in crisis may need more directive measures. Applied to individual counseling, some cultural groups will expect more counselor activity.

Techniques lead to intense emotional expression; if these feelings are not explored and if cognitive work is not done, clients are likely to be left unfinished and will not have a sense of integration of their learning. Clients who have difficulty using imagination may not profit from certain experiments.

Major criticisms are that it may change behavior but not feelings; that it ignores the relational factors in therapy; that it does not provide insight; that it ignores historical causes of present behavior; that it involves control by the therapist; and that it is limited in its capacity to address certain aspects of the human condition.

Tends to play down emotions, does not focus on exploring the unconscious or underlying conflicts, de-emphasizes the value of insight, and sometimes does not give enough weight to the client’s past. CBT might be too structured for some clients.

Choice theory/ Reality therapy

Feminist therapy

Postmodern approaches

Family systems therapy

Discounts the therapeutic value of exploration of the client’s past, dreams, the unconscious, early childhood experiences, and transference. The approach is limited to less complex problems. It is a problem-solving therapy that tends to discourage exploration of deeper emotional issues.

A possible limitation is the potential for therapists to impose a new set of values on clients—such as striving for equality, power in relationships, defining oneself, freedom to pursue a career outside the home, and the right to an education. Therapists need to keep in mind that clients are their own best experts, which means it is up to them to decide which values to live by.

There is little empirical validation of the effectiveness of therapy outcomes. Some critics contend that these approaches endorse cheerleading and an overly positive perspective. Some are critical of the stance taken by most postmodern therapists regarding assessment and diagnosis, and also react negatively to the “not-knowing” stance of the therapist. Because some of the solution-focused and narrative therapy techniques are relatively easy to learn, practitioners may use these interventions in a mechanical way or implement these techniques without a sound rationale.

Limitations include problems in being able to involve all the members of a family in the therapy. Some family members may be resistant to changing the structure of the system. Therapists’ self knowledge and willingness to work on their own family-of-origin issues is crucial, for the potential for countertransference is high. It is essential that the therapist be well trained, receive quality supervision, and be competent in assessing and treating individuals in a family context.

Limitations of the Approaches

Overview of Contemporary Counseling Models

Psychodynamic Approaches

Psychoanalytic therapy Founder: Sigmund Freud. A theory of personality development, a philosophy of human nature, and a method of psychotherapy that focuses on unconscious factors that motivate behavior. Attention is given to the events of the first six years of life as determinants of the later development of personality.

Adlerian therapy Founder: Alfred Adler. Key Figure: Following Adler, Rudolf Dreikurs is credited with popularizing this approach in the United States. This is a growth model that stresses assuming responsibility, creating one’s own destiny, and finding meaning and goals to create a purposeful life. Key concepts are used in most other current therapies.

Experiential and Relationship-Oriented Therapies

Existential therapy Key figures: Viktor Frankl, Rollo May, and Irvin Yalom. Reacting against the tendency to view therapy as a system of well-defined techniques, this model stresses building therapy on the basic conditions of human existence, such as choice, the freedom and responsibility to shape one’s life, and self-determination. It focuses on the quality of the person-to-person therapeutic relationship.

Person-centered therapy Founder: Carl Rogers; Key figure: Natalie Rogers. This approach was developed during the 1940s as a nondirective reaction against psychoanalysis. Based on a subjective view of human experiencing, it places faith in and gives responsibility to the client in dealing with problems and concerns.

Gestalt therapy Founders: Fritz and Laura Perls; Key figures: Miriam and Erving Polster. An experiential therapy stressing awareness and integration; it grew as a reaction against analytic therapy. It integrates the functioning of body and mind and places emphasis on the therapeutic relationship.

Cognitive Behavioral Approaches

Behavior therapy Key figures: B. F. Skinner, and Albert Bandura. This approach applies the principles of learning to the resolution of specific behavioral problems. Results are subject to continual experimentation. The methods of this approach are always in the process of refinement. The mindfulness and acceptance-based approaches are rapidly gaining popularity.

Cognitive behavior therapy Founders: Albert Ellis and A. T. Beck. Albert Ellis founded rational emotive behavior therapy, a highly didactic, cognitive, action-oriented model of therapy, and A. T. Beck founded cognitive therapy, which gives a primary role to thinking as it influences behavior. Judith Beck continues to develop CBT; Christine Padesky has developed strengths-based CBT; and Donald Meichenbaum, who helped develop cognitive behavior therapy, has made significant contributions to resilience as a factor in coping with trauma.

Choice theory/Reality Founder: William Glasser. Key figure: Robert Wubbolding. This short-term approach is based therapy on choice theory and focuses on the client assuming responsibility in the present. Through the therapeutic process, the client is able to learn more effective ways of meeting her or his needs.

Systems and Postmodern Approaches

Feminist therapy This approach grew out of the efforts of many women, a few of whom are Jean Baker Miller, Carolyn Zerbe Enns, Oliva Espin, and Laura Brown. A central concept is the concern for the psychological oppression of women. Focusing on the constraints imposed by the sociopolitical status to which women have been relegated, this approach explores women’s identity development, self-concept, goals and aspirations, and emotional well-being.

Postmodern approaches A number of key figures are associated with the development of these various approaches to therapy. Steve de Shazer and Insoo Kim Berg are the cofounders of solution-focused brief therapy. Michael White and David Epston are the major figures associated with narrative therapy. Social constructionism, solution-focused brief therapy, and narrative therapy all assume that there is no single truth; rather, it is believed that reality is socially constructed through human interaction. These approaches maintain that the client is an expert in his or her own life.

Family systems therapy A number of significant figures have been pioneers of the family systems approach, two of whom include Murray Bowen and Virginia Satir. This systemic approach is based on the assumption that the key to changing the individual is understanding and working with the family.

Overview of Contemporary Counseling Models

Ego-Defense Mechanisms

Defense

Uses for Behavior

Repression

Threatening or painful thoughts and feelings are excluded from awareness.

One of the most important Freudian processes, it is the basis of many other ego defenses and of neurotic disorders. Freud explained repression as an involuntary removal of something from consciousness. It is assumed that most of the painful events of the first five or six years of life are buried, yet these events do influence later behavior.

Denial

“Closing one’s eyes” to the existence of a threatening aspect of reality.

Denial of reality is perhaps the simplest of all self defense mechanisms. It is a way of distorting what the individual thinks, feels, or perceives in a traumatic situation. This mechanism is similar to repression, yet it generally operates at preconscious and conscious levels.

Reaction formation

Actively expressing the opposite impulse when confronted with a threatening impulse.

By developing conscious attitudes and behaviors that are diametrically opposed to disturbing desires, people do not have to face the anxiety that would result if they were to recognize these dimensions of themselves. Individuals may conceal hate with a facade of love, be extremely nice when they harbor negative reactions, or mask cruelty with excessive kindness.

Projection

Attributing to others one’s own unacceptable desires and impulses.

This is a mechanism of self-deception. Lustful, aggressive, or other impulses are seen as being possessed by “those people out there, but not by me.”

Displacement

Directing energy toward another object or person when the original object or person is inaccessible.

Displacement is a way of coping with anxiety that involves discharging impulses by shifting from a threatening object to a “safer target.” For example, the meek man who feels intimidated by his boss comes home and unloads inappropriate hostility onto his children.

Rationalization

Manufacturing “good” reasons to explain away a bruised ego.

Rationalization helps justify specific behaviors, and it aids in softening the blow connected with disappointments. When people do not get positions, they have applied for in their work, they think of logical reasons they did not succeed, and they sometimes attempt to convince themselves that they really did not want the position anyway.

Sublimation

Diverting sexual or aggressive energy into other channels.

Energy is usually diverted into socially acceptable and sometimes even admirable channels. For example, aggressive impulses can be channeled into athletic activities, so that the person finds a way of expressing aggressive feelings and, as an added bonus, is often praised.

Regression

Going back to an earlier phase of development when there were fewer demands.

In the face of severe stress or extreme challenge, individuals may attempt to cope with their anxiety by clinging to immature and inappropriate behaviors. For example, children who are frightened in school may indulge in infantile behavior such as weeping, excessive dependence, thumb-sucking, hiding, or clinging to the teacher.

Introjection

Taking in and “swallowing” the values and standards of others.

Positive forms of introjection include incorporation of parental values or the attributes and values of the therapist (assuming that these are not merely uncritically accepted). One negative example is that in concentration camps some of the prisoners dealt with overwhelming anxiety by accepting the values of the enemy through identification with the aggressor.

Identification

Identifying with successful causes, organizations, or people in the hope that you will be perceived as worthwhile.

Identification can enhance self-worth and protect one from a sense of being a failure. This is part of the developmental process by which children learn gender-role behaviors, but it can also be a defensive reaction when used by people who feel basically inferior.

Compensation

Masking perceived weaknesses or developing certain positive traits to make up for limitations.

This mechanism can have direct adjustive value, and it can also be an attempt by the person to say “Don’t see the ways in which I am inferior, but see me in my accomplishments.”

Ego-Defense Mechanisms

Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages

Period of Life

Freud

Erikson

First year of life

Oral stage
Sucking at mother’s breasts satisfies need for food and pleasure. Infant needs to get basic nurturing, or later feelings of greediness and acquisitiveness may develop. Oral fixations result from deprivation of oral gratification in infancy. Later personality problems can include mistrust of others, rejecting others; love, and fear of or inability to form intimate relationships.

Infancy: Trust versus mistrust

If significant others provide for basic physical and emotional needs, infant develops a sense of trust. If basic needs are not met, an attitude of mistrust toward the world, especially toward interpersonal relationships, is the result.

Ages 1-3

Anal stage
Anal zone becomes of major significance in formation of personality. Main developmental tasks include learning independence, accepting personal power, and learning to express negative feelings such as rage and aggression. Parental discipline patterns and attitudes have significant consequences for child’s later personality development.

Early childhood: Autonomy versus shame and doubt
A time for developing autonomy. Basic struggle is between a sense of self-reliance and a sense of self-doubt. Child needs to explore and experiment, to make mistakes, and to test limits. If parents promote dependency, child’s autonomy is inhibited and capacity to deal with world successfully is hampered.

Ages 3-6

Phallic stage
Basic conflict centers on unconscious incestuous desires that child develops for parent of opposite sex and that, because of their threatening nature, are repressed. Male phallic stage, known as Oedipus complex, involves mother as love object for boy. Female phallic stage, known as Electra complex, involves girl’s striving for father’s love and approval. How parents respond, verbally and nonverbally, to child’s emerging sexuality has an impact on sexual attitudes and feelings that child develops.

Preschool age: Initiative versus guilt
Basic task is to achieve a sense of competence and initiative. If children are given freedom to select personally meaningful activities, they tend to develop a positive view of self and follow through with their projects. If they are not allowed to make their own decisions, they tend to develop guilt over taking initiative. They then refrain from taking an active stance and allow others to choose for them.

Ages 6-12

Latency stage
After the torment of sexual impulses of preceding years, this period is relatively quiescent. Sexual interests are replaced by interests in school, playmates, sports, and a range of new activities. This is a time of socialization as child turns outward and forms relationships with others.

School age: Industry versus inferiority
Child needs to expand understanding of world, continue to develop appropriate gender-role identity, and learn the basic skills required for school success. Basic task is to achieve a sense of industry, which refers to setting and attaining personal goals. Failure to do so results in a sense of inadequacy.

Ages 12-18

Genital stage
Old themes of phallic stage are revived. This stage begins with puberty and lasts until senility sets in. Even though there are societal restrictions and taboos, adolescents can deal with sexual energy by investing it in various socially acceptable activities such as forming friendships, engaging in art or in sports, and preparing for a career.

Adolescence: Identity versus role confusion A time of transition between childhood and adulthood.
A time for testing limits, for breaking dependent ties, and for establishing a new identity. Major conflicts center on clarification of self-identity, life goals, and life’s meaning. Failure to achieve a sense of identity results in role confusion.

Period of Life

Freud

Erikson

Ages 18-35

Genital stage continues
Core characteristic of mature adult is the freedom “to love and to work.” This move toward adulthood involves freedom from parental influence and capacity to care for others.

Young adulthood: Intimacy versus isolation. Developmental task at this time is to form intimate relationships. Failure to achieve intimacy can lead to alienation and isolation.

Ages 35-60

Genital stage continues

Middle age: Generativity versus stagnation. There is a need to go beyond self and family and be involved in helping the next generation. This is a time of adjusting to the discrepancy between one’s dream and one’s actual accomplishments. Failure to achieve a sense of productivity often leads to psychological stagnation.

Ages 60+

Genital stage continues

Later life: Integrity versus despair
If one looks back on life with few regrets and feels personally worthwhile, ego integrity results. Failure to achieve ego integrity can lead to feelings of despair, hopelessness, guilt, resentment, and self-rejection.

Comparison of Freud’s Psychosexual Stages and Erikson’s Psychosocial Stages

The Basic Philosophies

Psychoanalytic therapy

Human beings are basically determined by psychic energy and by early experiences. Unconscious motives and conflicts are central in present behavior. Early development is of critical importance because later personality problems have their roots in repressed childhood conflicts.

Adlerian therapy

Humans are motivated by social interest, by striving toward goals, by inferiority and superiority, and by dealing with the tasks of life. Emphasis is on the individual’s positive capacities to live in society cooperatively. People have the capacity to interpret, influence, and create events. Each person at an early age creates a unique style of life, which tends to remain relatively constant throughout life.

Existential therapy

The central focus is on the nature of the human condition, which includes a capacity for self awareness, freedom of choice to decide one’s fate, responsibility, anxiety, the search for meaning, being alone and being in relation with others, striving for authenticity, and facing living and dying.

Person-centered therapy

Positive view of people; we have an inclination toward becoming fully functioning. In the context of the therapeutic relationship, the client experiences feelings that were previously denied to awareness.
The client moves toward increased awareness, spontaneity, trust in self, and inner-directedness.

Gestalt therapy

The person strives for wholeness and integration of thinking, feeling, and behaving. Some key concepts include contact with self and others, contact boundaries, and awareness. The view is nondeterministic in that the person is viewed as having the capacity to recognize how earlier influences are related to present difficulties. As an experiential approach, it is grounded in the here and now and emphasizes awareness, personal choice, and responsibility.

Behavior therapy

Behavior is the product of learning. We are both the product and the producer of the environment. Traditional behavior therapy is based on classical and operant principles. Contemporary behavior therapy has branched out in many directions, including mindfulness and acceptance approaches.

Cognitive behavior therapy

Individuals tend to incorporate faulty thinking, which leads to emotional and behavioral disturbances. Cognitions are the major determinants of how we feel and act. Therapy is primarily oriented toward cognition and behavior, and it stresses the role of thinking, deciding, questioning, doing, and redeciding. This is a psychoeducational model, which emphasizes therapy as a learning process, including acquiring and practicing new skills, learning new ways of thinking, and acquiring more effective ways of coping with problems.

Choice theory/ Reality therapy

Based on choice theory, this approach assumes that we need quality relationships to be happy. Psychological problems are the result of our resisting control by others or of our attempt to control others. Choice theory is an explanation of human nature and how to best achieve satisfying interpersonal relationships.

Feminist therapy

Feminists criticize many traditional theories to the degree that they are based on gender-biased concepts, such as being androcentric, gender centric, ethnocentric, heterosexist, and intrapsychic. The constructs of feminist therapy include being gender fair, flexible, interactionist, and life-span-oriented. Gender and power are at the heart of feminist therapy. This is a systems approach that recognizes the cultural, social, and political factors that contribute to an individual’s problems.

Postmodern approaches

Based on the premise that there are multiple realities and multiple truths, postmodern therapies reject the idea that reality is external and can be grasped. People create meaning in their lives through conversations with others. The postmodern approaches avoid pathologizing clients, take a dim view of diagnosis, avoid searching for underlying causes of problems, and place a high value on discovering clients’ strengths and resources. Rather than talking about problems, the focus of therapy is on creating solutions in the present and the future.

Family systems therapy

The family is viewed from an interactive and systemic perspective. Clients are connected to a living system; a change in one part of the system will result in a change in other parts. The family provides the context for understanding how individuals function in relationship to others and how they behave. Treatment deals with the family unit. An individual’s dysfunctional behavior grows out of the interactional unit of the family and out of larger systems as well.

The Basic Philosophies

Key Concepts

Psychoanalytic therapy

Normal personality development is based on successful resolution and integration of psychosexual stages of development. Faulty personality development is the result of inadequate resolution of some specific stage. Anxiety is a result of repression of basic conflicts. Unconscious processes are centrally related to current behavior.

Adlerian therapy

Key concepts include the unity of personality, the need to view people from their subjective perspective, and the importance of life goals that give direction to behavior. People are motivated by social interest and by finding goals to give life meaning. Other key concepts are striving for significance and superiority, developing a unique lifestyle, and understanding the family constellation. Therapy is a matter of providing encouragement and assisting clients in changing their cognitive perspective and behavior.

Existential therapy

Essentially an experiential approach to counseling rather than a firm theoretical model, it stresses core human conditions. Interest is on the present and on what one is becoming. The approach has a future orientation and stresses self-awareness before action.

Person-centered therapy

The client has the potential to become aware of problems and the means to resolve them. Faith is placed in the client’s capacity for self-direction. Mental health is a congruence of ideal self and real self. Maladjustment is the result of a discrepancy between what one wants to be and what one is. In therapy attention is given to the present moment and on experiencing and expressing feelings.

Gestalt therapy

Emphasis is on the “what” and “how” of experiencing in the here and now to help clients accept all aspects of themselves. Key concepts include holism, figure-formation process, awareness, unfinished business and avoidance, contact, and energy.

Behavior therapy

Focus is on overt behavior, precision in specifying goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes. Present behavior is given attention. Therapy is based on the principles of learning theory. Normal behavior is learned through reinforcement and imitation. Abnormal behavior is the result of faulty learning.

Cognitive behavior therapy

Although psychological problems may be rooted in childhood, they are reinforced by present ways of thinking. A person’s belief system and thinking is the primary cause of disorders. Internal dialogue plays a central role in one’s behavior. Clients focus on examining faulty assumptions and misconceptions and on replacing these with effective beliefs.

Choice theory/ Reality therapy

The basic focus is on what clients are doing and how to get them to evaluate whether their present actions are working for them. People are mainly motivated to satisfy their needs, especially the need for significant relationships. The approach rejects the medical model, the notion of transference, the unconscious, and dwelling on one’s past.

Feminist therapy

Core principles of feminist therapy are that the personal is political, therapists have a commitment to social change, women’s voices and ways of knowing are valued and women’s experiences are honored, the counseling relationship is egalitarian, therapy focuses on strengths and a reformulated definition of psychological distress, and all types of oppression are recognized.

Postmodern approaches

Therapy tends to be brief and addresses the present and the future. The person is not the problem; the problem is the problem. The emphasis is on externalizing the problem and looking for exceptions to the problem. Therapy consists of a collaborative dialogue in which the therapist and the client co-create solutions. By identifying instances when the problem did not exist, clients can create new meanings for themselves and fashion a new life story.

Family systems therapy

Focus is on communication patterns within a family, both verbal and nonverbal. Problems in relationships are likely to be passed on from generation to generation. Key concepts vary depending on specific orientation but include differentiation, triangles, power coalitions, family-of-origin dynamics, functional versus dysfunctional interaction patterns, and dealing with here-and-now interactions. The present is more important than exploring past experiences.

Key Concepts

Goals of Therapy

Psychoanalytic therapy

To make the unconscious conscious. To reconstruct the basic personality. To assist clients in reliving earlier experiences and working through repressed conflicts. To achieve intellectual and emotional awareness.

Adlerian therapy

To challenge clients’ basic premises and life goals. To offer encouragement so individuals can develop socially useful goals and increase social interest. To develop the client’s sense of belonging.

Existential therapy

To help people see that they are free and to become aware of their possibilities. To challenge them to recognize that they are responsible for events that they formerly thought were happening to them. To identify factors that block freedom.

Person-centered therapy

To provide a safe climate conducive to clients’ self-exploration. To help clients recognize blocks to growth and experience aspects of self that were formerly denied or distorted. To enable them to move toward openness, greater trust in self, willingness to be a process, and increased spontaneity and aliveness. To find meaning in life and to experience life fully. To become more self-directed.

Gestalt therapy

To assist clients in gaining awareness of moment-to-moment experiencing and to expand the capacity to make choices. To foster integration of the self.

Behavior therapy

To eliminate maladaptive behaviors and learn more effective behaviors. To identify factors that influence behavior and find out what can be done about problematic behavior. To encourage clients to take an active and collaborative role in clearly setting treatment goals and evaluating how well these goals are being met.

Cognitive behavior therapy

To teach clients to confront faulty beliefs with contradictory evidence that they gather and evaluate. To help clients seek out their faulty beliefs and minimize them. To become aware of automatic thoughts and to change them. To assist clients in identifying their inner strengths, and to explore the kind of life they would like to have.

Choice theory/ Reality therapy

To help people become more effective in meeting all of their psychological needs. To enable clients to get reconnected with the people they have chosen to put into their quality worlds and teach clients choice theory.

Feminist therapy

To bring about transformation both in the individual client and in society. To assist clients in recognizing, claiming, and using their personal power to free themselves from the limitations of gender-role socialization. To confront all forms of institutional policies that discriminate or oppress on any basis.

Postmodern approaches

To change the way clients, view problems and what they can do about these concerns. To collaboratively establish specific, clear, concrete, realistic, and observable goals leading to increased positive change. To help clients create a self-identity grounded on competence and resourcefulness so they can resolve present and future concerns. To assist clients in viewing their lives in positive ways, rather than being problem saturated.

Family systems therapy

To help family members gain awareness of patterns of relationships that are not working well and to create new ways of interacting. To identify how a client’s problematic behavior may serve a function or purpose for the family. To understand how dysfunctional patterns can be handed down across generations. To recognize how family rules can affect each family member. To understand how past family of origin experiences continue to have an impact on individuals.

The Therapeutic Relationship

Psychoanalytic therapy

The classical analyst remains anonymous, and clients develop projections toward him or her. The focus is on reducing the resistances that develop in working with transference and on establishing more rational control. Clients undergo long-term analysis, engage in free association to uncover conflicts, and gain insight by talking. The analyst makes interpretations to teach clients the meaning of current behavior as it relates to the past. In contemporary relational psychoanalytic therapy, the relationship is central, and emphasis is given to here-and-now dimensions of this relationship.

Adlerian therapy

The emphasis is on joint responsibility, on mutually determining goals, on mutual trust and respect, and on equality. The focus is on identifying, exploring, and disclosing mistaken goals and faulty assumptions within the person’s lifestyle.

Existential therapy

The therapist’s main tasks are to accurately grasp clients’ being in the world and to establish a personal and authentic encounter with them. The immediacy of the client–therapist relationship and the authenticity of the here-and-now encounter are stressed. Both client and therapist can be changed by the encounter.

Person-centered therapy

The relationship is of primary importance. The qualities of the therapist, including genuineness, warmth, accurate empathy, respect, and being nonjudgmental—and communication of these attitudes to clients—are stressed. Clients use this genuine relationship with the therapist to help them transfer what they learn to other relationships.

Gestalt therapy

Central importance is given to the I/Thou relationship and the quality of the therapist’s presence. The therapist’s attitudes and behavior count more than the techniques used. The therapist does not interpret for clients but assists them in developing the means to make their own interpretations. Clients identify and work on unfinished business from the past that interferes with current functioning.

Behavior therapy

The therapist is active and directive and functions as a teacher or mentor in helping clients learn more effective behavior. Clients must be active in the process and experiment with new behaviors. Although a quality client–therapist relationship is not viewed as sufficient to bring about change, it is considered essential for implementing behavioral procedures.

Cognitive behavior therapy

In REBT the therapist functions as a teacher and the client as a student. The therapist is highly directive and teaches clients an A-B-C model of changing their cognitions. In CT the focus is on a collaborative relationship. Using a Socratic dialogue, the therapist assists clients in identifying dysfunctional beliefs and discovering alternative rules for living. The therapist promotes corrective experiences that lead to learning new skills. Clients gain insight into their problems and then must actively practice changing self-defeating thinking and acting. In strengths-based CBT, active incorporation of client strengths encourages full engagement in therapy and often provides avenues for change that otherwise would be missed.

Choice theory/ Reality therapy

A fundamental task is for the therapist to create a good relationship with the client. Therapists are then able to engage clients in an evaluation of all of their relationships with respect to what they want and how effective they are in getting this. Therapists find out what clients want, ask what they are choosing to do, invite them to evaluate present behavior, help them make plans for change, and get them to make a commitment. The therapist is a client’s advocate, as long as the client is willing to attempt to behave responsibly.

Feminist therapy

The therapeutic relationship is based on empowerment and egalitarianism. Therapists actively break down the hierarchy of power and reduce artificial barriers by engaging in appropriate self disclosure and teaching clients about the therapy process. Therapists strive to create a collaborative relationship in which clients can become their own expert.

Postmodern approaches

Therapy is a collaborative partnership. Clients are viewed as the experts on their own life. Therapists use questioning dialogue to help clients free themselves from their problem-saturated stories and create new life-affirming stories. Solution-focused therapists assume an active role in guiding the client away from problem-talk and toward solution-talk. Clients are encouraged to explore their strengths and to create solutions that will lead to a richer future. Narrative therapists assist clients in externalizing problems and guide them in examining self-limiting stories and creating new and more liberating stories.

Family systems therapy

The family therapist functions as a teacher, coach, model, and consultant. The family learns ways to detect and solve problems that are keeping members stuck, and it learns about patterns that have been transmitted from generation to generation. Some approaches focus on the role of therapist as expert; others concentrate on intensifying what is going on in the here and now of the family session. All family therapists are concerned with the process of family interaction and teaching patterns of communication.

The Therapeutic Relationship

Limitations of the Approaches

Psychoanalytic therapy

Adlerian therapy

Existential therapy

Person-centered therapy

Gestalt therapy

Behavior therapy

Cognitive behavior therapy

Choice theory/ Reality therapy

Feminist therapy

Postmodern approaches

Family systems therapy

Limitations of the Approaches

116
116
116

DEVELOPING YOUR

THEORETICAL

ORIENTATION IN

COUNSELING AND PSYCHOTHERAPY

Third Edition

DUANE A. HALBUR

Georgia Military College

Life Management Group, Inc.

KIMBERLY VESS HALBUR

Medical College of Georgia at Georgia Regents University

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Library of Congress Cataloging-in-Publication Data
Halbur, Duane.
Developing your theoretical orientation in counseling and psychotherapy/Duane A. Halbur, Kimberly Vess Halbur.—Third edition. pages cm
Includes bibliographical references and index.
ISBN 978-0-13-348893-7
ISBN 0-13-348893-4
1. Psychology—Philosophy. 2. Counseling. 3. Psychotherapy. I. Halbur, Kimberly Vess. II. Title.
BF38.H33 2015
158.3—dc23
2014011528
10 9 8 7 6 5 4 3 2 1
ISBN 10: 0-13-348893-4 ISBN 13: 978-0-13-348893-7

In memory of

Edna May Thompson and

Carol Lynn Halbur,

who gave us much love and many of our theories about life and helped us to pass them along to our children

Dominic Anthony Halbur and

Carolyn Maye Halbur

About the Authors

Dr. Duane Halbur’s research interests include the needs of school counselors, philosophical counseling, and the integration of technology in counseling. Along with teaching and writing, he works as a licensed counselor in private practice specializing in children and families in transition. Dr. Kimberly Vess Halbur’s research includes cultural competencies for the helping professions and medical fields.
iv

We first wrote Developing Your Theoretical Orientation in Counseling and Psychotherapy with the objective of assisting other helping professionals through finding their theoretical orientation more easily than we did. We realize that the term helping professionals may seem generic, but we use it in an effort to include helpers who work with diverse populations in a wide array of fields. Specifically, we are speaking to mental health counselors, psychologists, social workers, school counselors, substance abuse counselors, psychotherapists, and peer helpers. This third edition attempts to assist clinicians further in finding their theoretical orientation in a diverse society while enjoying the process of self-exploration. The theories are presented in a way that allows the reader to identify quickly the philosophical and cultural foundations of the theories while accessing the goals and techniques of the theories.
Because the work of helping professionals needs to be grounded in theory, we have featured in this text an innovative model for selecting a theoretical orientation and hands-on activities to assist readers in their quest for a theoretical approach to helping. Learning activities, reflection questions, and case studies are included throughout the text, with several featured prominently in Chapter 5. These activities have been updated to demonstrate traditional and contemporary theories as well as multicultural perspectives so important to the helping fields.

Preface

The Intentional Theory Selection (ITS) model is a contemporary model for selecting a theoretical orientation. This model can assist helpers in finding a theory that is congruent with their personal values. We also acknowledge that the selection of a theoretical orientation may be quite cyclical. Just as in life, change in theoretical orientation is constant and inevitable. Thus, a professional helper may revisit the model many times throughout his or her career.
This text may also serve as a reminder or overview of the foremost helping theories and their respective schools of thought. We provide readers with a reminder of the basic philosophies, goals, and techniques of the major theories of counseling. We hope this text offers just enough information to remind professional helpers of what they already know while enticing them to seek out and learn more about a presented theory.
In addition to a summary of selected counseling theories, students and counselors will be exposed to 10 applied ways to aid in the self-discovery process. This self-discovery will begin the readers’ processes of intentionally finding a theoretical orientation that is congruent with their own worldview, beliefs, and values. The Selective Theory Sorter– Revised (STS–R) is a survey that was developed to help students and counselors discover which researched theories they might endorse. This sorter, more important in self- discovery than in assessment, is one of several tools that will be offered to readers while they are in the process of finding their own theoretical orientation.
We hope that readers find the material and the ITS model refreshing and at the same time meaningful. Those in the helping professions know, through research and
v

PREFACE
observation, that theory is important. Many innovators, researchers, and clinicians have dedicated their research and life work to finding techniques and philosophies that can best serve our clientele. We owe so much to these pioneers who have helped us to be effective and ethical in the work we do.
The helping professions are truly important to a developing society. Helping professionals have the opportunity to prevent and remediate when they serve in a field that makes its daily impact by improving the lives of others. As you work on your own professional identity and struggles, remember that this opportunity is both a blessing and a responsibility. In this text, as in many endeavors in your professional life, you will be asked to look inward. As professionals, we ask this of clients; as authors, we ask this of you. Take this opportunity to challenge yourself and grow.
We have presented the ITS model and the STS–R at many professional conferences and have greatly appreciated the feedback and the anticipation for this project to be in print for a third time. We still receive emails and phone calls from faculty members who have adopted the text and their students who have enjoyed using it. The interest we have received professionally has served as a muse and motivation for us to improve and update it in this third edition.
NEW TO THIS EDITION
The third edition of Developing Your Theoretical Orientation in Counseling and Psychotherapy offers the following new elements:
■ An increased focus on diversity, including commentary regarding the application of each theory in a culturally rich profession.
■ A greater review of the implications of empirically validated treatments.
■ A greater review of the implications of common-factor approaches to counseling.
■ An expansion and update of the counseling theories, which are necessary for the successful completion of national and state counselor examinations, including updated techniques.
■ Greater explanation of the application of multicultural counseling and feminism.
■ Increased focus on material that readers will find relevant to Counseling for Accreditation of Counseling and Related Educational Programs™ (CACREP) 2016 Standards.
■ Updated websites related to theories and theoretical training to allow readers quick access to more information.
■ Updated cases to assist readers through the process of choosing their theoretical orientation.
With the addition of several new topics, the references have been updated significantly since the previous editions. Readers with experience with the first and second editions will also note a more consistent voice throughout the text.
We would like to thank the reviewers of our manuscript for their insights and comments: John P. Galassi, University of North Carolina at Chapel Hill; Terence Patterson, University of San Francisco; David Shriberg, Loyola University of Chicago; and Amy M. Williams, University of Northern Colorado.
vi

vii

CHAPTER ONE
Why Theoretical Orientation is Important 1
A PERSONAL EXPERIENCE 1

THE BIG PUZZLE 2

WHAT IS THEORETICAL ORIENTATION? 3

THE HELPER’S TOOL BELT 3

WHAT CAN A THEORETICAL ORIENTATION DO FOR ME? 4

HOW HAVE OTHERS PICKED A THEORETICAL ORIENTATION? 5

WHAT IF I’M ECLECTIC? 6

EMPIRICALLY VALIDATED THERAPIES: ARE THEY BETTER? 8

GUIDANCE FROM COMMON FACTORS: DO THEY ALL WORK? 9

ONCE I HAVE IT, HOW CAN I USE IT? 10

HOW ARE THEORETICAL ORIENTATION AND ETHICS RELATED? 10

THE MAIN POINTS 11
Contents

REFLECTION QUESTIONS 11

CHAPTER TWO
Incorporating Theory into Practice 13
MAKING THEORY USEFUL: A MODEL 13

THEORY DEVELOPMENT 14

IMPORTANCE OF YOUR LIFE PHILOSOPHY 15

LIFE PHILOSOPHY—IT’S PERSONAL 16

SCHOOLS OF THOUGHT 17

THEORIES 18

GOALS AND TECHNIQUES: INTERVENTIONS AT WORK 19
vii

CONTENTS
COUNSELORS ARE DIVERSE 20

RESISTANCE TO THEORIES: ECLECTIC, INTEGRATED, OR JUST DON’T KNOW 21

DOES IT REALLY WORK? 23

WHAT TO TAKE HOME 24

REFLECTION QUESTIONS 25

CHAPTER THREE
Top 10 Ways to Find Your Theoretical Orientation 27
FIND YOURSELF 28

ARTICULATE YOUR VALUES 29

SURVEY YOUR PREFERENCES 30

USE YOUR PERSONALITY 30 Taking the MBTI 37
CAPTURE YOURSELF 37

LET OTHERS INSPIRE YOU IN YOUR LEARNING 38

READ ORIGINAL WORKS 38

GET REAL 38

STUDY WITH A MASTER 39

BROADEN YOUR EXPERIENCES 40

TOP 10 WRAP-UP 40

REFLECTION QUESTIONS 41

SUGGESTED READINGS AND WEBPAGES 41

CHAPTER FOUR
Six Schools of Thought and Their Theories of Helping 45
PSYCHODYNAMIC SCHOOL OF THOUGHT 48
Psychoanalytic Theory 48
Analytical Theory 53
Individual Psychology 55
vi

CONTENTS ix

BEHAVIORAL SCHOOL OF THOUGHT 58
Behavioral Therapy 58
HUMANISTIC SCHOOL OF THOUGHT 61 Person-Centered 62
Existential 64 Gestalt 67
PRAGMATIC SCHOOL OF THOUGHT 70
Cognitive-Behavioral 70
Rational Emotive Behavioral Therapy 72 Reality Therapy 74
CONSTRUCTIVIST SCHOOL OF THOUGHT 76
Multicultural Counseling and Therapy 77
Feminist Therapy 79
Narrative Therapy 81
Solution-Focused Brief Therapy 84
FAMILY APPROACHES SCHOOL OF THOUGHT 86
Bowen Family Systems Therapy 86
Strategic Family Therapy 88
Structural Family Therapy 89
Family Therapies and Diversity 91
SUMMARY 92

REFLECTION QUESTIONS 92

CHAPTER FIVE
Case Examples for Integrating Theory into Practice 93
CLINICIAN CASE STUDIES 93 Case One: Evan 93
Case Two: Jill 95
Case Three: Garrett 97
Case Four: Lillian 99
Comment on the Cases 101
CLIENT CASE STUDIES 102
Case One: Tony 102
Case Two: Nancy 102
Case Three: Brenda 103

CONTENTS
SUPERVISION CASE STUDIES 104
Case One: Grace 104
Case Two: Casey 104
Case Three: Dominic 105
Summary of Supervision Case Studies 106
PUTTING IT ALL TOGETHER 106
Importance Revisited 106
How Theory Is Found 106
Benefit of the ITS Model to the Field 107
References 109
Index 115

x
x
xiv

A PERSONAL EXPERIENCE
Since our first years of teaching graduate counseling classes, students have often asked, “How did you decide your theoretical orientation?” This question is reasonable and understandable because students in the helping professions are frequently asked about their theoretical orientation. Thus, we began pondering the development of our own theoretical orientations, which centered inevitably around three core issues: personalities, mentors and supervisors, and clients.

Why Theoretical
Orientation is
Important

First, we contemplated how personality might play a role in the theories that we liked and the ways we worked with clients. For example, one of us is an outgoing, energetic person who reflects these traits in interactions with others, both personally and professionally, and who sets high standards and believes that, in general, people strive to do what they believe is right. The other tends to focus on philosophical understanding, however, and consequently practices existential questioning in everyday life. These personal tendencies greatly influence our theories. One of us focuses on social and humanistic theories, while the other works with theories that have strong philosophical foundations. Personal qualities, values, actions, and assumptions clearly have an impact on our theoretical orientations and consequently on our work with clients.
Next, we thought about our mentors and supervisors and the various theoretical orientations they espoused. For instance, one mentor was very clearly humanistic and relied on Gestalt interventions. Some faculty members were fairly diverse in their theoretical orientations and championed constructivist, client-centered, cognitivebehavioral, and ecological approaches. One clinical supervisor said that he was a “planned eclectic.” These mentors and supervisors greatly affected our choices of theoretical orientation. Their feedback, guidance, and expectations were always tinted by their theoretical orientations. As a result, we knew that they had affected our choices as well; we were just not sure how.
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Acknowledging that we had been exposed to a wealth of theoretical orientations, we began to think about past and present clients with whom we had worked. We thought about how effective our theoretical orientations were for them. We c oncluded that each client must have also affected us as we selected our theoretical orientations. Despite, or perhaps because of, our examinations of these theoretical orientation issues, we seemed to answer students by saying, “You just figure it out as you go along.
When a theory really ‘fits’ for you, you will know it.”
But we knew this answer was not satisfactory. We remembered all too well our first years as helping professionals. We had often been quizzed about our own theoretical orientations and yet we had not been given any tools other than the required survey course in major theories to guide us. As we recounted our own similar struggles, we were reminded in many ways just how important theoretical orientation is in the helping professions. Thus, we wanted to offer clinicians and our students specific strategies to use in developing their theoretical orientation.
THE BIG PUZZLE
Selecting a theoretical orientation is typically a puzzling experience for students in the helping professions. A common goal of training programs is to teach effective helping skills. Academic programs also strive to help students conduct counseling in a way that is intentional and theory based. Consequently, students are frequently asked during the course of their graduate programs to state their theoretical orientation, typically by writing a paper about it. The assignment usually goes something like this: After reading a brief overview of counseling theories, which one do you believe fits your style of counseling?
Although this assignment is valuable, it may occur too early in the education of professional helpers. Because these students do not yet have enough clinical experience to guide them, they typically respond to the theoretical orientation assignment by picking theories that sound good on paper. Students at this stage usually have little understanding of the theories they choose. Unfortunately, many students continue to support, research, and apply their chosen theory, which ultimately limits their overall understanding of counseling theories. Some students simply choose the instructor’s theoretical orientation in hope of receiving a high grade on the assignment. Others pick the theory that they understand best. It is not that students are attempting to be lazy or manipulate instructors for a higher grade; rather, they are overwhelmed by the multitude of theories and therapeutic interventions to which they are exposed. Even when students find theories that they like on paper, they often feel lost and unable to apply theory to practice. Hence, most students in the helping professions find it extremely difficult to develop and articulate in both words and practice their own theoretical orientation. This dilemma can easily be compared to the experience of holding pieces to a jigsaw puzzle without having the picture on the front of the box that contained the puzzle pieces. In this situation, the corner and the edge pieces are easily identified, but the central pieces are difficult to discern.
On the journey to finding a theoretical orientation, the role of soul searching and clinical practice cannot be emphasized enough. Although this text does not offer
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direct clinical experience, it does provide for self-evaluation and soul searching. This text does offer applied methods to assist students and clinicians as they look for their theory of counseling. Within these pages you will first be offered the Intentional Theory Selection (ITS) model, which can serve as a guide to make finding your theoretical orientation a process. Tools, such as the Selective Theory Sorter–Revised (STS–R), will also be offered to serve as pragmatic assistants. Many resources, theory summaries, reflective questions, and case studies will also be offered to help clinicians and counselors-in-training begin to complete a puzzle that culminates in forming their theoretical orientation.
WHAT IS THEORETICAL ORIENTATION?
Before students in the helping professions can begin the voyage to finding and solidifying a theoretical orientation, they must have a working definition of the term theoretical orientation. This definition enables students, counselors, and the field in general to have a similar idea of what being theoretically orientated means. Poznanski and McLennan (1995) provide an excellent definition: A theoretical orientation is “a conceptual framework used by a counselor to understand client therapeutic needs” (p. 412). More specifically, theoretical orientation provides helpers with a theory-based framework for “(a) generating hypotheses about a client’s experience and behavior, (b) formulating a rationale for specific treatment interventions, and (c) evaluating the ongoing therapeutic process” (Poznanski & McLennan, 1995, p. 412). Thus, theoretical orientation forms the foundation for helping professionals in counseling, social work, and applied psychology. Having a theoretical orientation provides helpers with goals and techniques that set the stage for translating theory into practice (Strupp, 1955).
As students in the helping professions learn skills and theories, they often struggle with ways to integrate the information. Yet theory and practical application need a balance (Drapela, 1990). In counseling classes, for example, students may learn to express empathy and to confront, but they do not yet understand how to practice those skills with the intention that follows from a specific theoretical orientation. By choosing a theoretical orientation to practice and applying it, a counselor is able to use general counseling skills in an applied and intentional way.
THE HELPER’S TOOL BELT
Once counselors learn the basic helping skills, they have the opportunity to use them in an intentional way. In many ways, a theoretical orientation serves as a tool belt. The tool belt is filled with a multitude of tools that serve different functions. Among the tools, counselors will find the basic skills of confrontation, reflection of feeling, openended questions, and empathy. Additionally, counselors who have a theoretical foundation have tools specific to their theory. For example, a Gestalt counselor has the tool of the empty-chair technique, and the behaviorist counselor has the tool of behavioral contracting. Any of these tools can be useful in the construction (helping)
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process. All of the techniques have the potential of achieving the same desired result: helping the client. The difficult part is knowing when to use each tool. Continuing with the tool belt analogy, there is an old adage that says something like this: “If you only have a hammer, everything looks like a nail.”
For example, a student enrolled in a graduate counseling program is seeing a client at his practicum site. The client, a college freshman, is very frustrated with her mother and anxious about going home over the holiday break. The student believes that the client needs to express her feelings toward her mother. Depending on the counselor’s theoretical orientation, the tool selected for the expression of the client’s feelings may vary. If the counselor prefers rational emotive behavioral therapy (REBT), he may explore with the client her beliefs about going home for the holidays. If the counselor works from an existential framework, he might encourage the client to be authentic with her mother regarding her feelings of frustration. If the counselor ascribes to Gestalt theory, however, he may decide to use the empty-chair technique, prompting the client to express her feelings during the session. In this particular case, the counselor decides to use the empty-chair technique. The intervention looks somewhat awkward, and the counselor is clearly uncomfortable with the intervention and the processing of it with his client. After the session, the counselor says to his instructor, “Wasn’t that awful? I can’t believe it didn’t work. I really thought the c lient would like it.” Unfortunately, the counselor picked an intervention that really was not in his typical tool belt because his natural theory was REBT. He used an intervention, a tool that was not congruent with his theory. Although you can use a wrench to pound a nail, it will likely not feel right and may not be as effective.
WHAT CAN A THEORETICAL ORIENTATION DO FOR ME?
A theoretical orientation provides helpers with a framework for therapy that sets the foundation for intentional counseling. For the counselor, being intentional is a prerequisite to ethical and effective helping. Theory is an important factor in structuring therapy and directing interventions (Hansen & Freimuth, 1997). Consequently, intentional counseling requires counselors to rely on their theoretical orientation to guide therapy. Thus, when counselors get lost in the therapeutic process, theory can provide a road map. Theory is also a way for counselors to organize and listen to data and information given to them by clients. A number of theories provide specific steps to treatment planning; these steps may assist counselors in being intentional and consistent in their role as a therapist. Ideally, counselors’ interventions stem from their theoretical orientation; however, human beings do not fit neatly into categories. Hackney (1992) has written eloquently about theory and process, stating that, like human nature, “client problems are typically multidimensional” (p. 2). The following is a clinical example.
Louis, a 23-year-old, Mexican-American male seeks therapy. During the initial interview, he states: “I am a loser. I have a college degree and can’t get a job. I don’t ask people out on dates because I know they’ll see immediately that I’m a loser. When I do
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go out to meet people, women seem to avoid me.” The therapist believes the client has a problem with self-esteem. While self-esteem is an important facet of the client’s experience, it needs to be viewed from a larger perspective. The client’s problem seems to encompass his thinking, feeling, behavior, and interactions with the world around him. A therapist who has a specific theoretical orientation will be able to view the client holistically, knowing that the theory will provide a road map for the therapy.
Espousing a theoretical orientation to helping has numerous benefits for both clinicians and the clients they serve. Specifically, a theoretical orientation provides ways to organize client information. An orientation can also help intentionality and consistency within the work of a professional helper. Although the helper should understand what a theoretical orientation is, why it is important, and what it can do for both the client and the counselor, this information provides little help to a counselor who must pick a theory from which to work. The ways in which others have picked a theory may help students understand where they can go to pick a working theory.
HOW HAVE OTHERS PICKED A THEORETICAL ORIENTATION?
Hackney (1992) noted that most helpers choose their theoretical orientation based on one of three considerations: (1) the theoretical orientation of the helper’s training program, (2) the helper’s life philosophy, and/or (3) the helper’s professional experience as a client. Some helpers also consider the evidence supporting the various therapies or even look at the common characteristics of effective therapies. While helpers commonly use these traditional methods to find their theoretical orientation, each has inherent pitfalls. The shortcomings of each of these methods will be discussed in order to provide a rationale for a new model of choosing a theory that is presented in Chapter 2.
First, initial training programs may or may not expose students to every theoretical orientation. For example, if faculty members at the same institution support the same theoretical orientation, they limit their students’ exposure to the myriad of available theories. Conversely, if students enroll in an academic program where every faculty member has a different theoretical orientation, the students may receive mixed messages about “effective” therapy. Another potential difficulty for students is underexposure to the process of developing a personal orientation because faculties choose not to discuss their own theoretical orientations in hopes of being unbiased in their teaching. Thus, a theoretical orientation to helping cannot be based solely on students’ training programs.
Second, some counselors base their theoretical orientation on their own personality and philosophy of life. This approach can also present difficulties. For example, counselors who are predominantly optimistic and believe the best about people may choose a humanistic approach. Other counselors may believe that people’s thoughts are the core of their problems and choose REBT as a way to help clients develop more rational thinking. Both beliefs ultimately influence how counselors perceive, interact with, and treat their clients, even if those clients have a personality and worldview
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much different from those of the counselors. Although theory provides a framework for working with most clients, counselors must remember that each client is unique. A counselor must remain both open to experience and flexible with clients.
The third way helpers determine their theoretical orientation is through clinical experience, even though helpers may realize that their theoretical orientation does not fit for all clients or clinical situations. For example, counselors who favor a humanistic orientation may have difficulty in career-counseling settings. While these counselors may be skilled at the reflection of feeling, genuineness, and rapport building that lay at the core of the humanistic approach, their clients who are seeking résumé reviews and job information may feel frustrated when they get a “listening ear” but not the results they expected, such as direct advice on finding an internship or tips on interviewing.
In such cases, counselors need to adjust their theory to fit the needs of the client.
The fourth strategy employed by counselors to determine their theoretical orientation is choosing an evidence-based theory. While this is a sound decision-making strategy, it may be difficult for counselors to find an evidence-based theory that fits their personality, values, and/or client needs. Those who choose their theory in this way limit themselves to theories that lend themselves to empirical testing and validation. For example, therapies that focus on helping clients strive toward actualization and personality change may not be easy to validate and thus may be ignored in the process of choosing a theoretical orientation.
Counselors not only must maintain their fundamental beliefs and values regarding the helping relationship but also must adapt their interventions to help the client. In the example of the humanist in the career-counseling situation, he may choose to hold onto the belief that people are basically good and striving for actualization. However, in an attempt to meet the needs of the client, the humanistic career counselor may be open to a change of perception—one that acknowledges that formal career exploration can lead to greater actualization. In another example, while attempting to be grounded in theory, a cognitive-behavioral therapist utilized cognitive techniques that were not appropriate for her client because the client had low intellectual functioning. In attempting to stay completely in harmony with her theory, the therapist was not meeting her client’s needs. Consequently, she had to adapt her style and take a more behavioral approach.
WHAT IF I’M ECLECTIC?
Most examples provided in the text thus far highlight a counselor with one specific theoretical orientation. However, many counselors do not believe that one size fits all and believe that they can best serve their clients by offering a variety of approaches to their clients. Thus, they believe there is better efficacy in applying different theories and techniques to different clients. In general, eclecticism has been found to be a practiced theoretical orientation (Norcross, 1997), with many offering it as their primary identified theory. However, some cautions about eclecticism should be noted. First, eclecticism requires extensive training and competency, which beginning counselors typically lack (Norcross, 2005). To truly be an effective, eclectic counselor, clinicians
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should be able to be intentional in their application of techniques. They should have a great understanding of what techniques to apply when specific symptoms present or specific client characteristics emerge. Often those that purport to be eclectic share that their goals include assessing their clients, identifying clients’ needs, and providing those techniques or therapies that would be most beneficial to the clients. This, however, takes a great deal of skill and knowledge. It is truly a daunting task, during the complex interchange of a therapy session, to assess a client and pull from one’s repertoire the “right” technique or the “right “therapy” that will meet a presenting client’s needs. In addition, many who identify as eclectic have not completely identified and acknowledged the differences between technique and theory. Most who identify as eclectic refer to the eclectic component of their work as the action stage where interventions are offered to clients. Thus a potentially more accurate way to describe their work is by saying that they offer a variety of techniques or interventions.
Most eclectic counselors have an overarching theory that guides their work. Although this may not be true of all eclectic counselors, in practice, most counselors have a theoretical orientation they lean toward or even consider their primary orientation. “Switching” theoretical orientations to meet client needs does indeed seem to make sense. In the field of counseling, however, theoretical orientation offers a framework for how a clinician might view development, pathology, and the counseling relationship itself. Altering one’s view, or application of, such constructs while in the middle of a therapeutic relationship would seem to be almost risky to the productivity of therapy and could even be confusing to clients. If a clinician is to choose eclectic as an approach, however, it would seem that he or she should have a vast understanding of the theories and therapies they hope to utilize with clients. Thus, the authors of this text and many others recommend that beginning counselors may be best served by developing a single theoretical orientation that works best for them and learning to be as effective as possible within that paradigm.
However, eclecticism is indeed endorsed by many counselors, so its merit should not be just thrown out. Sometimes eclecticism is titled strategic eclecticism, highlighting the intentionality and purposefulness of using a wide variety of therapies and techniques. However, the authors offer a reframe. There is a difference between being eclectic and applying a variety of techniques. A counselor who is truly eclectic in terms of theory would change fundamental beliefs about human development, psychopathology, and epistemology from situation to situation and from client to client. However, applying a variety of techniques while maintaining a firm foundation in a fundamental belief is a different process. For example, an existential therapist working with a client with a phobia may use systematic desensitization (an eclectic technique for a t raditional existentialist) while maintaining that removing such a phobia will enable the client to move toward greater actualization and live a more meaningful life (theoretically founded).
Being grounded in a theoretical orientation does not stop you from being flexible to the needs of clients. To truly serve clients, we should be fluid in the process and adaptable in the relationship. We should be willing, and competent, to be able to understand clients from a variety of perspectives. Their symptoms, characteristics, and immediate needs should affect how therapists work with clients. As a therapist
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works with diverse clients and their needs, however, flexibility and eclecticism in fundamental beliefs seems like a potential disservice not only to clients but also to therapists who strive to be congruent, ethical, and effective.
EMPIRICALLY VALIDATED THERAPIES:

ARE THEY BETTER?
Similar to those who choose eclecticism as an answer to the question of theoretical orientation are those who choose how to work with clients based on research. Some clinicians and researchers believe that the best way to decide how to work with clients is by examining the research and seeing what, through scientific inquiry, we know are effective therapies. Research in the fields of counseling, psychology, and the related helping professions has produced a variety of empirically validated therapies (EVTs), with a large number of those being “proven” (see Chamless et al., 1998) to work.
Those who promote using EVTs or empirically supported treatments (ESTs; see Parson, 2009) as the focus of their work worry less about what theory to “choose” and instead ask what technique or theory is “proven” to work with the client issue that is presented. To discover EVTs, specific techniques are typically applied to clients with an isolated or limited symptomology through the use of controlled research methods to see which therapies indeed prove to be most effective for specific clients and specific symptoms. This commonsense approach is becoming vastly popular through the helping professions; however, it does present some difficulties.
Many of these proven approaches specifically look at therapies that attempt to address one specific symptom. Most of the EVTs discovered do not promote client health and welfare or alleviate diagnosed disorders. They look instead at how specific symptoms can be reduced or eliminated. Thus, EVT techniques are predominately behavior-based because there is a propensity to measure symptoms while using these techniques.
Consequently, although the EVT argument is often presented as relevant when discussing clinicians choosing a theoretical orientation, most EVTs are not theories at all. This is partly because, for a therapy to be empirically validated, it must “be studied as a treatment for a disorder or problem, be manualized, and be validated either by two different studies done using a randomized clinical trials design, or by use of a single-subject design (traditionally of relevance primarily to behavioral therapies)” (Bohart, O’Hara, & Leitner, 1998, p. 142). Thus, they may be categorized more accurately as techniques or collections of interventions. In addition, many of these therapies do not, as a theory would, provide conceptualization of clients, perspectives of development, or frameworks for the progression of therapy. They are focused on the relief of specific symptoms and include approaches such as interactive behavioral therapy (IBT) for people with intellectual disabilities (Tomasulo & Razza, 2009), dialectical behavioral therapy (DBT) for people with borderline personality disorder (Hoffman & Steiner-Grossman, 2012) and for eating disorders (Safer, Telch, Chen, & Linhan, 2009), and cognitive behavioral therapy for panic disorder (Craske & Zunker, 2001).
Many of the studies validating these approaches analyze interventions and approaches with clients that have specific symptoms (Yalom, 2002) and not with
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clients with complicated diagnoses. Although there is scientific support for the use of empirically validated therapies, there is limited ability about generalizing findings to a diversity of clients and symptomologies. As Yalom (2002) states, however, “nonvalidated therapies are not invalidated therapies” (p. 223).
GUIDANCE FROM COMMON FACTORS:

DO THEY ALL WORK?
Theories vary greatly in their depth, complexity, and usefulness. In the counseling field, there really could be as many theories, and there likely are, as there are counselors. However, the theoretical approaches that are generally published are those proven to have some generalized effectiveness (Kottler, 1999). Some answer the question of choosing their theoretical orientation by looking at the characteristics from all theories of counseling and examining the commonalities and the effectiveness about all of them. This so-called dodo bird effect states that factors common to all the various counseling theories account for the efficacy of all of the currently practiced psychotherapy theories (Leibert, 2011; Wampold, 2001). This effect states that we can find common, curative characteristics (Grencavage & Norcross, 1990) that occur in counseling and therapeutic relationships to explain why therapy ultimately works.
Wampold sought data for differential efficacies among therapies but discovered the opposite. Wampold ascribed this to the common factors theory of uniform efficacy among all existing psychotherapies. The idea that common factors among the different counselors are what account for their efficacy was first proposed by Rosenzweig (1936). This concept received little attention until nearly 40 years later, when Luborsky, Singer, and Luborsky (1975) found empirical data to suggest that all therapies had nearly equal outcomes, thereby confirming the accuracy of the dodo bird effect. Since that time, numerous studies have been done and articles have been written that support the dodo bird effect (Assay & Lambert, 1999; Duncan, 2002; Wampold et al., 1997).
Assay and Lambert (1999) concluded from their empirical study comparing various therapies that specific factors or techniques accounted for only 15% of the variance in treatment outcome, whereas common factors accounted for the remaining 85%. Specifically, they found that client factors (what the client brings to therapy) accounted for the majority of the variance in outcome (40%), followed by relationship factors (30%) and by placebo, hope, and expectancy (15%). Wampold (2001) offered similar common factors, including alliance, allegiance, adherence, and counselor effects.
Of particular importance are Assay and Lambert’s (1999) expectancy factor and Wampold’s (2001) allegiance factor. Expectancy involves the clients’ belief in the credibility of the theory and thus their expectation that it will be helpful and produce positive change. Allegiance involves a condition similar to that of expectancy, except it is the counselor who must believe that the treatment he or she is offering is efficacious. The concepts of expectancy and allegiance parallel Frank’s (1973) assertion that counseling is most helpful when both the client and the counselor believe in its efficacy. Arthur (2001) expressed a similar sentiment regarding efficacy in his review
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of studies on factors contributing to counselors’ choices of theoretical orientation. These common factors lead to the first consideration for counselors-in-training when choosing a theoretical orientation: They must assess whether they believe in the theory themselves and whether they believe they can convey that conviction to clients sufficiently to gain their acceptance of the theory as well.
Finding what is common and effective in various theories of therapy has proven successful to researchers (eg., Grencavage & Norcross, 1990) and beneficial to clinicians (Halbur & Halbur, 2006) across the various counseling theories. If people accept wholeheartedly the premise of the dodo bird, then what theoretical orientation one chooses is not nearly as important as that a theoretical orientation is chosen. As stated above, research on common factors theory has suggested that, although all major theories have the potential for equally effective outcomes, counselors’ belief in their theory is critical to its actual effectiveness (Arthur, 2001; Assay & Lambert, 1999; Frank, 1973; Wampold, 2001).
ONCE I HAVE IT, HOW CAN I USE IT?
Once a counselor’s theoretical orientation is developed, it must be put into action. Counselors are often ready to jump in with one of the many techniques shown to be effective with clients (e.g., Erford, Eaves, Bryant, & Young, 2010). It is important to know first, however, how to move forward. Theoretical orientation is used as a blueprint to organize a client’s information as well as a tool to guide clinical decisions, diagnosis, intervention selection, and treatment planning. Theoretical orientation can help determine the direction of and activities used during the course of counseling. Certainly, counselors use theory to explain or conceptualize clients’ problems. According to Kottler (1999), theory is “the place to start when you are trying to sort out a complex, confusing situation” (p. 30). Similarly, Strohmer, Shivy, and Chodo (1990) suggest that counselors may also use theoretical orientation to confirm selectively their hypotheses regarding their clients. Not only does theoretical orientation help in case conceptualization, diagnosis, and treatment planning, but it may also allow for a clinician to behave ethically.
HOW ARE THEORETICAL ORIENTATION AND ETHICS RELATED?
Clinicians are ethically and often legally bound to have a theoretical foundation. Informed consent is a component of many professional ethical codes, including those of the American Counseling Association (ACA), the American Psychological Association (APA), and the National Association of Social Workers (NASW). Each of these professional ethics codes states that clients enter the helping relationship with informed consent. Implicit within the notion of informed consent is that helpers should share their theoretical orientation with clients or must at least be able to articulate their theory if asked by clients. Helpers who share their theoretical orientation
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with clients allow them to make an informed choice to engage in therapy. Thus, helpers need to be able to articulate their theoretical orientation and how it affects the helping relationship and the therapeutic process. In addition, many states dictate that licensed practitioners provide their clients with a professional disclosure statement. Such a statement usually orients the client to the counseling process and typically includes information about the helper’s educational background and areas of expertise, the length of sessions, the responsibilities of each party, the hourly fee, and the helper’s theoretical orientation. Thus, helpers need to be able to articulate their theoretical orientation in order to meet these ethical and professional obligations.
THE MAIN POINTS
In summary, counselors must develop a theoretical orientation that gives them the tools to build ethical, helping relationships based on their values, personality, and intention. Choosing a theory, “a conceptual framework used by a counselor to understand client therapeutic needs” (Poznanski & McLennan, 1995, p. 412), is an ongoing process that will ultimately make counselors more confident and effective in serving the needs of their clients. Within the chapter, the processes that counselors often engage in to determine their theory range from finding their theory based on their own therapeutic experiences to examining research on empirically validated therapies.
In the following chapters, readers will be assisted in developing their theoretical orientation through many forms of self-examination. The Intentional Theory Selection (ITS) model, which is presented in Chapter 2, offers a framework for finding a theoretical orientation. Chapter 3 builds on this model by offering reflection questions, activities, value clarification, and the Selective Theory Sorter as ways to help counselors understand theories that are most likely congruent with who they are and the potential work they do and will do with clients. In the remaining chapters, theory is offered in a pragmatic way following the ITS model, and clinical and supervisory examples of the ITS model in action are discussed.
REFLECTION QUESTIONS
1. If you had to select your theoretical orientation today, what would it be? How confident are you with your current choice of theoretical orientation?
2. What experiences have you had with clients that either support or negate your current theoretical orientation?
3. What influences have faculty members and supervisors had on your theoretical orientation?
4. What do you see as advantages and disadvantages to using empirically validated therapies?
5. What steps do you need to take to increase your allegiance to the theories in which you are interested?
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Incorporating
Theory into
Practice

Practitioners and researchers alike contend that, for effective and intentional counseling to occur, helping professionals must adopt a comprehensive counseling theory. Theory serves as a conceptual framework and guide to interventions and assists helpers in the process of effective counseling. Thus, being theory driven is important, but clinicians have many theories to understand. And knowing the various theories and espousing one specific paradigm are not sufficient for helpers to translate theory into practice. Placing theory on a practical level requires more than textbook knowledge and a desire to be theory based. First, a helper must make an intentional cognitive shift. This shift, which is necessary for the most effective counseling, starts with a process of self-exploration; is built on a foundation of knowledge; and, if successful, culminates with the ability to move to client-counselor action. For the greatest therapeutic gains, helpers should begin to think in new ways. However, understanding and integrating a personal theory of counseling is often a foreign p rocess, especially to the neophyte helper.
MAKING THEORY USEFUL: A MODEL
Making theory practical requires a process that starts with increased self-knowledge and ends with techniques to help clients. In counseling practicum and fieldwork courses, students often ask, “Now what do I do with him?” or “What technique do you think would be best to use with her now?” Although quite relevant, these questions are similar to a golfer asking a caddy which clubs to use before learning the art of the golf swing. For you, as a helper, to do ethical and intentional counseling, a process of development must occur.
This development is not a linear process. Cognitive and personal changes will likely occur as you have new experiences and learn more about yourself and the world around you. Consequently, beginning helpers, as well as the most seasoned professionals,
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will have moments where their theoretical orientation is challenged or influenced. Although challenges are difficult, the helper must undergo intentional development to become more confident and effective.
If traveled successfully, the road to development begins with self-reflection and ends with application. Making theory practical starts with the understanding of what we call life philosophy. Obviously, as your life experiences change, your view of the world also changes. Thus, your counseling theory and ultimately the techniques you use may change over the course of your career. A commonly expressed fear of many beginning counselors is that, once they have adopted one theory, it will be tattooed on their foreheads for all instructors, supervisors, and future clients to judge. This worry is unnecessary because, as helpers change, so may their theory.
THEORY DEVELOPMENT
Through self-awareness, helpers may begin the ongoing and ever-evolving process of theory development. This development will continue to unfold for helping professionals as their life philosophy changes through experiences and insight. Once a counselor has taken the first step of acquiring self-knowledge through experience, classes, and reading, the next step is to gain a general understanding of the six major schools of thought. The schools of thought serve almost as families of ideas, each with related yet unique members. About 250 established counseling theories have been identified, and these can typically be placed into families or schools of thought. These theories are often categorized together by identifying specific ideological similarities. One way to categorize theories is through the following six schools of thought: (1) psychodynamic, (2) behavioral, (3) humanistic, (4) pragmatic, (5) constructivist, and (6) family approaches. These schools of thought hold unique philosophies regarding human nature; thus, a general understanding of them is a key component in selecting a working theory. Each of these schools is represented by more specific, finely honed theories. For example, within the pragmatic school, several paramount theories exist, such as rational emotive behavioral therapy (REBT), which focuses on being rational and thinking logically. The related, yet contrasting, reality therapy focuses on taking control of one’s actions and confronting the consequences (Corey, 2012). Adopting a specific theory from a school of thought is similar to picking a blue crayon from a package of 100 crayons that has several shades and hues of blue. Hence, like the color blue, the various theories in each school have hues that are similar yet distinct.
Once clinicians examine their life philosophy, adopt a school of thought, and select a specific theory, they are ready to take some action. At this stage, helping professionals need to develop goals and techniques for therapy that are supported by their theoretical orientation. This, too, is challenging because the uniqueness of clients f requently requires helping professionals to use different techniques, like pulling tools from a tool belt. Knowing which tool to access, however, requires having a working framework that is best supported by a strong foundation in theory.
Although the process of making theory practical may seem overwhelming now, it is manageable if helpers follow several steps, which are described in the next several
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Theory
School of
Thought
Life
Philosophy
Goals
Techniques
FIGURE 2.1 Intentional Theory Selection Model
sections. Later in the text, information, case studies, and activities are presented to help counselors gain awareness and make effective choices as they choose and solidify a theoretical orientation.
The Intentional Theory Selection (ITS) model of selecting a theoretical orientation is utilized as an example throughout this text (see Figure 2.1). The ITS model incorporates those aspects of theory selection that were found through research with students and counselors to be most significant in their personal solidification of theory. This model may be used to help counselors find not only their theoretical point of reference but also an orientation that is congruent with their individual values.
IMPORTANCE OF YOUR LIFE PHILOSOPHY
Life philosophy is the foundation of the ITS model. As a helper, being anchored in theory first requires that you have self-understanding and insight. You must become aware of how you view your world and must gain a greater comprehension of your own values (Hansen & Freimuth, 1997; Watts, 1993). Consider these questions: What is truth? Are people good? How do we gain knowledge? What causes behavior? Is spirituality important? What is right? It appears a revisit to Philosophy 101 is approaching. As a helper, however, you do not need to seek the writings of philosophers; instead, you have the opportunity to be introspective. You have the opportunity to look inside yourself and identify your own “assumptive world” (Hansen & Freimuth, 1997, p. 656). Your assumptive world is like a camera lens containing your ideas, beliefs, culture, and values; through this camera lens you perceive the world around you. Understanding how you view yourself, others, and the world around you is the first step in placing theory into a practical realm. These personal and motivating beliefs are core to your every action. Your schema of the world is not just essential to what you do but also ultimately the center of who you are. Helping professionals learn to help clients identify what they value and ultimately what gives meaning to their lives. As helpers i ncorporate
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theory into practice, they undergo a similar process. Once aware of your own views, you can move to adopting a counseling theory that not only serves clients in intentional ways but also complements who you are as a unique individual. An often-quoted phrase of Socrates, “The unexamined life is not worth living,” holds true for helping professionals as well. Without understanding your own life philosophy, you will find it difficult to provide effective counseling.
An additional building block of life philosophy is what you find personally meaningful. Whether this belief comes from family, ethnicity, traditions, spirituality, or culture or is created personally, it will greatly affect how you work with clients. At the root of these questions—What keeps you going? What gives you inspiration? Why do you wake each day?—is an important revelation: your purpose, your life’s meaning.
Your beliefs, values, and meanings are key components to who you are and your own subjective world. Yet you are so much more. As a multicultural individual, you are also a product of your culture, ethnicity, gender, family, sexual orientation, socioeconomic background, and religion. Your values and beliefs are founded on where you come from and where you intend to go. These differences may at times greatly affect your work as a counselor. For example, we once asked a class of ours, “What do you value?” We received the typical and expected answers—family, work, children, friends, being honest, working hard. However, several students had immediate, overt, nonverbal reactions when one international student responded, “Dependence.” We asked these students to clarify their reactions, and they discussed their values of autonomy, empowerment, and independence. Their values, like their classmate’s values, were greatly influenced by their cultural background and where they came from. You are influenced by your traditions and your adoption or adaptation of those traditions. Your life philosophy is indeed your own, yet it is made up of many influences.
Those working in the helping professions are becoming vastly more diverse, as are the clients served. As we pointed out to our class, values, beliefs, and worldviews are neither right nor wrong. It is paramount for helping professionals to identify their philosophy of life but not necessarily judge it. For example, is the student who valued dependence wrong? No. However, that student must understand her value and how it may affect her theoretical orientation and her work with clients. Conversely, those students who valued independence must understand that everyone does not hold this value. They must be careful about the assumptions they make about the personal worldviews of the clients they serve.
LIFE PHILOSOPHY—IT’s PERSONAL
Identifying your life philosophy is likely the greatest challenge in finding your theoretical orientation. The most important questions are often the hardest. Many beginning counseling theories courses offer a culminating exercise that asks the developing clinicians to state their theoretical orientation of choice. This capstone project reflects the field’s emphasis on theory and theoretical orientation. However, this creates strain and stress in some students. This occurs for many reasons; however, one paramount reason is that stating your theory, a reflection of your life philosophy, is actually a
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rather personal acknowledgment. Our theoretical orientation actually serves as a reflection of us—the values and beliefs that we hold dear. Sharing such personal information about ourselves places us in perceived vulnerable positions. We may feel vulnerable because there are only a few situations comparable to being questioned about our theoretical orientation. The first is in graduate training—often in a beginning course—a time where we already feel judged. The second is when we interview for positions as clinicians or educators. In this case, we also worry that our proclamation of a certain theory may either gain us acceptance or cause us rejection. Third, we are sometimes questioned about our theory by our clients. Typically clients are not asking us our theory to scrutinize it but to be informed and to understand what it is we might “do” to them.
It is important to remember that when we share our theory, it is the theoretical orientation of choice stemming from where we are in this particular point in life. One’s life philosophy is an ever-changing, ever-emerging construct. Life events— those that are positive, those that are negative, and everything in between—affect, influence, and mold us. Just as the experiences therapists see their clients grapple with life-altering events, counselors, too, have life-changing experiences. Some of these are subtle—minor changes in financial status, schedule changes, or new information gained at a workshop. However, some of these may have far greater impacts. Family changes, major health changes, epiphanies in faith, career changes, the death of a partner, or having children are “everyday” events that change how one construes meaning about the surrounding world. Some of these experiences, even those that are happenstance, create an opportunity for clinicians to change. In times where meaningful experiences occur, therapists are not only likely to change their life philosophies but, perhaps, should change their life philosophies. It makes sense that therapists should allow life to happen and affect them, one hopes in positive ways. As change occurs, however, and worldviews remain fluid, counselors will change, too. Consequently, life philosophy, the foundation of the Intentional Theory Selection Model, will also change. Ultimately this means that, as counselors experience life, the work they do with their clients will alter. It is important, as a component of self-reflection and ethical practice, that counselors remain astute and aware of how their clients are affected by counselor changes.
SCHOOLS OF THOUGHT
The truly difficult step in adopting a theory for a counselor is gaining self-knowledge. Once you identify your own life philosophy, you can begin to examine the schools of thought that drive theory. This initial examination of theory requires only the willingness to read, listen, and comprehend. The information is available in this text and in a multitude of other resources. Beyond classroom lectures, you can find a bounty of literature describing the six schools of thought and their various theories (see Suggested Readings and Webpages at the end of Chapter 3). This step in the process toward adopting a theory is simple to learn. Knowing the multitude of facts surrounding each theorist, the counseling history, and the specific rhetoric of each school is not a
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prerequisite at this stage. However, you must begin to learn the basic assumptions of each theory, which will empower you to identify those theories that seem to hold assumptions similar to your own life philosophy. Consequently, you may take on a process of discovery in which you look for those applications that are congruent with the core of who you are.
Professional helpers are not in complete agreement on how many general schools of thought exist. However, they typically count four to six (e.g., Corsini, 1979; Halbur & Halbur, 2006; Halbur & Halbur, 2011; Ivey et al., 1997) families, schools, or clusters that have similarities among the theories within. We have identified six schools of thought: (1) psychodynamic, (2) behavioral, (3) humanistic, (4) pragmatic, (5) constructivist, and (6) family approaches. We debated how best to include family approaches and chose to consider them as a separate and unique school of thought. Many, and perhaps most, counselors do indeed acknowledge the use of family paradigms in their work with families and individuals. Consequently, it is likely that some narrative therapists (from the constructivist school of thought) would also acknowledge family systems (a major approach within the family approaches) as a vital part of their theoretical orientation. However, many clinicians work predominantly out of a family approach serving individuals, couples, and families, so including family approaches as an independent school is practical.
Although these schools of thought may seem distinct, similarities between them make the job of choosing one more challenging. However, these schools of thought are diverse in their assumptions regarding how personality develops, how pathology is perceived, how health is achieved, and what the role of the counselor is. For example, the counseling theory of existentialism within the humanistic school of thought espouses the idea that clients’ health is achieved through helping them embrace meaning in their lives, while cognitive-behavioral approaches assist clients in developing more effective views of themselves and the world. While both approaches have proven successful in helping clients achieve more fulfilling lives, the underlying philosophies are quite different. Thus, helpers must first be oriented to the basic philosophies of the major schools of thought (see Chapter 4). Choosing your school of thought is ultimately an attempt to find a fit for you. Some schools of thought may leave you feeling that something is missing, while other schools may leave you feeling that you have found a natural match. However, choosing a school of thought will seem easier after you have completed the first step of personal reflection: looking at your life philosophy.
THEORIES
Once you have identified your life philosophy and have a general understanding of the school of thought that best fits your beliefs, you are ready to pick your theory or theories. This process begins when you gain a general understanding of the various theorists within the school of thought that is most congruent to your life philosophy (Watts, 1993). For example, within the psychodynamic school, do you agree with
Sigmund Freud, who viewed humans as mostly sexual creatures, or with Alfred Adler,
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who saw humans primarily as social creatures? At this stage, you will likely begin looking for those theories that most parallel your own views by using a process of comparing and contrasting. As you pick the theory that matches your own most closely, you will begin to feel yourself gaining a stronger foundation.
In choosing your theory, you should understand that anyone can build a theory. However, the theoretical approaches that are generally published are those proven to have some generalized effectiveness (Kottler, 1999). As you move toward acceptance of a theory, you may experience times of anxiety or frustration in the process. You may sometimes find dissonance between your own beliefs and the theories with which you are confronted. This dissonance results in emotional consequences, which is part of a natural developmental process. Once you identify with a specific theory, however, you are likely to have a general sense of relief because you will find direction and may feel more confident in your interactions with clients (Mahoney, 1991). For example, one of our graduate students took the Selective Theory Sorter–Revised (STS–R) (in Chapter 3) and scored high on rational emotive behavioral therapy and the constructivist school of thought. She then took the advice later stated in Chapter 3 to learn more about those theories that she scored high on. She visited a webpage that streamed a video about Albert Ellis, the founder of REBT, that showed REBT in action. She found herself feeling dissonance because she did not like the persona she found in Ellis. Later, however, after she wrestled with her decision, she found the theory to be congruent with her and her reactions were really more in reaction to Ellis. She felt relief as she settled into her theory and is a practicing REBT therapist today.
Finding your theoretical orientation can be likened to a tree, with theory serving as the branches. Your life philosophy serves as your soil and nutrients, sustaining your actions. Your adopted school of thought is the trunk, holding all that you do with your clients. The branches, the theories you choose, support all that you demonstrate to clients and all that you do to serve them therapeutically. Finally, these theories determine what you actually give to your clients. The leaves and fruits, your goals and techniques, provide your clients supporting shade and give them sustenance to grow. Although this may seem ambiguous right now, as you read on, you will likely gain a better understanding of the schools of thought and their theories and how this will prepare you to provide counseling and psychotherapy that is intentional (see Chapter 4).
GOALS AND TECHNIQUES:
INTERVENTIONS AT WORK
After making a theoretical choice, the next step for the helper is to adopt goals and techniques. Helpers should think ahead to the activities and interventions that will form their techniques (Jongsma & Peterson, 1995), which they will utilize when they provide counseling and therapy. What techniques you as a helper ultimately choose, however, will, and should, be based on your theoretical orientation, which will make you accountable for the therapeutic work you do with clients.
As a beginning counselor, you may decide or feel pressured to skip self- understanding and theoretical development and jump straight to applying goals and
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techniques. You rightfully want to know what to do, and you may believe that you should learn immediately how to help. In many training programs, however, discussing counseling techniques comes too early. In most programs, helpers often learn how to act as counselors before they learn who they are as counselors. This approach is often driven by the belief that counselors’ training rests primarily on helping counselors know what to do. As a result of the widely accepted belief that the counselor is the true instrument of change, we run the risk of forgetting that counseling is ultimately a unique yet specified relationship. At a fundamental level, almost anyone can learn techniques. For example, the empty-chair technique requires that you ask clients to talk to someone as though that person were present when she is not (the empty chair). This technique is utilized to help individuals through various therapeutic challenges. Using this technique requires very simple instructions that a nonprofessional can understand. However, the ways in which you as a helper follow up on this intervention and respond to the client are based in your theory. Consequently, you should be theory based before you can be properly technique driven.
The argument for eclectic work is typically the strongest when it comes to choosing techniques. It is very common for counselors to be hesitant about limiting the number of techniques they use. This is an especially strong argument because some techniques do truly work better with some clients. As discussed in Chapter 1, we believe there is truly a difference between intentionally utilizing diverse techniques and being eclectic. If a technique from an alternate theory can help the counselor and client move forward in the change process, and if the technique is congruent with the therapeutic goals, it is ethical and valuable to be flexible in the therapy process. A narrative therapist, for example, would traditionally not utilize behavioral contracting. However, if a behavioral technique would help the client work toward goals that are congruent with narrative work, the counselor-client relationship remains founded on theoretical orientation.
As the counselor, you are the one who ultimately provides interventions that help your clients achieve their goals. Each theory and school of thought provides you with techniques and therapeutic goals that are appropriate, given your values and your clients’ needs. If you have adopted a theoretical approach successfully, your effectiveness as a helper then depends on your ability to recognize with your clients their needs and to execute techniques congruent with your theory (e.g., Hansen, Rossberg, & Cramer, 1993). At this point, researchers and clinicians who have come before you have already done the work and the research, and you simply have to consult their teachings and writings. In this endeavor, you will learn quickly that the various schools, theories, and interventions strive to meet the needs and characteristics of a diverse society.
COUNSELORS ARE DIVERSE
Multicultural issues have been widely incorporated into counseling and its theoretical approaches. Integrating this facet of competence into your counseling approach first requires an understanding of the term culture. Culture is ultimately the rules, values, symbols, and ideologies of an identified group of people (Srebalus & Brown, 2001).
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This general definition of culture should help you to see that an interactive society includes both separate and unique cultures. To understand the implications of culture, you must first understand your own culture and have a general understanding of other cultures with which you work. Diversity that comes from age, gender, race, socioeconomic class, ability, religion, and sexual orientation has a major impact on how relationships in general, as well as counselor-client relationships, develop and mature. Typically, the literature focuses on how counselors may work most effectively with clients who represent a population that is different from their own. Most of the literature assumes, however, that the counselor is of the dominant culture, and counselors see themselves more and more often represent underrepresented cultures.
For example, many counseling textbooks offer practical suggestions for working with clients who are gay, lesbian, bisexual, or transgender. Their authors stress that helpers must be in touch with their values and biases and that it is vital for them to consider the social environment pertinent to their clients. Issues specific to these populations, such as oppression and the coming-out process, are discussed, and primers on various cultures are offered. However, little practical support exists for the counselor who is from an underrepresented population. The question, How can a counselor work with a client who is a lesbian? is not unique and is addressed in the professional literature. However, the question, How can a counselor who is a lesbian work with clients? is often ignored. In this emerging field, helpers continue to build on the research and literature addressing the multicultural needs of their clients. However, counselors often struggle in addressing their own multicultural needs, backgrounds, and experiences.
Like clients, counselors also come from a variety of cultures and backgrounds. Their life philosophy and values, which are a dramatic component of their counseling approach, do influence how they interact with clients and direct what they believe is important for their clients. The ITS model utilized throughout this text offers great benefits to counselors across cultures of race, gender, sexual orientation, ability, religion, and age. As we have outlined, the foundation of this model begins with the identification of one’s life philosophy. However, life philosophy is so deeply rooted in one’s specific culture that to imagine separation seems ludicrous. How people view the world is influenced greatly by their cultural experience and basically defines much of who they are. Because of this influence, as counselors we must not only embrace the diversity of our client population but also embrace the diversity within ourselves and our field.
RESISTANCE TO THEORIES: ECLECTIC,
INTEGRATED, OR JUST DON’T KNOW
Many beginning helping professionals do not subscribe to one specific theory but rather identify themselves as being eclectic or integrative. Evidence supports trends in this area. Many theory textbooks now include chapters that focus on eclectic and integrative approaches, such as Lazurus’s (1989) multimodal theory and Prochaska and DiClemente’s (1982) transtheoretical model, along with many others. This trend is further evidenced by surveys of mental health practitioners, who, when asked about their theoretical orientation, identify themselves as eclectic (Schmidt, 2001; Wrenn, 1960).
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While it is plausible and pragmatic for clinicians to choose interventions from various schools of thought, this choice requires intentionality and a thorough working knowledge of the utilized theories. Sometimes, however, students endorse eclectic theories without having the required knowledge and intentionality of seasoned practitioners.
Although not always the case, portraying oneself as eclectic can be an “easy out” when one is asked about personal theory. We have heard several students say that, while interviewing for clinical positions, they present themselves as eclectic in an attempt to avoid presenting a theory not endorsed by the interviewer. These students believe that there is a “right” answer and that part of their interviewing success depends on their ability to show themselves as congruent with the interviewer or open to the interviewer’s personal theory. As you likely can see, your theory is ultimately based on your life philosophy—your values and beliefs—which in many ways are highly personal. To offer a specific theory, a revelation of yourself, places you in a vulnerable position that portrays you and puts you in a place where judgment may occur. Especially as a beginning counselor, you may find it frightening to say specifically to which theory you ascribe. If you state, “I am a feminist therapist,” you may be questioned about what that means, what your beliefs are, and what interventions a feminist helper utilizes in therapy. By identifying yourself as grounded in a specific theory, you are making both a statement about what you believe and who you are and a commitment to how you will work with clients. For example, if we say we are psychoanalytic therapists, you have the opportunity to make some assumptions about us. Consequently, some students feel safer saying, “I am eclectic.”
Other students have shared that their portrayal as eclectic allowed them to utilize interventions that they believed would work. They shared that this allowed them to be “themselves” and to accept individual clients as they are. The helping p rofessions do typically promote individuality, so this argument has some merit. If helpers do not orient themselves with a specific theory, however, they are not in a place where they can justify their work with clients. By not justifying their approach, they thereby circumvent truly intentional, ethical counseling.
An additional struggle with eclectic approaches revolves around the issue of student and clinical supervision. To train effective and ethical helpers, educators and supervisors must give counselors feedback on their clinical work. Typically, counselor educators and clinical supervisors attempt to provide counselors with feedback that is based on the supervisees’ specific approach. When students and beginning counselors adopt an eclectic model, providing specific feedback is difficult. Not uncommonly, students and counselors endorse this paradigm of eclecticism to avoid targeted feedback. Students may do this not because they want to avoid learning or even grading but rather because they fear being evaluated as a helping professional.
This resistance to adopting a theoretical orientation can surface in many forms. While the purpose of this text is to help counselors dedicate themselves to a theory, it is also an attempt to advocate for the helping professions and increase the professionalism of their identities. For example, because of the impact of health-care reform and managed care, as a profession, we are constantly required to provide more justification for counseling and psychotherapy. If, as professionals, helpers are unable to portray
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themselves as being theory driven, they run the risk of being seen as incompetent and unreimbursable. Thus, each counselor’s openness to having strong theoretical foundations adds to the professionalism of the counseling field.
DOES IT REALLY WORK?
Let us offer you an example where we supervised a counselor-in-training through a practicum experience. In this class, the students saw clients while we had the opportunity to observe them through a one-way mirror and make calls into the session to offer suggestions and reflections. The student we observed, Carolyn, showed a great level of understanding of theory, and she demonstrated skills beyond what is typical of her level of training. She consistently demonstrated the ability to develop quick rapport with her clients and was keenly attuned to the affective world of her clients.
She was working with a college student who was experiencing social anxiety and was potentially struggling with test anxiety. Carolyn was doing great work with her client and was really helping the client to see herself in a new way. In session, Carolyn was helping the client to examine what thoughts and events tend to trigger times of greatest anxiety. She was also sharing her observations of her client’s social skills. Although the client was verbally expressing a fear of others, she was being quite open and honest with Carolyn. During the session, Carolyn also encouraged the client by saying that she “would be okay.” A segment of the session follows.
Carolyn: So, during times where you notice you have values in common with others, you feel the greatest sense of social confidence.
Client: Well, I guess, but I still find I don’t know how to talk with others. I struggle, as I don’t feel I can be open with others. I am scared, frightened, and feel I have nothing to offer. I feel others will look at me and laugh and see how . . . well, how stupid I am. I am not quick and, well, because of this I don’t talk. I try to keep the focus off of me.
Carolyn: So then you back down as you feel you have little to offer.
Client: Yes, I cannot be open with others. I have never been able to be honest with others about how I feel and stuff.
Carolyn: So you feel you really struggle opening up to others.
Client: Well, yes, all of the time.
Carolyn: What is hard for me to understand is how you believe you are never honest, yet you have been very honest with me today . . . you have shared your vulnerabilities without shutting down.
Client: Well . . . (smiling). Yeah, I guess. Maybe I am not always able to see when I am being open.
Carolyn: Sorta like, sometimes you are able to do it but don’t see it.
Client: Yeah!
Carolyn: You know, I think you will be okay.
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Following the session, we listened to Carolyn’s reflections and gave her f eedback. During this experience, we were shocked at Carolyn’s appraisal of the session. C arolyn shared that she believed her statement, “You know, I think you will be okay,” was the most beneficial during the session. In fact, however, this statement was the least grounded in theory. Carolyn went on to say that she felt that her statement, “What is hard for me to understand is how you believe you are never honest, yet you have been very honest with me today . . . you have shared your vulnerabilities without shutting down,” was completely a value statement that would have been better not to share and did not have a place in counseling. We were again surprised by her appraisal—not only because Carolyn’s statement was grounded in the existential approach’s value of being authentic but also because the client later shared that it was the most meaningful interaction she encountered during her course of therapy. When we shared this discrepancy with Carolyn, she said, “But I am not a humanist.” After exploration with Carolyn, we learned that she had adopted her theoretical approach based not on her philosophy or worldview but on, as she put it, “the theory my last supervisor liked.”
During the following weeks, we asked Carolyn if she would take a step back from her theory. We asked her first to identify her values and philosophy of life. As she did, many themes emerged, and these focused greatly on her belief that people know what is best for themselves and that being genuine with others is essential to meaningful relationships. These perspectives are the cornerstones of many humanistic approaches, and these new insights helped Carolyn to begin to build a theory that would not only be effective with clients but also enable her to have a theoretical approach that truly fit for her. Through this process, she was able to find a theory that was more congruent with her values and a way to be theory driven while incorporating herself in the session. Carolyn’s confidence and skill level with clients continued to increase. Clearly, in her work with clients, Carolyn’s new confidence and self- understanding were increasing her effectiveness and ultimately helping her clients. Carolyn found that the humanistic approach was a natural for her to be effective with clients. She found that she could be grounded in a theory that was congruent with her beliefs and truly allowed her actions in therapy to be based on her values.
WHAT TO TAKE HOME
Each helper brings individual qualities to the therapeutic process. Your religion, ethnicity, gender, and sociological background contribute so much not only to who you are as a person but also to how you serve as a counselor. As an individual, how you interpret or make meaning of your experiences inevitably changes you. Your adoption of core values and beliefs affects not only you but also your clients. Your theoretical orientation can help you conceptualize and intervene with clients in a way that is effective for the client while staying congruent with who you are.
The process of adopting a theory that truly fits your own belief system is difficult—but very attainable. It is an ongoing process because new experiences continuously influence your beliefs and values. At times, learning more about yourself may even require you to give up what were once cardinal components of your
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counseling approach. Being a theory-based clinician is an ethical and essential step in a helper’s development. Through self-inquiry and study, you can begin a journey that can help you to become an effective counselor whose actions not only are based in theory but also truly emanate from your own beliefs. Discovering your own values, life philosophy, and view of counseling and psychotherapy is an important step in your professional identity. However, you must also identify the views, values, and life philosophy of your clients.
Following the proposed ITS model is one pragmatic way for you to adopt a theory that is congruent with who you are. It offers you the opportunity to develop or hone your understanding and purposefulness of the goals you, and potentially your clients, choose in the therapeutic relationship. Theory offers you a framework for where to go in the counseling relationship. If goals are congruent with the counselor’s theoretical orientation, then what you do—the selected techniques—in counseling should also be theoretically founded.
REFLECTION QUESTIONS
1. The following questions are designed to assist you as you begin to articulate your life philosophy: (a) What do you value? (b) What do you find meaningful? (c) What influences in your life have been most profound in shaping your life philosophy?
2. Of the six schools of thought described in the chapter (psychodynamic, behavioral, humanistic, pragmatic, constructivist, and family), which one(s) do you feel most knowledgeable about? Which one(s) would you like to learn more about?
3. Think of three clinical techniques you currently can use or know of (e.g., empty chair, free association, charting, education, confrontation, and so on). Can you identify the theory to which each technique belongs?
4. What do you consider to be your cultural background? How do you feel your cultural background affects your personal relationships? Your professional relationships?
5. In recent counseling and psychotherapy research, there has been a trend toward integrative and eclectic techniques. What about these approaches do you find attractive? What about these approaches do you find unattractive?
6. In examining the ITS model, identify the components (a) with which you feel confident and (b) for which you need additional education, information, and/or experience.
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Selecting your theoretical orientation in a purposeful manner requires both knowledge of counseling theories and self-knowledge. As presented earlier, learning about yourself and your own life philosophy is the first step in integrating a theory of counseling. The Intentional Theory Selection (ITS) model serves as a road map to finding your theoretical orientation. Finding your theoretical orientation requires you to be active in learning about yourself and how this information influences what theory might best fit for you.
In the style of a late-night show, we will give you the top 10 ways to find your theoretical orientation. We believe that each strategy can lead you closer to your theoretical orientation and that each is important in the overall process of developing your theoretical orientation.
1. Find yourself.
2. Articulate your values.

Top 10 Ways to Find
Your Theoretical
Orientation

3. Survey your preferences.
4. Use your personality.
5. Capture yourself.
6. Let others inspire you in your learning.
7. Read original works.
8. Get real.
9. Study with a master.
10. Broaden your experiences.
We will discuss each of these top 10 methods in this chapter.
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FIND YOURSELF
To choose a theoretical orientation that best fits you, you need to consider your own values, life philosophy, and worldview in an honest way. All helpers may aspire to provide unconditional positive regard and respect for clients, but the reality of clients’ lives and behaviors may make that difficult to accomplish. Thus, we encourage you to be thoughtful and honest as you participate in the following activities, which are designed to help you examine your values. You may find journaling about your values and reactions to the following questions helpful.
1. Who should go to counseling? Ask yourself, “Who is counseling for?” Is it best for those who have major life traumas? Those who have “small problems”? Or perhaps for those whose problems are somewhere in between? Figuring out “who are our clients?” may be just as important as the process of figuring out “who are our counselors?”
2. What would you want in a counselor? Would you like a counselor who asked you lots of questions? Would you want a counselor who gave you lots of advice? What would you not want a counselor to do? Ponder the type of counselor you might want, and perhaps such thoughts will give you insight about your own theoretical orientation.
3. What do you think should be the focus of therapy? Should facts, feelings, or behaviors be the focus of therapy? Are therapists there to solve the client’s problems, or should the client be in charge? Therapies and therapists vary greatly. What do you think is the basis of therapy?
4. What do you think makes an effective counselor? Should counselors be serious? Is there a place for humor in therapy? Should therapists share about themselves? Or should therapy be focused on the client? Is rapport a needed component of therapy? Should therapists have “experienced” problems to be a good problem solver?
5. Should therapy consider spiritual or religious aspects? If you answered yes to this question, do the spiritual beliefs of the therapist make a difference in therapy? Do you believe in free-will? Is morality an absolute or is it defined by the situation?
6. What “causes us to be the way we are”? The past, the present, or even the spiritual? Should therapy look at these factors? Therapy is often about fixing something or making something better. What you believe about how we get to our current state of affairs may affect what you see as valuable in therapy.
These questions will help you examine your values as they relate to the counseling process. As you think about the questions, write down your answers, which can help you identify your theoretical orientation. Your values, as they relate to the helping process, are just one way to examine yourself. To get a complete picture of your values as they relate to the helping process, you need to examine your counselingrelated values and your personal values. You will examine your personal values more in the next step.
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ARTICULATE YOUR VALUES
We have developed some questions to assist you in examining your values and life philosophy. To begin the journey of introspection and imagination that will lead you to uncover your own value system and life philosophy, consider your honest answers to the questions in the following scenarios.
■ The Funeral. Imagine that you have been transported through time to your own funeral, where your family and all the friends in your life have gathered. As part of the ceremony, an open microphone is provided for people who want to speak about their remembrances of you.
What do you think people would say about you? What would you like them to say?
■ Free Week. Imagine that suddenly you have been given one magical week of “free” life—you do not have to take care of tasks at work, finances, family, and household responsibilities. No backlog would accumulate. You would reenter the year at exactly the same time you left it, but you would have seven days for yourself. It would be as though the calendar had 53 weeks, just for you.
What would you do? Who, if anyone, would you include?
■ Change. Imagine that you have been given the power to change three things about yourself permanently.
What three things would you choose to change? Why?
What would you change in your neighborhood? In your town? In your city? Why?
What would you change if your power were extended to people in general? Why?
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If your power were now extended to the world, what would you choose to change permanently? Why?
How do your views of multiculturalism and diversity relate to the details and ideas that you selected to change permanently about your city? About your state? About the world in which you live?
Review your answers to the personal values questions, and then answer the following questions:
■ What themes emerged from your answers?
■ How are the changes that you strive for related to the changes that you hope your clients will make?
■ What are your priorities?
■ How are those priorities related to the way you work with clients?
■ What kind of changes do you want to make for yourself and the world around you?
■ How do these changes affect your role as a helping professional?
SURVEY YOUR PREFERENCES
Now that you have had a chance to reflect on your priorities and values as a person and as a professional, you can participate in a survey that we developed to help you determine your theoretical orientation. The Selective Theory Sorter–Revised (STS–R) survey items are based on a literature review of numerous important counseling books and articles (e.g., Corey, 2004; Doyle, 1998; Ivey & Ivey, 1999; Jackson & Thompson, 1971; Murdock, 2009; Nichols, 2008; Young, 1998). The survey is designed to give you insight into your theoretical preferences and assess your views of pathology, the counseling process, and treatment modalities. It is not designed to be a diagnostic tool; rather, it is another tool for your self-exploration. The STS–R appears on pages 31–36.
USE YOUR PERSONALITY
Your personality type can help to guide you toward a theoretical orientation. The Myers-Briggs Type Indicator (MBTI), a measure commonly used to examine personality characteristics, can be another way to help you to understand your way of v iewing the world (Myers & Myers, 1977). If you do not know your Myers-Briggs type, you might find it helpful to take the test, which is typically offered at career services offices on college campuses.
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SCORING THE SELECTIVE THEORY SORTER
1. Add the scores in each column. Be sure to add the positive numbers and subtract the negative numbers accurately. You may have scores below zero.
2. Transfer the column totals to the corresponding theories listed below.

THEORY OR SCHOOL OF THOUGHT

TOTAL SCORE

A. Psychoanalytic

_______

B. Analytic psychology

_______

C. Individual psychology

_______

D. Person-centered

_______

E. Gestalt

_______

F. Constructivist school of thought

_______

G. Behaviorism

_______

H. REBT

_______

I. Reality therapy

_______

J. Cognitive-behavioral

_______

K. Family theories school of thought

_______

L. Existential

_______

3. Find the two or three theories or schools of thought with the highest scores and list them below. Based on your scores, these are the theories or schools of thought most appealing to you.

THEORY OR SCHOOL OF THOUGHT

TOTAL SCORE

__________________________________

_______

__________________________________

_______

__________________________________

_______

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EXPLANATION OF SCORING
The STS–R is based on a comprehensive review of literature surrounding counseling theories. The items contained in the STS–R reflect the beliefs inherent in each theory or school of thought. Currently, no published psychometric properties are attached to the STS–R; however, the survey has been effective in tracking changes in individuals’ theoretical orientation choice (Johnson & Halbur, 2013). Consequently, it is a survey that is intended for self-discovery.
The two or three theories or schools of thought you found most appealing and thus scored the highest are those that likely match your life philosophy as it is today; however, these are only preferences. For example, if you had two theories that tied, then you might need to examine and read about them in more depth. You may have also discovered that your preferences match a theory with which you are unfamiliar. Regardless of your results, you might find that looking in greater depth at the theories you identified gives you a better understanding of the theories and greater confidence in your ability to select one.
The theories corresponding to the constructivist and family schools of thought contain such great philosophical overlap that they are identified only as overall schools of thought. Consequently, their individual theories are not included in the STS–R. This is not intended to imply, however, that they are not as important.
Developed by Isabel Briggs Myers and Katherine Briggs in the 1950s, the MBTI is a forced-choice, self-report inventory that classifies individuals into 1 of 16 personality types, each with a unique set of characteristics and tendencies ( Willis, 1989). Because the MBTI is theoretically conceptualized from a personal wellness rather than a pathology perspective, all the choices presented are seen as appropriate and acceptable ways of interacting with the environment and emphasize the traits or characteristics that support the balance of the individual’s psychological personality system. According to Myers and McCaulley (1985), the main objective of the MBTI is to identify a combination of four basic preferences that determine type. An individual receives a four-letter code type determined by her scores on four theoretically independent dimensions. Each dimension has two dichotomous preferences, with only one preference from each dimension ascribed to any one individual (Willis, 1989).
The first dimension is the Extraversion/Introversion (E/I) index. The E/I index is designed to reflect whether a person is an extravert or an introvert. An extravert is defined as a person who directs energy and attention to the outer world and receives energy from external events, experiences, and interactions. An introvert prefers to focus on the inner world of ideas and impressions, thoughts, feelings, and reflections and draws energy from that process (Myers & McCaulley, 1998).
Sensing/iNtuition (S/N) is the second index. The S/N index reflects a person’s preference between two opposite ways of perceiving, sensing or intuiting. A person who relies primarily on the process of sensing reports observable facts or happenings through one or more of the five senses. People with sensing preferences observe the world around them and are skilled at recognizing the practical realities of a situation. A person who responds more to intuition reports meanings, relationships, and/or possibilities and sees the big picture, focusing on connections, understandings, and relationships between facts (Myers & McCaulley, 1998).
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The third dimension is the Thinking/Feeling (T/F) index. The T/F index describes a person’s preference between two contrasting ways of making judgments. A person who typically reacts from a thinking perspective to make decisions on the basis of logical consequences or objective truth is identified as a thinking type. Thinking relies on principles of cause and effect and tends to be impersonal (Myers & McCaulley, 1985). People associated with thinking may develop characteristics associated with analytical ability, objectivity, and concern with justice and fairness. In contrast, a person who operates based on feeling makes decisions on the basis of personal or social values with the goal of harmony and recognition of the individual (Myers, 1993). Feeling-type people support their decisions with an understanding of personal values and group values, and thus they tend to be more subjective than thinking-type people. Feeling-type people also tend to be peopleoriented and are characterized as having concern with the human, a need for affiliation, a capacity for warmth, and a desire for harmony (Myers & McCaulley, 1985).
The fourth dimension is the Judging/Perceiving (J/P) index. The J/P index describes the process that a person uses in dealing with the outer world—the extraverted part of life. Persons who prefer judgment use one of the judgment processes of thinking or feeling for dealing with the outside world. Perceiving types tend to operate from a sensing or an intuition perspective when dealing with the outside world.
Because counselors tend to select counseling theories that fit their own personality styles, you may find research regarding the MBTI and theoretical orientation helpful in your quest for a theoretical orientation (Erickson, 1993). The Thinking/Feeling preference on the MBTI is particularly illuminating when examining theoretical orientation. Thinking types tend to interact with others in a task-oriented, analytic, and objective manner. Feeling types tend to focus on personal values, subjective viewpoints, and people-oriented discussions. Thus, thinking types are disproportionately likely to choose predominantly cognitive theories such as Adlerian therapy, behavioral therapy, rational emotive behavioral therapy (REBT), and reality therapy. Feeling types are more likely to choose predominantly affective theories such as Gestalt, existential, and client-centered therapy.
Taking the MBTI
A number of resources allow counselors to take the MBTI. Counselors, consultants, and other human services professionals may offer this test as a professional service. Counseling students may be afforded the opportunity to take the test as part of their academic coursework and/or through their institution’s counseling center. Though the MBTI is recommended in this text, many other personality inventories may be helpful to you in your mission of self-discovery. We chose the MBTI because it has been researched in relation to theory selection among counselors and psychotherapists.
CAPTURE YOURSELF
Audio, digital, and video recording techniques are valuable ways to capture yourself working as a professional helper. Recording techniques can show you whether or not your counseling skills actually convey your theory. The theoretical orientation you espouse should be one that is easily recognizable on recordings so that you can
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determine whether your interventions, strategies, and ways of relating to your clients are congruent with your theoretical orientation. Sometimes, viewing themselves on a recording is the first time students in the helping professions recognize that their intended theoretical orientation is not apparent in the counseling session. Thus, observing yourself can help you track your progress toward intentional counseling and use of theory in the helping relationship. Recording yourself also provides an opportunity for you to receive feedback from others who can assist you in understanding whether or not your clinical work is reflective of the theoretical orientation you espouse.
LET OTHERS INSPIRE YOU IN YOUR LEARNING
Others can inspire you in your learning in many ways. This text, which gives you an opportunity to examine your theoretical orientation, is a launching pad for exploring your role as a professional helper. Professional conferences and other professional development opportunities that you can attend may also help. The most well-regarded people in the field often conduct workshops that can help you understand theory and therapeutic techniques better. To get involved in these educational opportunities, ask your faculty members, supervisors, and colleagues about the professional organizations to which they belong. You can find numerous professional growth opportunities at the state, regional, national, and international levels.
READ ORIGINAL WORKS
Theories textbooks offer a wealth of information about various theories. Each time a theory is paraphrased, however, something is lost. Thus, we recommend that you read as many works by the original theorists as possible. The list of suggested readings and webpages at the end of the chapter is organized around the six schools of thought and their theories, which are presented in Chapter 4. The list is not all-encompassing; it is simply intended to get you started. Reading the words of the theorists gives you additional insight into the values they espoused or hold and the philosophy of their theories, which helps you to see which are congruent with your own life philosophy.
GET REAL
Another way you can solidify your theoretical orientation is to put it to the test with some real-world trials. As you conduct the activities of your everyday life, try your theoretical orientation with people in all sorts of situations and backgrounds. For example, one professional counselor had what she called a “typical Saturday.” She spent her day going to the grocery store, getting a haircut, and attending a cultural event. The counselor reported that, while getting her hair cut, she interacted with a 20-yearold Caucasian hairdresser who was expecting her second child and was unsure of her relationship with the child’s father. At the grocery store, the counselor interacted with a cashier in a wheelchair, and later she met a Bosnian house painter who was a highly
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regarded artist in Bosnia before the Bosnian War. In each of these situations, the counselor had the opportunity to monitor whether or not her humanistic leanings worked in her everyday life. The counselor noticed that she was able to have unconditional, positive regard for each of the people with whom she interacted. She also noted that she was not able to be genuine with each person she encountered but decided that her response was okay because each of these relationships was not a personal or counseling relationship. The counselor’s experience illustrates the importance of finding a theoretical orientation that fits your personality. Because the theoretical orientation you espouse will ideally resonate with your being in most situations, you need one that fits with who you are both inside and outside the therapeutic relationship.
STUDY WITH A MASTER
One of the best ways to learn a theoretical approach to the helping professions is to study with a master or at an institute specializing in the theory in which you are interested. These opportunities will allow you to study with the creator of the theory or with some of the creator’s protégés. Regardless of how you obtain additional education about a specific theory, that education will help you establish a theoretical orientation that fits for you. You can find many training opportunities both inside and outside the United States. Although you would need an immense amount of time to study at all institutes, you can pick experiences that are most appealing to you by reading original works and learning more about yourself. The following websites contain information that can get you started.
Albert Ellis Institute: rebt.org
American Association of Marriage and Family Therapy: aamft.org
Association for Humanistic Psychology: ahpweb.org
Association for Multicultural Counseling and Development: multiculturalcounseling.org
Association for the Advancement of Gestalt Therapy: aagt.org
Beck Institute for Cognitive Therapy and Research: beckinstitute.org
Center for the Studies of the Person (Person-Centered): centerfortheperson.org
International Network on Personal Meaning (Existential): meaning.ca
Jean Baker Miller Training Institute (Feminist): jbmti.org
Mental Research Institute (Strategic/Brief): mri.org
Minuchin Center for the Family (Structural): minuchincenter.org
Narrative Therapy: narrativeapproaches.com
National Multicultural Institute: nmci.org
The Rollo May Center for Humanistic Studies: saybrook.edu
Solution-Focused Brief Therapy Association: sfbta.org
Viktor Frankl Institute of Logotherapy: logotherapyinstitute.org
William Glasser Institute: wglasser.com
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BROADEN YOUR EXPERIENCES
The best way to expose yourself to new ideas and situations is by living outside your comfort zone, which may entail learning about cultures different from your own. Experiences outside your comfort zone not only allow you to encounter diverse thoughts but also allow you to compare your own beliefs to those unique to others. This may help you in articulating your worldview and anchoring your beliefs in cultures around you. To accomplish this, you may need to work with and experience a variety of clients’ issues, which you can do in several ways. First, try to get experience working in a wide variety of settings. Spend time working with people of ethnicities, cultural backgrounds, and socioeconomic statuses that are different from your own. For example, if you are a mental health or community counselor, spend time working with adults, children, and families to expose yourself to as many diverse experiences as possible. If you are a school counselor, you may choose to get experience working with elementary, middle school, and high school students, ideally in schools that are different from one another.
Second, you may want to study abroad. Valuable opportunities to learn about counseling and other cultures are available through many graduate programs that offer multicultural and theories courses in other countries. You might seek grants such as a Fulbright scholarship to study the helping professions in another country. You can also have multicultural experiences without leaving the country. Many universities have organized international student groups where you can volunteer to be a conversation partner or to host an international student. These opportunities can add diversity to your day-to-day life.
TOP 10 WRAP-UP
The helping professions are unique compared to many other fields because selfunderstanding is essential to a job well done. To be an effective therapist, you must have a working theory to guide how you serve clients. Self-insight is the first step in the process of finding a theoretical orientation, and the key to finding your theoretical orientation is understanding your life philosophy. A few of the ways to gain greater self-understanding include finding your values, understanding your preferences, and having new experiences.
Engaging in activities that help you with personal insight can make you a better professional, which consequently contributes to your effectiveness in your work with clients. Your intentionality will ultimately help you to find a theory that is congruent with your values not only as a professional but also as a person. This will likely lead to a career you find more fulfilling.
In Chapter 4, we present some theories and explain how they fit with the ITS model. In Chapter 5, we provide some examples of students, clinicians, and supervisors who utilized the ITS model to aid them in their professional development. These individuals, diverse like the clients they now serve, went through the universal struggles that are common among those beginning in the helping field. We hope their experiences will help you in your own process.
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REFLECTION QUESTIONS
1. In this chapter, you were asked to complete some exercises to articulate your values. What did you learn about yourself? How will you integrate your learning into your quest for a theoretical orientation?
2. After reviewing your results on the STS–R, which theories or schools of thought did you find most appealing? Least appealing? What are your thoughts on your results?
3. How does your cultural background affect the values you have?
4. How do your current theories of choice match with your personality or MBTI type?
5. Evaluate one of your counseling sessions on a video or audio recording. How do your skills demon-strate your current theoretical orientation? In what areas do you need improvement? Who can you ask to assist you in making sure that your skills match your stated theoretical orientation?
6. In your search to ascertain a theoretical orientation, which original works do you plan to read? Which opportunities to study with a master are most appealing to you? How will you obtain these experiences? When?
SUGGESTED READINGS AND WEBPAGES
PSYCHODYNAMIC APPROACHES

Psychoanalytic Theory

Freud, S. (1966). A general introduction to psychoanalysis. New York, NY: W. W. Norton. (Original work published 1920) Freud, S., & Strachey, J. (Ed.). (1983). Interpretation of dreams. Asheville, NC: Avon.
Freud, S., Strachey, J., & Gay, P. (1975). Group psychology and the analysis of the ego. New York, NY: W. W. Norton. Freud, S., Strachey, J., & Gay, P. (1990). Beyond the pleasure principle. New York, NY: W. W. Norton. American Psychoanalytic Association (APsaA)—apsa.org
Division of Psychoanalysis (Division 39) of the American Psychological Association—division39.org
Institute of Psychoanalysis (British Psychoanalytical Society)—psychoanalysis.org.uk
International Psychoanalytic Association—ipa.org.uk/
Psychoanalytic Electronic Publishing—pep-web.org
Individual Psychology

Adler, A. (1998). What life could mean to you. Center City, MN: Hazelden Information Education.
Adler, A., Ansbacher, H. L., & Ansbacher, R. R. (1989). The Individual Psychology of Alfred Adler: A systematic presentation in selections from his writings. New York, NY: HarperCollins.
Adler Graduate School (AGS)—alfredadler.edu
International Association of Individual Psychology (IAIP)—iaipwebsite.org
North American Society of Adlerian Psychology (NASAP)—alfredadler.org
Analytical Theory

Jung, C. (1958). Psychology and religion. New York, NY: Pantheon.
Jung, C. (1965). Memories, dreams, reflections. New York, NY: Vintage Books.
Archive for Research in Archetypal Symbolism (ARAS)—aras.org
Jung Page —cgjungpage.org
New York Association for Analytical Psychology (NYAAP)—nyaap.org
BEHAVIORISM
Skinner, B. F. (1976). About behaviorism. New York, NY: Random House. Skinner, B. F. (1976). Walden two. Boston, MA: Pearson.
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Skinner, B. F. (2002). Beyond freedom and dignity. Indianapolis, IN: Hackett. Association for Behavioral and Cognitive Therapies (ABCT)—abct.org
HUMANISTIC PPROACHES

Person-Centered

Rogers, C. (1951). Client-centered therapy: Its current practice, implications, and theory. Boston, MA: Houghton Mifflin.
Rogers, C. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95–103.
Rogers, C. (1961). On becoming a person. Boston, MA: Houghton Mifflin.
Rogers, C. (1969). Freedom to learn. Columbus, OH: Merrill.
Rogers, C. (1970). On encounter groups. New York, NY: HarperCollins.
Rogers, C. (1972). Becoming partners. New York, NY: Delta.
Rogers, C. (1977). On personal power. New York, NY: Delacourt.
Rogers, C. (1980). A way of being. Boston, MA: Houghton Mifflin.
Rogers, C. (1995). On becoming a person: A therapist’s view of psychotherapy. Boston, MA: Houghton Mifflin.
Rogers, C., & Wallen, J. (1946). Counseling with returned servicemen. New York, NY: McGraw-Hill.
Association for Humanistic Psychology (AHP) —ahpweb.org
Center for Studies of the Person (CSP)—centerfortheperson.org
International Network of Personal Meaning (INPM)—meaning.ca Saybrook Graduate School—Research Center—saybrook.edu

Existential

Frankl, V. (1967). Psychotherapy and existentialism: Selected papers on Logotherapy. New York, NY: Washington Square Press.
Frankl, V. (1969). The will to meaning. New York, NY: New American Library.
Frankl, V. (1985). Logos, paradox, and the search for meaning. In M. J. Mahoney & A. Freeman (Eds.), Cognition and psychotherapy (pp. 259–275). New York, NY: Plenum.
Frankl, V. (1985). The unheard cry for meaning: Psychotherapy and humanism. New York, NY: Simon & Schuster.
Frankl, V. (1992). Man’s search for meaning: An introduction to Logotherapy (3rd ed.). New York, NY: Oxford University Press.
Maslow, A. (1962). Toward a psychology of being. New York, NY: Van Nostrand.
Maslow, A. (1971). The farther reaches of human nature. New York, NY: Viking.
May, R. (1958). The origins and significance of the existential movement in psychology. In R. May, E. Angel, & H. Ellenberger (Eds.), Existence (pp. 3–36). New York, NY: Basic Books.
May, R. (Ed.). (1961). Existential psychology. New York, NY: Random House.
May, R. (1969). Love and will. New York, NY: W. W. Norton.
May, R. (1983). The discovery of being: Writings in existential psychology. New York, NY: W. W. Norton. May, R. (1992). The art of counseling. London, England: Souvenir Press. (Original work published 1939) Yalom, I. D. (1980). Existential psychotherapy. New York, NY: Basic Books.
Yalom, I. D. (1990). Love’s executioner and other tales of psychotherapy. New York, NY: Basic Books.
Yalom, I. D. (2001). The gift of therapy. New York, NY: HarperCollins.
Existential-Humanistic Institute (EHI)—ehinstitute.org
Existential Psychotherapy—existentialpsychotherapy.net
PsychAlive—psychalive.org
Society for Existential Analysis (SEA)—existentialanalysis.co.uk
Gestalt

Perls, F. (1969). Gestalt therapy verbatim. Moab, UT: Real People’s Press.
Perls, F. (1969). In and out of the garbage pail. Moab, UT: Real People’s Press.
Perls, F. (1973). The Gestalt approach and eye witness to therapy. Palo Alto, CA: Science & Behavior Books. Association for the Advancement of Gestalt Therapy (AAGT)—aagt.org
Gestalt Review—gisc.org
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Gestalt Therapy Network (GTN)—gestalttherapy.net
New York Institute for Gestalt Therapy (NYIGT)—newyorkgestalt.org
PRAGMATIC APPROACHES

Cognitive Behavioral

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York, NY: International Universities Press.
Beck, A. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist, 46, 368–375.
Beck, J. S., & Beck, A. T. (1995). Cognitive therapy: Basics and beyond. New York, NY: Guilford Press.
Burns, D. D. (1999). Feeling good: The new mood therapy. New York, NY: Wholecare.
Burns, D. D. (1999). The feeling good handbook. New York, NY: Plume.
Kelly, G. (1955). The psychology of personal constructs (Vols. 1 & 2). New York, NY: W. W. Norton.
Meichenbaum, D. (1977). Cognitive-behavior modification: An integrative approach. New York, NY: Plenum Press.
Meichenbaum, D. (1985). Stress inoculation training. Boston, MA: Allyn & Bacon.
Beck Institute for Cognitive Therapy and Research—beckinstitute.org
Center for Cognitive Therapy, University of Pennsylvania Health System—med.upenn.edu/cct
Cognitive Therapy Associates (CTA)—cognitive-therapy-associates.com/therapy/cognitive
International Association for Cognitive Psychotherapy (IACP)—the-iacp.com
National Association of Cognitive Behavioral Therapists (NACBT)—nacbt.org

Rational Emotive Behavioral Therapy

Ellis, A. (1971). Growth through reason. Palo Alto, CA: Science & Behavior Books.
Ellis, A. (1983). The origins of rational-emotive therapy (RET). Voices, 18, 29–33.
Ellis, A. (1994). Reason and emotion in psychotherapy. New York, NY: Birch Lane.
Ellis, A. (1995). Changing rational-emotive therapy to rational-emotive behavior therapy. Journal of Rational-

Emotive and Cognitive-Behavior Therapy, 13, 85–90.
Ellis, A. (1996). Reason and emotion in psychotherapy. New York, NY: Carol Publishing Group.
Ellis, A. (1998). How to make yourself happy and remarkably less disturbable. San Luis Obispo, CA: Impact.
Ellis, A. (1999). Rational-emotive behavior therapy as an internal control psychology. International Journal of Reality Therapy, 19, 4–11.
Ellis, A. (2000). A continuation of the dialogue on issues in counseling in the postmodern era. Journal of Mental

Health Counseling, 22, 97–106.
Albert Ellis Institute (AEI)—rebt.org
Rational Emotive Behavioral Therapy (REBT)—rebtnetwork.org
Self-Management and Recovery Training (SMART)—smartrecovery.org
Reality Therapy

Glasser, W. (1965). Reality therapy. New York, NY: HarperCollins.
Glasser, W. (1998). Choice theory: A new psychology of personal freedom. New York, NY: HarperPerennial.
Wubbolding, R. E. (2000). Reality therapy for the 21st century. Philadelphia, PA: Brunner Routledge.
Center for Reality Therapy—realitytherapywub.com
William Glasser Institute —wglasser.com
CONSTRUCTIVIST APPROACHES

Multicultural Counseling and Therapy

Atkinson, D., Morten, G., & Sue, D. W. (1997). Counseling American minorities. New York, NY: McGraw-Hill.
Pontorotto, J., Casas, J. M., Suzuki, L. A., & Alexander, C. (2001). Handbook of multicultural counseling. Thousand Oaks, CA: Sage.
Sue, D. W. (2003). Overcoming our racism: The journey to liberation. New York, NY: John Wiley.
Sue, D. W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice. New York, NY: John Wiley. Association for Multicultural Counseling and Development (AMCD)—multiculturalcounseling.org
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International MultiCultural Institute (iMCI)—imciglobal.org
National Guidance Research Forum (NGRF)—guidance-research.org/EG/impprac/ImpP2/new-theories/mcc
Feminist Approaches

Enns, C. Z. (1993). Twenty years of feminist counseling and therapy: From naming biases to implementing multifaceted practice. Counseling Psychologist, 21(1), 3–87.
Gilligan, C. (1993). In a different voice: Psychological theory and women’s development. Cambridge, MA: Harvard University Press.
Miller, J. B. (Ed.). (1973). Psychoanalysis and women. Baltimore, MD: Penguin Books.
Miller, J. B. (1976). Toward a new psychology of women. Boston, MA: Beacon Press.
Miller, J. B., & Stiver, I. P. (1997). The healing connection: How women form relationships in therapy and in life. Boston, MA: Beacon Press.
Miller, J. B., & Welch, A. S. (1995). Learning from women. In P. Chesler, E. D. Rothblum, & E. Cole (Eds.), Feminist foremothers in women’s studies, psychology, and mental health (pp. 335–346). New York, NY: Haworth Press.
Association for Women in Psychology—awpsych.org
Jean Baker Miller Training Institute—jbmti.org
Society for the Psychology of Women / Division 35 of the American Psychological A ssociation—apa.org/ divisions/ div35

Narrative Therapy

White, M. (2007). Maps of narrative therapy. New York, NY: W. W. Norton.
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: W. W. Norton.
Center for Narrative Practice—narrativepractice.com
Institute of Narrative Therapy (INT)—theinstituteofnarrativetherapy.com
Narrative Therapy—narrativeapproaches.com
Narrative Therapy Centre of Toronto—narrativetherapycentre.com
Solution-Focused Brief Therapy

Berg, K. B. (2003). Children’s solution work. New York, NY: W. W. Norton.
De Shazer, S. (1985). Keys to solution in brief therapy. New York, NY: W. W. Norton.
BRIEF / Brief Therapy Practice—brieftherapy.org.uk
Solution Focused Brief Therapy Association (SFBTA)—sfbta.org/
FAMILY APPROACHES

Bowen Family Systems Therapy

Giat Roberto, L. (1992). Transgenerational family therapies. New York, NY: Guilford Press.
Lieberman, S. (1979). Transgenerational family therapy. London, England: Croom Helm.
Bowen Center for the Study of the Family—thebowencenter.org Living Systems—livingsystems.ca
Strategic Family Therapy

Haley, J., & Richeport-Haley, M. (2003). The art of strategic therapy. New York, NY: Brunner-Routledge. Madanes, C. (1981). Strategic family therapy. San Francisco, CA: Jossey-Bass.
Jay Haley on Therapy—jay-haley-on-therapy.com
Mental Research Institute—mri.org/strategic_family_therapy.html
Strategic Family Therapy—psychpage.com/learning/library/counseling/strategic
Structural Family Therapy

Minuchin, S. (1974). Families and family therapy. Cambridge, MA: Harvard University Press.
Minuchin, S., & Fishman, H. C. (1981). Family therapy techniques. Cambridge, MA: Harvard University Press.
Minuchin Center for the Family (MCF)—minuchincenter.org
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We hope you now have an understanding of how the Intentional Theory Selection (ITS) model can help you incorporate your theoretical orientation into practice. You may have also begun to see how your values affect your choice of a theoretical orientation and to consider how these values may influence your role as a helping professional. We now present six schools of related thought along with specific theories that often serve as the icons for each school. We have chosen to present a sample of those theories most commonly addressed in the literature. These theories are most commonly included in counseling training comprehensive exams and national examinations for counselor licensure. Each theory is presented in the format of the ITS model. The schools are presented as separate, discrete schools. It is important to remember, however, that there is crossover in the fundamental values, goals, and even techniques across the six schools of thought.

Six Schools of
Thought and Their
Theories of Helping

Each school will be outlined in a general overview. Then the philosophy, goals, and techniques, as well as comments on the application to diversity, of each specific theory are offered, serving as a summary of that theory’s key components and the actions it suggests for working with clients. One example of a person’s ITS is also shown within each school of thought. This will allow you to see how a sampling of counselors and psychotherapists would view the development of their own theoretical orientations.
This chapter is meant to serve either as a reminder of the main components of various theories to which you have been exposed or as a primer enticing you to look further at theories you may not completely understand. As was stated in Chapter 3, you can gain a greater appreciation and understanding of specific theories in many ways. Processes such as reading original works, surveying your preferences through tools such as the Selective Theory Sorter–Revised (STS–R), and studying with a master can provide you with the depth of understanding you need or want to truly integrate your own theoretical orientation and to help clients in a therapeutic setting.
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PHILOSOPHY MAJOR COMMON
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TABLE 4.1

ITS-Style Summary of Theories

THEORY OF PEOPLE SCHOOL THEORISTS GOALS TECHNIQUES

Psychoanalytic

Humans are sexual, hedonistic, and pleasure seeking; the unconscious is key to behavior; deconstructive; deterministic; developmental

Psychodynamic

Sigmund
Freud;
Anna Freud;
Karen Horney

Insight; understanding; moving through past hurts; uncovering the unconscious

Free association; dream analysis; interpretation; analysis of transference

Analytical Psychology

Humans are connected
ancestrally; holistic; spiritual; lifelong development; biological drives are important

Psychodynamic

Carl Jung

Individuation of the self; analysis of the psyche; archetypal understanding; personality integration

Insight; education; warm relationship; catharsis; dream analysis; archetypal analysis

Individual Psychology

Humans are social beings; holistic view of people; all behavior is goal-directed; people have free will and are creative

Psychodynamic

Alfred Adler

Increase social interest; understanding of personal private logic and goals

Therapeutic alliance; learning about client’s lifestyle; collecting early recollections

Behavioral

Empirical; behavior is an environmental product; present-focused; scientific; people are hedonistic

Behavioral

B. F.
Skinner

Environmental change; specific behavioral change

Education; reinforcement scheduling; modeling; systematic desensitization; relaxation techniques; assertiveness and skills training; charting; aversion therapy

Person-

Centered

Humans strive to self- actualize; phenomenological; present is important

Humanistic

Carl Rogers

Self-actualization; increased congruence

Genuineness; unconditional positive regard; empathy

Existential

Finding life meaning is important; anxiety is based on core life conditions; people are free; phenomenological

Humanistic

Viktor
Frankl;
Irvin
Yalom

Awareness; self- actualization; increased responsibility; acceptance of core conditions of life; create/find meaning in life

Relationship based; empathy; client understanding; meaning identification

Gestalt

Holistic; future-focused; experiential

Humanistic

Fritz Perls

Integration; increased self-responsibility

Awareness; empty chair; use of pronouns; sharing hunches; dream work

CognitiveBehavioral

Therapy

Thinking and feeling are connected; people are creative

Pragmatic

Aaron Beck;
David
Burns;
Donald
Meichenbaum

Changed thinking;
identification of beliefs; awareness of automatic thoughts

Psychoeducation; collaborative relationship; behavioral techniques; cognitive modification

REBT

Humans have an innate tendency toward actualization; tendency to focus on irrational thoughts

Pragmatic

Albert Ellis

Changed thinking; reduced Education; confrontation;

irrational thoughts; changed value system

disputing irrational beliefs; homework; skill training

Reality Therapy

Humans strive to have needs met; all need survival, belonging, power, freedom, and fun

Pragmatic

William
Glasser;
Robert E.
Wubbolding

Effective choices; acceptance of responsibility; understanding

Supportive relationships; contracts; create plans; pinning down; positive addicting behaviors; WDEP system

Multicultural Counseling

Culture-based; belief systems are important; problems may be external and culturally based

Constructivist

Derald Wing
Sue;
David Sue;
Paul
Pedersen;
Patricia
Arredondo

Cultural understanding; awareness of values and biases; understanding; change in oppressive systems

Worldview consideration; self-awareness; techniques vary based on client population

Feminist Theory

Oppressive systems contribute to women’s psychosocial struggles; view women as positive

Constructivist

J. B. Miller;
Carol
Gilligan

Ability of client to see the world in various ways; deconstruction of traditional patriarchal culture

Egalitarian relationship; resource utilization; information sharing; personal validation challenging stereotypes; assertiveness training; advocacy

Narrative Therapy

People define themselves through stories; people are
social; social constructivists; people have good intentions

Constructivist

Michael
White

Changed thinking and living; use of positive stories to define self

Collaborative relationship; finding exceptions; authoring new stories; increasing choices; externalization storytelling; metaphors

SolutionFocused Brief

Therapy (SFBT)

Change may occur in a short time; future-based; phenomenological

Constructivist

Insoo Kim
Berg; Steve
de Shazer

Identification of and action Miracle questions; finding
to solve problems; exceptions; strength assessment identification of the ways problems are maintained

Bowen

Family

Therapy

Family as an emotional unit; multigenerational

Family
Approaches

Murray
Bowen

Increased differentiation Family assessment; (similar to autonomy) of therapist objectivity; family members; lowered genograms; sharing family anxiety and turmoil hypotheses

Strategic

Family

Therapy

Families perpetuate their problems; change can be sudden; creativity in change is important; therapy should focus on solutions

Family
Approaches

Jay Haley;
Milton
Erikson;
Cloé
Madanes

Change in repetitive Paradoxical family patterns; learning interventions; what solutions have directives; prescribing been attempted before the symptom; reframing; pretend
techniques

Structural

Family

Therapy

Psychological illness is viewed as family issue, not individual issue; families need appropriate hierarchy; family has subsystems

Family
Approaches

Salvador
Minuchin

Definition of general Joining; boundaries; appropriate accommodating; alignments; power family mapping; adjustments; boundary boundary making; clarity; changed unbalancing; enactment; transactional patterns reframing

The authors of this text have identified over 250 potential theories of counseling and psychotherapy. In addition, there are a multitude of approaches, some empirically validated, that at times are presented as comprehensive theories (see Chapter 2). Each theory has its unique strengths and limitations, and relevance to diverse populations; many theories stand alone as a useful paradigm for client conceptualization and as a guide for therapeutic intervention. However, individual approaches often have much in common with other theories and may look very similar. Consequently, each theory fits into a family, or a school of thought. Within each school of thought, the specific theories presented have related beliefs, with each individual theory looking more or less like the others. The six schools presented in this chapter are the psychodynamic, behavioral, humanistic, pragmatic, constructivist, and family approaches. See Table 4.1 for a summary of each theory; the table follows the ITS model.
PSYCHODYNAMIC SCHOOL OF THOUGHT
The first school of thought, and the one with the longest history, is the p sychodynamic school of thought. In general, it views human beings as basically driven by psychic energy and molded by early experiences. Unconscious motives and conflicts are central in current presenting behavior. These psychic forces are strong, and individuals are thought to be driven by basic inherent impulses. Traditional psychoanalytic theory (primarily as developed by Sigmund Freud) views these impulses as solely sexual and aggressive. However, later theorists find strong motivations in other areas, such as socialization and individuation (a process of becoming whole). Development is of critical importance in psychodynamic approaches because later personality problems are believed to be rooted in childhood experiences.
The view of therapy in both the traditional and later approaches is typically based on a complex understanding of the personality, or the psyche. Each of these approaches looks deeply at what defines human experience and, with a few exceptions, what the structures of the personality are.
Therapeutic techniques are highly experiential and are typically considered to promote long-term, lifelong change. Change is rooted deeply in human nature and focused on insight and understanding. The therapeutic relationship is considered important. However, the insights offered are the primary precursors to change. The three primary theories of the psychodynamic approach are psychoanalytic theory, analytical theory, and individual psychology.
Psychoanalytic Theory
Sigmund Freud is often considered the founding father of psychotherapy. Freud lived in a time when medical intervention was the basis of psychological treatment. However, he increased the availability and recognition of talk therapy. Even in the layperson’s world, Freud is known for identifying everything from slips of the tongue to defense mechanisms. To paint even a small picture of Freud would take a lot of canvas to express his many layers and complexities; only a few highlights are offered here.
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Life Philosophy. Freud viewed the human world as filled with sexual impulses and deterministic ebbs. Freud basically believed that people struggle to balance complete animalistic and innate pleasure-seeking impulses with the challenges of social constraints (Gilliland & James, 1998). In addition, Freud believed that people must balance their repressed sexual and aggressive urges in order to feel and function in a healthy way.
Most of what people do is powered by libidinal energy that is hidden deep in their unconscious. This libidinal energy is dynamic in that it moves from various areas of the conscious and the unconscious, and it is limited. This energy, which is primarily sexual and aggressive, drives people’s actions. However, most motivations and desires are beneath one’s conscious awareness. Consequently, more often than not, when people experience psychological pain, they may not even know why. Freud believed that it was nearly impossible to directly “see” what is unconscious.
Freud was a deconstructivist; he broke the mind down into parts that played different roles in psychological functioning. He viewed the mind as having three structural divisions. At the most basic, primal level, he identified the id. The id, powered by the pleasure principle, is one’s internal, biological baby who wants to be fed and have all needs—including eating, sleeping, and sex—met at all times. The ego, however, works on the reality principle, attempting to deal with a social world with limited resources. The ego also serves as the mediator between the id and the moralistic superego. The superego strives to be perfect and is one’s personal, moralistic component. Conflict often occurs among these structural components of the mind, and these components of a person’s mind drive every behavior. However, each component has a developmental beginning. For example, the superego does not emerge at birth but develops as a person receives messages of right and wrong, typically from parents. Children’s egos develop as they learn that they live in a world of limited resources (e.g., food arrives only when adults deliver it). And one’s id, which is present at birth, is innate and wants its needs met from day one.
As mentioned, psychoanalysis has a deterministic view of life. Nothing happens without a reason, and the past causes our behaviors. Consequently, human personality is determined by early childhood experience. Freud identified specific psychosexual stages that all people experience. As people develop, what happens around them u ltimately happens to them. People mature and move through developmental stages and are met with challenges along the way. If they move through and meet these c hallenges successfully, they will typically maintain a relative level of health. If their struggles are too great, however, they may always be slightly stuck at one stage or, at the extreme, become fixated at an early psychosocial stage. At each stage, people focus on hedonistic gratification. This primarily sexual gratification is a developmental stage: getting one’s needs met (gratification) and the process by which this occurs. At each step of the way, people run the risk of being psychologically traumatized. To avoid psychological fear and pain, people often take experiences, fluid in their conscious mind, and push them deep down in their unconscious mind. These experiences remain in the mind, however, hidden by defense mechanisms. Defenses, such as projection and repression, keep traumatic thoughts and emotions from infecting people’s conscious lives. However, defense mechanisms do not banish fearful thoughts but merely keep them hidden. If the defense mechanisms do not work, however, finding a good therapist may be necessary.
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The Psychosexual Stages.
Oral Stage (0–1). The earliest psychosexual stage begins at birth. From birth to about one year of age, gratification comes orally. Chewing, biting, nursing, and eating become the sole forms of gratification. Babies innately respond to a mother’s nipple or bottle, which becomes their first way to get their needs met. At this stage, babies already struggle because their oral needs will not always be met.
Anal Stage (1–3). At the anal stage, children have their first opportunity to exhibit control and gain independence. While being toilet-trained, infants have the opportunity to release or withhold—their first control. Consequently, personality p atterns become further molded at this stage of development. For example, an anal explosive personality, defined by being messy and disorganized, may begin to develop and create a lifelong pattern. Conversely, the more commonly studied anal retentive people typically exert great control over their own toileting behaviors early in life and continue as adults to be orderly, controlled, and structured.
Phallic Stage (3–5). The phallic stage is characterized by a major shift in gratification. Beginning sexual urges are the source of great fear. Children at this stage have many difficult tasks to overcome, and often their later problems in life germinate here. In the phallic stage, toddlers develop an attraction to their opposite-sex parent. This strong yet unconscious desire becomes a well of difficulty. Little boys, attracted to their mother, desire her, yet someone much bigger and more powerful—Dad—stands in the way. This challenge, called the Oedipus complex, is difficult to resolve. The small and physically weak toddler learns that his mother lacks a penis. The child believes that, if he attempts to take over his mother, his father will remove the child’s penis as well, which results in an overwhelming fear of castration. The toddler suppresses these issues deep into his unconscious and begins to identify with his father as the safest way to be close to mom. When they become aware of their physical lacking, female toddlers, too, have a great challenge because they develop penis envy. This envy, eliciting the Electra complex, creates a great desire for the child’s father, but her mother stands in the way, so the female toddler learns to identify with her.
Latency Stage (5–puberty). The latency stage, existing until puberty, is characterized by great repression of sexual urges. Children shove sexual energy deep into their unconscious minds and focus more on developing healthy same-sex relationships. Friendships become their main source of enjoyment and motivation. This stage shows dormant sexual behavior until the all-changing puberty arrives.
Genital Stage (Puberty–death). The genital stage, focused on genital sexual gratification, continues throughout life. Freud believed that sexual relationships with the opposite sex begin at this stage and may lead to commitments such as marriage. Although not considered the most challenging stage of development, the genital stage is often plagued by past repressed experiences. Earlier, unconscious experiences influence choices and behaviors often below a person’s awareness. These experiences continue to play out through adulthood.
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Goals of Therapy. Freud’s view of the mind serves as the basis for the goals of therapy. The structure and conflict that occur through the inner workings of the id, ego, and superego create a state of flux and movement. As a person attempts to suppress the primal drives of the id, the ego often struggles to mediate in a world of limited resources, which breeds psychological conflict. The superego, with its demands for moral perfection, also puts great strain on the ego. This strain requires the ego to make decisions in a rational way, while being tugged by two irrational components of the mind. Consequently, the main goal of psychoanalysis is understanding.
Ultimately, the helper’s goal is to move a client through past repressed memories and mend or remove failing defense mechanisms. Problems of today are rooted in experiences in the past. Helping the client reexperience and move beyond past experiences is key to successful therapy. The unconscious, which houses all the deep thoughts and feelings, continues to be a person’s greatest motivation of behavior. Inherent in the structure of the mind, the unconscious is the part about which the least is known. Consequently, much of the goal of therapy is to bring the unconscious forward; uncovering what is hidden becomes a paramount component of successful therapy. If therapy is successful, symptoms will naturally disappear.
Techniques. What would Freud do? Well, of course, movies paint the standard, nearly inevitable picture of a client sprawled upon an antique fainting couch deep in thought speaking fluidly about mom and dad. This scenario is not inevitable, but a similar process is often a component of psychoanalysis. Because the goal of therapy is to make the unconscious conscious, psychoanalytic therapists attempt to remove distractions and resistance, allowing the client to free-associate. This technique helps bring the depths of the unconscious forward. In addition, Freud utilized dream analysis because it was, in his words, the “royal road to the unconscious.” Finally, interpretation and analysis of transference (in which the client projects feelings through the therapist) further serve to bring the depths of the unconscious forward. These crucial techniques require that the therapist know when to interpret the client’s feelings appropriately. This interpretation helps the client understand how current behavior relates to past conflicts and unconscious struggles (Corey, 2004; 2012).
Although often criticized for being a long-term therapy, psychoanalysis attempts to make long-term changes in clients. The integration of the mind and self-awareness are both dynamic and worthy pursuits for moving the client. The techniques mentioned here allow both the therapist and the client to see deep into the unconscious, which helps to explain the client’s current feelings, thoughts, and behaviors. As the client’s understanding occurs, the therapist helps the client move forward, which contributes to long-term, meaningful change.
Freud and Diversity. Traditional psychoanalytic therapy is often criticized for not being applicable to diverse clients and, at the extreme, “irrelevant” (Ivey, D’Andrea, Ivey, & Simek-Morgan, 2002, p. 125). At the same time, it is typically acknowledged that Freud’s thoughts were developed in a time very different from contemporary counseling and psychotherapy. Consequently, gender bias is often offered as a critique
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of Freud, and traditional psychoanalytic therapists viewed gay, lesbian, and bisexual clients as dysfunctional. However, most psychoanalytic therapists today have broadened the traditional approach to be applicable to diverse populations. Contemporary theories that developed from psychoanalytic theory, such as objection relations theory (eg., Klein, 1975), are often considered to be more generalizable to diverse populations. If traditional psychoanalytic approach becomes your chosen theoretical orientation, it is advised you look closely at how to utilize this approach best when working with diverse clients.
Freud and the Intentional Theory Selection Model. Obviously, Freud lived long before the ITS model. In this historical highlight, Freud had presented the theory of psychotherapy. During the conception of Freud’s work, no theories of helping competed with it. Other theories in existence at the time focused primarily on spiritual and biological issues, not on psychological ones. So how would Freud’s conceptualization look? At the base was his philosophy of life, which caused him to view humans as deterministic and pleasure seeking. His school of thought was his own psychodynamic school, and his theoretical orientation was his own psychoanalytic theory. Through his own research, Freud developed his goals and techniques based on his own philosophy. He wanted to help his clients through techniques, such as free association and dream analysis, to understand how their deterministic nature and innate pleasure-seeking behaviors caused their presenting problems. Figure 4.1 shows the ITS model as it applies to Freud’s theory.

Theory

School of Thought

Life Philosophy
People are
deterministic
Psychodynamic
Bring forward conflicts
surrounding pleasure-seeking
behaviors
Free association
Dream analysis
Psychoanalytic
Goals

Techniques

FIGURE 4.1 A Psychoanalytic ITS Model

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Analytical Theory
A one-time student, mentee, and “adopted son” of Freud, Carl G. Jung offered an intuitively developed, creative, and dynamic view of the psyche and human development called analytical theory. Around midlife, Jung had a near psychological breakdown—leaving his work and much of his life behind. Although he is described as nearly going mad, he emerged from this time with a greater development of his theory, which, following his psychic change, truly only barely resembled Freud’s and had many distinctive differences.
Life Philosophy. Jung believed that people are holistic individuals connected at an ancestral level. He agreed with Freud that people possess physical drives. However, he believed that one’s main life pursuit was to move intentionally toward individuation, which is a force that pushes us toward wholeness and helps the self to emerge. Although not historically designated as an existentialist, Jung felt that people longed for life meaning, and he identified humans as having a highly spiritual dimension.
Jung viewed humans positively. He did acknowledge that people’s past influenced who they were. However, he took a less deterministic view of life that assumed people actively moved toward their potential. Consequently, Jung deemed that development occurs throughout the life span and believed that actualization occurs later in life.
Jung offered a unique perspective of personality and is credited with coining the term psyche. In Jung’s view, the psyche is composed of three major systems: the ego; the personal unconscious; and the ancestral, collective unconscious. The ego—people’s current thoughts, feelings, and reflections—is easy to access and contains their current experiences. Those emotions that people experience at the present time and the information that they are currently absorbing are housed in the ego and are accessible and present. The personal unconscious houses those memories and thoughts that are filed away, accessible but more difficult to reach. If you imagine the face of your fourthgrade teacher, likely you accessed your personal unconscious. The teacher’s face was likely accessible but was not at first present in your ego. At the deepest level and very difficult to access is the collective unconscious. Through the study of myths, languages, and art, Jung realized that all cultures, from the most primitive to the most civilized, have common themes and stories. He found strong connections between cultures and identified a deeper, ancestral level to our psyche. Deep within this ancestral level, people contain archetypes, which are basic icons that build their personality. For example, all people contain shadow, the wise one, healer, anima (our female side), animus (our male side), and hero images. When people have life experiences, they build upon these archetypes, which formulate their personality. These archetypes serve as building blocks for categorizing and organizing experiences, ultimately making people who they are.
These archetypes, which are typically hidden from one’s awareness, are expressed in dreams, religions, myths, and cultural symbols. For example, take a Disney cartoon, a contemporary film, or any fable and decide who (or what) represents the hero and the shadow. Jung believed that these symbols of the collective unconscious could be found from the most contemporary of societies to the most primitive, isolated tribes.
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Human connection serves to bind all people in some way while still allowing individual personality to emerge.
Jung, like Freud, believed that people are motivated by libidinal energy. Later, however, Jung came to oppose Freud’s sexual and aggressive understanding of libido and perceive libido instead as creative life energy with a biological basis. This energy— moving back and forth, never lost or created, but placed in various areas of one’s psyche—was in constant movement. For example, people could place all of their energy in their creative, aggressive shadow side. Embracing their “evilness,” people could entertain a life in which they saw only negative in others and enjoyed controlling others though aggression. However, people could have energy fixated in their hero side, so that they were always looking for the hidden good in others while trying to care for them. Consequently, where people focus their libido drives their behavior and emotions.
Goals of Therapy. For Jung, a main goal of therapy is the integration of the psyche. Because he believed that people have a set and limited amount of psyche energy, they must find balance in their psychological world and intentionally help their self to emerge. This emerging self enables people ultimately to be full-functioning individuals. The main goal of counseling is individuation, or the integration of the conscious and unconscious systems through insight, personality transformation, and even education (Kaufmann, 1979).
This individuation and emerging of the self make up a lifelong, intentional journey. Unlike Freud, Jung believed that midlife is the first time an individual could begin to have integration, and he focused on the emerging of the psyche instead of the causes. As people grow, mature, and move toward individuation, they acknowledge and embrace all parts of themselves—the hero, anima, animus, healer, and even shadow. Without this intention and integration, the true self could never emerge. Regarding individuation, Jung (1991) states:
So although the objective psyche can only be conceived as a universal and uniform datum, which means that all men share the same primary, psychic condition, this objective psyche must nevertheless individuate itself if it is to become actualized for there is no other way in which it could express itself except through the individual human being. (p. 179)
Techniques. Jung did whatever it took for the client to gain insight. He was highly creative in therapy and believed in doing whatever was necessary for healing (e.g., Green, 2008; McClary, 2007). First and foremost, however, Jung believed the analyst and client should have a warm relationship, which is the foundation of quality therapy. Egalitarian, respectful relationships are the core to therapy. He believed that only through these relationships would clients have the comfort to share their stories and have the room to experience catharsis. Although Jung was known to sing, pray, dance, utilize art, and even examine astrological charts, he is most known for two techniques— dream analysis and archetypal analysis.
Jung believed that dreams ultimately help people see the deepest layer of their unconscious. Through a process of self-understanding, people can strive, grow, and
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enhance. If you, as a helper, espouse a Jungian paradigm, you understand that clients reach for individuation and health as they gain a greater understanding of their psyche and that this understanding can be achieved best through archetypal analysis.
Analysis helps to bring insight, which is the key to change. For example, we had a client in her early forties who was struggling with assertiveness and presenting with marital difficulties. She shared the following dream:
I was fighting with my husband, and he looked like me. I was trying to pull him in, almost into me. Not like I was going to eat him but . . . well, it sounds weird, because at the same time I was yelling at him and pushing him away, I was trying to hug him. He kept saying, “Don’t push me away, you need me.” I didn’t know what to do. I never really felt anger in the dream, but just fear or even guilt. I felt like it was wrong for me to hold on to him.
The client wisely believed the dream was a commentary on her marriage. She did push her husband away and yet wanted to draw nearer to him. To an analytic helper, however, the dream was something more individual, a commentary on the client. As a midlife individual, her goals were integration and individuation. Her husband represented her animus—the male part of herself. Her goal of being assertive was hindered by the guilt and fear of embracing her more masculine (animus) side. The dream was telling her “you need” to integrate your animus and anima. Once she understood the dream, the client was much more able to be assertive without feeling guilt.
Analytic Psychology and Diversity. Carl Jung’s work has a variety of thoughts regarding how to apply his work best to diverse clients. His approach emerged from looking at the commonalities of all people across cultures. Consequently, analytic therapists value the cultural context of all clients, highlighting this as an effective approach across cultures. Therapy commonly looks at dreams and spiritual aspects, and assumes basic commonalities of all people, which could challenge some clients’ belief systems. Analytical therapies believe in being creative and meeting clients where they come from, however, and are thus thought to be applicable to a wide range of clients.
Individual Psychology
Another prodigy of Freud, Alfred Adler, also believed humans were motivated by a few very basic needs. However, Adler, especially later, had differing views on concepts such as the ego and psychopathology (Ansbacher, 1985; Maniacci, 2007). Adler did believe parental relationships are important; however, the major need and focus of development are centered on socialization.
Life Philosophy.
Gemeinschaftsgefühl, typically translated as “social interest,” is the core tenet of individual psychology. Adler became disenchanted with Freud’s deterministic view that people are primarily sexual beings. Like Freud, Adler believed that one’s primary personality is constructed and set at an early age. Consequently, he focused great energy on understanding early life development and the role one plays in the family. Parenting style, sibling rivalry, and even childhood illness write the roles
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one will continue to play later in life. Parents who give too much, too little, or the wrong type of support may risk their child’s ability ultimately to become a socially mature and useful person.
As reflected in the title of Adler’s approach, people are holistic individuals (indiviuum is Latin for “individual” or “whole”). A major contrast to the reductionism that Freud endorsed, this approach looks at the various components that make people human. Adler’s concern was the entirety and completeness of the person.
People are also teological (goal-directed) creatures. All of one’s actions, even the smallest, seemingly random action, serve a purpose and can be understood when the goal is discovered. Adler believed that people have free will, free choice, and a creative power to choose their behaviors; consequently, they can choose new goals and behaviors. Unknown to most, each individual has a personal fictional finalism, her driving and unattainable goal. Our unattainable fictional finalism serves as all we strive to become. All people develop their own view of what they attempt to reach. People may have goals of being perfect, good, godlike, the perfect father, the funniest person, and so on. These goals may guide their behavior but are immeasurable and ultimately unobtainable. For example, a boy may strive to be the perfect son. His behaviors along the way help him, as he views it, to make this happen. Although this goal is immeasurable, striving to attain it drives his everyday behaviors.
As people strive to meet their life goals, they commonly develop smaller goals along the way to reaching their fictional finalism. However, these smaller goals may not always be effective in other areas of their life. These mistaken goals lead people to make decisions that have emotional consequences. For example, if a boy is striving to become the perfect son, he may make the assumption that this goal requires him always to give of himself and not to meet his personal needs. Consequently, at the extreme, this goal will not work to bring him happiness. If he meets every situation believing that he must give, he may ultimately become drained and even resentful of others.
Adler believed innate to being born is a feeling of inferiority. People’s natural beginning state is one where they feel “less than.” However, this state is not a weakness or abnormality and serves truly to be a powerful motivation of human behavior. Due to their beginning stance, people strive to achieve superiority. This motivates them to achieve as they attempt to compensate for this feeling. If people do not develop ways to accomplish this, they run the risk of developing an inferiority complex, which includes a pervasive feeling that one is less than others. An additional risk is the acquisition of a superiority complex: an attempt to overcompensate for one’s own inferiority feelings with grandiose opinions of one’s talents and success (Adler, Ansbacher, & Ansbacher, 1989).
In pursuit of the ultimate personal goal, Adler identified various styles of life, influenced by early experiences to help people along their goal-oriented journey. According to Adler, as social beings, people have several life tasks to accomplish. These tasks include love, friendship, occupation, family, and spirituality. Each of these tasks has unique social challenges. In this pursuit, the various styles of life drive how people are or are not successful in achieving them. The styles of life serve as the “spectacles” through which the person perceives her own life (Mosak, 1979, p. 44). As part of people’s styles of life, they lean toward a personality type. Dominant-type people lack social interest and often hurt themselves or others. Common getting-type people expect
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others to meet their needs and frequently become dependent upon others. Avoidingtype people minimize contact with others and the world, ultimately avoiding failure and success. These three types of individuals offer little to others, consistently struggle with problem solving, and have limited social interest. The fourth, and most healthy, style of life is the socially useful type. These individuals are able to accomplish the basic tasks of life while being socially minded. They typically contribute to the elevation of the human condition and society in general.
Goals of Therapy. Adler believed that the bulk of an individual’s personality is established in the early years of life. As creative individuals, however, people do have the ability to change. Through insight, their perceptions can change, which in turn creates personal and behavioral change. Because people are social creatures, increasing the social interest of clients is the ultimate goal of therapy.
In the process of change, it is often important to examine the private logic of the individual. These personal cognitive and emotional abilities are designed to help each person to achieve life goals. However, disruptive private logic, inferiority/superiority complexes, and mistaken goals all contribute to daily discouragement. Consequently, the goal of therapy is change—to reconfigure private logic, to gain healthy goals, and to accomplish life tasks in socially useful ways.
Techniques. Adlerian therapists first establish a therapeutic alliance: a relationship centered on warmth and collaboration. After establishing rapport, which is a necessary step for an Adlerian helper, a lifestyle assessment is required. Learning the client’s family constellation, including birth order, early recollections, private logic, and fictional finalism, is key to client change. Lifestyle assessment is the key to the therapeutic process because it assists the helper in learning about the client and later providing the client with insight and interventions.
The client’s constellation represents the roles played within the family. These roles affect who the client is today. Understanding how people view their developmental years tells the helper who they really are today. Adlerians also focus on gathering early recollections, a person’s early memories. These recollections tell the helper much about the client’s style of life and goals. The Adlerian helper believes that the important issue is not the reality and objectivity of early recollections but rather the client’s subjective meaning that is revealed in early recollections. The roles clients play in their early recollections will likely continue to be played in their contemporary lives. For example, here are three early recollections from a client named Anton: First, when Anton was four, his kitten disappeared, never to return. Second, when he was five, a neighbor child whom he feared stole his shoes. Third, when he was seven, his brother broke his favorite toy, a Star Wars Chewbacca doll. You likely see a theme. What do you think these early recollections say about Anton today? The recollections of the past he shares about himself speak to who he is today. The Adlerian therapist would look at these early recollections and attempt to find patterns or themes. In this case, the therapist might see that Anton felt hurt and loss in each of these situations; he felt like others were taking away what was then important to him. Through an Adlerian perspective, this would suggest that today, as an adult, he feels as though others take from him unfairly.
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First, the Adlerian helper establishes rapport. Then he or she conducts a thorough assessment that includes gaining an understanding of the client’s lifestyle, early recollections, birth order, family constellation, goals, and private logic. Beyond these, Adlerians present many pragmatic techniques, such as acting as if, pushing the button, paradoxical interventions, and catching oneself, that help clients to gain insight and make behavioral changes (these are defined in detail elsewhere; see e.g., Mosak, 1985; Murdock, 2009).
Individual Psychology and Diversity. Although Adler’s approach is called individual psychology, Adler and his contemporaries acknowledged the importance of social context for clients (Arciniega & Newlon, 1999) and understood the necessity to understand clients from the client’s own cultural background. It is possible that the focus on self could be a challenge in working with clients who come from a collectivist culture. The family is considered so important in bringing about understanding and change, and clients from cultures that feel psychological challenges bring shame or embarrassment on the family may be reluctant to provide open dialogue surrounding family issues. However, several have proposed that, when done correctly, the Adlerian approach has few limitations in multicultural settings (Corey, 2012) and is often complimented as a diverse-friendly approach. Adler may be considered the first feminist in the history of psychotherapy because he believed men and women should be treated equally. His belief that all individuals should be treated equally was evidenced in counseling sessions during which equalitarian relationships were promoted.
BEHAVIORAL SCHOOL OF THOUGHT
The behavioral approach takes a much different look at human behavior: Humans are shaped and determined by sociocultural conditioning. This paradigm is basically deterministic because all behaviors are believed to be a product of learning through conditioning and reinforcement. Effective as well as ineffective behaviors are learned and typically are the result of learned or expected consequences. True, traditional behaviorists take a scientific, empirical approach and primarily focus on tangible behaviors, goals, and techniques.
Traditional behavioral thinking has many contemporary variations. The process of therapy still focuses on behavioral aspects of clients, but it does not ignore the need for emotional expression and a warm therapeutic relationship. For the purpose of example, only behavioral therapy will be introduced here because this approach outlines the original philosophy of the behavioral school of thought.
Behavioral Therapy
B. F. Skinner (1976) in Walden Two describes a utopian society where behavioral techniques are utilized to reduce the need for individual morality and make the need for personal value unnecessary. This revolutionary, controversial writing made practical the value of behavioral therapy. While the concept of utopian societies may have little to do with today’s counseling and psychotherapy, the work of B. F. Skinner does.
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Life Philosophy. Nearly every day, professionals and laypersons use techniques from behavioral therapy. Spanking, speeding tickets, gambling casinos, and even employee-of-the-month programs are all the results of several key behavioral theories. Behavioral therapists believe that people’s behaviors are products of their environment and that their actions are the results of what happens to them. Behaviorists see people as genetic creatures. However, as empiricists, behaviorists believe people should examine only that which can be observed and measured. If something cannot be tasted, touched, felt, heard, or seen, it is not essential to therapy. Consequently, more value is placed on the present than on past experiences. Behaviorists are known for their adherence to the scientific method and objective approach to psychotherapy. An additional life view of the behaviorists is that we are all basically hedonistic—pleasure seeking. People seek reward and pleasure while avoiding punishment and pain.
What causes emotional and behavioral problems in life? Learning—the process that creates healthy emotions and behaviors—also creates problems. Because all behavior is reinforced through the process of learning, both positive and negative behaviors and their respective consequences are learned. Each person is unique, and each has a unique learning history. The rewards people experience and the consequences (both good and bad) they endure cause their behaviors.
Traditional behavioral approaches have three major theoretical underpinnings that describe human behavior: classical conditioning, operant conditioning, and social learning theory.

Classical Conditioning. Early in the twentieth century, while studying the digestive systems of dogs, Ivan Pavlov made an interesting discovery. He found that he could ring a bell and dogs would drool. His discovery forms the basis of many behavioral techniques and describes many basic human behaviors.
Pavlov showed that a stimulus that should not cause an automatic reaction could be made to do so. Pavlov rang his bell and gave his dogs food powder. What did they do? Salivate. He rang his bell again, gave the powder, and what did his dogs do? Salivate. Yet again he rang his bell and gave the powder. What did the dogs do? You are correct. They salivated. Then he again rang his bell without giving the dogs the powder. What did the dogs do? Yes, again, they salivated. The powder was an unconditioned stimulus, meaning it caused an automatic reaction—in this case, drooling—the unconditioned response. When a neutral stimulus, like the bell, is repeatedly paired with an unconditioned stimulus, like the powder, the bell becomes a conditioned stimulus that can elicit a response—the conditioned response—on its own. Thus, learning occurs.
Operant Conditioning. Although classical conditioning seemed to explain many behaviors, others (e.g., Bandura, 1969; Skinner, 1971) believed that there was more to learning. All behaviors have consequences, such as rewards and punishments, that cause behavior. For example, if you make fun of someone’s hair, that person may choose to kick you; pain is your consequence, and you will likely no longer make fun. If teachers want to increase the amount of questions their students pose in classes, they might give a dollar to each student after he or she asked a question. An educated bet says that this practice would increase questions and class participation. Operant conditioning explains that every behavior is either promoted or not promoted by what follows.
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Social Learning Theory. Human behavior is vastly complicated. What we do or don’t do is often beyond our own comprehension. For example, ask yourself these questions: “Have you ever run your car over a cliff? If not, why? Have you received positive rewards, like money, for not going over a cliff? Then how did you learn not to?” Social learning theory explains that people also learn vicariously by watching others (Bandura, 1969). If you see a person get punished with a parking ticket for illegal parking, you can learn vicariously from that person’s mistake. Behavioral therapists believe we can learn from observing the behaviors of others.
Goals of Therapy. In many ways, the goals of behavioral therapy are the most straightforward of the contemporary psychotherapy approaches. Behavioral therapists spend their time with clients addressing specific behaviors that help their clients learn to behave differently (e.g., Daly, Creed, Xanthopoulos, & Brown, 2007; Pagoto, Bodenlos, Schneider, Olendzki, & Spates, 2008; Weiskeop, Richdale, & Matthews, 2005). In this process, clients are often empowered to set specific goals that are relevant to them and their current presenting problem.
For therapy to be effective, data must be collected, goals must be set, and relevant interventions must be initiated. As an objective approach, behavioral therapy examines outcomes and strives to initiate assessments based on these interventions. The goals of therapy include helping clients to change their environment, because environment is truly the cause of all behaviors, and reinforcing new, more effective behaviors.
Techniques. Behavioral therapists utilize many techniques that are based primarily on classical conditioning, operant conditioning, and social learning theory. Techniques focus on changing the environment and behavioral consequences because all behaviors are fundamentally based on learning. The tool belt of a behavioral therapist is full and includes tools such as education, reinforcement scheduling, modeling, systematic desensitization, relaxation techniques, assertiveness and skills training, charting, contracts, aversion therapy, satiation, self-monitoring, and homework assignments (Corey, 2012; Day, 2004; Gilliland & James, 1998; Ivey, Ivey, D’Andrea, & SimekDowning, 2007). Behaviorists have been highly creative and have given the helping professions many tools to use. One example is the token economy. This intervention is based on giving small rewards for positive behaviors that can later be traded in for larger awards. Behaviorists have also given us aversion therapy, based on classical conditioning. A behavior can be limited by pairing it with something that is not enjoyable. For example, if you want to quit biting your nails, a helping professional might suggest that you put extremely hot pepper seeds under your nails. Soon nail biting will be associated with pain, and you will learn a new behavior: stop biting your nails.
Behaviorism and Diversity. The behaviorist approach is often considered applicable to all clients. The foundations of therapy and the techniques and evidence to prove their effectiveness go beyond cultural boundaries. Learning and behavior are universal across cultures and demographic characteristics, including age. Consequently, behaviorism works well with diverse populations (Corey, 2012). This makes it easy for counselors and psychotherapists to avoid the pitfalls that can happen when their v alues have an impact on therapeutic endeavors.
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Theory

School of Thought
People do what provides
them with rewards
Life Philosophy
Identify
specific
behaviors
Education
Reinforcement scheduling
Behavioral
Behaviorism
Goals

Techniques

FIGURE 4.2 Jim’s ITS Model
A Behaviorist School Counselor and the Intentional Theory Selection Model. Jim, a graduating therapist and school counselor, believed, as do most behaviorists, that the key to changing a child’s behavior is identifying target behaviors and changing reinforcements that perpetuate these behaviors. Jim commonly works with students whom teachers have identified as acting out. He has found that certain students who disturb the classroom environment often get attention only when they act out. Consequently, Jim focuses on educating teachers about behavioral phenomena and assists them in creating reinforcement schedules that reward students when they are on task and performing well in the classroom. Jim’s ITS model might look like Figure 4.2.
HUMANISTIC SCHOOL OF THOUGHT
The core belief of the humanistic school is that humans have a basic inclination to become fully functioning, to develop and grow psychologically. Individuals are viewed in a positive manner, and the context of therapy is often focused on the affective world of the client, moving toward self-actualization, gaining trust, achieving spontaneity, and focusing on the human condition. Humanistic approaches take a phenomenological, here-and-now approach. The relationship between the client and therapist is thought to be fundamental to successful therapy and helping clients achieve their potential. The most common humanistic approaches are person- centered, existential, and Gestalt.
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Person-Centered
The focus of the person-centered approach (also referred to as the Rogerian, clientcentered, or nondirective approach) is truly inherent in the theory’s title. The personcentered approach typifies the humanistic approach and focuses on the client and the world of the client as the center of therapeutic change.
Life Philosophy. The true person-centered helper views the world and human nature as positive. People, left to their own volition, continually strive to reach their potential (Rogers, 1961). A fundamental belief is that humans strive toward self-actualization in a process of growth. Self-actualization, the process of moving toward one’s greatest potential, is never achieved but is a continuous process. This actualization requires one to grow and gain experience constantly.
Person-centered helpers believe everyone is unique and everyone has a unique worldview. Consequently, clients should be understood in a phenomenological approach, which requires the therapist to attempt to see the world as clients see it. Although often hard to remember as a helper, the clients’ emotions and actions make sense given the way they view the world. Carl Rogers (1995), often considered the father of humanistic therapy, stated that it is important “to open one’s spirit to what is going on now, and to discover in that present process whatever structure it appears to have” (p. 189). Rogers also believed that life and therapy are characterized by a subjective reality and should be immersed in the here and now. Each moment is unique, and people are defined not by their past but by who they are in the moment.
Person-centered helpers believe that clients ultimately know themselves better than therapists could ever know them. Clients are experts on their own lives. Consequently, person-centered helpers may offer little advice and few directives. They might be directive about the process of therapy, but they allow their clients to make their own choices. This approach serves many purposes, including empowering the client. The value of this stance is highlighted in this trite but concrete example. Imagine you could go to a therapist and ask what you should wear for a big interview; the answer given to you is “the red power tie.” If you get the job, you might think it had more to do with the helper’s choices than with your abilities. In contrast, if you did not get the job, you might be angry with the helper and feel you were led astray. A person-centered helper should help you find what you want and what ultimately works for you. You are assisted in the process of finding your own answers, which empowers you beyond one specific situation.
Goals of Therapy. The major goal of therapy is ultimately to help the individual continue toward self-actualization. At times, however, life situations or the individual’s perceptions may hinder growth. The road to actualization can become blocked, and therapy is about removing these blocks. People have a natural tendency to move forward to reach their greatest potential, and they can surpass difficulties only through removing these blocks.
Does this mean people must have large problems to be in therapy? No. Something will always be in the way of reaching their complete potential. Therapy can focus on prevention of struggles at predictable life transitions or simply on helping
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someone become “more.” Therapy is actually most effective for those who are relatively healthy (Yalom, 1995) because they have the energy, insight, and potential to learn and consequently to grow psychologically.
A common block people often face is a distorted view of self (Gilliland & James, 1998). Through the process of therapy, helpers hope their clients can find greater selfunderstanding and increased congruence between their ideal self and their real self. This difference between who people want to be and how they perceive themselves can cause great psychological turmoil and is a major roadblock to people living to their greatest potential. If a workshop attendee gives speakers negative feedback about their presentation style, the speakers may believe they are “bad public speakers,” which may not be true. They may be great public speakers but view themselves as less skilled based on this limited information. This view creates anxiety; the job of the counselor is not to “directly reduce anxiety” (Hazler, 2003, p. 166) but to increase congruence between the ideal and real self. Consequently, a healthier self-concept is often the result of effective therapy.
Techniques. People are individuals with different needs and wants. Therapy is immersed in phenomenology and the here and now. Consequently, directives and typical techniques are not common in the person-centered approach. In contrast, the cornerstone of the person-centered approach is the therapeutic relationship. Genuineness, the ability to be nonjudgmental, and empathy are the keys to therapy and the therapeutic alliance. These three core conditions of therapy are necessary and sufficient for change to occur (Rogers, 1957).
Genuineness, or the ability to be authentic, requires helper transparency. Therapists must be aware of their own feelings and allow this awareness to be part of the relationship. Clients know when therapists are being dishonest, so developing facades only harms the therapeutic relationship. Being truly authentic is difficult, however; it requires self-knowledge and understanding, and it takes the ability to know and share one’s self. These requirements challenge helpers in cognitive and emotional dimensions and also force them to serve with congruence, being honest in both words and actions: “Congruence is the stream upon which accurate and therapeutic communication travel” (Quinn, 2008, p. 461). This congruence challenges us as helpers because it requires us to use ourselves as a therapeutic tool and reveal ourselves as individuals.
Being nonjudgmental, or offering unconditional positive regard, requires helpers to completely and wholly accept their clients (Rogers, 1957, 1995). Therapists must not put conditions on therapeutic relationships in order for an environment of trust and acceptance to occur. They do not have to accept all that their clients do, but they must accept clients at the core for being human. To be truly effective, therapists must accept clients in their entirety.
For therapy to be successful, therapists must convey empathy to their clients. Empathy is, first, the ability to see the world through the eyes of another and, second, the ability to convey this insight. This empathy requires that therapists take a phenomenological approach and truly listen to the affective world of their clients. Person-centered therapy requires such basic truly powerful skills such as
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the ability to reflect the client’s narrative, to listen, and to paraphrase it all—all while producing rapport. As a helper, understanding and having insight are important. To help clients move toward their potential, however, therapists must have the ability to share this insight with clients—to show them that they see their joys and struggles.
Being Person-Centered in a Diverse World. With a phenomenological approach, it is hard to find a critique of a person-centered perspective from a multicultural context because the phenomenological approach prompts understanding clients from their cultures. Within the literature, however, a few potential limitations have been noted. One, the focus on the individual may have a negative impact for clients who come from collectivist cultures (Corey, 2012; Murdock 2012). Many clients, especially those from cultures who believe therapy may be an embarrassment to their family, come to therapy as a last resort. Some clients from culturally diverse backgrounds will expect therapy to be directive (Corey, 2012), and an approach that does not use such techniques with these clients may be difficult for them to accept. However, the person-centered approach has also been highlighted as being open to diversity, striving toward understanding diverse cultures, and emphasizing the client’s values as paramount to the therapy. The goal of the therapist is to truly understand clients from their worldview and their culture, and thus the person-centered approach has great promise in work with clients from all races, ethnicities, religions, orientations, socioeconomic statuses, and abilities.
Existential
Why are we here? What happens when we die? What is our purpose? How can we live a meaningful life? These questions lie at the core of the existential approach. The fundamental questions of existence are core to people’s successes and challenges in life.
Life Philosophy. Often known as philosophical helpers, existentialists have woven their fabric into the tapestry of humanism. Existentialists are often misperceived as pessimistic because they deal with fundamental issues such as death, isolation, and anxiety and with questions of existence. They help clients deal with the fundamental and basic conditions of being human. For example, existentialists view life as ultimately meaningless (Yalom, 1995). Some people may see this view as discouraging or sad; in the existential paradigm, however, it offers people an opportunity to create their own life meaning and pursue their own life purpose. This belief allows people to make their life personal and to tailor their life’s work to who they are.
Existentialists believe that anxieties and worries are ultimately consequences of basic and core conditions of life. People’s most basic emotions stem from acknowledging the realities of life. For example, the fact that one will ultimately die creates great psychological stress. People question what death is like and what happens following death, and they may even imagine the world without them. This arena of the unknown
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creates angst. People want to have answers to these difficult questions but often do not. Knowing that they will die reminds people that they are limited in the time they have to accomplish their goals. Death is a constant reminder that in order to do all they want, or to say all they want, people are working with an unknown timeframe.
Existentialists also acknowledge that people have complete freedom within their capabilities. This freedom often frightens people, however, so they often pretend not to have it. For example, you might often like to sleep in. However, you feel you must go to work as opposed to sleeping in. You do not actually have to go because you have the freedom to do what you want. However, knowing that you are completely free can be scary. This realization challenges people’s view of the s ecurities they have.
People struggle with knowing that they are responsible for their own lives, and they often fight accepting responsibility and look to blame others for the consequences of not accepting responsibility. If people do not accept that they are the makers of their own situations, they run the risk of not taking control of their own lives.
Several authors (e.g., Corey, 2004) consider existential psychotherapy to be more of a philosophical approach than a unique humanist approach. Existentialism serves as a way to view clients but is not a completely unique approach. Although existentialism has common identified tenets (Halbur, 2000), individual existentialists themselves are unique. Each individual is understood as unique, so it makes sense that there are as many existential approaches as there are existentialists.
Existential psychotherapy does not replace but builds upon humanism. Consequently, it is also present-focused, phenomenological, and holistic; believes in the uniqueness of others; and attempts to help others continue toward self-actualization. Rogers (1995) writes, “It is this tendency toward existential living which appears to me very evident in people who are involved in the process of the good life” (p. 189). He believed that a component of actualization is to live in an existential way.
Goals of Therapy. Awareness is a major goal in existential psychotherapy (Corey, 2004; Yalom, 1980). Like person-centered therapy, existential psychotherapy focuses on moving forward and continuing toward actualization. However, existentialists also believe that their duty is to facilitate a process through which clients can confront conflicts and ultimately issues of existence, meaning, and what being human means (Hansen, Rossberg, & Cramer, 1993; Yalom, 1980). More specifically, this goal includes awareness of the possibilities available, one’s freedom to choose, responsibility for one’s choices, and barriers to freedom.
Another major goal in existential therapy is acceptance of the core conditions of being human. Helping clients to acknowledge their freedom and use it wisely is important. Accepting one’s personal freedom is a much more difficult task than merely being aware. Acceptance of responsibility is also key. Many clients have said, “I know I can do it,” yet they do not follow through. To be active and to take control of one’s self and one’s life is important. As a helper, you can serve to empower clients to make personal choices and to have the courage to follow through.
An additional and paramount goal of therapy is to help people find or create meaning in their behavior, their lives, and even their suffering (Frankl, 1967;
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Kottler & Brown, 1992). Accepting that life is meaningless is difficult, especially if people do not then take the next step to rediscover or create meaning in their lives. The existential helper assists clients in discovering or rediscovering meaning in their lives.
Techniques. As was discussed in the person-centered approach, the helping relationship is necessary, and for the most part sufficient, for effective psychotherapy. This relationship continues to require the therapist’s acceptance, authenticity, and empathy. The therapist’s task is to enter the client’s world and understand the client’s unique worldview (Corey, 2004; Kottler & Brown, 1992). The counselor’s role is also to be present as clients confront their concerns, rather than acting as a problem solver (Corey, 2004), while helping clients accept responsibility for their own choices (Ivey et al., 1987). In general, however, existential counseling is not technique-oriented; it is relationship-focused and may utilize techniques from other supporting counseling approaches. Existential shock therapy, client disclosure, therapist disclosure, acceptance of responsibility, paradoxical intention, and existential discourse (Becker, 2006; Frankl, 1973; May 1983; Yalom, 1980, Yalom, 2002) have all been suggested as “techniques” utilized in existential approaches. Although they are not traditional techniques and interventions common to other therapeutic approaches, these tools and general counselor characteristics are utilized to help promote client change.
Existentialism and Diversity. Existentialism as an overall approach is often thought to be highly effective with a diverse clientele. Similar to previously addressed theories, however, the focus on the individual may challenge those from collectivist cultures because they may struggle with feeling completely understood. As a phenomenological approach, however, existentialism focuses on the individual’s values, beliefs, and cultures. Albert Camus states, “[S]eeking what is true is not seeking what is desirable.” Ultimately existential therapists seek to understand what clients believe is their own reality. Thus, existential therapists strive to understand the client; his or her choices, feelings, and behaviors; and the way meaning is constructed by the client. An effective existentialist would approach a client from a collectivistic culture, or any other culture, by attempting to understand the client from his or her worldview and accepting that as the client’s reality.
An Existential Psychotherapist and the Intentional Theory Selection
Model. John, a psychotherapist who specializes in addictions, has offered consultation to Kristin, a beginning substance abuse counselor. Kristin stated, “My clients drink, use, and abuse because it is all that fills voids in their lives. Nothing else gives them meaning. . . . It’s like it’s all they have to live for.” Kristin said that she had struggled finding a theory that worked for her and that “people are free to make choices, good or bad.” John asked Kristin to identify her goals with clients, and she said, “To help them stop using drugs and alcohol and replace their use with more meaningful experiences.” Based on this discussion, John thought her ITS might look something like Figure 4.3.
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Theory

School of Thought

Life Philosophy
Find
meaning
in life
Provide empathy
Identify meaningful life experiences
Humanistic
Existentialism
Goals

Techniques
People are free
Death causes life’s anxiety

FIGURE 4.3 Kristin’s ITS Model
Gestalt
Human experience, behaviors, and reactions are vastly complex. Physically, we are primarily carbon, oxygen, water, and sugar. These ingredients are the components that make up human beings. However, we are more than the sum of our parts—the mantra of Gestalt therapy.
Life Philosophy. With strong roots in German philosophy and many parallels to the perceptual field of Gestalt psychology, Gestalt therapy is attributed primarily to the work of Fritz Perls (e.g., Perls, 1969a). The term gestalt is German meaning “a unified whole” and is the foundation of this humanistic approach.
Gestalt Psychology. To understand the philosophy of Fritz Perls, you must first understand some basic assumptions of Gestalt psychology. Gestalt psychologists believe that individual components, such as the sugar in cola, have no meaning without their complementary components. Isolated parts are meaningful only when viewed holistically. Humans by nature attempt to bring about gestalts—they attempt to organize data into complete wholes. We even attempt to fill in what is missing in day-to-day experiences. Gestalt psychologists identified several key perceptual tendencies, with the easiest to explain being visual. One is the principle of closure. People’s nature is to finish experiences that are lacking key details, to make sense of data. People also tend to organize based on the principle of proximity. Items that are close together tend to be grouped together. For example, what do you see in the following groupings?
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O O O O O O O O O
O O O O O O O O O
O O O O O O O O O
Most individuals see a square made of circles in the first group, three columns of circles in the second, and three rows of circles in the third. This is due to people’s desire to organize and make sense of data. In all three groupings, the same amount of ink was used, but how you organized them changed.
Another common way to organize data is through the principle of similarity. People have a strong perceptual tendency to group like objects together. For example, what do you see here?
O O O O X X X O O O O O O X X X O O O O
O O O X O O O X O O O O X O O O X O O O
O O X O O O O O X O O X O O O O O X O O
O X O O O O O O O X X O O O O O O O X O
X O O O O O O O O O O O O O O O O O O X
X O O O O O O O O O O O O O O O O O O X
Most people do not see rows of Os and Xs. Yet that is what is printed. Likely they group the Xs together and observe them as a wavy line.
Sometimes, people organize data in very predictable ways. However, you must remember that each person is an individual and organizes data in different ways. Thus, each person lives in his own phenomenological world. Humans are limited when it comes to how much they can take in and can process. People constantly move their perceptual focus. What they focus on at any one time is called figure by Gestalt theorists. What grabs people’s greatest attention, focus, or figure is highlighted in the rest of their perceptual field, referred to as ground. What do you see here?
O X O X
O X O X
O X O X
O X O X
Most individuals see one of two things, either rows of Os and Xs or alternating columns of Os and Xs. However, they really cannot see them both at once. People’s ability to digest all information at the same time is limited.
Several Gestalt psychology tenets become important in understanding Gestalt therapy. First, people actively attempt to organize and form wholes in their figureground field. Second, stimuli can be exchanged from ground to figure based on the phenomenological needs of the individual. Third, the individual’s awareness of her surrounding field determines the accuracy of her perception (Perls, 1969a).
Gestalt Therapy. If you have an understanding of the Gestaltist mind, you can start to understand Perls. Perls developed his approach based on the tenets of the psychologists. As a humanist, he believed that people have one inherent goal—self-actualization.
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In this ongoing process, people sometimes separate and lose their wholeness psychologically (Perls, 1969a). Similar to how they perceive, they can focus emotionally only on the figure and often lose site of the background.
Goals of Therapy. The main goal of Gestalt therapy is to bring integration. For people to achieve the goal of integration, it is necessary for them to gain awareness. People begin as whole individuals but at times lose their equilibrium. Helping the client to gain a heightened self-awareness is the key for integration. Through awareness, the client can begin to complete gestalts.
Change requires that clients look at themselves and accept or reject what they will integrate. Consequently, a major goal of therapy is to assist clients in gaining a strong sense of self-responsibility. Only through responsibility can the client begin to integrate.
Techniques. Basically, Perls wanted clients to gain awareness of who they are and who they are becoming. Consequently, in line with other humanists, he immersed himself and his clients in the here and now. The past is relevant because it brings one to today, but it is not the focus of therapy. Because each individual sees the world in a unique way, therapy takes a phenomenological approach.
Perls (1969a) accessed a variety of techniques while believing that the helper should not be tied to technique, even going so far as to say, “A technique is a gimmick . . . and should only be used in the extreme case” (p. 1). However, many (e.g., Ivey, Ivey, D’Andrea, & Simek-Morgan, 2007) think that Perls contributed more to techniques and methodology than he did to theory, and many of these techniques are utilized in various counseling approaches. The following are just a few examples.
Empty Chair. The empty-chair technique is likely Perls’s most famous technique. It is utilized to help clients move beyond unfinished business—unresolved emotions. The counselor simply directs the client to imagine that someone is in the other chair and encourages the client to have a dialogue with the imagined person. Often, the counselor will instruct the client to move to the other (empty) chair and play the various roles. This powerful technique has proved very effective in working with couples and grief issues (e.g., Greenberg & Malcolm, 2002).
Pronouns. Responsibility is key to effective change. Clients often distance themselves from their own issues by referring to themselves in the third person or by using the word you instead of I in their narrative. The Gestalt helper encourages clients to use personal pronouns such as I and me to aid in their personal growth.
Sharing Hunches. The role of the counselor is not interpretation, but sharing hunches is a key technique. The counselor stays focused in the present, and it is important for him or her to notice nonverbal messages. For example, the actions of a client who describes something as sad, while smiling and tapping a foot, likely have clinical significance. Sharing the potential meaning, or even asking the client to do so, can help the client gain greater awareness.
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Dream Work. Perls promoted the use of dreams in therapy. However, he was not looking for deep-rooted unconscious thought. Instead of engaging in traditional interpretation, he asked the client to play out specific roles or even to finish conversations begun in the dream.
These are just a few of the techniques available to you as a Gestalt helper. These creative and diverse techniques serve to help the client work through emotional impasses and continue toward self-actualization.
Gestalt and Diversity. Gestalt therapy is a highly interactive and creative approach. Consequently, it shows great promise in working with clients from many cultural backgrounds. However, the techniques employed by Gestalt therapists often invoke strong emotional reactions (Corey, 2012). Therapists of all theories should take caution in using Gestalt techniques with diverse clients and remain mindful of how such directive and interactive techniques may affect clients.
PRAGMATIC SCHOOL OF THOUGHT
In the pragmatic approaches, what people think and want is at the root of their emotional and behavioral lives. Consequently, a change in cognition or a realization of one’s needs inevitably causes a change in behaviors and emotions. Dysfunction and maladjustment are primarily problems of faulty or irrational thoughts. Other counseling theory texts call this school of thought cognitive. This makes sense because therapy is often focused on learning what people need and want and on understanding how their own thoughts and behaviors influence how successful they are in making this happen. However, we choose to call this school pragmatic because therapists from this school often serve in the role of teacher, offering clients commonsense techniques and helping clients learn how to help themselves.
Cognitive-Behavioral
Daily affirmations, sharing positive messages to yourself in the mirror, and promoting positive self-talk are commonsense techniques that exemplify the cognitive-behavioral approach. What people think about themselves and the world around them directly causes their feelings and behaviors.
Life Philosophy. Cognitive-behavioral therapy (CBT) is a contemporary and favored approach of managed-care plans. Attributed primarily to Aaron Beck (1976, 1991), this approach views emotional and behavioral consequences as the result of inner thoughts and cognitions. People control how they feel by what they think. Typically, people feel that they are sad or happy due to what happens to them. “I won the lottery. I am happy!” “I was late for work. I feel guilty.” However, how people view their experiences is truly important, not what happens to them.
Luckily, people are creative and highly imaginative, and thus they have the ability to perform self-examination (Corey, 2004; Ivey et al., 1987). The core emphasis of
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change must center on conscious thought (Hansen et al., 1993). However, simple awareness of one’s own thoughts and cognitions is not sufficient for change; people must choose and want to live life differently (Ivey et al., 1987).
People’s thoughts determine their emotions, and the meaning they attach to events determines their reactions. Psychological distress (a fancy phrase for “bad feelings”) is largely due to one’s thought processes (Gilliland & James, 1998; Hansen et al., 1993). People have a natural tendency to develop faulty, ineffective thinking. Therapy can be a powerful tool in positively influencing the lives of clients (e.g., McCloskey, Noblett, Deffenbacher, Gollan, & Coccaro, 2008), and many of its supporting researchers (e.g., Rosselló, Bernal, & Rivera-Medina, 2008) see it as more effective than other therapies when working with specific client issues such as phobias, depressive thinking, issues of esteem, and suicidal ideation.
Goals of Therapy. The ultimate goal of CBT is to teach clients to think about how they think so that they can correct faulty reasoning (Nelson-Jones, 2000). The greater goal is to assist clients in changing systematic, faulty thinking and developing the ability to be their own therapists (Nelson-Jones, 2000). As helpers, we are training clients not to need us and to be independent, autonomous human beings. Some specific goals of CBT include helping clients identify, test, and evaluate beliefs and automatic thoughts so that they may change those that are maladaptive (Corey, 2012).
Techniques. In a cognitive-behavioral environment, therapy is largely psychoeducational, and the emphasis is on developing practical skills for dealing with specific problems (Hansen et al., 1993). Cognitive behaviorists typically work collaboratively with clients and believe that a mutual relationship with strong rapport is important in the process. In contrast to the person-centered approach, empathy, genuineness, and unconditional positive regard are considered necessary for change, but alone they are not sufficient. A therapeutic alliance is needed for change, but technique is needed as well.
Cognitive behaviorists contribute many techniques to the tool belts of contemporary psychotherapists. However, helpers are also willing to use the techniques from many other approaches—especially those of the behaviorists. For example, the behavioralmodification contracting common in the behavioral approach is often utilized when this technique might help clients gain insight regarding personal cognitions.
Some commonplace techniques used in this approach include skills training; assertiveness training; relaxation techniques; and training in areas such as life skills, social skills, and communication (Corey, 2012; Gilliland & James, 1998; Ivey et al, 2002). Cognitive-behavioral therapy, as a directive, dynamic, and temporal approach, uses any technique that can help clients first to identify automatic thoughts and then to change those that are maladaptive. Other techniques that help in this process include role-play, systematic desensitization, flooding, thought stopping, and cognitive modification.
Cognitive Behavioral Therapy and Diversity. Cognitive behavioral therapy is often cited as being effective in multicultural counseling. Although CBT is often considered an empirically validated approach, some studies show CBT as being less effective with some racially and ethnically diverse clients (e.g., Sue & Sue, 2008). It is
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important for cognitive behaviorists to understand the culture background (Corey, 2012) of their clients and what potential cognitions are common to their cultures.
Rational Emotive Behavioral Therapy
What type of day have you had? No matter how the day has gone, you likely remember what not-so-good events occurred today. If you do, then you, too, likely fall victim to a natural human tendency: Remembering the worst is easier than remembering the best.
Life Philosophy. Rational emotive behavioral therapy (REBT) views human nature as including innate tendencies toward growth, actualization, and rationality as well as opposing tendencies toward irrationality and dysfunction (Ellis, 1962; Gilliland & James, 1998; Hansen et al., 1993; Nelson-Jones, 2000). This polarization creates tension. Clearly, events, facts, and behaviors play a role in one’s daily health. However, one’s beliefs about these objective events are more important than the actual events or behaviors (Gilliland & James, 1998; Ivey et al., 1987). Left to their own devices, people tend to move toward irrationality. Consequently, their innate thoughts tend to move in a direction that allows negative thoughts to thrive. Because all people’s behaviors and emotions are consequences of their internal selves, they have the capacity to change how they act and feel. However, they must attack their irrational thoughts.
With its initial development in the 1950s by Albert Ellis (1962), REBT maintains that most people learn to think irrationally. Even early interactions with parents influence and exaggerate the innate tendency to think in these irrational ways. Because people are developmental creatures, irrational thoughts become ingrained within their belief system at an early age and surface later in life (Gilliland & James, 1998). Humans are capable of change, however, and do so by changing their thoughts (Nelson-Jones, 2000). For example, here is Duane’s experience with Penny: Even typing her name causes him to feel a tinge of anger. In Duane’s first year as a professor, he met Penny (named by him). He was in a hurry, a big hurry. He needed to get to campus because he was being observed and evaluated in the classroom by a senior faculty member. With his nervous energy, he decided that he could not succeed without the aid of a cold soda, so he stopped at the local grocery. In front of him in the checkout line was Penny. Remember that Duane is in a hurry. Penny said, “It is a good day to use the change in my purse.” So, in order to pay her $8.93, she rummaged through her palatial purse, looking for every last penny (thus, the reason for the name bestowed upon her). Duane was getting angry, very angry. As Penny counted out her last penny, she had only $7.53. At this point, Duane began to personally understand rage when Penny took the next three minutes writing a check for $1.40. He was so angry—but why? He was angry because of two major irrational thoughts. First, he believed, “I might be late for my observation. I will then be fired, go broke, and never have money to buy food again.” Second, he believed, “My time is more important than Penny’s.” These irrational thoughts caused him to arrive on campus (and he did arrive on time) sweating, angry, and anxious. Who was at fault? Duane, not Penny. These typical thought patterns are core to much of our emotional distress. Like Duane in this example, we fundamentally create our own emotional pain.
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Goals of Therapy. The primary focus of REBT is to change the way people think because thoughts, rather than events, cause emotional problems (Gilliland & James, 1998; Kottler & Brown, 1992). The main goal of REBT is to reduce self-defeating, irrational thinking (Gilliland & James, 1998).
The goals and process of REBT are often summarized using the ABC method. A refers to the “activating event” or “adversity.” B is the individual’s “beliefs about the event,” which may be rational and helpful or irrational and maladaptive. C refers to the “emotional and behavioral consequences of those beliefs.” The working goal of the therapist is to help the client to “dispute those irrational beliefs,” D, and help the client to obtain more rational, helpful beliefs. If REBT is successful, the client gains new behavioral and emotional consequences, symbolized by E—a “new, more effective view” (Gilliland & James, 1998; Nelson-Jones, 2000).
REBT attempts to change the client’s basic value system (Hansen et al., 1993), and the ultimate consequence is for the client to “not just feel better but get better” (Nelson-Jones, 2000, p. 200). As is common with other cognitive-behavioral approaches, the therapist helps the clients “become their own therapists” (NelsonJones, 2000, p. 201) so that they may live a rational life, independent of the therapist.
Techniques. It is common for REBT counselors to convey unconditional acceptance. However, a warm relationship is not considered necessary and is certainly not considered sufficient, to effect change. Too much warmth may actually lead to the client’s dependence and approval seeking and thus hinder client growth (Gilliland & James, 1998; Nelson-Jones, 2000). Some REBT counselors believe that the relationship between counselor and client is important initially (Hansen et al., 1993). Because the relationship is not the focus, techniques are. The most common technique is teaching: Helpers teach their clients about REBT assumptions and how the consequences of human nature play out in their lives. Helpers focus on teaching clients how to think differently.
One technique common to the process of REBT is confrontation (Ivey et al., 1987; Kottler & Brown, 1992; Nelson-Jones, 2000). However, a wide variety of techniques are used in REBT to help clients identify and change beliefs. Some techniques, such as the disputing of irrational beliefs and bibliotherapy, work primarily in the cognitive area. Affective and behavioral aspects are also addressed, however, and techniques in these areas might include imagery, questioning (e.g., Burnwell & Chen, 2002), role-play (e.g., Sharp & MaCallum, 2005), homework assignments, rational emotive imagery (Wilde, 2008), thought stopping, and skill training (Gilliland & James, 1998; Nelson-Jones, 2000).
REBT and Diversity. Although most validation studies for the pragmatic approaches have focused on CBT, REBT has some empirical support regarding its usefulness with a range of clients. It has been critiqued as difficult for clients with lower intelligence and lower educational levels (Murdock, 2012). It is a straightforward approach that many clients appreciate, but at times is critiqued as being too simple for addressing systemic, culturally oriented difficulties that clients face. As with other pragmatic approaches, if the therapist is diligent in looking at the thought patterns of clients from the clients’ cultural perspectives, therapy should be effective.
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Reality Therapy
Most people would love to have every one of their needs met to complete satiation and at all times. However, one big, ever-present force stands in the way—reality. Reality therapists focus on helping clients make responsible choices while getting their basic needs met (Glasser, 1998; Prenzlau, 2006; Wubbolding, 2000).
Life Philosophy. Human beings strive to have their needs meet. According to helpers who use reality therapy, human needs fall into five major areas: survival, loving and being loved, power, freedom, fun. To survive requires that people have food, water, shelter, and safety. They also have the basic need to belong, to give love to others and receive love. People need to feel close to others and to feel others need and want them. Although the needs to survive and to love are important, people have other needs as well. To be playful, have fun, and be active in recreation is important to the human mind. People also need control, power, and freedom. These needs define what it means to be human (Glasser, 1998). Our behaviors are our tools for getting our needs meet.
However, the founder of reality therapy, William Glasser (1998), shared that getting one’s needs met is not always possible. People consistently seek to have their needs met in a world where resources are limited, and they cannot have all their needs met completely and consistently. For example, if people consistently work to have their power needs met by taking control of others, by telling others what to do, and by just being bossy in general, they will likely not get other needs met. For example, meeting the need for power in this manner would likely hinder one’s ability to give and receive love.
The effectiveness of human beings is ultimately based on their decisions. Almost every scenario presents people with choices, and their ability to make choices that meet their basic needs determines their level of health. At the two extremes of a continuum are those who can meet their needs in socially appropriate ways, or a Success Identity, and those who cannot, or a Failure Identity. Learning to get one’s needs met is not a guarantee that they will be met. Children learn that the best way to get food is to cry. If an infant’s stomach is empty due to lack of food, she cries, and the parents would inevitably take care of the infant’s needs. Crying worked. Now, if an adult tried that same approach, perhaps in a faculty meeting, he would likely be met with some strange stares. A reality therapist would assist him in learning what his fundamental needs are and the effective ways to get them met.
Goals of Therapy. The primary goal of reality therapy is to help clients make effective choices, a process that requires the assistance of the helper. A necessary goal of therapy is helping clients to accept responsibility. Making choices requires that clients accept their own role in making change (Glasser, 1965). Clients often want change but do not want to do the work. They must realize what their own role is in creating change.
Understanding is also a driving goal. The helper must assist clients in understanding their own needs. What do the clients want? For most, the basic answer to this question is “something different.” However, each individual has different desires within the basic human needs. Identifying these needs and wants is crucial to making new choices.
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Techniques. How can counselors help? First, the helper must form a relationship with the client. An effective working relationship requires a helper who offers the client support. The helper should also be nonjudgmental. As a helper, you will likely have different needs and make different choices from your clients. First, you must understand that your clients’ choices make sense to them. They believe their decisions are the best way for them to get their needs met. At some point, their behaviors were likely rewarded, but they just are no longer working.
Reality therapists have several signature techniques. First, they often use contracts and plans with clients, which help clients to articulate specifically what they plan to do to make changes in their lives. Another common technique is termed pinning down, which is an essential process in helping the client to be specific in when and how he will follow through with a plan. For example, if Kim asks Duane to “contact the accountant for our private practice,” he will respond, “I will.” However, she is wise and knows Duane will never do it based on his response. As an individual seated in reality, she then asks, “When?” She is following the principles of reality therapy. For example, if a client shares that she will start taking medicine, as a helper you may explore when, with what doctor, and even how it will be financed.
An additional reality strategy is to encourage clients to adopt positive-addicting behaviors, which are behaviors that are so important in people’s lives that without them they feel a void. Praying, meditating, exercising, helping others, and volunteering are all examples of behaviors that serve people in socially appropriate ways, fill voids in their lives, and become meaningful to them. Clients who are successful in achieving positive-addicting behaviors are more resilient when they are faced with challenges. Positive-addicting behaviors serve to provide clients with greater tolerance when they are faced with situations that challenge their ability to satisfy basic needs (Glasser, 1965). Contemporary reality therapists offer the WDEP system (Wubbolding, 2000). This sequential process has the therapist first help clients recognize their wants (W), evaluate their behavior and what they are doing (D), evaluate (E) themselves to see their present behavior and where it is moving them, and finally to make plans (P) to help clients improve how they get their needs and wants. This process is used to help clients make change and understand what they must do to make change happen.
Reality Therapy and Diversity. Reality therapy continues to be used with a wide variety of clients from many cultures. Reality therapy puts the focus on the individual making change, so it may sometimes minimize the experience clients from minority cultures may experience through oppression, racism, and prejudice. However, if the therapist acknowledges the real disadvantages some minorities face and helps them to make change and adapt to these realties, therapy can be effective with diverse clients.
Reality, Being a Student, and the Intentional Theory Selection Model. A graduate student in psychology came to Kim complaining about feeling “depressed and burned out.” He complained that all he did was study and work. He was feeling “out of balance,” and life was not giving him what he wanted. He came in for several
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Theory

School of Thought
People struggle
to meet all of their
needs and wants
Life Philosophy
Make better
choices to
meet needs
Create plans to meet needs
Pin down decisions
Pragmatic
People need fun
Reality Therapy
Goals

Techniques

FIGURE 4.4 A Graduate Student’s ITS Model
sessions, and then, for the fourth session, he came in smiling, saying he had “figured it out.” He described how, after reading a chapter on reality therapy, he realized that he was not making “good choices” in meeting his life “needs and wants.” He said, “I have forgotten to play.” His ITS now includes his life philosophy of “people struggle to meet all of their needs and wants” and “people need fun” (see Figure 4.4).
CONSTRUCTIVIST SCHOOL OF THOUGHT
As information and research on counseling are collected, new helping theories emerge. These approaches often include aspects of previously founded theories. Currently, contemporary approaches tend to be heavily focused on phenomenology, human uniqueness, multicultural concerns, and client empowerment. Although it has been given different names, we have chosen to refer to this school of thought as constructivist. Others refer to several of these approaches as postmodern (e.g., Corey, 2004), social-constructivist, contemporary (e.g., Halbur & Halbur, 2006), and emerging.
Constructivist counselors typically focus on the meaning and knowledge clients attribute to their experiences. The four approaches we present are not always considered complete theories that stand on their own in a therapy session but rather p aradigms that may be incorporated into existing theories. Inherent in many constructivist and
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contemporary approaches are the common themes of advocacy and prevention. The four theories highlighted in this school are multicultural counseling and therapy, feminist therapy, narrative therapy, and solution-focused brief therapy (SFBT).
Multicultural Counseling and Therapy
Often presented as a unique and independent approach, multicultural counseling and therapy (MCT) is a contemporary answer to working in diverse world; however, it can be utilized as a separate theory or incorporated into existing theories (Corey, 2012). Research demonstrates that being aware of multicultural issues is important in the counseling relationship (e.g., Li, Kim, & O’Brien, 2007). However, it is important to focus not only on clients’ individual values and beliefs but also on those of the therapist.
Life Philosophy. The need for MCT arises from the Western European basis of many theories of counseling and psychotherapy (Sue & Sue, 2003). As a result, clients from minority groups may not share the worldview inherent in many traditional theories. Culture must be examined in the counseling and psychotherapy realm (Sue & Sue, 2003) because it serves as an important determinant of who clients were, are, and will become. “All learning is culturally defined and comprehended” (Pedersen & Ivey, 1993, p. 26), as is one’s own identity. Counselors who are culturally competent frequently address specific dimensions of culture, including power distance, degree of individualism or collectivism, levels of uncertainty avoidance, trust and mistrust, and masculinity and femininity (Pedersen, Draguns, Lonner, & Trimble, 1996; Sue & Sue, 2003).
Counselors who use MCT value the importance of cultural identity and its development (Ivey et al., 1987; Pedersen et al., 1996) and believe that ethnicity is an important aspect of meaning in personal belief systems (Nichols & Schwartz, 2001). Consequently, the MCT approach was developed in response to the critique that some mainstream theories propose worldviews that are too individualistic to serve all clients effectively (Pedersen et al., 1996).
Counselors who incorporate the MCT approach into their clinical repertoire firmly believe that the presence of an alternative worldview, background, or culture does not necessarily indicate pathology (Nichols & Schwartz, 2001). Culturally competent counselors are aware that problems, concerns, and communication patterns may differ across cultures, and they are skilled at recognizing and treating culturebound disorders (Pedersen et. al., 1996; Sue & Sue, 2003). Problems may be external rather than internal to the client. For example, the problem might be racism in society (Ivey et al., 1987) rather than an individual being “pathological” or paranoid.
Goals of Therapy. A culturally competent therapist has the awareness, skills, and knowledge needed to address cultural issues and their intersection in the therapeutic process. Often, the first and foremost goal of multicultural counseling is cultural awareness. Effective multicultural helpers are aware of their own cultural values and biases and how they may be detrimental to the counseling relationship (Gilliland & James, 1998; Pedersen & Ivey, 1993; Sue & Sue, 2003). Therefore, pluralist-minded therapists must strive not only to understand their clients’ worldviews but also to have
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a consistent life goal of self-understanding. In addition, helpers must have an understanding of how their own cultural identity adds complexity to the therapeutic relationship. Therapists with cultural awareness view dissimilarities between themselves and their clients as comfortable differences, not deficits (Sue & Sue, 2003).
Culturally competent counselors possess knowledge of worldviews other than their own (Sue & Sue, 2003). The goal of awareness is complicated because counselor interventions are based on knowledge of the specific culture of the client and institutional barriers that might affect the client (Pedersen & Ivey, 1993). Being knowledgeable about cultures other than one’s own may entail what is called cultural role taking, whereby the therapist “acquires practical knowledge concerning the scope and nature of the client’s cultural background, daily living experience, hopes, fears, and aspirations” (Sue & Sue, 2003, p. 20). Inherent in the process of cultural role taking is an understanding of the sociopolitical influences and institutional barriers in the lives of clients from diverse backgrounds (Sue & Sue, 2003).
In addition to awareness and knowledge, appropriate and effective skills and interventions are necessary components of MCT. Culturally competent counselors must have the ability to generate both verbal and nonverbal communication because of the various ways diverse groups may value communication (Sue & Sue, 2003). For example, in some Native American cultures, families share their stories and history through storytelling. This norm may alter how a therapist gathers information from a client from this culture. In addition to being able to communicate in a variety of ways, culturally competent counselors may need to play various roles within the counseling realm. These roles may include consultant and advocate if the clients’ needs so dictate.
The MCT approach has implications that move beyond the therapy hour.
Counselors who utilize an MCT approach often work to change oppressive systems (Pedersen & Ivey, 1993). Counselors may serve as advocates who not only initiate client change but also reach out on political and sociological levels.
Techniques. A major technique in the MCT approach centers on the role of the counselor, who must consistently consider the client’s worldview, background, and culture (Ivey et al., 1987; Pedersen et al., 1996). Effective counseling requires that counselors be aware of how their skills and interventions might be perceived differently by different groups of people (Ivey et al., 1987; Pedersen & Ivey, 1993). Counseling skills and techniques are often appropriate only for specific populations. Thus, helpers have the difficult job of anticipating how a specific technique will affect clients.
Multicultural counselors must be wise consumers of previous research and remember that many interventions “proven” to work have had limited testing in certain populations. Counselors must maintain flexibility and work to reframe or revise definitions of basic concepts such as empathy, health, and growth (Pedersen et al., 1996). They may even need to modify or vary techniques that will address clients of various cultural backgrounds more effectively (Pedersen et al., 1996; Pedersen & Ivey, 1993). Effective helpers do not have to “throw out” their own personal theory or techniques that have been effective in the past. Rather, after gauging their own worldview and that of their clients, they do need to be culturally appropriate in meeting the clients’ needs.
This difficult task is vital to effective multicultural counseling and psychotherapy.
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Multicultural Counseling Therapy and Diversity. It may almost seem silly or redundant to comment on how MCT works in a diverse world and specifically when counseling clients from diverse backgrounds. However, several critiques can be made. First, MCT’s primary focus has been on how to work with clients from diverse backgrounds. However, counselors themselves come from diverse backgrounds and there is little commentary or research on how this affects counseling relationships. MCT has been criticized at times for creating cultural divides that are unnecessary. Clients from diverse backgrounds still have universal challenges in their affective worlds and mental health. Multicultural counselors and therapists must be careful not to turn clients’ concerns into multicultural issues when diversity may not be a component of the problem presented.
Feminist Therapy
Feminist theories are not unique to the field of counseling and can be found in the fields of philosophy and gender studies as well as art, film, literature, and many other areas. However, feminist theory emphasizes empowerment and advocacy and is becoming increasingly integrated within the helping professions.
Life Philosophy. Like the multicultural approach to counseling and psychotherapy, feminist therapy can stand as a unique theory but is often integrated into other theoretical approaches in practice. Feminist theory examines oppressive sociological trends and how they relate to defined problems and pathology of women. This approach has a variety of beliefs that are often categorized as radical, liberal, social, and cultural (Enns, 1993). However, a common belief of feminist helpers is that our established patriarchal systems subjugate women and either create or support the psychological and sociological challenges women face (Brown & Bryan, 2007; Corey, 2004; Ivey et al., 1987; Nichols & Schwartz, 2001). Newer approaches to feminist therapy are often identified as postmodern, supporting the inclusion of feminist therapy as a social constructivist approach (Murdock, 2009).
Feminist therapists focus on the implications of gender issues (Murdock, 2009; Nichols & Schwartz, 2001) and shed light on the importance of reproductive, biological, and violence issues that play roles in women’s lives. Feminist theory also strives to maintain a positive attitude toward women (Corey, 2004) and views the historical female characteristics of connection and caring as strengths rather than weaknesses. Feminist theory finds that problems tend to lie in the social-cultural context and result specifically from a patriarchal society (Corey, 2004; Ivey et al., 1987; Nichols & Schwartz, 2001). This approach deems that external forces such as oppression, discrimination, and harassment—rather than a client’s internal shortcomings—may be the source of many disorders and psychological stress. Thus, the therapist must understand that client concerns do not happen in isolation.
Feminist theories and the therapies that emerge from them differ in their focus. There are many different feminist theories and thus many different types of therapy. Although there are commonalities across the philosophies, there are also differences. In the fields of counseling and psychotherapy, the three most common feminist therapies are radical feminism, cultural feminism, and liberal feminism.
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Radical feminism is the most historic and often the most controversial feminist approach. It started the feminism movement both socially and in the field of counseling. Radical feminism focuses on the inequality between men and women and the ongoing oppression of women. Often, the deconstruction of patriarchal dominance is of great concern to radical feminists.
Cultural feminists tend to look more at the positive components of the roles women play in society. The tendency is to look at women and men and examine their differences. Through this process women’s roles as nurturing and caring, for example (Enns, 1993), are valued and promoted.
Liberal feminists, on the other hand, attempt to minimize the differences between women and men. Most liberal feminists acknowledge that men and women are both capable of similar successes and struggles and that, in bias-free environments, men and women behavior similarly.
Goals of Therapy. The main goal of feminist theory is to help clients see the world in a variety of ways and provide them with choices that allow them to live authentically (Enns, 1993; Ivey et al., 2002; Mancoske, Standifer, & Cauley, 1994; Matsuyuki, 1998). Another driving goal of feminist therapy is to deconstruct traditional patriarchal culture and to establish and strengthen egalitarian, women-supported roles (Corey, 2012). In this pursuit, feminist helpers also strive to encourage and support interdependence (Ivey et al., 1987) as opposed to the goal of independence found in more traditional, historical approaches. In this process, feminist helpers strive to give women alternatives to the roles they play (Mancoske et al., 1994). Additional goals may depend on the type of feminist therapy being offered; thus, feminist counselors may have the goals of social change, empowerment, and building women’s roles (Halbur & Halbur, 2011).
Techniques. As the basis of the counseling process, the feminist therapist must form an egalitarian relationship with the client. However important this relationship may be, the feminist therapist also actively utilizes community resources, participates in therapy, gives information, and provides personal validation (Ivey et al., 1987). In general, counselors have a similar and necessary repertoire of skills across the various theoretical approaches. However, feminist helpers must also strive to listen attentively, honor their clients, challenge stereotypes, and support equality (Corey, 2004, 2012).
Feminist helpers typically serve in a collaborative role, strive to validate clients, and support the development of women within society (Corey, 2004; Ivey et al., 1987). As a political and social approach, counselors move beyond the therapy hour, often striving to make larger changes, like counselors using the MCT approach. Feminist theory is based in part on the notion that the personal is political and that oppression occurs in many forms. As noted earlier, the theory deems that external forces, such as oppression, discrimination, and harassment rather than a client’s internal deficiencies, may be the source of many disorders and psychological stress. Thus, examining and evaluating social structures and biases comprise a technique that is often used during therapy (Nichols & Schwartz, 2001), as is raising consciousness about difficulties that may be due to prescribed gender roles. Therapy may also include taking action to eliminate injustice rather than adjusting to the world as it is (Ivey et al., 1987; Murdock, 2009).
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Although advocacy as a general technique is common in feminist approaches, other modalities such as empowerment feminist therapy and androgyny and assertiveness training are common techniques used by feminist counselors.
To complicate matters, techniques vary greatly depending on which style of therapy is used. For example, in liberal feminist therapy, the focus is often to “ minimize the differences between men and women and to assume that within bias-free environments, men and women will behave similarly” (Enns, 1993, p. 45). A cultural feminist would attempt to “emphasize differences between men and women and place special importance on the development of nurturing, cooperative, interpersonal qualities within society” (Enns, 1993, p. 46). Although the various styles of feminist therapy rely on unique techniques, their underlying philosophies and goals are similar.
Feminist Therapy and Diversity. At first glance, it would seem that feminist therapies should be ready to help a pluralistic society. Feminist therapists are keenly aware of how culture affects, and sometimes even pathologizes, individuals—especially women. Depending on the style of feminism utilized, there can be value struggles with diverse clients. For example, radical feminism focuses on deconstructing patriarchal roles. Female clients who are in traditionally feminine roles or who want to move into traditional roles may be uncomfortable working with a therapist who focuses so greatly on empowerment and interdependence. However, a female who wants a more traditionally feminine role in some aspects of her life, may feel understood by a cultural feminist who celebrates the nurturing role some traditional women’s roles require.
Feminist approaches have been critiqued as not being beneficial to male clients. However, many men have had great counseling experiences with feminist therapists using gender-neutral counseling. Feminist therapy can be very effective; however, therapists must be intentional, understand the values of their clients, and avoid imposing their own values.
Feminist Theory and the Intentional Theory Selection Model. The ITS of a feminist might look unique because he might utilize various techniques to meet the major goals of this philosophical approach. For example, a feminist therapist with whom Kim recently talked shared that he believes many of his clients with eating disorders struggle due to “society norms of what is attractive.” He believes that his clients struggle to mirror media and sociological icons but fail because these icons are not typically realistic. Many of his clients struggle not just with unhealthy eating behaviors but also with issues of self-esteem. He articulated what his ITS might look like (see Figure 4.5).
Narrative Therapy
Narrative therapy and its contemporary popularity are attributed primarily to the work of Michael White (2007). Narrative therapists believe that healing and change can occur through conversations—through the telling and retelling of stories.
Life Philosophy. Ultimately, narrative helpers believe that, as individuals, people make sense of their everyday lives through narratives (Rosen & Kuehlwein, 1996;
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Theory

School of Thought
Positive view of women
See society
as patriarchal
Life Philosophy
Clients need choices
Strengthen egalitarian
relationships
Utilize community resources
Constructivist
Feminist
Goals

Techniques
Validate clients
Challenge oppression
FIGURE 4.5 A Feminist’s ITS Model
Russell, Van de Brock, Adams, Rosenberger, & Essig, 1993). These stories include what people want, what they like about themselves, and even what they want to change. They define themselves fundamentally through the stories they share. They may share stories of themselves as a son, daughter, parent, partner, and so on. The stories they choose to tell reveal much about who they are.
Narrative therapists also believe that people are social creatures and that much of what they describe as paramount in their narratives occurs within relationships. Consequently, therapists must understand clients in a social context. Narrative therapists believe that personal experience is ambiguous and may be understood and interpreted in multiple ways, and they believe that the stories people tell themselves are important in determining how they will act (Nichols & Schwartz, 2001).
Narrative helpers take a rather positive view of humans. They tend to see the best in people, and typically believe that people have good intentions (Nichols & Schwartz, 2001) and strive to live in a “good” way. Of course, this approach is subjective; there is no right or wrong, good or bad, and especially normal or abnormal.
Narrative helpers are social constructivists who believe people are greatly influenced by their culture and environment (Corey, 2004; Murdock, 2009). Narrative theorists believe that the truth of experience is created rather than discovered (Nichols & Schwartz, 2001); consequently, they believe that truly understanding others requires seeing how others view the past, present, and future (Nichols & Schwartz, 2001; Zimmerman & Dickerson, 1996).
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Goals of Therapy. The goal of narrative therapy is not just to solve problems but also to change the client’s whole way of thinking and living (Nichols & Schwartz, 2001). Problems are external to the individual and occur consistently. The therapist must help the individual be prepared for the future and not simply offer a therapeutic bandage for the current pain the client faces.
People tell others and themselves who they are through stories of their own lives and experiences. The stories help define where they have been and what they have done on the way to becoming who they are. If you tell someone who you are by sharing stories of glory, you define yourself as confident. If you instead tell someone who you are by your defeats, you share a person defined by failure. As helpers, you cannot change the past, but you can help clients restory, or tell their life story in a new way.
As people develop, they all have experiences that shape their stories. For example, when Duane was 5, he started wearing glasses, and he also won his first award—most creative fire-safety poster. When he was 12, he was picked on by a few boys for wearing the wrong shoes, and he was given an award for outstanding computer skills. Each of these events had a personal, subjective meaning attached to it for Duane. If he entered therapy and said, “I feel like a successful person,” which events do you think he used to define himself? Likely, he would describe himself through successes: He won awards when he was 5 and 12. However, if he entered therapy and said, “I am different,” he likely defined himself by those experiences that separated him: wearing big glasses and funny shoes. If he entered therapy defining himself as different, your goal may likely be to help him restory and define himself as successful.

Techniques. The narrative therapist serves as a collaborator. Like a driver education instructor, the therapist is along for the ride and may even give directions, but the client has hold of the wheel. In this process, the counselor is active, often asking many questions to aid in the client’s understanding. The therapist is also active in discovering and articulating client strengths, often looking for exceptions in the client’s story. Exceptions occur when clients share experiences that are contrary to how they are defining their story. For example, if a client describes himself as being unassertive but then shares a time he stood up to someone, the therapist sees an exception. By identifying this exception for the client, the therapist can help him begin to see himself in a new way.
Some write that the basic goals of narrative counseling are to increase clients’ choices, to coauthor new stories while helping clients view themselves in a new way, and to transform clients’ identity (e.g., Nichols & Schwartz, 2001). In this process, the helper must develop an initial narrative that externalizes and personifies the problem, seek unique outcomes, deconstruct the story, develop a new story or life narrative, and reinforce the client’s new story (Corey, 2004; Nichols & Schwartz, 2001). However, narrative therapists often consider externalization to be the most important technique they use (Cashin, 2008; Rosen & Kuehlwein, 1996; Weist, Wong, Brotherton, &
Cervantes, 2001). Effective narrative therapists help their clients to see that their
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problems exist outside themselves (Corey, 2004; Nichols & Schwartz, 2001), which allows clients to be separated from their problems instead of defined by them. This approach also “allows conflict to decrease, lessens the sense of failure, encourages the client to struggle against the problem, opens new possibilities, and creates dialogue” (Weist et al. 2001, p. 5).
Of course, an additional major technique of the narrative helper is to promote storytelling, which, for many people, is therapeutic in and of itself; clients gain relief through their own sharing. For other clients, however, storytelling is simply a necessary step to begin doing therapeutic work (Rosen & Kuehlwein, 1996) that often includes the use of metaphors as a powerful tool. The client should end therapy with a new story, a story defining self in positive, healthy ways.
Narrative Approach and Diversity. The narrative approach to counseling is rooted in social constructivism. Clients are viewed in the context of their culture and how they attribute meaning to their personal experience. Narrative therapy attempts to allow the clients to be the experts on their lives. This invites a multiculturally sensitive relationship. Because clients are the experts on their lives, however, some cultures and individuals will struggle with the therapist’s potential lack of direction. This challenge may be overcome when therapists remind clients that the therapist is the expert on the therapeutic process (Corey, 2012).
Solution-Focused Brief Therapy
In the days of Freud, therapy was often five times a week and lasted for many years. As you can imagine, this would not get much support from most contemporary insurance companies! However, solution-focused brief therapy makes the assumption that change can be facilitated effectively and quickly.
Life Philosophy. Solution-focused brief therapy, with its many different names and diverse founders (e.g., Berg, 2003; de Shazer, 1985), is becoming vastly popular as a time-sensitive approach. Helpers practicing in this paradigm believe that specific changes can occur in a brief time when that time is focused. On day one of therapy, the solution-focused helper gathers information from clients to learn what changes they want to occur. Solution-oriented helpers speak little about the etiology of problems. The focus of solution-oriented approaches is defining the problem, not determining why it exists.
One of the best descriptions comes from Gilliland and James (1998), who state that solution-focused brief therapy is “a person-centered, behavioral stew with a dash of cognitive-behaviorism thrown in for good measure” (p. 309). Helpers in this paradigm do not direct their clients to make change that is valued by the therapist. Instead, the helper stays focused on the future and assists clients in finding those areas that they want changed.
Similar to helpers using the humanistic approaches, solution-focused helpers understand that their worldview is different from their clients’ view. A client’s
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behaviors and emotions truly make sense only from that individual’s unique perspective. Consequently, a phenomenological approach is vital to therapy.
Solution-focused helpers believe that one key component of therapy is first to determine what an individual is doing that is contributing to the problem. Clients often do not realize, or do not articulate, what they do to actively make their problem or problems continue. This vital question is often the first one that solution-focused helpers try to answer. A second belief is that knowing where one wants to go makes getting there much more likely. People can easily get lost if they do not know their destination. The solution-focused helper first helps clients realize where they want to go because, without that knowledge, direction cannot be found.
Goals of Therapy. Quite simply, the paramount goal of solution-focused brief therapy is to assist clients in finding their unique solutions. In solution work, the goal is to see what needs to change for the specific client and then to make that happen. Therapy is focused and specific about what change needs to occur and attempts to fix only what needs fixing. The goals for clients vary because each client is unique and so will be their solutions.
Techniques. Imagine that this text is magic and that, after reading it, you would be the therapist you always wanted to be. Knowing what would happen, how would you be different than you are today? This variation of the miracle question typifies a paramount technique in the solution-focused approach. The question moves immediately to seeing what the client wants to be different. The miracle question (e.g., Lloyd & Dallos, 2006) is often asked the first day in therapy because it helps clients move to a future orientation, where their problems have already changed and hopefully disappeared. “If I could give you a magic pill that would change your life to be exactly how you want it, what would your life look like?” This question and others like it assist helpers in seeing where clients want to go. They are based on the assumption that, in therapy, knowing where to go makes getting there much easier.
The solution-focused helper also looks for exceptions in the client’s story. Exceptions are components in clients’ stories that do not fit the problem they are sharing. For example, Kim worked with a client who knew she was a therapist and professor. He stated, “I have little empathy and want to change that.” One day in session, when he knew finals week was quickly approaching, he stated, “I bet this is a tough time of the semester for you.” Kim smiled and pointed out his empathetic statement as an exception to his story. Helping clients identify these exceptions helps them see their own ability to change.
Helpers also look for and help clients find personal strengths. This strength assessment is vital because it helps clients see their own resources, which they can include in the process of change. This process of empowerment helps clients focus on their goals and their abilities and resources that can aid in achieving those goals.
The solution-focused brief helper first attempts to build a therapeutic relationship. If successful, the therapist moves immediately to helping the client see what she wants to change and how life can be different. Then, armed with techniques, the therapist helps the client gain insight and move to action. Therapy
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focuses not on the briefness of the therapy but on the immediate alleviation of the problems the client faces.
SFBT and Diversity. In general, SFBT is considered effective with a wide range of clients. Individuals from diverse backgrounds come to therapy wanting change. However, SFBT may be a challenge for clients from cultures that want to avoid problem saturation in their narrative and in the counseling relationship. SFBT promotes respect for all clients and an understanding of clients’ cultural and social contexts, so it can be used effectively with most clients.
FAMILY APPROACHES SCHOOL OF THOUGHT
Separating family therapies from those previously presented is a major challenge for several reasons. A major confounding issue is that all of the theories previously addressed in this text have family applications; techniques; and, at times, complete family theories that expand on their individual approaches. Several theorists’ approaches, such as Adler’s analytic approach (e.g., Corey, 2004; Dinkmeyer, 2007) and Roger’s person-centered approach (e.g., Snyder, 2002), have commonly been presented as family theories. Other approaches are often difficult to separate from family approaches, as is the case with narrative therapy, which continues to gain acceptance as a family therapy approach (Saltzburg, 2007). Therapies not typically considered family therapies, such as Logotherapy (e.g., Lantz, 1989), also have support for their importance as family approaches.
Family theories and therapies that are iconic in the field have some differences, however. Most family therapies are referred to as systemic. The family is considered a systemic unit, and change of one family member will cause the rest of the system and its members to change. Thus, there is little focus on individual development, personality structures, or pathology. There is often a rejection of the traditional approach of an identified patient that serves as the focus of therapy. Instead, the family as a whole is viewed as “the client.” The interactions of the family are considered the causes of individual systems, and to create change, the family must change. For the purpose of this text, we present Bowen family systems theory, strategic family therapy, and structural family therapy. However, there are many other theories of family therapy, such as experiential, symbolic, communication, and Milan strategic theories (e.g., Goldenberg & Goldenberg, 2008; Nichols, 2008), that offer richness to the family therapy school of thought.
Bowen Family Systems Therapy
Murray Bowen is iconic in the development of transgenerational models of family therapy. His approach is often referred to as family systems theory, transgenerational, or just simply Bowenian. His approach provides much of the “scaffolding” of many historical and contemporary family therapies (Goldenberg & Goldenberg, 2008, p. 175) and is a seminal approach to family therapy.
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Life Philosophy. Bowen was greatly affected by the psychodynamic approach and believed that the relationship between child and mother was of great importance. However, he believed that parents, like their parents before, pass on their emotional struggles, such as their anxieties. He observed that families exist as unique, collective emotional systems. He believed that, within any family system, there are various processes that interact to tie family members together and to separate them. There are two opposing forces: one moving family members closer and one moving them farther apart (Bowen, 1966; Ivey, Ivey, D’Andrea, & Simek-Morgan, 2007).
Central to family functioning is the degree to which self-differentiation occurs and presents within each member of the family. The term self-differentiation is used to describe how people react to their emotions. Those who are too undifferentiated respond quickly to emotions. Their emotions become hard for them to separate from their actions and beliefs. Bowen believed that levels of differentiation greatly affected the multigenerational transmission of anxieties and dysfunction in a family.
Bowen believed that patterns occur in families across generations. Values, religious behavior, dysfunction, gender roles, and even occupational similarities can be viewed across generations to help understand the presenting family. Consequently, his philosophy was focused on the present and how the past has surfaced.
Goals of Therapy. Bowenian goals of therapy involve changing the family as a system. A major goal of therapy is to help individual family members increase their levels of differentiation (Ivey et al., 2007), allowing them to be more autonomous and emotionally mature. An additional primary goal is to manage emotions (Goldenberg & Goldenberg, 2008) within the family, thus helping to reduce symptoms and emotional turmoil. In attempting these endeavors, a common additional goal is to provide boundary clarification between family members. The family serves as an emotional unit and consequently at times experiences internal conflict. Bowen first presented what are still commonly called triangles. He observed that, when there is conflict or anxiety involving two family members, there is an attempt to draw in a third person to diffuse some of the negative energy. Often, these triangles are ineffective, so a goal of therapy is to identify these triangles.
Techniques. A major technique of Bowen family systems therapy arises out of the view that problems are most often the result of multigenerational patterns. The genogram is used to identify, discuss, and assess the family patterns. Genograms are created with the family to develop a picture of typically at least three generations (Gerson, McGoldrick, & Petry, 2008). The goal is to help families to understand and change patterns by viewing marriages, health concerns, religious patterns, and triangles.
Bowen did believe in remaining objective in therapy (in sharp contrast to other later family theories). He believed it is important, at times, to avoid entering into triangles within the family or couple with whom he was working. He believed that this objectivity would show family members what a healthy relationship with functional boundaries would look like.
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Typically, however, Bowen did not identify many techniques. He believed that questioning the family members to understand family history was important and that the counselor providing hypotheses would help the family gain great knowledge of its own patterns and emotional system.
Strategic Family Therapy
Jay Haley and Milton Erikson are two of the most prominent names associated with strategic family therapy. The strategic approach focuses on changing repetitive patterns that create present problems in the family. It is an active, directive, and typically brief systemic approach.
Life Philosophy. Strategic therapists believe it is important to focus on present problems in the family. There is little talk of a “life philosophy” because this approach does not emphasize individual development or personality construction. Instead, strategic therapists focus on removing problems that are occurring now.
Strategic therapists, like others, are concerned with making change. However, change is viewed in several ways. Some changes are really first-order changes, which means that the specific behavior or concern is alleviated. Change occurs in a linear fashion. However, strategic therapists recognize that greater change results when second-order changes occur. Second-order changes focus on changing the rules of the family (Nichols, 2008), which allows for change that is meaningful and lasting.
The family approach, as a systemic approach, rarely focuses on personal growth (Goldenberg & Goldenberg, 2008) or individual needs (Haley, 1991). The family is a complete system with dysfunctional behaviors that serve to keep it in a state of homeostasis. Consequently, families as systems resist change. The philosophy of the therapist is that change can happen and that, through creative and new solutions, the family will acquire new rules and new, healthier patterns.
Goals of Therapy. The goal of therapy, on the one hand, is rather simple. It is to change family patterns intentionally. Specific movements within the strategic approach, for example, the Mental Research Institute (MRI), have also identified potential goals such as defining family complaints, learning how the family has attempted to alleviate problems, and understanding the family’s communication in describing problems (Nichols, 2008). Goals vary greatly, however, because therapy and the specific techniques are considered unique for each family. Once a family’s view of the problem is understood, the therapist’s main goal is to eliminate or change the problem as presented by the family.
Techniques. Strategic therapists attempt to produce a warm and relaxed environment for therapy to be most effective. Counselors then develop unique interventions specific to the family seeking help. Jay Haley, for example, was especially known for his use of directives, which are highly intentional directions or prescriptions that help the family view or change its problems or behaviors in its perpetuating system.
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Directives are individually tailored to the specific needs of the presenting family. Therapists’ creativity and intentionality are very important.
Paradoxical interventions are indirect ways for the therapist to maneuver around family resistance and help to create change. The MRI approach describes the importance of prescribing the symptom. This process may actually involve instructing the family to increase or work harder on its presenting issue. The hope is that the family members learn they have control over the pattern or realize its absurdity. For example, Kim was working with a family in which the son and stepmother were giving each other the “silent treatment.” Her assignment for them was to spend the next week not talking at all! Well, they were unsuccessful at not talking—they learned they actually needed each other—and made a huge breakthrough in therapy.
Strategic therapists also utilize reframing. This technique requires therapists to describe family problems in a new way. For example, describing “overprotection” as extreme care can help family members view what was previously viewed as overinvolvement as a sign of love. This often allows the process of changing family patterns to begin.
Pretend techniques involve having family members act differently than they normally would under the guise of play (Madanes, 1981). This often helps behaviors change as the family begins to behave in a new way. As you can see, strategic therapists’ techniques are highly directive in their attempts to change family patterns in creative new ways.
Structural Family Therapy
Structural family therapy is primarily attributed to the work of Salvador Minuchin. The influence of this approach is easy to see because the constructs and terms are iconic in what professionals and laypeople think of as family therapy.
Life Philosophy. As a systemic approach, structural therapy focuses on the family as a whole. Structural therapists do not typically accept the belief that there are dysfunctional, sick, or psychosomatic individuals. Instead, they focus on dysfunctional, sick, or psychosomatic families. Taking a rather traditional approach, they see much of the difficulty in families as a lost or misconstrued hierarchy within the family. Without an appropriate hierarchy within the structure of the family, there are bound to be problems. Obviously, the structure of the family is of utmost importance, and the philosophy of this approach is to understand and even join the many subsystems that may occur in a family. For example, parents, children, females, or even the socially minded individuals in a family may develop subsystems that perpetuate the functioning of the family—perhaps in positive or negative ways. Within the family, boundaries describe the psychological closeness of members, and permeability describes how easily members can cross into other subsystems. Members of a family with boundaries that are weak are enmeshed through overinvolvement in each other’s lives (Goldenberg & Goldenberg, 2008). However, members of a family with strict, overly rigid boundaries are disengaged. Different boundaries may exist for different family members and different subsystems.
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Goals of Therapy. The philosophy or view for the family from a structuralist’s point of view makes the goals seem rather commonsense. Understanding the structure and hierarchy of the presenting family is extremely important. There is a key assumption that the coping mechanisms and hierarchy of the family are no longer working and must be changed. Developing a healthy structure for the family is important. In this process, it is important to define and develop healthy boundaries. To maintain a healthy structure, appropriate alignments should also be developed. For example, in the face of family discord and couple conflicts, it is not uncommon for a parent to develop alignments with his children and not his spouse. As a result, a goal of therapy might be to develop a spousal alignment. Changing the family means changing the structure, the hierarchy, and the transactional patterns. The ultimate goal of therapy is to create a family system that is healthier, with patterns that lead to healthy family functioning.
Techniques. There are a multitude of identified skills and techniques within structural therapy (e.g., Figley & Nelson, 1990). A key technique or role of the therapist is joining and accommodating the family, which is a process of becoming like a family member, relating (joining) and adjusting (accommodating) to the family’s style and mannerisms (Minuchin, 1974).
Family mapping (see Minuchin, 1974, for a description) helps to clarify the structure of the family and to assess where change needs to occur. The family map is a graphic representation of the family’s coalitions, subsystems, affiliations, and power. Mapping makes it easier to do boundary making, which is a process of realigning and changing psychological boundaries within the family and between family subsystems. Sometimes it becomes important to loosen or tighten boundaries between family members and to use unbalancing, a technique the therapist uses to change the relationships between family members by providing greater support to one member (Goldenberg & Goldenberg, 2008) and allowing change to occur. Although there are a variety of other techniques, two main techniques aimed at changing the transactional patterns of the family are enactment and reframing. Enactment is an attempt to have family members bring into the session a conflict, problem, or situation that occurs outside the session. Reframing, is similar to reframing in strategic family therapy. It is an attempt to redefine family behaviors to keep the family together as a functioning unit. Giving new meaning to behaviors allows members to change their patterns.
A Family Therapist and the Intentional Theory Selection Model. Rosa had been a practicing psychologist for several years. She considered herself a cognitivebehavioral therapist but was challenged by the fact that much of the change she attempted with clients was thwarted by their families. Her caseload was becoming filled with couples and families, so she attended a workshop on contemporary family interventions. The workshop challenged her to use the ITS model to see what family theories might fit best for her. She shared that she felt the clients she worked with would struggle to change unless the “shape” of the family changed. She also shared that she mostly believed change should occur to solve problems currently presented.
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Theory

School of Thought
Family Theories
Change should occur within
the family
The present is more
important than the past
People are basically good
Change can occur quickly
Life Philosophy
Change family
patterns as a whole,
promote healthy
family hierarchy
Family Mapping
Boundary Making
Enactment
Structural Family
Therapy
Techniques

FIGURE 4.6 A Family System ITS Model
Rosa acknowledged that she could find an approach that was more congruent with her beliefs and developed an ITS that looked similar to Figure 4.6.
Family Therapies and Diversity
A discussion of family therapies and their application to diversity would be long because it would have to cover many points showing strengthens and weaknesses. Family therapists should understand that the specific family therapies differ only slightly on how multicultural concepts are ingrained. In general, the strength of f amily therapies with diverse clients is that the family therapist is already taking a systemic approach that includes family values, rules, and patterns. The addition of cultural values is not that difficult. Traditional family therapies are often critiqued for having a
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limited definition on what indeed makes a family; however, most family therapists across the board are looking for ways to make their work more inclusive. For example, most training programs have changed the name of family courses from Marriage and Family Counseling to Couples and Family Counseling to include same-sex and cohabitating relationships. More traditional family approaches do run the risk of promoting gender-specific roles and highlighting a nuclear family as the ideal structure. An effective family therapist will be able to take a systemic approach while integrating clients’ cultures and family structures.
SUMMARY
Over 15 theories falling into 6 schools of thought were presented in this chapter. Each theory comes from the work of different authors with unique life philosophies that reflect how they intervene and the goals they value in working with families and individuals. The chapter presented some of the most cited, best researched, and most utilized counseling approaches. The included summaries of the various theories can serve as a good reference when you need to be reminded of their key concepts. Chapter 5 offers you examples of professionals and students who have used the ITS model to help them decide which theory is most applicable for them.
REFLECTION QUESTIONS
1. After reading this chapter, which theory or theories did you find most interesting?
2. Which theories were most difficult for you to understand?
3. Which theories seem to be less culturally sensitive to you?
4. In your search to ascertain a theoretical orientation, which theory do you hope to explore in more detail?
5. Which family theory makes the most sense for you, given your life philosophy?
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As you search to integrate theory into your practice, you might wonder how others have worked through the Intentional Theory Selection (ITS) model of making theory practical. This chapter will provide you with several scenarios where the model can be and has been used. The case studies included in the chapter represent (1) clinicians who have used the model to determine their theoretical orientation, (2) client cases where you will be able to apply the model to shape your theory and plan the helping relationship, and (3) supervision examples where you can apply the model to clinicians seeking supervision from you.
CLINICIAN CASE STUDIES

Case Examples for Integrating Theory into Practice

Now that you have perused the ITS model of making theory practical, you may choose to work through the process for yourself. A cursory reading of most theories textbooks can help you determine the theories you like best. The difficulty for most people occurs, however, when the theory needs to be applied to a client sitting in front of them. This chapter will provide you with the experiences and reflections of four helpers as they worked through the ITS model of selecting a theoretical orientation. Each case is a real account of people in the helping professions who have utilized the ITS model. The helping professionals presented in the cases are diverse in their cultural backgrounds, fields of study, practice settings, and years of experience in the field. Their experiences searching for a theoretical orientation are just as diverse and interesting. After each case study, reflection questions help you better understand the process of developing and solidifying your theoretical orientation.
Case One: Evan
Life Philosophy. Prior to coming to my master’s program, I had never really been
“forced” to think about or verbalize my life philosophy. I had been through college,
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obtained a bachelor’s degree in family services, and come out of that program still not knowing who I really was and what I wanted out of life. I’m not sure at that time that I even wanted to figure these things out. I felt as if I was just “doing what I was supposed to do.” I knew I had been through a lot in my first two years of college: many negative experiences with sex and relationships, alcohol and drug abuse, an abusive relationship, and whittling relationships with friends and family. When I came to this program, I was asked things I had never before been asked—and had never asked myself. I had thought about them sporadically but had never been expected to answer them verbally or in written form. I was asked to define values and morals in general, and I remember this being difficult to do. I was expected to define my own specific personal values, morals, beliefs, and ideas about how the world works. After having gone through the first two years of my three-year program, I had a pretty good idea of what my own specific values, morals, and beliefs were as well as ideas about how the world works.
I think one of the most transforming and difficult processes for me was recording some of my sessions and having others view my recordings and give feedback on my clinical skills. Learning to accept and positively view constructive criticism and feedback is the part of the process that helped me to partially figure out my life philosophy. I remember being crushed and feeling as if I was almost worthless after receiving feedback on my skills during my first few semesters. Now, I try to view the feedback as a necessary stepping-stone to get to where I am today. I now recognize that I needed to go through feeling crushed and almost worthless initially in order to want and appreciate all types of feedback. This process assisted me in defining what things I believe in, how I am, and the type of person I strive to be.
Participating in personal counseling is another factor that aided me in my transformation. My academic program required that I participate in a minimum of five sessions of personal counseling. I wanted to fulfill this requirement, but I also knew deep down inside that I truly needed to get some help. I felt like I was sinking because areas of my life felt out of control. Over a period of two years, I journeyed through the experience of counseling as a client. This process assisted me in defining who I am, my beliefs, and my values. It also greatly helped me to understand how counseling really works. I believe I was partially exposed to a successful counselor-client relationship. I was able to learn the other side of the counselor-client relationship. I experienced the full range of the relationship, from building trust to confrontation to termination. I now truly believe that one does not know how scary, stressful, terrifying, and uncomfortable counseling is for the client unless one has been a client. Without being a client, one also does not know how rewarding and fulfilling counseling can be for the client who has the motivation to change. Throughout this process, I “found” myself and came to believe in myself, thus clarifying my beliefs, morals, values, ideas of how the world works, and life philosophy.
School of Thought. To figure out my school of thought, I first needed to figure out my life philosophy. My own philosophy included my beliefs, morals, values, ideas of how the world works, self-understanding, and what gives meaning to my life. After I had figured out much of my life philosophy, I then began reading about the different
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schools of thought and deciding which ones fit my way of viewing the world and how I think it works. I tried simultaneously to figure out my life philosophy and into which school of thought it fit. I seemed really to struggle through this process, but it seemed to work out in the end. For the most part, I feel I have now figured it out. As I am nearing the completion of my master’s degree, I realize that I have had ample opportunity for introspection.
Theory. I have been able to feel grounded in selecting a theoretical orientation after reading books; taking additional courses; and completing my practical courses, where I gained more experience with clients. I wanted to pick a theory and then try to use it with clients in addition to using the techniques with them. This felt so uncomfortable to me, almost as if I wasn’t myself in sessions. It was very frustrating and anxiety provoking because that’s how I thought the theory should work and it didn’t. I felt like the process was so ambiguous and didn’t understand why it had to be “backward.” “Trust the process” is what I have continued to hear from professors and have continued to tell myself. What I found was that I needed to have experience being myself with clients and not focusing on what theoretical orientation I was using in sessions. I found that using my own personality and then fitting that style into a theory or theories really worked for me.
Techniques and Goals. I have a base of general techniques and goals I use with each client, but other ones are developed or matched after I have developed a therapeutic relationship with my client. I base techniques on the client’s personality and what I think the client will most accept. I may use techniques more directly or more collaboratively with the client. It just seems to depend on the person. The way I figured out that this works best for me was to experiment in sessions with different ideas and techniques. That seemed to be the best way for me to find out practically what seemed to fit.
REFLECTION QUESTIONS
After reading Evan’s experience, answer the following questions:
1. What have you learned from Evan’s process?
2. What were the key moments in Evan’s learning?
3. What were the major transitions in Evan’s development as a professional helper?
4. What were your thoughts and feelings as you read Evan’s journey?
Case Two: Jill
Life Philosophy. As I have gone through the first building block in making theory practical, I have realized that examining my life philosophy is as complicated as it sounds. Asking questions such as “What is truth?” and “Are people good?” takes courage and motivation. I have found that I must look inside myself to answer these questions and that the answers are true only for me. My ultimate answer to life philosophy
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CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

has been to realize that mine changes daily and no one else thinks, feels, or views the world in the same way. I find myself examining my life philosophy with each new client who sits in front of me, and it changes, expands, contracts, and shifts based on each new circumstance. I may ask the same questions in each situation, but the answers will inevitably be different. How would I react in this situation? What coping mechanisms would I employ? What are this person’s coping mechanisms? Does this person have a support system? What are his or her resources? What are my expectations of this situation based on my unique worldview?
In examining these questions, I have come to the conclusion that I am a person who emphasizes thinking. It is my view that our actions influence our thoughts, and vice versa. Clients may present with distortions of thought, may act before thinking, or may be able to think but not act. Understanding that I place importance on thinking has led me fluidly to the next building block, which is choosing a school of thought.
School of Thought. In examining each school of thought, I have asked the questions “What is it about this school of thought that matches the way I think and feel about the world?” and “Are there components that I feel contradict my views?” In other words, “What can I take from this school of thought and what can I discard?” This is the tedious aspect of choosing theory in that it requires a lot of reading and research. I found myself looking first at the founders of the theory and then branching out to emerging theorists. What I found is that there are aspects of cognitive- behavioral theory that fit my personal style and aspects of humanistic theory that I deem essential. Once I chose these theories, I began to break down these schools of thought and look at individual aspects of each in order to choose a theory.
Theory. Determining a person’s theory is a delicate process that can become frustrating. When I first began looking at theory, I had the idea that I needed to agree with all the tenets in order to call it my chosen theory. Through instruction and discussion, I have found that choosing a theory is like choosing a piece of chocolate from a sampler box. A person might choose a piece of chocolate, take a bite, find that he or she does not enjoy the taste, and throw it away. Conversely, a person might choose a piece, take a bite, and find that the piece of chocolate tastes wonderful on the tongue and stimulates the senses. Choosing aspects of theory can be similar in that a person might find an aspect that makes a lightbulb appear above her head or choose a technique that inspires results consistently. As I began to look at cognitive-behavioral and humanistic theories, I found aspects that fit my personality, such as the thinkingbehavior connection, the essential component of building a solid therapeutic relationship, and the importance of providing education and opportunities for the client to practice therapeutic techniques outside counseling sessions. Finally, choosing a theory is not a linear process. A person chooses a theory or theories based on his worldview, which evolves over time. My worldview as a new clinician will not be the same as my worldview as a counseling professional with 20 years of experience. My professional and personal experiences will influence my worldview as well as my choice of theory throughout my life.
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Goals and Techniques. Once a person chooses aspects of theory that fit her personality, it is easy to choose goals and techniques. I have chosen cognitive-behavioral and humanistic theories as my foundation. Therefore, my therapeutic goals most often center on assisting a person to change behaviors, recognize irrational or unproductive thinking patterns, and process emotions surrounding life events. My techniques often involve providing education for the client, assigning and processing appropriate homework assignments with the client, and assisting the client in exploring emotions and thinking patterns. Goals and techniques need to be flexible, however, and counselors need to realize that they can choose techniques from all schools of thought. Different clients require different interventions, and counselors must be willing to look outside their theory or theories to find suitable goals and techniques.
REFLECTION QUESTIONS
After reading Jill’s experience, answer the following questions:
1. What did you learn from Jill’s process?
2. What were the major transitions in Jill’s development as a professional helper?
3. How was Jill’s journey similar to and/or different from Evan’s in Case One?
4. What were your thoughts and feelings as you read Jill’s journey?
5. Which parts of Jill’s story are similar to and/or different from your own?
Case Three: Garrett
I was excited to be able to participate in a workshop offered by the authors of this text because I wanted to find out which theoretical orientation would best fit my approach to counseling as I study to become a counseling psychologist. In my theories of psychotherapy class, we went through each theory and learned a variety of techniques. For my final project, I put a binder together, listing each theory, its theorist, and its techniques. But I was not satisfied. I did not know where to go from there. I knew that I preferred a few theories over others, but I did not know how to go about finding a theoretical orientation that fit for me. Around the same time, I had the opportunity to explore the ITS model with the authors.
As a result of my coursework, I feel that I have the knowledge and skills to counsel, but I just don’t know how to put it toward a theoretical orientation. I am currently a therapist at a residential treatment facility, and I feel that a theoretical orientation would help me to guide my clients in a more beneficial way. Some therapists where I work do not use theoretical orientation, but I feel it would help me be more consistent with my clients.
The foundation of the ITS model is life philosophy, what gives meaning to my life. As I sat down and pondered my life philosophy, I began to look back throughout my life and examined what has made me happy in the past. At times, when I am stressed out, I look back and see myself sitting around talking with my family or being with my girlfriend. As I look back, what gives meaning to my life is my family and
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CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

friends and being there for one another. When I was a junior in college, my best friend from high school was in an accident and spent a couple of weeks in intensive care before he passed away. When something tragic happens, it makes you look at how you are living your life. What sets you apart from others? How you have been treating others? Where do you want to go? How much time do you have left to achieve your goals? Who do you want there, standing at the finish line, supporting you as you accomplish a major task? When I sit down and think about my life philosophy, that is what I think gives meaning to my life. As I took the Selective Theory Sorter, it really helped me put things into perspective. The questions are not questions that an individual would think about on a day-to-day basis. When answering the questions, I needed to sit down and think about them. My results stated that I believed thoughts lead to actions and misconceptions lead to problems. I see that a lot with the clients with whom I currently work. When a client that I am working with has a misconception, she will continue to have that misconception until she thinks about it in a different way. I also did the values exercise from Chapter 3. From this, I found I would like more peace, balance, serenity, and quality time with others. It is hard to be free from stress and emotion while going to graduate school, working 30 to 35 hours per week, finding time to do homework and study, and yet spending time with the people I love. Being able to spend time with my family and friends means a lot to me. My family has always supported me, and spending time with my family helps me achieve more balance and serenity. The results also indicated that in myself I value motivation, feeling supported, being driven, perseverance, accomplishment, balance, and even temper.
Examining my values and life philosophy helped me put things into perspective. I started thinking back a couple years about how I would never leave any time throughout my day to sit down and watch a half-hour television program or read a magazine without feeling guilty about wasting some time. I have learned to slow down and take a half-hour break or call up an old friend or a family member. I feel better when I am doing things that are important to me because they give more meaning to my life. Understanding the world around us is a necessity as we look at our life philosophy, especially because mental health counselors are working with individuals on a day-today basis. How a person thinks largely determines how she feels and behaves. I also think it is important to see what gives meaning to a client’s life and what motivates him.
The next step is examining the schools of thought. I think I have a pretty good grasp on the schools of thought from my academic program. As I review the six schools of thought, the most appealing to me are the behavioral and pragmatic approaches. I feel that psychodynamic does not fit my thoughts or beliefs. I think I would have a hard time having a psychodynamic approach in my counseling, mostly because I do not believe in a lot of the psychoanalytic views. Behavioral theory is appealing to me because I feel that humans are shaped and determined by sociocultural conditioning and learn through conditioning and reinforcement. I also like cognitive-behavioral theory because I believe that a change in an individual’s cognition will result in changes in her behaviors and actions.
I felt that taking the Selective Theory Sorter would be most beneficial to picking my own theory because it would help me determine how I view the theories. My results showed that I lean greatly toward the pragmatic school of thought, having values consistent with cognitive-behavioral therapy (CBT), rational emotive behavioral therapy (REBT), and
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reality therapy. They all require examining c ognitions as well as client wants and needs. The three statements that I most strongly believed in were: ( 1) How a person thinks largely determines how that person feels and behaves, (2) irrational beliefs are the principal cause of emotional disturbance, and (3) recognizing cognitive processing in emotion and behavior is central in therapy. These results were extremely helpful in putting my views into a theoretical orientation.
As I narrowed down my schools of thought and specific theories of interest, I thought about goals and techniques I would use. I will ultimately choose goals and techniques based on my theoretical orientation. I think finding the different techniques will be easy to explore now that I have a general idea of what theoretical orientation fits my values and beliefs.
As I read the first two chapters of this text and explored the ITS model, I felt more confident in my theoretical orientation. I feel that the ITS model is beneficial for tying up the loose ends from my theories class. To understand which theory I liked best and which one would fit my values and beliefs as I counsel, the ITS model helped guide me in the right direction. I think taking the time and effort to understand and walk through the steps of the model is very beneficial. The starting point really needs to be life philosophy, how you view yourself, others around you, and the world. If your theoretical orientation does not fit your views, then it is not going to work for you or your client. I think having the life philosophy as the first step is a good choice. I like how the ITS model breaks down the school of thought and keeps it separate from the individual theories. It helped me to go through and look at the six different schools of thought before I took a look at all of the individual theories. It was not as overwhelming. Also, the techniques and goals are a good feature to have at the end of the ITS model. If you picked only your theory but did not research the techniques and goals to go with it, you would have only a theory but no way to guide your client. The ITS model helps you figure out your theoretical orientation in an easy and accurate way.
REFLECTION QUESTIONS
After reading Garrett’s experience, answer the following questions:
1. What did you learn from Garrett’s process?
2. What were the key moments in Garrett’s learning?
3. What were the major transitions in Garrett’s development as a professional helper?
4. What were your thoughts and feelings as you read Garrett’s journey?
5. Which aspects of Garrett’s development are similar to and/or different from your own?
Case Four: Lillian
Life Philosophy. I came back to school later in life compared to most of my classmates. I had some experiences in life that really affected me, but I did not necessarily acknowledge those before coming back to school. In my counseling theories class,
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CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

I was asked to look at my values and life philosophy. It was a very hard exercise because I was in such change. I was going through a divorce and my view of the world was altering day by day. I, actually, to be very honest, was rather bitter and angry. I had spent almost 20 years raising children, working part-time, and keeping a household together. I was a very hard worker, but I knew little about taking care of myself. I took care of everyone else. I was pretty sure that I had done no wrong and was not to blame for my martial problems. So when I went to therapy to help deal with depression and grief, I was not pleased to learn, at first, that I was part of the problem! All of this was happening while I was starting school, as I thought, to redeem myself for years of (again, as I thought) being a victim of a bad marriage.
In my theories class I was asked to look at myself. Me—not others around me— but to look truly at me. It was hard. Very hard. I actually was mad at the professor at first. I did not like the assignment. But as I looked at myself and I was going to therapy, I learned that I was part of the problem of what was going on in my life. I wasn’t really happy to learn that! But it helped me because I think today I am a better counselor for it.
What I learned in class supported my learning in therapy. I had spent a lot of years being the “woman” at home, and when my children were moving out of the house, my role changed. And my husband at the time and I did not know what else I had to offer. It was such a hard time because my foundation of who I was gone. But it also, looking back, was an exciting time because I was able really to grow and become something new,
School of Thought. I was asked to look at my school of thought in my class. This was hard because I was really inspired by the family theories and feminism. I was worried I liked feminism simply because I was mad at my ex-husband. I learned this was not true, however. Feminism made sense to me because I saw I was placed (and put myself) in a traditionally feminine role and that when that role became obsolete in my family, with my children growing up, I was lost.
I also learned at this time about the family theories. These really made sense to me. I had really thought, before my counseling theories course and therapy, I was what was “wrong” in my marriage. I was learning, and still am, that my role in my marriage, and my family, was part of a bigger picture. I really liked learning about the family theories. They made such sense to me because I was learning the role I played in my problems but also learning I was just part of the problem. It was important for me to learn that I was not the cause of others’ unhappiness. It may seem like common sense to others, but it was a revelation to me!
Theory. The family theories and feminism seemed so fitting to me when I was asked to pick a theory. It was hard to decide. However, I thought feminism was something I could put into whatever counseling theory I chose. I untimely looked at my own beliefs and came to realize that within the family theories, I really believed that values and beliefs are passed down from previous generations. I saw that the role I played in my immediate family was similar to the roles my mother, grandmother, and, as I learned in class, my great-grandmother, played. So Bowen family therapy made
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great sense to me. I also learned that the role I tried to play for so long was similar to the role women played in my ex-husband’s family. But when I changed, he, our f amily, and I were not really ready. And we did not, as a family, change with me.
Goals and Techniques. It was clear to me, that the family theories made sense for me, at least when I applied them to me. I was really relieved to see that, once I started seeing clients, the family theories made sense there as well. I was able to work successfully with my clients from a family therapy perspective and help them. I loved that it worked so well for my clients and me! I feel like I have healed, and I see my clients heal as well.
I am just beginning to work as a counselor, so I am still working on what goals and techniques I should use. I do know that my clients, like I did, sure learn a lot about themselves and their families from doing genograms and gaining insight. I have clients come in who think their concerns have nothing to do with their family, yet they learn so much from looking at their immediate family and their family of origin.
I am so pleased I found an approach that works for me both personally and professionally. I find that as a counselor I am able to be congruent with who I am and what I do professionally. I have learned so much about being a competent counselor but also how to be a compassionate counselor. Having a theoretical orientation that matches my personal beliefs has helped me to be confident and effective in my counseling.
REFLECTION QUESTIONS
After reading Lillian’s experience, answer the following questions:
1. Why do you suppose Lillian chose a family therapy instead of feminist therapy as a working theoretical orientation?
2. What would you focus on if Lillian were your client in a client-counselor relationship?
3. How do you see the role of person and counselor interacting as you learn about Lillian?
4. What were your thoughts and feelings as you read Lillian’s experience?
5. Are there parts of Lillian’s experience to which you could relate?
Comment on the Cases
Each of the helpers described their experiences working through the ITS model and striving to find their theoretical orientation. Because each of them approached the ITS model in a different way, with unique experiences and personalities, each had unique results. Evan’s experience reflects that of a new helping professional who has struggled a great deal with his own emotional growth during his educational process of becoming a helping professional, which is a common experience for many counselors. Jill’s experience reflects a person confident in her theoretical orientation and ways
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CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

of viewing the world. Lillian’s and Garrett’s experiences, through divorce and family changes and the death of someone close, respectively, both ended with a clear understanding of themselves and with clearer priorities.
Now that you have had a chance to see how other helpers have used the ITS model, you will have the opportunity to read about ways the model can be used in both clinical and supervision situations. The model is valuable not only in determining your own theoretical orientation but also in helping you to work effectively with clients.
CLIENT CASE STUDIES
These clinical cases are representative of clients you may see in your work as a helping professional. After each case is presented, you will have the opportunity to respond to the reflection questions that follow.
Case One: Tony
Tony is a 28-year-old, African American male who lives alone and attends graduate school on a part-time basis. He supports himself by working as a stock clerk in a local department store. He completed his coursework for a master’s degree in human resources four years ago, but he has yet to begin the thesis needed to earn the degree. Tony presents with flat affect and reports being unhappy most of his life. He reports that his father had a history of drug use and that his mother died of a cocaine overdose when he was 12 years old. Tony reports no history of drug or alcohol use. He is seeking counseling to deal with his relationships with women. His current relationship is the longest he has ever sustained. He states that girlfriends find him “too clingy,” and it appears that his current girlfriend of eight months is also frustrated by his neediness. Tony wants to make this relationship work. He feels that his girlfriend is “the one” and wants your help learning new ways to be “less clingy.”
REFLECTION QUESTIONS
1. What concerns do you have about working with Tony?
2. How does your life philosophy affect your view of Tony?
3. Which of your personal values might affect your work with Tony?
4. What, if any, cultural factors might play a role in your relationship with Tony?
5. Which theory or theories parallel your values and views?
6. What goals will you set and what techniques will you use in your work with Tony?
Case Two: Nancy
Nancy is a 38-year-old Vietnamese woman seeking treatment to determine “what to do about my marriage.” Nancy reports that her husband is “nice but annoys me.” Nancy states that she has stayed in her marriage because people would think she “is an
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idiot to leave a guy as great as her husband.” Nancy states that both she and her husband were “boat people” who immigrated to the United States as children. Nancy’s parents were pleased that she married “another Vietnamese,” especially because the families have been friends for several generations. Nancy has been married for 13 years and has engaged in “a couple of other relationships” since the second year of her marriage. Nancy states that one of her extramarital relationships has gone on for 11 years. She believes this extramarital relationship is “exactly what” she really wants. However, she feels stuck. Nancy wants your help making this “huge” decision about her marriage.
REFLECTION QUESTIONS
1. How does your life philosophy affect your view of Nancy?
2. Which of your personal values might affect your work with Nancy?
3. What, if any, cultural factors might play a role in your relationship with Nancy?
4. Which theory or theories parallel your values and views?
5. What goals will you set and what techniques will you use in your work with Nancy?
Case Three: Brenda
Brenda is a 19-year-old, Caucasian college sophomore. She is seeking counseling to deal with three issues: (1) her feelings of depression, (2) her tendencies toward perfectionism, and (3) her fear of feeling attracted to women. In your work with Brenda, she determines that she needs medication for her depression. A doctor at the student health clinic gives her a prescription, and she feels “a lot less depressed” within a month of beginning the medication. Brenda continues coming to see you. In your work together, she realizes that her depression and perfectionism are due to her “romantic feelings toward women.” Brenda decides that she would like to focus her time with you on figuring out whether she is a lesbian. Specifically, she wants help figuring out how her feelings toward people of the same gender intersect with her Christian upbringing. Brenda is also concerned about how her family members and friends may react to her if she is a lesbian.
REFLECTION QUESTIONS
1. What positive and negative biases do you bring to your work with Brenda?
2. How does your life philosophy affect your view of Brenda?
3. How might your personal and/or spiritual values affect your work with Brenda?
4. What, if any, cultural factors might play a role in your relationship with Brenda?
5. Which theory or theories parallel your values and views?
6. What goals will you set and what techniques will you use in your work with Brenda?
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CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

SUPERVISION CASE STUDIES
You have experienced the ITS model as a tool with which to examine theoretical orientation as well as some clinical cases. Now, you will have the opportunity to use the model in a supervision setting. Many clinicians in the helping professions have rather strong opinions regarding clinical supervision. Specifically, you may be familiar with the supervisory styles you like and do not like. You may be able to recall certain interventions and strategies that worked better for you than others. As a professional helper, you too will likely have the opportunity to serve as a clinical supervisor because professional helpers are often asked or required to supervise students and colleagues new to the profession. In your role as a supervisor, you may find the ITS model helpful to you. The following cases offer the chance to apply the model with those whom you will supervise.
Case One: Grace
As a seasoned mental health counselor who works in a community agency, you have been asked to supervise a new mental health counselor named Grace. In your weekly supervision meetings, you notice how easily Grace engages you. She is very affectiveoriented. Her level of empathy and reflection of feeling are far greater than you would anticipate from someone with this level of experience. You perceive that Grace is humanistic-oriented. Unfortunately, you are surprised when you watch the video recordings of her counseling sessions. In every session, she tries to do behavior modification. She approaches nearly each session, regardless of the client’s issue, with a preset plan for behavior modification. You notice that Grace is so intent on behavior modification that she misses what the clients are saying.
REFLECTION QUESTIONS
Using the ITS model as a guide, answer the following questions:
1. How can you help Grace pick a theory that is more congruent with who she is as a person?
2. How would your own theoretical orientation hinder or help your work with Grace?
3. Where do you think Grace falls on the ITS model of making theory practical?
Case Two: Casey
You are the director of a college counseling center and have taken on the supervision of a new, master’s-level intern named Casey. He is eager to work with college students and believes he is an existentialist and “really open to feedback.” In your supervision of Casey, you are consistently impressed with his ability to build rapport with clients and construct meaning in their stories. He is caring and open to concerns that clients share with him. He tells you during a supervision meeting that he “really likes” one of his clients because of the growth she is attempting. When you watch the video recording,
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you notice that Casey seems to be flirting with the client rather than conducting therapy. You ask Casey about his nonverbal communication with the client, and he states that he is “just concerned” about her. As you watched more of the recording, you noticed that Casey barely utilizes any counseling skills. When you confront Casey about your concerns, he says, “You must not have watched the whole recording!” He is enraged and unable to hear your concerns about his potential attraction to the client.
REFLECTION QUESTIONS
Using the ITS model as a guide, answer the following questions:
1. How can you help Casey achieve more congruence between his stated theoretical orientation and his recorded behavior?
2. How can you help Casey use his existential theory to understand what you see as countertransference?
3. How would your own theoretical orientation hinder or help your work with Casey?
4. Which pieces of the ITS model of making theory practical would be most relevant for Casey to revisit?
Case Three: Dominic
You are the director for your city’s hospice program, which serves clients battling different types of illness, and you are supervising Dominic, a staff counselor with 10 years of experience. Dominic has worked at the hospice facility for three years and has received excellent evaluations each year. Lately, you have heard from Dominic’s clients that he seems less interested than he once did. Many clients have complained that Dominic wants them to go to group therapy instead of seeing him so frequently as individual counseling clients. In your concern for Dominic and the clients, you talk with him. During the course of the conversation, Dominic shares with you that his way of looking at the world has changed. His wife is battling cancer, and Dominic reports that they have greatly benefited from group therapy. He thinks group therapy is underutilized among people and families with cancer. He would like you to expand his position so that he can provide both individual and group counseling. You want to be sensitive to Dominic as a colleague and friend. However, his job requires that he provide individual counseling to the clients served by your office. Group counseling is provided under contract by another agency.
REFLECTION QUESTIONS
Using the ITS model as a guide, answer the following questions:
1. Which steps of the ITS model would you recommend Dominic examine?
2. How can you help Dominic to incorporate his values into his work?
3. What recommendations would you make to Dominic to ensure that he has sufficient support?
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

Summary of Supervision Case Studies
The ITS model can serve as both a practical and a conceptual tool in the helping professions. In this chapter, we have presented numerous ways in which the model can be applied by students, professional helpers, and supervisors. In finding your theoretical orientation, you may have challenges along the way, which was made clear in several of the case studies. When working with specific client populations, your specific theory and values may be challenged because many clients will have a worldview that diverges from your own. As a future supervisor, you may also find yourself wanting to assist helpers as they develop and solidify their theoretical orientation.
Choosing a theory that is based on your personal life philosophy and values has an extra challenge because life experiences will change your worldview. As shown in the case examples, transitions will likely challenge you in personal and professional endeavors. Life philosophy is the foundation of the ITS model. As a developing professional, you may find that intermittently reviewing your own theoretical development is necessary and refreshing.
PUTTING IT ALL TOGETHER
Importance Revisited
Theoretical orientations in the helping professions serve many purposes. Accountability and intentionality are important aspects to the field of counseling because actions and words may have huge impacts on the lives of clients. Research has driven the effectiveness of counseling theory; consequently, helpers must provide techniques and interventions that have been proven to work. The only way helpers can do this is to be founded in theory. Legal mandates, ethical codes, and informed consent also require that helping professionals have a personal theoretical orientation and be able to articulate it.
Having a defined theory is important to the work of a counselor because theory can serve as a road map to understanding the direction to take with clients. When counselors need direction both during and outside the therapy session, theory can serve as a conceptual tool to aid them.
How Theory Is Found
Training programs often require students to articulate their theory of counseling. However, students are often given little support in choosing a theory from which to work. Most students find their theory in one of four ways: (1) They choose the theoretical orientation of the helper’s training program, (2) they rely on the helper’s life philosophy, (3) they rely on the helper’s experience as a helper and/or a client (Hackney, 1992), or (4) they embrace research-driven approaches (Halbur & Halbur, 2011). However, each of these traditional methods has its unique weaknesses.
The ITS model was developed to meet the need for a more comprehensive model for choosing a theory. The model offers direction in finding a theory of counseling and in finding a theory that is congruent with one’s life philosophy and values. It is based
100 CHAPTER FIVE
100 CHAPTER FIVE
100 CHAPTER FIVE

on life philosophy. Through processes such as value clarification or the Selective Theory Sorter–Revised (STS–R), counselors may explore their own beliefs and values. This exploration is the first step in finding a theoretical orientation that is congruent with core beliefs. Once counselors achieve this difficult objective of identifying their life philosophy, they can look at the already existing body of knowledge to see what school of thought and theory best fit them. Luckily, research on effective therapies already exists, and counselors can pursue and digest the material already available.
Benefit of the ITS Model to the Field
The ITS model can serve several purposes. First, it provides direction for students and clinicians seeking their theories. For some, it is a good first step for beginning or continuing the important process of choosing and solidifying a comprehensive theoretical orientation. As life experiences and transitions occur, however, professionals and clinicians in the field may seek to again hone or change their theoretical orientation. The foundation of the ITS model is rooted in self-reflection and identifying one’s life philosophy. This challenge, addressed within these pages, is a meaningful endeavor; however, it is an ongoing endeavor. Life experiences affect counselors just as they do our clients. Therefore, it is important that counselors be amenable to the fluidity of life as it changes one’s life philosophy and possibly changes one’s theoretical orientation. These experiences and changes ultimately affect clients.
For educators, supervisors, and researchers, the ITS serves as a conceptual clinical tool outside the therapy hour. It helps us to view the development of counselors as they choose their theoretical orientation of counseling. Being anchored in theory, as mentioned throughout this text, is fundamental in providing ethical, intentional, and effective therapy (Halbur & Halbur, 2011). Choosing a theoretical orientation is a vital part of most clinicians’ development, and the ITS model provides a framework for understanding this development and being intentional in this process.
The primary goal of the ITS model is to reach those professionals and students facing theoretical challenges. Having a theoretical orientation is a core component of being a counselor, even though the various theoretical orientations have similar efficacy (Halbur & Halbur, 2011; Wampold, 2001) when applied clinically. Finding a theoretical orientation is often a daunting task for many clinicians (Halbur & Halbur, 2006). What is important is that the theoretical orientation of counselors is congruent with who they are and their life philosophy, and helps them to serve clients ethical, competently and in an enjoyable way. The ITS model may assist neophyte as well as seasoned counselors in this process.
The helping professions are dynamic and evolving. Counselors, social workers, and psychologists all have careers that serve the public in important ways. Through prevention and therapy, these meaningful fields provide unique opportunities for both the public and the profession. Professionals in the helping fields are constantly challenging the clients they serve; however, these professionals must also accept being continuously challenged. Clients are constantly asked to seek, grow, and change.
Counselors have this same opportunity to change, both as professionals and as people.
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95
CASE EXAMPLES FOR INTEGRATING THEORY INTO PRACTICE 95

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Note: Information presented in tables and figures is denoted by t or f respectively.

A
ABC method, 73 Actualization, 65
Adler, Alfred, 55–58, 86
Advocacy, 81
Allegiance factor, 9
Anal stage, 50
Analytical theory background of, 53 diversity and, 55 family approaches in, 86 goals of, 54 life philosophy and, 53–54 suggested readings and websites
on, 41
summary of, 46t techniques of, 54–55
Androgyny and assertiveness training, 81
Archetypal analysis, 54, 55
Archetypes, 53
Aversion therapy, 60
Avoiding-type personality, 57 Awareness, 65
B
Beck, Aaron, 70
Behavioral contracting, 3
Behavioral theory suggested readings and websites
on, 41–42
summary of, 46t
Behavioral therapy diversity and, 60 explanation of, 58, 61f goals of, 60
Intentional Theory Selection model and, 61
life philosophy and, 59–60 techniques of, 60
Bisexuals. See LGBT (lesbian, gay, bisexual, or transgender) individuals
Boundaries, 89
Boundary making, 90
Bowen, Murray, 86–88
Bowen family systems therapy function of, 86
goals of, 87 life philosophy and, 87 suggested readings and websites
on, 44
summary of, 47t techniques of, 87–88 Briggs, Katherine, 36
C
Case studies client, 102–103 clinician, 93–102 supervision, 104–106
Castration, fear of, 50
CBT. See Cognitive-behavioral therapy (CBT)
Classical conditioning, 59, 60 Client case studies, 102–103 Client-centered approach.
See Person-centered approach Clinician case studies, 93–102
Cognitive-behavioral therapy
(CBT)

Index

diversity and, 71–72 function of, 8, 70 goals of, 71 life philosophy and, 70–71 suggested readings and websites
on, 43
summary of, 46t techniques of, 71
Collective unconscious, 53
Conditional response, 59
Confrontation, 73
Constellation, 57
Constructivist school of thought background of, 76–77 feminist therapy and, 79–81 multicultural counseling and therapy and, 77–79
narrative therapy and, 81–84
solution-focused brief therapy and,
84–86 suggested readings and websites
on, 43–44
Contracts, 75
Counselors culturally competent, 77–78 diversity among, 21, 24 professional development
opportunities for, 38, 39
selection of theoretical orientation by (See Theoretical orientation; Theoretical orientation selection methods)
Counselors-in-training observation of, 23–24 real-world experiences for, 38–39
Creative power, 56
Cultural diversity. See Diversity
Cultural feminists, 80, 81
Culture, 20–21. See also Diversity; Multicultural counseling and therapy (MCT)
D
Deconstructivists, 49
Defense mechanisms, 49, 51
Dialectical behavioral therapy
(DBT), 8 Directives, 88
Disengaged, 89
Diversity analytical theory and, 55 behaviorism and, 60 cognitive-behavioral therapy and,
71–72
existential approach and, 66 family therapies and, 91–92 feminist therapies and, 81 Gestalt therapy and, 70 individual psychology and, 58 multicultural counseling and therapy and, 79
narrative therapy and, 84 nature of, 21 person-centered approach and, 64
psychoanalysis and, 51–52 rational emotive behavioral therapy
and, 73
reality therapy and, 75 solution-focused brief therapy
and, 86
Dodo bird effect, 9 Dominant-type personality, 56
115

INDEX
Dream analysis analytical theory and, 54–55 in psychoanalysis, 51, 52
Dream work (Gestalt technique), 70
E
Early recollections, 57
Eclectic approach feedback issues and, 22 focus on, 21, 22 function of, 20
Eclecticism, 6–8
Ego, 49, 51, 53, 55
Electra complex, 50
Ellis, Albert, 72
Empathy, 63
Empirically supported therapies (ESTs), 8
Empirically validated therapies
(EVTs), 8–9
Empowerment feminist therapy, 81
Empty-chair technique, 3, 20, 69
Enactment, 90
Enmeshed, 89
Erikson, Milton, 88
Ethics, 10–11
Ethics codes, 11
Evidence-based theory, 6
Exceptions, 85
Existential approach diversity and, 66 explanation of, 64 goals of, 65–66 Intentional Theory Selection
Model and, 66, 67f life philosophy and, 64–65 suggested readings and websites
on, 42
summary of, 46t techniques of, 66
Expectancy factor, 9
Externalization, 83
Extroversion/Introversion (E/I) index, 36
F
Failure identity, 74
Family approaches background of, 86 Bowen family systems therapy and,
86–88
diversity and, 91–92 strategic family therapy and, 88–89 structural family therapy and,
89–91, 91f suggested readings and websites
on, 44
Family mapping, 90
Family systems theory. See Bowen family systems therapy
Fear of castration, 50
Feminist theories explanation of, 79 suggested readings and websites
on, 44
summary of, 47t
Feminist therapy diversity and, 81 function of, 79 goals of, 80 Intentional Theory Selection
Model and, 81, 82f life philosophy and, 79–80 suggested readings and websites
on, 44
summary of, 47t techniques of, 80–81
Fictional finalism, 56
First-order changes, 88
Free association, psychoanalytic theory and, 51, 52
Freud, Sigmund diversity and, 51–52
Intentional Theory Selection model and, 52, 52f
psychoanalysis and, 48–49, 51 psychosexual stages and, 50 techniques used by, 51
G
Gay. See LGBT (lesbian, gay, bisexual, or transgender) individuals
Gemeinschaftsgefühl, 55
Gender bias, Freud and, 51–52
Genital stage, 50
Genograms, 87
Genuineness, 63
Gestalt, 67
Gestalt psychology, 67–68
Gestalt therapy background of, 67 diversity and, 70 function of, 4 goals of, 69 life philosophy and, 67–69 suggested readings and websites
on, 42–43
summary of, 46t techniques of, 69–70
Getting-type personality, 56–57
Gilliland, B. E., 84
Glasser, William, 74
Goals. See also Therapy goals decisions regarding, 19–20 mistaken, 56
H
Hackney, H., 4, 5
Haley, Jay, 88
Hedonism, 59
Humanistic school of thought existential, 64–66, 67f explanation of, 61 function of, 5 Gestalt, 67–70 person-centered, 62–64 suggested readings and websites
on, 42–43
I
Id, 49, 51
Ideal self, 63
Identified patient, 86
Identity, 74
Individual psychology background of, 55 diversity and, 58 goals of, 57 life philosophy and, 55–57 suggested readings and websites
on, 41
summary of, 46t techniques of, 57–58
Individuation, 53, 54
Inferiority, 56
Inferiority complex, 56
Integrative approach, focus on, 21
Intentional Theory Selection (ITS) model. See also Case studies;
specific theories
behavioral therapy and, 61 benefits of, 107 existential approach and, 66, 67f explanation of, 3, 15f family therapy and, 90–91, 91f feminist therapy and, 81, 82f Freud and, 52, 52f function of, 21, 48, 2545 reality therapy and, 75–76, 76f structural family therapy and,
90–91, 91f theory summaries and, 46–47
Interactive behavioral therapy (IBT), 8
Interpretation, in psychoanalysis, 51
ITS model. See Intentional Theory Selection (ITS) model
J
James, R. K., 84
Joining and accommodating technique, 90
Judging/Perceiving (J/P) index, 37 Jung, Carl, 53–55
K
Kottler, J. A., 10
L
Latency stage, 50
Lesbian. See LGBT (lesbian, gay,
116
116
116

INDEX
bisexual, or transgender) individuals
LGBT (lesbian, gay, bisexual, or transgender) individuals, 21, 52
Liberal feminists, 80
Libidinal energy, 49, 54
Life philosophy analytical theory and, 53–54 behavioral therapy and, 59–60
Bowen family systems therapy and, 87
case studies and, 93–96, 99–100
cognitive-behavioral therapy and,
70–71 existential approach and, 64–65 feminist therapy and, 79–80 importance of, 15–16 individual psychology and, 55–57 multicultural counseling and therapy and, 77
narrative therapy and, 81–82 person-centered approach and, 62 psychoanalytic theory and, 49 rational emotive behavioral therapy
and, 72
reality therapy and, 74 solution-focused brief therapy and,
84–85
strategic family therapy and, 88 structural family therapy and, 89 theoretical orientation and,
16–17, 22 Life tasks, 56
Logotherapy, 86
M
McLennan, J., 3
Mental Research Institute (MRI), 88, 89
Metaphors, 84
Miracle question, 85
Mistaken goals, 56
Multicultural counseling and therapy
(MCT)
diversity and, 79 explanation of, 20–21, 77 goals of, 77–78 life philosophy and, 77 suggested readings and websites
on, 43–44
summary of, 47t techniques of, 78, 80
Myers, Isabel Briggs, 36
Myers-Briggs Type Indicator
(MBTI), 30, 36–37
N
Narrative therapy diversity and, 84 function of, 81 goals of, 83
life philosophy and, 81–82 suggested readings and websites
on, 44
summary of, 47t techniques of, 83–84
Native Americans, 78
Nondirective approach. See Personcentered approach
Nonjudgment nature, 63
O
Oedipus complex, 50
Operant conditioning, 59, 60 Oral stage, 50
P
Paradoxical intervention, 89
Parenting, individual psychology and,
55–56
Pavlov, Ivan, 59
Penis envy, 50
Perls, Fritz, 67–70
Permeability, 89
Personality type Adler and, 56–57 identification of, 30, 36–37
Personal unconscious, 53
Person-centered approach diversity and, 64 explanation of, 62 family approaches in, 86 goals of, 62–63 life philosophy and, 62 suggested readings and websites
on, 42
summary of, 46t techniques of, 63–64
Phallic stage, 50
Phenomenological approach, 62
Philosophy. See Life philosophy Pleasure principle, 49
Positive-addicting behaviors, 75
Poznanski, J. J., 3
Pragmatic school of thought background of, 70 cognitive-behavioral therapy and,
70–72
rational emotive behavioral therapy and, 72–73
reality therapy and, 74–76, 76f suggested readings and websites
on, 43
Pretend techniques, 89
Principle of closure, 67
Principle of proximity, 67
Principle of similarity, 68
Private logic, 57
Professional conferences, 38
Pronouns, Gestalt therapy and, 69
Psyche, 53, 54
117
Psychoanalytic theory background of, 48 diversity and, 51–52 goals of, 51 life philosophy and, 49 psychosexual stages and, 49, 50 summary of, 46t techniques of, 51
Psychodynamic school of thought analytical theory, 46t, 53–55
individual psychology, 46t,
55–58 overview of, 48 psychoanalytic theory, 46t, 48–52 suggested readings and websites
on, 41
Psychopathology, 55
Psychosexual stages, 49, 50
Puberty, psychoanalytic theory and, 50
R
Radical feminism, 80
Rational emotive behavioral therapy
(REBT)
diversity and, 73 function of, 4, 5 goals of, 73 life philosophy and, 72 suggested readings and websites
on, 43
summary of, 47t techniques of, 73
Reality principle, 49
Reality therapy diversity and, 75 function of, 74 goals of, 74 Intentional Theory Selection
Model and, 75–76, 76f life philosophy and, 74 suggested readings and websites
on, 43
summary of, 47t techniques of, 75
Real self, 63
REBT. See Rational emotive behavioral therapy (REBT)
Recording techniques, 37–38
Reductionism, 56
Reframing, 89, 90
Restory, 83
Rodgerian approach. See Personcentered approach Rodgers, Carl, 62, 65
S
Second-order changes, 88
Selective Theory Sorter-Revised
(STS-R), 3, 30–36

INDEX
Self, 53, 54, 58
Self-actualization, 62, 68–69
Self-differentiation, 87
Sensing/iNtuition (S/N) index, 36
Sexual gratification, 49
Sharing hunches technique, 69
Skinner, B. F., 58
Social learning theory, 60
Socially useful type, 57
Solution-focused brief therapy
(SFBT)
diversity and, 86 function of, 84 goals of, 85 life philosophy and, 84–85 suggested readings and websites
on, 44
summary of, 47t techniques of, 85–86
Stimulus, 59
Strategic family therapy function of, 88 goals of, 88 life philosophy and, 88 suggested readings and websites
on, 44
summary of, 47t techniques of, 88–89
Strength assessment, 85
Structural family therapy function of, 89 goals of, 90 Intentional Theory Selection
Model and, 90–91, 91f life philosophy and, 89 suggested readings and websites
on, 44
summary of, 47t techniques of, 90
Styles of life, 56
Subsystems, 89
Superego, 49, 51
Supervision case studies, 104–106 Systemic therapies, 86
T
Techniques. See Therapy techniques
Teological individuals, 56
Theoretical orientation application of, 10 eclecticism as, 6–8 effectiveness and, 9–10 empirically validated therapies and,
8–9 ethics and, 10–11 function of, 4–5, 106 helping skills and, 3–4 nature of, 1–3, 5–6 personal background and belief system and, 24–25
Theoretical orientation selection methods
articulating your values as, 29–30 broadening your experiences as, 40 capturing yourself as, 37–38 finding yourself as, 28 getting inspired by others as, 38 identifying your personality type as, 30, 36–37
overview of, 27, 40, 106–107
reading about theories as, 38,
41–44
studying with master as, 39
surveying your preferences as,
30–36
using real-world trials as, 38–39
Theories application of, 13–14 choosing your, 18–19 counselor resistance to, 21–23 development of, 14–15 schools of thought that drive,
17–18
Therapy goals analytical theory and, 54 behavioral therapy and, 60
Bowen family systems therapy and, 87
cognitive-behavioral therapy and, 71
existential psychotherapy and,
65–66
feminist therapy, 80 Gestalt therapy, 69 individual psychology and, 57 multicultural counseling and therapy and, 77–78
narrative therapy and, 83 person-centered approach and, 62–63 psychoanalytic theory and, 51 rational emotive behavioral therapy
and, 73
reality therapy and, 74 solution-focused brief therapy and, 85
strategic family therapy and, 88 structural family therapy and, 90
Therapy techniques analytical theory, 54–55 behavioral therapy, 60 Bowen family systems therapy and,
87–88
cognitive-behavioral therapy and, 71
existential approach, 66 feminist therapy, 80–81 Gestalt therapy, 69–70 goals and, 19–20 individual psychology, 57–58 multicultural counseling and therapy, 78
narrative therapy and, 83–84 person-centered approach, 63–64 psychoanalytic theory, 51 rational emotive behavioral
therapy, 73
reality therapy, 75 solution-focused brief therapy and,
85–86
strategic family therapy and, 88–89 structural family therapy and, 90
Thinking/Feeling (T/F) index, 37
Token economy, 60
Training opportunities, websites for, 39
Transference, in psychoanalysis, 51
Transgender. See LGBT (lesbian, gay, bisexual, or transgender) individuals
Transgenerational theory. See Bowen family systems therapy Triangles, 87
U
Unbalancing, 90
Unconditional positive regard, 63
Unconditional response, 59
Unconditional stimulus, 59
Unconscious analytical theory and, 53 psychoanalytic theory and, 49, 51 Unfinished business, 69
V
Values, 29–30
W

Walden Two (Skinner), 58
WDEP system, 75
Websites on counseling theories and approaches, 41–43
for training opportunities, 39 White, Michael, 81
Y
Yalom, I. D., 9

counseling.org

2014

A

C

A

Code of Ethics

As approved by the ACA Governing Council

A

MERICAN

C

OUNSELING

A

SSOCIATION

Mission

The mission of the American Counseling Association is to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.

© 2014 by the American Counseling Association.

All rights reserved. Note:

This document may be reproduced in its entirety

without permission for non-commercial purposes only.

Contents

ACA Code of Ethics Preamble • 3

ACA Code of Ethics Purpose • 3

Section A

Section B

Section C

Section D

Section E

The Counseling Relationship

• 4

Confidentiality and Privacy

• 6

Professional

Responsibility

• 8

Relationships With

Other Professionals

• 10

Evaluation, Assessment, and

Interpretation • 11

Section F

Section G

Section H

Supervision, Training, and Teaching

• 12

Research and Publication

• 15

Distance Counseling, Technology,

and Social Media • 17

Section I

Resolving Ethical Issues

• 18

Glossary of Terms

• 20

Index

• 21

ACA Code of Ethics Preamble

The American Counseling Association (ACA) is an educational, scientific, and professional organization whose members work in a variety of settings and serve in multiple capacities. Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.

Professional values are an important way of living out an ethical commitment. The following are core professional values of the counseling profession:

1. enhancing human development throughout the life span;

2. honoring diversity and embracing a multicultural approach in support of the worth, dignity, potential, and uniqueness of people within their social and cultural contexts;

3. promoting social justice;

4. safeguarding the integrity of the counselor–client relationship; and

5. practicing in a competent and ethical manner.

These professional values provide a conceptual basis for the ethical principles enumerated below. These principles are the foundation for ethical behavior and decision making. The fundamental principles of professional ethical behavior are

· autonomy, or fostering the right to control the direction of one’s life;

· nonmaleficence, or avoiding actions that cause harm;

· beneficence, or working for the good of the individual and society by promoting mental health and well-being;

· justice, or treating individuals equitably and fostering fairness and equality;

· fidelity, or honoring commitments and keeping promises, including fulfilling one’s responsibilities of trust in professional relationships; and

· veracity, or dealing truthfully with individuals with whom counselors come into professional contact.

ACA Code of Ethics Purpose

The ACA Code of Ethics serves six main purposes:

1. The Code sets forth the ethical obligations of ACA members and provides guidance intended to inform the ethical practice of professional counselors.

2. The Code identifies ethical considerations relevant to professional counselors and counselors-in-training.

3. The Code enables the association to clarify for current and prospective members, and for those served by members, the nature of the ethical responsibilities held in common by its members.

4. The Code serves as an ethical guide designed to assist members in constructing a course of action that best serves those utilizing counseling services and establishes expectations of conduct with a primary emphasis on the role of the professional counselor.

5. The Code helps to support the mission of ACA.

6. The standards contained in this Code serve as the basis for processing inquiries and ethics complaints

• 4 •

• 3 •

concerning ACA members.

Section A:
The Counseling Relationship

Section B:
Confidentiality and Privacy

Section C:

Professional Responsibility

Section D:

Relationships With Other Professionals

Section E:

Evaluation, Assessment, and Interpretation

Section F:
Supervision, Training, and Teaching

Section G:
Research and Publication

Section H:

Distance Counseling, Technology, and

Social Media

Section I:
Resolving Ethical Issues

The ACA Code of Ethics contains nine main sections that address the following areas:

Each section of the ACA Code of Ethics begins with an introduction. The introduction to each section describes the ethical behavior and responsibility to which counselors aspire. The introductions help set the tone for each particular section and provide a starting point that invites reflection on the ethical standards contained in each part of the ACA Code of Ethics. The standards outline professional responsibilities and provide direction for fulfilling those ethical responsibilities.

When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decision-making process, consulting available resources as needed. Counselors acknowledge that resolving ethical issues is a process; ethical reasoning includes consideration of professional values, professional ethical principles, and ethical standards.

Counselors’ actions should be consistent with the spirit as well as the letter of these ethical standards. No specific ethical decision-making model is always most effective, so counselors are expected to use a credible model of decision making that can bear public scrutiny of its application. Through a chosen ethical decision-making process and evaluation of the context of the situation, counselors work collaboratively with clients to make decisions that promote clients’ growth and development. A breach of the standards and principles provided herein does not necessarily constitute legal liability or violation of the law; such action is established in legal and judicial proceedings.

The glossary at the end of the Code provides a concise description of some of the terms used in the ACA Code of Ethics.

Section A

The Counseling Relationship

Introduction

Counselors facilitate client growth and development in ways that foster the interest and welfare of clients and promote formation of healthy relationships. Trust is the cornerstone of the counseling relationship, and counselors have the responsibility to respect and safeguard the client’s right to privacy and confidentiality. Counselors actively attempt to understand the diverse cultural backgrounds of the clients they serve. Counselors also explore their own cultural identities and how these affect their values and beliefs about the counseling process. Additionally, counselors are encouraged to contribute to society by devoting a portion of their professional activities for little or no financial return (pro bono publico).

A.1. Client Welfare

A.1.a. Primary Responsibility The primary responsibility of counselors is to respect the dignity and promote the welfare of clients.

A.1.b. Records and

Documentation

Counselors create, safeguard, and maintain documentation necessary for rendering professional services. Regardless of the medium, counselors include sufficient and timely documentation to facilitate the delivery and continuity of services. Counselors take reasonable steps to ensure that documentation accurately reflects client progress and services provided. If amendments are made to records and documentation, counselors take steps to properly note the amendments according to agency or institutional policies.

A.1.c. Counseling Plans

Counselors and their clients work jointly in devising counseling plans that offer reasonable promise of success and are consistent with the abilities, temperament, developmental level, and circumstances of clients. Counselors and clients regularly review and revise counseling plans to assess their continued viability and effectiveness, respecting clients’ freedom of choice.

A.1.d. Support Network Involvement

Counselors recognize that support networks hold various meanings in the lives of clients and consider enlisting the support, understanding, and involvement of others (e.g., religious/spiritual/community leaders, family members, friends) as positive resources, when appropriate, with client consent.

A.2. Informed Consent in the Counseling Relationship

A.2.a. Informed Consent

Clients have the freedom to choose whether to enter into or remain in a counseling relationship and need adequate information about the counseling process and the counselor. Counselors have an obligation to review in writing and verbally with clients the rights and responsibilities of both counselors and clients. Informed consent is an ongoing part of the counseling process, and counselors appropriately document discussions of informed consent throughout the counseling relationship.

A.2.b. Types of Information Needed

Counselors explicitly explain to clients the nature of all services provided. They inform clients about issues such as, but not limited to, the following: the purposes, goals, techniques, procedures, limitations, potential risks, and benefits of services; the counselor’s qualifications, credentials, relevant experience, and approach to counseling; continuation of services upon the incapacitation or death of the counselor; the role of technology; and other pertinent information. Counselors take steps to ensure that clients understand the implications of diagnosis and the intended use of tests and reports. Additionally, counselors inform clients about fees and billing arrangements, including procedures for nonpayment of fees. Clients have the right to confidentiality and to be provided with an explanation of its limits (including how supervisors and/or treatment or interdisciplinary team professionals are involved), to obtain clear information about their records, to participate in the ongoing counseling plans, and to refuse any services or modality changes and to be advised of the consequences of such refusal.

A.2.c. Developmental and

Cultural Sensitivity

Counselors communicate information in ways that are both developmentally and culturally appropriate. Counselors use clear and understandable language when discussing issues related to informed consent. When clients have difficulty understanding the language that counselors use, counselors provide necessary services (e.g., arranging for a qualified interpreter or translator) to ensure comprehension by clients. In collaboration with clients, counselors consider cultural implications of informed consent procedures and, where possible, counselors adjust their practices accordingly.

A.2.d. Inability to Give Consent When counseling minors, incapacitated adults, or other persons unable to give voluntary consent, counselors seek the assent of clients to services and include them in decision making as appropriate. Counselors recognize the need to balance the ethical rights of clients to make choices, their capacity to give consent or assent to receive services, and parental or familial legal rights and responsibilities to protect these clients and make decisions on their behalf.

A.2.e. Mandated Clients Counselors discuss the required limitations to confidentiality when working with clients who have been mandated for counseling services. Counselors also explain what type of information and with whom that information is shared prior to the beginning of counseling. The client may choose to refuse services. In this case, counselors will, to the best of their ability, discuss with the client the potential consequences of refusing counseling services.

A.3. Clients Served by Others

When counselors learn that their clients are in a professional relationship with other mental health professionals, they request release from clients to inform the other professionals and strive to establish positive and collaborative professional relationships.

A.4. Avoiding Harm and

Imposing Values

A.4.a. Avoiding Harm Counselors act to avoid harming their clients, trainees, and research participants and to minimize or to remedy unavoidable or unanticipated harm.

A.4.b. Personal Values Counselors are aware of—and avoid imposing—their own values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients, trainees, and research participants and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.

A.5. Prohibited

Noncounseling Roles and Relationships

A.5.a. Sexual and/or

Romantic Relationships

Prohibited

Sexual and/or romantic counselor– client interactions or relationships with current clients, their romantic partners, or their family members are prohibited. This prohibition applies to both inperson and electronic interactions or relationships.

A.5.b. Previous Sexual and/or

Romantic Relationships

Counselors are prohibited from engaging in counseling relationships with persons with whom they have had a previous sexual and/or romantic relationship.

A.5.c. Sexual and/or Romantic

Relationships With

Former Clients

Sexual and/or romantic counselor– client interactions or relationships with former clients, their romantic partners, or their family members are prohibited for a period of 5 years following the last professional contact. This prohibition applies to both in-person and electronic interactions or relationships. Counselors, before engaging in sexual and/or romantic interactions or relationships with former clients, their romantic partners, or their family members, demonstrate forethought and document (in written form) whether the interaction or relationship can be viewed as exploitive in any way and/or whether there is still potential to harm the former client; in cases of potential exploitation and/or harm, the counselor avoids entering into such an interaction or relationship.

A.5.d. Friends or Family Members

Counselors are prohibited from engaging in counseling relationships with friends or family members with whom they have an inability to remain objective.

A.5.e. Personal Virtual

Relationships With

Current Clients

Counselors are prohibited from engaging in a personal virtual relationship with individuals with whom they have a current counseling relationship (e.g., through social and other media).

A.6. Managing and Maintaining Boundaries and Professional Relationships

A.6.a. Previous Relationships

Counselors consider the risks and benefits of accepting as clients those with whom they have had a previous relationship. These potential clients may include individuals with whom the counselor has had a casual, distant, or past relationship. Examples include mutual or past membership in a professional association, organization, or community. When counselors accept these clients, they take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgment is not impaired and no exploitation occurs.

A.6.b. Extending Counseling Boundaries

Counselors consider the risks and benefits of extending current counseling relationships beyond conventional parameters. Examples include attending a client’s formal ceremony (e.g., a wedding/commitment ceremony or graduation), purchasing a service or product provided by a client (excepting unrestricted bartering), and visiting a client’s ill family member in the hospital. In extending these boundaries, counselors take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgment is not impaired and no harm occurs.

A.6.c. Documenting Boundary Extensions

If counselors extend boundaries as described in A.6.a. and A.6.b., they must officially document, prior to the interaction (when feasible), the rationale for such an interaction, the potential benefit, and anticipated consequences for the client or former client and other individuals significantly involved with the client or former client. When unintentional harm occurs to the client or former client, or to an individual significantly involved with the client or former client, the counselor must show evidence of an attempt to remedy such harm.

A.6.d. Role Changes in the

Professional Relationship When counselors change a role from the original or most recent contracted relationship, they obtain informed consent from the client and explain the client’s right to refuse services related to the change. Examples of role changes include, but are not limited to

1. changing from individual to relationship or family counseling, or vice versa;

2. changing from an evaluative role to a therapeutic role, or vice versa; and

3. changing from a counselor to a mediator role, or vice versa.

Clients must be fully informed of any anticipated consequences (e.g., financial, legal, personal, therapeutic) of counselor role changes.

A.6.e. Nonprofessional Interactions or

Relationships (Other Than Sexual or

Romantic

Interactions or

Relationships)

Counselors avoid entering into nonprofessional relationships with former clients, their romantic partners, or their family members when the interaction is potentially harmful to the client. This applies to both in-person and electronic interactions or relationships.

A.7. Roles and Relationships at Individual, Group, Institutional, and Societal Levels

A.7.a. Advocacy When appropriate, counselors advocate at individual, group, institutional, and societal levels to address potential barriers and obstacles that inhibit access and/or the growth and development of clients.

A.7.b. Confidentiality and Advocacy

Counselors obtain client consent prior to engaging in advocacy efforts on behalf of an identifiable client to improve the provision of services and to work toward removal of systemic barriers or obstacles that inhibit client access, growth, and development.

A.8. Multiple Clients

When a counselor agrees to provide counseling services to two or more persons who have a relationship, the counselor clarifies at the outset which person or persons are clients and the nature of the relationships the counselor will have with each involved person. If it becomes apparent that the counselor may be called upon to perform potentially conflicting roles, the counselor will clarify, adjust, or withdraw from roles appropriately.

A.9. Group Work

A.9.a. Screening

Counselors screen prospective group counseling/therapy participants. To the extent possible, counselors select members whose needs and goals are compatible with the goals of the group, who will not impede the group process, and whose well-being will not be jeopardized by the group experience.

A.9.b. Protecting Clients In a group setting, counselors take reasonable precautions to protect clients from physical, emotional, or psychological trauma. A.10. Fees and Business

Practices

A.10.a. Self-Referral Counselors working in an organization (e.g., school, agency, institution) that provides counseling services do not refer clients to their private practice unless the policies of a particular organization make explicit provisions for self-referrals. In such instances, the clients must be informed of other options open to them should they seek private counseling services.

A.10.b. Unacceptable Business Practices

Counselors do not participate in fee splitting, nor do they give or receive commissions, rebates, or any other form of remuneration when referring clients for professional services.

A.10.c. Establishing Fees In establishing fees for professional counseling services, counselors consider the financial status of clients and locality. If a counselor’s usual fees create undue hardship for the client, the counselor may adjust fees, when legally permissible, or assist the client in locating comparable, affordable services.

A.10.d. Nonpayment of Fees If counselors intend to use collection agencies or take legal measures to collect fees from clients who do not pay for services as agreed upon, they include such information in their informed consent documents and also inform clients in a timely fashion of intended actions and offer clients the opportunity to make payment.

A.10.e. Bartering Counselors may barter only if the bartering does not result in exploitation or harm, if the client requests it, and if such arrangements are an accepted practice among professionals in the community. Counselors consider the cultural implications of bartering and discuss relevant concerns with clients and document such agreements in a clear written contract.

A.10.f. Receiving Gifts Counselors understand the challenges of accepting gifts from clients and recognize that in some cultures, small gifts are a token of respect and gratitude. When determining whether to accept a gift from clients, counselors take into account the therapeutic relationship, the monetary value of the gift, the client’s motivation for giving the gift, and the counselor’s motivation for wanting to accept or decline the gift.

A.11. Termination and

Referral

A.11.a. Competence Within

Termination and Referral

If counselors lack the competence to be of professional assistance to clients, they avoid entering or continuing counseling relationships. Counselors are knowledgeable about culturally and clinically appropriate referral resources and suggest these alternatives. If clients decline the suggested referrals, counselors discontinue the relationship.

A.11.b. Values Within

Termination and Referral Counselors refrain from referring prospective and current clients based solely on the counselor’s personally held values, attitudes, beliefs, and behaviors. Counselors respect the diversity of clients and seek training in areas in which they are at risk of imposing their values onto clients, especially when the counselor’s values are inconsistent with the client’s goals or are discriminatory in nature.

A.11.c. Appropriate Termination Counselors terminate a counseling relationship when it becomes reasonably apparent that the client no longer needs assistance, is not likely to benefit, or is being harmed by continued counseling. Counselors may terminate counseling when in jeopardy of harm by the client or by another person with whom the client has a relationship, or when clients do not pay fees as agreed upon. Counselors provide pretermination counseling and recommend other service providers when necessary.

A.11.d. Appropriate Transfer of Services

When counselors transfer or refer clients to other practitioners, they ensure that appropriate clinical and administrative processes are completed and open communication is maintained with both clients and practitioners.

A.12. Abandonment and Client Neglect

Counselors do not abandon or neglect clients in counseling. Counselors assist in making appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacations, illness, and following termination.

Section B
Confidentiality and Privacy

Introduction

Counselors recognize that trust is a cornerstone of the counseling relationship. Counselors aspire to earn the trust of clients by creating an ongoing partnership, establishing and upholding appropriate boundaries, and maintaining confidentiality. Counselors communicate the parameters of confidentiality in a culturally competent manner. B.1. Respecting Client Rights

B.1.a. Multicultural/Diversity Considerations

Counselors maintain awareness and sensitivity regarding cultural meanings of confidentiality and privacy. Counselors respect differing views toward disclosure of information. Counselors hold ongoing discussions with clients as to how, when, and with whom information is to be shared.

B.1.b. Respect for Privacy Counselors respect the privacy of prospective and current clients. Counselors request private information from clients only when it is beneficial to the counseling process.

B.1.c. Respect for

Confidentiality

Counselors protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification.

B.1.d. Explanation of Limitations

At initiation and throughout the counseling process, counselors inform clients of the limitations of confidentiality and seek to identify situations in which confidentiality must be breached.

B.2. Exceptions

B.2.a. Serious and Foreseeable

Harm and Legal

Requirements

The general requirement that counselors keep information confidential does not apply when disclosure is required to protect clients or identified others from serious and foreseeable harm or when legal requirements demand that confidential information must be revealed. Counselors consult with other professionals when in doubt as to the validity of an exception. Additional considerations apply when addressing end-of-life issues.

B.2.b. Confidentiality Regarding End-of-Life Decisions

Counselors who provide services to terminally ill individuals who are considering hastening their own deaths have the option to maintain confidentiality, depending on applicable laws and the specific circumstances of the situation and after seeking consultation or supervision from appropriate professional and legal parties.

B.2.c. Contagious, Life-

Threatening Diseases

When clients disclose that they have a disease commonly known to be both communicable and life threatening, counselors may be justified in disclosing information to identifiable third parties, if the parties are known to be at serious and foreseeable risk of contracting the disease. Prior to making a disclosure, counselors assess the intent of clients to inform the third parties about their disease or to engage in any behaviors that may be harmful to an identifiable third party. Counselors adhere to relevant state laws concerning disclosure about disease status.

B.2.d. Court-Ordered Disclosure When ordered by a court to release confidential or privileged information without a client’s permission, counselors seek to obtain written, informed consent from the client or take steps to prohibit the disclosure or have it limited as narrowly as possible because of potential harm to the client or counseling relationship.

B.2.e. Minimal Disclosure To the extent possible, clients are informed before confidential information is disclosed and are involved in the disclosure decision-making process. When circumstances require the disclosure of confidential information, only essential information is revealed.

B.3. Information Shared

With Others

B.3.a. Subordinates Counselors make every effort to ensure that privacy and confidentiality of clients are maintained by subordinates, including employees, supervisees, students, clerical assistants, and volunteers.

B.3.b. Interdisciplinary Teams When services provided to the client involve participation by an interdisciplinary or treatment team, the client will be informed of the team’s existence and composition, information being shared, and the purposes of sharing such information.

B.3.c. Confidential Settings Counselors discuss confidential information only in settings in which they can reasonably ensure client privacy.

B.3.d. Third-Party Payers

Counselors disclose information to third-party payers only when clients have authorized such disclosure.

B.3.e. Transmitting Confidential Information

Counselors take precautions to ensure the confidentiality of all information transmitted through the use of any medium.

B.3.f. Deceased Clients Counselors protect the confidentiality of deceased clients, consistent with legal requirements and the documented preferences of the client.

B.4. Groups and Families

B.4.a. Group Work In group work, counselors clearly explain the importance and parameters of confidentiality for the specific group.

B.4.b. Couples and Family Counseling

In couples and family counseling, counselors clearly define who is considered “the client” and discuss expectations and limitations of confidentiality. Counselors seek agreement and document in writing such agreement among all involved parties regarding the confidentiality of information. In the absence of an agreement to the contrary, the couple or family is considered to be the client.

B.5. Clients Lacking Capacity to Give Informed Consent

B.5.a. Responsibility to Clients When counseling minor clients or adult clients who lack the capacity to give voluntary, informed consent, counselors protect the confidentiality of information received—in any medium—in the counseling relationship as specified by federal and state laws, written policies, and applicable ethical standards.

B.5.b. Responsibility to Parents and Legal Guardians Counselors inform parents and legal guardians about the role of counselors and the confidential nature of the counseling relationship, consistent with current legal and custodial arrangements. Counselors are sensitive to the cultural diversity of families and respect the inherent rights and responsibilities of parents/guardians regarding the welfare of their children/charges according to law. Counselors work to establish, as appropriate, collaborative relationships with parents/guardians to best serve clients.

B.5.c. Release of Confidential Information

When counseling minor clients or adult clients who lack the capacity to give voluntary consent to release confidential information, counselors seek permission from an appropriate third party to disclose information. In such instances, counselors inform clients consistent with their level of understanding and take appropriate measures to safeguard client confidentiality.

B.6. Records and

Documentation

B.6.a. Creating and Maintaining

Records and Documentation Counselors create and maintain records and documentation necessary for rendering professional services.

B.6.b. Confidentiality of Records and Documentation Counselors ensure that records and documentation kept in any medium are secure and that only authorized persons have access to them.

B.6.c. Permission to Record Counselors obtain permission from clients prior to recording sessions through electronic or other means.

B.6.d. Permission to Observe Counselors obtain permission from clients prior to allowing any person to observe counseling sessions, review session transcripts, or view recordings of sessions with supervisors, faculty, peers, or others within the training environment.

B.6.e. Client Access Counselors provide reasonable access to records and copies of records when requested by competent clients. Counselors limit the access of clients to their records, or portions of their records, only when there is compelling evidence that such access would cause harm to the client. Counselors document the request of clients and the rationale for withholding some or all of the records in the files of clients. In situations involving multiple clients, counselors provide individual clients with only those parts of records that relate directly to them and do not include confidential information related to any other client.

B.6.f. Assistance With Records

When clients request access to their records, counselors provide assistance and consultation in interpreting counseling records.

B.6.g. Disclosure or Transfer Unless exceptions to confidentiality exist, counselors obtain written permission from clients to disclose or transfer records to legitimate third parties. Steps are taken to ensure that receivers of counseling records are sensitive to their confidential nature.

B.6.h. Storage and Disposal After Termination

Counselors store records following termination of services to ensure reasonable future access, maintain records in accordance with federal and state laws and statutes such as licensure laws and policies governing records, and dispose of client records and other sensitive materials in a manner that protects client confidentiality. Counselors apply careful discretion and deliberation before destroying records that may be needed by a court of law, such as notes on child abuse, suicide, sexual harassment, or violence.

B.6.i. Reasonable Precautions Counselors take reasonable precautions to protect client confidentiality in the event of the counselor’s termination of practice, incapacity, or death and appoint a records custodian when identified as appropriate.

B.7. Case Consultation

B.7.a. Respect for Privacy Information shared in a consulting relationship is discussed for professional purposes only. Written and oral reports present only data germane to the purposes of the consultation, and every effort is made to protect client identity and to avoid undue invasion of privacy.

B.7.b. Disclosure of

Confidential Information

When consulting with colleagues, counselors do not disclose confidential information that reasonably could lead to the identification of a client or other person or organization with whom they have a confidential relationship unless they have obtained the prior consent of the person or organization or the disclosure cannot be avoided. They disclose information only to the extent necessary to achieve the purposes of the consultation.

Section C
Professional
Responsibility

Introduction

Counselors aspire to open, honest, and accurate communication in dealing with the public and other professionals. Counselors facilitate access to counseling services, and they practice in a nondiscriminatory manner within the boundaries of professional and personal competence; they also have a responsibility to abide by the ACA Code of Ethics. Counselors actively participate in local, state, and national associations that foster the development and improvement of counseling. Counselors are expected to advocate to promote changes at the individual, group, institutional, and societal levels that improve the quality of life for individuals and groups and remove potential barriers to the provision or access of appropriate services being offered. Counselors have a responsibility to the public to engage in counseling practices that are based on rigorous research methodologies. Counselors are encouraged to contribute to society by devoting a portion of their professional activity to services for which there is little or no financial return (pro bono publico). In addition, counselors engage in self-care activities to maintain and promote their own emotional, physical, mental, and spiritual well-being to best meet their professional responsibilities.

C.1. Knowledge of and

Compliance With

Standards

Counselors have a responsibility to read, understand, and follow the ACA Code of Ethics and adhere to applicable laws and regulations.

C.2. Professional Competence

C.2.a. Boundaries of Competence

Counselors practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Whereas multicultural counseling competency is required across all counseling specialties, counselors gain knowledge, personal awareness, sensitivity, dispositions, and skills pertinent to being a culturally competent counselor in working with a diverse client population.

C.2.b. New Specialty Areas of Practice Counselors practice in specialty areas new to them only after appropriate education, training, and supervised experience. While developing skills in new specialty areas, counselors take steps to ensure the competence of their work and protect others from possible harm.

C.2.c. Qualified for Employment

Counselors accept employment only for positions for which they are qualified given their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Counselors hire for professional counseling positions only individuals who are qualified and competent for those positions.

C.2.d. Monitor Effectiveness

Counselors continually monitor their effectiveness as professionals and take steps to improve when necessary. Counselors take reasonable steps to seek peer supervision to evaluate their efficacy as counselors.

C.2.e. Consultations on

Ethical Obligations

Counselors take reasonable steps to consult with other counselors, the ACA Ethics and Professional Standards Department, or related professionals when they have questions regarding their ethical obligations or professional practice.

C.2.f. Continuing Education

Counselors recognize the need for continuing education to acquire and maintain a reasonable level of awareness of current scientific and professional information in their fields of activity. Counselors maintain their competence in the skills they use, are open to new procedures, and remain informed regarding best practices for working with diverse populations.

C.2.g. Impairment Counselors monitor themselves for signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when impaired. They seek assistance for problems that reach the level of professional impairment, and, if necessary, they limit, suspend, or terminate their professional responsibilities until it is determined that they may safely resume their work. Counselors assist colleagues or supervisors in recognizing their own professional impairment and provide consultation and assistance when warranted with colleagues or supervisors showing signs of impairment and intervene as appropriate to prevent imminent harm to clients.

C.2.h. Counselor Incapacitation,

Death, Retirement, or

Termination of Practice

Counselors prepare a plan for the transfer of clients and the dissemination of records to an identified colleague or records custodian in the case of the counselor’s incapacitation, death, retirement, or termination of practice.

C.3. Advertising and

Soliciting Clients

C.3.a. Accurate Advertising

When advertising or otherwise representing their services to the public, counselors identify their credentials in an accurate manner that is not false, misleading, deceptive, or fraudulent.

C.3.b. Testimonials

Counselors who use testimonials do not solicit them from current clients, former clients, or any other persons who may be vulnerable to undue influence. Counselors discuss with clients the implications of and obtain permission for the use of any testimonial.

C.3.c. Statements by Others When feasible, counselors make reasonable efforts to ensure that statements made by others about them or about the counseling profession are accurate.

C.3.d. Recruiting Through Employment

Counselors do not use their places of employment or institutional affiliation to recruit clients, supervisors, or consultees for their private practices.

C.3.e. Products and Training Advertisements

Counselors who develop products related to their profession or conduct workshops or training events ensure that the advertisements concerning these products or events are accurate and disclose adequate information for consumers to make informed choices.

C.3.f. Promoting to Those Served

Counselors do not use counseling, teaching, training, or supervisory relationships to promote their products or training events in a manner that is deceptive or would exert undue influence on individuals who may be vulnerable. However, counselor educators may adopt textbooks they have authored for instructional purposes.

C.4. Professional Qualifications

C.4.a. Accurate Representation Counselors claim or imply only professional qualifications actually completed and correct any known misrepresentations of their qualifications by others. Counselors truthfully represent the qualifications of their professional colleagues. Counselors clearly distinguish between paid and volunteer work experience and accurately describe their continuing education and specialized training.

C.4.b. Credentials

Counselors claim only licenses or certifications that are current and in good standing.

C.4.c. Educational Degrees Counselors clearly differentiate between earned and honorary degrees.

C.4.d. Implying Doctoral-Level Competence

Counselors clearly state their highest earned degree in counseling or a closely related field. Counselors do not imply doctoral-level competence when possessing a master’s degree in counseling or a related field by referring to themselves as “Dr.” in a counseling context when their doctorate is not in counseling or a related field. Counselors do not use “ABD” (all but dissertation) or other such terms to imply competency.

C.4.e. Accreditation Status

Counselors accurately represent the accreditation status of their degree program and college/university.

C.4.f. Professional Membership

Counselors clearly differentiate between current, active memberships and former memberships in associations. Members of ACA must clearly differentiate between professional membership, which implies the possession of at least a master’s degree in counseling, and regular membership, which is open to individuals whose interests and activities are consistent with those of ACA but are not qualified for professional membership.

C.5. Nondiscrimination

Counselors do not condone or engage in discrimination against prospective or current clients, students, employees, supervisees, or research participants based on age, culture, disability, ethnicity, race, religion/spirituality, gender, gender identity, sexual orientation, marital/ partnership status, language preference, socioeconomic status, immigration status, or any basis proscribed by law.

C.6. Public Responsibility

C.6.a. Sexual Harassment Counselors do not engage in or condone sexual harassment. Sexual harassment can consist of a single intense or severe act, or multiple persistent or pervasive acts.

C.6.b. Reports to Third Parties Counselors are accurate, honest, and objective in reporting their professional activities and judgments to appropriate third parties, including courts, health insurance companies, those who are the recipients of evaluation reports, and others.

C.6.c. Media Presentations

When counselors provide advice or comment by means of public lectures, demonstrations, radio or television programs, recordings, technology-based applications, printed articles, mailed material, or other media, they take reasonable precautions to ensure that

1. the statements are based on appropriate professional counseling literature and practice,

2. the statements are otherwise consistent with the ACA Code of

Ethics, and

3. the recipients of the information are not encouraged to infer that a professional counseling relationship has been established.

C.6.d. Exploitation of Others Counselors do not exploit others in their professional relationships.

C.6.e. Contributing to the Public Good

(Pro Bono Publico)

Counselors make a reasonable effort to provide services to the public for which there is little or no financial return (e.g., speaking to groups, sharing professional information, offering reduced fees).

C.7. Treatment Modalities

C.7.a. Scientific Basis for Treatment

When providing services, counselors use techniques/procedures/modalities that are grounded in theory and/or have an empirical or scientific foundation.

C.7.b. Development and Innovation

When counselors use developing or innovative techniques/procedures/ modalities, they explain the potential risks, benefits, and ethical considerations of using such techniques/procedures/ modalities. Counselors work to minimize any potential risks or harm when using these techniques/procedures/modalities.

C.7.c. Harmful Practices Counselors do not use techniques/procedures/modalities when substantial evidence suggests harm, even if such services are requested.

C.8. Responsibility to

Other Professionals

C.8.a. Personal Public Statements

When making personal statements in a public context, counselors clarify that they are speaking from their personal perspectives and that they are not speaking on behalf of all counselors or the profession. Section D

Relationships With
Other Professionals

Introduction

Professional counselors recognize that the quality of their interactions with colleagues can influence the quality of services provided to clients. They work to become knowledgeable about colleagues within and outside the field of counseling. Counselors develop positive working relationships and systems of communication with colleagues to enhance services to clients.

D.1. Relationships With Colleagues, Employers, and Employees

D.1.a. Different Approaches

Counselors are respectful of approaches that are grounded in theory and/or have an empirical or scientific foundation but may differ from their own. Counselors acknowledge the expertise of other professional groups and are respectful of their practices.

D.1.b. Forming Relationships Counselors work to develop and strengthen relationships with colleagues from other disciplines to best serve clients.

D.1.c. Interdisciplinary

Teamwork

Counselors who are members of interdisciplinary teams delivering multifaceted services to clients remain focused on how to best serve clients. They participate in and contribute to decisions that affect the well-being of clients by drawing on the perspectives, values, and experiences of the counseling profession and those of colleagues from other disciplines.

D.1.d. Establishing

Professional and

Ethical Obligations

Counselors who are members of interdisciplinary teams work together with team members to clarify professional and ethical obligations of the team as a whole and of its individual members. When a team decision raises ethical concerns, counselors first attempt to resolve the concern within the team. If they cannot reach resolution among team members, counselors pursue other avenues to address their concerns consistent with client well-being.

D.1.e. Confidentiality When counselors are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, they clarify role expectations and the parameters of confidentiality with their colleagues.

D.1.f. Personnel Selection and Assignment

When counselors are in a position requiring personnel selection and/or assigning of responsibilities to others, they select competent staff and assign responsibilities compatible with their skills and experiences.

D.1.g. Employer Policies

The acceptance of employment in an agency or institution implies that counselors are in agreement with its general policies and principles. Counselors strive to reach agreement with employers regarding acceptable standards of client care and professional conduct that allow for changes in institutional policy conducive to the growth and development of clients.

D.1.h. Negative Conditions

Counselors alert their employers of inappropriate policies and practices. They attempt to effect changes in such policies or procedures through constructive action within the organization. When such policies are potentially disruptive or damaging to clients or may limit the effectiveness of services provided and change cannot be affected, counselors take appropriate further action. Such action may include referral to appropriate certification, accreditation, or state licensure organizations, or voluntary termination of employment.

D.1.i. Protection From Punitive Action

Counselors do not harass a colleague or employee or dismiss an employee who has acted in a responsible and ethical manner to expose inappropriate employer policies or practices.

D.2. Provision of

Consultation Services

D.2.a. Consultant Competency Counselors take reasonable steps to ensure that they have the appropriate resources and competencies when providing consultation services. Counselors provide appropriate referral resources when requested or needed.

D.2.b. Informed Consent in Formal Consultation

When providing formal consultation services, counselors have an obligation to review, in writing and verbally, the rights and responsibilities of both counselors and consultees. Counselors use clear and understandable language to inform all parties involved about the purpose of the services to be provided, relevant costs, potential risks and benefits, and the limits of confidentiality.

Section E
Evaluation, Assessment, and Interpretation

Introduction

Counselors use assessment as one component of the counseling process, taking into account the clients’ personal and cultural context. Counselors promote the well-being of individual clients or groups of clients by developing and using appropriate educational, mental health, psychological, and career assessments.

E.1. General

E.1.a. Assessment The primary purpose of educational, mental health, psychological, and career assessment is to gather information regarding the client for a variety of purposes, including, but not limited to, client decision making, treatment planning, and forensic proceedings. Assessment may include both qualitative and quantitative methodologies.

E.1.b. Client Welfare Counselors do not misuse assessment results and interpretations, and they take reasonable steps to prevent others from misusing the information provided. They respect the client’s right to know the results, the interpretations made, and the bases for counselors’ conclusions and recommendations.

E.2. Competence to Use and

Interpret Assessment Instruments

E.2.a. Limits of Competence Counselors use only those testing and assessment services for which they have been trained and are competent. Counselors using technology-assisted test interpretations are trained in the construct being measured and the specific instrument being used prior to using its technologybased application. Counselors take reasonable measures to ensure the proper use of assessment techniques by persons under their supervision.

E.2.b. Appropriate Use

Counselors are responsible for the appropriate application, scoring, interpretation, and use of assessment instruments relevant to the needs of the client, whether they score and interpret such assessments themselves or use technology or other services.

E.2.c. Decisions Based on Results

Counselors responsible for decisions involving individuals or policies that are based on assessment results have a thorough understanding of psychometrics.

E.3. Informed Consent in Assessment

E.3.a. Explanation to Clients Prior to assessment, counselors explain the nature and purposes of assessment and the specific use of results by potential recipients. The explanation will be given in terms and language that the client (or other legally authorized person on behalf of the client) can understand.

E.3.b. Recipients of Results Counselors consider the client’s and/ or examinee’s welfare, explicit understandings, and prior agreements in determining who receives the assessment results. Counselors include accurate and appropriate interpretations with any release of individual or group assessment results.

E.4. Release of Data to Qualified Personnel

Counselors release assessment data in which the client is identified only with the consent of the client or the client’s legal representative. Such data are released only to persons recognized by counselors as qualified to interpret the data.

E.5. Diagnosis of

Mental Disorders

E.5.a. Proper Diagnosis Counselors take special care to provide proper diagnosis of mental disorders. Assessment techniques (including personal interviews) used to determine client care (e.g., locus of treatment, type of treatment, recommended follow-up) are carefully selected and appropriately used.

E.5.b. Cultural Sensitivity Counselors recognize that culture affects the manner in which clients’ problems are defined and experienced. Clients’ socioeconomic and cultural experiences are considered when diagnosing mental disorders.

E.5.c. Historical and Social

Prejudices in the

Diagnosis of Pathology

Counselors recognize historical and social prejudices in the misdiagnosis and pathologizing of certain individuals and groups and strive to become aware of and address such biases in themselves or others.

E.5.d. Refraining From Diagnosis

Counselors may refrain from making and/or reporting a diagnosis if they believe that it would cause harm to the client or others. Counselors carefully consider both the positive and negative implications of a diagnosis.

E.6. Instrument Selection

E.6.a. Appropriateness of Instruments

Counselors carefully consider the validity, reliability, psychometric limitations, and appropriateness of instruments when selecting assessments and, when possible, use multiple forms of assessment, data, and/or instruments in forming conclusions, diagnoses, or recommendations.

E.6.b. Referral Information If a client is referred to a third party for assessment, the counselor provides specific referral questions and sufficient objective data about the client to ensure that appropriate assessment instruments are utilized.

E.7. Conditions of

Assessment

Administration

E.7.a. Administration Conditions

Counselors administer assessments under the same conditions that were established in their standardization. When assessments are not administered under standard conditions, as may be necessary to accommodate clients with disabilities, or when unusual behavior or irregularities occur during the administration, those conditions are noted in interpretation, and the results may be designated as invalid or of questionable validity.

E.7.b. Provision of Favorable Conditions

Counselors provide an appropriate environment for the administration of assessments (e.g., privacy, comfort, freedom from distraction).

E.7.c. Technological

Administration

Counselors ensure that technologically administered assessments function properly and provide clients with accurate results.

E.7.d. Unsupervised Assessments

Unless the assessment instrument is designed, intended, and validated for self-administration and/or scoring, counselors do not permit unsupervised use.

E.8. Multicultural Issues/ Diversity in Assessment

Counselors select and use with caution assessment techniques normed on populations other than that of the client. Counselors recognize the effects of age, color, culture, disability, ethnic group, gender, race, language preference, religion, spirituality, sexual orientation, and socioeconomic status on test administration and interpretation, and they place test results in proper perspective with other relevant factors.

E.9. Scoring and Interpretation of Assessments

E.9.a. Reporting

When counselors report assessment results, they consider the client’s personal and cultural background, the level of the client’s understanding of the results, and the impact of the results on the client. In reporting assessment results, counselors indicate reservations that exist regarding validity or reliability due to circumstances of the assessment or inappropriateness of the norms for the person tested.

E.9.b. Instruments With

Insufficient Empirical

Data

Counselors exercise caution when interpreting the results of instruments not having sufficient empirical data to support respondent results. The specific purposes for the use of such instruments are stated explicitly to the examinee. Counselors qualify any conclusions, diagnoses, or recommendations made that are based on assessments or instruments with questionable validity or reliability.

E.9.c. Assessment Services

Counselors who provide assessment, scoring, and interpretation services to support the assessment process confirm the validity of such interpretations. They accurately describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use. At all times, counselors maintain their ethical responsibility to those being assessed.

E.10. Assessment Security

Counselors maintain the integrity and security of tests and assessments consistent with legal and contractual obligations. Counselors do not appropriate, reproduce, or modify published assessments or parts thereof without acknowledgment and permission from the publisher.

E.11. Obsolete Assessment and Outdated Results

Counselors do not use data or results from assessments that are obsolete or outdated for the current purpose (e.g., noncurrent versions of assessments/ instruments). Counselors make every effort to prevent the misuse of obsolete measures and assessment data by others.

E.12. Assessment

Construction

Counselors use established scientific procedures, relevant standards, and current professional knowledge for assessment design in the development, publication, and utilization of assessment techniques.

E.13. Forensic Evaluation:

Evaluation for

Legal Proceedings

E.13.a. Primary Obligations When providing forensic evaluations, the primary obligation of counselors is to produce objective findings that can be substantiated based on information and techniques appropriate to the evaluation, which may include examination of the individual and/or review of records. Counselors form professional opinions based on their professional knowledge and expertise that can be supported by the data gathered in evaluations. Counselors define the limits of their reports or testimony, especially when an examination of the individual has not been conducted.

E.13.b. Consent for Evaluation Individuals being evaluated are informed in writing that the relationship is for the purposes of an evaluation and is not therapeutic in nature, and entities or individuals who will receive the evaluation report are identified. Counselors who perform forensic evaluations obtain written consent from those being evaluated or from their legal representative unless a court orders evaluations to be conducted without the written consent of the individuals being evaluated. When children or adults who lack the capacity to give voluntary consent are being evaluated, informed written consent is obtained from a parent or guardian.

E.13.c. Client Evaluation Prohibited

Counselors do not evaluate current or former clients, clients’ romantic partners, or clients’ family members for forensic purposes. Counselors do not counsel individuals they are evaluating.

E.13.d. Avoid Potentially

Harmful Relationships

Counselors who provide forensic evaluations avoid potentially harmful professional or personal relationships with family members, romantic partners, and close friends of individuals they are evaluating or have evaluated in the past. Section F

Supervision, Training, and Teaching

Introduction

Counselor supervisors, trainers, and educators aspire to foster meaningful and respectful professional relationships and to maintain appropriate boundaries with supervisees and students in both face-to-face and electronic formats. They have theoretical and pedagogical foundations for their work; have knowledge of supervision models; and aim to be fair, accurate, and honest in their assessments of counselors, students, and supervisees.

F.1. Counselor Supervision and Client Welfare

F.1.a. Client Welfare A primary obligation of counseling supervisors is to monitor the services provided by supervisees. Counseling supervisors monitor client welfare and supervisee performance and professional development. To fulfill these obligations, supervisors meet regularly with supervisees to review the supervisees’ work and help them become prepared to serve a range of diverse clients. Supervisees have a responsibility to understand and follow the ACA Code of Ethics.

F.1.b. Counselor Credentials Counseling supervisors work to ensure that supervisees communicate their qualifications to render services to their clients.

F.1.c. Informed Consent and Client Rights

Supervisors make supervisees aware of client rights, including the protection of client privacy and confidentiality in the counseling relationship. Supervisees provide clients with professional disclosure information and inform them of how the supervision process influences the limits of confidentiality. Supervisees make clients aware of who will have access to records of the counseling relationship and how these records will be stored, transmitted, or otherwise reviewed.

F.2. Counselor Supervision

Competence

F.2.a. Supervisor Preparation Prior to offering supervision services, counselors are trained in supervision methods and techniques. Counselors who offer supervision services regularly pursue continuing education activities, including both counseling and supervision topics and skills.

F.2.b. Multicultural Issues/

Diversity in Supervision

Counseling supervisors are aware of and address the role of multiculturalism/ diversity in the supervisory relationship.

F.2.c. Online Supervision When using technology in supervision, counselor supervisors are competent in the use of those technologies. Supervisors take the necessary precautions to protect the confidentiality of all information transmitted through any electronic means.

F.3. Supervisory Relationship

F.3.a. Extending Conventional

Supervisory Relationships

Counseling supervisors clearly define and maintain ethical professional, personal, and social relationships with their supervisees. Supervisors consider the risks and benefits of extending current supervisory relationships in any form beyond conventional parameters. In extending these boundaries, supervisors take appropriate professional precautions to ensure that judgment is not impaired and that no harm occurs.

F.3.b. Sexual Relationships Sexual or romantic interactions or relationships with current supervisees are prohibited. This prohibition applies to both in-person and electronic interactions or relationships.

F.3.c. Sexual Harassment Counseling supervisors do not condone or subject supervisees to sexual harassment.

F.3.d. Friends or Family Members

Supervisors are prohibited from engaging in supervisory relationships with individuals with whom they have an inability to remain objective.

F.4. Supervisor

Responsibilities

F.4.a. Informed Consent for Supervision

Supervisors are responsible for incorporating into their supervision the principles of informed consent and participation. Supervisors inform supervisees of the policies and procedures to which supervisors are to adhere and the mechanisms for due process appeal of individual supervisor actions. The issues unique to the use of distance supervision are to be included in the documentation as necessary.

F.4.b. Emergencies and Absences

Supervisors establish and communicate to supervisees procedures for contacting supervisors or, in their absence, alternative on-call supervisors to assist in handling crises.

F.4.c. Standards for Supervisees Supervisors make their supervisees aware of professional and ethical standards and legal responsibilities.

F.4.d. Termination of the

Supervisory Relationship

Supervisors or supervisees have the right to terminate the supervisory relationship with adequate notice. Reasons for considering termination are discussed, and both parties work to resolve differences. When termination is warranted, supervisors make appropriate referrals to possible alternative supervisors.

F.5. Student and Supervisee Responsibilities

F.5.a. Ethical Responsibilities Students and supervisees have a responsibility to understand and follow the ACA Code of Ethics. Students and supervisees have the same obligation to clients as those required of professional counselors.

F.5.b. Impairment Students and supervisees monitor themselves for signs of impairment from their own physical, mental, or emotional problems and refrain from offering or providing professional services when such impairment is likely to harm a client or others. They notify their faculty and/or supervisors and seek assistance for problems that reach the level of professional impairment, and, if necessary, they limit, suspend, or terminate their professional responsibilities until it is determined that they may safely resume their work.

F.5.c. Professional Disclosure Before providing counseling services, students and supervisees disclose their status as supervisees and explain how this status affects the limits of confidentiality. Supervisors ensure that clients are aware of the services rendered and the qualifications of the students and supervisees rendering those services. Students and supervisees obtain client permission before they use any information concerning the counseling relationship in the training process.

F.6. Counseling Supervision Evaluation, Remediation, and Endorsement

F.6.a. Evaluation Supervisors document and provide supervisees with ongoing feedback regarding their performance and schedule periodic formal evaluative sessions throughout the supervisory relationship.

F.6.b. Gatekeeping and Remediation

Through initial and ongoing evaluation, supervisors are aware of supervisee limitations that might impede performance. Supervisors assist supervisees in securing remedial assistance when needed. They recommend dismissal from training programs, applied counseling settings, and state or voluntary professional credentialing processes when those supervisees are unable to demonstrate that they can provide competent professional services to a range of diverse clients. Supervisors seek consultation and document their decisions to dismiss or refer supervisees for assistance. They ensure that supervisees are aware of options available to them to address such decisions.

F.6.c. Counseling for Supervisees

If supervisees request counseling, the supervisor assists the supervisee in identifying appropriate services. Supervisors do not provide counseling services to supervisees. Supervisors address interpersonal competencies in terms of the impact of these issues on clients, the supervisory relationship, and professional functioning.

F.6.d. Endorsements Supervisors endorse supervisees for certification, licensure, employment, or completion of an academic or training program only when they believe that supervisees are qualified for the endorsement. Regardless of qualifications, supervisors do not endorse supervisees whom they believe to be impaired in any way that would interfere with the performance of the duties associated with the endorsement.

F.7. Responsibilities of

Counselor Educators

F.7.a. Counselor Educators Counselor educators who are responsible for developing, implementing, and supervising educational programs are skilled as teachers and practitioners. They are knowledgeable regarding the ethical, legal, and regulatory aspects of the profession; are skilled in applying that knowledge; and make students and supervisees aware of their responsibilities. Whether in traditional, hybrid, and/or online formats, counselor educators conduct counselor education and training programs in an ethical manner and serve as role models for professional behavior.

F.7.b. Counselor Educator Competence

Counselors who function as counselor educators or supervisors provide instruction within their areas of knowledge and competence and provide instruction based on current information and knowledge available in the profession. When using technology to deliver instruction, counselor educators develop competence in the use of the technology.

F.7.c. Infusing Multicultural Issues/Diversity

Counselor educators infuse material related to multiculturalism/diversity into all courses and workshops for the development of professional counselors.

F.7.d. Integration of Study and Practice In traditional, hybrid, and/or online formats, counselor educators establish education and training programs that integrate academic study and supervised practice.

F.7.e. Teaching Ethics Throughout the program, counselor educators ensure that students are aware of the ethical responsibilities and standards of the profession and the ethical responsibilities of students to the profession. Counselor educators infuse ethical considerations throughout the curriculum.

F.7.f. Use of Case Examples The use of client, student, or supervisee information for the purposes of case examples in a lecture or classroom setting is permissible only when (a) the client, student, or supervisee has reviewed the material and agreed to its presentation or (b) the information has been sufficiently modified to obscure identity.

F.7.g. Student-to-Student

Supervision and

Instruction

When students function in the role of counselor educators or supervisors, they understand that they have the same ethical obligations as counselor educators, trainers, and supervisors. Counselor educators make every effort to ensure that the rights of students are not compromised when their peers lead experiential counseling activities in traditional, hybrid, and/or online formats (e.g., counseling groups, skills classes, clinical supervision).

F.7.h. Innovative Theories and Techniques

Counselor educators promote the use of techniques/procedures/modalities that are grounded in theory and/or have an empirical or scientific foundation. When counselor educators discuss developing or innovative techniques/ procedures/modalities, they explain the potential risks, benefits, and ethical considerations of using such techniques/ procedures/modalities.

F.7.i. Field Placements

Counselor educators develop clear policies and provide direct assistance within their training programs regarding appropriate field placement and other clinical experiences. Counselor educators provide clearly stated roles and responsibilities for the student or supervisee, the site supervisor, and the program supervisor. They confirm that site supervisors are qualified to provide supervision in the formats in which services are provided and inform site supervisors of their professional and ethical responsibilities in this role.

F.8. Student Welfare

F.8.a. Program Information and Orientation

Counselor educators recognize that program orientation is a developmental process that begins upon students’ initial contact with the counselor education program and continues throughout the educational and clinical training of students. Counselor education faculty provide prospective and current students with information about the counselor education program’s expectations, including

1. the values and ethical principles of the profession;

2. the type and level of skill and knowledge acquisition required for successful completion of the training;

3. technology requirements;

4. program training goals, objectives, and mission, and subject matter to be covered;

5. bases for evaluation;

6. training components that encourage self-growth or self-disclosure as part of the training process;

7. the type of supervision settings and requirements of the sites for required clinical field experiences;

8. student and supervisor evaluation and dismissal policies and procedures; and

9. up-to-date employment prospects for graduates.

F.8.b. Student Career Advising Counselor educators provide career advisement for their students and make them aware of opportunities in the field.

F.8.c. Self-Growth Experiences Self-growth is an expected component of counselor education. Counselor educators are mindful of ethical principles when they require students to engage in self-growth experiences. Counselor educators and supervisors inform students that they have a right to decide what information will be shared or withheld in class.

F.8.d. Addressing Personal Concerns

Counselor educators may require students to address any personal concerns that have the potential to affect professional competency.

F.9. Evaluation and

Remediation

F.9.a. Evaluation of Students

Counselor educators clearly state to students, prior to and throughout the training program, the levels of competency expected, appraisal methods, and timing of evaluations for both didactic and clinical competencies. Counselor educators provide students with ongoing feedback regarding their performance throughout the training program.

F.9.b. Limitations

Counselor educators, through ongoing evaluation, are aware of and address the inability of some students to achieve counseling competencies. Counselor educators do the following:

1. assist students in securing remedial assistance when needed,

2. seek professional consultation and document their decision to dismiss or refer students for assistance, and

3. ensure that students have recourse in a timely manner to address decisions requiring them to seek assistance or to dismiss them and provide students with due process according to institutional policies and procedures.

F.9.c. Counseling for Students If students request counseling, or if counseling services are suggested as part of a remediation process, counselor educators assist students in identifying appropriate services.

F.10. Roles and Relationships

Between Counselor

Educators and Students

F.10.a. Sexual or Romantic Relationships

Counselor educators are prohibited from sexual or romantic interactions or relationships with students currently enrolled in a counseling or related program and over whom they have power and authority. This prohibition applies to both in-person and electronic interactions or relationships.

F.10.b. Sexual Harassment Counselor educators do not condone or subject students to sexual harassment.

F.10.c. Relationships With Former Students

Counselor educators are aware of the power differential in the relationship between faculty and students. Faculty members discuss with former students potential risks when they consider engaging in social, sexual, or other intimate relationships.

F.10.d. Nonacademic Relationships

Counselor educators avoid nonacademic relationships with students in which there is a risk of potential harm to the student or which may compromise the training experience or grades assigned. In addition, counselor educators do not accept any form of professional services, fees, commissions, reimbursement, or remuneration from a site for student or supervisor placement.

F.10.e. Counseling Services Counselor educators do not serve as counselors to students currently enrolled in a counseling or related program and over whom they have power and authority.

F.10.f. Extending Educator–Student Boundaries

Counselor educators are aware of the power differential in the relationship between faculty and students. If they believe that a nonprofessional relationship with a student may be potentially beneficial to the student, they take precautions similar to those taken by counselors when working with clients. Examples of potentially beneficial interactions or relationships include, but are not limited to, attending a formal ceremony; conducting hospital visits; providing support during a stressful event; or maintaining mutual membership in a professional association, organization, or community. Counselor educators discuss with students the rationale for such interactions, the potential benefits and drawbacks, and the anticipated consequences for the student. Educators clarify the specific nature and limitations of the additional role(s) they will have with the student prior to engaging in a nonprofessional relationship. Nonprofessional relationships with students should be time limited and/or context specific and initiated with student consent.

F.11. Multicultural/Diversity

Competence in Counselor Education and Training Programs

F.11.a. Faculty Diversity Counselor educators are committed to recruiting and retaining a diverse faculty.

F.11.b. Student Diversity Counselor educators actively attempt to recruit and retain a diverse student body. Counselor educators demonstrate commitment to multicultural/diversity competence by recognizing and valuing the diverse cultures and types of abilities that students bring to the training experience. Counselor educators provide appropriate accommodations that enhance and support diverse student well-being and academic performance.

F.11.c. Multicultural/Diversity Competence

Counselor educators actively infuse multicultural/diversity competency in their training and supervision practices. They actively train students to gain awareness, knowledge, and skills in the competencies of multicultural practice.

Section G
Research and Publication

Introduction

Counselors who conduct research are encouraged to contribute to the knowledge base of the profession and promote a clearer understanding of the conditions that lead to a healthy and more just society. Counselors support the efforts of researchers by participating fully and willingly whenever possible. Counselors minimize bias and respect diversity in designing and implementing research.

G.1. Research Responsibilities

G.1.a. Conducting Research Counselors plan, design, conduct, and report research in a manner that is consistent with pertinent ethical principles, federal and state laws, host institutional regulations, and scientific standards governing research.

G.1.b. Confidentiality in Research

Counselors are responsible for understanding and adhering to state, federal, agency, or institutional policies or applicable guidelines regarding confidentiality in their research practices.

G.1.c. Independent Researchers When counselors conduct independent research and do not have access to an institutional review board, they are bound to the same ethical principles and federal and state laws pertaining to the review of their plan, design, conduct, and reporting of research.

G.1.d. Deviation From

Standard Practice

Counselors seek consultation and observe stringent safeguards to protect the rights of research participants when research indicates that a deviation from standard or acceptable practices may be necessary.

G.1.e. Precautions to Avoid Injury

Counselors who conduct research are responsible for their participants’ welfare throughout the research process and should take reasonable precautions to avoid causing emotional, physical, or social harm to participants.

G.1.f. Principal Researcher Responsibility

The ultimate responsibility for ethical research practice lies with the principal researcher. All others involved in the research activities share ethical obligations and responsibility for their own actions.

G.2. Rights of Research Participants

G.2.a. Informed Consent in Research Individuals have the right to decline requests to become research participants. In seeking consent, counselors use language that

1. accurately explains the purpose and procedures to be followed;

2. identifies any procedures that are experimental or relatively untried;

3. describes any attendant discomforts, risks, and potential power differentials between researchers and participants;

4. describes any benefits or changes in individuals or organizations that might reasonably be expected;

5. discloses appropriate alternative procedures that would be advantageous for participants;

6. offers to answer any inquiries concerning the procedures;

7. describes any limitations on confidentiality;

8. describes the format and potential target audiences for the dissemination of research findings; and

9. instructs participants that they are free to withdraw their consent and discontinue participation in the project at any time, without penalty.

G.2.b. Student/Supervisee Participation

Researchers who involve students or supervisees in research make clear to them that the decision regarding participation in research activities does not affect their academic standing or supervisory relationship. Students or supervisees who choose not to participate in research are provided with an appropriate alternative to fulfill their academic or clinical requirements.

G.2.c. Client Participation Counselors conducting research involving clients make clear in the informed consent process that clients are free to choose whether to participate in research activities. Counselors take necessary precautions to protect clients from adverse consequences of declining or withdrawing from participation.

G.2.d. Confidentiality of Information

Information obtained about research participants during the course of research is confidential. Procedures are implemented to protect confidentiality.

G.2.e. Persons Not

Capable of Giving

Informed Consent

When a research participant is not capable of giving informed consent, counselors provide an appropriate explanation to, obtain agreement for participation from, and obtain the appropriate consent of a legally authorized person.

G.2.f. Commitments to Participants

Counselors take reasonable measures to honor all commitments to research participants.

G.2.g. Explanations After Data Collection

After data are collected, counselors provide participants with full clarification of the nature of the study to remove any misconceptions participants might have regarding the research. Where scientific or human values justify delaying or withholding information, counselors take reasonable measures to avoid causing harm.

G.2.h. Informing Sponsors Counselors inform sponsors, institutions, and publication channels regarding research procedures and outcomes. Counselors ensure that appropriate bodies and authorities are given pertinent information and acknowledgment.

G.2.i. Research Records Custodian

As appropriate, researchers prepare and disseminate to an identified colleague or records custodian a plan for the transfer of research data in the case of their incapacitation, retirement, or death.

G.3. Managing and

Maintaining Boundaries

G.3.a. Extending Researcher–

Participant Boundaries

Researchers consider the risks and benefits of extending current research relationships beyond conventional parameters. When a nonresearch interaction between the researcher and the research participant may be potentially beneficial, the researcher must document, prior to the interaction (when feasible), the rationale for such an interaction, the potential benefit, and anticipated consequences for the research participant. Such interactions should be initiated with appropriate consent of the research participant. Where unintentional harm occurs to the research participant, the researcher must show evidence of an attempt to remedy such harm.

G.3.b. Relationships With

Research Participants

Sexual or romantic counselor–research participant interactions or relationships with current research participants are prohibited. This prohibition applies to both in-person and electronic interactions or relationships.

G.3.c. Sexual Harassment and Research Participants

Researchers do not condone or subject research participants to sexual harassment.

G.4. Reporting Results

G.4.a. Accurate Results Counselors plan, conduct, and report research accurately. Counselors do not engage in misleading or fraudulent research, distort data, misrepresent data, or deliberately bias their results. They describe the extent to which results are applicable for diverse populations.

G.4.b. Obligation to Report

Unfavorable Results

Counselors report the results of any research of professional value. Results that reflect unfavorably on institutions, programs, services, prevailing opinions, or vested interests are not withheld.

G.4.c. Reporting Errors If counselors discover significant errors in their published research, they take reasonable steps to correct such errors in a correction erratum or through other appropriate publication means.

G.4.d. Identity of Participants Counselors who supply data, aid in the research of another person, report research results, or make original data available take due care to disguise the identity of respective participants in the absence of specific authorization from the participants to do otherwise. In situations where participants selfidentify their involvement in research studies, researchers take active steps to ensure that data are adapted/ changed to protect the identity and welfare of all parties and that discussion of results does not cause harm to participants.

G.4.e. Replication Studies

Counselors are obligated to make available sufficient original research information to qualified professionals who may wish to replicate or extend the study.

G.5. Publications and Presentations

G.5.a. Use of Case Examples

The use of participants’, clients’, students’, or supervisees’ information for the purpose of case examples in a presentation or publication is permissible only when (a) participants, clients, students, or supervisees have reviewed the material and agreed to its presentation or publication or (b) the information has been sufficiently modified to obscure identity.

G.5.b. Plagiarism Counselors do not plagiarize; that is, they do not present another person’s work as their own.

G.5.c. Acknowledging Previous Work

In publications and presentations, counselors acknowledge and give recognition to previous work on the topic by others or self.

G.5.d. Contributors Counselors give credit through joint authorship, acknowledgment, footnote statements, or other appropriate means to those who have contributed significantly to research or concept development in accordance with such contributions. The principal contributor is listed first, and minor technical or professional contributions are acknowledged in notes or introductory statements.

G.5.e. Agreement of Contributors

Counselors who conduct joint research with colleagues or students/supervisors establish agreements in advance regarding allocation of tasks, publication credit, and types of acknowledgment that will be received.

G.5.f. Student Research

Manuscripts or professional presentations in any medium that are substantially based on a student’s course papers, projects, dissertations, or theses are used only with the student’s permission and list the student as lead author.

G.5.g. Duplicate Submissions Counselors submit manuscripts for consideration to only one journal at a time. Manuscripts that are published in whole or in substantial part in one journal or published work are not submitted for publication to another publisher without acknowledgment and permission from the original publisher.

G.5.h. Professional Review Counselors who review material submitted for publication, research, or other scholarly purposes respect the confidentiality and proprietary rights of those who submitted it. Counselors make publication decisions based on valid and defensible standards. Counselors review article submissions in a timely manner and based on their scope and competency in research methodologies. Counselors who serve as reviewers at the request of editors or publishers make every effort to only review materials that are within their scope of competency and avoid personal biases. Section H

Distance Counseling,

Technology, and Social Media

Introduction

Counselors understand that the profession of counseling may no longer be limited to in-person, face-to-face interactions. Counselors actively attempt to understand the evolving nature of the profession with regard to distance counseling, technology, and social media and how such resources may be used to better serve their clients. Counselors strive to become knowledgeable about these resources. Counselors understand the additional concerns related to the use of distance counseling, technology, and social media and make every attempt to protect confidentiality and meet any legal and ethical requirements for the use of such resources.

H.1. Knowledge and

Legal Considerations

H.1.a. Knowledge and Competency

Counselors who engage in the use of distance counseling, technology, and/ or social media develop knowledge and skills regarding related technical, ethical, and legal considerations (e.g., special certifications, additional course work).

H.1.b. Laws and Statutes

Counselors who engage in the use of distance counseling, technology, and social media within their counseling practice understand that they may be subject to laws and regulations of both the counselor’s practicing location and the client’s place of residence. Counselors ensure that their clients are aware of pertinent legal rights and limitations governing the practice of counseling across state lines or international boundaries.

H.2. Informed Consent and Security

H.2.a. Informed Consent and Disclosure Clients have the freedom to choose whether to use distance counseling, social media, and/or technology within the counseling process. In addition to the usual and customary protocol of informed consent between counselor and client for face-to-face counseling, the following issues, unique to the use of distance counseling, technology, and/ or social media, are addressed in the informed consent process:

· distance counseling credentials, physical location of practice, and contact information;

· risks and benefits of engaging in the use of distance counseling, technology, and/or social media;

· possibility of technology failure and alternate methods of service delivery;

· anticipated response time;

· emergency procedures to follow when the counselor is not available; • time zone differences;

· cultural and/or language differences that may affect delivery of services;

· possible denial of insurance benefits; and

· social media policy.

H.2.b. Confidentiality

Maintained by the

Counselor

Counselors acknowledge the limitations of maintaining the confidentiality of electronic records and transmissions. They inform clients that individuals might have authorized or unauthorized access to such records or transmissions (e.g., colleagues, supervisors, employees, information technologists). H.2.c. Acknowledgment of Limitations Counselors inform clients about the inherent limits of confidentiality when using technology. Counselors urge clients to be aware of authorized and/ or unauthorized access to information disclosed using this medium in the counseling process.

H.2.d. Security Counselors use current encryption standards within their websites and/or technology-based communications that meet applicable legal requirements. Counselors take reasonable precautions to ensure the confidentiality of information transmitted through any electronic means.

H.3. Client Verification

Counselors who engage in the use of distance counseling, technology, and/ or social media to interact with clients take steps to verify the client’s identity at the beginning and throughout the therapeutic process. Verification can include, but is not limited to, using code words, numbers, graphics, or other nondescript identifiers.

H.4. Distance Counseling

Relationship

H.4.a. Benefits and Limitations Counselors inform clients of the benefits and limitations of using technology applications in the provision of counseling services. Such technologies include, but are not limited to, computer hardware and/or software, telephones and applications, social media and Internet-based applications and other audio and/or video communication, or data storage devices or media.

H.4.b. Professional

Boundaries in Distance

Counseling

Counselors understand the necessity of maintaining a professional relationship with their clients. Counselors discuss and establish professional boundaries with clients regarding the appropriate use and/or application of technology and the limitations of its use within the counseling relationship (e.g., lack of confidentiality, times when not appropriate to use).

H.4.c. Technology-Assisted Services

When providing technology-assisted services, counselors make reasonable efforts to determine that clients are intellectually, emotionally, physically, linguistically, and functionally capable of using the application and that the application is appropriate for the needs of the client. Counselors verify that clients understand the purpose and operation of technology applications and follow up with clients to correct possible misconceptions, discover appropriate use, and assess subsequent steps.

H.4.d. Effectiveness of Services When distance counseling services are deemed ineffective by the counselor or client, counselors consider delivering services face-to-face. If the counselor is not able to provide face-to-face services (e.g., lives in another state), the counselor assists the client in identifying appropriate services.

H.4.e. Access

Counselors provide information to clients regarding reasonable access to pertinent applications when providing technology-assisted services.

H.4.f. Communication

Differences in

Electronic Media

Counselors consider the differences between face-to-face and electronic communication (nonverbal and verbal cues) and how these may affect the counseling process. Counselors educate clients on how to prevent and address potential misunderstandings arising from the lack of visual cues and voice intonations when communicating electronically.

H.5. Records and

Web Maintenance

H.5.a. Records Counselors maintain electronic records in accordance with relevant laws and statutes. Counselors inform clients on how records are maintained electronically. This includes, but is not limited to, the type of encryption and security assigned to the records, and if/for how long archival storage of transaction records is maintained.

H.5.b. Client Rights Counselors who offer distance counseling services and/or maintain a professional website provide electronic links to relevant licensure and professional certification boards to protect consumer and client rights and address ethical concerns.

H.5.c. Electronic Links Counselors regularly ensure that electronic links are working and are professionally appropriate.

H.5.d. Multicultural and

Disability Considerations Counselors who maintain websites provide accessibility to persons with disabilities. They provide translation capabilities for clients who have a different primary language, when feasible. Counselors acknowledge the imperfect nature of such translations and accessibilities.

H.6. Social Media

H.6.a. Virtual Professional Presence

In cases where counselors wish to maintain a professional and personal presence for social media use, separate professional and personal web pages and profiles are created to clearly distinguish between the two kinds of virtual presence.

H.6.b. Social Media as Part of Informed Consent

Counselors clearly explain to their clients, as part of the informed consent procedure, the benefits, limitations, and boundaries of the use of social media.

H.6.c. Client Virtual Presence

Counselors respect the privacy of their clients’ presence on social media unless given consent to view such information.

H.6.d. Use of Public Social Media

Counselors take precautions to avoid disclosing confidential information through public social media.

Section I

Resolving Ethical Issues

Introduction

Professional counselors behave in an ethical and legal manner. They are aware that client welfare and trust in the profession depend on a high level of professional conduct. They hold other counselors to the same standards and are willing to take appropriate action to ensure that standards are upheld. Counselors strive to resolve ethical dilemmas with direct and open communication among all parties involved and seek consultation with colleagues and supervisors when necessary. Counselors incorporate ethical practice into their daily professional work and engage in ongoing professional development regarding current topics in ethical and legal issues in counseling. Counselors become familiar with the ACA Policy and Procedures for Processing Complaints of Ethical Violations[footnoteRef:1] and use it as a reference for assisting in the enforcement of the ACA Code of Ethics. [1: See the American Counseling Association web site at http://www.counseling.org/knowledge-center/ethics]

I.1. Standards and the Law

I.1.a. Knowledge

Counselors know and understand the ACA Code of Ethics and other applicable ethics codes from professional organizations or certification and licensure bodies of which they are members. Lack of knowledge or misunderstanding of an ethical responsibility is not a defense against a charge of unethical conduct.

I.1.b. Ethical Decision Making When counselors are faced with an ethical dilemma, they use and document, as appropriate, an ethical decisionmaking model that may include, but is not limited to, consultation; consideration of relevant ethical standards, principles, and laws; generation of potential courses of action; deliberation of risks and benefits; and selection of an objective decision based on the circumstances and welfare of all involved. I.1.c. Conflicts Between Ethics and Laws

If ethical responsibilities conflict with the law, regulations, and/or other gov-

erning legal authority, counselors make known their commitment to the ACA Code of Ethics and take steps to resolve the conflict. If the conflict cannot be resolved using this approach, counselors, acting in the best interest of the client, may adhere to the requirements of the law, regulations, and/or other governing legal authority.

I.2. Suspected Violations

I.2.a. Informal Resolution When counselors have reason to believe that another counselor is violating or has violated an ethical standard and substantial harm has not occurred, they attempt to first resolve the issue informally with the other counselor if feasible, provided such action does not violate confidentiality rights that may be involved.

I.2.b. Reporting Ethical Violations

If an apparent violation has substantially harmed or is likely to substantially harm a person or organization and is not appropriate for informal resolution or is not resolved properly, counselors take further action depending on the situation. Such action may include referral to state or national committees on professional ethics, voluntary national certification bodies, state licensing boards, or appropriate institutional authorities. The confidentiality rights of clients should be considered in all actions. This standard does not apply when counselors have been retained to review the work of another counselor whose professional conduct is in question (e.g., consultation, expert testimony).

I.2.c. Consultation

When uncertain about whether a particular situation or course of action may be in violation of the ACA Code of Ethics, counselors consult with other counselors who are knowledgeable about ethics and the ACA Code of Ethics, with colleagues, or with appropriate authorities, such as the ACA Ethics and Professional Standards Department.

I.2.d. Organizational Conflicts If the demands of an organization with which counselors are affiliated pose a conflict with the ACA Code of Ethics, counselors specify the nature of such conflicts and express to their supervisors or other responsible officials their commitment to the ACA Code of Ethics and, when possible, work through the appropriate channels to address the situation.

I.2.e. Unwarranted Complaints

Counselors do not initiate, participate in, or encourage the filing of ethics complaints that are retaliatory in nature or are made with reckless disregard or willful ignorance of facts that would disprove the allegation.

I.2.f. Unfair Discrimination Against Complainants and Respondents Counselors do not deny individuals employment, advancement, admission to academic or other programs, tenure, or promotion based solely on their having made or their being the subject of an ethics complaint. This does not preclude taking action based on the outcome of such proceedings or considering other appropriate information.

I.3. Cooperation With Ethics Committees

Counselors assist in the process of enforcing the ACA Code of Ethics. Counselors cooperate with investigations, proceedings, and requirements of the ACA Ethics Committee or ethics committees of other duly constituted associations or boards having jurisdiction over those charged with a violation.

• ACA Code of Ethics •

• ACA Code of Ethics •
• ACA Code of Ethics •

• 2 •

• 6 •

• 7 •

Glossary of Terms

Abandonment – the inappropriate ending or arbitrary termination of a counseling relationship that puts the client at risk.

Advocacy – promotion of the well-being of individuals, groups, and the counseling profession within systems and organizations. Advocacy seeks to remove barriers and obstacles that inhibit access, growth, and development.

Assent – to demonstrate agreement when a person is otherwise not capable or competent to give formal consent (e.g., informed consent) to a counseling service or plan.

Assessment – the process of collecting in-depth information about a person in order to develop a comprehensive plan that will guide the collaborative counseling and service provision process.

Bartering – accepting goods or services from clients in exchange for counseling services.

Client – an individual seeking or referred to the professional services of a counselor.

Confidentiality – the ethical duty of counselors to protect a client’s identity, identifying characteristics, and private communications.

Consultation – a professional relationship that may include, but is not limited to, seeking advice, information, and/ or testimony.

Counseling – a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.

Counselor Educator – a professional counselor engaged primarily in developing, implementing, and supervising the educational preparation of professional counselors.

Counselor Supervisor – a professional counselor who engages in a formal relationship with a practicing counselor or counselor-in-training for the purpose of overseeing that individual’s counseling work or clinical skill development.

Culture – membership in a socially constructed way of living, which incorporates collective values, beliefs, norms, boundaries, and lifestyles that are cocreated with others who share similar worldviews comprising biological, psychosocial, historical, psychological, and other factors.

Discrimination – the prejudicial treatment of an individual or group based on their actual or perceived membership in a particular group, class, or category.

Distance Counseling – The provision of counseling services by means other than face-to-face meetings, usually with the aid of technology.

Diversity – the similarities and differences that occur within and across cultures, and the intersection of cultural and social identities.

Documents – any written, digital, audio, visual, or artistic recording of the work within the counseling relationship between counselor and client.

Encryption – process of encoding information in such a way that limits access to authorized users.

Examinee – a recipient of any professional counseling service that includes educational, psychological, and career appraisal, using qualitative or quantitative techniques.

Exploitation – actions and/or behaviors that take advantage of another for one’s own benefit or gain.

Fee Splitting – the payment or acceptance of fees for client referrals (e.g., percentage of fee paid for rent, referral fees).

Forensic Evaluation – the process of forming professional opinions for court or other legal proceedings, based on professional knowledge and expertise, and supported by appropriate data.

Gatekeeping – the initial and ongoing academic, skill, and dispositional assessment of students’ competency for professional practice, including remediation and termination as appropriate.

Impairment – a significantly diminished capacity to perform professional functions.

Incapacitation – an inability to perform professional functions.

Informed Consent – a process of information sharing associated with possible actions clients may choose to take, aimed at assisting clients in acquiring a full appreciation and understanding of the facts and implications of a given action or actions.

Instrument – a tool, developed using accepted research practices, that measures the presence and strength of a specified construct or constructs.

Interdisciplinary Teams – teams of professionals serving clients that may include individuals who may not share counselors’ responsibilities regarding confidentiality.

Minors – generally, persons under the age of 18 years, unless otherwise designated by statute or regulation. In some jurisdictions, minors may have the right to consent to counseling without consent of the parent or guardian.

Multicultural/Diversity Competence – counselors’ cultural and diversity awareness and knowledge about self and others, and how this awareness and knowledge are applied effectively in practice with clients and client groups.

Multicultural/Diversity Counseling – counseling that recognizes diversity and embraces approaches that support the worth, dignity, potential, and uniqueness of individuals within their historical, cultural, economic, political, and psychosocial contexts.

Personal Virtual Relationship – engaging in a relationship via technology and/or social media that blurs the professional boundary (e.g., friending on social networking sites); using personal accounts as the connection point for the virtual relationship.

Privacy – the right of an individual to keep oneself and one’s personal information free from unauthorized disclosure.

Privilege – a legal term denoting the protection of confidential information in a legal proceeding (e.g., subpoena, deposition, testimony).

Pro bono publico – contributing to society by devoting a portion of professional activities for little or no financial return (e.g., speaking to groups, sharing professional information, offering reduced fees).

Professional Virtual Relationship – using technology and/ or social media in a professional manner and maintaining appropriate professional boundaries; using business accounts that cannot be linked back to personal accounts as the connection point for the virtual relationship (e.g., a business page versus a personal profile).

Records – all information or documents, in any medium, that the counselor keeps about the client, excluding personal and psychotherapy notes.

Records of an Artistic Nature – products created by the client as part of the counseling process.

Records Custodian – a professional colleague who agrees to serve as the caretaker of client records for another mental health professional.

Self-Growth – a process of self-examination and challenging of a counselor’s assumptions to enhance professional effectiveness.

Serious and Foreseeable – when a reasonable counselor can anticipate significant and harmful possible consequences.

Sexual Harassment – sexual solicitation, physical advances, or verbal/nonverbal conduct that is sexual in nature; occurs in connection with professional activities or roles; is unwelcome, offensive, or creates a hostile workplace or learning environment; and/or is sufficiently severe or intense to be perceived as harassment by a reasonable person.

Social Justice – the promotion of equity for all people and groups for the purpose of ending oppression and injustice affecting clients, students, counselors, families, communities, schools, workplaces, governments, and other social and institutional systems.

Social Media – technology-based forms of communication of ideas, beliefs, personal histories, etc. (e.g., social networking sites, blogs).

Student – an individual engaged in formal graduate-level counselor education.

Supervisee – a professional counselor or counselor-in-training whose counseling work or clinical skill development

is being overseen in a formal supervisory relationship by a qualified trained professional.

Supervision – a process in which one individual, usually a senior member of a given profession designated as the supervisor, engages in a collaborative relationship with another individual or group, usually a junior member(s) of a given profession designated as the supervisee(s) in order to (a) promote the growth and development of the supervisee(s), (b) protect the welfare of the clients seen by the supervisee(s), and (c) evaluate the performance of the supervisee(s).

Supervisor – counselors who are trained to oversee the professional clinical work of counselors and counselors-in-training.

Teaching – all activities engaged in as part of a formal educational program that is designed to lead to a graduate degree in counseling.

Training – the instruction and practice of skills related to the counseling profession. Training contributes to the ongoing proficiency of students and professional counselors.

Virtual Relationship – a non–face-to-face relationship (e.g., through social media).

Index

ACA Code of Ethics Preamble ……………………3 ACA Code of Ethics Purpose ……………………..3

Section A: The Counseling

Relationship ……………………………………..4 Section A: Introduction …………………………..4 A.1. Client Welfare ………………………………….4

A.1.a. Primary Responsibility …………………4

A.1.b. Records and Documentation ………..4

A.1.c. Counseling Plans ………………………….4

A.1.d. Support Network Involvement ……4

A.2. Informed Consent in the

Counseling Relationship …………………..4

A.2.a. Informed Consent ………………………..4

A.2.b. Types of Information Needed ………4

A.2.c. Developmental and

Cultural Sensitivity …………………………..4

A.2.d. Inability to Give Consent ……………..4

A.2.e. Mandated Clients …………………………4

A.3. Clients Served by Others ………………..4

A.4. Avoiding Harm and

Imposing Values ………………………………..4

A.4.a. Avoiding Harm …………………………….4

A.4.b. Personal Values ……………………………5

A.5. Prohibited Noncounseling Roles

and Relationships ……………………………..5

A.5.a. Sexual and/or Romantic

Relationships Prohibited …………………..5

A.5.b. Previous Sexual and/or

Romantic Relationships …………………….5

A.5.c. Sexual and/or Romantic

Relationships With Former

Clients ……………………………………………….5

A.5.d. Friends or Family Members …………5

A.5.e. Personal Virtual Relationships

With Current Clients …………………………5

A.6. Managing and Maintaining

Boundaries and Professional

Relationships……………………………………..5

A.6.a. Previous Relationships …………………5

A.6.b. Extending Counseling

Boundaries ……………………………………….5

A.6.c. Documenting Boundary

Extensions ………………………………………..5

A.6.d. Role Changes in the

Professional Relationship ………………….5

A.6.e. Nonprofessional Interactions or

Relationships (Other Than Sexual or

Romantic Interactions or

Relationships) …………………………………..5

A.7. Roles and Relationships at Individual, Group, Institutional,

and Societal Levels …………………………….5

A.7.a. Advocacy ……………………………………..5

A.7.b. Confidentiality and Advocacy ……..5

A.8. Multiple Clients ………………………………6

A.9. Group Work …………………………………….6

A.9.a. Screening ……………………………………..6

A.9.b. Protecting Clients …………………………6

A.10. Fees and Business Practices ……………6

A.10.a. Self-Referral ……………………………….6

A.10.b. Unacceptable Business

Practices ……………………………………………6

A.10.c. Establishing Fees ………………………..6

A.10.d. Nonpayment of Fees ………………….6

A.10.e. Bartering …………………………………….6

A.10.f. Receiving Gifts ……………………………6

A.11. Termination and Referral ……………….6

A.11.a. Competence Within

Termination and Referral ………………….6

A.11.b. Values Within Termination

and Referral ………………………………………6

A.11.c. Appropriate Termination ……………6

A.11.d. Appropriate Transfer of

Services …………………………………………….6

A.12. Abandonment and

Client Neglect …………………………………..6 Section B: Confidentiality and Privacy ….6

Section B: Introduction …………………………..6 B.1. Respecting Client Rights …………………..6

B.1.a. Multicultural/Diversity

Considerations ………………………………….6

B.1.b. Respect for Privacy ……………………….6

B.1.c. Respect for Confidentiality ……………7

B.1.d. Explanation of Limitations …………..7

B.2. Exceptions ………………………………………..7

B.2.a. Serious and Foreseeable Harm

and Legal Requirements …………………..7

B.2.b. Confidentiality Regarding

End-of-Life Decisions ……………………….7

B.2.c. Contagious, Life-Threatening

Diseases ……………………………………………7

B.2.d. Court-Ordered Disclosure …………….7

B.2.e. Minimal Disclosure ………………………7

B.3. Information Shared With Others ………7

B.3.a. Subordinates …………………………………7

B.3.b. Interdisciplinary Teams ………………..7

B.3.c. Confidential Settings …………………….7

B.3.d. Third-Party Payers ……………………….7

B.3.e. Transmitting Confidential

Information ………………………………………7

B.3.f. Deceased Clients ……………………………7

B.4. Groups and Families ……………………….7

B.4.a. Group Work ………………………………….7

B.4.b. Couples and Family Counseling ………7

B.5. Clients Lacking Capacity to

Give Informed Consent …………………….7

B.5.a. Responsibility to Clients ……………….7

B.5.b. Responsibility to Parents and

Legal Guardians ……………………………….7

B.5.c. Release of Confidential

Information ………………………………………7

B.6. Records and Documentation …………….7

B.6.a. Creating and Maintaining Records

and Documentation ………………………………7

B.6.b. Confidentiality of Records

and Documentation ………………………….8

B.6.c. Permission to Record …………………….8

B.6.d. Permission to Observe ………………….8

B.6.e. Client Access …………………………………8

B.6.f. Assistance With Records ……………….8

B.6.g. Disclosure or Transfer …………………..8

B.6.h. Storage and Disposal

After Termination ……………………………..8

B.6.i. Reasonable Precautions …………………8

B.7. Case Consultation …………………………….8

B.7.a. Respect for Privacy ……………………….8

B.7.b. Disclosure of Confidential

Information ………………………………………8

Section C: Professional Responsibility ……..8

Section C: Introduction ……………………………8

C.1. Knowledge of and Compliance

With Standards …………………………………8

C.2. Professional Competence ………………..8

C.2.a. Boundaries of Competence …………..8

C.2.b. New Specialty Areas of Practice …..8

C.2.c. Qualified for Employment ……………8

C.2.d. Monitor Effectiveness …………………..8

C.2.e. Consultations on Ethical

Obligations ………………………………………..9

C.2.f. Continuing Education …………………..9

C.2.g. Impairment ………………………………….9

C.2.h. Counselor Incapacitation, Death, Retirement, or Termination

of Practice …………………………………………9

C.3. Advertising and Soliciting Clients ……9

C.3.a. Accurate Advertising ……………………9

C.3.b. Testimonials …………………………………9

C.3.c. Statements by Others ……………………9

C.3.d. Recruiting Through

Employment ……………………………………..9

C.3.e. Products and Training

Advertisements …………………………………9

C.3.f. Promoting to Those Served …………..9

C.4. Professional Qualifications ………………9

C.4.a. Accurate Representation ………………9

C.4.b. Credentials …………………………………..9

C.4.c. Educational Degrees …………………….9

C.4.d. Implying Doctoral-Level

Competence ……………………………………..9

C.4.e. Accreditation Status ……………………..9

C.4.f. Professional Membership ……………..9

C.5. Nondiscrimination ………………………….9

C.6. Public Responsibility ………………………9

C.6.a. Sexual Harassment ……………………….9

C.6.b. Reports to Third Parties ……………….9

C.6.c. Media Presentations ……………………..9

C.6.d. Exploitation of Others ………………..10

C.6.e. Contributing to the Public Good

(Pro Bono Publico) …………………………….10

C.7. Treatment Modalities ……………………..10

C.7.a. Scientific Basis for Treatment ………10

C.7.b. Development and Innovation …….10

C.7.c. Harmful Practices ……………………….10

C.8. Responsibility to Other

Professionals ……………………………………10 C.8.a. Personal Public Statements …………10

Section D: Relationships With

Other Professionals ……………………….10

Section D: Introduction ………………………..10

D.1. Relationships With Colleagues,

Employers, and Employees ……………..10

D.1.a. Different Approaches …………………10

D.1.b. Forming Relationships ……………….10

D.1.c. Interdisciplinary Teamwork ……….10

D.1.d. Establishing Professional and

Ethical Obligations ………………………….10

D.1.e. Confidentiality ……………………………10

D.1.f. Personnel Selection and

Assignment …………………………………….10

D.1.g. Employer Policies ………………………10

D.1.h. Negative Conditions ………………….10

D.1.i. Protection From Punitive Action

D.2. Provision of Consultation Services …10

D.2.a. Consultant Competency …………….10

D.2.b. Informed Consent in

Formal Consultation ……………………….10

Section E: Evaluation, Assessment,

and Interpretation ………………………….11 Section E: Introduction ………………………… 11 E.1. General …………………………………………. 11

E.1.a. Assessment …………………………………. 11

E.1.b. Client Welfare …………………………….. 11

E.2. Competence to Use and

Interpret Assessment Instruments …… 11

E.2.a. Limits of Competence ………………… 11

E.2.b. Appropriate Use ………………………… 11

E.2.c. Decisions Based on Results ………… 11

E.3. Informed Consent in Assessment ….. 11

E.3.a. Explanation to Clients ………………… 11

E.3.b. Recipients of Results ………………….. 11

E.4. Release of Data to Qualified

Personnel ……………………………………….. 11

E.5. Diagnosis of Mental Disorders ………. 11

E.5.a. Proper Diagnosis ………………………… 11

E.5.b. Cultural Sensitivity ……………………. 11

E.5.c. Historical and Social Prejudices in the Diagnosis of Pathology ………… 11 E.5.d. Refraining From Diagnosis ………… 11

E.6. Instrument Selection………………………. 11

E.6.a. Appropriateness of Instruments …. 11

E.6.b. Referral Information ………………….. 11

E.7. Conditions of Assessment

Administration ………………………………. 11 E.7.a. Administration Conditions ………… 11

E.7.b. Provision of Favorable

Conditions ……………………………………… 11

E.7.c. Technological Administration …….. 11

E.7.d. Unsupervised Assessments ………..12

E.8. Multicultural Issues/Diversity

in Assessment …………………………………12

E.9. Scoring and Interpretation

of Assessments ………………………………..12

E.9.a. Reporting ……………………………………12

E.9.b. Instruments With Insufficient

Empirical Data …………………………………12

E.9.c. Assessment Services ……………………12

E.10. Assessment Security ……………………..12

E.11. Obsolete Assessment and

Outdated Results ……………………………..12

E.12. Assessment Construction …………….12

E.13. Forensic Evaluation: Evaluation

for Legal Proceedings ……………………..12

E.13.a. Primary Obligations ………………….12

E.13.b. Consent for Evaluation ……………..12

E.13.c. Client Evaluation

Prohibited ……………………………………….12

E.13.d. Avoid Potentially Harmful

Relationships …………………………………..12

Section F: Supervision, Training,

and Teaching ………………………………….12

Section F: Introduction ………………………….12

F.1. Counselor Supervision and

Client Welfare ………………………………….12

F.1.a. Client Welfare ………………………………12

F.1.b. Counselor Credentials …………………12

F.1.c. Informed Consent and

Client Rights …………………………………..13

F.2. Counselor Supervision

Competence ……………………………………13

F.2.a. Supervisor Preparation ………………..13

F.2.b. Multicultural Issues/Diversity

in Supervision …………………………………13

F.2.c. Online Supervision ……………………….13

F.3. Supervisory Relationship ………………..13

F.3.a. Extending Conventional

Supervisory Relationships ……………….13

F.3.b. Sexual Relationships ……………………13

F.3.c. Sexual Harassment ………………………13

F.3.d. Friends or Family Members ………..13

F.4. Supervisor Responsibilities ……………..13

F.4.a. Informed Consent for

Supervision …………………………………….13 F.4.b. Emergencies and Absences ………….13

F.4.c. Standards for Supervisees ……………13

F.4.d. Termination of the Supervisory

Relationship ……………………………………13

F.5. Student and Supervisee

Responsibilities ………………………………..13

F.5.a. Ethical Responsibilities ………………..13

F.5.b. Impairment …………………………………13

F.5.c. Professional Disclosure ………………..13

F.6. Counseling Supervision Evaluation,

Remediation, and Endorsement ………13

F.6.a. Evaluation …………………………………..13

F.6.b. Gatekeeping and Remediation …….13

F.6.c. Counseling for Supervisees ………….14

F.6.d. Endorsements ……………………………..14

F.7. Responsibilities of Counselor

Educators …………………………………………14

F.7.a. Counselor Educators ……………………14

F.7.b. Counselor Educator Competence ..14

F.7.c. Infusing Multicultural

Issues/Diversity ……………………………..14 F.7.d. Integration of Study and Practice ….14

F.7.e. Teaching Ethics ……………………………14

F.7.f. Use of Case Examples ………………….14

F.7.g. Student-to-Student Supervision

and Instruction ……………………………….14

F.7.h. Innovative Theories and

Techniques ………………………………………14

F.7.i. Field Placements …………………………..14

F.8. Student Welfare ……………………………..14

F.8.a. Program Information and

Orientation ………………………………………14

F.8.b. Student Career Advising ……………..14

F.8.c. Self-Growth Experiences ……………..14

F.8.d. Addressing Personal Concerns ……14

F.9. Evaluation and Remediation …………..15

F.9.a. Evaluation of Students ………………..15

F.9.b. Limitations ………………………………….15

F.9.c. Counseling for Students ………………15

F.10. Roles and Relationships Between Counselor Educators

and Students ……………………………………15

F.10.a. Sexual or Romantic

Relationships …………………………………..15

F.10.b. Sexual Harassment ……………………15

F.10.c. Relationships With Former

Students ………………………………………….15

F.10.d. Nonacademic Relationships ………15

F.10.e. Counseling Services …………………..15

F.10.f. Extending Educator–Student

Boundaries ………………………………………15

F.11. Multicultural/Diversity Competence in Counselor Education and

Training Programs……………………………15

F.11.a. Faculty Diversity ……………………….15

F.11.b. Student Diversity ………………………15

F.11.c. Multicultural/Diversity

Competence ……………………………………15

Section G: Research and Publication …..15

Section G: Introduction ………………………..15 G.1. Research Responsibilities ………………15

G.1.a. Conducting Research ………………….15

G.1.b. Confidentiality in Research ………..15

G.1.c. Independent Researchers ……………15

G.1.d. Deviation From Standard

Practice ……………………………………………16

G.1.e. Precautions to Avoid Injury ………..16

G.1.f. Principal Researcher

Responsibility …………………………………16 G.2. Rights of Research Participants ………16

G.2.a. Informed Consent in Research ……16

G.2.b. Student/Supervisee

Participation ……………………………………16

G.2.c. Client Participation …………………….16

G.2.d. Confidentiality of Information …….16

G.2.e. Persons Not Capable of Giving

Informed Consent ……………………………16 G.2.f. Commitments to Participants ……..16

G.2.g. Explanations After Data

Collection ………………………………………..16

G.2.h. Informing Sponsors ……………………16

G.2.i. Research Records Custodian ……….16

G.3. Managing and Maintaining

Boundaries ……………………………………..16

G.3.a. Extending Researcher–

Participant Boundaries ……………………16

G.3.b. Relationships With Research

Participants …………………………………….16

G.3.c. Sexual Harassment and

Research Participants ………………………16

G.4. Reporting Results …………………………..16

G.4.a. Accurate Results …………………………16

G.4.b. Obligation to Report

Unfavorable Results ………………………..16

G.4.c. Reporting Errors …………………………16

G.4.d. Identity of Participants ………………17

G.4.e. Replication Studies …………………….17

G.5. Publications and Presentations ………17

G.5.a. Use of Case Examples …………………17

G.5.b. Plagiarism ………………………………….17

G.5.c. Acknowledging Previous Work ……17

G.5.d. Contributors ………………………………17

G.5.e. Agreement of Contributors …………17

G.5.f. Student Research …………………………17

G.5.g. Duplicate Submissions ……………….17 G.5.h. Professional Review …………………..17

Section H: Distance Counseling,

Technology, and

Social Media ……………………………………17

Section H: Introduction …………………………17

H.1. Knowlede and

Legal Considerations ………………………17 H.1.a. Knowledge and Competency ……..17

H.1.b. Laws and Statutes ………………………17

H.2. Informed Consent and Security ……..17

H.2.a. Informed Consent and Disclosure …. 17

H.2.b. Confidentiality Maintained by

the Counselor ………………………………….18

H.2.c. Acknowledgment of

Limitations ………………………………………18

H.2.d. Security ………………………………………18

H.3. Client Verification …………………………18

H.4. Distance Counseling

Relationship ……………………………………18

H.4.a. Benefits and Limitations ……………..18

H.4.b. Professional Boundaries in

Distance Counseling ………………………..18 H.4.c. Technology-Assisted Services ……..18

H.4.d. Effectiveness of Services ……………..18

H.4.e. Access …………………………………………18

H.4.f. Communication Differences in

Electronic Media ………………………………18

H.5. Records and Web Maintenance ………18

H.5.a. Records ……………………………………….18

H.5.b. Client Rights ……………………………….18

H.5.c. Electronic Links ………………………….18

H.5.d. Multicultural and Disability

Considerations ………………………………..18

H.6. Social Media…………………………………..18

H.6.a. Virtual Professional Presence ……..18

H.6.b. Social Media as Part of

Informed Consent ……………………………18

H.6.c. Client Virtual Presence ……………….18 H.6.d. Use of Public Social Media …………18 Section I: Resolving Ethical Issues ………18 Section I: Introduction …………………………..18 I.1. Standards and the Law ……………………19

I.1.a. Knowledge …………………………………..19

I.1.b. Ethical Decision Making ………………19

I.1.c. Conflicts Between Ethics

and Laws ………………………………………..19

I.2. Suspected Violations ……………………….19

I.2.a. Informal Resolution ……………………..19

I.2.b. Reporting Ethical Violations ………..19

I.2.c. Consultation …………………………………19

I.2.d. Organizational Conflicts ………………19

I.2.e. Unwarranted Complaints

I.2.f. Unfair Discrimination Against

Complainants and

Respondents ……………………………………19

I.3. Cooperation With Ethics

Committees …………………………………….19 Glossary of Terms ………………………………..20

Ethics Related Resources From ACA!

· Free consultation on ethics for ACA Members

· Bestselling publications revised in accordance with the 2014 Code of Ethics, including
ACA Ethical Standards

Casebook, Boundary Issues in Counseling, Ethics Desk

Reference for Counselors,

and
The Counselor and the Law

· Podcast and six-part webinar series on the 2014
Code

· The latest information on ethics at
counseling.org/ethics

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OUNSELING
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SSOCIATION

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Section A:	The Counseling Relationship
Section B:	Confidentiality and Privacy
Section C:	Professional Responsibility
Section D:	Relationships With Other Professionals
Section E:	Evaluation, Assessment, and Interpretation
Section F:	Supervision, Training, and Teaching
Section G:	Research and Publication
Section H:	Distance Counseling, Technology, and
	Social Media
Section I:	Resolving Ethical Issues