History of Counseling
The idea of counseling has been evident throughout history. People have sought guidance from religious leaders, philosophers, medical doctors, and many other sources for thousands of years. For example, Epictetus wrote about how perceptions affect mental health (1983) many years ago, and medical doctors for hundreds of years have theorized about biological components of depression and psychosis.
A modern concept of counseling began in the late 1800s and early 1900s when Freud and many others started applying talk therapy concepts in helping patients with mental health problems. Freud pioneered the psychoanalytic movement that pervaded the profession for the next 50 years. Freud used case studies from clients to develop a model of therapy. Freud utilized hypnosis, dream interpretation, and free association to help clients gain insight into what he considered unconscious conflicts. His model of psychoanalysis is no longer widely applied, but the idea of talk therapy that he championed has wide appeal and been supported by numerous studies (Thurschwell, 2000).
During the same time era as Freud, another legend was working in Boston helping guide people with vocational counseling. Frank Parsons is considered to be the father of vocational guidance, which is the precursor for the contemporary counseling profession (Davis, 1969). He developed a vocational bureau that provided career counseling, he created the first major counseling professional organization, the National Vocational Guidance Association, and he wrote Choosing a Vocation, one of the first books in counseling. Unlike Freud, Parsons often worked with underrepresented and lower-income populations, which is a common thread for the counseling profession throughout its history.
In the 1940s and 1950s new movements emerged to challenge psychoanalysis. Carl Rogers and others developed the humanistic approach to counseling that significantly changed the dynamics and focus of the process of counseling. Rogers developed person-centered therapy, also known as client-centered and non-directive counseling. He postulated that people will naturally grow in a positive direction if basic conditions are met in therapy. These three conditions included empathy, positive regard (acceptance), and congruence (authenticity) (Rogers, 1957). In contrast to psychoanalysis clients are able to develop their own insights and solutions within the framework of a supportive relationship. Similar to Freud, the focus is on insight and awareness, with the belief that clients will make the necessary changes when this insight is achieved.
Fritz Perls also helped to launch the humanistic counseling movement. His Gestalt therapy approach highlighted the importance of focusing on the present (he called it the “here and now”) and being aware of how all parts of a person’s self are connected. Our non-verbal behaviors, thoughts, feelings, and beliefs are all connected and inter-dependent (Perls, 1973). The humanistic models have been validated by research in many cases but the next approach, Cognitive Behavioral Therapy, has the most research validation of all approaches at this time. In many cases, humanistic principles have been integrated with other models and are widely used today.
Cognitive behavioral therapy is a blend of cognitive and behavioral theories (Weishaar, 1993). Aaron Beck and Albert Ellis were key figures in developing cognitive approaches along with Donald Meichenbaum. The key concept for these models is that self-defeating thoughts lead to mental health problems such as depression and anxiety. These thoughts might include “I am not successful enough” or “I am unlovable,” as examples. Accordingly, counselors help clients identify these negative thoughts and replace them with more reasonable and helpful alternatives. The behavioral approaches were first recognized by Ivan Pavlov, B. F. Skinner, and Albert Bandura. Clients learn unhealthy behaviors, according to these models, through conditioning and role models. Therefore, the behaviors can be unlearned with positive reinforcement, better role models, and counter conditioning.
The psychoanalytic approach, the humanistic approach, and the cognitive behavioral therapy approach have been referred to as the first, second, and third forces in psychology and counseling. In addition the multicultural counseling (MC) approach (Sue & Sue, 2016) has been named the fourth force in counseling and psychology. MC highlights concepts such as equality, social justice, oppression, and bias in counseling. For example, many times environmental variables such as unfair criminal justice practices promote mental health problems. According to MC societal problems represent the root cause for many mental health issues. And accordingly we have to address these systemic problems to serve as advocates for our clients.
During the first half of the 1900s most counseling activity was in vocational and educational settings and often the term guidance was used. In the mid-century Carl Rogers provided a framework for therapy outside of psychoanalysis which opened up counseling to a different group of professionals. In 1963, The Community Mental Health Centers Act was passed, paving the way for many public clinics and the need for diverse groups of mental health providers. And in the 1970s Virginia passed the country’s first licensure law for counselors which also helped the profession grow.
Now all states have counseling license laws. In the 1980s the Council for Accreditation of Counseling and Related Educational Programs (CACREP) and the National Board for Certified Counselors (NBCC) were formed, demonstrating organizational development within the profession. CACREP set standards for training programs and the NBCC provides professional certification. During the 1990s the national organization changed its name from the American Association for Counseling and Development (AACD) to the American Counseling Association (ACA), and the forming of multicultural competency standards was also completed. In the 2000s the American School Counselor Association published a national school counseling model, and in the 2010s a new Code of Ethics was published.
In the area of school counseling Jesse Davis created the first guidance program in 1907 in schools located in Michigan (Pope, 1997, 2009). School counseling expanded exponentially with the passage of the National Defense Education Act in the 1950s. In response to the launching of the Russian satellite Sputnik the United States government wanted to promote math and science education and guidance. Later in the 1970s law 94–142 was passed which provided educational services to all students regardless of disability. School counselors have been used frequently in working with the education plans in place for those using the services, and the need for school counselors expanded. And in the 2000s the American School Counselor Association (ASCA) published the school counseling standards.
And finally, several events occurred outside the profession that greatly impacted counseling. World Wars I and II resulted in a need for mass testing of individuals for proper placement in the military (Woolf, 1948). This testing movement expanded the use of psychologists and counselors. The wars also caused many cases of posttraumatic stress disorder and increased the need for counseling. The development of new psychotropic medication allowed many people to receive treatment in community settings instead of hospitalization, increasing the need for community counseling.
The Civil Rights Movement of the 1960s and 1970s increased the focus on underrepresented populations and the need for the counseling profession to work as advocates for systemic changes. Distance counseling became evident with the creation of the Internet in the 1990s. And legislative changes and health care reform in the early 21st century promoted mental health care coverage from insurers and expanded health care coverage in general.
Counseling is a relatively new profession; however it has been through many changes. It started with a focus on vocational and education services, and expanded to being part of integrated medicine along with many other mental health care providers. Over time it has overcome a lower-tier status among mental health professions and has become a leading profession in behavioral health care.
Table 1.1 Timeline of the Counseling Profession
| Early 1900s | Psychoanalytic approach – first force in psychology and counseling Behavioral approaches emerge – Pavlov, Skinner, and Bandura Jesse Davis created the first guidance program |
| 1909 | Frank Parson’s Choosing a Vocation |
| 1913 | National Vocational Guidance Association (NVGA) |
| 1914–1918 | World War I – testing for proper military placement Shell shock and trauma increase with war |
| 1939–1945 | World War II – testing for proper military placement |
| 1940s | Humanistic approach – second force in psychology and counseling Carl Rogers – person-centered therapy Fritz Perls – Gestalt therapy |
| 1950–1970s | Cognitive behavioral therapy approach – third force in psychology and counseling Aaron Beck – cognitive therapy Albert Ellis – rational emotive behavior therapy (REBT) Donald Meichenbaum – cognitive behavioral therapy |
| 1960–1970 | Civil Rights Movement – increased the focus on underrepresented populations and the need for the counseling profession to work as advocacy |
| 1963 | The Community Mental Health Centers Act passed |
| 1970s | Albert Bandura – social learning theory Virginia – First licensure law for counselors Law 94–142 – Educational services for all students regardless of disability |
| 1980s | Council for Accreditation of Counseling and Related Educational Programs (CACREP) and National Board for Certified Counselors (NBCC) formed |
| 1990s | American Association for Counseling and Development (AACD) changed name to American Counseling Association (ACA) Multicultural counseling (MC) approach – fourth force in psychology and counseling Distance counseling became evident with the creation of the Internet |
| 2000 | American School Counselors Association (ASCA) published the school counseling Standards |
| 2000s | Promotion of mental health care coverage from insurers and expanded health care coverage in general |
| 2010s | Proliferation of online counseling |
| 2014 | New Code of Ethics |
Professional Identity
The main providers of behavioral health are counselors, psychiatrists, psychologists, social workers, and marriage and family therapists. They overlap in many areas but differ in some areas of training and competence. For example, counselors often apply a developmental model for understanding client issues. This means they view problems as a normal result from stressors that occur during changes in the lifecycle. And the focus on intervention is helping to promote positive change over time.
There is less emphasis on pathology with the developmental model. Psychiatrists and psychologists are more likely to work in hospital settings and they can often apply the medical model. Testing and diagnosis represent major aspects of the medical model. Social workers often apply the systems model when trying to understand client problems. They explore more environmental and societal causes of client concerns. And marriage and family therapists focus heavily on family systems and dynamics. These are general professional tendencies and many times individuals choose a variety of approaches regardless of profession. William Glasser was trained in psychiatry but is one of the biggest influences in the counseling profession.
Often state and federal laws dictate elements of professional identity for counselors. For example, each state has different rules about who can diagnose and what tests can be conducted by counselors. Each profession employs lobbyists who promote their own profession’s success, often in conflict with other professions. Federal laws declare who can work at Veteran Affairs settings and who can bill for federal-funded programs such as Medicaid. This explains why joining a professional organization can be so valuable because they advocate for the profession. Over time we have become licensed in all states and have gained access to many funding sources; these achievements have greatly improved the counseling professional identity.
Although state and local governments influence counselor identity, the profession itself plays the biggest role. Counseling organizations along with credentialing and accreditation agencies have the greatest influence on professional identity. In 1913 the National Vocational Guidance Association (NVGA) was chartered and then joined other groups in 1952 to form the American College Personnel Association. In 1983 they changed the name to the American Association of Counseling and Development. And in 1992 the association changed its name to the American Counseling Association (ACA). Each change represents a shift in professional identity. The terms guidance, personnel, and development have been dropped as counseling has become less centered on educational and career settings. The more general ACA title provides a big umbrella to cover counselors from all settings (Sheeley, 2002).
Table 1.2 American Counseling Association (ACA) Divisions (18 Divisions)
| American College Counseling Association (ACCA) |
| American Rehabilitation Counseling Association (ARCA) |
| Association for Adult Development and Aging (AADA) |
| Association for Assessment and Research in Counseling (AARC) |
| Association for Child and Adolescent Counseling (ACAC) |
| Association for Creativity in Counseling (ACC) |
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| Association for Counselor Education and Supervision (ACES) |
| Association for Huma... |