Counseling and Psychotherapy

Theories and Interventions

David Capuzzi, Mark D. Stauffer

• Publisher: American Counseling Association
• Year: 2016
• ISBN:
  9781119292005
• Edition: 6
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Featuring important theories and trends not covered in other foundational texts, this book is designed to equip the next generation of counselors with the tools they need for understanding the core dimensions of the helping relationship. Topical experts provide contemporary information and insight on the following theories: psychoanalytic, Jungian, Adlerian, existential, person-centered, Gestalt, cognitive behavior, dialectical behavior, rational emotive behavior, reality therapy/choice theory, family, feminist, transpersonal, and—new to this edition—solution-focused and narrative therapies, as well as creative approaches to counseling. Each theory is discussed from the perspective of historical background, human nature, major constructs, applications, the change process, traditional and brief intervention strategies, cross-cultural considerations, and limitations. The use of a consistent case study across chapters reinforces the differences between theories.

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Part 1
Foundations for Individual Counseling and Psychotherapy

Chapters

• 1. The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities
• 2. Diversity and Social Justice Issues in Counseling and Psychotherapy

Counseling and psychotherapy encompass a number of relationship and personal and professional modalities in which the counselor or therapist needs to be proficient. These modalities include the creation of essential core conditions that are both foundational to the establishment of a helping relationship and prerequisite to change on the part of the client. In addition, because brief approaches to counseling and psychotherapy are a rapidly developing area and their development has been encouraged by managed care, and because counselor awareness of diversity and social justice issues is so important in the context of the counseling and psychotherapy process, these areas, along with the possibility of taking an integrative approach to working with clients, are also addressed in Part 1 of our text.

The helping relationship is the foundation on which the process of counseling and psychotherapy is based. It is not possible to use the concepts and associated interventions of a specific theory unless such applications are made in the context of a relationship that promotes trust, insight, and behavior change. Chapter 1, “The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities,” is designed to aid students in both the development and delivery of the helping relationship. To achieve this purpose, we present the helping relationship in terms of definitions and descriptions, stages, core conditions and personal characteristics, and helping strategies and their application with diverse populations. Chapter 1 also introduces the reader to the importance of considering brief approaches to counseling and psychotherapy and how traditional theories can be adapted for briefer, more focused work in the counseling and psychotherapy process. Because so many counselors combine elements of different theories as they work with clients, an introduction to integrative counseling is also provided. Authors of Chapters 3 through 17 provide follow-up information by discussing both traditional and brief interventions in the applications sections of their chapters.

To address the limitations of traditional counseling theories and practices, Chapter 2, “Diversity and Social Justice Issues in Counseling and Psychotherapy,” enhances counselor awareness of the variety of diversity and social justice issues that need to be addressed in the context of the counseling and psychotherapy process. The chapter provides this context by clarifying key concepts and reviewing the history of diversity and social justice issues in counseling; increasing reader understanding of how diversity influences individual and group functioning; increasing reader awareness of how diversity may influence the counseling and psychotherapy process; providing several perspectives on diversity-appropriate interventions; and making suggestions for how counselors and therapists can develop their self-awareness, knowledge of diverse populations, and counseling skills relevant to diversity and social justice.

As these chapters indicate, practitioners must achieve high levels of competence, effectiveness, and expertise to create a helping relationship beneficial to clients. They must also become sensitive to diversity and social justice issues as they affect their work with clients. We have made every attempt to introduce readers to these topics in the chapters included in this section of the text. Readers are encouraged to do additional reading and follow-up coursework and to commit to personal counseling or therapy to achieve the purposes we have outlined in these chapters.

Chapter 1
The Helping Relationship: From Core Dimensions to Brief and Integrative Possibilities

David Capuzzi, Mark D. Stauffer, and Douglas R. Gross

The helping relationship is the cornerstone on which all effective helping rests (Bertolino & O'Hanlon, 2002; Seligman, 2001; Skovholt, 2005; Sommers-Flanagan, 2007, 2015). Words such as integral, necessary, and mandatory are used to describe this relationship and its importance in the ultimate effectiveness of the helping process. Even though different theoretical systems and approaches use different words to describe this relationship (see Chapters 3–17), each addresses the significance of the helping relationship in facilitating client change. Kottler and Brown (1992), in their Introduction to Therapeutic Counseling, made the following comments regarding the significance of this relationship:

Regardless of the setting in which you practice counseling, whether in a school, agency, hospital, or private practice, the relationships you develop with your clients are crucial to any progress you might make together. For without a high degree of intimacy and trust between two people, very little can be accomplished. (p. 64)

In further support of the significance of the helping relationship, Brammer and MacDonald (1996) noted,

The helping relationship is dynamic, meaning that it is constantly changing at verbal and nonverbal levels. The relationship is the principal process vehicle for both helper and helpee to express and fulfill their needs, as well as to mesh helpee problems with helper expertise. Relationship emphasizes the affective mode, because relationship is commonly defined as the inferred emotional quality of the interaction. (p. 52)

Barry Farber and Erin Doolin (2011) commented,

While the Rogerian influence on clinical practice has diminished in the last three decades—or, more accurately, has been incorporated into the psychotherapeutic mainstream with minimal awareness or explicit acknowledgment (Farber, 2007)—therapists of varying persuasions, even those from theoretical camps that had traditionally emphasized more technical factors, have begun to acknowledge the importance of the relationship. (p. 58)

Most recently, John Sommers-Flanagan (2015) emphasized the importance of the helping relationship by using a relationally oriented evidence-based practice model to achieve competence as a mental health counselor.

The ideas expressed by these and other authors describe the essential value of the helping relationship in the process of counseling and psychotherapy and the significant role that the counselor or therapist plays in developing this relationship. Through the counseling relationship and the therapeutic alliance that develops, client change occurs. Although the creation of this relationship is not the end goal of the process, it certainly is the means by which goals are met. It serves as the framework within which effective helping takes place.

This chapter has three purposes. First, it aids the reader in understanding the various factors that affect the helping relationship: definitions and descriptions, stages, core dimensions, strategies, and issues of diversity. Second, because we have asked each of our theory authors to discuss brief approaches as applied to the theory under consideration, we provide our readers with an overview of selected brief approaches, because these approaches, plus the impact of managed care, have precipitated an emphasis on using traditional theories in shorter term counseling. Third, because we know that, after reading this book, readers will have questions about whether to be a purist, in the literal sense of the term, and base all of their work with clients on a single theoretical set or somehow integrate the possibilities for working with clients into a more flexible way of helping, we also provide an overview of integrative counseling. We hope that the information presented in this chapter will not only help readers to understand the dynamics of the helping relationship and their application in both theory-specific and brief approaches but also aid them in incorporating these dynamics into an integrative theoretical approach.

Definitions and Descriptions

Although agreed-on definitions and descriptions of the helping relationship should be easy to find, this is not the case. Despite the importance of this relationship in the overall helping process, a perusal of textbooks and articles dealing with counseling and psychotherapy shows the lack of a common definition. Rogers (1961), for example, defined a helping relationship as one “in which at least one of the parties has the intent of promoting the growth, development, maturity, improved functioning and improved coping with life of the other” (p. 39). Okun (1992) stated that “the development of a warm, trustful relationship between the helper and helpee underlies any strategy or approach to the helping process and, therefore, is a basic condition for the success of any helping process” (p. 14). According to Miars and Halverson (2001), “The ultimate goal of a professional helping relationship should be to promote the development of more effective and adaptive behavior in the clients” (p. 51). Skovholt (2005) provided an overview of the evidence-based research on counseling outcomes and overwhelmingly concluded that the counseling relationship is key to successful client outcomes. Sommers-Flanagan (2015) noted that “each mental health counselor will inevitably display therapeutic relational factors in unique ways that may be difficult for other practitioners to replicate, because anything relational or interpersonal is alive, automatically unique, and therefore resists sterile descriptive language” (p. 100). Sommers-Flanagan then went on to recommend that counselors implement core relational attitudes and behaviors based on evidence-b...