Are there different types of COUNSELING?
While there are many variations of counseling models, they can be grouped into two distinct categories: Cognitive-behavior therapies (CBT) and psychodynamic therapies (PDT). In addition, there are differences in the level of training required to practice each. Frequently, behavioral therapies are practiced by Master's prepared counselors who have not experienced thorough personal counseling, and who often have limited breadth to their training. Doctoral level behavioral psychologists, while having more extensive training, may also not have completed much, if any, personal counseling or psychotherapy.
Cognitive-Behavioral Therapies and Mental Health Counseling are similar in approach. The goal of cognitive-behavioral therapy is symptom reduction (less anxiety, less depression, etc.). The psychotherapist/counselor:
Psychodynamic psychotherapies both relieve symptoms and foster within the person positive capacities and resources. The goal of psychodynamic psychotherapy is to focus on the whole person with its additional capacities to work with a person’s feelings and unconscious. The psychotherapist and patient:
Psychodynamic psychotherapy focuses on a deeper understanding and healing of the whole person whereas most counseling and cognitive-behavioral therapies focus primarily on beliefs and behaviors rather than emotion, and are not suited for working with the patient’s unconscious processes.
Cognitive-Behavioral Therapies and Mental Health Counseling are similar in approach. The goal of cognitive-behavioral therapy is symptom reduction (less anxiety, less depression, etc.). The psychotherapist/counselor:
- Focuses on the patient’s/client’s current situation (the here and now).
- Focuses on cognitive (rather than emotional) themes, particularly thoughts and belief systems.
- Structures and directs the topics to be discussed in the appointments.
- Organizes the patient/client relationship as an expert teaching a less informed person.
- Offers direct guidance and advice to the patient/client.
Psychodynamic psychotherapies both relieve symptoms and foster within the person positive capacities and resources. The goal of psychodynamic psychotherapy is to focus on the whole person with its additional capacities to work with a person’s feelings and unconscious. The psychotherapist and patient:
- Focus on the patient’s current and past relationships.
- Focus on the relationship of the patient with the therapist and link connections between the therapy relationship and other relationships.
- Seek to understand the patient’s feelings and perceptions in light of both past and present experiences (the there and then in addition to the here and now).
- Explore feelings regarded by the patient as unacceptable (e. g. anger, envy, excitement).
- Discover the patient’s defensive operations for avoidance of feelings and develop the patient’s capacities to better tolerate difficult feelings and situations.
- Explore the patient’s fantasies and dreams, and discover meanings for disowned or unconscious wishes, feelings and ideas.
Psychodynamic psychotherapy focuses on a deeper understanding and healing of the whole person whereas most counseling and cognitive-behavioral therapies focus primarily on beliefs and behaviors rather than emotion, and are not suited for working with the patient’s unconscious processes.
Are some psychotherapies more effective?
Psychotherapy research has definitively demonstrated that the most effective component of a beneficial psychotherapy is the quality of the relationship between the patient and the psychotherapist. Related psychotherapy research has found that desired outcomes in psychotherapy are consistently achieved when the psychotherapist has completed extensive personal psychotherapy.
Common problems found in psychotherapists who have not resolved their own problems in psychotherapy are: 1) low self-esteem, 2) elevated levels of impulsiveness and anxiety, and lower levels of emotional expressiveness, 3) hostility toward themselves which is more likely to convert to hostility toward a patient or client, and 4) problems in their own child and adolescent development which correlate with negative psychotherapy outcomes with their patients.
Psychotherapy research has also demonstrated that psychodynamically-informed therapies are more beneficial than other psychotherapies in many cases. The benefits of counseling and strictly cognitive-behavioral psychotherapies tend to erode following discontinuation of appointments. This decay of benefits in the empirically-supported non-psychodynamically-informed therapies is found even with the most common emotional impairments including depression and generalized anxiety. Enduring intrapsychic changes including improved reflective functioning and more secure attachment organization have been found in persons receiving psychodynamically-informed psychotherapy.
Common problems found in psychotherapists who have not resolved their own problems in psychotherapy are: 1) low self-esteem, 2) elevated levels of impulsiveness and anxiety, and lower levels of emotional expressiveness, 3) hostility toward themselves which is more likely to convert to hostility toward a patient or client, and 4) problems in their own child and adolescent development which correlate with negative psychotherapy outcomes with their patients.
Psychotherapy research has also demonstrated that psychodynamically-informed therapies are more beneficial than other psychotherapies in many cases. The benefits of counseling and strictly cognitive-behavioral psychotherapies tend to erode following discontinuation of appointments. This decay of benefits in the empirically-supported non-psychodynamically-informed therapies is found even with the most common emotional impairments including depression and generalized anxiety. Enduring intrapsychic changes including improved reflective functioning and more secure attachment organization have been found in persons receiving psychodynamically-informed psychotherapy.