ERIC Identifier: ED347485
Publication Date: 1992-12-00
Author: Hackney, Harold
Source: ERIC Clearinghouse on
Counseling and Personnel Services Ann Arbor MI.
Differentiating between Counseling Theory and Process. ERIC
The role that theory plays in the process and outcome of counseling has been
a subject of discussion, and sometimes heated debate, for almost as long as
counseling has been a profession. While schools of therapy have argued that
different theories produce differing and nonequivalent outcomes, this position
has been challenged on numerous occasions. Fiedler (1951) first observed that
therapists of differing orientations were very similar in their views of the
"ideal therapy." Then Sundland and Barker (1962) reported that more experienced
therapists tended to be more similar, regardless of their theoretical
orientation. In their extensive review of the subject, Gelso and Carter (1985)
stated that "most clients will profit about equally (but in different ways) from
the different therapies" (p. 234). They go on to suggest that the effect of
process and relationship do differ among therapies and that some clients may do
better with one approach than with another, based upon these two factors.
Finally, Stiles, Shapiro and Elliott (1986) concluded that "(a) common features
shared by all psychotherapies underlie or override differences in therapists'
verbal techniques and (b) these common features are responsible for the general
equivalence in effectiveness (of therapies)" (p. 171). Process and relationship,
then, may be as relevant as theoretical conceptualization of the problem. This
notion has led a number of researchers (Goldfried, 1982; Highlen & Hill,
1984) to an integrationist position which emphasizes process and action in the
counseling relationship over theoretical imperatives.
THE APPLICATION OF THEORY IN COUNSELING
How do counselors
choose a particular counseling theory? Among the alternatives are (1) the
orientation of one's initial training program; (2) one's own philosophy or life
view; and/or (3) one's therapeutic experience and evolving therapeutic patterns.
Given the more than 130 extant theories of counseling, do counselors tend to be
purist in their theoretical orientation? Rarely. Where counselors are purist, it
tends to be a function of exclusivity of training (receiving training in a
single theoretical orientation) and/or recency of training (the more recent the
training, the more consistent the counselor's conformity to a particular
theory). How do counselors use their theory? Certainly, counselors use theory to
explain or conceptualize client problems. In addition, they may use theory to
dictate what they do in the counseling process. Finally, Strohmer, Shivy, & Chiodo (1990) suggest that they may also use theoretical orientation to
selectively confirm their hypothesis.
SEPARATING COUNSELING INTERVENTIONS FROM THEORY
whether in pure form or adapted by the individual counselor, can be used to
define the nature of the relationship between the counselor and client, to
conceptualize the nature of the presenting problem(s), and to define the
resulting counseling goals or desired outcomes. While some counselors would also
say that theory dictates the types of interventions used in counseling,
increasingly the argument is being made that interventions are related more to
goals and outcomes than to theoretical conceptualization. If one examines
theoretical integrity today, based upon what counselors faithful to that theory
do with clients, a convergence of theories appears to be occurring. Humanistic
theories have been infiltrated by some classical behavioral interventions.
Behavioral approaches acknowledge the legitimacy of feelings and the
appropriateness of affect change. Cognitive approaches are frequently referred
to as "cognitive-behavioral." Systemic approaches utilize many interventions
that one can only describe as cognitive in nature. Thus, distinctions between
theories are not as clearly defined as one might think, and intervention
selection may be only indirectly related, and certainly not dictated by
MATCHING INTERVENTIONS TO CLIENT PROBLEMS
How does the
counselor who is working within a consistent theory, be it a textbook theory or
a personal theory, choose the interventions to use with a particular client?
Logic would hold that the counselor's choice of therapeutic interventions would
derive from the conceptualization of the problem(s), thus from the counselor's
theory. But the theoretical world of counseling and change isn't quite that
neat. From an integrative perspective, that choice is made by relating the
intervention directly to the nature or character of the problem being addressed.
On the other hand, most client problems are typically multi-dimensional. A
problem with negative self-talk ("I'm constantly telling myself I'm no good") is
not only cognitive, but would also reflect an affective dimension ("I feel lousy
about myself"), a behavioral dimension ("I choose to stay home and watch a lot
of TV"), and a systemic dimension ("When I do go out, I avoid contact with
others because they find me strange, or I behave strangely and others react to
me accordingly"). Even though most problems are multi-dimensional, intervention
at any of those dimensions affects the other dimensions, i.e., systemic change
may influence affective and/or behavioral dimensions. How, then, does one plan a
strategy for counseling interventions if multiple choices exist and "all roads
lead to Rome?" A general guideline is that clients are most receptive when the
choice of strategy matches their experiencing of the problem (Cormier &
A THEORETICAL CLASSIFICATION OF INTERVENTIONS
examines the variety of counseling interventions that have been described in the
professional literature, they tend to fall into four broad categories:
interventions that produce affective change; interventions that produce
cognitive change; interventions that produce behavioral change; and
interventions that produce social system change (Cormier & Hackney, 1993).
In addition, within each of these four categories, one can further differentiate
among theories in terms of the counselor skill required to implement the
intervention and the level of change produced by the intervention.
AFFECTIVE INTERVENTIONS. The primary goals of affective interventions are (a)
to help clients express feelings or feeling states; (b) to identify or
discriminate between feelings or feeling states; or (c) to alter or accept
feelings or feeling states (Cormier & Hackney, 1993). Some clients have
never learned to identify and/or express their feelings. At a somewhat more
complicated level, some clients come to counseling flooded with emotional
reactions, overloaded by their awareness of and sensitivity to feelings. Their
protective response may be to tune out the emotions, to be confused or
disoriented. Interventions that may be used to unblock, bridge resistance, or
develop expressive skills include teaching the client what a feeling is, affect
focusing techniques, role reversal, the alter ego exercise, the empty chair, and
COGNITIVE INTERVENTIONS. The primary goal of cognitive interventions is to
"reduce emotional distress and corresponding maladaptive behavior patterns by
altering or correcting errors in thoughts, perceptions and beliefs (Beck, 1976).
Cognitive interventions stress the importance of self-control. Clients are
viewed as the direct agents of their own changes, rather than as helpless
victims of external events and forces (Cormier & Hackney, 1993).
Illustrations of cognitive interventions include Ellis's (1989) A-B-C-D-E
analysis, thought suppression, thought postponement, therapeutic paradox, and
cognitive restructuring (including reframing).
BEHAVIORAL INTERVENTIONS. The overall goal of behavioral interventions is to
help clients develop adaptive and supportive behaviors to multifaceted
situations. Developing adaptive behavior often means helping the client weaken
or eliminate behaviors that work against the desired outcome, e.g. eating snacks
when you wish to lose weight. A significant part of this process involves
teaching the client. Illustrative interventions include live modeling, symbolic
modeling, covert modeling, role play and rehearsal, relaxation training,
systematic desensitization, self-contracting and self-monitoring.
SYSTEMIC INTERVENTIONS. Systemic interventions are premised upon the
assumption that one's environment elicits and supports the individual's
dysfunctional cognitive, behavioral and affective responses. The go goal of
systemic interventions is to change the individual's social environment or
system, thus changing the patterns of interrelationship that elicited or
supported these responses. Examples of systemic interventions (in addition to
those in the preceding categories that also produce system change) include:
altering communication patterns through role play and renegotiation, altering
family (or system) structure by reconstructing boundaries, the family genogram,
family sculpture, and providing directives for change. Children pose special
issues in the selection of counseling interventions for several reasons. They
have little power or control over their environment, or may lack the cognitive
or affective development to respond to some interventions. For this reason, a
systemic view which involves significant adults in their world often is the most
effective approach to intervention selection.
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