COUNSELING THEORIES

1. PSYCHOANALYTIC

BASIC Human beings are basically determined by psychic energy and by early experiences.
PHILOSOPHY 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.
KEY CONCEPT 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.
GOALS 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.
THERAPEUTIC The classical analyst remains anonymous, and clients develop projections toward him or her.
RELATIONSHIPS 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.
TECHNIQUES The key techniques are interpretation, dream analysis, free association, analysis of
resistance, analysis of transference, and counter-transference. 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.
APPLICATIONS 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.
MULTI Its focus on family dynamics is appropriate for working with many cultural groups. The
CULTURAL therapist’s formality appeals to clients who expect professional distance. Notion of ego
COUNSELING defense is helpful in understanding inner dynamics and dealing with environmental stresses.
LIMITATION TO Its focus on insight, intrapsychic dynamics, and long-term treatment is often not valued by
MULTICULTURAL 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.
CONTRIBUTIONS 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 6 years of life. It has developed several techniques for tapping the
unconscious and shed light on the dynamics of transference and counter-transference,
resistance, anxiety, and the mechanisms of ego defense.
LIMITATIONS 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.
 2. ADLERIAN

BASIC Humans are motivated by social interest, by striving toward goals, by inferiority and
PHILOSOPHY 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, infl uence,
and create events. Each person at an early age creates a unique style of life, which tends to
remain relatively constant throughout life.
KEY CONCEPT 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 fi nding goals to give life meaning. Other key concepts
are striving for signifi cance 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.
GOALS 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.
THERAPEUTIC The emphasis is on joint responsibility, on mutually determining goals, on mutual trust and
RELATIONSHIPS respect, and on equality. Focus is on identifying, exploring, and disclosing mistaken goals and
faulty assumptions within the person’s lifestyle.
TECHNIQUES 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.
APPLICATIONS 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.
MULTI Its focus on social interest, helping others, collectivism, pursuing meaning in life, importance
CULTURAL of family, goal orientation, and belonging is congruent with the values of many cultures.
COUNSELING Focus on person-in-the-environment allows for cultural factors to be explored.
LIMITATION TO This approach uses a detailed interview about one’s family background; this can confl ict
MULTICULTURAL 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 confl icts with
the egalitarian, person-to-person spirit as a way to reduce social distance
CONTRIBUTIONS A key contribution is the infl uence that Adlerian concepts have had on other systems and
the integration of these concepts into various contemporary therapies. This is one of the fi
rst approaches to therapy that was humanistic, unifi ed, holistic, and goal-oriented and that
put an emphasis on social and psychological factors.
LIMITATIONS Weak in terms of precision, testability, and empirical validity. Few attempts have been made
to validate the basic concepts by scientifi c methods. Tends to oversimplify some complex
human problems and is based heavily on common sense.
 3. EXISTENTIAL THERAPY

BASIC The central focus is on the nature of the human condition, which includes a capacity for self-
PHILOSOPHY 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.
KEY CONCEPT Essentially an experiential approach to counseling rather than a fi rm 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.
GOALS 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.
THERAPEUTIC The therapist’s main tasks are to accurately grasp clients’ being in the world and to establish
RELATIONSHIPS 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.
TECHNIQUES Few techniques fl ow from this approach because it stresses understanding fi rst 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.
APPLICATIONS 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 fi nding 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.
MULTI Focus is on understanding client’s phenomenological world, including cultural background.
CULTURAL This approach leads to empowerment in an oppressive society. Existential therapy can help
COUNSELING 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.
LIMITATION TO Values of individuality, freedom, autonomy, and self-realization often confl ict with cultural
MULTICULTURAL values of collectivism, respect for tradition, deference to authority, and interdependence.
Some may be deterred by the absence of specifi c techniques. Others will expect more focus
on surviving in their world.
CONTRIBUTIONS 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.
LIMITATIONS Many basic concepts are fuzzy and ill-defi ned, 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.
 4. PERSON-CENTERED THERAPY

BASIC Positive view of people; we have an inclination toward becoming fully functioning. In the
PHILOSOPHY 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 innerdirectedness.
KEY CONCEPT 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.
GOALS To provide a safe climate conducive to clients’ self-exploration, so that they can recognize
blocks to growth and can 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 fi nd meaning in life and to experience life fully.
To become more self-directed.
THERAPEUTIC The relationship is of primary importance. The qualities of the therapist, including
RELATIONSHIPS genuineness, warmth, accurate empathy, respect, and nonjudgmentalness— 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.
TECHNIQUES This approach uses few techniques but stresses the attitudes of the therapist and a “way of
being.” Therapists strive for active listening, refl ection of feelings, clarifi cation, “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.
APPLICATIONS 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.
MULTI Focus is on breaking cultural barriers and facilitating open dialogue among diverse cultural
CULTURAL populations. Main strengths are respect for clients’ values, active listening, welcoming of
COUNSELING differences, nonjudgmental attitude, understanding, willingness to allow clients to
determine what will be explored in sessions, and prizing cultural pluralism.
LIMITATION TO Some of the core values of this approach may not be congruent with the client’s culture. Lack
MULTICULTURAL of counselor direction and structure are unacceptable for clients who are seeking help and
immediate answers from a knowledgeable professional.
CONTRIBUTIONS 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 modifi ed. It is an open system. People without advanced training can
benefi t 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.
LIMITATIONS Possible danger from the therapist who remains passive and inactive, limiting responses to
refl ection. 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.
 5. GESTALT

BASIC The person strives for wholeness and integration of thinking, feeling, and behaving. Some
PHILOSOPHY 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 infl uences are related to present diffi culties. As an experiential approach, it is
grounded in the here and now and emphasizes awareness, personal choice, and
responsibility.
KEY CONCEPT 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, fi gure-formation process,
awareness, unfi nished business and avoidance, contact, and energy
GOALS 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.
THERAPEUTIC Central importance is given to the I/Thou relationship and the quality of the therapist’s
RELATIONSHIPS 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 unfi nished business from the past
that interferes with current functioning.
TECHNIQUES A wide range of experiments are designed to intensify experiencing and to integrate confl
icting 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.
APPLICATIONS 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.
MULTI Its focus on expressing oneself nonverbally is congruent with those cultures that look beyond
CULTURAL words for messages. Provides many experiments in working with clients who have cultural
COUNSELING 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
confl icts.
LIMITATION TO Clients who have been culturally conditioned to be emotionally reserved may not embrace
MULTICULTURAL Gestalt experiments. Some may not see how “being aware of present experiencing” will lead
to solving their problems
CONTRIBUTIONS 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 confl icts.
Therapy is viewed as an existential encounter; it is process-oriented, not technique-oriented.
It recognizes nonverbal behavior as a key to understanding.
LIMITATIONS 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 unfi nished and will not have a sense of
integration of their learning. Clients who have diffi culty using imagination may not profi t
from certain experiments.
 6. BEHAVIOR THERAPY

BASIC Behavior is the product of learning. We are both the product and the producer of the
PHILOSOPHY environment. Traditional behavior therapy is based on classical and operant principles.
Contemporary behavior therapy has branched out in many directions
KEY CONCEPT Focus is on overt behavior, precision in specifying goals of treatment, development of specifi
c 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.
GOALS To eliminate maladaptive behaviors and learn more effective behaviors. To identify factors
that infl uence behavior and fi nd 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.
THERAPEUTIC The therapist is active and directive and functions as a teacher or mentor in helping clients
RELATIONSHIPS 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 suffi cient to
bring about change, it is considered essential for implementing behavioral procedures.
TECHNIQUES The main techniques are reinforcement, shaping, modeling, systematic desensitization,
relaxation methods, fl ooding, eye movement and desensitization reprocessing, cognitive
restructuring, assertion and social skills training, self-management programs, mindfulness
and acceptance methods, behavioral rehearsal, coaching, and various multimodal therapy
techniques. 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.
APPLICATIONS 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 fi elds such as pediatrics, stress management, behavioral medicine,
education, and geriatrics
MULTI Focus on behavior, rather than on feelings, is compatible with many cultures. Strengths
CULTURAL include a collaborative relationship between counselor and client in working toward
COUNSELING 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.
LIMITATION TO Family members may not value clients’ newly acquired assertive style, so clients must be
MULTICULTURAL taught how to cope with resistance by others. Counselors need to help clients assess the
possible consequences of making behavioral changes.
CONTRIBUTIONS Emphasis is on assessment and evaluation techniques, thus providing a basis for accountable
practice. Specifi c problems are identifi ed, 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.
LIMITATIONS 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.
 7. COGNITIVE BEHAVIOR THERAPY

BASIC Individuals tend to incorporate faulty thinking, which leads to emotional and behavioral
PHILOSOPHY 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.
KEY CONCEPT Although psychological problems may be rooted in childhood, they are reinforced by present
ways of thinking. A person’s belief system 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.
GOALS 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.
THERAPEUTIC In REBT the therapist functions as a teacher and the client as a student. The therapist is
RELATIONSHIPS 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 selfdefeating thinking and acting.
TECHNIQUES 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,
selfinstructional training, and stress inoculation training.
APPLICATIONS 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 specifi c problems.
MULTI Focus is on a collaborative approach that offers clients opportunities to express their areas of
CULTURAL concern. The psychoeducational dimensions are often useful in exploring cultural confl icts
COUNSELING 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 may value the active and
directive stance of the therapist.
LIMITATION TO Before too quickly attempting to change the beliefs and actions of clients, it is essential for
MULTICULTURAL 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 for deciding what are appropriate ways to solve problems.
CONTRIBUTIONS Major contributions include emphasis on a comprehensive and eclectic therapeutic practice;
numerous cognitive, emotive, and behavioral techniques; an openness to incorporating
techniques from other approaches; and a methodology for challenging and changing faulty
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.
LIMITATIONS Tends to play down emotions, does not focus on exploring the unconscious or underlying
confl icts, de-emphasizes the value of insight, and sometimes does not give enough weight to
the client’s past. REBT, being a confrontational therapy, might lead to premature
termination. CBT might be too structured for some clients.
 8. REALITY THERAPY

BASIC Based on choice theory, this approach assumes that we need quality relationships to be
PHILOSOPHY happy. Psychological problems are the result of our resisting the 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.
KEY CONCEPT 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 signifi cant relationships. The approach rejects the medical model, the
notion of transference, the unconscious, and dwelling on one’s past
GOALS 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
THERAPEUTIC A fundamental task is for the therapist to create a good relationship with the client.
RELATIONSHIPS Therapists are then able to engage clients in an evaluation of all their relationships with
respect to what they want and how effective they are in getting this. Therapists fi nd 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.
TECHNIQUES 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 specifi c plan for change
and make a commitment to follow through
APPLICATIONS 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.
MULTI Focus is on clients making their own evaluation of behavior (including how they respond to
CULTURAL their culture). Through personal assessment clients can determine the degree to which their
COUNSELING needs and wants are being satisfi ed. They can fi nd a balance between retaining their own
ethnic identity and integrating some of the values and practices of the dominant society.
LIMITATION TO This approach stresses taking charge of one’s own life, yet some clients are more interested
MULTICULTURAL in changing their external environment. Counselor needs to appreciate the role of
discrimination and racism and help clients deal with social and political realities
CONTRIBUTIONS 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 signifi cant force in challenging the
medical model of therapy.
LIMITATIONS 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.
 9. FEMINIST THERAPY

BASIC Feminists criticize many traditional theories to the degree that they are based on gender-
PHILOSOPHY biased concepts, such as being androcentric, gendercentric, ethnocentric, heterosexist, and
intrapsychic. The constructs of feminist therapy include being gender fair, fl exible,
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.
KEY CONCEPT 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 defi nition of psychological distress, and all types of oppression
are recognized.
GOALS 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.
THERAPEUTIC The therapeutic relationship is based on empowerment and egalitarianism. Therapists
RELATIONSHIPS actively break down the hierarchy of power and reduce artifi cial 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.
TECHNIQUES Although techniques from traditional approaches are used, feminist practitioners tend to
employ consciousnessraising 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.
APPLICATIONS 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.
MULTI Focus is on both individual change and social transformation. A key contribution is that both
CULTURAL the women’s movement and the multicultural movement have called attention to the
COUNSELING negative impact of discrimination and oppression for both women and men. Emphasizes the
infl uence of expected cultural roles and explores client’s satisfaction with and knowledge of
these roles.
LIMITATION TO This model has been criticized for its bias toward the values of White, middle-class,
MULTICULTURAL 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 signifi cant personal change,
which may result in isolation from extended family as clients assume new roles and make life
changes.
CONTRIBUTIONS 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 gendersensitive practice and bringing attention to the gendered uses
of power in relationships. The unifi ed 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.
LIMITATIONS 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, defi ning 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
 10. POSTMODERN APPROACHES

BASIC Based on the premise that there are multiple realities and multiple truths, postmodern
PHILOSOPHY 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.
KEY CONCEPT 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.
GOALS To change the way clients view problems and what they can do about these concerns. To
collaboratively establish specifi c, 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.
THERAPEUTIC Therapy is a collaborative partnership. Clients are viewed as the experts on their own life.
RELATIONSHIPS Therapists use questioning dialogue to help clients free themselves from their problem-
saturated stories and create new life-affi rming 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.
TECHNIQUES 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, specifi c techniques include listening
to a client’s problemsaturated 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 fi nding an audience that will
support their changes and new stories.
APPLICATIONS 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 diffi culties 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.
MULTI Focus is on the social and cultural context of behavior. Stories that are being authored in the
CULTURAL therapy offi ce need to be anchored in the social world in which the client lives. Therapists do
COUNSELING 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.
LIMITATION TO Some clients come to therapy wanting to talk about their problems and may be put off by
MULTICULTURAL 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.
CONTRIBUTIONS The brevity of these approaches fi t 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
LIMITATIONS 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 techniques are relatively easy to learn, practitioners
may use these interventions in a mechanical way or implement these techniques without a
sound rationale.
 11. FAMILY SYSTEMS THERAPY

BASIC The family is viewed from an interactive and systemic perspective. Clients are connected to a
PHILOSOPHY 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.
KEY CONCEPT 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 specifi c 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
GOALS To help family members gain awareness of patterns of relationships that are not working
well and to create new ways of interacting
THERAPEUTIC The family therapist functions as a teacher, coach, model, and consultant. The family learns
RELATIONSHIPS 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.
TECHNIQUES A variety of techniques may be used, depending on the particular theoretical orientation of
the therapist. Techniques include genograms, teaching, asking questions, joining the family,
tracking sequences, issuing directives, use of countertransference, 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
APPLICATIONS 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.
MULTI Focus is on the family or community system. Many ethnic and cultural groups place value on
CULTURAL the role of the extended family. Many family therapies deal with extended family members
COUNSELING 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
LIMITATION TO Family therapy rests on value assumptions that are not congruent with the values of clients
MULTICULTURAL 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 diffi cult to explore confl icts openly.
CONTRIBUTIONS 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 confl icts
in systems outside of the family
LIMITATIONS 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.