Video: 'How CBT helped me'

After her husband died, Carol, 73, used cognitive behaviour therapy (CBT) to help her
deal with her emotions and boost her confidence.

Counselling is a type of talking therapy. People talk to a counsellor about their problems.
Counsellors are trained to listen sympathetically and can help people deal with any
negative thoughts and feelings that they have.

There are several different types of counselling. For example, cognitive behavioural
therapy (CBT) is used to retrain a person’s way of thinking to help them cope with
stressful situations.

For more information on different types of counselling, see Types of counselling, above.

NICE recommendations

The National Institute for Health and Clinical Excellence (NICE) recommends certain
types of counselling for treating a number of different health conditions.

Counselling may be helpful in treating the following conditions:

• depression,
 • anxiety,
• obsessive compulsive disorder (OCD),
• post-traumatic stress disorder (PTSD),
• long-term illnesses,
• eating disorders, such as anorexia nervosa and bulimia, and
• substance abuse.

The aims of counselling

Counselling can help people:

• discuss their problems honestly and openly,

• deal with issues that are preventing them from achieving their goals and
ambitions, and
• have a more positive outlook on life.

Talking therapy

Everyone has different ways of coping with their personal difficulties. People often deal
with stressful situations and events by talking to their partner, a family member or a
friend. However, in certain situations, talking to a professional counsellor may be more
helpful.

Admitting you need help is a positive step

At some stage, you will probably experience feelings of stress, disappointment and grief.
At these times, seeking assistance can help you deal with your feelings and emotions.

Counselling can be a positive way of addressing any unresolved issues that you have. It
can help you to understand your problems better, rather than ignoring them and hoping
that they will go away, only for them to come back later. It can also give you a better
understanding of other people's points of view.

• show glossary terms

Depression

Depression is when you have feelings of extreme sadness, despair or inadequacy that last
a long time.
Anxiety

Anxiety is an unpleasant feeling when you are worried, uneasy or distressed about
something that may or may not be about to happen.

Last reviewed: 16/02/2009

Next review due: 16/02/2011

Type of counseling:

Watch this...

A cognitive behaviour therapy expert explains how this psychological treatment works
and who could benefit from it.

There are a number of different types of counselling. Each type aims to help people deal
with negative thoughts and feelings, and enables them to make positive changes.

The main types of counselling are:

• cognitive behavioural therapy (CBT),

 • psychodynamic therapy,
• humanistic therapy, and
• other types of talking therapies, such as group therapy and relationship therapy.

These therapies are discussed in more detail below.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a form of psychotherapy that may retrain a

person’s way of thinking to help them to deal with stressful situations.

CBT is used to help solve a number of problems such as:

• depression,
• anxiety,
• obsessive compulsive disorder (OCD),
• post-traumatic stress disorder (PTSD),
• managing long-term illness,
• eating disorders, and
• schizophrenia.

The National Institute for Health and Clinical Excellence (NICE) recommends CBT for
all of these.

CBT was developed from two earlier types of psychotherapy:

• Cognitive therapy: designed to change a person’s thoughts, beliefs, attitudes and

expectations.
• Behavioural therapy: designed to change a person's actions.

CBT is a talking therapy that is based around the idea that the way a person thinks about
a situation affects the way that they act. In turn, a person’s actions influence the way they
think and feel. It is therefore necessary to change both the act of thinking (cognition) and
behaviour at the same time.

The NHS is using CBT more frequently, particularly for treating common conditions,
such as depression and anxiety. CBT courses are usually short-term, for example,
between six and 24 one-hour sessions.

See Useful links for more information about cognitive behavioural therapy.

Psychodynamic therapy

During psychodynamic therapy, a therapist will help a person consider how their
personality and life experiences influence their current thoughts, feelings, relationships
and behaviour. This understanding enables them to deal with difficult situations more
successfully.

Psychodynamic therapy can be used to help treat:

• depression,
• anxiety,
• post-traumatic stress disorder (PTSD),
• long-term physical health problems,
• eating disorders, and
• addictions.

NICE recommends psychodynamic therapy for people with depression and other
complex illnesses. Psychodynamic therapy is available privately and on the NHS in some
areas. It usually lasts between several months and several years, but shorter courses are
also available.

Humanistic therapy

Humanistic therapies take a holistic approach to a person’s problem in order to help them
develop to their full potential and live life to the full.

To achieve this, humanistic therapies incorporate the body, mind, emotions, behaviour
and spirituality. In addressing the problem, they also look at other people, including
family, friends, society and culture.

Humanistic therapies are often used to treat problems such as depression, anxiety and
addiction. NICE recommends this type of therapy for children and young people with
mild depression, and for some cases of schizophrenia.

Humanistic therapies are available both privately and on the NHS and, depending on the
problem, can be either short- or long-term, although they usually last for at least several
months.

Other talking therapies

Group therapy

The aim of group therapy is to help people find solutions to their problems by discussing
them in a group setting. Sessions are led by a facilitator who helps by directing the flow
of conversation.

NICE recommends group therapy for people with obsessive compulsive disorder (OCD),
and for children and young people with mild depression.
Relationship and family therapy

Relationship therapy is where couples who are having difficulties in their relationship
work with a therapist to try to resolve their problems. Family therapy is similar but
involves a therapist working with a family that is having problems.

NICE recommends relationship therapy for people who have tried individual therapy
without success, and family therapy is recommended for children with depression, or
where a family member has a condition such as anorexia nervosa or schizophrenia.

Interpersonal therapy

Interpersonal therapy focuses on how a person’s mood can influence the way that they
relate to others who are close to them. NICE recommends this type of counselling for
people with eating disorders and depression.

Mindfulness-based therapies

Mindfulness-based therapies combine talking therapies with meditation. They are used to
make positive changes by helping a person to reduce stress and cope with problematic
thoughts and feelings. NICE recommends this type of therapy to help people avoid
repeated bouts of depression.

Eye movement desensitisation and reprocessing (EMDR)

Eye movement desensitisation and reprocessing (EMDR) is a treatment method that uses
eye movements to stimulate the brain. EMDR has been shown to make distressing
memories feel less intense.

EMDR can be used to treat a number of traumas, such as addictions, accidents and
injuries, phobias, and sexual, physical or emotional abuse. NICE recommends EMDR for
post-traumatic stress disorder (PTSD).

Motivational counselling

Motivational counselling involves talking about issues and problems that could prevent a
person from achieving their goals and ambitions. NICE recommends this type of
counselling for people who have a mental health problem, or a problem with alcohol or
substance misuse.

Telephone counselling

Telephone counselling, such as the service provided by the Samaritans, enables you to
talk to a therapist without having to meet them face-to-face. It may be available through
charities or your employer. Alternatively, you may be able to receive counselling by
email or on the internet.

Last reviewed: 16/02/2009

Next review due: 16/02/2011

How it works:

Counselling can help you deal with a range of issues, from day-to-day worries or
concerns to more serious, long-term psychological problems.

Counselling can help you come to terms with distressing or traumatic events, such as the
loss of a loved one, divorce, or confusion about your identity or sexual orientation. It can
also be an effective way of dealing with long-term mental health problems, such as
depression and anxiety.

How can a counsellor help?

A counsellor is someone who is trained to listen sympathetically to your problems and

can suggest strategies that will help you to resolve issues and change your behaviour.

By discussing your concerns with you, the counsellor will be able to help you gain a
better understanding of your feelings and actions, as well as suggesting ways for you to
find your own solutions to your problems.

The counsellor may encourage you to identify issues more easily and take personal
responsibility where appropriate. They can help you to recognise the effect of other
people and their actions, and to explore alternative ways of coping.

It can be a great relief to be able to share your worries and fears with someone who will
confirm your feelings and help you to reach a positive solution.

Counselling can take a range of different formats

There are many different types of counselling that are available in a range of different
formats. Counselling can take place:

• face-to-face,
• over the telephone, or
• by email.

You may be offered counselling as a single session, as a short-term course of sessions for
a few weeks or months, or as a long-term arrangement that lasts for many months or
years.
See Types of counselling to find out more about the different types of counselling that are
available, and the conditions for which they are recommended.

• show glossary terms

another one

Résumé
Introduction to Counseling provides an overview of counseling and the helping
professions from the perspective of art and science: the science of counseling that
generates a knowledge base proven to promote competency and efficacy in the
practitioner, and the art of using this knowledge base to build skills that can be applied
sensitively to clients in a multicultural society. The Third Edition has been organized into
three sections: An overview of counseling and the counseling process developing a
personal approach to counseling from a multicultural perspective and special approaches
and settings. The text stays true to its original focus by using the concept of art and
science as a unifying theme. This new edition addresses topics of multicultural counseling
and diversity issues such as gender, culture, and sexual orientation in each chapter,
communicating how multiculturalism can be integrated into all aspects of counseling
rather than viewed as a separate entity.

Sommaire
Each chapter concludes with Summary.

I. AN OVERVIEW OF COUNSELING AND THE COUNSELING PROCESS.

1. An Overview of Counseling.

Welcome to the Field of Counseling.

What Is Counseling?

The Art and Science of Counseling and Psychotherapy.

Counseling as Storytelling.

Counseling and Psychotherapy.

Differentiating Formal from Informal Helping.

Personal Qualities of Effective Helpers.

The Helping Profession.

Counseling: Past, Present, and Future.

Counseling from a Historical Perspective.

Future Trends.

2. Professional Preparation and Ethical and Legal Issues.

Becoming a Professional Counselor.

Formal Study and Professional Affiliation.

Certification and Licensure.

Continuing Education.

Professional Involvement.

Ethical-Legal Issues.

The Art and Science of Ethical-Legal Issues.

Ethical Issues.

Legal Issues.

Special Ethical and Legal Issues.

Ethical-Legal Decision Making.

Clinical Examples.

3. The Counseling Process.

The Art and Science of the Counseling Process.

The Six Stages of the Counseling Process.

Stage One: Relationship Building.

Stage Two: Assessment and Diagnosis.

Stage Three: Formulation of Counseling Goals.

Stage Four: Intervention and Problem Solving.

Stage Five: Termination and Follow-Up.

Stage Six: Research and Evaluation.

Listening Skills.

Primary Listening Skills.

Secondary Listening Skills.

Counseling Vignette.

Effective Listening 'Don'ts.'

Effective Listening 'Do's'

A Final Thought Regarding Listening Skills.

Recent Trends in the Counseling Process.

Emotions.

Postmodern Trends.

Brief-Counseling Approaches.

Brief-Solution-Focused Counseling.

Common Problems for Beginning Counselors.

Focusing on the First Issue in a Session.

Overlooking Physical or Medical Issues.

Wanting to Rescue Clients from Their Unhappiness.

Having Perfectionist Tendencies.

Having Unrealistic Expectations.

Getting Carried Away with the Latest Technique.

Getting Lost in the Counseling Process.

Using Inappropriate Phrases.

Having an Excessive Desire to Help.

Having an Excessive Need to Be Liked.

Getting Too Emotionally Involved.

Taking Things Too Personally.

Having Difficulty Differentiating Between Normal and Abnormal.

Being Uncertain about Self-Disclosure.

Being Uncertain about Confidentiality.

Diversity Issues.

4. Assessment and Diagnosis.

The Art and Science of Assessment and Diagnosis.

Assessment and Diagnosis.

Assessment.

Evaluation of Tests.

Administration and Interpretation of Tests.

Test Bias.

Types of Tests.

Environmental/Ecological Assessment.

Diagnosis.

Historical Perspective.
The DSM-IV-TR.

The Clinical Interview.

Treatment Planning.

Diversity and Postmodern Issues in Assessment and Diagnosis.

5 Counseling Research and Evaluation.

The Art and Science of Research and Evaluation.

The Purpose of Research and Evaluation.

Theory, Research, and Practice.

Research, Evaluation, and Counselor Accountability.

The Contribution of Research to the Counseling Field.

Overview of the Types of Research.

Types of Research Methodologies.

Shortcomings of Traditional Counseling Research.

Div

History of counseling

Table of Contents

History of the Counseling Profession

In the Beginning . . .
Parson’s Vision of Counseling
Early Counseling Activities
Evolution f School Counseling
Evolution of School Counseling

Evolution of School Counseling

Evolution of School Counseling

Evolution of School Counseling

Evolution of Agency and Mental Health Counseling

Allied Human Service Fields

Professional Organizations
Professional Organizations and Credentialing

Professional Organizations

Licensure and Certification

Qualities of the Counselor

Three Dimensions of a Counselor
Who the Counselor is: Personal Qualities (Combs, 1986)

Other Qualities of Good Counselors

Patterson’s Description of a Good Counselor (1985)

What the Counselor Knows

What the Counselor Can Do

What the Counselor Can Do

Discussion Questions
Benefit of counceling:

What are the possible benefits of counseling or

therapy?
The main benefit of counseling is that it helps you to
have a life which you can more fully enjoy and
appreciate. It can help you to become the sort of
person you want to be. It can also help you to more
deeply enjoy your important relationships.
You might use therapy to:
• feel better about yourself

• feel more at peace, more comfortable, or more secure in the world

• feel more successfully (and more joyfully) connected with others

(including your spouse/partner)

• reduce stress (which promotes physical health too)

• work through problems with a skilled, and compassionate

professional

• identify your goals

(those which can support the kind of life you would like to
have)
 • learn new behaviors and/or responses which can help you to
achieve your goals

• establish ways and techniques for reaching your goals

• understand your own thoughts, feelings, and responses better

• understand your loved ones better

• have a safe and friendly ear; someone to use as a sounding

board

• speak with a skilled and interested professional about your fears

and perceptions

• talk with a compassionate professional about troubling or private

concerns

• work towards greater self-fulfillment and self-mastery

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Benefits of Counseling

• improved communication
• enhanced relationships
• a happier family
• peace of mind
• improved self-esteem
• more satisfaction out of life
• personal growth
• improved job performance

There are times that the challenges in our lives may lead to isolation, anxiety, depression, and
other health problems. Through counseling, you can explore your alternatives, build on your
strengths, and develop new skills.

You possess the inner strength to meet life’s challenges.

Last one

The Benefits of Counseling

Counseling can greatly benefit a person with cancer; however, it is hard for some people
to ask for professional help. A person may worry that seeking help for emotional distress
shows a weakness or failure to handle one’s own problems. Some may also discount the
importance of seeking support because of a strong sense of needing to be independent
and self-sufficient. People living with cancer are often focused on their medical needs,
and they may feel they don't have the time, money, energy, or need to care for their
emotional needs.

Seeking outside, professional help is not a weakness. In fact, it shows the willingness to
take care of oneself and find helpful ways to respond to challenging situations.
Counseling is designed to help a person develop healthy ways to understand and respond
to emotional needs and concerns. Counselors don't solve problems, but they provide a
safe environment where a person with cancer can talk about his or her concerns. Because
counselors are removed from the situation, they provide a helpful, outside perspective.

How counseling helps

There are many ways professional counseling helps a person with cancer. Counseling can
be a way for someone to better understand and resolve a pressing issue or concern.
Counseling can also help explore longstanding problems unrelated to the disease that may
have come to the surface during the cancer experience. In addition, counseling may
clarify and prioritize emotional needs that have taken a back seat to other needs and
responsibilities.

Here are some ways that counseling can help people with cancer and those who care
about them:

• Learn ways to help cope with the cancer diagnosis

• Feel less overwhelmed by the disease and more in control of one's life

• Explore the meaning of the cancer experience

• Manage difficult feelings, such as sadness, depression, and anxiety

• Manage cancer symptoms and treatment side effects, such as pain and fatigue

• Learn how to communicate effectively with the health care team

• Address relationship and financial concerns that are causing distress

• Explore options and get feedback about important decisions

• Talk about concerns after completing cancer treatment

• Learn about community cancer resources

• Learn how to help others understand and adjust to the changes cancer has brought
to the family

• Explore and resolve issues related to body image and sexuality as they relate to
cancer

When counseling is needed

Counseling may be recommended to deal with emotional distress. While it's normal for a
person to have emotional distress while coping with cancer, it's important to seek
professional help when the distress is long lasting and interferes with the ability to carry
out daily activities. When searching for a counselor, it is important to ask whether the
counselor has worked with people with cancer before. Select a counselor who
understands the issues and challenges unique to this situation.

Types of counseling
There are different types of counseling services available to help a person with cancer
cope with and manage distress. The type of counseling a person chooses may depend on
personal preferences and financial resources. Here are some general descriptions of
different types of counseling:

Individual counseling is a one-on-one interaction with a counselor to talk about specific

feelings, thoughts, and problems that a person is struggling with. The counselor will
listen attentively, express caring concerns, ask questions, and offer feedback.

Family counseling includes members of the immediate family and is based on the idea
that a person is greatly influenced by his or her family's belief system and culture. A
family counselor will help the family look at a situation from a different perspective and
try new ways to help and support each other.

Couples counseling is between two people, usually spouses or partners. The counselor
listens objectively to both participants and helps identify how specific thoughts and
behaviors may contribute to conflict between the couple. Couples can learn new ways to
help and support one another during times of stress.

Group counseling is when a group of individuals with similar concerns meets together
with a trained counselor. The counselor leads the group sessions and provides support
and guidance.

Effectiveness of counseling

Professional counseling often helps a person feel gradual relief from emotional distress,
develop more self-assurance, have a greater ability to make decisions, and enjoy an
increased comfort in relationships with others. If counseling isn't offering these benefits,
it may be helpful to consider whether the topic of discussion, the kind of therapy, or the
counseling relationship is working. Talk about the concerns with the counselor, and if
necessary, explore other therapy options that may be a better match.

Next one

LifeShops
What Is Counseling?
There are many myths about what Counseling entails. Most of them are rooted in
some outdated ideas about psychology and psychotherapy. Unfortunately, images of
old men in beards, clients on couches and patients in asylums still define what
counseling is for many individuals who might benefit from what counseling offers
today. Often, people dismiss counseling as
 Something for “crazy people”?

Professional help for people with really major problems?

An activity for people who are way too preoccupied with themselves!

A crutch for people who are just too weak to handle life.

or

Where you go and get analyzed by somebody and then hope

something changes for the better!

Usually, if counseling is described in these ways, the descriptions are coming from
people who have never been to counseling....

Counseling is many things....but a good place to start is by clarifying

what counseling is NOT!

Counseling is NOT a place that people go to find out if they’re "crazy" ...but rather
to get support because sometimes the world can seem pretty “crazy.”

Counseling is NOT something that attends only to challenges regarded as “major

problems” and dismissing things some may regard as “less important problems” but
rather attends to the issues that students bring in whenever they feel the distress is
getting in the way of living life with satisfaction. Counseling simply helps show those
who come to counseling that they possess the strength and abilities to manage their
challenges.

Counseling is NOT an activity for self-absorbed people. In fact, most students who
seek counseling are struggling because they are very sensitive to the feelings and
experiences of others and want to preserve their relationships by working on the
difficulties that threaten them..

Counseling is NOT an activity where one expert analyzes the client.

Rather, it is an activity where counselor and client work as a team to make positive
changes in the client's approach to life.

Counseling is NOT a crutch for weak people. Rather, it is a vehicle for strong
people who decide to face their challenges directly rather than continue in the more
frightened and “escape”-oriented ways that others use to deal with difficulties.
 A Mirror
Counseling is a unique relationship in which the Counselor’s job
is to hold up a mirror for the client to see himself or herself in.
We all have experiences in which we can’t see things about
ourselves without a mirror.

Whether our hair is fully combed, whether we have something stuck in our teeth, or
whether we have a wound in a hard to see place, we often need mirrors to see these
things well enough to do something about them. And, sometimes, we need someone
to hold the mirror so we can see the things at are at more hidden angles.

In addition to knowing what angles to hold the mirror from, the counselor
understands that sometimes it takes a while for folks to see what they need....
especially if there are more subtle things needing our recognition.

Finally, because most people tend to be hard on themselves (if not downright mean
to themselves) the counselor knows to hold the mirror in such a way that the client
can see himself or herself from a caring, supportive, and sympathetic perspective.

Reflections
Often counselors seem to only be repeating what clients are saying to them or
paraphrasing clients rather than giving answers.

I hear you saying....

It seems that you are....
I can feel that you are experiencing...
How does that make you feel?
What emotions do you have about this?

Actually, when counselors are doing this, there is a strategy behind it. Remember,
counseling is not about experts fixing problematic people. Mirrors don’t comb our
hair, they just motivate us to pick up the comb by showing the areas that need our
attention.

When counselors ask such questions or make such statements, they are not
necessarily seeking answers from clients. Rather, they are simply giving the clients
an opportunity to focus on the things that seem out of view for them.... often this
involves pointing the mirror to some neglected painful emotions.

Counseling is about reflecting back to the client that he or she is being heard and
providing them an opportunity to hear themselves. Often, hearing one's own
thoughts and feelings in another person's words adds a clarity and support that's
difficult to grasp when the emotional turmoil simply swims around in our heads
without any form. When students can see the most complete reflection of
themselves, pain and all, they are more capable of learning about the details of
 themselves. With this enhanced perspective, those in counseling can make the
adjustments needed to make their lives more satisfying.

The Counseling Relationship

Mirrors With Expertise
Sometimes, because Counselors have a lot of experience witnessing human beings in
various forms of life challenges, they can ask questions or share observations that
are more revealing than what friends or family members might say. With these
new revelations, clients make decisions and--with the support of the counselor--
clients take action toward positive growth in their lives.

Thus, the relationship between the Counselor (this supportive mirror) and the
Client, is helpful in and of itself. The Counseling Relationship is one that exists
between a person with caring expertise and a person with discouraging isolation
around difficult life experiences. It is a relationship that emerges through a sharing
of personal history and exploring powerful emotions.

Confusions Traumas Rejections

Hurt Hopes Anger
Fears Abandonment
Because the counselor is a real person who typically cares genuinely about the client,
a relationship develops between the person of the counselor and the
person of the client. Genuine connection, defined by a closeness between
two persons out of the trust-based sharing, emerges between them.

However, because the counselor typically self-discloses very little in the counseling
relationship in order to maintain a focus on meeting the client’s needs, and because
the counselor’s job is to “hold up the mirror,” you, the client are actually forming a
new relationship with yourself--- in more emotional detail and with a more
accepting perspective.

Thus, the client in pain and confusion begins to form a close relationship with the
client as a growing individual, increasingly equipped to take care of him or her Self.
This point is important to emphasize because it explains Counseling as a venture
aimed at helping clients become autonomous rather than fostering dependence on
professionals.

Mirrors Come in Different Shapes

There are different formats of counseling and different approaches counselors may
take, but most are in one of three forms: Individual Counseling, Couples
Counseling, and Group Counseling
Students are often hesitant to engage in anything other than individual counseling.
While often this is the most appropriate intervention, the other formats have unique
advantages that should be considered.

Often, students are resistant to couples counseling, opting to talk

“about their relationship” with a counselor in individual counseling.
Couples Counseling adds the partner’s perspective to the counseling
to the benefits of individual counseling.

Group Counseling, a prospect that is intimidating to many students, has several

advantages. For one thing, Group Counseling provides at least as many mirrors as
there are group members, compared to the single mirror available in individual
counseling. When a person’s difficulties have a significant interpersonal
component---in other words, if the client’s struggle is something that impacts
relationships with others---Group Counseling is often most helpful because it
provides a safe place to get feedback on how they are experienced by others.

For individuals having difficulty establishing or maintaining relationships...

Shyness,
New Friends or New Romantic Interests Don’t Call, Confusing Conflicts,
Feeling Left Out from Social Groups---
....the group offers an arena where the client eventually begins acting and reacting
in similar ways to their relating style outside the group....The group, facilitated
toward a supportive and caring approach, can shed light in how you may come
across as well as helping correct some incorrect assumptions that may lead to some
of the relationship difficulties to begin with.

So What Is Counseling?
It’s an Honest and Supportive Mirror

It’s a Relationship that Builds Confidence.

It’s available for any Georgia State University student who may need to
explore some of the difficulties that have started to form barriers to success and
satisfaction with this thing called Life.

Contact Us
If you decide that you might want to explore Counseling as a resource, call or come
by to schedule an appointment.