Overview:

Theories of Psychotherapy
&
Counselling
Dr. Laila Jeebodh-Desai
Educational Psychologist
Credibility of a Theory
 Psychotherapy & Counselling

• https://youtu.be/OxuZiqY5ypU
 Psychotherapy & Counselling
• “Psychotherapy and Counselling are professional activities
that utilise an interpersonal relationship to enable people
to develop self-understanding and to make changes in their
lives.”
• “Professional counsellors and psychotherapists work within
a clearly contracted, principled relationship that enables
individuals to obtain assistance in exploring and resolving
issues of an interpersonal, intrapsychic, or personal
nature.”
• “Professional Counselling and Psychotherapy are explicitly
contracted and require in-depth training to utilise a range
of therapeutic interventions, and should be differentiated
from the use of counselling skills by other professionals.”
Psychotherpay and counselling federation
of Austrailia. (2013). Retrieved from:
www.pacfa.or.au.
 Professional Psychotherapy &
Counselling
• Although Counselling and Psychotherapy overlap
considerably, there are also recognised
differences.
• While the work of Counsellors and
Psychotherapists with clients may be of
considerable depth, the focus of Counselling is
more likely to be on specific problems, changes in
life adjustments and fostering clients’ wellbeing.
• Psychotherapy is more concerned with the
restructuring of the personality or self and the
development of insight.
 Theories of Psychotherapy &
Counselling
• Counselling Theories
– Behaviour therapy
– Person-Centered Therapy (Carl Rogers)
– Rational-Emotive Behavior Therapy (Albert Ellis)/Cognitive-Behavioral Therapy
– Reality Therapy (William Glasser)
– Feminist Therapy
– Solution focused brief therapy and narrative therapy
– Family therapy
– Integrated perspective

• Personality Theories
– Psychoanalysis (Sigmund Freud)
– Individual Psychology (Alfred Adler)
– Erik Erikson

• Learning Theories
– Classical Conditioning
– Operant Learning (Stimulus-Response Theory)
– Social Learning
 By understanding the origins of distress, we are
better able to deal with distress.

Counseling Theories assert that problems stem

from ineffective relationships or thoughts in
adulthood.

Purpose
Personality Theories speculate that distress stems
from more innate, long standing problems often
starting in childhood

Learning Theories emphasize the fact that

distress and behavior is learned from exposure to
rewards and punishments
 Characteristics of
an Effective Counsellor
 Characteristics of
an Effective Counsellor
• Be organized within
your practice.
• Whether they're first-time
clients or you've
counselled them for
years, organization in a
counselling practice is key.
• Organization of
paperwork, scheduling,
and personal details will
give your clients peace of
mind and confidence in
your work.
 Practice ethically and
professionally.

Characteristics
There are many resources
of for counsellors to
understand the ethics of
an Effective the profession.
Counsellor

Some resources include

the HPCSA, Scope of
Practice; Mental Health
Acts
 Educate yourself.

If you are on the path to earn a degree in

counselling, you're already moving forward
Characteristics with one of the most important ways to
of become an effective counsellor.

an Effective Another great way to gain experience is to

Counsellor attend a counselling conferences, such as
the PSYSSA Conference.

Study hard, ask a lot of questions, and get

all the experience you can while earning
your undergraduate or master's in
counselling.
 Characteristics of
an Effective Counsellor

• Be confident in your position and

responsibility.
• Whether you've been a licensed
professional counsellor for 20 years or
you're new to the profession, you must
maintain confidence in your work.
• A client is looking to you for help, so use
your education and experience assuredly.
Good clinical supervision is also
suggested.
 Characteristics of
an Effective Counsellor

• Be respectful and non-judgmental.

• According to the PsySSA: SOUTH AFRICAN PROFESSIONAL
CONDUCT GUIDELINES IN PSYCHOLOGY 2007:
• Principle IV: Respect for People’s Human Rights and Dignity:
• Psychologists accord appropriate respect to the fundamental
human rights, dignity and worth of all people.
• They respect the rights of individuals to privacy, confidentiality,
self-determination, and autonomy, and are mindful that legal and
other obligations may lead to inconsistency and conflict with the
exercise of these rights.
• Psychologists are aware of cultural, individual and role
differences, including those due to age, gender, race, ethnicity,
national origin, religion, sexual orientation, disability, language
and socioeconomic status. Psychologists try to eliminate the
effect on their work of biases based on these factors and they do
not knowingly participate in or condone unfair discriminatory
practices.
 • Understand the importance of
communication.
Characteristics • Since every client is different, you may
have some that need time to warm up
of to you, while some aren't afraid to
an Effective divulge their life story from the start.
Counsellor • Understand that communication needs
to be personalized to each client.
 Characteristics of
an Effective Counsellor
• Have a flexible attitude.
• Working as a counsellor, you will have to be
accommodating.
• Some clients will be late or may cancel, along
with clients that are seeking an emergency
session.
• Possess a flexible attitude to ensure your
clients feel safe and understood.
Behaviour Therapy
 Behaviour therapy is focused on The goal of behaviour therapy is

Theories:
helping an individual understand how usually focused on increasing the
changing their behaviour can lead to person’s engagement in positive or
changes in how they are feeling. socially reinforcing activities.

Behaviour
Therapy
Behaviour therapy is a structured
approach that carefully measures
what the person is doing and then
seeks to increase chances for positive
experience.
 Behaviour Therapy
 Assessment

– Direct Observation

– Client Interview

– Behavior Logs

– Symptom Checklists

• Goals of therapy

 Increase adaptive behaviors

 Decrease maladaptive behaviors

Person Centred Therapy
 Theories: Person Centered
• Humans are good and forward moving unless
they are blocked
• Blockages often occur from a lack of
unconditional positive regard which leads to
low self esteem and low self efficacy
• By creating a nurturing, positive environment,
people will naturally move in the right
direction.
 • 6 necessary conditions required for change:

– Therapist-Client Psychological Contact: a

relationship between client and therapist
in which each person's perception of the
other is important must exist.
– Client incongruence, or Vulnerability:
Theories: incongruence exists between the client's
experience and awareness causing

Person vulnerability/anxiety increasing

motivation.

Centered – Therapist Congruence, or Genuineness

– Therapist Unconditional Positive Regard
(UPR)
– Therapist Empathic understanding
– Client Perception of the therapist's UPR
and empathic understanding.
Rationale
Emotive
Therapy
 • Focuses on changing the
current evaluations and/or
reactions
• Distress is caused by a
Theories: combination of the event and
the person’s perception of the
REBT/CBT event
• By using the A-B-Cs, people can
evaluate their beliefs and
reactions (consequences) to
events.
 – A= Activating Event
– B= Beliefs/assumptions
about/interpretations of an event
– C= Consequences
– D= Dispute irrational beliefs
• What is the evidence for my beliefs?
• What are other possible explanations
for what happened?
– E= Evaluate reactions/consequences for
A-B-C effectiveness
• What are the implications of my
believing this way, and do they make it
worth holding on to my beliefs?
• How useful are my beliefs? Do I or
others get any benefits from holding
on to them, or would we benefit more
if we held other beliefs?
CBT/REBT: Irrational Thoughts
Irrational Idea 1 - It is a dire necessity to be loved or approved by
almost everyone for virtually everything he or she does.

Irrational Idea 2 - One should be thoroughly competent, adequate,

and achieving in all possible respects.

Irrational Idea 3 - Certain people are bad or wicked, and should be

severely blamed and punished.

Irrational Idea 4 - It is terrible, horrible, and catastrophic when things

are not going the way one would like them to go.

Irrational Idea 5 - Happiness is externally caused and people have

little or no ability to control their emotions.
 Irrational Idea 6 - If something is dangerous or fearsome, one
should dwell on it

Irrational Idea 7 - It is easier to avoid facing many life difficulties

and self-responsibilities than to undertake more rewarding
forms of self-discipline.

Irrational
Thoughts
Irrational Idea 8 - The past is all-important and because
something once strongly affected one’s life, it should indefinitely
do so.

cont…
Irrational Idea 9 - People and things should be different, and it is
catastrophic if things do not immediately change.

Irrational Idea 10 - Maximum human happiness can be achieved

by inertia and inaction or by passively "enjoying oneself."
 CBT/REBT: Irrational Thoughts
Perceived
Emotional
Performance perfectionism: People
perfectionism: I should Fear of disapproval or
perfectionism: I must will not love and accept
always feel happy, criticism: I need
never fail/make a me as a flawed and
confident, and in everybody’s approval
mistake. vulnerable human
control of my emotions.
being.

Fear of rejection: If I’m Fear of being alone: If Fear of failure: My Conflict phobia: People
not loved, then life is I’m alone, then I’m worth depends on my who love each other
not worth living. miserable achievements shouldn’t fight.

Emotophobia: I should Entitlement: People

not feel angry, anxious, should always be how I
jealous etc. expect
 CBT/REBT: Irrational Thoughts
• all or nothing thinking
• overgeneralization
• mental filter – dwell on the bad and let it discolor everything
• discount the positives
• jumping to conclusions/overgeneralization
• magnification
• emotional reasoning –we FEEL bad so we believe we are
• shoulds
• labeling – we label ourselves negatively instead of trying to learn from the situation or
thinking about the best way to overcome it
• blame – we hold other people responsible for our pain or blame ourselves entirely for
every problem
• mind reading
• catastrophizing - we expect disaster.
• personalizing - we think that everything people do or say is some kind of reaction to us
 Control Fallacy - If you feel externally controlled, you see
yourself as a totally helpless victim of fate. Conversely, it can
hold you responsible for the pain and happiness of
everyone around you.

Fallacy of Fairness –Life is not fair.

CBT/REBT:
Irrational Fallacy of Change - You expect that other people will change
to suit you if you just pressure or cajole them enough.

Thoughts Fallacy of Being Right - Being wrong is unthinkable, and you

will go to any length to demonstrate your rightness.

Heaven's Reward Fallacy - You expect all your sacrifice and

self-denial to pay off, as if there were someone keeping
score. You feel bitter when the reward does not come.
Reality Therapy
 Focus on the present

Avoid discussing symptoms and complaints. These are

the ineffective ways that clients to deal with problems.

Theories:
Focus on what clients can do directly-act and think.

Reality Spend less time on what they cannot do directly:

changing their feelings and physiology.

Therapy Avoid criticizing, blaming and/or complaining

Remain non-judgmental, but encourage people to ask:

Is what I am doing getting me closer to the people I
need?

Teach that excuses stand in the way of making needed

connections.
 Focus Focus on specifics. Who/ what are clients
on disconnected from

Reality Help them make specific, workable plans to

Therapy Help reconnect with the people they need. Follow

through on what was planned by helping
them evaluate their progress.

cont…
Be patient and supportive but keep focusing
Be on the source of the problem,
disconnectedness.
Feminist Therapy
 • Feminist therapy also focuses on
empowering women by helping them
see the impact of gender issues.
• The aim of therapy is change rather
then adjustment.
• It is important to acknowledge sex
roles, minority status and socialization
in society as possible sources or causes
Feminist Therapy of psychological difficulties.
• A core concept is equality; therefore,
the therapist is seen as equal in the
relationship with an outside
perspective who provides guidance and
new information but the client is seen
as having the power to create his or
her own desired outcome in
themselves and their lives.
 The theory has evolved significantly from
psychotherapy for women, where it functioned
primarily as a corrective against the sexist
approaches of the era, into a sophisticated,
postmodern, technically integrative model of
practice that uses the analysis of gender, social
location, and power as a primary strategy for
comprehending human difficulties.

Feminist
Therapy
Feminist therapy has become a practice that
encompasses work with women, men, children,
families, and larger systems.
Solution Focused Brief Therapy
Solution Focused Brief Therapy
SFBT is future-focused, goal-directed, and focuses on solutions, rather than
on the problems that brought clients to seek therapy.

Developed by Steve de Shazer (1940-2005), and Insoo Kim Berg (1934-

2007) and their colleagues beginning in the late 1970’s

Become a major influence in such diverse fields as business, social policy,

education, and criminal justice services, child welfare, domestic violence
offenders treatment.

Conversation is directed toward developing and achieving the client’s vision

of solutions. The following techniques and questions help clarify those
solutions and the means of achieving them.
Family Therapy
 Family Therapy

• Family therapy is based on the belief that the

family is a unique social system with its own
structure and patterns of communication.
• These patterns are determined by many
things, including the parents' beliefs and
values, the personalities of all family
members, and the influence of the extended
family (grandparents, aunts, and uncles).
• As a result of these variables, each family
develops its own unique personality, which is
powerful and affects all of its members.
 • Teaches family members about how families
function in general and, in particular, how their
own functions.
• Helps the family focus less on the member who
has been identified as ill and focus more on the
family as a whole.
• Helps to identify conflicts and anxieties and
Family helps the family develop strategies to resolve
them.
Therapist • Strengthens all family members so they can
work on their problems together.
• Teaches ways to handle conflicts and changes
within the family differently. Sometimes the
way family members handle problems makes
them more likely to develop symptoms.
Integrated Perspective
Integrated Perspective

Integrative Psychotherapy takes into account many views of human

functioning.

The psychodynamic, client centred, behaviourist, cognitive, family

therapy, Gestalt therapy, body-psychotherapies, object relations
theories, psychoanalytic self psychology, and transactional analysis
approaches are all considered within a dynamic systems perspective.

Each provides a partial explanation of behavior and each is enhanced

when selectively integrated with other aspects of the therapist's
approach.
Integrated Perspective

Refers to the bringing together of the affective, cognitive,

behavioural, and physiological systems within a person, with an
awareness of the social and transpersonal aspects of the systems
surrounding the person.

These concepts are utilized within a perspective of human

development in which each phase of life presents heightened
developmental tasks, need sensitivities, crises, and opportunities
for new learning.
Integrated perspective
It refers to the process of integrating the personality: taking disowned, unaware, or
unresolved aspects of the self and making them part of a cohesive personality,
reducing the use of defense mechanisms that inhibit spontaneity and limit flexibility
in problem solving, health maintenance, and relating to people, and re-engaging the
world with full contact.

It is the process of making whole.

Through integration, it becomes possible for people to face each moment openly and
freshly without the protection of a pre-formed opinion, position, attitude, or
expectation.
 Personality Theories:
Psychoanalysis

• The conscious mind is what you are aware of at

any particular moment, your present
perceptions, memories, thoughts, fantasies,
feelings
• Working closely with the conscious mind is what
Freud called the preconscious, what we might
today call "available memory.“
• The largest part by far is the unconscious. It
includes all the things that are not easily
available to awareness, including many things
that have their origins there, such as our drives
or instincts, and things that are put there
because we can't bear to look at themthe
unconscious is the source of our motivations
 The id, the ego, and the superego
– The id (instinct)works with the
pleasure principle to take care of
needs immediately
– The ego helps the person searches for
objects to satisfy the id’s wishes
– as the ego struggles to keep the id
happy, it meets with obstacles in the
world. It keeps a record of
Psychoanalysis consequences. This record of things to
avoid and strategies to take becomes
the superego.
cont… • There are two aspects to the
superego:
– conscience, which is an
internalization of
punishments and warnings.
– The other is called the ego
ideal. It derives from
rewards and positive
models presented to the
child.
 Psychoanalysis cont…

• The defense mechanisms

• When the Id/superego conflict becomes overwhelming, the ego must defend
itself.
• The techniques are called the ego defense mechanisms
– Denial
– Sublimation
– Displacement
– Humor
– Reaction Formation
 Personality Theories: Adler

• Striving for perfection is a single "drive" or motivating force behind all our behavior and
experience
• Since we are not perfect, our personalities are accounted for by the ways in which we do -- or
don't -- compensate or overcome our failures
• Adler felt that there were three basic childhood situations that most contribute to a faulty
lifestyle.
– Disabilities. If someone doesn't come along to draw their attention to others, they will
remain focused on themselves.
– pampering. Many children are taught, by the actions of others, that they can take
without giving.
– neglect. They learn inferiority because they are told and shown every day that they are
of no value; They learn selfishness because they are taught to trust no one.
 • We develop through a predetermined
eight stages.
Personality • Progress through each stage is
determined by our success in all the
Theories: previous stages.
• Each stage involves certain
Erickson developmental tasks
• If a stage is managed well, we develop
a certain virtue or strength
 Erickson’s Stages

purpose - Initiative vs. Guilt -

hope - Basic Trust vs. Mistrust - will - Autonomy vs. Shame and
Kindergarten - The child can do
Infant stage. Does the child Doubt - Toddler stage. Child
things on his own. If "guilty"
believe its caregivers to be needs to learn it is safe to
about making choices, the child
reliable? explore the world.
will not function well.

fidelity - Identity vs. Role

Confusion - Teenager.
competence - Industry vs.
Questioning of self. Who am I,
Inferiority - Around age 6 to
how do I fit in? If the parents
puberty. Child comparing self
continually push him/her to
worth to others.
conform to their views, the teen
will face identity confusion.
 caring - Generativity vs. Stagnation
love (in intimate relationships, - the Mid-life crisis. Measure
work and family) - Intimacy vs. accomplishments/failures. Am I
Isolation - Young adult. Who do I satisfied or not? The need to assist
want to be with or date, what am I the younger generation.
going to do with my life? Will I Stagnation is the feeling of not
settle down? having done anything to help the
next generation.

wisdom - Ego Integrity vs. Despair -

old age. Some handle death well.
They reflect on the past, and either
conclude at satisfaction or despair
 Learning Theories: Classical
Conditioning

• Classical conditioning involves

presentations of a neutral stimulus along
with a stimulus of some significance
(usually an unconditioned stimulus)
• Classical conditioning is most important
in helping us understand why seemingly
neutral stimuli evoke a response from a
client
Learning Theories: Operant
Conditioning
Operant conditioning is the use of consequences to modify
the occurrence and form of behavior (Treatment planning)

Reinforcement is a consequence that increases a behavior.

+/-

Punishment is a consequence that decreases a behavior. +/-

Extinction is the elimination of a behavior by removing the

reward.
Learning Theories: Social Learning

• People learn from one another, through

observational learning, imitation, and
modeling.
• People can learn by observing behavior and
the outcomes of those behaviors.
• Learning can occur without a change in
behavior.
• Cognition, awareness and expectations of
future consequences can have a major effect
on the behaviors that people exhibit.
• Reciprocal causation: The person, the
behavior, and the environment can have an
influence on each other.
 4 conditions that are necessary
before an individual can learn
– Attention: the person must
first pay attention to the
model/situation

Social – Retention: the observer

must remember the
behavior that has been
Learning observed.

cont… – Rehearsal: the third

condition is the ability to
replicate the behavior.
– Motivation: Learners must
want to demonstrate what
they have learned.
 Social • Self Regulation
– Set goals and standards
Learning – Self-observe
– Judge yourself
cont… – React, revisit and reinforce
 • Students often learn a lot by
observing others.
• Describing the consequences of
behavior can effectively increase
the appropriate behaviors and

Implications •
decrease inappropriate ones.
Modeling can be used in
of Social •
conjunction with shaping
Expose people to a variety of other
Learning •
models/behaviors/lifestyles
People must believe that they are
Theory capable or have a sense of self-
efficacy.
• Help students set realistic
expectations
• Teach self-regulation techniques
 • There are a multitude of
theories
• Most boil down to clients
lacking self confidence or

Summary motivation to do the correct

behaviors
• By helping people identify
obstacles to their behaviors or
motivation, we can help them
improve their quality of life.