Theoretical Approaches to Counseling
Theories questions ask you to attribute a technique to its founder, match a case description to a model, or predict what a therapist in a given orientation would do next. Group theories by their view of the problem: past and unconscious, present experience, learned behavior and cognition, or the system around the client.
Psychodynamic
Freud: id, ego, superego; defense mechanisms (repression, projection, displacement, reaction formation, rationalization); free association, dream analysis, interpretation, transference analysis. Brief psychodynamic therapy targets a focal conflict.
Humanistic and existential
Person-centered: core conditions, nondirective stance, client as expert. Gestalt (Perls): awareness, here-and-now, empty chair, body work, unfinished business. Existential (Frankl, Yalom): Yalom's four ultimate concerns - death, freedom, isolation, meaninglessness; therapy builds authentic choice and meaning.
Cognitive and behavioral
Behavior therapy: Wolpe's systematic desensitization rests on reciprocal inhibition; Bandura's modeling; operant reinforcement and shaping. Beck's cognitive therapy targets automatic thoughts, cognitive distortions (all-or-nothing thinking, overgeneralization, catastrophizing, mind reading), the cognitive triad, and uses Socratic questioning and thought records. Ellis's REBT uses ABCDE - Activating event, Belief, Consequence, Dispute, Effect - and attacks absolutist "must" beliefs.
Systemic and postmodern
Bowen: differentiation of self, triangles, multigenerational transmission, genogram. Minuchin: structural family therapy, boundaries, enmeshment, disengagement. Solution-focused (de Shazer): miracle question, exceptions, scaling. Narrative (White): externalizing the problem, re-authoring. Glasser's choice theory/reality therapy: WDEP - wants, direction/doing, evaluation, plan.
Worked example
A client says, "My supervisor criticized one report, so I'm a complete failure and I'll be fired." A therapist asks, "What evidence supports and contradicts 'complete failure'?" and assigns a thought record. Reason: this is collaborative evidence testing of a specific automatic thought - Beck's cognitive therapy. REBT would instead dispute the underlying "must" belief ("I must never be criticized") with forceful disputation; psychodynamic work would explore the criticism's earlier relational meaning. The wording of the stem decides.
Traps
- Swapping Ellis (REBT, musts, ABCDE) and Beck (distortions, thought records).
- Assigning the miracle question to narrative therapy.
- Confusing Bowen's differentiation with Minuchin's boundaries.
- Calling Gestalt past-focused - it is present-centered.
- Assuming all behavioral work is classical conditioning.