Counselling Approaches

There are literally hundreds of psychotherapeutic and counselling approaches, but fortunately they fall into no more than three broad categories.

This approach originated with the famous Viennese physician Sigmund Freud. The psychodynamic perspective holds that our problems arise from internal conflicts between different parts of our personality or between conscious and unconscious elements. Although many of Freud’s original ideas have been modified by his followers or even abandoned completely, all psychodynamic therapies tend to focus on the relationship between the client’s past and present, and how past relationship problems may be acted out in present ones. There is usually a focus, too, on unconscious processes that are explored via dreams, symptom symbolism etc.  

Cognitive-Behavioural (CBT)
This approach was developed in the 1960s-1970s. It has become very popular in the NHS, where it is often offered for cases of depression. Cognitive-behavioural therapists believe our problems arise from irrational patterns of thinking. Such “faulty” thinking simultaneously affects the way we feel and the way we behave, and these in turn undermine our ability to act and prevent us from achieving our full potential. A cognitive-behavioural therapist will typically encourage clients to identify their distorted thinking and to make determined efforts to substitute more effective patterns. Homework tasks will also help clients to break unhelpful behavioural habits.

Another school that flowered in the 1960s-1970s, humanistic therapies include person-centred and Gestalt approaches. Both of these believe that our problems in living arise from our attempts to shape ourselves so as to be acceptable to other people rather than be true to ourselves. The more we wear a mask or act out some socially approved role in daily life, the more distant we become from our real selves. Thus we often end up feeling like total frauds and we wait anxiously in the expectation of exposure. In a warm and unthreatening counselling relationship clients are encouraged to put aside their masks and reveal themselves - not just to the counsellor but also to themselves! - for the first time. Existential counselling/therapy, while also touching these themes, also tends to deal with the inescapably tragic and absurd aspects of our humanity - anxiety, guilt, death, aloneness, personal values, and the need to live a meaningful life.