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LECTURE FIVE

COUNSELLING THEORIES contd.

5.1 CLIENT-CENTERED THEORY/THERAPY

This counselling theory which is also called Rogerian therapy was developed in 1940s by
Carl Rogers (1902 – 1987) who was an American humanist and clinical psychologist. He is
widely regarded as one of the most influential psychologists of the 20th-century.

Rogers’ theory was originally called Client-centered theory, but he later renamed it Person-
centered theory because he felt that the term ‘client’ implies somebody who has a problem
and needs to be helped. Rogers believed that people who are called ‘clients’ are ‘persons’
who strive for and have the capacity to fulfil their own potentials. He suggested that
people have a self-actualizing tendency, or a desire to fulfill their potential and become the
best people that they can be. His form of therapy was intended to allow clients to fulfill that
potential by relying on their own resources and strength to change.
Rogers believed clients are people who understand their problems more the counsellors and
that they have the capacity and the resources to solve their own problems. According to him,
Person-centered therapy is a non-directive form of talk therapy where the counsellor and
the client are considered as equal partners in the process of counselling. To him a
counsellor should remain non-directive and refrain from telling a client to do to solve his/her
problem. In other words, a counsellor should not pass judgments on client’s feelings or offer
solutions to a client’s problem.
He believed that people are fundamentally good and, in his approach to therapy, he treated
everyone as an expert on their own lives and experiences. Rogers believed that the
therapeutic relationship could lead to insights and lasting changes in clients.

While his goal was to be as non-directive as possible, he eventually realized that therapists
guide clients even in subtle ways. He also found that clients often do look to their therapists
for some type of guidance or direction.

Techniques used in Person-centered Theory


According to this theory, a counsellor should strive to create a counselling/therapeutic
environment that is conformable, non-judgmental, and empathetic. In such an environment, a
counsellor should use the following techniques to help clients understand themselves and
solve their own problems:

1. Congruence and Genuineness


2. Unconditional positive regard
3. Empathetic understanding

Congruence and Genuineness

Counsellors should display genuineness and congruence with their clients. By congruence,
Rogers meant that the counsellor and client should be compatible, agreeable and
harmonious in their relationship. The counsellor should not be aloof, but be present and
transparent to the client.

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By genuineness, he meant that the counsellor should be authentic, real, open and sincere in
dealing with a client. In other words, counsellor and client should have open
communication where the counsellor feels comfortable to share his/her feelings with the
client. This will encourage the client to share his/her own feelings and engage in honest
conversations. This means that both the counsellor and the client always act in accordance
with their own thoughts and feelings, allowing themselves to share openly and honestly.

This requires self-awareness and a realistic understanding of how internal experiences, like
thoughts and feelings, interact with external experiences.

By modeling genuineness and congruence, the counsellor can help teach client these
important skills. Displaying genuineness and congruence also helps create a secure, trusting
relationship between client and counsellor. This contributes to a feeling of safety, which may
help client engage with counsellor more comfortably.

Unconditional Positive Regard


Counsellor should show unconditional positive regard by always accepting client for who
s/he is and displaying support and care no matter what s/he is facing or experiencing. In other
words, the counsellor should accept the client the way s/he is without judgment. A
counselor should express positive feelings to client, offer reassurance,  practice active
listening, responsive eye contact, and display positive body language to let the client know
that s/he is engaged in the session.
Thus, unconditional positive regard means that the counsellor has and shows overall
acceptance of the client by setting aside his/her own personal opinions and biases. By
creating a climate of unconditional positive regard, a counsellor may help client feel free to
express his/her true emotions without fear of rejection. This is often an affirming experience,
and it may set the stage for client to make positive changes.

Rogers believed that offering conditional support often make clients develop further
problems. He also believed that by showing unconditional positive regard, the counsellor is
providing the best possible conditions for personal growth to the client.

 Empathetic Understanding

Empathy is the ability of the counsellor to understand and share the feelings of a client
about his/her problem. Empathy enables a counsellor to recognize and relate to client’s
emotions and thoughts. It is characterized as the willingness and ability of the counsellor to
place himself/herself in a client’s situation, to feel the client’s felling. A counsellor practicing
empathy during sessions, act as a mirror of client feelings and thoughts. They will seek to
understand client and maintain an awareness and sensitivity to client’s experience and point
of view.

The goal empathy is to help client build a rapport with a counsellor and ensure that a
client’s feeling is fully understood. This may provide client with the environment to reflect
on his/her own inner thoughts, perceptions, and emotions, which may offer unique insights
s/he didn't have access to previously. But, it is important to note that empathy is different
from sympathy, which is passive and imply pity.
NB. Rogers deliberately used the term "client" rather than "patient." He believed that patient
implied that the individual was sick and seeking a cure from a therapist. He also deliberately

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used the term “person” instead of “client.” He believed that client implied the individual who
has a problem and is desperate to be told what to do solve the problem. He emphasized the
importance of the individual in seeking assistance, controlling their destiny, and overcoming
their own difficulties. This self-direction plays a vital part in person-centered therapy.

What Client-Centered Therapy Can Help With

Client-centered therapy may be used by counsellors to help clients who are experiencing:
Anxiety, Psychosis, Dementia, Depression, Mood disorders and Negative thoughts related
to post-traumatic stress disorder (PTSD).

Benefits of Client-Centered Therapy

Client-centered therapy may improve self-concept which plays an important role in


determining not only how people see themselves, but also how they view and interact with
the world around them. Self-concept should be congruent with reality, but sometimes it is in
conflict with reality resulting in incongruence. Through the process of client-centered
therapy, client can learn to adjust his/her self-concept in order to achieve congruence.

Effectiveness of the Techniques used in Client-centered Therapy

Several studies have shown that the techniques used in client-centered therapy are beneficial
as follows:

1. Genuineness and congruence appear to lead to better outcomes, especially when they
are used in school counseling settings.
2. Unconditional positive regard is also effective, particularly at improving overall well-
being for people with mood or anxiety disorders.
3. Empathetic understanding appears to promote positive outcomes, especially for
people experiencing depression and anxiety.

Limitations of Client/Person centered counseling

The following are the limitations of client/person centered theory/therapy:

1. The approach may be too simplistic, optimistic, leisurely and unfocused for client in crisis
or who need more structure and direction.
2. The approach depends on bright, insightful, hardworking clients for best results. It has
limited applicability and is seldom employed with the severely disabled or young children.
3. The approach ignores diagnosis, the unconscious, developmental theories and innately
generated sexual and aggressive drives. Many critics think it is overly optimistic.
4. The approach deals only with surface issues and does not challenges the client to explore
deeper areas. Because person centered counseling is short term, it may not make a permanent
impact on the person.
5. The approach is more attitudinal than a technique based. It is void of specific techniques to
bring about client change.

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5.2 RATIONAL EMOTIVE BEHAVIOUR THERAPY (REBT)

What Is Rational Emotive Behavior Therapy?


Rational emotive behavior therapy (REBT) was developed by an American psychologist
Albert Ellis (1913 – 2007) is the 1950s. Ellis believed that, people are not disturbed by
things but rather by their thinking about things. He is one of the most influential figures
in the history of psychology who is the originator of cognitive behavior therapy (CBT).  By
CBT, it is meant that a person’s thought (cognition) process influences their behaviors
and actions.
As is implied by the name (REBT), this form of therapy encourages the development of
rational thinking to facilitate healthy emotional expression and behavior. REBT is
based on the idea that how we feel is largely influenced by how we think. REBT aims at
directly addressing irrational beliefs that lead to self-defeating behaviors. REBT is an action-
oriented approach that’s focused on helping people deal with irrational beliefs and learn
how to manage their emotions, thoughts, and behaviors in a healthier, more realistic way.
When people hold irrational beliefs about themselves or the world, problems can result. The
goal of REBT is to help people recognize and alter those beliefs and negative thinking
patterns in order to overcome psychological problems.
According to REBT, our cognition, emotions, and behavior are connected. In order to
understand the impact of events and situations that people encounter throughout life, it’s
essential to look at the beliefs people hold about these experiences and the emotions that arise
as a result of those beliefs.
Techniques used in REBT
Based on the notion that we are typically unaware of our deeply imbedded irrational
thoughts and how they affect us on a day-to-day basis, Ellis established three guiding
principles of REBT. These are principles also known as the ABCs model are: activating
event, beliefs, and consequences. These principles explain how, while we may blame
external events for our problems, it is our interpretation of these events that truly lies at the
heart of our psychological problems. The “A-B-C” model can be explained as follows:
A: Activating (Adverse) event, which means whatever it is that started things off: a
circumstance, another person’s behaviour or our own thoughts about something which has
happened. E.g. getting a low mark in Maths; being jilted; poor presentation.

B: Belief, which describes your thoughts about the event or situation. It is usually irrational
beliefs that cause psychological problems in clients. These beliefs can be about ourselves,
others, things, or situations. Beliefs can be specific or generalised. E.g. my brain is not wired
for Maths; I’m not lovable; I’m incapable of good presentation.

C: Consequence, which is your emotional response to your belief i.e. our reaction to (A) in
terms of both emotions and behaviours. E.g. poor performance in Maths; stressed and
isolated; fumble/blunder during presentation.

Illustration of ABC model:

Say two boys have to make individual presentations in front of the same audience. This will
be the first presentation that either of them has ever made and both of them have prepared
well.

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Yet the first boy at the time of presentation gets nervous, goes blank and delivers a poor
presentation. Whereas the second boy is confident and makes the presentation effectively.
Both these boys were in exactly the same situations but their emotional and behavioural
response was different.

For both the boys, the activating event was facing the audience. For the first boy, the
activating event triggered a belief that I am not capable or good enough which lead to the
feeling of nervousness and poor presentation. For the second boy, the activating event
triggered a belief that I am capable and good which lead to the feeling of confidence and
effective presentation.

Role of Counsellor in REBT

When using REBT, the role of the counsellor it to help client identify the activating event and
the irrational beliefs which are triggering negative feelings and problem in the client. The
counsellor then helps the client to change his/her irrational beliefs into rational beliefs which
ultimately change his/her emotional response to the conflict.
Once the ABCs are discovered and explored, the intervention (DEF) begins. Thus, when a
counsellor has used ABC model to help a client understand his problem, he should add DEF
to the model to become: ABCDEF to the mode where:

D: represents Disputing or challenging irrational beliefs. Disputation involves changing


client’s irrational belief system. During disputation, a counsellor will challenge client’s
irrational beliefs using direct methods. S/he may question client’s beliefs head-on, causing
client to rethink them, or could ask client to imagine another point of view that he or she
haven’t considered before. E.g. why must you be perfect? Does doing poorly in Maths mean
you are bad at everything? Does it make you totally inadequate? Where is the evidence that
people think you are useless? Where is the evidence that your brain is not wired for maths?

Disputation is also meant to teach client life-long skills to help him/her manage his/her
emotional response and overall mental health.
E: represents creating Effective new belief.  The counsellor helps the client to develop new
thinking or belief about the activating event. The client is helped to take action against the
faulty cognitions and dysfunctional beliefs. Taking action means answering the questions
from the disputing stage (D) and making changes to the irrational beliefs (B). “There is no
reason why I can’t do better in Maths. I don’t have to be great at everything. Most likely, if I
keep trying, I’ll succeed at this. I’d prefer to do well. Not doing well this time does not mean
I can’t do well the next time.” There is no good reason for me to believe that I’m not lovable
etc.

F: stand for new set of Feelings based on effective new rational beliefs in a client. E.g.
feeling confident in solving Maths problems; feeling lovable and approachable; feeling
confident in presentation.

Three key insights that REBT teaches are:

1. You are worthy of self-acceptance no matter what. Even when you struggle or make
mistakes, there is no need for shame or guilt.
2. Others are also worthy of acceptance, even when their behavior involves something
that you don’t like.

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3. Negative things will sometimes happen in life, and that doesn’t mean that things are
happening in a way they shouldn’t be. Life is not positive all of the time, and there’s
no rational reason to expect it to be.

What REBT Can Help With


REBT can be effective in the treatment of a range of psychological disorders, and it can also
help people manage specific behaviors that disrupt their lives. It may help address: Anxiety,
Distress, Depression, Disruptive behavior in children, Obsessive-compulsive disorder (OCD),
Social anxiety disorder (SAD), Psychotic symptoms, and Poor performance in sports.
Disadvantages/Weaknesses of REBT
1. Harsh on clients because it is confrontation in disputing clients irrational beliefs.  REBT has always
drawn criticism from counselors as being harsh.  Ellis even said that a caring relationship does not need
to exist for REBT to work. 
2. When working in schools, REBT can be very difficult because often times students lack the
emotional or cognitive levels needed for this to be successful. 
3. Another disadvantage is that the client needs to be willing to work on their problem.  Often time's,
REBT requires the use of homework so if the client is not willing to even work on it during the session,
it is a sure bet that they will not do any type of homework. 
4. Some emotional techniques are forceful and degrading.  Activities like shame-attacking exercises can
be difficult for the client to enjoy and really understand the purpose and whether is worth it. 
5. People with a low frustration tolerance level will struggle. 

NB. With all this being said, REBT is just like other theories, a counsellor has to choose clients wisely
because it will not always be effective. 

5.3 ECLECTIC THERAPY/PERSPECTIVE

What Is Eclectic Therapy?


An Eclectic therapy is a form of psychotherapy in which a counsellor combines aspects of
two or more different approaches to meet the needs of a client. It is also sometimes referred
to as multi-modal or integrative therapy. It is a flexible and multifaceted approach that
allows the counsellor to use the most effective methods available to address each individual
client's needs. For example, an eclectic therapist might use techniques from psychodynamic
therapy, cognitive-behavioural therapy, and rational emotive behavioural therapy, depending
on what works best for a particular client.
In the early part of the 20th century, many counsellors rigidly adhered to a single style of
treatment. Over the last decade, more counsellors started to draw ideas from multiple
theoretical orientations and techniques. Research suggests that most counsellors today take an
eclectic or integrative approach. One survey of professionals found that only 15% used a
single theoretical model and that the median number of orientations used in practice was four.

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Types of Eclectic Therapy

A number of specific types of eclectic therapy have also emerged. In each case, these
approaches draw from a range of techniques in order to address the unique needs of the
individual. Some of these types include:

1. Brief eclectic therapy: As the name suggests, this is a short-term form of eclectic
therapy that often incorporates aspects of psychodynamic and cognitive behavioral
treatments that are applied over a limited number of sessions, often to address a
specific problem. This approach has been used to treat PTSD by helping people make
meaning out of their traumatic experience and develop new coping strategies.
2. Cognitive-interpersonal therapy: This approach utilizes aspects of cognitive
behavioral therapy to help people understand how their thoughts influence their
relationships.
3. Multi-modal therapy: This type draws on elements of social-cognitive learning
theory and integrates a number of techniques from other therapies. An individual's
specific needs are assessed by looking at their behavior, affect, senses, visualizations,
cognition, relationships, and physical health. 
4. Trans-theoretical therapy: This approach focuses on understanding the stages and
process of making a change. Using this knowledge, people are then able to work on
achieving their goals, improving their relationships, and creating positive changes in
their lives.

Techniques used in Eclectic Therapy

While eclectic therapy is flexible, therapists carefully create an intentional, individual plan
for each client based on that person's unique needs. Theoretical approaches that an eclectic
therapist might draw on include: Behavioral therapy, Cognitive behavioral therapy
(CBT), Dialectical behavioral therapy (DBT), Person-centered therapy, Psychodynamic
therapy

What Eclectic Therapy Can Help With

Eclectic therapy can be utilized to help people with a wide range of needs. Some conditions
and problems it can successfully treat include: Anxiety, Bipolar disorder, Coping and
adjustment difficulties, Depression, Eating disorders, Personality disorders, Post-traumatic
stress disorder (PTSD), Relationship problems, Selective mutism, Social issues, Stress.

Benefits of Eclectic Therapy

Eclectic therapy can have a number of important benefits. These include:

1. Individualized approach: Because this approach to therapy is so adaptable, a


counsellor can design a treatment plan that is suited to client’s specific, unique needs.
2. Engagement: The use of multiple techniques may help clients feel more interested
and engaged in the therapy process. 
3. Flexible: Because a counsellor can assess a client’s needs and select the approaches
and techniques s/he think will help client the most, it is possible to switch between

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techniques to address one or more needs. For example, client treatment might involve
treating a phobia but also address problems with chronic stress.

Criticisms of Eclectic therapy

While eclectic therapy can be effective, there are some potential downsides to consider. Some
issues a counsellor and client might encounter during eclectic therapy include:

 Lack of structure: If a client tends to prefer a more structured, easy-to-follow


approach, s/he might find eclectic therapy more difficult. In such cases, a client
should talk to the counsellor about devising a more predictable structure.
 Trial-and-error: It may also seem at times that a counsellor is following a trial-and-
error approach. Trying to find the best approach to use in helping a client it can be
frustrating and time-consuming.
 Not ideal for some conditions: For certain conditions that tend to respond best to a
specific type of therapy it is often a better idea to primarily stick to that specific
treatment modality.
 Therapist training: Some counsellors adhere largely to a single orientation, such as
psychodynamic or cognitive behavioral theory, but may actually use a variety of
techniques rooted in other theories as needed. Others self-identify as eclectic in their
treatment orientation. Either way, it is important that the counsellor possesses a solid
understanding of each theory for the techniques they use.

NB. Any type of counsellor can successfully practice eclectic therapy. The counsellor should
be familiar with the evidence-based techniques used in different types of therapy that have
been proven to help clients with specific problems. Scientific evidence, as well as knowledge
and training on the part of the counsellor, should always be the basis behind the decision to
use any type of therapeutic technique. An eclectic approach can be used in both individual
and group counselling settings.

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