Major Counseling Theories Comparison Paper
Name
Major Counseling Theories Comparison Paper
Grand Canyon University-PCN 500
Date
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Major Counseling Theories Comparison Paper
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Major Counseling Theories Comparison Paper
Despite the spectrum of psychological theorems of varying and sometimes conflicting
constructs, philosophies, goals, techniques, assessments, therapeutic conditions and efficacies,
the ingredients which lead to successful treatment are the same – An environment that’s safe and
conducive to healing, accompanied by a therapist who is trustworthy, respectful, competent,
knowledgeable and kind.
The ultimate goal of psychotherapy (regardless of its theory) is to help the client get
better, live a more fulfilled life and reduce the current symptoms he or she may be experiencing.
In this paper, I will be comparing cognitive behavior therapy , solution focused therapy,
and psychoanalysis to my theory of choice – Reality Theory. What are the similarities and
differences between each theory? What are their standard interventions and techniques? Are they
a viable candidate for theoretical and therapeutic companionship of Reality Therapy?
Counseling Theories: Founding Members, Interventions & Comparisons
According to the APA, the definition of counseling is, “Helping a client overcome
obstacles to their personal growth, wherever these may be encountered, and toward achieving
optimum development of their personal resources,” (APA, 1956).
I chose Reality Theory as my principle theory because it resonates most with my personal
and professional philosophy. Reality Theory is a philosophy, a way of thinking, a gateway to
helping clients manifest contentment in their lives, and cultivate healthier interpersonal
relationships, which is aligned with my motivation for becoming a therapist.
Reality Theory
Founding Members
Reality Theory also known as Choice Theory was conceptualized out of the
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dissatisfaction William Glasser had with psychoanalytic theory. It is important to acknowledge
Robert Wuhbolding, who was another pioneer of RT.
According to Murdock (2013), Reality Theory is a “school of thought,” which believes
the primary goal of humans is to be happy by way of cultivating healthy, intimate interpersonal
relationships (pg. 352).
Interventions and Goals
Lujan (2015) points out that Glasser believed humans possess free will and are in control
of their behavior and actions. Glasser conceptualized that all of our behavior is purposeful –
leading to the fulfillment of our five basic needs: survival, love and belonging, power, freedom,
and fun (Lujan, 2015). We create a “quality world,” a picture of our ideal, perfect world and our
behavior is an attempt to reach our mental image of our utopia. Glasser stated that this is the
cause of our irrational and dangerous behavior. Our behaviors are attempts to get what we want
and make our imagined quality world, a reality.
Reality Therapy (choice therapy) uses directive and active interventions to help clients
retrain their thinking and acting, which changes their emotional and physiological state. This is
accomplished through the process of WDEP (discovering what the client wants, evaluating his
behavior, making a plan and executing it).
According to a practitioners involved in longitudinal study of Reality Therapy led by,
Watson, Dealy, Todorova & Tekwani (2014), “RT is one of those therapies you can practice so
effectively that it does not appear as therapy in its application.”
The ultimate goal of Reality Therapy is to help clients change and adapt their thought
patterns and actions to produce a balanced emotional and physiological state, as well as help
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them create intimate, interpersonal relationships with their environments (Murdock, 2013, pg.
352).
RT therapist utilizes directive questioning to evaluate the client’s quality world, total
behaviors and quality of his or her current relationships:
1. Is what you are doing now, helping you?
2. Is what you are doing now, helping or hurting others?
3. Will your current actions fulfill your wants and needs?
4. Are your wants realistic for your present life?
5. If your current wants are fulfilled, will they contribute to or detract from your
need fulfillment? (Murdock, 2013, pg. 354)
RT therapists reject the use of external control during treatment instead, allowing the
client to experience natural consequences for his or her actions.
According to Lujan (2015), the RT therapist is most effective when he or she uses the
ACT method: Accept the client as he or she is, adopting his or her quality world in an empathic
attempt to understand his or her perspective. Care for the client in a straightforward, supportive,
empathetic way. Transact – once the therapist has accepted and cared for the client, he or she can
begin the WDEP process and commence treatment.
Cognitive Behavior Theory (CBT)
Founding Members
Cognitive Behavioral Therapy (CBT) is based on several scientific models of human
behavior, emotion and cognition. CBT began in the late fifties as an alternative to psychotherapy.
John Watson was a pioneer of the CBT movement with the intention of erasing “mentalism”
from psychology’s practice. Others influential under the umbrella of Cognitive Behavioral
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Therapy are Pavlov, Thorndike, B.F. Skinner, Bandura, and Eysenck (Murdock, 2013, pg. 237).
A decade later, CBT was adapted by, Aaron Beck creating, Cognitive Therapy (CT) in the
1960’s, followed by Albert Ellis who created REBT.
Interventions and Goals
Aaron Beck is the founder of CT (an extension of CBT). Beck maintained that emotional
disturbances are understood through thought patterns, and behaviors are only modified through a
shift in our thought processes. CT uses open-ended questioning, cognitive techniques, bibliotherapy and self help strategies to treat the client (Leichsenring, Hiller, Weisseberg, Leibing,
2006).
The philosophy behind the umbrella theory of CBT is that behavior is strengthened or
weakened by our behavior. When we are rewarded, our behavior increases, and when we are
punished it decreases. CBT is driven by empirical data and supported by the theory -- human
nature is determined by one’s surrounding environments. CBT/CT are objectivist theories (one
reality exists separate from the individual).
Beck used specific tools to evaluate thoughts and funnel them into a conscious structured
format. The cognitive model states, “the way we think affects the way we feel.” (Murdock, 2013,
pg. 319). CT focuses on dysfunction over healthy functioning. CT’s focuses more on the ability
to process information and construct problem solving strategies than it does on creating a plan of
action. The questioning intervention of CT is similar to that of RT in that it probes the client to
consider what would happen in the absence of the thought process.
The interventions of CBT rely on the use of relaxation training, exposure therapy,
systematic desensitization, aversive techniques (when necessary), extinction, assertiveness
training and stimulus control (Murdock, 2013, pg, 260-262).
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CBT is beneficial for treating a wide range of client issues—anxiety, depression, phobias,
eating disorders, chronic pain, insomnia and have helped reduce delusions and hallucinations.
Similarities and Differences
Both CBT and RT concur that “the symptom is the problem,” and that psychological
dysfunction stems from maladaptive behavior (Murdock, 2013, pg. 248). They maintain it is
unnecessary to know the origin of the problem to solve it. The main responsibility of a CBT
therapist is to identify the sources of reinforcement that feed the current behavioral patterns,
which is similar to that of RT. Another similarity is the therapeutic atmosphere, which is warm
and empathic. A close, collaborative relationship between the therapist and client is cultivated. In
CBT, the goal is to reduce or eliminate maladaptive behaviors and teach adaptive responses,
whereas the goal of RT is optimistically based in assisting the client cultivate behaviors, which
fulfill his or her needs instead of focusing on what is not working, and eradicating behavior. Both
therapies are focused on the present, however RT projects to the future during goal orientation.
RT is a social constructivist theory, whereas CBT takes an objectivist approach to human nature.
Both CBT and RT were birthed from an opposition to psychoanalytic theory. Both
theories agree that we act and behave the ways we do in order to fulfill our needs. CT (an
extension of CBT) evaluates our basic needs as: preservation, reproduction, dominance and
sociability, while RT theorists state the five basic needs as: survival, love and belonging, power,
freedom, and fun.
Both theories treat the “here and now,” and offer short term, directive approaches. The
greatest difference between classical CBT and RT is that CBT theorists do not emphasis a
client’s thought process or emotional range --- CBT is solely concerned with the client’s
behavior. In RT therapy, therapists put as much emphasis on thinking as they do acting -- we
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cannot separate our minds from our bodies, they are interconnected—the way we act or think
drives and steers our emotionality and physiological responses.
RT states that all behavior is internally motivated, whereas CBT stresses that our
behavior is motivated by external forces and our internal motivations are products of those
external influences.
RT theory is founded on the belief that no one can control how we behave and we can’t
control how anyone else behaves. CBT maintains we are products of our environments, directly
influenced by them, however we have the ability to change our interaction, experiences and
meanings of our experiences through correcting our maladaptive behaviors, in turn shifting our
mental perceptions of our experiences.
Solution Focused Theory
Founding Members
Solution Focused Brief Therapy was created from two different therapeutic approaches:
communications/systems theory and the work of Milton Erickson. SFBT was conceptualized by,
Steve de Shazer and Insoo Kim Berg. Bill O’ Hanlon expanded on SFBT, creating Possibility
Therapy.
Standard Interventions and Goals
De Shazer deduced that most psychological dysfunction stems from interactional patterns
between people (Murdock, 2013, pg. 460). SFBT is a social constructivist theory, which
maintains that humans manifest their realities and have the ability to shift their realities in
response to their experiences. SFBT is an optimistic theory, stating that people have the strength
and resources to change their lives for the better.
SFBT dictates that change is constant therefore the focus of treatment should be the
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present and future status of the client. SFBT therapists are not concerned with the past, the
pathology or even the problem; they are only interested in the solution.
The SFBT therapist interviews the client by way of investigative questioning to
determine the exceptions to the problem, in order to create a goal-oriented program with the
client. SFBT is a short term, directive therapy that has noted success in one to five sessions
(success being determined by a satisfactory improvement reported by the client) (Murdock,
2013, pg. 483).
SFBT effectiveness is based on the principle that only small changes are necessary to
change the system as a whole (Stalker, Levene, Coady, 1999). De Shazer said, “Every client
carries the key to the solution. The therapist needs to know where to look,” (1985, pg. 90). By
determining the positive and negative motivations of the client, the therapist is able to pinpoint
the exceptions in his or her present life. In the exception lies the “resources that will support the
solution,”(Crockett & Prosek, 2013).
The simplicity of the SFBT process is found in its interventional foundation -- “Keeping
it simple.” Through investigative questioning, the therapist can determine what works for the
client and what does not. The therapist is able to guide the dialogue between himself and the
client by restructuring the resistance of a client into possibilities and remedies to the problems.
(Campbell, Elder, Gallagher, Simon, Taylor, 1999).
The goal of SFBT therapy is to eradicate the client’s problems by uncovering the
solutions through extracting the client’s strengths, positive behaviors and resources he or she
already possesses. The therapist will ask clear and optimistic questions:
What does the client want to accomplish?
What does the client do that does not evoke the problem feelings and behaviors?
Major Counseling Theories Comparison Paper
What are his or her goals (observable)?
What will be the first sign of change? (Murdock, 2013, pg. 473)
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The intervention process of therapy is immediate, occurring at the commencement of therapy:
What is it like when you aren’t experiencing the problem?
What is different about the times when the problem is not present?
How did you influence that happening?
In the first session the therapist creates a “solvable complaint to solve the problem,”
(Murdock, 2013, pg. 475).
By the end of the first session, the therapist will propose the miracle question, “Suppose
one night there was a miracle and when you woke up, the problem was solved. How would you
know it? What would be different?”
Another key tactic of intervention is asking the client to rate where he or she is on the
scale from 0 (being the beginning of therapy) and 10 (being the miracle has happened) --Where
does he or she feel he or she lies on the scale? This is an effective way to gauge progress.
Similarities and Differences
SFBT and RT therapies are both based on social constructivist theories. They both
facilitate treatment using in depth directive questioning to elicit the goals and solutions of the
client. SFBT is focused on solutions to the problems at hand, whereas RT therapy is interested in
helping the client change his or her behavioral and thought patterns to fulfill his or her basic
needs in turn establishing healthier interpersonal relationships.
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In SFBT, the counselor is responsible for the sessions, which is similar to RT. He or she
is hired to serve the client, as the therapist is the expert in solutions. He focuses on strengths,
rather than weaknesses of the client. He is nonjudgmental and builds intimacy with his client by
adopting his or her language (Murdock, 2013, pg. 471), which is similar to the interactions
between an RT therapist and his or her client. The counselor is seen as the expert, knowing how
to facilitate change, but the client is the expert about himself and the situation/problem, which is
also the same as the RT roles of counselor and client.
The counselor guides the client through a maze of questions to determine the problem
(complaint), find the exceptions, and support the client in his or her goals toward a solution. The
therapists of SFBT are seen as “serious optimists,” (Murdock, 2013, pg. 460), as are therapists
of Reality Therapy.
A main difference between RT and SFBT is: SFBT work in teams to accomplish their
goals. Their strategies vary from that of RT therapists. SFBT therapists leave the room, consult
and return with homework. RT therapists offer one on one therapy in which they remain engaged
with their client throughout the sessions and do not utilize the support of other therapists to help
manage their intervention strategies. RT requires the client to engage in homework outside of the
therapeutic environment and does not expect “a miracle” within the first session of therapy.
SFBT therapists are hopeful that their clients will report a satisfactory change within 1 to 5
sessions. Although RT therapy is short term, it allows for growth between sessions before
determining successful termination.
Psychoanalysis
Founding Members
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Psychoanalysis is the creation of Sigmund Freud (1856-1939), who developed “talk”
therapy as a treatment for psychological dysfunction (Murdock, 2013, pg. 29). Freud believed
that the forces we are unaware of (our unconscious) is the most “powerful” source of our
external behavior.
Interventions and Goals
According to the ABECSW (2004), psychoanalysis is conducted with intense frequency
and focus, to unearth the mental constructs that are disturbing an individual’s wellbeing, while
helping them become aware of the unconscious force which influences their behavior. The
therapist will guide the client into understanding their symptomatic originations, while teaching
them how to establish healthy, strong coping mechanisms.
The counselor’s role in psychoanalysis is to observe the client in an objective way.
According to Rubin (2009), it is the therapist’s role to adhere to “evenly hovering/ evenly
suspended attention” during the analysis. The therapist is required to remain “alert, receptive
and attentive,” to what the client is saying, while being aware of his or her own reactions to the
client (being aware of countertransference). The therapist engages the client in free association,
analyzing the underlying psychic conflict the client may be unaware of. Through interpretation,
the therapist is able to help the client resolve his or her unconscious issues. The therapist uses the
presence of resistance and transference to help delve deeper into the client’s psychological
disturbances. According to Taubner, Kessler, Buchheim, Kächele, & Staun (2011), long term
treatments such as psychoanalysis has lasting effects on the client, even after the therapy ends.
Similarities and Differences
Psychoanalysis and RT are more different than they are alike, however there are a couple
commonalities. Both therapies are offered as individual therapies. Both therapies are reliant on
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the insight and observations of the therapist and the willingness of the client to be open and
honest with the therapist regarding his or her experiences. The observations of both therapists are
used to determine the route of and focus of therapy. They both rely on “talk therapy” to promote
change.
The main differences of Psychoanalysis and RT are the foundational beliefs and
structures of their theories. Psychoanalysis holds the belief that there is an objective reality,
while RT maintains that each person creates his or her own reality (a social constructivist view).
Psychoanalysis has a pessimistic standpoint, while RT is optimistic and hopeful, focused on the
present and future. Psychoanalysis views early experiences as foundational to a client’s present
circumstance. RT utilizes questioning as intervention while psychoanalysis uses dream analysis,
formal assessment and free association to treat clients. Psychoanalysis is a long-term treatment,
while RT is directive and short. The greatest difference is in conflicting theories of human
motivation. Psychoanalytic theory states that humans are motivated by their instinctual sex
drives, whereas RT theorizes that humans are driven by their desire to fulfill five universal basic
needs in their current life.
References
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Crockett, S. A., & Prosek, E. A. (2013). Promoting cognitive, emotional, and spiritual client
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