Sunday, February 19, 2012



Ideally, the strategy counselors use to treat clients are based on specific theoretical orientations they chose that are most appropriate for the presenting problems of clients. Five theoretical orientations commonly used are cognitive, behavioral, psychodynamic, existential, and family systems. Each of these theories purports different strategies as the best method for treating clients.

Cognitive Strategies

Cognitive therapy is used to treat common presenting issues such as substance abuse, anxiety, and depression. One of the cognitive strategies currently used is A-B-C-D analysis that is closely associated with rational-emotive therapy. In A-B-C-D strategy, A represents the activating event, B represents the clients’ belief system, C presents the consequence produced by the interaction between A and B, and D represents the disputation of such irrational beliefs and thoughts. The goals of the A-B-C-D modality, as in many of the strategies used in cognitive therapy, are designed to help “the client modify existing thought patterns, or remind the client to avoid undesirable thought, or even help the client assess events more constructively”. The main goal, therefore, is to change thoughts so that a positive change in feelings and behaviors of clients can follow, thereby alleviating clients’ distress.

Behavioral Strategies

Behavioral therapy is another commonly used approach in helping clients resolve issues. The general goal of behavioral therapy is to “help clients develop adaptive and supportive behaviors to a variety of settings”. Phobias are usually treated with behavioral therapy.

One of the most important strategies of behavioral therapy is goal-setting which allows clients to translate their concerns into specific therapeutic tasks. Goal setting also encourages the client to take small, successive steps toward resolving their issues. Therapeutic goals must be concrete, observable, and measurable and developed by both client and counselor to be specific and realistic.

In most cases, client-involvement in designing their goals is paramount, thus increasing the likelihood of their motivation and commitment in goal completion. For example, behavioral contracts are commonly used to help clients feel more committed to completing a task because contracts require clients to decide which behaviors they want and are able to attain.

Psychodynamic Strategies

Psychodynamic therapy places emphasis on clients’ unconscious processes. Therapists using a psychodynamic approach attempt “to deal with underlying characterological changes”. Therapists usually play an authoritative role and encourage clients’ transference to identify and resolve clients’ issues. In contrast, however, the free association psychodynamic modality often used requires therapists to become more like teachers/consultants rather than parental figures. Free association allows clients to freely report whatever enters their mind without bias or criticism from therapists thereby aiding unhampered reporting of clients’ unconscious mind.

Existential Strategies

Existential therapy allows clients to explore the meaning of life and their human existence. The existential approach is useful in helping clients examine issues of personal meaning in their lives and realize their ability for empowerment. Techniques of existentialism are extremely flexible.

Four steps essential in using an existentialist approach are: (1) being in the moment, (2) integrating the felt experience into primary relationships, (3) making connections to the past, and (4) integrating what was learned.

By including these steps, both therapists and clients are better facilitated in exploring the world of clients, thereby identifying presenting issues and possible solutions.

Family Systems

A systemic view “sees the family as the primary unit and holds that all the members of the family are important contributors to clients’ psychological functioning and development”. The family systems approach allows clients to separate the person from the problem, reduces guilt, and helps clients in joining with other family members to defeat the problem. Therapists using a family systems approach often use narrative therapy to help teach clients to externalize rather than internalize their problems.

 (I wrote this post for students and practitioners of psychology/therapy; however, I believe it contains much interesting information for the layperson, especially those interested in psychology and/or philosophy.)


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