Taking a Closer Look at Counseling

What is counseling? Counseling is both a process and a journey. It’s a working relationship between two (sometimes more) people who work to make differences happen, and it develops in unpredictable ways.

In my experience, when clients begin counseling, some have a very clear idea of what they want to work on and how they want to go about it, while others only have a vague sense of where they would like to begin. There are different types of counseling, and I’d encourage anyone considering it to gather information so that they have a better understanding about counseling/psychotherapy. Numerous resource sites exist online. However, it’s worth exercising caution. Sometimes when the media mentions schools of counseling such as CBT, EMDR, DBT they tend to oversimplify the research on the effectiveness of these methods. Realistically, researchers are still struggling to provide definite answers as to which methods of counseling are most effective for specific types of problems. But these debates mostly occur between scientists, scholars and rarely show up outside of academic circles and journals.

Cognitive Behavioral Therapy

One of the more popular approaches currently used in counseling is Cognitive-behavioral Therapy (CBT). It also has the unique position of being the most studied and well-researched school of psychotherapy. From its humble roots on the fringes of the psychoanalysis-dominated mental health field in the 1960s and 1970s, CBT grew into the standard-bearer of modern evidence based mental health treatments. Psychology journals and conferences are filled with research documenting the effectiveness of CBT for the treatment of a wide range of issues. Additionally, the self-help sections of bookstores are filled with CBT-based books, which include such titles as “change your Thinking: Overcome Stress, anxiety and depression” and “mind over mood: Change how you Feel by changing the Way you Think”. To the layperson, it might seem that CBT is now synonymous with good psychotherapy and that any psychotherapist worth their salt these days is practicing CBT. Despite the success rate of CBT, however, this story isn’t as simple as it first seems. While CBT is certainly helpful to many people, there isn’t just one simple answer to the question, “What type of therapy would be most helpful to me?” People and their lives are incredibly complex.

Effective, Time-limited Treatment

Psychotherapy is a subtle process which supports the fact that people rarely make changes in a straightforward, linear way. There are several good reasons why CBT is so popular. For one, it explains emotional imbalances as being caused by irrational thinking patterns rather than by unconscious energy or family dynamics. Secondly, it offers the possibility of feeling better and being more functional without spending excess time, money and energy, which are generally required when utilizing more in-depth or soul-searching methods. CBT fits smoothly with the demands of managed care for psychotherapy practitioners who want to provide effective, time-limited treatments. It also works well with the push for “evidence-based treatment” being promoted by governments and private health insurers eager to limit medical and mental health care reimbursements and their demands for scientific evidence of the effectiveness of treatments for the disorders they claim to “cure.” The motivation behind this push is understandable. It’s not reasonable to expect health insurers to reimburse for interventions that are not beneficial, and it would be dishonest and unethical for clinicians to use therapies that are not likely to be helpful for their clients.

Defining Effective Counseling

Problems arise, however, when researchers try to determine how effective counseling is. How does one try to define what “effective” means? For example, is reducing symptoms a decrease in anxiety? Does it improve life-satisfaction and self-understanding? Most people who work with counselors have a variety of expectations for the counseling process, so it is very hard to find a definition of effectiveness that researchers can agree on. For this and other reasons, the pendulum is slowly but surely shifting away from the idea that CBT is the only effective therapy for certain conditions, or that it’s generally superior to any other type of therapy. Psychologists are increasingly in agreement that the specific type of counseling is not nearly as important as its quality. Nowadays, the majority of practitioners no longer adhere to a single method. Instead, counselors tend to use an eclectic or integrative approach. For the eclectic approach counselors use specific strategies that apply to the given situation and will be helpful. Counselors using the theoretical integration approach believe that having a firm grasp on the rationale behind the techniques to be used is necessary. Dr. Jeff Brooks-Harris’ Multi-theoretical Psychotherapy Model is a very interesting example of how this integrated approach is utilized. He suggests that in order for counselors to be helpful to the needs of their clients, they need to consider both the targeted area of change, and which counseling approach will be most appropriate for that area of need.

Our lives are a series of complicated complex events and issues. No matter where a person may fall on the Multitheoretical Psychotherapy Model’s spectrum, the counseling process and a counselor can provide healthy options for choice and change. If you have any questions or concerns about the counseling process, the counselors at the Community Services Center will be happy to listen and discuss them with you.

 Michael Mullahy resides in Taipei and has recently completed a Master’s degree in Counseling. He enjoys hiking, running and traveling in his free time.