In an early attempt to define counseling, the Society of Counseling Psychology, which is Division 17 of the American Psychological Association, described counseling as a process of “helping individuals toward overcoming obstacles to personal growth, wherever these may be encountered, and toward achieving optimum development of personal resources” (Committee on Definition, Division of Counseling Psychology, (1956), p. 283). A more recent definition, offered by the American Counseling Association (ACA), is more specific: “...a process in which clients learn how to make decisions and formulate new ways of behaving, feeling, and thinking...[and] involves both choice and change, evolving through distinct stages such as exploration, goal setting, and action” (American Counseling Association, 2007). The ACA further elaborates that counseling is “the application of mental health, psychological, or human development principles, through cognitive, affective, behavioral or systemic intervention strategies, that address wellness, personal growth, or career development, as well as pathology” (ACA, 2008).
According to the American Counseling Association, the profession of counseling grew out of the guidance movement. Guidance involves helping a person make a choice that is in line with his or her values, whereas counseling involves helping a person learn to make changes and learn new ways of thinking, behaving, or feeling. Guidance is also provided by someone in a position of power or authority; in contrast, many models of counseling endorse an attitude of equality between counselor and client (ACA, 2007).
Professionals disagree on the use of the closely related terms counseling and psychotherapy. Counseling, by tradition, deals with individuals who are functioning within the “normal” range, whereas psychotherapy is thought to address more severe psychopathology. Another distinction drawn between psychotherapy and counseling is in length of treatment. For example, psychotherapy typically lasts between six months and two years, whereas counseling is generally more short term, typically consisting of 8 to 12 sessions over the course of less than six months. Additionally, psychotherapy is provided in both inpatient and outpatient settings, whereas counseling is generally restricted to outpatient settings such as schools or community mental health centers and focuses on vocational, empowerment, educational, personal, or social issues (ACA, 2007).
Traditional definitions of counseling and psychotherapy thus point to differences between the two forms of helping. However, other opinions exist. For example, major models of intervention that are generally considered to be psychotherapy (e.g., cognitive behavioral therapy) are short-term in nature. Further, those who provide counseling often encounter clients who express high levels of distress. Most textbooks on theories of intervention are titled “theories of counseling and psychotherapy” suggesting blurred boundaries between the two activities. These kinds of observations lead some professionals to discount the distinctions traditionally drawn between these terms (Murdock, 2009).
Over the years, many general outlines of the process of counseling have been formulated. One current model that is widely accepted is that of Hill (2004), who proposes three stages of counseling: exploration, insight, and action. In the exploration stage of counseling, counselors focus on developing a therapeutic relationship with the client and learning about their clients by facilitating an examination of the client’s thoughts, emotions, and behavior (Hill, 2004). Additionally, counselors help clients to set goals for counseling, clarify the presenting concern, and formulate treatment plans (Nugent & Jones, 2005). Carl Rogers’ Person Centered Therapy informs, to a large degree, the role of the counselor in the exploration stage of counseling (Hill, 2004; Rogers, 1957).
The second stage of counseling is the insight stage. This stage is focused on helping clients gain an understanding and make connections between their thoughts, feelings, and actions. The role of the counselor is a collaborative one, in which he or she works with clients to discover “...inner dynamics and attain new awareness of [clients’] role in perpetuating their own problems” (Hill, 2004, p. 30). This is an important stage in counseling, because insight and understanding are considered fundamental to client change. The counselor works with the client to reframe experiences and make meaning and sometimes challenges the client to see things in a new way. Additionally, the counselor may provide clients feedback about their behaviors in sessions and how the counselor perceives these behaviors. Because to some degree the counseling relationship parallels the types of relationships clients have outside of counseling, clients’ understanding how their behaviors are perceived by the counselor may allow them to be better able to understand the reactions other people have to them (Hill, 2004).
In the action stage, counselor and client decide what action to take based on the exploration and insight stages of counseling (Hill, 2004; Nugent & Jones, 2005). The role of the counselor in this stage is in “...guid[ing] clients toward making decisions and changes that reflect their new understanding of themselves” and together with the client “...determin[ing] whether clients want to change and explor[ing] the meaning of change in clients’ lives” (Hill, 2004, p. 32).
Rogers (1957) identified the essential elements of counseling, and most within the profession today would acknowledge these same elements, even if slightly different terminology is used. These elements are (1) the therapeutic relationship (also called the working alliance), (2) empathic understanding, (3) unconditional positive regard, and (4) counselor congruence. The therapeutic relationship refers to the “...part of the relationship focused on the therapeutic work” (Hill, 2004, p. 44). Counselors deliberately build the therapeutic relationship and encourage the client to explore thoughts and feelings by attending nonverbally, listening carefully to what clients say, reflecting feelings, and asking open-ended questions (Hill, 2004). Nugent and Jones (2005) describe the relationship as one that allows the client to feel empowered to solve his or her problem as a result of building “...trusting, dynamic, interactive relationship...” with the counselor (p. 207). According to Gelso and Fretz (2001), the outcomes of counseling are directly related to the strength of the working alliance in the first few sessions: early positive alliances produce good results. Wampold (2001) also speaks to the importance of the alliance between counselor and client and includes aspects such as the motivation and ability of the client to work collaboratively with the therapist, client and therapist agreement about the goals of counseling, the client’s emotional relationship with the counselor, and the therapist’s “...empathic responding to and involvement with the client” (p. 149–150).
Good therapeutic relationships also involve congruence, which refers to the ability of both the counselor and client to be authentic, open, and honest in sessions, allowing counselor and client to perceive one another in a realistic way (Gelso & Fretz, 2001). Congruence on the part of the therapist is considered particularly critical, so it is often highlighted as a specific element required for successful counseling, following Rogers’ early formulations (Gelso & Fretz, 2001). In fact, Rogers further defined congruence as the ability of counselors to fully experience and convey their thoughts and feelings in the counseling relationship (Rogers, 1957). More generally, counselors are urged to attend to their own mental health and personal growth, and often those who educate counselors recommend that students engage in personal counseling while in training.
Empathic understanding occurs when the counselor experiences the client’s world as if it was his or her own and expresses this to the client, but without passing judgment. Conveying this understanding to clients builds the therapeutic relationship and helps clients develop insight into their thoughts, behavior, and experiences (Rogers, 1957).
Rogers (1957) described unconditional positive regard as “...a warm acceptance of each aspect of the client’s experience as being part of that client...there are no conditions of acceptance...” (p. 249). Gelso and Fretz (2001) point out that unconditional positive regard refers to a counselor’s “...basic attitude toward the client [that] does not fluctuate according to the client’s emotions or behavior” (p. 251).
Counseling can be conducted with individuals, couples, families, or groups. Many models or theories of counseling have been offered throughout the years, and the general consensus among professionals is that the major approaches to counseling generally produce positive outcomes (Lambert & Ogles, 2004; Wampold, 2001). All of these theories emphasize the importance of the therapeutic relationship, and most would acknowledge the significant effects of unconditional positive regard, empathy, and congruence. The stated goals offered by different theories of counseling span a wide range of objectives, from simply achieving goals identified by the client, to decreasing or eliminating distressing thoughts, emotions, and behaviors and fostering personal growth, authenticity, and improved personal relationships.
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