Kenya Association of Professional Counsellors

Higher Diploma in Counselling Studies

Title

Compare and contrast the three major theories of counselling:

Psychodynamic, Cognitive Behavioural and Person-Centred with

reference to relevant literature (3000 words).

Facilitators: Beatrice Otieno

Briggid Muisyo

Student: Albert Muraya

Date: 16th June, 2011

Words: 3097

Final Copy

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Table of Contents

Table of Contents...............................................................................................................2

Introduction........................................................................................................................3

Key Figures.........................................................................................................................4

Basic Assumptions and Key Concepts.............................................................................7

Therapy – goals, clinical relationship and techniques..................................................10

Conclusion........................................................................................................................14

Appendix A – References................................................................................................16

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Introduction

This essay will present and contrast the workings of the three major theories of

counselling psychology mainly – psychodynamic, cognitive behavioural and person-

centred. First I will describe what psychology is and what counselling entails, then I will

explain why there are different schools of thought around counselling psychology, before

introducing each in turn. My discussion will examine the three theories or approaches for

a history of the founder and a rationale for why they were led to introducing a new

therapy approach and a sketch of the key concepts. Further, I will look at methods and

processes employed by each theory, the respective roles played by the therapist and the

client and the various situations to which the theory can be applied. Finally I will

examine the limitations of the theory and how well it integrates with other approaches.

Throughout this paper I will offer my own view of the issues at hand and in so doing

attempt a synthesis of the three theories.

Counselling is a therapeutic and growth relationship process concerned with

helping individuals make adjustments to themselves, significant others and the

environment in which they live (Hansen et al, 1986). Through the process they are

assisted to define goals, make decisions and solve problems related to personal, social,

and vocational concerns. The British Association of Counsellors and Psychotherapists

(1986) states that the purpose of counselling is have an individual live more fully and

satisfyingly. Counselling involves talking with a person in a way that helps that person

solve a problem or helps to create conditions that will cause the person to understand

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and/or improve his behaviour, character, values or life circumstances (Douglas Woods,

2011). This assistance is supplied in the context of a relationship which is structured,

disciplined and deliberate, though it may take place informally.

Counselling theories have evolved out of a continuing need to explain and

understand human behaviour and development. The different theories have alternative

views of human nature and the development of the person stemming often from the early

experiences of their founders or developers as well as the socio-cultural context in which

they grew.

Key Figures

The most logical way to examine counselling theories is to first look at the

various individuals who founded or contributed in the main, to them. The Psychodynamic

Theory was first postulated by Sigmund Freud (1856-1939) as “Psychoanalysis”. In

essence he learned, in overcoming his own emotional pain, the dynamics of personality

development (Corey, 2000). He developed an interest in hypnosis which was an early

precursor of psychotherapy. Born to a Viennese family, he graduated from medical

school and became a psychiatrist. His early interest in the workings of the human

personality was piqued by patients with physiological symptoms that had no organic

cause and who had no conscious knowledge of the origin of their problems. He

concluded the cause lay in their unconscious minds and sought to know more about this

(Hough, 2000). This led him to develop techniques to delve into the subconscious which

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have wide application today. He is the seminal figure in the field of psychology and

psychotherapy.

Freud did not tolerate divergent views from himself and this led his

contemporaries and students establishing their own theoretical approaches. These

included Alfred Adler (1870-1937) who introduced what he call “Individual Psychology”

in 1911. His primary difference with Freud was on emphasis. Carl Jung, postulated

“Analytical Psychology” he sought a wider basis for development of the personality

than Freud. Other figures in the psychodynamic school include Melanie Klein (1882-

1960) who developed “Object Relations Theory” and Erik Erikson (1902-1994) who in

devising “ego psychology” developed his of view of development through the lifespan

the “Psychosocial Stages of Development”.

The Cognitive Behavioural Therapy (CBT) grew from academic psychology

whose emphasis was on measurement and testing for vocational as well as educational

purposes (Macleod, 2000, pg 31). The theory is really an amalgam of several individual

approaches and whose towering figure is Albert Ellis (1913-2007). After practicing as a

psychoanalyst for six years (Corey G, 2005), he concluded that it was superficial

unscientific and he embarked on a series of experiments on the efficacy of his therapy in

which he combined elements of humanistic and behavioural therapies. He called his

therapy approach “Rational-Emotive” and later “Rational Emotive Behaviour Therapy” -

REBT. He was motivated to develop his ideas in response to early challenges of fear of

public speaking and fear of rejection by girls; he was able to overcome these fears.

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Another central figure in the CBT group of therapies was Aaron Beck (1921). An

American psychiatrist trained in psychoanalysis, Beck formed what is now known as

Cognitive Therapy (CT) from a failed attempt at empirically validating Freud’s notion of

depression; that it was anger turned inward. He found distortions in the thinking of the

patients under review rather than retroflected anger (turned inward) in their dreams and

thoughts (Corsini, R. 1995). Beck overcame childhood illness and adversity and used his

experience in overcoming generalised fears and anxiety to develop a natural empathy for

others suffering from similar conditions (Corey, 2000).

Person-centred therapy is part of the Humanistic school of counselling. It was

founded by Carl Rogers (1902-1987), an American clinical psychologist who found that

he was influenced by experiences in his formative years to veer away from the directive

controlling stance of the psychoanalysis in which he had been trained to a more open

questioning attitude when working with his clients – initially children in an institution for

troubled youth he headed. He was also influenced by the scientific validation of

behaviourism to conduct his own experiments into the effectiveness of his methods, and

was one of the first psychotherapists to record his sessions. The method that he evolved

had the premise that the client had answers to their own problems and that he as therapist

had to follow the lead of the client. His ideas like those of Freud before him have been

adapted by other schools of counselling and are generally accepted as the basis for most

therapeutic relationships.

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Basic Assumptions and Key Concepts

The counselling theories in question all encompass therapeutic techniques as well

as a model of the human personality. Freud’s view of human nature was that the human

being was controlled by irrational forces and instinctual drives established in childhood

whereby people were products of their environment and innate unconscious forces. These

instincts serve as a means of survival for the individual where the goal of life is to

enhance pleasure and avoid pain. He viewed the human personality as comprising three

elements – the id, the primitive; the ego, refined by contact with the outside world; and

the super ego, representing authority figures. Freud believed that for psychological

health, all three had to be in balance (Hough, 2002). The ego’s role was to balance the

conflicting demands between the id and the superego that led to tension. In order to

protect the ego from this negative energy, defence mechanisms develop; these include

denial, repression, regression and others. He saw human development through stages

denominated by changing awareness and attitudes towards the human sexual organs.

Accordingly he devised the notion of libido which refers to the energy of all life instincts.

This energy then is the motivation that drives us to the central goal of life which is to

enhance pleasure and avoid pain. Later he came up with the death instinct that accounts

for human aggression. In his view, these unconscious drives determine how people act

(Corey, 2000).

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Psychodynamics was further developed by refinements to this basic view of

human nature Specifically Jung attributed other drives as being cultural and spiritual

through which one found meaning in life. He developed the notion of individuation in

which the conscious and the unconscious are harmonised into one whole. He went further

and introduced the idea that we inherit elements of our ancestors’ unconscious – the

collective unconscious or archetypes – which are interwoven with our very own. These

different levels of unconscious are given expression in dreams. Melanie Klein developed

Object-relations theory in which psychological development is dependent on the process

of separation and individuation (developing a distinct identity) from the primary care-

giver. It explains the first three years of a child’s life before giving way to orthodox

psychosexual theories (Hough, 2002). Erikson’s extended the notion of personality

development through the lifespan where both sexual and social development happen

concurrently in which there is a struggle for mastery and competence by the ego – thus

“Ego Psychology”; the epigenetic principle in human development through which social

considerations come into play in the development of the person.

Person-centred therapy is quite distinct from Psychodynamic therapy in that it

views human beings as essentially trust-worthy and who have a capacity for solving their

own problems, setting their own goals and working towards them with minimal

supervision and direction. Rogers saw them as capable of self-directed growth in the right

kind of enabling environment (Corey, 2005). The basis of his view is that all human

beings (organisms) have a tendency to self-actualisation – movement towards greater

complexity, interrelatedness and order – which leads to full potential and wholeness,

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what he termed as the “fully functioning person”. (Corsini and Wedding, 1995). This

means that people will be free of anxiety and grow in a constructive way when their

environments are supportive.

The third school of counselling psychology under consideration is the Cognitive-

behavioural which is comprised of more than twenty distinct therapy methods that are

grouped together as having a common approach to problem solving. These include

Rational Emotive Behavioural therapy postulated by Albert Ellis and Cognitive therapy

(CT) by Aaron Beck. They view human problems as stemming from disturbances in the

thought or cognitive processes in which people are disturbed not by events themselves,

but by their view of events. Emotions are derived from our beliefs, evaluations,

interpretations and reactions to life situations and events, and that changing these will

lead to a change in how we feel about things, and consequently how we behave or the

actions we take (Corey, 2005).

In summary then, cognitive-behavioural therapy is centred on the present and

views psychological difficulties as stemming from the cause and effect relationship

between thoughts, feelings and actions whereas, the psychodynamic view of human

emotional and relational difficulty is rooted in the past and specifically in childhood, and

that achieving present catharsis requires correcting imbalances rooted in the very depths

of out psyche – our subconscious. Cognitive-behavioural therapy deals entirely with what

is conscious and evident to the client. Person-centred therapy is also focused on the here

and now, though it departs from the other two in that it regards the human being as self-

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directed and capable of setting his own goals. Psychodynamic and cognitive-behavioural

therapy are both directive and the role of the client is more passive than in person-centred

therapy. Finally cognitive-behavioural therapy does not really offer a thesis on the

development of the human person, but rather accepts them as they are. Its view of human

nature is limited to the immediate problem at hand. Both psychodynamic and person-

centred therapy offer rich views of human nature – the former sees the human being in

developmental terms whilst the latter sees this more in growth terms.

Therapy – goals, clinical relationship and techniques

It is useful now to look at the process of therapy offered by all three schools of

counselling psychology for their contrasting features. Cognitive-behavioural therapy is

directive and persuasive and even confrontive, though it can also be reflective and

structured in its approach (Corsini & Wedding, 1995). It is didactic and the therapist

takes the role of a teacher pointing out distorted thinking, helping the client identify and

process emotions and practicing new skills by way of role-play.

In cognitive-behavioural therapy there is a heavy reliance on homework

assignments and it is very much a skills-based method. The aim of therapy is to

distinguish the person from their behaviour and focus on the behaviour so that the client

can acquire a more realistic and practical philosophy of life by minimising emotional

disturbances and self-defeating behaviour. They learn how to turn dysfunctional emotions

into healthy ones whilst achieving universal self-acceptance and universal other-

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acceptance and begin to see the relationship between their own wellbeing and others. The

counsellor provides insight into the client’s belief system and irrational or faulty thinking.

They help the client modify their cognitions to more useful and sustainable ones, and

teach coping skills for future self-management.

Cognitive-behavioural therapy is also solution-focused rather than problem-

focused implying that the duration of therapy is determined by the goals set at the

beginning. Once achieved, therapy is terminated, and therefore can easily be for just one

session.

In person-centred therapy, the client is very much in the driver’s seat; they set the

agenda, determine the goals of therapy and the therapist takes their cues from there.

Therapy aims at bringing to the immediate awareness of the client their inner experiences

similar to the psychodynamic which aims at bringing the unconscious to the conscious.

Rogers devised “core conditions” for successful therapeutic interaction that are supplied

by both the therapist and the client. The former are congruence or genuineness – the

counsellor being real; unconditional positive regard or acceptance of the client; empathy

or understanding – a profound interest in the clients world of meanings and feelings

(Hough, 2002). There were also client-side attributes that contribute to successful therapy

that were essentially feelings about self, namely; self-concept – perception of self which

improves therapy outcomes the more positive it is; locus of evaluation (or control) –

where the client get validation from, self or others; and experiencing - how open-minded

and willing the client is to new opportunities. The theory states that the more available

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the six conditions are, the greater the chances that the client will become positive and

realistic about self, become more expressive and self-directed, and become more free and

open to try new things. Clients grow in maturity and stability which allows them to

manage stress better. This is because the source of conflict and problems – the divergence

between experience and the self-concept narrows reducing anxiety and increasing the

ability of the person to adjust healthily to their environment (Corsini and Wedding,

1995).

In person-centred therapy, the client is helped to come to a greater acceptance of

those parts of self that they disapprove of, whilst helping them overcome any fear of the

therapist they may have. Their view of the world moves from a rigid stance to a more

open and fluid one that is flexible and malleable so that they become more accepting of

life’s terms, and more resilient to disappointment (Hough, 2002). As self-acceptance

grows, the client will shift to an internal locus of evaluation where they depend more on

inner feelings and they can trust their instincts better. It is an open-ended therapeutic

method in that just as with the agenda and goals, the duration is set by the client, and

generally tends to run for longer than in cognitive-behavioural.

The aims of psychodynamic therapy are to bring the unconscious into the

conscious and “to strengthen the ego over the id and superego so that behaviour is based

more on reality and less on instinctual cravings” (Corey, 2005). Reconstruction of

character is the ultimate aim; thus psychoanalysis tends to go on for years. The real

distinction from the other therapies is in the role of the counsellor and the therapeutic

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process. The belief is that if the counsellor makes himself as unobtrusive as possible, then

whatever feelings, notions, attitudes etc. that the client projects onto the therapist are the

reflections of withheld subconscious material that will be the subject of analysis. A major

task in psychodynamic therapy therefore is inferring meanings from what the client is

providing and using the data to reconstruct the personality. It is less collaborative than

either person-centred therapy or cognitive-behavioural, but there does need to be a

therapeutic alliance, and the client needs to understand the process somewhat. The

relationship between client and therapist is artificial as the counsellor needs to give as

little as themselves as possible.

The contrast between these therapies is clear – on the one extreme is person-

centred therapy where the therapeutic relationship is the core of the therapy and any

healing depends on the efficacy of this alliance. It is relationship as treatment. In

psychodynamic therapy the relationship is also key but for different reasons – the

therapist needs to disappear from the client’s radar for maximum effectiveness whereas

with cognitive-behavioural therapy the relationship is less critical. The process of

building the relationship and the significance of this process also differs; in person-

centred therapy – building insight and achieving catharsis can begin immediately,

whereas with psychodynamic rapport must be built first.

Attached to the therapeutic relationship is the question of transference – in

psychodynamic it is crucial, whereas with person-centred therapy it can be a distraction

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as well as an important source of information; with cognitive-behavioural therapy it has

no role, and when it arises it is dealt with as an irrational belief to be confronted.

Cognitive-behavioural therapy runs for the shortest duration whilst

psychodynamic may run for years. Person-centred therapy can take place over a single

session, but it more likely runs for a few months to a year or more.

The biggest difference for me is that both psychodynamic and person-centred

therapy rely very much on the insight of the client – that is he ability of the client to look

at themselves as if from outside of themselves in order have an accurate perspective on

their condition. This is not necessary in cognitive-behavioural therapy which is centred

on the acquisition and application of skills.

Conclusion

These schools of psychotherapy and counselling come from very different

persuasions and are inextricably linked to their founders’ struggles in youth to find

meaning and purpose in their lives. They are largely contemporaries in that their founders

lived in roughly similar decades, with psychoanalysis being the father of them all.

Starting as the psychoanalytic, psychodynamic therapy grew out of the reaction to

psychoanalysis and its perceived shortcomings that spawned person-centred and

cognitive-behavioural therapies.

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My view is that all these methods are complementary and one can draw from each

– the concepts of the unconscious and ego defences of the psychodynamic, the

relationship base and client respect of the person-centred and the skills and applications

thrust of the cognitive-behavioural. My own interest and ambition to be a skilled helper

has grown by studying these methods, as I can see that each offers a unique insight into

understanding the whole person. None is truly complete by itself, nor can any be

discarded as irrelevant or useless.

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Appendix A – References

1. British Association of Counselling and Psychotherapy, 1986, “Counselling-Definition

of terms in use with expansion and rationale (Information Sheet 1)”, Rugby: British

Association for Counselling.

2. Corey, G, (2005) Theory and Practice of Counselling and Psychotherapy, 7th Edition,

Belmont: Brooks/Cole.

3. Corsini R.J. & Wedding D, eds, (1995) Current Psychotherapies, 5th Edition, Itasca:

F.E.Peacock.

4. Douglas Woods, (2011) “What is Counselling”

http://www.dougwoods.com/counselling.html

5. Hansen, J.C., Rossberg, R.H., Cramer, S.H (1994) Counselling Theory and Process,

5th Edition, Needham Heights: Allyn and Bacon.

6. Hansen, J.C., Stevic, R.R, Warner Jr., R.W. (1986) Counselling Theory and Process,

4th Edition, Boston: Allyn and Bacon.

7. Hough M, 2002; A Practical Approach to Counselling, 2nd Edition, Harlow: Pearson.

8. Macleod J, 2003, An Introduction to Counselling, 3rd Edition, Buckingham: Open

University Press.

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