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What are They?

Comparing and Contrasting Three of the Main Counselling


Approaches
Written by listed counsellor/psychotherapist: Jane Bronwyn Holder
August 21st, 2013

Three of the main forms of counselling can sometimes be confusing. In


this article I hope to unravel and clarify some of the mystery surrounding
these three types of counselling approaches by means of comparing and
contrasting with reference to their differing theoretical rationale,
therapeutic interventions and processes of change.
The Person Centred Approach (Originator: Carl Rogers 1902 1987)
focuses on the belief that we are all born with an innate ability for
psychological growth if external circumstances allow us to do so. Clients
become out of touch with this self-actualising tendency by means of
introjecting the evaluations of others and thereby treating them as if they
were their own. As well as being non-directive the counselling relationship
is based on the core conditions of empathy, congruence and unconditional
positive regard. By clients being prized and valued, they can learn to
accept who they are and reconnect with their true selves.
The Psychodynamic Approach (Originator: Sigmund Freud 1856 1939)
focuses on an individuals unconscious thoughts that stem from childhood
experiences and now affect their current behaviour and thoughts. The
urges that drive us emanate from our unconscious and we are driven by
them to repeat patterns of behaviour. Therapy includes free association,
the analysis of resistance and transference, dream analysis and
interpretation and is usually long term. The aim is to make the
unconscious conscious in order for the client to gain insight.
Cognitive Behavioural Therapy (Contributors: Ellis 1913 - & Beck 1921 - )
focuses on how an individuals thoughts and perceptions affect the way
they feel (emotions) and behave. We are reactive beings who respond to a
variety of external stimuli and our behaviour is a result of learning and
conditioning. Because our behaviour is viewed as having being learned, it
can therefore be unlearned. By helping clients to recognise negative
thought patterns they can learn new positive ways of thinking which
ultimately will affect their feelings and their behaviour.
When comparing and contrasting these three major approaches in relation
to their differing theoretical rationale, I found the following similarities
between the Person Centred Approach and Cognitive Behavioural Therapy.

Both deal with the conscious mind, the here and now and focus on current
problems and issues the client may have. They both have a positive view
of human nature and view the individual as not necessarily being a
product of their past experiences, but acknowledge that they are able to
determine their own futures. They both attempt to improve well-being by
means of a collaborative therapeutic relationship that enables and
facilitates healthy coping mechanisms in clients who are experiencing
psychological pain and disharmony in their lives.
In comparing the similarities between the Person Centred Approach and
the Psychodynamic Approach, it is possible to see some similarities and
parallels between the concepts of the actualising tendency, the
organismic self and the self-concept to Freuds theory on personality
structure. The id and the organismic self are both representative of that
part of the psyche that is often ignored or repressed. The super-ego and
the self-concept, both describe internalised rules and moral values which
have been imposed upon us by significant others. The ego is similar to the
actualising tendency in that it is concerned with mediating between the id
and the super-ego and the actualising tendency seems to echo this.
In contrasting the Person Centred Approach with Cognitive Behaviour
Therapy in relation to their differing theoretical rationale Cognitive
Behavioural Therapy sees behaviour as being a learned response whereas
the Person Centred view is that clients have not been able to have
previously self-actualised. From a Cognitive Behavioural perspective,
human experience is viewed as a product of the interacting elements of
physiology, cognition, behaviour and emotion. The Cognitive Behavioural
Approach is based upon the theoretical rationale that the way in which we
feel and behave is determined by how we perceive and structure our
experience. In the Person Centred Approach, a person is viewed as having
had various experiences and developing a personality as a result of these
subjective experiences.
In contrast to the Psychodynamic Approach, the Person Centred Approach
focuses on the conscious mind and what is going on in the here-and-now
whereas the Psychodynamic Approach focuses on the subconscious and
looks to early childhood to examine unresolved conflicts. Freud
emphasized the need to modify defences, to reduce the pressures from
the superego so that the patient could become less frightened of the
superego and to strengthen the ego.[1] The aim of the Person Centred
Approach is self-actualisation whilst the aim of the Psychodynamic
Approach is insight. The Person Centred Approach focuses on the positive
belief in the human ability to self-actualise whereas the Psychodynamic
Approach focuses largely on the negative aspects.
In highlighting the differences in theoretical rationale between the
Psychodynamic Approach and Cognitive Behavioural Therapy, the
Psychodynamic Approach encourages the client to uncover the past and
early childhood in order to bring to memory significant events. Cognitive
Behavioural Therapy, however, focuses on the here and now and is goal
orientated. The Psychodynamic Approach sees us as being driven by

unconscious urges whereas Cognitive Behavioural Approach sees our


behaviour as being a learned response.
Freuds structural model states that the human psyche is an interaction of
the three forces: the id, the ego and the superego and he also assumed
that we are driven by inherent sexual and aggressive drives. Cognitive
Behavioural Therapy sees functioning or dysfunctioning as being a learned
response to external stimuli.
In looking at the similarities between the Person Centred Approach and
Cognitive Behavioural Therapy with regard to their therapeutic
interventions both utilise the core conditions of empathy, unconditional
positive regard and congruence but in Cognitive Behavioural Therapy it is
used mainly in the establishing of the working alliance. The creation of a
relationship of safety and trust is an essential first step in CBT, as in any
form of therapy.[2] In both these approaches, the relationship between
client and counsellor is similar by means of the counsellor being
congruent and both would use the skills of reflection, paraphrasing and
summarising. In both these approaches, the client is prepared for the
eventual ending a few sessions before the actual end of therapy. Both
would use awareness techniques.
The therapeutic intervention of immediacy used in the Person Centred
Approach could be compared to the technique of transference used in the
Psychodynamic Approach however; in the Person Centred Approach, the
emphasis on the present replaces the investigative perspective of the
Psychodynamic Approach.
In comparison, the differences between the therapeutic interventions used
in the Person Centred Approach and the Cognitive Behavioural Approach,
the Person Centred Approach is non-directive whereas CBT is taught and
is goal orientated. In Cognitive Behavioural Therapy clients are taught
skills which are needed and necessary for them to change which would in
turn reduce their emotional angst and change their behaviour. In the
Person Centred Approach growth is self-directed. The number of sessions
in the Person Centred Approach can be open ended whereas CBT has a set
period.
When looking at the main differences between Person Centred Approach
and the Psychodynamic Approach the Person Centred counsellor would
encourage the client to seek the solution to their problem within
themselves and would not attempt interpretation which is the major
therapeutic intervention of the Psychodynamic Approach. The Person
Centred Approach pays no attention to the issue of transference. The
relationship between the client and the counsellor is also different in that
in the Person Centred Approach the core conditions are a vital tool
whereas in the Psychodynamic Approach the counsellor is a blank slate
onto which the client can project.
There are however some similarities between the Psychodynamic
Approach and Cognitive Behavioural Therapy. Many of our schemas were

put in place when we were very young and stem from childhood, this
learned response and behavior could be linked to the Psychodynamic
intervention of linking childhood events and associated feelings to current
problems.
Looking at the differences in the therapeutic interventions between
Psychodynamic Approach and Cognitive Behavioural Therapy the key
therapeutic interventions used in the Psychodynamic Approach are free
association, thematic apperception test / Rorschach inkblot test,
parapraxis, interpretation of transference, dream analysis, hypnosis and
regression. In Cognitive Behavioural Therapy, the techniques used could
be systematic desensitisation, reinforcement techniques, forceful
disputing, reality testing and the identifying of automatic thoughts.
Cognitive Behavioural Therapy is directive and is goal orientated and does
not look at the clients past. In Psychodynamic Therapy, there is a danger
that the client could become dependent on their counsellor whereas in
Cognitive Behavioural Therapy the client is taught to be autonomous.
The similarities between the Person Centred Approach and Cognitive
Behavioural Therapy in relation to their process of change are that the
core conditions used in both would bring about change in the client by the
building up of trust and rapport.
When comparing the differences in the process of change between the
Person Centred Approach and the Cognitive Behavioural Approach, change
would occur for the client in Cognitive Behavioural Therapy through
guiding and assisting them into firstly identifying negative thought
patterns and then by changing their irrational beliefs. By changing
thoughts, we can change the way in which we react to situations and
events. In Cognitive Behavioural Therapy, this process of change occurs
by means of education, and by bringing these thought patterns into
awareness behavioural change will occur. Change can also occur through
reality testing in which the clients negative beliefs will be challenged and
their subsequent negative emotions eliminated.
In the Person Centred Approach, change occurs with the core conditions of
empathy, congruence and unconditional positive regard being in place.
This relationship is all that is necessary to bring about change and with no
threat of being judged, the client learns to perceive their world from a new
perspective and gains the ability to self-actualise with felt senses
connecting the different aspects of their particular issues.
In contrasting this to the Psychodynamic Approach, change occurs by
means of uncovering repressed or significant events and their associated
feelings. By this process, change will occur and the client will be better
equipped to understand the connections between past events and present
behaviour. Change in the Psychodynamic Approach, occurs for the
individual through the strengthening the individuals ego whilst in the
Person Centred Approach the aim is to achieve growth through the
individuals self-actualising tendency. In the Person Centred Approach, it is

a personal process for the client of being in a warm relationship but in


Psychodynamic counselling the counsellor is a blank slate on which the
client can project feelings. Transference is crucial in the process of
change, requiring understanding and interpreting but the Person Centred
Approach ignores the past events in a clients life unless these events
affect the clients conditions of worth.
When comparing the similarities between the Psychodynamic Approach
and Cognitive Behavioural Therapy, change could occur through the
uncovering of schemas, which is similar to bringing the unconscious into
conscious awareness.
In contrast, the differences in the process of change between the
Psychodynamic Approach and Cognitive Behavioural Therapy in the
Psychodynamic Approach the process of change would involve
encouraging clients to look into their past with a view to uncovering
repressed or significant events and memories and their associated
feelings. By gaining this insight the client will achieve a new perspective
which will form the basis for healing and change. Cognitive Behavioural
Therapy deals only with the here-and-now, it does not address the past,
deals only with presenting symptoms and could miss underlying problems.
The cognitive model assumes that emotional and behavioural change is
mediated by changes in beliefs and interpretations.[3]
Cognitive Behavioural Therapy sees the process of change as being a
relatively short-term process whereas Psychodynamic Therapy is a long
term process of change. The aim of Psychodynamic Therapy is for the
client to gain insight and the aim of Cognitive Behavioural Therapy is
change. Cognitive Behavioural Therapy believes that change is possible
and focuses on behaviour rather than on emotions. A major difference
between CBT and psychodynamic therapies lies in the degree of
importance given to exploring early childhood experiences for the origins
of maladaptive patterns of thinking and behaviour. In CBT it can be helpful
to explore early experiences to enable the client to place his problems in
a historical context, but this is not seen as a major part of the
counselling.[4]
In conclusion, each model has its own strengths and weaknesses and
individuals may find one approach more appropriate than another,
depending on their own personal preference or on the severity and depth
of their presenting problem. Time factors and costs would also need to be
taken into consideration.
Bibliography:
[1] Dryden, W (2002) Handbook of Individual Therapy Fourth Edition. Page
27.
[2] McLeod J, (2009) An Introduction to Counselling Fourth Edition. Page
148.
[3] Dryden W (2002) Handbook of Individual Therapy Fourth Edition. Page
304.
[4] Trower P, Casey A, Dryden W (1988) Cognitive Behavioral Counselling
in Action. Page 7,8.