Practising counselling or psychotherapy

There are many great ways of practising counselling or psychotherapy and this can make it confusing to know how to choose an appropriate therapist.

Research suggests that the therapeutic relationship itself is more important for a good outcome than the particular theories your therapist favours. This means that if your therapist succeeds in helping you to feel safe, accepted and treated with respect and perhaps also challenges you in a positive constructive way, you are likely to be able to make good use of your sessions.

It can nevertheless be useful to have some understanding of the wide range of approaches that therapists may have been trained in and will use in deciding how to work with you. You may find one approach more appealing than another or find that some approaches are more suited to your particular needs than others.

Different approaches to counselling have different ideas about human development, where psychological problems come from and the best way to use ‘talking therapy’ to help. Some counsellors, for example, will encourage you to take the lead in what is discussed and to support you in realizing that you are actually more capable and resourceful than you may feel. Others may be more ‘directive’ and will teach you ways of changing your beliefs and behaviour by, for example giving you ‘homework’ exercises.

Here is a list of some of the different types of counselling with a brief description - please click a type below to move to the relevant information. There are other types of counselling and if you need any more information please contact us.


Behavioural therapy

Behavioural therapy is based on the theory that you can ‘unlearn’ learnt behaviour or change that behaviour, without focusing on the reason behind the original behaviour. People with compulsive and obsessive disorders, fears, phobias and addictions may benefit from this type of therapy. Originally, behaviour therapy and cognitive therapies were distinct from each other. They have tended to be combined to produce what is now known as Cognitive-Behavioural Therapy or CBT.


Cognitive analytical therapy

This is an example of an Integrative approach. It is a short term, structured and directive therapy which explores the client’s language and thinking, and also the link between historical, cultural and social factors on how they function. It then encourages the client to develop the skills to change destructive patterns of behaviour and negative ways of thinking and acting. It was devised to fit NHS needs for short term treatment of a variety of problems. It requires specialist training.


Cognitive behavioural therapy (CBT)

CBT has become very well known as a treatment of choice within the NHS for symptoms of anxiety and depression. It seeks to change distressing behaviour relatively quickly by challenging unhelpful thoughts and beliefs and teaching the client to use coping strategies in the future. It aims to be ‘scientific’ by assessing and measuring change and does not prioritise finding original causes or exploring hidden potential. People with compulsive and obsessive disorders, fears, phobias and addictions tend to benefit from this type of therapy. Cognitive-behavioural therapists believe that while it is important to have a good, trusting relationship, but that is not enough in itself. A willingness to do homework tasks in between sessions is considered very important.


Cognitive therapy

Cognitive therapy is based on the idea that our thoughts cause our feelings and behaviours, not external things, like people, situations, and events. Originally, behaviour therapy and cognitive therapies were distinct from each other. They have tended to be combined to produce what is now known as Cognitive-Behavioural Therapy or CBT.


Family therapy

Family therapy explores family relationships. It works by looking at the family as a whole, rather than working with a single person in the family unit. The focus is on how families interact together and the therapist's aim is to involve the whole family in finding positive solutions. It requires specialist training.


Gestalt Therapy

Gestalt therapy places a lot of emphasis on helping the client understand their non-verbal and body language, here-and-now behaviour and potential for positive change. The client will be encouraged, and sometimes challenged, to accept responsibility for his or her actions, decisions and feelings. It is likely to be suited to people who are willing to try to do this. Modern Gestalt therapy is not, however, necessarily a ‘confrontational’ approach.


Hypnotherapy

Hypnotherapy uses the technique of hypnosis to induce a deep state of relaxation during which the unconscious mind is highly receptive to new ideas. Accessing this part of the mind through hypnosis can help to change behaviour, attitudes and emotions, as well as manage pain, anxiety, stress-related illnesses and bad habits, including promoting personal development. To find out more, visit our partner organisation the National Hypnotherapy Society.


Integrative approaches

An increasing number of counsellors describe themselves as ‘Integrative’. This means that rather than specializing in one traditional approach, they seek to combine aspects of different approaches to provide the most effective way of working.

Many counsellors describe what they do as integrative without following a specific integrative model. They should be able to explain clearly to you how you will work together and what you can expect.


Multimodal therapy

This is an example of an Integrative approach originating in behaviour therapy. This approach uses broader techniques by looking at how the client functions overall in many areas of their life. The therapist is specifically trained to choose techniques most likely to be helpful and these are likely to include assertiveness training, anxiety management and visualisation.


Neuro-linguistic programming (NLP)

The theory of NLP is broken down into three layers:

  • Neuro involves creating our own mental map of the world.
  • Linguistic involves how we each give meaning to the information.
  • Programming involves how we respond to the meaning we have given to information.

NLP techniques are often used to bring about change and improve our personal growth, development and performance.


Person-centred counselling

This approach is based on the idea that there are certain therapeutic conditions which are the key to successful personal growth. Most counsellors will have learnt about the ideas of Carl Rogers, who emphasized the importance of the counsellor being warm, empathic, non-judgmental and non –directive. A client in ‘pure’ person-centred counselling is particularly likely to feel accepted, supported and encouraged.


Psychoanalysis

Psychoanalysis originated with the work of Sigmund Freud, from which many different theories and ways of working have developed. It deals with the exploration of the unconscious mind, and requires a long specialist training. The analyst can make you aware of unconscious patterns so you can change them. Your relationship with the analyst is important as it can highlight your patterns of behaviour within relationships generally.


Psychodynamic Counselling

Psychodynamic counselling developed form psychoanalysis. It focuses on the unconscious mind and past experiences, and explores their influence on current behaviour. You will be encouraged to talk about childhood relationships with parents and other significant people. As part of the therapy you may transfer and pass on deep feelings about yourself, parents and others to the therapist. Although psychodynamic counselling can be practised in a short series of sessions, it is more usual for it to be a relatively lengthy process. It is likely to appeal to people who are interested in exploring their own unconscious processes and who can accept that the changes they are seeking may take time to achieve.


Relationship counselling

Relationship counselling aims to help people recognise and manage differences and negative patterns within their relationships. The therapist will explore your feelings and how you communicate. The aim is to help you find ways to change and adapt for a more positive future.


Solution-focused brief therapy

This kind of therapy focuses on a particular issue and promotes positive change, rather than dwelling on the issue or past problems. You are encouraged to focus positively on what you do well, your strengths and resources and to set goals to achieve the changes you want to make. It is likely to appeal to people who prefer a highly practical, goal-oriented approach to problem-solving.

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