Chapter 1:
Introduction to counseling
and psychotherapy
Overview
• Counseling versus Psychotherapy
• Counseling:
What is counseling?
Specialized knowledge
Skills & procedures utilized
• Psychotherapy:
What is psychotherapy?
Who administers psychotherapy?
Psychiatry and psychotherapy
Modes of psychotherapy
Mechanisms of psychotherapy
Therapy as a relationship
Counseling versus
Psychotherapy
Counseling and Guidance
Counseling is a profession that involves
the use of an integrated approach to the
What is development of a well-functioning
counseling? individual primarily by helping him/ her
to utilize his/ her potentials to the fullest
and plan his future in accordance with
his/her abilities, Interests and needs.
Counseling and Guidance
Psychologist
Short term therapy (8-
conducting 12 sessions but in
the session. certain cases a month)
Focus on the Question,
resolution of inform,
advise and
a problem
direct
Counseling and Guidance
Specialized knowledge
• Psychologists have an understanding of and capacity to
engage in:
evidence-based and culturally-informed intervention
Assessment
Prevention
Training
research practices
They focus on healthy aspects and strengths of their clients (whether
they are individuals, couples, families, groups, organizations, or
communities)
environmental/contextual influences (such as cultural, sociopolitical,
gender, racial, ethnic, sexual orientation, and socioeconomic factors)
that shape people’s experiences and concerns
the role of career and work in peoples’ lives; and advocacy for equity
Counseling and Guidance
Skills & procedures utilized
The procedures and techniques used within counseling
psychology include:
• Individual, family and group counseling and
psychotherapy.
• Crisis intervention, disaster and trauma management.
• Assessment techniques for the diagnosis of
psychological disorders.
• Programs/workshops that educate and inform the
public about mental health, school, family,
relationship and workplace issues so that problems
can be prevented before they start or reduced before
they get worse.
Counseling and Guidance
Skills & procedures utilized
The procedures and techniques used within counseling
psychology include:
• Consulting with organizations.
• Program evaluation and treatment outcome (e.g.,
client progress).
• Training.
• Clinical supervision.
• Test construction and validation.
• Research methodologies for scientific investigations
History of
psychotherapy
• In the past, we have treated psychological disorders by cutting holes
in the head, restraining patients, beating out the devil, by giving
electric shock therapy….
Biological and psychological treatments have been developed simultaneously
• Brutal to humane
• 19th century: treatment of hysteria
Franz Anton Mesmer: developed hypnosis to treat hysteria
Development of psychoanalysis
• 20th century: rise of behavior therapy
• Second half of 20th century: humanistic and cognitive treatment
• Today: Evidence-based practice
Combines research, clinical expertise, and patient values to provide the best
outcome for the client
Psychotherapy
what is psychotherapy?
• Psychotherapy is a talk therapy
• Formal process of interaction, it is different than a discussion or
casual conversation
• Two parties: one or more therapist/ one or more clients
• Amelioration of distress relative to:
cognitive functions
Affective emotional functions
Behavior functions
Once you target one, you target the others. If one is affected, so does the
others.
Psychologists
Psychiatrists Social workers
Who
administers
psychotherapy
General
medical ? Nurses
practitioners
Psychiatry vs psychotherapy
Psychological and medical concepts to treat mental disorders
• Psychiatric intervention: mainly medication, hospital admissions
• Complementary to psychotherapy
• Psychiatrist is not a therapist
• 7 years of MD in medical program and 5 years of residency in
psychology
Modes of psychotherapy
• Clinical psychology: working with clients with psychological disorders
• Psychotherapy: methods of learning in treating clients and helping
them talk
• Methods of learning in psychotherapy:
Thoughts (cognitive therapy)
Moods and feelings (psychodynamic, interpersonal Therapies)
Behavior and actions
• All therapies are combinations of theses 3 modalities
• Learning something new or relearning something that is forgotten
Mechanisms of psychotherapy
A- cognitive factors:
o Universalization: when the patient realizes they are not alone, they
improve.
o Insight: change occurs as patients understand themselves and others
(gain different perspectives on their own motives and behavior)
o Modeling: people benefit from watching other people (In group
therapy)
B- Affective factors:
o Acceptance: sense of being part of a group and getting unconditional
positive regard, especially from the therapist.
o Altruism: selfless concern for the well-fair of others. Change results
from the recognition that the patient is the recipient of the
therapist’s care.
o Transference: identifies the emotional bond that occurs between the
therapist and the clients (between patients in group therapies). The
therapist becomes a major significance in the life of his client.
o The patient wants to introduce personal considerations into therapy
(he loves me more than he his other clients)
C- behavioral factors:
o Reality testing: change becomes possible when clients experiment a
new behavior in a safe therapy session while receiving support and
feedback from the therapist/ in a group therapy from the members. (in
phobia once prepared to the idea, the person is able to overcome his
fear. Testing something that he can’t do on his own)(in social phobia,
use role play)
o Ventilation: the client is asked to express emotions especially negative
ones (blowing out steam through shouting and crying in a session is
very helpful because the patient still feels that he is accepted)
o Interaction: patients improve and change when they are able to talk
openly to the therapist or group, and they are able to say if they have a
problem (admitting is a first step). (Ex: My name is _________. I’m a
chocoholic.)
Therapy as a relationship
What differentiates therapy from any other helping relationship or a friendship?
• It is not a friendship nor a moral relationship.
• Client need for a special and professional assistance for an unresolved problem
that the patient is not able to resolve independently.
• Formal and structured relationship and not continued on a casual basis. It is very
difficult to know that the therapist is not a friend, but this formality will make the
patient cure. The therapeutic relation is characterized by special arrangements
for duration, privacy and confidentiality.
• Limited to time and place. Therapy is limited to the therapeutic hour and the
patient should be seen in a specific place, the clinic.
• Deeper than ordinary social friendship. It is carefully established that it permits
the patient’s self disclosure (to expose himself, to be vulnerable)
• General principles of all good human relationships: trust, acceptance,
confidentiality, active listening. These principles are applied consciously and on
purpose without ordinary social interaction.