Running head: PERSONAL THEORY OF COOUNSELLING
My Personal Theory of Client Change:
An integrative approach to counselling
Scott Wensmann
University of Lethbridge
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My personal theory of client change:
An integrative approach to counselling.
Theory plays an important role in the process and outcome of therapy. As a counsellor in
training, the development of a personal theory is essential and provides the basis for informed and
effective counselling (Spruill & Benshoff, 2000). Furthermore, it has been suggested (Hackney,
1992) that a theory is used to define the nature of the therapeutic interaction, to conceptualize the
nature of the problem, and define counselling goals and outcomes.
While reviewing the different counselling theories, I became overwhelmed at times trying
to identify with one particular approach. I found that each theory had useful features that I could
incorporate into my theoretical perspective. It was not until reviewing an integrative perspective
to therapy, that I was able to define an approach that closely fits my view of human nature.
My theoretical approach to counselling incorporates an integrative approach to therapy,
with an emphasis towards a humanistic, primarily Person-Centered (PCT) perspective. However,
because this approach does not prescribe to a specific set of techniques or procedures, I have
integrated a Cognitive-Behavioral (CBT) perspective. This paper is a reflection of my theoretical
perspective to counselling, the interaction of my beliefs and their implications on thinking,
feelings, and behaviour.
View of Human Nature
My philosophical approach to counseling does not view individuals as being “sick” and
in need of a psychological “cure”. Rather, I borrow from an Adlerian and Jungian perspective and
view individual’s behaviours as purposeful. I view psychological problems as being symptoms
that emerge when individual’s become discouraged and stuck in old thought patterns. The focus
from my perspective is on here and now experiences, but I also do not minimize that past
experiences can and do impact on current behaviour. Approaching individuals in this manner
allows me to adopt a strengths-based approach to therapy, rather than one that focuses on deficits.
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The underlying assumptions of CBT and PCT fit my overall view of human nature, as
both approaches are based on the underlying assumption that free will exists. In order for change
to occur, we must first look within ourselves and then exercise free will (Miller, Sward, Nielsen,
& Robertson, 2011). I believe that individuals possess the capacity to make choices and value
their free will to make those choices. This does not mean that we always make the positive or the
right choice. I also believe that individual’s possess the resources required to achieve personal
development and growth.
Role of the Counsellor
I view counselling as a process of engagement between a client and counsellor, where the
counsellor is the facilitator of the process. I also believe that the counsellor’s function is not to
reform the client, but to engage them in a collaborative process. Throughout the therapeutic
process the client and counsellor work together to identify the problem, establish the goal of
therapy, and develop strategies to reach the goal. I believe the power to make change lies within
the client.
It has been consistently demonstrated that the quality of the therapeutic relationship
predicts treatment outcomes (Hovarth & Bedi, 2002; Hovarth & Symonds, 1991; Martin, Garske,
& Davis, 2000), and can have positive contributions in most forms of therapy (Horvarth, 1994;
Horvath & Bedi, 2002; Martin, Garske & Davis, 2000). This is where the teachings of Carl
Rogers (1957) and PCT provide the foundation of my approach to therapy. PCT places a strong
emphasis on the therapeutic relationship, and views the personal core characteristics of empathy,
positive regard, and congruence as being both necessary and sufficient for successful treatment
outcomes (Young, 2009). Although I agree that the core conditions are necessary, I don’t agree
that they are sufficient in and of themselves to produce lasting change. In this aspect I agree with
Gelso and Carter (1991), that Roger’s core conditions are “actually ingredients of effective
therapy, and say nothing about the client-therapist interaction per se” (p. 296).
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On the other hand, CBT places on emphasis on process and action, but has been criticized
for its lack of emphasis on the factors that develop a strong therapeutic relationship. From my
perspective, as the counselling focus shifts from rapport building to problem-solving, the
counsellor must also shift his or her focus to using counselling strategies that are more directive;
like those found in CBT (Miller, Sward, Nielson, & Robertson, 2011).
Role of the Client
From both a CBT and PCT theoretical perspective, the client is seen as an active
participant in all aspects of therapy. Drawing from an integration of both approaches, I believe
that clients should be expected to express their concerns. They should help define the goals of
counselling, learn new strategies and implement those strategies to make changes in their lives.
With support from the counsellor, the client will experiment with new behaviours and new ways
of thinking to evoke change. This experimentation primarily involving the completion of
homework assignments, provides an opportunity for the client to practice new skills outside of the
counselling session, which some find more valuable then the work done during the counselling
session (Ledley, Marx, & Heimberg, 2010).
Client Change
CBT and PCT believe that for change to occur, the individual must accept the
responsibility to respond based on his or her ability to do so (Miller et al., 2011). I believe that
through the therapeutic process clients learn to recognize and reassess old thought patterns, and
replace them with more positive and productive thoughts. I also believe that lasting change results
from the client learning to translate the skills they learned in therapy to their daily lives. A key
aspect of my perspective is that the way we think influences the way behave and feel (Corey,
2013).
Techniques and Applications
PCT views the characteristics of the counsellor, their attitude and the environment as
being more important than the technical skills they utilize. According to Motschnig and Nykl
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(2003), a major limitation of PCT is the lack of structure and use of action-oriented intervention
techniques. The lack of structure in PCT is why I incorporated CBT into my integrated approach.
I value the integrative nature of CBT and its reliance on the use of a variety of cognitive, emotive
and behavioural techniques to bring about change (Corey, 2013). CBT also allows the flexibility
to incorporate cognitive and behavioural methods so techniques can be tailored to meet the
unique needs of each client (Corey, 2013; Hobbis & Sutton, 2005). Literature also suggests that
when the change producing aspects of both CBT and PCT are combined and applied skillfully,
counselling can be more effective (Josefowitz, & Myran, 2005; Miller, et al., 2011; Tursi, &
Cochran, 2006).
Therapeutic applications of using a CBT and PCT integrative approach may include:
motivational interviewing, individual and group counselling, clinic applications (e.g., personality
disorders, anxiety, depression and suicide), crisis intervention, family counselling and couples
counselling.
Strengths and Limitation
CBT and PCT have both been proven to produce positive changes in therapy. The
strength of CBT is its emphasis on process and action, but its lack of emphasis on development of
a strong therapeutic alliance has been criticized. The strength of PCT is the emphasis it places on
the therapeutic relationship and its contribution to counselling outcomes (Hovarth & Symonds,
1991; Martin et. al., 2000). However, a weakness of PCT is its lack of direction, structure, and
techniques (Corey, 2013). By integrating a PCT and CBT perspective, I am able to develop a
theoretical framework that emphasizes a positive therapeutic relationship throughout counselling,
while providing structure and techniques that have proven to produce change.
Personal Values, Culture, and Environment
In my life I place great importance on the quality of my relationships. I value the
characteristics of honesty, authenticity, genuineness, loyalty, and trust. This is reflective in my
strong preference for the PCT approach to counselling. However, as a counsellor in training, I am
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uncomfortable with the lack of structure and techniques utilized by PCT. The CBT perspective
provides me with more confidence, based on its “empirical testability, efficacy, and costeffectiveness” (Hobbis & Sutton, 2005).
As Canada’s demographic composition is culturally diverse, it is important to incorporate
a multi-cultural perspective into my theoretical approach. As Corey (2013) points out, “it is an
ethical obligation for counsellors to develop sensitivity to cultural differences if they hope to
make interventions that are consistent with the values of their clients” (p. 24). The emphasis that
PCT places on the core conditions is a useful approach to understanding diverse worldviews
(Corey, 2013), while the psychoeducational dimension of CBT is useful in exploring cultural
conflicts and teaching new behaviours (Corey, 2013).
Conclusion
Historically, counsellors practiced psychotherapy from one theoretical approach.
Research now indicates that psychotherapy is shifting to an integrative approach to therapy
(Norcross, 2005), as no single theory can address all client challenges (Miller et. al., 2011).
Psychotherapy integration allows the counsellor to combine concepts and techniques from more
than one theoretical approach. According to Norcross (2005), the ultimate goal of an integrative
approach is to enhance the efficacy, efficiency and applicability of psychotherapy.
According to Miller et al. (2011), when CBT and PCT are “skillfully integrated, they can
complement one another and enhance the efficacy and applicability of counselling” (p. 7). By
blending the humanistic approach of PCT with the techniques and structure of CBT, a
“superordinate clinical framework” (Guterman & Ruides, 2005) is created. My integrative
approach to counselling emphasizes building a strong relationship, while helping clients
restructure thoughts and modifying behaviour, with the ultimate goal of accelerating client
change.
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References
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