An integrative approach to
counseling combines the various approaches of the schools of though employed in
counseling in order to enhance the success of the counseling processes. This
approach creates a creative synthesis of the specific elements of various
theoretical orientations thereby creating integrating concepts that can fit the
unique personality and style of the counselors (Watts and Carlson, 1999). According
to Watts and Carlson (1999), the integrative approach has gained prominence
since the 1980s with most therapists agreeing with its role in improving the
effectiveness of the counseling of their clients. This has been due to the
acknowledgement of the fact that no single theoretical approach can
comprehensively cover the complexities of human behavior taking consideration
of the wide range of personalities and problems. The integrative approach to
counseling can be achieved in a number of ways: theoretical integration,
technical eclecticism, and common factors (Preston, 1998). Technical
eclecticism is a combination of techniques drawn from different schools and
does not require the practitioner to subscribe to the schools that designed the
different techniques (Lazarus and Beutler, 1993). Theoretical integration goes
beyond the blending of techniques. It focuses on producing creation of a
framework that combines the best theoretical approaches in order to produce an
outcome that is more effective than either of the theories when used alone (Lazarus
and Beutler, 1995). The common factors approach analyses a variety of
theoretical alignments with the aim of putting together the commonly found
elements (Preston, 1998). It is important for the practitioner to embrace the
theories that are most compatible with their personality in order to remain
effective when conducting therapy.
When considering the schools of
counseling to include when developing an integrative model, it is important
that the counselor selects the theoretical frameworks that are most compatible
with their personality. This goes a long way in ensuring that the practitioner
is effective in their practice. The preferred approaches in this section are the
Existential and the Person-Centered theories.
The existential approach proposes
that inner conflicts within people are due to their confrontation with the
realities around them (Mary and Yalom, 2000). These realities may include
death, freedom and the responsibility that comes with it, isolation and
meaninglessness. These four realities form the core framework within which the
therapists develop solutions during their counseling endeavors. This theory
recognizes the desire for humans to feel connected with each other (Deurzen and
Arnold-Baker, 2005). It reckons that people would often want to have meaning in
each other’s lives but must guard against depending on others for validation of
their existence and importance. This implies that the validation of a person
should emanate from within them and not from people around them. Regarding the
question of psychological dysfunction, this theory does not recognize the
existence of mental illness (Deurzen and Kenward, 2005). It emphasizes that all
states of being are merely an expression of the choices that people make on how
to live their lives. It however recognizes the inability of people to come to
terms with the realities around them and advocates for helping such individuals
to counter these realities better by exposing the alternative choices at their
disposal (Milton and Judd, 1999). Existential approach recognizes the ability
of humans to face squarely the realities of life by making various choices and
taking responsibility for such choices. It reckons that it is not crucial that
one overcomes the feelings of meaninglessness. Instead, people should develop
new meanings for their lives and use them to attain self actualization.
Having considered the essentials of
the theory, focus is turned on the manner in which therapy is conducted under
this theoretical framework. Existential approach lays no emphasis on the
client’s past: it instead concentrates on the present and the future and
explores the choices that are at the disposal of the client that would suit
them best (Schneider and Krug, 2010). The practitioner may draw attention to the
manner in which the client dealt with situations in the past but will
ultimately emphasize on the present choices to be made and the responsibility
that goes with it. The clients are made to accept that their state has more to
do with their choices and not as a result of a special status, fate or destiny
(Schneider and Krug, 2010). This invigorates their desire to take control of
their lives by embracing their freedom and the responsibility that goes with
it. These mainly dwell on the levels of experience and existence which persons
across cultural divides come face to face with from time to time. This theory
outlines the four dimensions of human existence as the physical, the
psychological, the social and the spiritual (Milton, 1993). The physical
dimension relates to the natural world and the environment. This relates to the
attitudes that people may have on their own physical bodies, other people’s
bodies, the climate, weather, buildings, health and mortality among others. The
typical source of conflict in this dimension places the need to dominate
against the need to accept realities that cannot be changed. The realization of
the inevitability of some negative or feared outcomes despite the steps taken
to insure self against them is often the source of great tension that may often
be the subject of therapeutic experience (Milton, 1993).
The social dimension relates to the
interaction between people and each other, the public and the cultural context
in which they live. The attitudes may include love, hate, cooperation, and
competition which in turn lead to contradictions such of isolation versus
belonging and rejection versus acceptance. The failure of one to gain
acceptance or lack the feeling of belonging in the society may need the need of
a counselor in order to help the clients make informed choices. The
psychological dimension relates to how individuals create a personal world
through the interaction with their inner selves (Schneider and Krug, 2010).
People will always have an image of themselves in relation to their strengths,
weaknesses and potential. In the event that these beliefs are challenged to
disprove the beliefs held by the individual, it often results in a state of
great confusion which may persist for longer than the average acceptable periods.
The spiritual dimension involves the creation of an ideal world by persons who
try to finding meaning by fitting in pieces of a puzzle by themselves (Milton,
1993). This may be done by embracing a religion or embracing a certain belief
seen to be sufficiently explanatory to the person.
The person-centered theory is
associated with a great psychologist Carl Rogers and was developed in 1940s and
1950s (Cooper, Watson and Hoedampf, 2010). It’s one of the most popular
theories applied in psychotherapy. In this approach, the counselor creates a
comfortable environmental and remains non-judgmental. The therapist also
demonstrates genuineness, empathy and remains visibly positive about their
clients while using a non-directive approach (Poyrazli, 2003). This approach
enables the clients to find their own solutions to their problems. The
rationale for this emphasis is based on the presumption that people are the
ones who are best placed to tell what is good for them. The main contribution
of the therapist is being a facilitator in the process of own-solution finding
by the clients (Cooper, Watson and Hoedampf, 2010). This approach has been
criticized for its lack of structure and its provision of a conditional
relationship (Prochaska and Norcross, 2007). However, analysts view it as one
of the most effective approaches when applied in isolation. The following
conditions must exist for this approach to remain effective: therapist-client
psychological contact where each of the two parties perceive the other positively;
client vulnerability where the client is motivated to stay in the relationship
due to their vulnerability to anxiety; therapist congruence or genuineness; therapist
positive regard for the client; the therapist’s empathetic understanding and
client perception where the client perceives the therapist as understanding and
genuinely concerned about their welfare (Cooper, Watson and Hoedampf, 2010). According
to Poyrazli (2003), this approach is favorable in its applicability across many
scenarios and on persons coming from diverse cultural backgrounds without
necessitating material adjustments to the approach taken.
The least appealing schools of
counseling considered relate to the psychoanalytical approach to counseling.
Psychoanalysis is mainly associated with Sigmond Freud although the
psychoanalysis ideas have been contributed to by a myriad of other neurologists
(Edelson, 1984). Psychoanalysis focuses on human psychological functioning and
behavior as well as that of the society. It comprises three key components
namely: investigation methods of the human mind and the way people think; sets
of theories that attempt to explore human behavior; and methods of treating
mental or psychological illness (Edelson, 1984). The main theories associated
with this approach to counseling include the topographical theory, the
structural theory and the ego psychology (Mitchell and Black, 1995). The
topographical theory separates the thinking processes into three components
namely the conscious, the pre-conscious, and the unconscious (Mitchell and
Black, 1995). The structural theory on the other hand concentrates on the human
psyche and subdivides it into id, ego, and
super-ego (Mitchell and Black, 1995). The id is naturally present in all humans and is present at birth. The
ego develops through experiences and is usually a reflection of reality. The
super-ego is composed of the self observation and self criticism of the
individuals and mainly reflects what they think of themselves vis a vis the
environment.
The ego psychology has generated input from
many neurologists with many theories being advanced to further explore the
theoretical framework. These theories include the modern conflict theory, the
object relations theory, the self psychology theory, the Lacanian psychoanalysis
theory, the interpersonal psychoanalysis theory, the culturalist psychoanalysis
theory, the relational psychoanalysis, the interpersonal-relational
psychoanalysis, the intersubjective psychoanalysis and the modern
psychoanalysis among others (Stolorow, Atwood and Orange, 2002). The treatment
techniques mainly concentrate on the interpretation of the client’s conflicts
which are mostly unconscious that interfere with the mental day to day
functioning. The conflicts may cause symptoms such as anxiety, phobias,
compulsions, and depression. Psychoanalytical approach to counseling comes with
a number of challenges and limitations. To start with, it presumes that the
therapist should know what primarily ails the clients and takes a directive
approach where the therapist directs the clients to take various actions as he
seems best (Mitchell and Black, 1995). Moreover, the various theories in this
school tend to conflict each other thereby leaving doubts on what the school
explicitly advocates for. The technicality of the approach may also be highly
restrictive as it does not provide the therapists with the freedom to apply
techniques based on their own assessment of the client needs (Edelson, 1984). It
has been in many cases equated to the traditional Christianity that remained
rigid and opposed new and innovative practices of the religion.
The integrative approach will
therefore factor in the existential and the person-centered theories. The
combined approach of focusing on the interaction between the individual and the
realities around them as well as the focus on the individual where the
therapist plays the role of a facilitator is complimentary and bound to achieve
superior results on counseling clients (Goldfried and Castonguay, 1992). Integrative
approach to counseling offers a number of advantages to the counselor. Human
beings are integrative beings and their actions cannot be comprehensively
understood in the light of single theories (Lazarus, 1995). To be able to
counsel such persons effectively, the counselor must apply a combination of
affective and cognitive behavioral techniques. The advantages offered by using
the existential approach to counseling is that it focuses on the results and
does not restrict on the techniques to be employed while counseling. The end
result is that the counselor would only need to focus on serving the clients
and apply techniques which in their opinion serve the purpose of the therapy
best. The integrative approach to counseling also helps the therapist to
explore a number of theories (Lazarus, 1995). This broadens their spectrum and
understanding on the ways to deal with the increasingly complex psychological
conditions.
The process of integration must be
approached with great caution. This is due to the fact that, unlike the parent
theories that were developed after careful thought by the founders, the
integration often takes place against a background of mostly inexperienced
practitioners who barely understand the theories in question (Milton and Judd,
1999). The resultant techniques adopted may therefore end up being pretty
confusing and with little lack of focus, lead to ineffectiveness or in worse
circumstances further harm the clients for whose improvement is being sought. To
mitigate the risk of such eventualities, therapists wishing to pursue an
integrative approach to counseling are advised to base their integration on one
theory which they find to be most preferable to them. In this case, the most
preferable theory was the existential theory which concentrates on exploring
the choices available to clients in order to cope with the realities around
them. The fact that this theory focuses mainly on the objective of the
counseling makes it highly compatible with a myriad of other theories and
techniques while remaining objective about the effectiveness of the techniques
adopted (Schneider and Krug, 2010). The other limitation associated with
pursuing an integrative approach based on the existential theory is the lack of
structural frameworks to guide the practitioner when integrating with other
theories. The only guiding principle is the focus on results which is highly
subjective. This may be counter-productive where the counselor chooses to
exploit conflicting techniques in the process of counseling clients.
The integrative approach to
counseling has been very popular with therapists in the recent years. This is
due to the acknowledgement of the fact that human beings are in themselves
highly integrated and may therefore be served effectively though the
application of a single theory in therapy. The integrative approach has been
found to be more effective than the application of any theory in isolation in
most cases. The process of integration must however be taken with utmost
caution to prevent the ill effects that often result in the combination of
conflicting techniques that may end up being counter-productive. This hazard
can be mitigated by the therapists using their most favorite theories as the
philosophical base for forming the integrative approach. This serves to ensure
that whatever techniques are adopted are checked for consistency with the
provisions of the primary theory. The theory selected to serve as the base in
this paper is the existential approach which states that inner conflicts within
people are due to their confrontation with the realities around them. These
realities may include death, freedom and the responsibility that comes with it,
isolation and meaninglessness. These four realities form the core framework
within which the therapists develop solutions during their counseling
endeavors. The existential approach does not explicitly provide for the
techniques to be used in offering therapy. Instead, it focuses on the results
and leaves the specific of application to the counselor. This makes it the
ideal theory to provide the philosophical base for integration.
For more theory and case studies on: http://expertresearchers.blogspot.com/
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