Counseling Theories Exam 1

What is counseling?

A collaborative, one-way professional process where clients work through problems, trauma, or diagnoses

Counseling vs. friendship

Counseling is one‑way and focused entirely on the client; friendship is mutual.

Counseling vs. advice giving

Counseling supports clients in finding their own solutions rather than adopting the therapist’s beliefs.

Why people go to counseling

Trauma processing, learning about a diagnosis, court‑mandated therapy, overwhelming emotional pain.

Why counseling is a process

It requires time, trust, and confronting difficult material; things often get worse before better.

Barriers: Stigma

Negative beliefs about mental health that discourage seeking help.

Barrier: Cultural/gender norms

Beliefs that discourage emotional expression or therapy.

Barriers: Fear

Fear of judgment, vulnerability, or the unknown.

Barriers: Financial Limitations

Cost, insurance issues, or lack of access.

Barriers: Distrust in confidentiality

Fear that personal information won’t be kept private.

Barriers: Lack of connection

Difficulty finding a therapist who feels like a good fit

Barriers: Negative past experiences

Prior unhelpful or harmful therapy experiences.

Barriers: Fear of reliving trauma

Avoidance of painful memories or emotions.

Therapeutic success factors

Factors that play a role in therapy’s chance at success

Techniques

Account for 15% of success

The counselor’s theoretical orientation and interventions.

Expectancy

Account for 15% of success

Client’s belief that therapy will help.

Therapeutic relationship

Accounts for 30% of success

Trust, rapport, empathy; strongest predictor of success.

Extratherapeutic Factors

Accounts for 40% of success

Client’s environment, strengths, support system, and life circumstances.

Mandatory ethics

Following the minimum professional rules and codes.

Aspirational ethics

Going beyond the minimum to uphold the spirit of ethical practice.

Informed consent factors

How therapy works, expectations, confidentiality limits, orientation, fees, homework, client’s story.

Limits of confidentiality: Abuse

Must report abuse of children or elders.

Limits of confidentiality: Suicide

Break confidentiality if there is plan, means, and imminent intent

Limits of confidentiality: Homicide

Break confidentiality if there is imminent risk and identifiable target

Limits of confidentiality: Court order

Must release information if ordered by court.

Dual Relationships

When counselor and client have another relationship outside therapy.

Ex: in a small town your client may be your grocer or banker

Boundary crossing

Minor blurring of boundaries (e.g., small gift).

Best to avoid if possible, but often happens

Boundary violation

Harmful, exploitative breach (e.g., s*xual relationship)

Good boundaries

Healthy balance of closeness and distance

Appear warm and personable but do not disclose personal details unless it will help progress therapy

Bad boundaries

Too close or too distant; unclear limits

Drive/Instinct Theory

Human behavior is driven by life (s*x) and death (aggression) instincts.

Psychic determinism

Everything we do has an unconscious cause.

Conscious mind

Thoughts we are currently aware of

Preconscious mind

Information easily brought into awareness

Unconscious mind

Repressed, painful, or hidden material

Id

Instinctual, impulsive part of personality

Ego

Rational mediator between id and superego

Superego

Overly moralistic, rule-bound part of personality

Psychosexual stages

Oral, anal, phallic, latency, genital

If we get stuck or unsuccessfully complete one these stages there are issues associated with it

Free association

Speaking freely to reveal unconscious material

Interpretation

Therapist’s explanation of unconscious material; timing is crucial

Resistance

Behaviors that block progress; provide useful insight

Transference

Client projects past relationship patterns onto therapist

Countertransference

Therapist projects their own feelings onto client; can interfere or provide insight

Limits of Confidentiality: Supervision

You may be required to discuss your sessions with patients to a supervisor if you are working under supervision

Can happen if you are working towards a counseling degree

You have to let patients know that this will happen