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  • Writer's pictureCarolyn Cutillo

Counseling Theories 101

If you’re reading this, you’re probably already aware of the usefulness of counseling! But do you know the ins and outs of different modalities (or theories) of therapy? This guide aims to help you be an informed consumer in the realm of mental health counseling:

  • Psychoanalysis: With classic psychoanalysis, think Freud. This is where talk therapy originated, and yes, it is the kind where the client free-associates, lies down on a couch, and the therapist is a “blank state” to project interpersonal dilemmas upon (i.e. “transference”). The focus is on the unconscious (such as dream work). Analysis traditionally consists of multiple sessions per week for many years. It is now rarely done in this original form.

  • Psychodynamic: Therapists using a psychodynamic orientation have updated Freud’s (and others’) ideas, while still primarily focusing on unconscious material. A psychodynamic therapist in the modern era will likely be less active and directive than, say, a cognitive-behavioral therapist.

  • Person-centered: Carl Rogers popularized the notion of “unconditional positive regard.” This means what it sounds like: a client is held by the therapist in a positive light no matter what they bring to the table. This humanistic approach is now almost always, by default, the norm in the modern era of therapy; though a practitioner who identifies as person-centered likely takes a particularly nondirective—but warm and empathic—stance with their clients, letting the healing lead from within the client’s self.

  • Cognitive-behavioral therapy: Best known as CBT, cognitive behavioral therapy centers around the trifecta of thoughts, feelings, and behaviors, with each aspect influencing the others and one’s core beliefs about the world. CBT challenges the client to make changes that are measurable: thus, it is more concerned with active rather than unconscious processes. CBT is the “gold standard” in the science world in terms of studies of its effectiveness. It is the foundation for many recent theories, including…

  • Dialectical-behavioral therapy: DBT, which originated from work with borderline clients, uses the idea of the “dialectic,” or two extremes that can be integrated. DBT is big on skills: distress tolerance, mindfulness, interpersonal effectiveness, and emotion regulation are its four main pillars.

  • Acceptance and Commitment Therapy: ACT (pronounced “act”) asks clients to accept that which cannot be changed, while committing to making changes that can. Another cognitive-behavioral theory, ACT promotes mindfulness practices plus cognitive flexibility for living life aligned with one’s values.

  • Family systems: Taking a family systems approach means seeing the client (or couple, or family) in light of the systems which they inhabit: their family, their environment, and other social forces. Every part of the system has a function and is inextricably interconnected with the others.

  • Integrative: Truly, many therapists today are integrative in their techniques: they take bits and pieces from two or more modalities and apply them in a way that is most helpful for the client in question. While the integrative therapist is particularly flexible, they typically ground themselves in a couple of choice theories and can incorporate others from there.

These are but a few of the popular theories of counseling that you might see in clinician’s bios. Different clients will gravitate toward different modalities depending on their goals or concerns. Hopefully, this knowledge will empower you to seek the kind of therapy that is best suited to you and what you want to work on. Don’t be afraid to speak up to your counselor!


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