Counseling: A Comprehensive Profession: Eighth Edition

Counseling: A Comprehensive Profession
Eighth Edition
Chapter 8
Behavioral, Cognitive,
Systemic, Brief, and Crisis
Theories of Counseling
Copyright © 2018, 2013, 2009 Pearson Education, Inc. All Rights Reserved
Learning Objectives
8.1 Explore behavioral, cognitive-behavioral, systemic, and
brief theories of counseling
8.2 Examine the strengths and limitations of behavioral,
cognitive-behavioral, systemic, and brief theories of
counseling
8.3 Discuss the distinct and universal nature of crisis
counseling
Behavioral Counseling
• Approach of choice for clients with problems such as
eating disorders, substance abuse, psychosexual
dysfunction, anxiety, stress, assertiveness, parenting and
social interaction
• Especially popular in institutional settings, such as mental
hospitals or sheltered workshops
Behavioral Counseling: Founders and
Developers
• B.F. Skinner (1904-1990) popularized behavioral treatment
methods
• Others include:
– Ivan Pavlov
– John B. Watson
– Mary Cover Jones
– Albert Bandura
– John Krumboltz
– Niel Jacobson
– Steven Hayes
– Marsha Linehan
Behavioral Counseling: View of Human
Nature (1 of 2)
• Behaviorists share the following ideas:
– Concentration on behavioral processes - that is,
processes closely associated with overt behavior
– Focus on the here-and-now
– Assumption that all behavior - adaptive and
maladaptive - is learned
– Belief that learning can change maladaptive behavior
– Focus on setting goals in therapy
– Rejection of the idea that human personality is
composed of traits
Behavioral Counseling: View of Human
Nature (2 of 2)
• Social-cognitive form of learning - people gain new
knowledge and behavior by observing people and events
without engaging in the behavior themselves and without
any direct consequences to themselves
Behavioral Counseling: Role of the
Counselor
• May take several roles, depending on his or her behavioral
orientation and the client’s goals.
• Generally, a behaviorally based counselor is active in
counseling sessions.
• The counselor functions as a consultant, teacher, adviser,
reinforce, and facilitator (James & Gilliland, 2013).
Behavioral Counseling: Techniques (1 of 3)
• Reinforces - events that follow a behavior and increase
the probability of the behavior repeating
– Schedules of reinforcement - operate according to
number of responses (ratio) or length of time (interval)
between reinforces
• Shaping - behavior learned gradually in steps through
successive approximation
• Generalization - display of behaviors outside where they
were originally learned
• Maintenance - being consistent in performing the actions
desired without depending on anyone else for support
– Self-monitoring - clients modify their own behaviors
– Self-observation - clients notice their particular
behaviors
– Self-recording - records behaviors noted in self-
observation
• Assertiveness training - counselor teaches client about
assertiveness and self-expression
• Contingency contracts - spell out behaviors to be performed,
changed, or stopped, the rewards to each goal and conditions to each
reward
• Implosion and flooding - both involve desensitizing the client to a
situation by imagining the anxiety-producing scene
• Time-out - client is separated from positive reinforcement
• Overcorrecting - client restores the environment to its natural state
and then makes it better than normal
• Covert sensitization - undesired behavior is eliminated by
associating it with unpleasantness
Behavioral Counseling: Strengths and
Limitations (1 of 2)
• Strengths
– Deals directly with symptoms
– Focuses on the here and now
– Offers numerous techniques for counselors to use
– Based on learning theory
– Buttressed by the Association for Behavioral and
Cognitive Therapies (ABCT)
– Supported by exceptionally good research on how
behavioral techniques affect the process
Behavioral Counseling: Strengths and
• Limitations
– Does not deal with the total person, just explicit behaviors
– Sometimes applied mechanically
– Best demonstrated under controlled conditions that may be
difficult to replicate in normal counseling situations
– Ignores the client’s past history and unconscious forces
– Does not consider developmental stages
– Programs the client toward minimum or tolerable levels of
behaving, reinforces conformity, stifles creativity, and
ignores clients need for self-fulfillment, self-actualization,
and feelings of self-worth
Cognitive and Cognitive-Behavioral
Counseling (1 of 2)
• Cognitions - thoughts, beliefs, and internal images that
people have about events in their lives
• Are most successful with clients who:
– Are average to above-average in intelligence
– Have moderate to high levels of functional distress
– Are able to identify thoughts and feelings
– Are not psychotic or disabled by present problems
– Are willing and able to complete systematic homework
assignments
Cognitive and Cognitive-Behavioral
Counseling (2 of 2)
– Possess a repertoire of behavioral skills and responses
– Process information on a visual and auditory level
– Process information on a visual and auditory level
• Theories included are rational emotive behavioral therapy
(REBT), reality therapy (RT) and cognitive therapy (CT)
Rational Emotive Behavioral Therapy
• Founded by Albert Ellis (1913-2007)
• View of Human Behavior:
– People have both self-interest and social interest, but
are also inherently rational and irrational
– Irrational thinking/beliefs - may include invention of
upsetting or disturbing thoughts
– Self-talk - what an individual tells him/herself
– Ellis believes that everyone is a fallible human being
Rational Emotive Behavioral Therapy: Role
of the Counselor
• Counselors are active and direct.
• They are instructors who teach and correct clients’
cognitions.
• Counselors must listen carefully for illogical or faulty
statements from their clients and challenge beliefs.
• According to Ellis (1980) and others, an REBT counselor
needs to be bright, knowledgeable, empathetic, respectful,
genuine, concrete, persistent, scientific, interested in
helping others, and users themselves of REBT.
Rational Emotive Behavioral Therapy:
Techniques (1 of 2)
• The A-B-C-D-E Model of REBT:
– A: activating experience
– B: the person’s thoughts/beliefs about the
experience
– C: emotional reaction to B
– D: disputing irrational thoughts
– E: replacing irrational thoughts with effective
thoughts
Techniques (2 of 2)
• Teaching - having clients learn the basic ideas of REBT
and understand how thoughts are linked with feelings and
behaviors
• Disputing thoughts and beliefs:
– Cognitive disputation - use of direct questions, logical
reasoning, and persuasion
– Imaginal disputation - uses a client’s ability to
imagine and employs a technique called Rational
Emotive Imagery (REI ) EI
– Behavioral disputation - behaving in a way that is the

opposite of the client’s usual way
Strengths and Limitations (1 of 2)
• Strengths
– Clear, easily learned, and effective
– Can easily be combined with other behavioral techniques to
help clients more fully experience what they are learning
– Relatively short term, and clients may continue to use the
approach on a self-help basis
– Has generated a great deal of literature and research for
clients and counselors
– Has continued to evolve over the years as techniques have
been refined
– Has been found effective in treating major mental health
disorders such as depression and anxiety
Strengths and Limitations (2 of 2)
• Limitations
– Cannot be used effectively with individuals who have
mental problems or limitations, such as schizophrenia
– May be too closely associated with its founder
– Direct approach may lead to counselors being overly
zealous rather than therapeutic
– Emphasis on changing thinking may not be the
simplest way of helping clients change their emotions
Reality Therapy
• Founded by William Glasser (1925 - 2013) and further developed by
Robert Wubbolding.
• View of Human Nature:
– Focus on consciousness - humans function on a conscious level
rather than unconscious drives
– Everyone has a health/growth force both physically and
psychologically
– Four primary psychological needs:
 Belonging - need for friends, family, love
 Power - need for self-esteem, recognition, competition
 Freedom - need to make choices and decisions
 Fun - need for play, laughter, learning and recognition
Reality Therapy: Role of the Counselor
• The counselor serves primarily as a teacher and model,
accepting the client in a warm, involved way and creating
an environment in which counseling can take place.
• The counselor immediately seeks to build a relationship
with the client by developing trust through friendliness,
firmness, and fairness (Wubbolding, 1998).
• Counselors use “ing” verbs, such as anger or bullying to
describe client thoughts and actions.
• Counselor-client interactions focus on behaviors that the
client would like to change and ways to go about making
these desires a reality.
Reality Therapy: Techniques
• Reality therapy uses action-oriented techniques
• WDEP System:
– Wants (what does the client want?)
– Direction (explore direction of the client’s life)
– Evaluation (of client’s behaviors)
– Plan (client makes a plan for changing behaviors)
Reality Therapy: Strengths
• Strengths
– Versatile and can be applied to many populations
– Concrete
– Emphasizes short-term treatment
– Has national training centers and is taught internationally
– Promotes responsibility and freedom within individuals
without blame or criticism or as an attempt to restructure the
entire personality
– Challenged the medical model of client treatment
– Addresses conflict resolution
– Stresses the present because current behavior is most
amenable to client control
Reality Therapy: Limitations
• Limitations
– Emphasizes the here and now of behavior so much that it
sometimes ignores other concepts
– Holds that all forms of mental illness are attempts to deal
with external events (Glasser, 1984)
– Has few theoretical constructs, although it is now tied to
choice theory
– Does not deal with the full complexity of human life
– Susceptible to becoming overly moralistic
– Dependent on establishing a good counselor-client
relationship
– Depends on verbal interaction and two-way communication
Cognitive Therapy
• Founded by Aaron Beck (1921 - ), and daughter Judith
Beck continues work with CT today.
– Perception and experience are active processes that
involve inspective and introspective data
– How a person views a situation is evident in his/her
thoughts and visual images
– Dysfunctional behavior is caused by dysfunctional
thinking; if beliefs change, behaviors change.
Cognitive Therapy: Role of the Counselor
• Active in session
• Work with the client to make covert thoughts more overt
• Making the covert thoughts more overt is especially
important in examining cognitions that have become
automatic
Cognitive Therapy: Techniques
• Challenge how clients process information
• Counter mistaken belief systems
• Encourage self-monitoring exercises to stop negative
“automatic thoughts”
• Improve communication skills
• Increase positive self-statements and exercises
• Encourage doing homework, including disputing
irrational thoughts
Cognitive Therapy: Strengths and
• Strengths
– Has been adapted to a wide range of disorders
– Has spawned, in conjunction with CBT, dialectical
behavior therapy
– Applicable in a number of cultural settings
– Well-researched, evidence-based therapy
– Spawned a number of useful and important clinical
instruments
– Has a number of training centers across the US and
Europe
Cognitive Therapy: Strengths and
• Limitations
– Structured and requires clients to be active
– Not appropriate for individuals seeking an insight-
oriented approach
– Not the best approach for individuals who are
intellectually limited
– Demanding
Systems Theories (1 of 2)
• Systems theory is a generic term for conceptualizing a
group of related elements (people) that interact as a whole
entity (a family or a group).
• Three basic assumptions of system theories:
1. Causality is interpersonal
2. Psychosocial systems are best understood as repeated
patterns of interpersonal reactions
3. Symptomatic behaviors must be understood from an
interactional viewpoint
Systems Theories (2 of 2)
• Circular causality - events are related through a series of
interactive feedback loops
• Theories include:
– Bowen Systems Theory
– Structural Family Counseling
– Strategic (Brief) Counseling
Bowen Systems Theory
• Created by Murray Bowen (1913 - 1990). Further advanced by
Michael Kerr and Edwin Friedman.
– There is chronic anxiety in all life, both emotional and
physical
– Differentiation - distinguishing one’s thoughts from one’s
emotions and oneself from others
– When a great deal of friction exists in a marriage, the
following may occur:
 Fusion - undifferentiated emotional togetherness, or
 Cutoff - physical or psychological avoidance
 Triangulation - focus on a third party
Bowen Systems Theory: Role of the
Counselor
• To coach and teach the client to be more cognitive in his or
her dealings with others
• At its best, it is very much like a Socratic dialogue.
• The counselor may construct a multigenerational
genogram with the client to aid in the process of helping
the client learn to think for himself or herself.
Bowen Systems Theory: Techniques (1 of 2)
• Genogram - a visual representation of a person’s family
tree depicted in geometric figures, lines, and words
• Asking content-based questions to cognitively
understand what happened in one’s family without any
emotional overlay
• Go home again - visit with his or her family in order to get
to know them better, which promotes
– person-to-person relationships, and
– asking of questions about pivotal events that had an
impact on the family
Bowen Systems Theory: Techniques (2 of 2)
• Detriangulation - the process of being in contact but
emotionally separate
• Differentiation of self - ability to distinguish between
subjective feelings and objective thinking
Bowen Systems Theory: Strengths and
• Strengths
– Focuses on multigenerational family history and the
importance of noticing and dealing with past patterns in
order to avoid repeating these behaviors in
interpersonal relationships
– Uses genograms to plot historical links
– The cognitive emphasis of the approach and its focus
on differentiation of self and detriangulation are unique
Bowen Systems Theory: Strengths and
• Limitations
– Extensive and complex
– Those who benefit the most from this theory are
severely dysfunctional ad have a low differentiation of
self
– May require considerable investment on multiple levels
Structural Family Counseling
• Founded by Salvador Minuchin (1921 - ), with Braulio
Montalvo and Jay Haley as notable contributors
– Structure - the informal way in which a family
organizes itself and interacts
– Coalitions - alliances between specific members
against a third member
– Cross-generational alliances - alliances between
family members of two different generations
Structural Family Counseling: Role of the
Counselor
• Both observers and experts in making interventions to
modify and change the underlying structure of a family
• Advocate for structural change in the organization of the
family unit, with particular attention on changing
interactional patterns in subsystems of the family such as
the marital dyad
• Work at establishing clear boundaries among family
members (Minuchin et al., 1967)
Structural Family Counseling: Techniques (1
of 2)
• A primary technique is to work with family interaction

• Reframing - helping the family see its problems from a
different, more positive perspective
• Punctuation - the selective description of a transaction
• Unbalancing - counselor supports an individual or
subsystem against the rest of the family
• Enactment - family demonstrates problematic behaviors
Structural Family Counseling: Techniques (2
of 2)
• Boundary making - creating lines that separate people or

subsystems from each other psychologically
• Intensity - changing maladaptive behaviors by using
strong affect, repeated intervention, or prolonged pressure
• Restructuring - changing the structure of a family by
altering existing hierarchies or interaction patterns
• Adding cognitive constructions - includes advice,
information, pragmatic fictions, and paradox
Structural Family Counseling: Strengths
and Limitations (1 of 2)
• Strengths
– Versatile, in that it is a process that is appropriate for
low-socioeconomic level families and other families
– Effective, having been used in treating juvenile
delinquents, alcoholics, and individuals with anorexia
– Culturally sensitive and appropriate for use in
multicultural settings
– Clear in its definition of terms and procedures and is
easily applicable
– Emphasizes symptom removal and a reorganization of
the family in a pragmatic way
Structural Family Counseling: Strengths
• Limitations
– Not complex enough, may be sexist at times, and
focuses too much on the present
– Influenced by and difficult to differentiate it from
strategic family therapy
– May not empower families enough
Strategic (Brief) Counseling (1 of 2)
• Founders and developers:
– Joe Weakland
– Paul Watzlawick
– Chloe Madanes
– Jay Haley
– Sees problems as occurring within a developmental
framework of the family life cycle
Strategic (Brief) Counseling (2 of 2)
– Developmentally significant dimensions of family life:
 Family rules - overt and covert rules family use to
govern selves
 Family homeostasis - tendency of families to
remain in their same pattern of functioning unless
challenged to do otherwise
 Quid pro quo - treating other family members the
way they are treated
 Circular causality - events are interconnected with
multiple factors behind a behavior
Strategic (Brief) Counseling: Role of the
Counselor
• Take a systemic view of problem behavior and focus on the process
rather than the content of dysfunctional interactions
• Work to get people to try new behaviors because their old behaviors
are not working
• Target a specific behavior for change, which, if modified, may create a
spillover effect, resulting in the individual making other behavioral
changes
• Strive to resolve presenting problems and pay little attention to
instilling insight
• Are active, direct, and goal-oriented as well as problem-focused,
pragmatic, and brief.
• Usually limit the number of sessions with families to 10 visits or less
Strategic (Brief) Counseling: Techniques (1 of
2)
• Strategic family counselors are non blaming and accept

the presenting problems of families and view symptoms
as serving the purpose of communication
• Relabeling - giving a new perspective to a behavior
• Para doxing - insisting on the opposite of what one wants
• Prescribing the symptom - have the family display
voluntarily what was previously manifested involuntarily
• Pretend - have clients make changes or complete
homework that would not have been done otherwise
Strategic (Brief) Counseling: Techniques (2 of
2)
• Ordeals - families are asked to make sacrifices during the

treatment process
• Homework - tasks as prescriptions or directives to be
completed between sessions
Strategic (Brief) Counseling: Strengths and
• Strengths
– Many times the therapists work in teams
– Nature o the approach is pragmatic and flexible
– Focus of practitioners is on innovation and creativity
– Emphasis is to change the perception within people as a
way of fostering new behaviors
– Intentional attempts are made to work on one problem at a
time and limit the number of therapeutic sessions so that the
focus and motivation for doing things differently is enhanced
– May be modified and carried over into settings, such as
schools, where it may be systemically applied to serve a
total population
Strategic (Brief) Counseling: Strengths and
• Limitations
– Some of its underlying foundation and techniques
overlap with other systems and brief therapy theories
– Some stands taken by leading strategic practitioners
are controversial
– Clients may not attain as much independence or ability
Brief Counseling Approaches
• Skills in brief counseling approaches are applicable for
counseling settings where counselors are expected to do
more in less time (i.e. managed care settings, schools,
public settings)
• Theories include:
– Solution-Focused Counseling
– Narrative Counseling
Solution-Focused Counseling
• Originated by Steve de Shazer and Bill O’Hanlon, with
contributions from Michele Weiner-Davis and Insoo Kim
Berg
– Sees people as being constructivist in nature - reality
is a reflection of observation and experience
– People want to change and change is inevitable
Solution-Focused Counseling: Techniques:
Role of the Counselor (1 of 2)
• First role is to determine how active and committed a client
is to the process of change
• See clients in one of three ways:
– Visitors who are not involved in the problem and are
not a part of the solution
– Complainants who complain about situations but can
be observant and describe problems even if they are
not invested in resolving them
Solution-Focused Counseling: Techniques:
Role of the Counselor (2 of 2)
– Customers who are not only able to describe problems
and how they are involved in them, but are willing to
work on finding solutions (Fleming & Rickord, 1997)
• Act as facilitators of change to help clients “access the
resources and strengths they already have but are not
aware of or are not utilizing” (Cleveland & Lindsey, 1995, p.
145)
• Encourage, challenge, and set up expectations for change
Solution-Focused Counseling: Techniques
• Miracle question - “Suppose a miracle happened that solved
all the problems that brought you here. How would you know it?
What would be different?”
• Scaling - client evaluates a problem on a scale of 1 (low) to 10
(high)
• Compliments - counselors praise clients for their strengths
• Clues - counselors alert clients that some behaviors are likely to
continue and they should not worry about them
• Skeleton keys - procedures that have worked before and have
universal applications to unlocking a variety of problems.
Solution-Focused Counseling: Strengths and
• Strengths
– Emphasizes brevity and its empowerment of client
families
– Displays flexibility and excellent research in support of
its effectiveness
– Reveals a positive nature to working with a variety of
clients in various settings
– Focuses on change, even small change
– Can be combined with other counseling approaches
Solution-Focused Counseling: Strengths and
• Limitations
– Pays almost no attention to client history
– Has a lack of focus on insight
– Uses teams, at least by some practitioners, which
makes the cost of this treatment high
Narrative Counseling
• Founders include Michael White and David Epston with
contributions from Michael Durrant and Gerald Monk
– Meaning or knowledge is constructed through social
interaction
– There is no absolute reality except as a social product
– People are seen as internalizing and judging
themselves through creating stories of their lives
Narrative Counseling: Role of the Counselor
• Sees counselors as collaborators and masters of asking
questions
• Engages clients and uses basic relationship skills such as
attending, paraphrasing, clarifying, summarizing, and checking
to make sure they hear clients’ stories or problems correctly
• Assumes that symptoms do not serve a function and are, in fact,
oppressive
• Address and eliminate problems as rapidly as possible
• Use narrative reasoning, which is characterized by stories,
meaningfulness, and liveliness, in an effort to help clients
redefine their lives and relationships through new narratives
Narrative Counseling: Techniques (1 of 2)
• Externalization of a problem - separates the person from
the problem
• Asking how the problem and person affect each other
raises objectivity and awareness
• Raising dilemmas - client examines possible aspects of a
problem before the need arises
• Predicting setbacks - client thinks about what to do in the
face of adversity
Narrative Counseling: Techniques (2 of 2)
• Reauthoring - client changes life and relationship stories
and creates possibilities for change
• Celebrations/letters/certificates - counselors recognize
clients’ progress and accomplishment through letters and
certificates, and celebrate termination of treatment
Narrative Counseling: Strengths and
• Strengths
– Blame is alleviated and dialogue is generated as
everyone works to solve a common problem
– Clients create a new story and new possibilities for
action
– Exceptions to problems are highlighted as in solution-
focused therapy
– Clients are prepared ahead of time for setbacks or
dilemmas through counselor questions
Narrative Counseling: Strengths and
• Limitations
– Quite cerebral and does not work well with clients who
are not intellectually astute
– No norms regarding who clients should become
– History of a difficulty is not dealt with at all
Crisis and Trauma Counseling (1 of 2)
• Founders and developers: Erich Lindemann and Gerald
Caplan
– Loss is inevitable to life
– Four common types of crises include: developmental,
situational, existential, exosystemic
Crisis and Trauma Counseling
• Techniques:
– Assessment of the client experiencing trauma
– Define the problem
– Ensure client safety
– Provide support
– Examine alternatives
– Make plans
– Obtain commitment
Crisis and Trauma Counseling: Role of the
Counselor
• Need to be mature individuals with a variety of life
experiences with which they have successfully dealt
• Need to have a good command of basic helping skills, high
energy, and quick mental reflexes, and yet be poised,
calm, creative, and flexible in the midst of highly charged
situations
• Often they need to be direct and active in crisis situations
• Must be ready for the three stages of crisis counseling:
precrisis preparation, in-crisis action, and postcrisis
recovery
Crisis and Trauma Counseling: Techniques
• Assessment of the client experiencing trauma
• Define the problem
• Ensure client safety
• Provide support
• Examine alternatives
• Make plans
• Obtain commitment
Crisis and Trauma Counseling: Strengths
• Strengths
– Benefits from its brevity and its directness
– Uses modest goals and objectives because of the
sudden and/or traumatic nature of crises
– Relies on its intensity, which is greater than regular
forms of counseling
– Utilizes a more transitional nature
Crisis and Trauma Counseling: Strengths
• Limitations
– Deals with situations of an immediate nature
– Does not go into the same depth in regard to resolution
that most counseling approaches do
– Is more time limited and trauma oriented than most
forms of therapeutic interventions
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Counseling: A Comprehensive Profession

– Behavioral disputation - behaving in a way that is the

• A primary technique is to work with family interaction

• Boundary making - creating lines that separate people or

• Strategic family counselors are non blaming and accept

• Ordeals - families are asked to make sacrifices during the

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