Thursday, November 1, 2012

Types of Counselling - Part 2


Emotionally focused therapy (EFT) is a short-term (8-20) sessions  structured psychotherapy approach to working with individuals, couples and families.Emotionally focused therapy proposes that emotions themselves have an innately adaptive potential that, if activated, can help clients change problematic emotional states or unwanted self-experiences. Emotions themselves do not inhibit the therapeutic process, but people’s incapability to manage emotions and use them well is seen as the problem . Emotions are connected to our most essential needs. They rapidly alert us to situations important to our advancement. They also prepare and guide us in these important situations to take action towards meeting our needs. Clients undergoing EFT are helped to better identify, experience, explore, make sense of, transform and flexibly manage their emotional experiences.
   
Existential counselling is a philosophical form of counselling which addresses the situation of a person's life and situates the person firmly within the predictable challenges of the human condition. Existential counselling considers human living to take place within four dimensions: physical, social, psychological and spiritual. It shows each of these dimensions to be constituted like a force field, within which predictable paradoxes, tensions and dilemmas play out. Human beings can learn to deal with these tensions and conflicts more effectively by facing up to the negatives as well as the positives of their lives, including the tensions of life and death, love and hate, strength and weakness and meaning and absurdity
   
Genetic counselling is the process by which patients or relatives, at risk of an inherited disorder, are advised of the consequences and nature of the disorder, the probability of developing or transmitting it, and the options open to them in  family planning. This complex process can be separated into diagnostic (the actual estimation of risk) and supportive aspects. Genetic counselling is to understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. This process integrates:
Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence.
Education about inheritance, testing, management, prevention, resources of diseases. Counselling to promote informed choices and adaptation to the risk or condition. A genetic counsellor is an expert with a Master of Science degree in genetic counselling. Genetic counsellors should be expert educators, skilled in translating the complex language of genomic medicine into terms that are easy to understand.  Genetic counsellors work as members of a health care team and act as a patient advocate as well as a genetic resource to physicians. Genetic counsellors provide information and support to families who have members with birth defects or genetic disorders, and to families who may be at risk for a variety of inherited conditions. They identify families at risk, investigate the problems present in the family, interpret information about the disorder, analyze inheritance patterns and risks of recurrence, and review available genetic testing options with the family.

Grief counselling is a form of psychotherapy that aims to help people cope with grief and mourning following the  death of loved ones, or with major life changes that trigger feeling of grief (example divorce).
Grief counsellors feel that everyone experiences and expresses grief in their own way, often shaped by culture. They believe that it is not uncommon for a person to withdraw from their friends and family and feel helpless; some might be angry and want to take action. Some may laugh.
Grief counsellors hold that one can expect a wide range of emotion and behavior associated with grief. Some counselors believe that in all places and cultures, the grieving person benefits from the support of others. Further, grief counsellors believe that where such support is lacking, counselling may provide an avenue for healthy resolution. Grief counsellors believe that grief is a process , the goal of which is "resolution." The field further believes that where the process of grieving is interrupted, for example, by simultaneously having to deal with practical issues of survival or by being the strong one and holding the family together, grief can remain unresolved and later resurface as an issue for counselling.  Grief counselling becomes necessary when a person is so disabled by their grief, overwhelmed by loss to the extent that their normal coping processes are disabled or shut down.  Grief counselling facilitates expression of emotion and thought about the loss, including sadness, anxiety, anger, loneliness, guilt, relief, isolation, confusion, or numbness.
It includes thinking creatively about the challenges that follow loss and coping with concurrent changes in their lives. Often people feel disorganized, tired, have trouble concentrating, sleep poorly and have vivid dreams, and experience change in appetite. These too are addressed in counselling.

Relationship counselling is a  process of counselling the parties of a relationship in an effort to recognize and to better manage or reconcile troublesome differences and repeating patterns of distress. The relationship involved may be between members of a family or a couple (see also family therapy), employees or employers in a workplace, or between a professional and a client.

Couple therapy (or relationship therapy) is a related and different process. It may differ from relationship counseling in duration. Short term counseling may be between 1 to 3 sessions whereas long term couples therapy may be between 12 to 24 sessions. An exception is brief or solution focused couples therapy. In addition, counselling tends to be more 'here and now' and new coping strategies are the outcome. Couples therapy is more about seemingly intractable problems with a relationship history, where emotions are the target and the agent of change.

Marriage counselling or marital therapy can refer to either or some combination of the above.
The methods may differ in other ways as well, but the differences may indicate more about the counsellor/therapist's way of working than the title given to their process.
A postvention is an intervention conducted after a suicide, largely taking the form of support for the bereaved (family, friends, professionals and peers). Family and friends of the suicide victim may be at increased risk of suicide themselves.  The aim is to support and debrief those affected; and reduce the possibility of suicide contagion. Interventions recognize that those bereaved by suicide may be vulnerable to suicidal behaviour themselves and may develop complicated grief reactions.
Postvention includes procedures to alleviate the distress of suicidally bereaved individuals, reduce the risk of imitative suicidal behavior, and promote the healthy recovery of the affected community. Postvention can also take many forms depending on the situation in which the suicide takes place. Schools and colleges may include postvention strategies in overall crisis plans. Individual and group counseling may be offered for survivors (people affected by the suicide of an individual).
               
Rehabilitation Counselling is focused on helping people who have disabilities achieve their personal, career, and independent living goals through a counseling process. Rehabilitation Counsellors can be found in private practice, in rehabilitation facilities, hospitals, universities, schools, government agencies, insurance companies and other organizations where people are being treated for congenital or acquired disabilities with the goal of going to or returning to work.

Solution focused brief therapy (SFBT), often referred to as simply 'solution focused therapy' or 'brief therapy', is a type of talking therapy that is based upon constructionist philosophy. It focuses on what clients want to achieve through therapy rather than on the problem(s) that made them seek help. The approach does not focus on the past, but instead, focuses on the present and future. The therapist/counsellor uses respectful curiosity to invite the client to envision their preferred future and then therapist and client start attending to any moves towards it whether these are small increments or large changes. To support this, questions are asked about the client’s story, strengths and resources, and about exceptions to the problem.
Solution focused therapists believe that change is constant.  By helping people identify the things that they wish to have changed in their life and also to attend to those things that are currently happening that they wish to continue to have happen, SFBT therapists help their clients to construct a concrete vision of a preferred future for themselves.  The SFBT therapist then helps the client to identify times in their current life that are closer to this future, and examines what is different on these occasions. By bringing these small successes to their awareness, and helping them to repeat these successful things they do when the problem is not there or less severe, the therapists helps the client move towards the preferred future they have identified. One way of understanding the practice of SFBT is displayed through the acronym MECSTAT, which stands for Miracle questions, Exception questions, Coping questions, Scaling questions, Time-out, Accolades and Task.

Logotherapy was developed by neurologist and psychiatrist Viktor Frankl. It  focuses on Kierkegaard's will to meaning as opposed to Adler's Nietzschean doctrine of will to power or Freud's will to pleasure. Rather than power or pleasure, logotherapy is founded upon the belief that it is the striving to find a meaning in one's life that is the primary, most powerful motivating and driving force in humans.
The notion of Logotherapy was created with the Greek word logos ("meaning"). Frankl’s concept is based on the premise that the primary motivational force of an individual is to find a meaning in life. The following list of tenets represents basic principles of logotherapy:
Life has meaning under all circumstances, even the most miserable ones.
Our main motivation for living is our will to find meaning in life.
We have freedom to find meaning in what we do, and what we experience, or at least in the stand we take when faced with a situation of unchangeable suffering.

REBT- (Rational Emotive Behaviour Therapy) – REBT  is a comprehensive, active-directive, philosophically and empirically based psychotherapy which focuses on resolving emotional and behavioral problems and disturbances and enabling people to lead happier and more fulfilling lives.[1] REBT was created and developed by the American psychotherapist and psychologist Albert Ellis who was inspired by many of the teachings of Asian, Greek, Romanand modern philosophers.[2][3] REBT is one form of cognitive behavior therapy (CBT).
One of the fundamental premises of REBT is that humans, in most cases, do not merely get upset by unfortunate adversities, but also by how they construct their views of reality through their language, evaluative beliefs, meanings and philosophies about the world, themselves and others.
In REBT, clients usually learn and begin to apply this premise by learning the A-B-C-model of psychological disturbance and change. The A-B-C model states that it normally is not merely an A, adversity (or activating event) that contributes to disturbed and dysfunctional emotional and behavioral Cs, consequences, but also what people B, believe about the A, adversity. A, adversity can be either an external situation or a thought or other kind of internal event, and it can refer to an event in the past, present, or future.
The Bs, beliefs that are most important in the A-B-C model are explicit and implicit philosophical meanings and assumptions about events, personal desires, and preferences. The Bs, beliefs that are most significant are highly evaluative and consist of interrelated and integrated cognitive, emotional and behavioral aspects and dimensions. According to REBT, if a person's evaluative B, belief about the A, activating event is rigid, absolutistic and dysfunctional, the C, the emotional and behavioral consequence, is likely to be self-defeating and destructive. Alternatively, if a person's evaluative B, belief is preferential, flexible and constructive, the C, the emotional and behavioral consequence is likely to be self-helping and constructive.
Through REBT, by understanding the role of their mediating, evaluative and philosophically based illogical, unrealistic and self-defeating meanings, interpretations and assumptions in upset, people often can learn to identify them, begin to D, dispute, refute, challenge and question them, distinguish them from healthy constructs, and subscribe to more constructive and self-helping constructs.
The REBT framework assumes that humans have both innate rational (meaning self- and social-helping and constructive) and irrational (meaning self- and social-defeating and un-helpful) tendencies and leanings.
REBT is applied as an educational process in which the therapist often active-directively teaches the client how to identify irrational and self-defeating beliefs and philosophies which in nature are rigid, extreme, unrealistic, illogical and absolutist, and then to forcefully and actively question and dispute them and replace them with more rational and self-helping ones. By using different cognitive, emotive and behavioral methods and activities, the client, together with help from the therapist and in homework exercises, can gain a more rational, self-helping and constructive rational way of thinking, emoting and behaving. One of the main objectives in REBT is to show the client that whenever unpleasant and unfortunate activating events occur in people's lives, they have a choice of making themselves feel healthily and self-helpingly sorry, disappointed, frustrated, and annoyed, or making themselves feel unhealthily and self-defeatingly horrified, terrified, panicked, depressed, self-hating, and self-pitying. By attaining and ingraining a more rational and self-constructive philosophy of themselves, others and the world, people often are more likely to behave and emote in more life-serving and adaptive ways.

For other types of counselling, please refer to our blogpost 
 
Best Wishes,
Margalit Chordekar
Career Counsellor
EduGroomers Career Counselling

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