Counseling is a collaborative effort between the counselor and client. Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health.

Counseling psychology is a general practice and health service provider specialty in professional psychology. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations.

Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well‐being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Clients served by counseling psychologists include individuals, groups (including couples and families) and organizations. Counseling psychologists work with individual clients of all ages, such as children who have behavioral problems; late adolescents with educational and career concerns or substance abuse problems; adults facing marital or family difficulties, career changes, or overcoming disabilities; and older adults facing retirement.

They work with groups to assist them in finding solutions to many of these same problems, as well as to improve the personal and interpersonal functioning of group members. Counseling psychologists also consult with organizations (e.g., businesses) and work groups to help provide a work environment in which people can succeed, and to enhance the ability of organizations to increase productivity and effectiveness.

There is no barrier to whom counselling can assist. We welcome you, regardless of your culture, religion, gender, sexual orientation, or employment group. Counselling is also not just for adult individuals, but is beneficial for couples, families, teenagers and children.

The counseling process is, in many ways, like an educational experience. The client not only learns more about him/herself, but also acquires new skills. Sometimes, counseling involves learning more about a particular condition (e.g., depression, anxiety, eating disorders) by which the client is affected, so that he/she can better understand treatment options. Below are some examples of what students can gain from personal/psychological counseling:

• Improved communication and interpersonal skills

• Greater self-acceptance and self-esteem

• Ability to change self-defeating behaviors/habits

• Better expression and management of emotions, including anger

• Relief from depression, anxiety or other mental health conditions

• Increased confidence and decision-making skills

• Ability to manage stress effectively

• Improved problem-solving and conflict resolution abilities

Personal or psychological counseling offers you the opportunity to talk about social, emotional, or behavioral problems that are either causing you distress or interfering with your functioning. Counselors are trained professionals who can respond to your concerns in an objective and non-judgmental manner. The counseling relationship is unique in that it provides a safe forum for you to speak freely, knowing that what is shared will be kept private and confidential.

There are many reasons for pursuing personal or psychological counseling. Some of the most common problems for which students seek help include the following:

• Difficulty concentrating or completing academic tasks

• Family or relationship problems

• Procrastination and other self-defeating behaviors/habits

• Issues of grief and loss

• Difficulty managing stress

• Coping with traumatic events

• Domestic violence or sexual assault

• Depression or lack of motivation

• Anxiety or acute panic attacks

• Problems with alcohol or other drugs

• Issues with eating behavior and/or body image

• Problems with anger

• Sexual concerns

• Compulsive behaviors

Ideally, counseling is terminated when the problem that you pursued counseling for becomes more manageable or is resolved. However, some insurance companies and managed care plans may limit the number of sessions for which they pay. Check with your health plan to find out more about any limitations in your coverage.

The length of your treatment will very much depend on your unique circumstances and needs, with six sessions often recommended and a review after that.

It also depends on the type of therapy you choose to try. Cognitive behavioural therapy is designed to be short-term and lasts six to 20 sessions. Psychodynamic, psychoanalytic, and existential therapies tend to be longer term, and many last for many months or even years.

Keep in mind that once you start sessions, new issues and angles can arise you were not aware existed that you then want to explore. It is of course possible to also see improvement faster than you expected.

No two people understand the same language in the same way; their understanding will always be linked to their personal experience of the world. The role of the counsellor, therefore, is to help the client to develop their own understanding of their situation.

They will enable the client to explore aspects of their life and feelings, by talking openly and freely. Talking like this is rarely possible with family or friends, who are likely to be emotionally involved and have opinions and biases that may affect the discussion. Talking to a counsellor gives clients the opportunity to express difficult feelings such as anger, resentment, guilt and fear in a confidential environment.

The counsellor may encourage the client to examine parts of their lives that they may have found difficult or impossible to face before. There may be some exploration of early childhood experiences to throw some light on why an individual reacts or responds in certain ways in given situations. This is often followed by considering ways in which the client may change such behaviours.

Good counselling should reduce the client’s confusion, allowing them to make effective decisions leading to positive changes in their attitude and/or behaviour. The ultimate aim of counselling is to enable the client to make their own choices, reach their own decisions and act upon them.

The first counselling session is an opportunity to talk about all the issues that have been disturbing you. If you are attending with a partner or family member the neutral space allows you both to share your worries respectfully. Even if there has been considerable conflict in a relationship to begin with, counselling can assist in developing a mutual understanding.

A counsellor will never judge you or criticise you. What you say will be held in the strictest confidence and not disclosed. Anything you feel you need or want to say is fine to be discussed in counselling.

Effective counselling is as much about what you do after the counselling session as what happens during it. A solution to your current situation might involve some kind of behaviour change. That of course will be more effective the more you practice it outside of your counselling appointments.

For example couples with children setting aside a dedicated time to talk and be with each other, with no distractions and no children.

Clients come to us with wide-ranging problems, including:

• Anxiety (generalised anxiety problems, panic attacks, agoraphobia, social anxiety, claustrophobia)

• Workplace issues (stress, work-life imbalances)

• relationship issues (breakups, divorce, affairs, choosing inappropriate partners, loneliness, life adjustments, marital problems, arguments, jealousy, wedding and premarital issues)

• Depression (including suicidal thoughts, low mood, social withdrawal)

• Low self-esteem and lack of confidence

• sexual problems (impotence, internet/pornography/sex addiction, loss of desire, infertility)

• Trauma (including post-traumatic stress disorder from accidents, rape and other attacks/incidents)

• Obsessive-compulsive disorder

• Eating problems (including bulimia, binge eating, negative body image)

• Phobias and fears

• Addiction and substance misuse

• Abuse (including physical, verbal, and sexual abuse)

• Bereavement/grief/loss

Research evidence about the effectiveness of counselling and psychotherapy overall is relatively unambiguous: counselling does work. For a wide range of types of psychological distress, both subjective client reports and more objective measurements indicate that counselling and psychotherapy are effective, both in the short term and over longer time periods.

For certain kinds of psychological distress, such as depression, some evidence also suggests that the benefits of counselling can interact positively with medications such as antidepressants: in other words, counselling and medication together sometimes offer better results than either counselling or medication on their own.

When people talk about going to “therapy” this is generally what they mean. CBT is one of the most common types of therapy provided to teens and is often used as a foundation for treatment that can be combined with other types of therapy. The premise of CBT is that our early lives including our childhood, upbringing, and the environment in which we were raised dictate who we become. This means that the dysfunctional patterns and coping strategies we learned in our childhood and adolescence follow-us into adulthood.

CBT works to identify and replace the dysfunctional areas with healthy alternatives primarily through talk therapy.

• Behavioral Therapy

Behavioral therapy uses key behavioral modifications to effect change in thought patterns and emotional responses. It is much more structured than CBT and focuses on changing behaviors in order to overcome challenges.

• Dialectical Behavior Therapy (DBT)

DBT uses the same techniques for learning to regulate and manage emotions as CBT but pairs them with practices like mindfulness and acceptance. Although this type of therapy was originally developed as a way to treat people with borderline personality disorder (BPD), it is also proving to be effective at helping those who participate in self-harm like cutting and those with mood spectrum disorders.

• Humanistic Therapy

Humanistic therapy takes a completely different approach to helping those with mental health concerns that the behavior-based therapies listed above. Here, any dysfunction resulting from childhood experiences, traumatic events, or learned behaviors is irrelevant. Instead, this method of treatment centers on self-actualization, fostering the idea that people are responsible for their own choices and that what matters is taking responsibility for the thoughts, feelings, and behaviors that are being experienced.

It is important to remember that these are only the most common therapeutic approaches used in treating mental health concerns that are often combined with these foundational techniques to better meet the needs of the individual client.

Most mental health providers will have a variety of tools in their toolbox which enables them to tailor their approach to treatment to the strategies, techniques, and tactics that are the most suitable for the situation.

References

Alfonso CA, Olarte SW. Contemporary practice patterns of dynamic psychiatrists—survey results. J Am Acad Psychoanal Dyn Psychiatry. 2011;39(1):7–26.

American Psychological Association. Understanding psychotherapy and how it works. 2016. http://www.apa.org/helpcenter/understanding-psychotherapy.aspx

Cuijpers P, Sijbrandij M, Koole SL, et al. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013;12(2):137–148.

Etkin A, Pittenger C, Polan HJ, et al. Toward a neurobiology of psychotherapy: basic science and clinical applications. J Neuropsychiatry Clin Neurosci. 2005;17(2):145–158.

Garfinkel PE, Bagby RM, Schuller DR, et al. Predictors of professional and personal satisfaction with a career in psychiatry. Can J Psychiatry. 2005;50(6):333–341.

Karlsson, H. How Psychotherapy Changes the Brain. Psychiatric Times. 2011.

Kellerman SE, Herold J. Physician response to surveys. A review of the literature. Am J Prev Med. 2001;20(1):61–67.

Kontos N, Querques J, Freudenreich O. The problem of the psychopharmacologist. Acad Psychiatry. 2006;30(3):218–226.

Leichsenring F, Rabung S. Long-term psychodynamic psychotherapy in complex mental disorders: update of a meta-analysis. Br J Psychiatry. 2011;199(1):15–22.

Mellman LA, Beresin E. Psychotherapy competencies: development and implementation. Acad Psychiatry. 2003;27(3):149–153.

Olfson M, Marcus SC. National trends in outpatient psychotherapy. Am J Psychiatry. 2010;167(12):1456–1463.

Parekh, M.D., M.P.H., R., & Givon, M.D., PH.D., L. (2019, January). The American Psychiatric Association. What is Psychotherapy? Retrieved from https://www.psychiatry.org/patients-families/psychotherapy.

Rector NA, Beck AT. Cognitive behavioral therapy for schizophrenia: an empirical review. J Nerv Ment Dis. 2012;200(10):832–839.

Shedler J. The efficacy of psychodynamic psychotherapy. Am Psychol. 2010;65(2):98–109.

Spielmans GI, Berman MI, Usitalo AN. Psychotherapy versus second-generation antidepressants in the treatment of depression: a meta-analysis. J Nerv Ment Dis. 2011;199(3):142–149.

Weingarten CP, Strauman TJ. Neuroimaging for psychotherapy research: current trends.

Psychother Res. 2015;25(2):185–213.

Wiswede D, et al. 2014. Tracking Functional Brain Changes in Patients with Depression under Psychodynamic Psychotherapy Using Individualized Stimuli. PLoS ONE. 2014. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109037