What are the five theories of counseling?

The American Mental Health Counselors Association defines clinical mental health counseling (CMHC) as “flexible, consumer-oriented therapy” conducted by highly skilled mental health professionals. Traditional forms of psychotherapy are integrated with a problem-solving, practical approach to solve day-to-day problems and affect change.¹ Many different methods are used, based on general theories of psychological counseling developed over the years.

In this article, we discuss the five theories of counseling, their origins and how counseling theories are used in today’s mental health care practices.

Psychotherapy, also known as talk therapy, is a method of helping people with various kinds of emotional problems and mental illnesses. It may be useful in helping them cope with their daily lives, deal with trauma or loss, or manage anxiety or depression.²

In the counseling setting, there are five main approaches to psychotherapy:³

• Psychoanalytical counseling
• Behavioral counseling
• Cognitive counseling
• Humanistic counseling
• Holistic counseling (integrative therapy)

Initially developed by Sigmund Freud, psychoanalysis strives to uncover unconscious motivations and meanings to explain and alter thoughts, feelings and behaviors. Psychoanalytic techniques include dream analysis, free association and emotional transference. It is believed that trauma experienced at a young age influences how an individual acts later in life. Since the 1890s, when Freud first made his discovery, psychoanalytical counseling has undergone many modifications and significant expansion. The technique involves a close partnership between the patient and the therapist, as the patient explores actions with the doctor within this setting.^4,3

The behaviorist theory maintains that peoples’ behavior is in reaction to their environment, and that behaviors are developed through daily interactions with others and the world. It is based on Ivan Pavlov’s research in 1897 concerning classical conditioning, such as his famous experiment in which dogs would salivate at the sound of a bell, once the bell’s sound was associated with food. Researcher BF Skinner found that rewards can encourage good behavior, while punishment discourages bad behavior. Behavior modification continues to be a primary goal of behavioral counseling today and are some of the most common counseling theories. Behavioral counselors employing dialectical behavioral therapy (DBT) have clients learn how to tolerate feelings of distress and better manage their emotions through mindfulness and other techniques. ^5,4

Dr. Aaron T. Beck is considered the father of cognitive counseling and cognitive behavior theory (CBT). Cognitive therapy theorizes that an individual’s thoughts, feelings and behaviors are all connected and that human behavior is strongly influenced by how we think. In CBT, it is thought that by changing a person’s thoughts, one can affect that person’s feelings and behaviors. Cognitive behavior therapy seeks to replace harmful thought patterns with helpful ones, is often used for people with anxiety, obsessive-compulsive disorder (OCD), mood disorders or eating disorders.^5,6

Rational Emotive Behavior Therapy (REBT), introduced in 1955 by Albert Ellis, uses a practical, action-oriented approach to manage emotional, behavioral and cognitive disturbances. This behavioral therapy maintains that one’s thinking about certain events causes emotional as well as behavioral upset. REBT provides a variety of methods to help people reformulate their dysfunctional beliefs into more sensible, realistic and helpful ones.⁷

Based on the teachings of philosophers Jean-Paul Sartre and Søren Kierkegaard, humanistic therapy is focused on the belief in the inherent goodness of people. The purpose of these types of counseling theories is for individuals to realize their own goodness and make rational choices so that they can reach their greatest potential. Unlike psychoanalysis, humanistic counseling is centered not on the past but on the present, and the person’s free will and determination.^4,3

Three counseling theories of the humanistic approach are client-centered therapy, gestalt therapy and existential therapy.³

Client-Centered Therapy

In this modality, also known as person-centered humanistic therapy, the focus is on self-actualization. Developed by psychologist Carl Rogers in the 1940s, this modality operates on the belief that every individual has the desire and capacity for personal growth. The counselor acts as an understanding facilitator and clients take a more active lead in sessions to make personal discoveries and find their own solutions. This counseling approach can be particularly useful for teenagers.^8,9

Gestalt Therapy

The gestalt approach involves looking at present-day unresolved issues, which might include family or relationship conflicts, and thinking about how they affect the person’s well-being. Techniques might include role-playing or visualization and movement to act out specific scenarios. Gestalt therapy can be helpful as a format of family therapy especially for those who may be unaware of interpersonal dynamics.¹⁰

Existential Therapy

A philosophical outlook as much as a treatment modality, existential therapy recognizes the person’s freedom to make choices, as well as that person’s responsibility for those choices. Also considered a narrative therapy, in a session, clients might talk about what certain aspects of life mean to them and explore how to uncover greater meaning.¹⁰

Humanistic counseling is often used to address depression, trauma, self-esteem and relationship issues, substance use disorder, trouble coping with chronic health problems and feelings of being worthless.¹⁰

In holistic counseling, a person is guided toward seeing themself as consisting of physical, psychological, mental and spiritual components, joining together as a whole. Holistic therapy is often aligned with a specific faith, and it is becoming more and more popular.⁴

Also known as integrative therapy, it can incorporate many different techniques and strategies based on individual needs, including art or music therapy, mindfulness, humanistic therapy, psychodynamic therapy, yoga, breathwork, meditation and family systems therapy.¹¹

In 2022, three years into the COVID-19 pandemic, more individuals are seeking out treatment for mental health challenges than ever before. According to the Centers for Disease Control and Prevention (CDC), the percentage of the adult population receiving mental health treatment and/or counseling rose to 21.6% in 2021, up from 19.2% in 2019.¹² Currently, the U.S. does not have the number of mental health professionals required to fill the need. More than a third of Americans live in regions that lack these critical resources.¹³

Several types of counseling positions are especially in demand. Some of these (and their annual salaries) include:

• Marriage and Family Therapist ($78,567)
• Substance Abuse Counselor ($59,832)
• School Counselor ($56,265)
• Recreational Therapist ($52,801)
• Career Counselor ($46,130)
• Behavioral Therapist ($43,909)
• Mental Health Counselor ($43,574)
• Rehabilitation Counselor ($43,574)¹⁴

Overall, the Bureau of Labor Statistics estimates future job growth for substance abuse, behavioral disorder, and mental health counselors at 22% between 2021 and 2031, with an average salary of $48,520.¹⁵

Make a difference in peoples’ lives and communities with an online Master of Science in Clinical Mental Health Counseling from Marquette University. Taught by industry experts, Marquette’s CMHC program helps you further your career goals through rigorous academics, a practicum and two internship courses, and a strong grounding in the Jesuit tradition of intellectual inquiry and service to others.

The comprehensive curriculum teaches the foundations of behavior, ethical and legal considerations, mental healthcare advocacy, counseling theories, and clinical mental health counseling prevention and treatment for individuals and groups. Specialize in child and adolescent counseling or pursue a general track, and you’ll be ready for a rewarding career in clinical mental health counseling in as few as three years. Apply now or talk to an Admissions Advisor to learn more.