Integrating psychoanalysis, cognitive-behavior therapy, and reality therapy

Counseling Orientation

Integrated Counseling Orientation

Key Concepts of the Integrated Approach

My theoretical orientation as a counselor will be based on an integration between the psychoanalytical approach, the cognitive-behavior therapy approach and the reality therapy approach. These approaches complement one another and serve to address issues of concern in a multicultural society. The key concepts in the psychoanalytical approach are the conflict between the id, ego and superego. This conflict is created as an individual tries to balance needs with social norms and expectations, pleasure and reality. These conflicts are generally present in the unconscious but psychoanalysis helps to bring these issues into the conscious of the client so that their ego strength is increased and they can take better control of their behavior.

In cognitive-behavior therapy, the key concepts are learning and skill acquisition. A number of interventions are formulated, administered and evaluated to enable the client to acquire new behaviors and skills for dealing with their environment. In reality therapy approach, the client is encouraged to focus on the present as opposed to the past and the future. A sense of self-control and personal responsibility is created to empower the client to take personal responsibility for desired personal goals and needs such as survival, love, power, freedom and fun (Wubbolding, 2010).

These key concepts are closely related, which enables them to be integrated into a single theoretical orientation that allows the counselor to bring to the client's knowledge through psychoanalytical techniques the issues and conflicts that may be lying in their subconscious. Then, through reality therapy, clients are encouraged to take responsibility for making changes to the present. The skills required to enact and implement those decisions can be acquired through carefully-formulated and culturally-appropriate learning interventions.

My Role as a Counselor

My primary role as a counselor is to help my clients in analyzing their behavior objectively and in making the right decisions to improve their quality of life (Corey, 2012). Using my skills and knowledge as a counselor, my role is that of a counselor who helps the client analyze her or his behaviour and emotional issues. My role is to formulate the issue and develop appropriate interventions to resolve the issue. It is also important for me to involve the client and encourage her or him to take primary responsibility for the outcome of the intervention. Therefore, my role is to act as a source of information and an objective counselor for the client. It is also important for me to motivate the client and seek cooperation so that the client can own the session. I should also act as an effective communicator so that I can encourage the client to engage in self-disclosure and discuss issues openly without any feeling of guilt or embarrassment.

While maintaining objectivity and impartiality, my role as a counselor also requires me to act as a natural and real human being in my interactions with my client. This helps to satisfy the human and social needs of the client and also helps me to avoid becoming too stressed with the problems of my clients. As a counselor I also have to take care of my own physical and emotional health so that the client may perceive me as a competent and credible professional.

Therapeutic Goals

Since I will be integrating the psychoanalytical, cognitive-behavioral and reality approaches to counseling and psychotherapy, the therapeutic goals will also be based on the orientation of these therapy orientations. As a primary goal of my approach, I will use the psychoanalytical approach to enable my client to adapt to their environment by helping them to identify their inner conflicts and the motives behind their behavior (Corey, 2012). On the basis of these findings, appropriate interventions should encourage them to increase their self-control and adopt new and more productive behaviors. This is an important goal for enabling clients to acculturate in a multicultural society by resolving the tension between diverse cultural expectations and norms.

A second essential goal of my approach will be to encourage my client to learn new behaviors. The cognitive-behavior approach describes learning behavior and illustrates how new skills and behaviors can be learnt through associative learning. To adjust in a multicultural society, it is essential to acquire new skills in language, social interaction and techniques of interpretation. Therefore, the goal of increasing clients' sense of self-control will be complemented by the goal of encouraging them to learn new behaviors and life skills for better dealing with their environment. The third goal of my approach will be based on developing optimism and personal responsibility among my clients and encouraging them to take a goal-oriented view of their life and take personal choices in the present to achieve their goals in the future (Wubbolding, 2010). This goal will also integrate with the goals of increasing self-control and learning new behaviors.

Central Techniques to be Applied

In order to implement the integrated theoretical orientation, a number of techniques can be used to achieve the therapeutic goals. To bring underlying anxieties and motives to the conscious, techniques like free association and dream analysis can be used. To analyze how clients process information and perceive the environment, the Rorschach test can also be administered. Secondly, to inspire a sense of personal responsibility towards making personal changes in the present to achieve personal goals, effective interpersonal communication is needed to encourage the client to evaluate current behaviors and cooperate in developing and evaluating proposed behavioral changes. Finally, associative learning techniques, formulation driven cognitive-behavior therapy interventions can be formulated for the client. As the client assumes greater personal responsibility, insight and self-control, self-help can also be used to assign control and planning of the learning interventions to the client. Emotion regulation strategies can also be used to help cope with anxiety (Hofmann, 2012).

Dealing with Issues of Cultural Diversity

Cultural diversity is an important issue in counseling and psychotherapy. A multicultural society places varying levels of pressure on its members to acculturate in the mainstream society while other societies expect people from diverse cultural and ethnic backgrounds to assimilate. This creates unique psychological issues as individuals try to cope with these pressures by reconciling their beliefs, attitudes and values with the majority members of the society. Cultural diversity also imposes challenges on communication particularly if the communicators possess different frames of reference and attach different meanings to words and symbols on the basis of their culture. This is a crucial factor in the success of any psychotherapy because barriers to communication between the patient and the counselor need to be removed to achieve the therapeutic goals (Corey, 2012).

As a professional counselor, I would increase my awareness of how my own cultural background shapes my values and interpretations of events (Corey, 2012). I will also learn about the cultural background and value system of my patient so that during techniques such as free association and dream interpretation, I may be able to arrive at a culturally-relevant analysis of the motives of my patient's behavior. Similarly, when implementing the techniques of reality therapy, my understanding of the varying emphasis on self-control and individualism in collectivistic societies will help me to avoid encouraging the patient to develop behaviors or strategies that conflict with their value systems or group norms. Also, when creating learning associations under the cognitive-behavior therapy paradigm, I will select culturally relevant stimuli with adequate motivating power for my patient. Also when selecting self-help material and books, I will engage with the client to ensure that the material is culturally relevant and in line with the communication and learning stage of the client.