Comparing Counseling Models: Psychoanalytic, Existential & Family Systems

Overview of Major Counseling and Therapy Models

The following table summarizes eight major counseling and therapy models across four dimensions: therapeutic goal, the nature of the therapeutic relationship, and primary techniques used.

Psychoanalytic: Goal — "To turn neurosis into ordinary unhappiness." Relationship — silent, occasionally venturing an interpretation; therapist as "one who knows." Techniques — dream analysis, attention paid to early childhood development and relations with parents.

Adlerian: Goal — encourage client's premises and goals. Relationship — collaborative. Techniques — focuses on feelings of self that arise from relationships and conflicts.

Existential Therapy: Goal — self-mastery, self-examination, creativity, and client accepting responsibility for self. Relationship — therapist as person, with emphasis on the quality of the therapist–client relationship. Techniques — not a technique-oriented therapy but instead a philosophical approach.

Person-Centered Therapy: Goal — increased self-esteem and greater openness to experience. Relationship — neutral, non-hierarchical, and empathetic. Techniques — restatement of the client's statements in neutral language, unconditional positive regard, empathy.

Gestalt Therapy: Goal — client awareness of self, environment, and relation to others. Relationship — sharing the client's experience, giving feedback, a dialogue relationship without manipulation. Techniques — internal dialogue exercises, guided fantasies.

Cognitive-Behavioral Therapy: Goal — goal- and problem-oriented; the objective is for the client to gain control of reactions to things by changing thought patterns. Relationship — collaborative. Techniques — homework, workbooks, self-observation of personal behavior and thoughts.

Reality Therapy: Goal — learn better ways to fulfill basic needs and connect with people the client wants in his or her world. Relationship — gets the client to be specific about desired changes in life. Techniques — emphasis on choices made by the client and how the client can attain positive goals.

Family Systems Therapy: Goal — understand the client within the context of the larger family system. Relationship — will often treat the client as part of a larger system, focused on understanding the "homeostasis" of that system. Techniques — reframing or redescribing problems, recognition that any change will necessitate a change in the entire system.

Of the different therapeutic models presented by Corey in Table 1.1, the three that most intrigue and appeal to me are the traditional psychoanalytic model, the existential (or reality therapy) model, and family systems therapy (Corey, 2008, pp. 9–10).

The Appeal of Traditional Psychoanalysis

Traditional psychoanalysis still exerts a strong fascination, and for those of my generation it represents — for better or worse — the first experience many of us had of an intellectual "theory of mind," in the form of Sigmund Freud's various ideas. It is, of course, important in the twenty-first century to separate psychoanalysis as a model for therapeutic procedure from wholesale Freudian theory. There are not many people who would still defend some of Freud's more questionable ideas, such as "penis envy." But the simple fact is that the emphasis placed by psychoanalysis on "unconscious motives" — in Corey's words — as a means to understanding the self is something that still holds a large appeal for the imaginations of many of those seeking help (p. 455).

There is much about traditional Freudian psychoanalysis that has now proven itself to be dubious science at best and outright harmful at worst. One example is Freud's emphasis on the incestuous attraction of the Oedipus complex as the central fact of the male psyche. It is possible to assume that a man's early relationship with his parents is an important determinant of later behavior without introducing the idea of incest into the discussion. But the chief reason for my own lasting interest in the psychoanalytic model lies in its early description as "the talking cure." This is a model of therapy which proposes that the conversation between client and analyst — particularly when the analyst withholds comment and interpretation — can in and of itself be therapeutic. I believe that basic notion is correct, and I am genuinely fascinated with the history of psychoanalysis as a means of achieving cures for hysterical illnesses, for example.

Existential and Reality Therapy as a Proactive Approach

The reality therapy or existential model also interests me because it is more proactive in orientation. Corey notes the influence of Irving Yalom on this school, and I am already familiar with Yalom's name as a proponent of group therapy and as the author of popular case histories of clients achieving success in therapy (p. 10). The basic description of existential analysis also fits most closely with the kind of therapeutic work I envision doing as a life coach. To place an emphasis on the choices and actions made by a client — and to draw out the deeper unconscious motivations behind those choices and actions — seems a straightforward and effective way to help people who are struggling with ordinary forms of discomfort and distress in contemporary society.

The simple fact is that most people anticipating a career change are not going to want to engage in elaborate Freudian examination of their reactions to maternal abandonment in pre-school, or anything of that nature. The existential approach offers a rigorous accounting of the client's own involvement in what he or she is seeking help for. The emphasis on "choice" found in reality therapy — typical of existentialism as a broader school of thought — seems to offer a clear and distinct way for therapy to make a lasting difference in the client's life after treatment ends (p. 456).

Conclusion

Of the eight counseling models surveyed, traditional psychoanalysis, existential/reality therapy, and family systems therapy offer the most compelling frameworks — each for distinct reasons. Psychoanalysis appeals through its historical depth and the enduring power of the talking cure. Existential and reality therapy align most closely with practical, proactive therapeutic work, particularly in a life-coaching context. Family systems therapy, while not a professional focus, provides an indispensable conceptual lens for understanding how human relationships shape the problems clients bring to therapy.

References

Corey, G. (2008). Theory and practice of counseling and psychotherapy (8th ed.). Brooks/Cole.