.. um, college campuses appear to be a perfect setting for the use of brief therapy/counseling approaches.
With the recent influx of older students returning to college, the diversity of presenting problems among the college client pool should be rather large. This provides the counselor with a rich and varied source of clients with which to hone his/her skills. Although my long term goals are to become a clinical psychologist and author, I have chosen College Counseling as an interim step in order to be able to work my way (financially) through a PhD/Psy.D program and gain valuable counseling experience along the way.
My hope is to land a job as a college counselor at a university where I plan to complete a Doctoral program in clinical psychology. Another motivation for this interim short-term strategy is that I am already forty years old and I want to make damn sure that I have an employable credential in the event that I should not complete my long term goals of a PhD/Psy.D. The bills are stacking up and I want to know that I have a means of paying them. On a less selfish note, I also chose college counseling because I have direct experience in this arena and feel I will be able to relate to many of the problems I will be presented with by students. I myself received abundant counseling while an undergraduate for vocational as well as psychotherapeutic reasons.
I know what its like to have and be treated for clinical depression, while being a full time student. This kind of empathy and insight is hard to learn from less than first hand experience and can be a most valuable asset when working with someone who is suffering with a problem or condition that you know about from first hand experience. If not for the help I received from counselors and therapists, I really dont think I would be in this class today. Although short-term approaches can be found based on any of the current therapy theories that exist today, the two most common are psychodynamic and cognitive-behavioral based approaches to brief therapy and counseling (Nugent). I would integrate both of these approaches and also some Gestalt techniques (especially for group work) into my own eclectic/integrative style of brief therapy/counseling. Of the several mainstream cognitive-behavioral short-term approaches (all based upon the previous works of Ellis, Beck, Meichenbaum, Haley, M.
Erickson, etc.), I believe that Donald Genters Solution-focused model, is the best suited for the majority college student population (Nugent). In Solution-focused short-term therapy, the counselor defines the problem, establishes goals, designs an intervention, assigns a strategic task, emphasizes positive new behavior changes, and then before termination, helps clients gradually incorporate new behaviors into their everyday living. (Nugent).
This is very directive. The main reason I like this approach is because it clearly fulfills the criterium mentioned earlier for effective time-limited interventions, and like all cognitive- behavioral approaches it is psychoeducational, structured, and focuses on specific target problems (Nugent). Although it can be especially effective in dealing with most normal developmental and academic issues, it is not a panacea, and may not be as effective in dealing with more intrapsychic long-term presenting problems, where I would prefer a more psychodynamic or humanistic approach, but it will probably help most of the client populations (college students) presenting problems most of the time.The limitations of this specific approach are the same as those for all cognitive-behavioral models.
Cognitive therapy has been criticized as focusing too much on the power of positive thinking; as being too superficial and simplistic; as denying the importance of the clients past; as being too technique-oriented; as failing to use the therapeutic relationship; as working only on eliminating symptoms, but failing to explore the underlying causes of difficulties; as ignoring the role of unconscious factors; and neglecting the role of feelings. (Corey, 1996 p.356). Also, because the underlying premise/techniques of all cognitive-behavioral therapy is challenging the clients beliefs/values and behaviors, this has potentially harmful implications for culturally diverse populations/clients.
It is especially important that the counselor make himself aware of the cultural context and values of these clients before attempting to confront or change their way of thinking or behavior (Corey).When dealing with clients that have issues that are more of a emotional, long-standing, intrapsychic nature, I would choose a short-term psychodynamic approach possibly coupled with some gestalt techniques to help bring past issues into the here and now. In short-term psychodynamic therapies, the focus is on the analysis of transference and countertransference in the therapeutic relationship, but unlike long term psychodynamic therapy they associate this analysis to present circumstances instead of focusing on childhood traumas. This analysis of patient-therapist interactions can then be generalized to interactions with others outside of therapy. The past may be explored, but only in the context of the clients present circumstances (Corey, Nugent). I like this approach because unlike cognitive-behavioral methods, it allows the client and therapist more room to explore the role of unconscious factors, feelings, and other underlying causes of difficulties instead of just being symptom oriented.
I would use Gestalt techniques (such as role-reversal, etc.) in both individual and group sessions when appropriate (Nugent, Corey).Some of the limitations of this approach (Psychodynamic), revolve around ambiguity and the intrapsychic nature of these therapies. Some ethnic minority cultures, such as many Asian Americans, may not be comfortable with this focus and prefer a more structured approach to counseling.
Corey states that, ...intrapsychic analysis may be in direct conflict with some clients social framework and environmental perspective. (Corey, 1996 p.128).
Gestalt, and Holistic therapies both have qualities/characteristics that fit well within the college counseling arena. Gestalt techniques such as role play/reversal, etc.would be particularly good for group sessions. And I think that bringing the health of the physical body and spirit into play is an essential aspect to overall health and well-being as emphasized by Holistic practitioners. I would choose an integrative/eclectic approach combining particular aspects of all the previously discussed therapy/counseling theories depending on the individual case before me.
In review, although brief therapy/counseling is by no means a panacea for all the presenting problems in the world of mental health, it is in fact a great therapeutic tool for the majority of the more normal developmental life issues or problems that present themselves in the lives of the average population. Severe addictions, and psychoses may require long-term interventions and the use of psychoactive drug therapies. Although its present wide spread use and acceptance is a rather recent phenomenon, the concept of brief therapy is well rooted in historical foundation.From the early formative days of psychoanalysis Freud was looking for a quick cure for neurosis and did not intend on the long drawn-out process that psychoanalysis eventually became. I think he would have liked the brief psychodynamic therapies of today.
The research shows that there is no significant difference in outcome between short and long-term approaches, but short-term is much more efficient when used with appropriate clients. In effect, even the majority of long-term therapy approaches are short (by default, not by design), when you consider the actual number of sessions the average patient attends. In conclusion, with the pressures of an ever increasingly fast paced society such as ours, the need for an effective, efficient, and accessible therapy/counseling approach is obvious. Short-term or brief counseling/therapy is that approach.Brief therapies have been adapted to most of the major therapy/counseling theories so there should be an approach that suits just about every one. It seems inhumane to treat people for long periods of time at huge expense if they can be effectively and efficiently be helped with short-term approaches.
Classic Psychoanalysis, among other long-term approaches, need to be more honest with themselves about who is really being served in the majority of time-unlimited interventions. Old habits and attitudes often die hard, and this is especially true when they are linked to individuals professional identities and bank accounts. When long-term intervention are truly needed, its great to know we have them, but in the face of the evidence, professionals should not make, or maintain, generalized questionable claims about the efficacy and merits of open-ended therapeutic practices at the expense of the best interests of their clients.REFERENCES Butcher, J. N., & Koss, M.
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