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Thursday
Jul122012

What's on the Radar?

By Stacy Notaras Murphy

What’s the next big counseling theory or technique out there?

Earlier this year, Counseling Today posed that question informally to American Counseling Association members in an edition of ACAeNews. We wanted to get a sense of what is grabbing the attention of today’s counselors — what approaches are influencing the way they do their work, what new topics they are most curious to learn more about and how they are making room for these fresh ideas every day in the counseling room.

Not surprisingly, the responses revealed that ACA members are a diverse and creative group. You are mixing old theories with new techniques, while remaining flexible and attuned to the individual needs of your clients. You are building unique tool kits with extra training in the tried-and-true orientations you came to appreciate in graduate school, such as cognitive behavioral and existential approaches. Yet, you also are building on traditional skills with new approaches as varied as mindfulness, family systems and even equine-assisted psychotherapy.

Despite the wide range of responses to our question, a handful of subjects came up again and again on the knowledge wish lists of counselors, including a structured approach to couples therapy, ways to integrate mind-body techniques and guidance for getting a handle on “all that brain science stuff.” Regarding these topics as an admittedly partial snapshot of what is gaining momentum in today’s counseling circles, we asked counselors in the field to discuss how they made their training decisions and what others can expect by following their lead.

Body-centered psychotherapies

The increasing acceptance of a mind-body connection in mental health has yielded a number of new body-centered approaches to counseling in the past few decades. A wide variety of therapies are considered body-centered: sensorimotor psychotherapy, eye movement desensitization and reprocessing, somatic psychotherapy and even therapeutic massage and bodywork. As more clients seek assistance in connecting how their bodies feel with how they feel about their lives, some counselors are diversifying their skill sets by adding body-centered competencies found to enhance more traditional counseling techniques.

Evolved from the work of Wilhelm Reich, body psychotherapy helps people recognize their bodily sensations while considering emotions and behavior. Body psychotherapists operate from the belief that all experiences are reflected in the way clients move, in addition to how they think and feel. Techniques vary but may involve meditation, deep breathing, appropriate touch and observation that invites clients to notice how their bodies react to certain thoughts and feelings.

Jesse Virago is a licensed professional counselor in Verona, Pa., who discovered body-centered work while exploring her own “stuckness” in a previous career. “I found body psychotherapy to be the most fascinating thing I had ever experienced, and I soon realized I had found my own work too,” she says. To become a “somatic psychotherapist,” Virago completed her master’s degree in clinical mental health counseling while also engaging in somatic and psychodynamic training. Additionally, she studied massage, bodywork, hydrotherapy and other therapeutic arts, including yoga and tai chi.

“I don’t think of a focus on the body in counseling and psychotherapy as a ‘technique,’” Virago says. “It is more of an understanding that what we call ‘mind’ is, in fact, a function of the body — the whole body, not just the brain or the head. Thus, psychotherapeutic interventions can and do occur at what the transtheoretical researcher and theorist Wilma Bucci, Ph.D., calls the ‘subsymbolic level,’ as well as the symbolic — verbal and nonverbal — level. Given my experience, interests and training, it’s natural for me to integrate attention to the body in psychotherapy sessions. What can be difficult is finding relevant, accessible, high-quality training.”

Virago has discovered that a wide range of clients can benefit from counseling techniques that incorporate the body. “[It] can be a natural for very physical people — dancers, athletes, actors, artists, yoga and other somatic practitioners, etc. Conversely, it can be extremely helpful for those who are very out of touch with their bodies and want to address that in therapy,” she says.

“Diagnostically speaking, I have found that both the general public and mental health professionals tend to assume that somatic psychotherapy is most appropriate for conditions with a clearly identified physical component like somatoform, pain or eating disorders, hypochondria or body dysmorphia. But I find somatic psychotherapy extremely useful for clients with mood and anxiety disorders, and especially well suited for addressing the effects of developmental and situational trauma.”

“Developmentally speaking,” she continues, “somatic psychotherapy can be especially helpful with issues originating in the first three years of life, many of which are preverbal but can be very effectively engaged with somatic interventions. In terms of situational trauma, working with the body can be invaluable in helping clients integrate and recover from traumatic experience.”

Jan Beauregard, an LPC and American Counseling Association member in Fairfax, Va., founded the Integrative Psychotherapy Institute of Virginia, where she serves as clinical director. She had long surmised that body memories could be part of her work with trauma survivors, but she didn’t possess a solid framework for incorporating body memories until she took part in a workshop by Pat Ogden in 2004 and learned about sensorimotor psychotherapy. For the next two years, Beauregard traveled to Boston to participate in intensive training weekends through Ogden’s Sensorimotor Psychotherapy Institute (SPI). Sensorimotor psychotherapy unites traditional, verbal counseling with body-centered therapeutic techniques to help clients face trauma, attachment and developmental struggles.

“The training was both didactic and experiential,” Beauregard says. “We had peer partners and process groups and extensive practice of the sensorimotor techniques throughout the training. One of the hallmarks of an excellent training for me is when I learn new things about myself through application of a new model. I knew immediately that sensorimotor psychotherapy would deeply inform how clinicians do trauma treatment.

“What I like about sensorimotor psychotherapy is that it incorporates what we have learned about the brain, mindfulness and neurobiology. Pat Ogden’s work has given clinicians a systematic and engaging way to help a client release the negative energies held in the nervous system as a result of traumatic experiences.”

Initially, Beauregard found it challenging to introduce sensorimotor techniques to clients who had what she calls a “very cognitive, left-brain orientation.” So, she found herself focusing on the psychoeducational tools provided in her training. When presented with Beauregard’s own enthusiasm for this method, “even the most reluctant clients were eventually willing to step into some of the simple experiments,” she recalls. “Once a client experiences relief or feels a new sense of empowerment, they are eager to learn more.” Beauregard also discovered that moving to a more spacious office and purchasing chairs with rollers that allowed clients to navigate the space based on their own “body wisdom” helped them become more comfortable with the work.

Body psychotherapists, because they are counselors, must be more careful with the use of therapeutic touch than, say, body workers who apply sensorimotor techniques. “The way I solved this problem was to explain to clients that I would be using props like pillows, balls and other objects and that, sometimes, these objects were used in the trauma processing,” Beauregard says. “I demonstrated a variety of scenarios in how the objects would be used so that changing to the sensorimotor method would not be perceived as too invasive or different from other treatment techniques.”

Beauregard says sensorimotor psychotherapy helps clients release blocked energies and then decode and process the nonverbal experiences of trauma. She also has found it effective in working with addictions, anxiety and depression because, she explains, these diagnoses often result in somatic complaints due to unprocessed traumatic experiences.

Virago plans to continue training in somatic psychotherapies and to explore how to incorporate movement into her work. “I found that engaging in somatic psychotherapy myself — ‘learning through the body’ — was a great way to begin,” she says. “If this work speaks to you, read everything you can on the subject, train in a variety of approaches, seek out like-minded colleagues, join professional associations, consult with experienced practitioners, but most importantly, experience somatic psychotherapy for yourself.”

Numerous options are available for those wanting to incorporate body-centered therapies into their counseling practices. Boulder, Colo.-based SPI offers three levels of training, with prices based on location. In addition to her SPI training, Beauregard also has studied the Hakomi Method, LifeForce Yoga, Yoga Warriors and other body-based healing methods. She notes that maintaining her skill set requires ongoing peer supervision, and she plans to continue participating in telephone consultations and webinars with the SPI trainers. “I am continually searching for other body-based interventions that I can add to my tool kit,” she says, “[because] I have found incorporating Pat Ogden’s method to be transformative in terms of my effectiveness with trauma clients.”

EMDR for trauma treatment

It’s difficult to ignore the role that trauma plays in our interpretation of modern life events. From the trauma of losing a spouse through death or infidelity, to losing the opportunity to become a parent because of infertility, to the rise of traumatic brain injury, trauma is at the core of many counseling interactions. It makes sense that more counselors are seeking tools for helping clients understand trauma and release the pain around it. Increasingly, many counselors are turning to eye movement desensitization and reprocessing (EMDR).

Francine Shapiro developed EMDR psychotherapy and went on to found the EMDR Institute, which offers training to therapists and spearheads research on the technique’s effectiveness. The approach has been shown to help clients look at their distressing memories and develop better coping mechanisms. Practitioners guide clients through eight phases of treatment, including history taking, stabilization, identifying distressing memories, considering negative beliefs about self and naming a preferred positive belief. The client is then asked to focus on the targeted memory, considering both the negative thoughts associated with it and any related body sensations, while following the therapist’s fingers as he or she moves them back and forth across the client’s field of vision for approximately 30 seconds.

This process is repeated throughout the session, with the goal being to make the client’s experience of the memory less and less painful. Eventually, the client will attempt to replace the negative memory with a preferred positive belief, gaining confidence in this belief as the process is repeated. Clients are asked to pay attention to both positive and negative body sensations throughout the session.

Martina Glasscock-Barnes, an ACA member and LPC with offices in Arden and Asheville, N.C., learned about EMDR while working with hospice clients grieving losses due to violent ends. “I researched trauma recovery techniques and saw that the numerous clinical studies conducted on EMDR clearly yielded the highest trauma-recovery results,” she says.

She decided to start training in EMDR, which took place over the course of two intensive weekend seminars. Once comfortable with the techniques, Glasscock-Barnes began introducing EMDR to clients who had been exposed to the traumatic or sudden death of a loved one. “I found my clients to be quite open to the modality,” she says. “It is a simple eight-step model and easy to explain to a potential recipient.”

Learning to work with her clients’ distressing arousal was more challenging, Glasscock-Barnes acknowledges. “Simply talking about the traumatic memories [is] emotionally triggering,” she says, “so the clinician has the challenge of eliciting the pertinent information, while helping contain and calm the client’s distress. For me, it helped that I had considerable experience as a meditation instructor and teaching self-soothing skills such as [dialectical behavior therapy]. … The clinician cannot move forward until she can help the client develop a fair ability to self-soothe. Due to this, we might need to spend many sessions teaching these skills. Eventually, the template [will be] created for the event, and we can move forward to the EMDR application of bilateral stimulation to the brain.”

EMDR training fees may vary. Shapiro’s EMDR Institute charges a total of $1,530 for the two basic training weekend workshops required for certification. Students also must complete 10 hours of case consultation with an approved supervisor. Glasscock-Barnes encourages her fellow counselors to make the investment to train in EMDR. “Money and time spent on learning this excellent technique will more than pay for itself in the results you will yield helping your clientele. I find that more and more, clients come to my practice seeking an integrative approach using modalities beyond traditional talk therapy,” she says, adding that EMDR has significantly accelerated the healing process for her clients. “Not only will your clients experience relief; they [will] have the opportunity to experience resolution. The fact that a client suffering traumatic flashbacks and nightmares could have lasting resolution is life changing. My own clinical experience is consistent with the studies that show treatment results are maintained over time.”

Judy Vellucci is an ACA member who works in private practice in Northville, Mich. She uses EMDR with clients who have been sexually abused, those who are adult children of alcoholics and those who experience anxiety or depression. “People with everyday issues can be helped significantly [by EMDR] too,” she adds. Vellucci has observed that those clients who are initially most fearful of the EMDR experience typically yield the greatest benefit from the process. “Counselors can expect good results, especially for those clients whom they have been seeing long term,” she asserts.

“EMDR release[s] the sights, sounds, feelings and emotions that are locked in a part of the brain and allows [clients] to process these things adaptively,” she says. “It has freed clients who have been stuck in life to move forward in their recovery. Truly, the outcomes have been amazing for many, many clients.” Vellucci, who says she is moving toward retirement, completed the EMDR training four years ago and says it has added excitement to her working life. “I only wish I had made the choice to do the training earlier,” she says. “Anyone who seeks to enhance their self professionally and help their clients at the deepest level should seriously investigate the benefits of EMDR.”

Mel Gardner, an ACA member in Scottsdale, Ariz., began EMDR training in 2005 while working for a nonprofit organization serving populations with severe mental illness. “My DBT [dialectical behavior therapy] and CBT [cognitive behavior therapy] training applied to this difficult population was effective without question,” says Gardner, an LPC. “However, what I found was that the continuously high levels of emotional arousal that maladaptive coping styles were driven by could be significantly reduced by addressing the early life challenges that established them in the first place. Sometimes, disturbing memories like a rape or abandonment can be targeted. Sometimes, childlike ‘rules to live by’ or conclusions about self or the world drawn out of chaotic parenting are better targets. Whatever appears to be driving the present dysfunction … directs what needs to be targeted.”

Gardner firmly believes EMDR can benefit anyone who is open to the process. Today, she introduces EMDR as an option during the second session with a new client. She estimates that 80 percent of her clients opt to try the technique. “Whether the target is outright panic attacks, nightmares and overwhelming anxiety, or habitual behaviors of avoidance or dependence on sleep, substances, food or destructive relationships, once the target is clearly defined, the work can begin and the differences can begin to take hold,”
she says.

All three practitioners recommend ongoing supervision and continuing education in EMDR. Gardner also believes that counselors who take the time to experience EMDR with an individual therapist will cultivate a deeper understanding of its power. “The most important piece in building my own proficiency,” she says, “was to get my own EMDR work done by a local professional who — I knew from having the training myself — used the protocol as it is taught and had the specialization that I myself was looking to learn for my own population.”

Emotionally focused therapy for couples

With half of all first marriages ending in divorce (according to the Centers for Disease Control and Prevention), counselors are sitting across from more and more couples these days. Although most graduate counseling programs offer some insights into working with couples as part of broad courses on family therapy, few counselors leave school with a fully developed understanding of how to work with couples facing disconnection, infidelity, parenting struggles and, potentially, divorce. One research-based approach attracting counselors is emotionally focused therapy for couples, known as EFT.

Developed by Les Greenberg and Sue Johnson in the 1980s, EFT is an empirically based treatment approach rooted in attachment theory that guides the partners in a couple in identifying their emotional attachment and dependence on each other. Following a short-term schedule of structured sessions (usually between eight and 20 appointments), EFT counselors aim to help couples create a secure bond while developing new ways of interacting as loving adults.

The International Centre for Excellence in Emotionally Focused Therapy (ICEEFT) administers training and certification of EFT therapists. Those seeking certification must be licensed psychotherapists who have had graduate-level study in couples or family therapy. Potential EFT therapists can follow two tracks to certification, including a mix of externships, skills trainings, and group and individual supervision totaling more than 70 hours. Therapists also are required to present videotapes of their work for supervision. Training fees vary, but most two-day training workshops cost around $700, while individual supervision and tape review can be $75 or more per session.

EFT practitioner Jack Childers, an LPC in Leesburg, Va., and a member of ACA, notes that the training process was not an easy one. Childers provided a new tape of himself working with a couple for each of the eight required individual supervision sessions and then submitted an application, including two DVDs showing his work, for final approval. He says the individual supervision and tape evaluation proved to be the most helpful part of his training experience. Today, Childers estimates that he uses EFT about 95 percent of the time when working with couples.

“Once the EFT concepts sunk in for me, I found it pretty hard to [use other approaches with couples],” he says. “I also find myself thinking in EFT terms quite a bit in my work with individual clients. I think that in a way similar to intimate partner relationships, people often struggle with fear and pain when they try to connect with aspects of themselves.” Childers and a colleague currently are co-leading an EFT couples group that has been getting positive reviews. He says counselors learning to use EFT can expect to see their couples clients develop a safer and more secure emotional bond.

After visiting eight different couples therapists early in her marriage, Jenny Proudfoot longed to find an approach that would help her feel more connected to her partner rather than just resolve surface issues such as problem-solving and conflict management. She also left a job in the corporate world to study counseling but encountered EFT only after graduating from her program. Today, Proudfoot is an EFT therapist and ACA member practicing in Charlotte, N.C. “I would be lying if I said there is anything easy about learning EFT,” she says. “One needs to view it as a lifetime commitment to learning. It is such an experiential approach that it makes it far more challenging to master than some of the more cognitive approaches.”

Proudfoot plans to continue participating in EFT training opportunities and supervision while also connecting with EFT professionals nationwide through a Web-based message board. “[Learning EFT] is definitely not for the faint of heart. It takes a huge time commitment and is very challenging, but when you see your couple’s [conflict] magically begin to de-escalate and are able to help them create a safe haven, it makes it all worthwhile,” she says.

ICEEFT notes research suggesting that 70-75 percent of EFT couples move from distress to recovery, but the organization says the approach is contraindicated for couples experiencing “ongoing violence in the relationship.”

Childers adds that significant addiction issues and emotional abuse also may impede EFT’s efficacy. “Other contraindications, I believe, include cases where one of the partners has already decided they want out of the marriage and is coming to couples counseling for reasons other than wanting to save the marriage, such as to appear to have done ‘everything possible.’ This is fairly common but, unfortunately, not very easy to assess,” he explains. “Clinically, once EFT has started, some partners are unable to focus on the pattern of interaction they have with their partner and stay with the narrative that the other partner is ‘the problem.’ These cases do not resolve successfully.”

Both Childers and Proudfoot recommend that anyone interested in EFT start with some of Sue Johnson’s publications, including the books Hold Me Tight and The Practice of Emotionally Focused Couple Therapy: Creating Connection.

Neuroscience: Banking on the brain

One topic creeping beyond the borders of counseling and into popular culture is neuroscience and its potential impact on happiness and well-being. Clients are walking into counseling armed with their own studies and expectations about neuroscience and its implications for their lives. According to ACA members Mary Bradford Ivey and Allen Ivey, both well-known professors and authors in the counseling field, this shift should be both exciting and motivating for counselors. Their recent live webinar describing neuroscience as the “cutting edge of counseling’s future” (see counseling.org/Resources/Webinars.aspx) was one of the most popular webinars ACA has produced thus far.

“The popular media is almost forcing neuroscience on counseling, psychology and medical practice,” Bradford Ivey says. “Almost every day we now read about exciting new research. And our clients are reading the same stories and watching it happen on television. Clearly, neuroscience represents a paradigm change and the cutting edge for the future. Neuroscience has vast implications for counseling practice. And, frankly, this is fascinating material. It draws our attention, and then we want more. The scientific literature is astounding, enriching and growth-producing, with many immediate, practical implications.”

Specifically, the Iveys point out that neuroscience has provided data-based evidence for what counselors have believed for decades: that the counseling process can change the human brain. “Millions of new connections — synapses — are gained and lost each day. Effective counseling strengthens positive connections, and new ideas produce new neural connections,” says Ivey, explaining the concept of neuroplasticity. “Neuroscience provides a new, broader and practical scientific base for counseling and validates what we have always done. We now have scientific evidence for empathy’s concrete existence.”

The counseling field’s tendency toward social justice is also supported by neuroscience, Ivey notes. “The best research that we’ve seen supporting the need for social justice comes from neuroscience. Poverty, child abuse, violence [and] bullying all impact our children and adolescents in negative ways, destroying neural connections and permanently shrinking brain size. But, fortunately, a wellness approach coupled with a positive, stimulating environment is able to build resilience for many of our clients,” he says.

As such, the Iveys now teach workshops on “brain-based counseling,” which emphasizes the counselor’s role in helping clients create “change goals” that can strengthen the power of the prefrontal cortex to override the negative feelings streaming from the separate amygdala and limbic system. “Our task is to shore up and strengthen the positive versus the negative,” Ivey says, noting that exercise and meditation have been shown to increase the brain’s gray matter.

The ultimate goal is not to ignore the negative emotions created in the limbic system and amygdala, however. “While we need to focus on positive emotions and strengths, we still need to support appropriate reactions to fear,” Ivey advises. “For example, some abused women ‘think’ [using the frontal cortex] that their abusive partner will straighten out. In this case, we need to use both natural fear plus cognitive reframing to help this woman move out on her own. And social support is needed. Neuroscience reminds us that we are social animals, and we cannot and should not leave clients alone to drift.”

The Iveys believe the blending of traditional counseling techniques with brain-oriented psychoeducation and interventions will become well established in the next 10-20 years. They point to the National Institute of Mental Health’s efforts to institute a brain-based approach to counseling that will create criteria for multidimensional diagnosis, integrating medicine, developmental psychology and multicultural issues with neuroscience.

“Neuroscience represents a paradigm shift for counseling and psychology,” Ivey notes. “Our teaching and research is already changing. Our curriculum and textbooks will as well. Very shortly, practitioners will be discussing with their clients how counseling and stress management have the potential to change the brain. This will become important in motivating clients to act on and take home discoveries made in the interview. With neuroscience, we will become more accountable and results oriented, but still aware that empathy, listening and our existing modes of practice remain central.”

Counselors in particular may be better suited to incorporating these changes into their work, according to Bradford Ivey. “The counseling profession is potentially ahead of other more pathology-oriented helping professionals such as psychologists and social workers due to our long history of a positive wellness approach,” she says. “However, recently we have partially succumbed to the allure of DSM [the Diagnostic and Statistical Manual of Mental Disorders], and we continue an emphasis on theories that focus on client ‘problems.’ It is time to discard that word and substitute ‘issue,’ ‘concern,’ ‘challenge’ and ‘opportunity for change.’ Neuroscience speaks so clearly to the importance of a wellness and positive approach. We need to adopt neuroscience findings and show the world that counseling and wellness is what is needed for the future.”

One way counselors already may be incorporating the benefits of neuroscience into their work is through efforts to help clients make what the Iveys call “therapeutic lifestyle changes” (TLCs). Examples may include establishing a healthy exercise routine, practicing meditation, getting more sleep, improving nutrition and seeking cognitive challenges. Other TLCs may require the subtraction of certain behaviors, such as being sedentary, consuming junk food, watching too much television, spending too much time in front of a computer or being too set in an unchallenging routine.

“The TLCs need to become central in counseling practice,” Ivey says. “These key elements of mental health are insufficiently stressed in our books and training systems. We can help both our clients’ brains and their bodies through this move to wellness.”

The Iveys recommend that anyone interested in learning more about neuroscience start by reading John Ratey’s book Spark: The Revolutionary New Science of Exercise and the Brain. They also suggest studying the work of Daniel Siegel, Jon Kabat-Zinn and Louis Colozino. They credit Robert Sapolsky’s lectures (available through The Teaching Company at thegreatcourses.com/greatcourses.aspx) with launching their own interest in neuroscience.

Integrative models: Finding your own perfect blend

With so many opportunities and avenues now available for learning new counseling theories and techniques, it’s growing increasingly rare for counselors to limit themselves to a single theoretical system. Many counseling graduate programs require students to explore and incorporate a variety of theories as they develop their own individual approaches. Gerald Corey, professor emeritus at California State University at Fullerton, is a psychologist, author and ACA fellow who has devoted his life and work to helping counselors and students develop their own blended orientations. His reasoning is simple: Individual clients come from a variety of backgrounds, and counselors need to possess the skills and experience to meet them right where
they are.

“One reason for the current trend toward an integrative approach to the counseling process is the recognition that no single theory is comprehensive enough to account for the complexities of human behavior when the full range of client types and their specific problems are taken into consideration,” Corey explains. “Most counselors now acknowledge the limitations of basing their practice on a single theoretical system and are open to the value of integrating various therapeutic approaches. Those clinicians who are open to an integrative perspective may find that several theories play crucial roles in their personal approach.”

In the process of uncovering their own integrative approaches, Corey suggests that counselors study all of the theories and accept that each theory has strengths and weaknesses, particularly when it comes to working with clients from different cultures and backgrounds. “Each theory represents a different vantage point from which to look at human behavior, but no one theory has the total truth,” he says. “Because there is no ‘correct’ theoretical approach, it is [best] for students to search for an approach that fits who they are and to think in terms of working toward an integrated approach that addresses thinking, feeling and behaving. To develop this kind of integration, students need to be thoroughly grounded in a number of theories, be open to the idea that these theories can be unified in some ways and be willing to continually test their hypotheses to determine how well they are working.”

Corey stresses that creating an integrative approach is no easy task. It is a mistake, he contends, to “simply pick pieces from theories in an unsystematic manner or based upon personal whim.” Rather, developing a blended theoretical orientation requires significant thought about the compatibility of certain theories. Corey emphasizes that it is not a method for avoiding committing to one direction or another.

“Attempting to practice without having an explicit theoretical rationale is like flying a plane without a flight plan. If you operate in a theoretical vacuum and are unable to draw on theory to support your interventions, you may flounder in your attempts to help people change,” he says. “Ultimately, the most meaningful perspective is one that is an extension of your values and personality. Your theory needs to be appropriate for your client population, setting and the type of counseling you provide. A theory is not something divorced from you as a person. At best, a theory becomes an integral part of the person you are and an expression of your uniqueness.”

Corey, who says he personally has been influenced by the existential and person-centered counseling approaches, among most of the other contemporary approaches, recommends that counselors master a primary theory that can serve as their foundation and that exemplifies their own beliefs about human nature and the change process. “Take the key concepts of several theories that have personal relevance for you and apply these ideas to your own life,” he says. “What aspects of the different theories would most help you as a client in understanding yourself?”

“Personally, I do not subscribe to any single theory in its totality. Rather, I function within an integrative framework that I continue to develop and modify as I practice,” he explains. “I draw on concepts and techniques from most of the contemporary counseling models and adapt them to my own personality and therapeutic style. My conceptual framework takes into account the thinking, feeling and behaving dimensions of human experience.”

Continuing education and ongoing supervision are particularly beneficial in helping counselors to articulate the rationale for the techniques they choose, Corey says.

“Don’t adopt ideas without first putting them through your personal filter,” he says. “As you experiment with many different counseling techniques, avoid using techniques in a rigid or ‘cookbook’ method. Techniques are merely tools to assist you in effectively reaching your clients. Personalize your techniques so they fit your style, the needs of your clients, and be open to feedback from your clients about how well your techniques are working for them.”

Noting the importance of client/counselor attunement, Corey adds that experienced counselors are able to assess what is happening in the counseling room and then adjust their interventions to meet the client’s unique needs. “Perhaps the best way for a new professional to develop this ability is to be committed to listening to how clients perceive and react to their experience in counseling,” he says. “Counselors need to educate clients about the importance of their active participation in the process … and one way of being active is being a collaborator with the counselor and providing honest feedback on what they are getting from the counseling.”

By investing in continuing education and challenging one’s self through career-long supervision, a counselor’s active skill development truly can be a reflection of her or his own evolution as a human being, Corey says. “Continue reflecting on what fits for you and what set of blueprints will be most useful in creating an emerging model for practice,” he says. “Although you will have a solid foundation consisting of theoretical constructs, realize that the art of integrative counseling consists of personalizing your knowledge so that how you function as a counselor is an expression of your personality and life experiences. No prefabricated model will fit you perfectly. Instead, your task is to customize a counseling approach, tailoring it to fit your personality and the needs of your clients.”

This article originally ran as the July 2012 cover story of Counseling Today.