Basic Counseling Techniques

I did not set out to write a textbook of counseling and therapy techniques. My original purpose was to find a textbook I could use for a class I would be teaching beginning master’s level students. What I found, to my surprise, is that I could find no suitable book. There are many books of theories, and many books which address important issues that this one does not. This text aims to fill in the gaps left by those other texts, to supplement them and not to replace them. Specifically, the purpose of this text is to give the beginning therapy or counseling student the nuts-and-bolts of how to actually apply some of the major theories. I assume that in other courses the student will study theories of therapy in depth to gain a more complete understanding, and I assume the student will take a practicum or internship to learn how to actually do therapy. No book, including this one, can teach someone how to counsel. You learn therapy by doing therapy under the careful guidance of a skilled supervisor.

I do want to express my gratitude to my clients over the last twenty-five years. They have taught me so much. All of the case material in this text is drawn from my clinical experience with these wonderful people. Their actions do not necessarily reflect this author’s position on moral issues, but they do reflect the reality of therapy as I have experienced it. Some of the “clients” in this text are actual people. Others are composites of several real people. In all cases, enough of the facts are altered so that the client’s confidentiality is protected. If you, the reader, think you recognize one of these clients, chalk that up to the universality of human experience and know that you cannot possibly identify who these real people are. Please do read these cases carefully to get a “feel” of the client and the client’s situation. Use your imagination to put yourself in the client’s shoes. This is a skill which will not only help you get the most out of this text, it will also serve you well in your future profession.

I also want to express a word of caution to those beginning counselors and therapists who read this text. All of the case material in this text comes out well. The client gets better. That is not always the case in real life therapy. Most of us know that, but no one ever tells you that even the best therapy properly performed will not be 100-percent successful. Do work hard to improve your skills and remember that, sadly, some people are more dedicated to staying in their illness than they are to improving. If we therapists could fully understand the client’s world from the client’s point of view, we could understand why that makes sense to them and perhaps help them move toward health. However, as Salvador Minuchin reminds us, “Life is more complex than that.” You will always lose some.

There is one more word of caution. This text presents a variety of techniques because no one style of therapy has yet been proven superior to all other styles in all cases. Likely, you will gravitate toward one or two styles of therapy because they “fit” your personality, and that is usually a good thing. The therapist’s primary tool is his or her personality, so finding a style of therapy which allows the therapist to make the most of that tool is a great goal. When that usual style does not work, however, be ready to change your way of working. If you do not see behavior change in the client by the second session, whatever your style of therapy, your client is non-verbally telling you that there is a disconnect between your preferred style and this particular client’s needs. Do something different. As I often remind my supervisees, “Insanity can best be defined as doing the same thing over and over expecting different results every time.” That applies to us as well as to our clients.

I wish you the best as you learn how to help people. Therapy is an honorable profession with many frustrations and many joys. May your joys outweigh your frustrations.

Wayne Perry
November 2001