Counseling as Therapy

Around 1940, the dominance of the guidance model began to erode; by the end of the decade it was replaced by psychotherapy, an intervention often associated with a more medically oriented setting. A number of factors contributed to the decline. Part of the downfall coincided with social changes brought on by the end of the Depression and the beginning of World War II. People were confronted with rapid social change that seemed to broadly affect their lives.

Effects went beyond educational or occupational problems as people sought help with all types of personal adjustment issues. In this Age of Psychotherapy, the publication of Carl Rogers's Counseling and Psychotherapy was important. Rogers, trained as a clinical psychologist, brought psychotherapy from the medical clinic to non-medical practitioners. He transformed therapy as a medical intervention by framing therapy in terms of a humanistic philosophy, an approach more congenial to counselors.

This psychotherapy tradition represented by Rogers had multiple sources. Perhaps the central experience for Rogers was his work with clients. From these experiences, Rogers formulated and reformulated his approach to counseling and psychotherapy. Although there have been changes and shifts of emphasis, the basic outlook has been a person-centered approach in which the self-determination capacities of the client are the focus of attention, concern, activity, and acceptance conveyed through a therapeutic relationship. Like Parsons's conceptual contribution to the guidance tradition, Rogers focused on individual assets. Both of these traditions, guidance and therapy, highlight the worldview of counseling, a focus on strengths rather than pathology.

Since Rogers, there have been numerous counseling and psychotherapy approaches advanced. As the twenty-first century begins, there is renewed emphasis on counseling that works, with most attention focusing on competing models of treatment—cognitive-behavioral treatment versus a common-factors position. For psychotherapy, the challenge in a rapidly changing health care market is to document the effectiveness of counseling practices, especially the validity of our treatments for racial and ethnic minorities.

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