Positive Strength-Based Counseling and Therapy

Laura L.C. Johnson, MA, MBA, LMFT, LPCC is a Cognitive Behavior Therapist and the founder and executive director of the Cognitive Behavior Therapy Center of Silicon Valley and Sacramento Valley. She integrates positive psychology with cognitive behavior therapy and schema therapy, which have been shown to be effective for a wide variety of problems in hundreds of studies. Her clients learn skills to build positive emotions, optimism, and resilience while decreasing unhelpful thinking, behaviors, and emotions. Full bio. Laura's articles are here.

Counseling Psychology is Positive and Strength-Based

Many psychotherapists across many different theoretical models and client populations are already using a positive, strength-based approach to therapy. I was fortunate to graduate from Santa Clara University’s Counseling Psychology Program. The courses were diverse and included positive psychology, health psychology, mindfulness-based stress reduction, cognitive behavior therapy and multicultural counseling, to name just a few. For me, integrating my preferred therapy style, cognitive behavior therapy, with positive psychology felt natural. I often scratch my head about the division between psychotherapy and positive psychology. I believe an effective therapist not only wants to alleviate pain and suffering, but also optimize well-being and functioning. I don’t want clients just to survive. I want to help them thrive.

What is Counseling Psychology?

A core component of Counseling Psychology is, and always has been, its strength-based client focus. According to the Society of Counseling Psychology (division 17 of the APA):

“Counseling Psychology is a specialty within professional psychology that maintains a focus on facilitating personal and interpersonal functioning across the life span…The practice of Counseling Psychology encompasses a broad range of culturally-sensitive practices that help people improve their well-being, alleviate distress and maladjustment, resolve crises, and increase their ability to function better in their lives. With its attention to both normal developmental issues as well as problems associated with physical, emotional, and mental disorders, the specialization holds a unique perspective in the broader practice-based areas of psychology.”

How Do Counseling Psychology and Clinical Psychology Differ?

To contrast the two disciplines, clinical psychologists have tended to focus on psychopathology and clients suffering from more severe mental illnesses while counseling psychologists tend to focus on overall well-being through the lifespan and folks who are experiencing less severe symptoms. For example, Donald Super noticed that clinical psychologists tend to focus their attention on “what is wrong and how to treat it,” whereas counseling psychologists look for “what is right and how to help use it.”

How Therapists Use Client Strengths in Therapy

While there are several theoretical models describing positive, strength-based processes in therapy, there is a scarcity of rigorous scientific studies about how to use positive therapeutic processes in psychological treatment. Scheel, David & Henderson (2012) conducted a small study of eight therapists using a variety of theoretical models in order to identify positive processes that regularly occur in mainstream therapy. The results of the study showed that these therapists recognize the importance of positive processes in therapy and use client strengths to affect therapeutic change.

Gelso and Woodhouse define the use of client strengths as involving two aspects of therapy:

• Conceptualization process (discovering strengths): a) asking questions about client strengths, b) strengths revealed through the therapeutic relationship, c) strengths embedded in client deficits and d) being able understand meaning and expression of strengths within the client’s cultural context.
• Therapist enactments (what therapists actually do that uses clients’ strengths in the change process): a) pointing out strengths to the client, b) positive reframing of strengths, and use of strengths to solve problems, and c) attending to strengths embodied in defenses and perceived deficits.

Cognitive Behavior Therapy (CBT) Focuses on the Positive Processes

Let me quote James Harbin and colleagues:

“CBT interventions focus not only on decreasing negative behaviors but also on increasing positive behaviors…Consistent with strength-based approaches, then, cognitive-behavioral therapists may purposefully encourage client progress to reinforce their hard work in therapy. Strength-based approaches can also be incorporated into goal setting and cognitive restructuring techniques often used in CBT.”

Five General Themes

In-depth interviews with the eight therapists conducted by Scheel, Davis & Henderson (2012) produced 266 significant statements related to how therapists identify and incorporate strengths in the therapy process.

This leads to five themes and associated interventions:

Advantages of Focusing on Strengths in Therapy

Therapists described strengths work as having many advantages. It was perceived as building trust in the therapeutic relationship, motivating and instilling hope in the client, and demonstrating the therapist’s hope for and belief in the client. In addition, the use of client strengths in therapy is thought to increase client cooperation and acceptance of therapy, and to prevent other problems, promote human growth, and maximize human potential.

A Call for Science

In conclusion, there is a great need for scientific efforts to support and develop evidence-based treatments incorporating positive therapeutic processes. According to Gelso & Woodhouse (2012), “the promotion of human strengths and assets is nowhere more prevalent than in the field of counseling psychology, yet scientific inquiry is needed to advance strength-oriented practices in psychological treatment.”

Resources:

Gelso, C. J. & Woodhouse, S. (2003). Toward a positive psychology: Focus on human strength. In B. W. Walsh (Ed.), Counseling psychology and optimal human functioning (pp. 171-197). Mahwah, NJ: Lawrence Erlbaum Associates.

Harbin, J. M., Gelso, C. J. & Perez Rojas, A. E. (2013). Therapist work with client strengths: Development and validation of a measure. The Counseling Psychologist, XX(X), 1-29.

Scheel, M. J., Davis, C. K., & Henderson, J. D. (2012). Therapist use of client strengths: a qualitative study of positive processes. The Counseling Psychologist, XX(X), 1-36. Society of Counseling Psychology (division 17 of the APA)

Super, D. E. (1977). The identity crisis of counseling psychologists. The Counseling Psychologist, 7, 13-15.

Photo Credits via Compfight with Creative Commons licenses:
Tree of Strengths courtesy of RichardStep.com
Move, Change, Adapt courtesy of RichardStep.com
Umbrella courtesy of Purple Sherbet Photography
You courtesy of RichardStep.com