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Theory and Design in Counselling Essay


Psychotherapy has been used for years now as a way of trying to improve the lives of people. It is a method used by the professionals to help individuals overcome life-related problems in the desired and most convenient ways. Different theories of psychotherapy are used. The choice of the theory to be used by the psychotherapist in dealing with their client is dependent on the issue at hand. The theories have been developed over time as specialists in the field of psychology continued to discover the different causatives of related mental disorders (Fall, et al. 2011). However, of importance to note is the fact that the different theories of psychotherapy differ in their approach towards predicting the issue ailing each. This paper shall be focusing on the theory of psychoanalysis and how it can be used. The paper shall also focus on the role of the psychotherapist in implementing the same, the issues that may arise as a result and the central techniques and methods used in implementing the same.

Key concepts of the psychoanalysis theory

There are different concepts usually that are within the psychoanalysis theory. According to Freud, the most important concept is the determinism concept which means to be born with. These are what determines the personality of an individual in the later stages of their development. In his statement, Sigmund Freud notes that there is no such thing as an accident in the life of a human being (Elliott, 2015). Whatever they go through in their early lives takes a determining effect on their future. In most cases, the environment in which we grow in and the people surrounding us are very instrumental in determining who we become. This includes family, friends and the way of life in the society that we are brought up in.

The unconscious mind is also another concept that was brought forth by Freud. He stated that the mind of a human being is divided into two; the conscious and the unconscious. The unconscious mind is said to be the part of our brain that stores that which we are unable to execute while using our conscious mind. These may include feelings, ideas, memories, and impulses that we view as unacceptable to us. Whatever we perceive as wrong in the context of our understanding is usually stored in our unconscious mind and is usually triggered whenever we find ourselves experiencing that what we consider as not acceptable. As much as the concept of unconscious mind is a predate of psychoanalysis, Freud’s contribution was to discover how the concept could be used to understand the condition of the patient and inform the best treatment for the condition.

The third and an important concept as per the psychoanalysis theory is the concept of instinct. Instinct can be defined as the bodily impulse that drives our actions. According to Freud, instinct can be divided into two; one is the life instinct in which is driven by libido and may also be referred to as sexual instincts. They are basically what drives the survival and sustaining of the species. The second one is the death instincts also referred to as the Thanatos. Freud was quick to note that the goal of all life is death. In his argument, most of the people have an unconscious desire to die, but the desires of life driven by the life instincts tamper this wish.

The fourth and final concept that we are going to discuss the theory of psychoanalysis is the concept of personality. Freud viewed the personality of an individual as very complex and composed of three components. The three components are the Id, the ego, and the superego. The three work together to form the complex human behavior. The three elements of personality interact in some way influencing the on each in a different way. The Id is a personality aspect that is present at the time of birth. This form of personality is entirely dependent on the unconscious and includes the primitive behaviors of the individual. This makes it the primary component of personality. The ego is the aspect of personality in an individual that helps them deal with reality. Ego is usually developed from the Id and helps the individual react in a manner that is acceptable to the society. The superego, on the other hand, is the ability to internalize moral standards and ideals that are usually acquired from the people we associate with and the society as well. The superego part of a personality is what is used to make judgments.

The role of a psychotherapist

The role of a psychotherapist varies depending on the situation being handled at a particular time. Different patients will have different life-related issues that are affecting their livelihoods and therefore the need for the psychotherapist to understand the nature of the problem at hand. While using the psychoanalytic approach, the therapist has to understand their role. Some of the roles of that I will have to assume as a psychotherapist are;

Understanding the patient

The first face of psychotherapy is the initial meeting with the client. This makes it possible for the psychotherapist to understand their client better. Therapy is mainly based on the relationship between the professional and the patient. It is expected that at the end of the sessions to be carried out, both the therapist and the patient shall be able to foster the required change in the life of the affected person. For instance, psychoanalysis defines the processes of life as what mainly affects most of the people who need such treatment. It is therefore important for the therapist to create an environment where the patient shall be able to open up and give their side of the story without fear being too open and giving information they feel would have rather remained confidential. The therapist has to plan therefore a pre-session that will create that environment of trust between the two.

Understanding and interpretation

As a psychotherapist, one aspect that is to be expected during the sessions is that the patient shall be free to open up and speak out their minds. The main task at this point is to read between the lines, understand the patient well and interpret their issues. Understanding the patient is important as it helps us determine the best approach to tackling their issues. Most of the patients who go for the psychoanalytic therapy usually will need someone who can listen to them and show a bit of care and concern. It is therefore important at some point not to let the patient keep talking as if they are on their own. Interjecting them and trying to make statements that interconnect the situation they are in would be very helpful in making them feel that they are talking to the right person.

Applying the therapy

After listening to the patient with keenness and internalizing their situation, the next thing is to apply the therapy in the manner that seems fit for the patient. As the therapist, the best approach to dealing with the patient should be employed. There is also the scheduling which requires that the therapy does not interfere with normal programs of the person undertaking the therapy. The therapist should, therefore, strive to ensure that he/she finds flexible times to meet the schedules of the patient.


This is one of the essential parts of the therapy. As the therapist, I have to guarantee confidentiality to the patient on the information that they are going to give. This will go a long way in maintaining the trust between the therapist and the patient. At no point and not unless with the consent of the patient or otherwise advised should the information discussed between me and the patient find its way to the public. As a therapist, I am obliged to protect the privacy if the patient at whatever cost.

Psychotherapeutic goals

The main aim of psychotherapy is to strengthen the mental power of the patient. As a result, it is important to ensure that goals are set before embarking on the therapy. As much as most of the therapists usually understand their work as professionals, it is important that goals are set after the session has commenced. Some of the general goals of psychotherapy include;

Strengthening the mind

Most of the people seeking psychotherapy if not all are unable to explore the full potential of their minds hence the need to have someone they can talk tow. As a psychotherapist, the main goal should be to help the individual understand their abilities by helping restore their strengths. This will go a long way in enabling the person use their full mental potential to tackle issues that may arise in their lives.

Bringing contentment and inner happiness

Another goal of the therapy should be to ensure that the patient learns to accept the fact of the matter that they may be able to stay contented in their inner souls. This can only be done by helping the individuals to raise their self-esteem and making them understand that they are not alone in the journey. It should be noted that the patient is there not to find comfort but rather solutions to problems they are facing in life.

Strengthening the ego

From our earlier discussion, we noted that the ego is what defines an individual regarding their personality. The therapy sessions should, therefore, be focused on helping the person reevaluate their purpose in life and learn how to cope with life-related issues (Petrowski, et al 2015). Psychotherapy should, therefore, be aimed at improving the ability of the patient to tolerate destabilization situations in life.

Bringing change

The whole idea behind the therapy is to bring a long lasting solution to a particular issue that may be disturbing the client. As a result, the therapist should be focused on making the life of the patient better than during the time they enrolled in the therapy. They should, therefore, leave the sessions better as better people compared to the time of enrollment.

Relationship and multicultural issues in psychotherapy

Before embarking on any task, it is important to note that there are issues that may arise in the course of working on the tasks. As a result, it is important that the therapist be wary of the cultural and relationship issues that may arise in the process of executing their duties. This part shall be looking at both the relationship and cultural issues that may arise.

Relationship issues

  1. Reluctance

As a therapist, one should not expect that the patient will open up on the issue in the first instance. There is the fear that might engulf the patient, and they find it hard to give the required information to the therapist. There is always something holding them back since they are not sure if they should feel free to explain themselves to this new person at the point of their first meeting. It is therefore expected that there shall be some mountain to climb before trust has been built and the patient accepts to open up.

  1. Codependence

Most of the cases brought for therapy are not in most cases are not voluntary. Family members may have noted a problem that one of their own is facing and decided to seek medical attention. They may at times want to be involved in the whole process which is not advisable in most cases. The question could be, what if the same people who brought them in are the same reason behind the condition of the patient? The therapist has to, therefore, maintain being to light the need for the family to let the whole process remain a two people’s affair, i.e. between them and the patient. At no point should anyone other than the person session not unless otherwise advisable.

Multicultural issues

People from different cultural backgrounds will always be something to expect when in the field of psychotherapy. One of the most common issues that therapists have to deal with is the issue of language. Interpretation of some of the words that might be used by the patient may differ from what they wanted to mean. As such, the therapist needs to ensure that they can understand the fusion between languages used in the streets and profession.

The second issue is the cultural beliefs which are determined by such aspects as religion and beliefs. Some of the requirements during therapy may not be socially accepted in the society where the patient comes from. Having grown in such a society, they might not be willing to oblige to the requirements of the therapy. This may be a great hindrance to ensuring a positive outcome of the therapy.

Central techniques and methods in psychotherapy

To deal with the situation at hand, different approaches can be used. This means that any person in the field of psychotherapy has to have a variety of options that can be used while handling the issue. Some of the techniques and methodologies include;

Attachment theories

This approach towards implementing psychotherapy is based on previous research that has been documented. Most of the studies have concluded that the issues occurring in adulthood have something to do with the childhood of the patient. By identifying patterns and situations in the life and style of the patient, the therapist can recommend the best approach towards dealing with the issue at hand (Lindhiem, et al. 2015). It becomes easy to sort the different times in the life of the patient hence picking up the one that seems to have impacted on them leading to the said condition.

Interpersonal approaches

Involves identification of self-defeating patterns in relationships that one is involved in. The therapist wants to figure out what could be causing a particular situation is taking place in a particular context. In so doing, they are easily able to identify patterns in the relationship or in the life of the individual that does not work and figuring out healthier ones.

Systematic approaches

Aims at understanding the problems from a contextual framework. This method mostly focuses on the roles and behaviors that an individual may take from a particular context whether it is from the family or it is something that has been taken from their workstations. This gives the therapist a wider view of the issues surrounding the individual coming to a quick conclusion of what the problem could be.


Fall, K. A., Holden, J. M., & Marquis, A. (2011). Theoretical models of counseling and psychotherapy. Routledge.

Elliott, A. (2015). Psychoanalytic theory: An introduction. Palgrave Macmillan.

Petrowski, K., Kracz, A., & Joraschky, P. (2015). Contributions of patient and psychotherapist attachment status to treatment outcome, and the role of the patient’s openness. Journal of Psychosomatic Research78(6), 618.

Lindhiem, O., Bennett, C. B., Orimoto, T. E., & Kolko, D. J. (2016). A meta‐analysis of personalized treatment goals in psychotherapy: A preliminary report and call for more studies. Clinical Psychology: Science and Practice23(2), 165-176.



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