Counselling Theories and Approaches
Senior 6 · Psychology
Counselling Theories and Approaches
Lesson 2 of 5
25 min
Uwimana, an S5 student, knows the answers in class but freezes when asked to speak; her heart races and her voice disappears. She has started skipping lessons with presentations. A psychoanalyst might look for hidden childhood conflicts. A behavioural counsellor asks something simpler: what has she learned, what keeps the fear going, and how can she unlearn it, one step at a time? Together they build a ladder of speaking tasks, from a one-word answer to a friend up to speaking at the school assembly (Figure 1). (An illustrative case.)
Definition
Behaviour therapy: approaches that apply the principles of learning (classical conditioning, operant conditioning and social learning) to change unhelpful behaviour and emotional responses.
Reinforcement: any consequence that makes a behaviour more likely. Positive reinforcement adds something pleasant (praise); negative reinforcement removes something unpleasant (anxiety falling when you avoid).
Extinction: the weakening of a learned response when it is no longer reinforced, or when the feared stimulus repeatedly occurs without the feared outcome.
Systematic desensitisation: gradually pairing relaxation with steps of increasing fear, so that relaxation replaces anxiety.
Exposure: confronting a feared situation, without escaping, until anxiety falls.
Systematic desensitisation. Joseph Wolpe (1958) based it on reciprocal inhibition: a person cannot be deeply relaxed and highly anxious at the same time. It has three steps: (1) learn deep muscle relaxation; (2) build an anxiety hierarchy of situations rated from least to most frightening (Figure 1); (3) imagine or face each step while relaxed, moving up only when the current step causes little anxiety.
Figure 1. An anxiety hierarchy ("fear ladder") for a student afraid of speaking in class. Distress ratings are the client's own estimates (subjective units of distress, 0–100). The client moves up one step only when the step below causes little anxiety. The steps and ratings are illustrative.
Exposure therapy works without the relaxation step: the client faces the feared situation, in reality (in vivo) or in imagination, and stays until anxiety falls. Graded exposure climbs the ladder; flooding starts at or near the top. Exposure works through extinction and new learning: the client discovers that the feared outcome does not happen, or can be coped with. Exposure and response prevention for OCD (Unit 7) is a form of exposure.
Aversion therapy pairs an unwanted behaviour with an unpleasant experience, for example a medicine that causes nausea if the person drinks alcohol. It is rarely used today: its effects often fade, it raises ethical concerns about deliberately causing distress, and in the past it was misused, for example in attempts to change people's sexual orientation, which caused harm and is condemned by professional bodies.
Albert Bandura showed that people learn by watching others (Unit 2). In modelling, the client watches someone perform the feared or difficult behaviour. Bandura, Blanchard and Ritter (1969) found that participant modelling, in which people with a snake phobia watched a model handle a snake and were then guided to do so themselves, was more effective than watching alone or desensitisation. Social skills and assertiveness training use modelling, role-play, feedback and practice.
| Antecedent (what comes before) | Behaviour | Consequence (what follows) |
|---|---|---|
| Chemistry teacher asks a question to the class | Uwimana looks down and says nothing | Anxiety drops at once (negative reinforcement); teacher stops calling on her |
The analysis shows why the problem continues: silence is rewarded by relief. The plan therefore changes the consequences (praise and relief for speaking) and uses graded exposure.
Bear it in MIND: "How to TREAT Phobias | Systematic Desensitisation & Flooding | AQA Psychology | A-level". A revision video for A-level students comparing the two techniques. Note how each is explained in terms of classical conditioning, and the ethical issues raised for flooding.
Warning
Exposure must be planned and consented to. Never "cure" a friend's fear by surprise, for example by forcing him towards a dog. Unplanned, forced exposure can make fear worse and breaks trust. In therapy, the client agrees to every step.
Tip
Systematic desensitisation in three Rs: Relax, Rank, Rise. Learn relaxation; rank the fears into a hierarchy; rise one step at a time. For any behaviour, ask "A–B–C: what triggers it, and what rewards it?"
Important
Where to get help in Rwanda. If you, or someone you know, is struggling, talk to a trusted adult (a parent, teacher or school counsellor) and visit your local health centre. The Rwanda Biomedical Centre asks people to call its toll-free number 114 with questions about its services or in an emergency. Asking for help is a sign of strength, not weakness.
Practice
Sources and credits
Written by Ganzaa: the text, the diagram (Figure 1), the table and the exercises.
