Introduction
Counseling as an essential part of psychotherapy has been at the center of discussion among scholars, policymakers, and practitioners. Generally, there is an agreement that all main forms of counseling and psychotherapy have a positive aggregate effect. Moreover, current research on the effectiveness of counseling and psychotherapy is rather clear-cut: counseling is effective (Welfel, 2015). According to subjective client reports and more objective statistics, counseling may be helpful for a range of mental health discomforts, both in the short term and over longer periods. Some research also suggests that therapy’s benefits may work well with antidepressants and other medications (Alkatheri et al., 2013). However, the research evidence on the effectiveness of specific types of counseling could be clearer. Thus, this study reviews the current literature to assess the three prominent counseling approaches. Specifically, the review covers Carl Rogers’ Person-Cantered therapy, Adlerian theory, and Gestalt therapy. To achieve this, the paper critically analyzes current research on the strengths and weaknesses of these counseling methodologies. It concludes with research gaps and recommendations for future research. While no model of psychotherapy stands out as the best in delivering desired therapeutic outcomes, the approaches have different strengths that work distinctively, depending on the type of clients involved.
Common Factors in Therapeutic Effectiveness
Much research has been needed to explain what specific factors make certain counseling approaches effective. In this regard, researchers generally agree that counseling is effective and outline specific factors to consider when determining the level of effectiveness. For instance, Gupta and Tripathi (2020) highlight the necessary conditions for achieving the desired therapeutic results based on Rogers’ proposals in the person-centered approach: (i) there must be a therapeutic understanding between the client and the therapist, (ii) there must be congruency between the client and the therapist, (iii) unconditional positive regard for the client must be shown by the therapist, (iv) empathy and understanding is expected from the therapist when handling the internal frame of the client, and (v) the client should have a positive perception of the therapist. Experiential learning is another key feature that enhances the therapeutic effectiveness of this methodology. It promotes social responsibility and personal accountability while eschewing traditional teaching approaches. Adler and Sarstedt (2021) opine that individuals with challenges consult a therapist to learn to understand their problems and how to handle them. After people have developed a greater understanding of themselves, they can concentrate on developing new abilities and behaviors that will aid them in overcoming these difficulties. Their assertion is based on the provisions of Adlerian therapy, where enhanced mental health and overall well-being are linked to a stronger sense of social connectivity based on assisting others, understanding the community, and developing a sense of purpose.
The challenges experienced in determining the effectiveness of different therapeutic approaches are mainly because clients respond differently to various counseling approaches. For instance, in Gestalt Therapy, González-Hidalgo (2017), while studying the effects of GT on indigenous and peasant activists, established that therapy sessions—conducted after Naranjo’s SAT-HTH training—assisted the participants in reflecting on their personal stories and gaining in social life. Many attendees, particularly women, felt more confident after the sessions and could actively engage more in community gatherings. On the other hand, Rodgers et al. (2022) observed that numerous clients express satisfaction with online therapy, which may lead therapists to be more receptive and accepting of the person-centered approach to therapy. Theirs was an assessment of video counseling, where they noted that remote counseling would likely continue to be popular, but it is important to recognize that technology has a non-neutral role in the therapeutic process. In Adlerian therapy, Chen et al. (2021) argues the case for incorporating empathy in therapy, maintaining that such practices make the clients optimistic, move past their reluctance to change, and create the expectation that the client will attain success. Therapists may ask their clients to consider the rationale for their behavior as they explore them. It is also thought that reflecting on past events helps clients understand past behavioral patterns that may have contributed to their expected challenges (…). Thus, therapists can search for recurring themes after reviewing multiple reflections based on the client’s situation.
Carl Rogers’s Person-Centred Approach
Carl Rogers uses client-centered psychotherapy to challenge clients to reclaim their resources for healing and growth (Joseph, 2014). As Gupta and Tripathi (2020) explain, Rogers, challenges clients to rethink success as empowerment and well-being by drawing on personal development and connection-building. There is a general understanding that Rogers’ conception of the self is phenomenological, existential, and humanistic. In his guide on person-centered coaching, Joseph (2014) opines that Rogers’ beliefs are predicated on a fundamental belief in people and that, given a supportive therapeutic environment, people naturally desire to self-actualize toward growth and fulfillment. Generally, the success of the person-centered model relies on the relationship between the client and the counseling professional. This assertion is supported by Rodgers and Tudor (2020), who established three basic conditions regarding the counselor’s attitude that can be used to improve the effectiveness of the therapeutic approach. The first condition demands transparency from the therapist, where they are expected to be genuine in their desire to help the client. Secondly, the therapist has to value the client unconditionally. Finally, empathy is necessary as the service provider needs to view things from the client’s perspective.
Researchers have assessed the potential contribution of person-centered therapy to the highly digitalized healthcare environment. To this extent, the model has made significant inroads in video counseling and psychotherapy, where it is used to offer remote counseling services (Treanor, 2017). Existing text-based, non-visual, non-auditory, or nonsynchronous types of counseling and therapy are acknowledged as viable information sources to more fully understand patient-centered techniques’ role in online therapeutic work. Using video conferencing software, a strong connection and a therapeutic alliance can be created between the client and the counselor. Harrison and Wright (2020) point out that therapists favor person-centered online working methods, especially short-term work. Such approaches include how unconditional positive regard can easily be promoted via synchronous, text-based counseling where the tone is given with no facial expression or voice, and congruence may be formed and put to good use in non-visual modes of counseling online. Similarly, the person-centered approach emphasizes experiential relationships as agents of change, and Treanor (2017) notes that empathy is frequently demonstrated in online work at relational depth. It is better for the client if any comments made by the counselor that a particular technique would be useful are based on an informed sense of why it might work. It may be true that therapists should go with what works, but to accomplish that, they must try to comprehend and assess the underlying idea.
While the person-centered approach to therapy has shown its effectiveness in dealing with Anxiety and helping in remote psychotherapy, it has also received its fair share of criticism. According to Seligman (2006), the effectiveness of this approach is limited because it needs to be more leisurely, simplistic, and optimistic and lacks the required focus on clients; hence a need for structural and directional change. Thompson and Henderson (2007) also mention the models’ reliance on highly intelligent and hardworking clients as a fundamental weakness, especially concerning its applicability. Such sentiments are echoed by Moon (2007), who noted that the model relies more on the client and therapist’s attitude rather than technique. Thus, the applicability of the model is restricted to specific contexts.
Adlerian Theory
The psychodynamic, goal-oriented, and brief Adlerian therapy is based on the views of Alfred Adler, a former Sigmund Freud’s partner. Adler focused most of his studies on feelings of inferiority vs. superiority, discouragement, and a sense of belonging in the context of one’s community and society (Adler & Sarstedt, 2021). He argues that, despite the potential for neurotic behavior, feeling inferior can motivate one to put in more effort and accomplish more. Adlerian treatment emphasizes the development of each patient’s distinct personality while appreciating and realizing how interconnected all people are. Goal-directedness in human conduct is the central idea of Adlerian treatment (Adler & Sarstedt, 2021). Current research suggests that several of Adler’s most significant hypotheses may have neurological roots. For instance, Cohen (2022) discovered a connection between eudemonia, or happiness anchored in meaning, and lower inflammatory levels and improved genetic expression. Additionally, it is said that the theory stresses the significance of using techniques and resilience for the client. These can be summarized as providing encouragement, developing expectations, examining behavior purpose, and assessing memory (Ashby et al., 2020; Chen et al., 2021). Agarwal and Meany-Walen (2019) noted that therapists listen to their challenges and empathize with their patients. Their research on multiracial children also demonstrates that therapy involves helping patients become aware of their talents and confident in their ability to succeed. Therapists may urge patients to consider how they would act if they were already the person they aim to be. On the other hand, understanding the function of some of these maladaptive behaviors can frequently help individuals create better-coping techniques (Ashby et al., 2020).
Current literature also suggests that the four stages of Adlerian therapy contribute to its effectiveness in counseling and psychotherapy. By using the theory concepts, therapists aid clients in better comprehending their objectives and life motivations. The first stage is the engagement phase, whose primary objective is to create a therapeutic understanding between the therapist and the client (Agarwal & Meany-Walen (2019). This calls for the capacity for cooperation, coordination, and interpersonal harmony. Ashby et al. (2020) explain the second stage, assessment, where the therapist works to understand the client adequately. This includes gathering background information, learning about prior experiences, and using psychotherapeutic tests. This typically requires looking at childhood experiences, family dynamics, and how the person views these events. Adlerian therapists may perform assessments to find and learn about these goals as a way to ascertain the goals a person is seeking to attain and the normal methods by which they go above the third step, insight, is to help the person understand their situation and become more conscious of their behavior. (Chen et al., 2021). At this level, the person receiving treatment must develop personal insight into their ideas and behaviors, even though a therapist may make observations. Finally, the therapy concludes with reorientation (Chen et al., 2021), where the therapist helps clients develop new skills, habits, and behaviors to help their personal growth. The only notable criticism towards Adlerian therapy is seen through Miller and Dillman Taylor’s (2016) work, who say the model lacks scientific and empirical evidence.
Gestalt Therapy
Gestalt therapy (GT) is a form of psychotherapy focusing more on the patient’s present circumstances than their prior experiences. This type of treatment emphasizes how crucial it is to understand a client’s life context and personal experiences by analyzing their challenges (Forgarty et al., 2020). Additionally, it entails accepting responsibility rather than blaming others. Gestalt, which by definition refers to the form or shape of something, implies that the whole is more than the sum of various elements (González-Hidalgo, 2017). The premise of this counseling program primarily emphasizes perception. Gestalt therapy focuses on interpreting and assigning meaning to our experiences and surroundings. Current literature on GT also focuses on the client’s reported changes to determine the model’s outcome effectiveness, especially where it is used for group interventions (Forgarty et al., 2020). Researchers have mostly concentrated on certain psychopathological, societal, and personal issues and specific targets. In an earlier study by Arip et al. (2013), the group guidance module’s overall content validity regarding student self-development was based on Gestalt theory and some of its fundamental tenets, including the holistic approach and person experience individual responsibility, and the here-and-now method. However, Doric (2017) used Gestalt therapy in prison with offenders who had psychopathology symptoms and noted no changes in the offenders’ behaviors or lives, though they did notice minimal enhancements in depressive groups than in maniac groups, who specifically benefited from their active participation in sessions and from the opportunity to resolve fundamental disputes in their lives using the analysis of incomplete gestalts.
Other studies have also compared the effectiveness of GT through comparisons to other counseling and psychotherapy approaches. Béja (2020) investigated the effectiveness of GT as a method of psychotherapy through a comparison with the national databases of comparable UK studies on different clinical models like Psychodynamic Therapy and Person-Centred Therapy. The researchers found that GT is equally successful as other methods. Indeed, the researcher established that their study’s pre-post treatment variances could be compared to the findings in other literature that examined different clinical models using the same assessment method. When Farahzadi and Masafi (2013) investigated how well GT and cognitive-behavioral therapy worked to lessen dysthymic disorders and the severity of symptoms among Iranian children, they arrived at the same conclusions. Instead, they noticed a big difference between the control group and the means of the two clinical models. Specifically, the warm interactions and confidence-building in the first sessions seem to be the most crucial aspects of both clinical models.
Like in the person-centered approach, critics of Gestalt Therapy question its applicability to various contexts. Specific controversies relate to whether or not the model is consistent with the available methodology. Doric (2017) noted that although the therapeutic approach is spontaneous, it only works for some clients as some may find it too aggressive. They also cite the limited monitoring during the interactions between the client and the therapist as an area of concern. GT is also considered time-consuming because it often takes time to establish the required level of trust between the therapist and the client (Forgarty et al., 2020). Thus, its weaknesses could challenge the arguments in support of its effectiveness.
Conclusion
In conclusion, the reviewed literature demonstrates that Carl Rogers’ Person-Cantered therapy, Adlerian theory, and Gestalt therapy are effective in counseling and psychotherapy. None of the three approaches stand out in terms of overall effectiveness beyond the rest, as they have all shown how instrumental they are to clients’ recovery process. Notably, Carl Rogers’ Person-Cantered therapy has demonstrated its ability to help clients battling Anxiety and its ability to operate in the highly digitalized modern healthcare environment. To this extent, it facilitates remote therapy as personal connections between the client and their therapists can be maintained within video counseling. Similarly, Adlerian theory creates better mental health and overall well-being, associated with a stronger sense of social connectivity based on helping others, integrating into the community, and discovering a sense of purpose. On the other hand, GT has shown its strengths in group settings, where it helps clients to build confidence and improve their relationships.
While these studies have fairly assessed the effectiveness of these therapeutic approaches, significant research gaps lie in their inability to effectively investigate the therapeutic orientation of these models based on the client’s perspective. Even though the quality of the relationship a client can develop with a specific counselor is often at the top of the list of factors to consider before beginning counseling, the compatibility of a client’s preferences with a specific therapeutic approach is still crucial. Such preferences significantly impact how the client feels about the relationship and the process, affecting how simple it is for them to benefit from the process. Thus, future research should focus on incorporating the client’s feelings toward different therapeutic approaches rather than solely on treatment outcomes. Moreover, a counselor should not accidentally recommend a particular work style; rather, it should be deliberate and informed. Ultimately, the effectiveness of a therapeutic process should be decided by how the client feels about it.
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