22 Best Counseling Interventions & Strategies for Therapists

When individuals arrive for counseling, they typically seek change, clarity, advice, and help to overcome their difficulties.

Counseling is highly beneficial, with “far-reaching effects in life functioning” (Cochran & Cochran, 2015, p. 7).

While therapeutic relationships are vital to a positive outcome, so too are the selection and use of psychological interventions targeting the clients’ capability, opportunity, motivation, and behavior (Michie et al., 2014).

This article introduces some of the best interventions while identifying the situations where they are likely to create value for the client, helping their journey toward meaningful, value-driven goals.

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What Is a Counseling Intervention?

“Changing ingrained behavior patterns can be challenging” and must avoid or at least reduce the risk of reverting (Michie et al., 2014, p. 11).

The American Psychological Association (n.d., para. 1) describes an intervention as “any action intended to interfere with and stop or modify a process, as in treatment undertaken to halt, manage, or alter the course of the pathological process of a disease or disorder.”

Interventions are intentional behaviors or “change strategies” introduced by the counselor to help clients implement problem management and move toward goals (Nelson-Jones, 2014):

• Counselor-centered interventions are where the counselor does something to or for the client, such as providing advice.
• Client-centered interventions empower the client, helping them develop their capacity to intervene in their own problems (for example, monitoring and replacing unhelpful thinking).

Creating or choosing the most appropriate intervention requires a thorough assessment of the client’s behavioral targets, what is needed, and how best to achieve them (Michie et al., 2014).

The selection of the intervention is guided by the:

• Nature of the problem
• Therapeutic orientation of the counselor
• Willingness and ability of the client to proceed

During counseling, various interventions are likely to be needed at different times. For that reason, counselors will require a broad range of techniques that fit the client’s needs, values, and culture (Corey, 2013).

In recent years, an increased focus has been on the use of evidence-based practice, where the choice and use of interventions is based on the best available research to make a difference in the lives of clients (Corey, 2013).

List of Popular Therapeutic Interventions

Various therapeutic interventions can be beneficial at different points in the treatment, depending on the client’s needs.

“Clients are hypothesis makers and testers” who have the reflective capacity to think about how they think (Nelson-Jones, 2014, p. 261).

Helping clients attend to their thoughts and learn how to instruct themselves more effectively can help them break repetitive patterns of insufficiently strong mind skills while positively influencing their feelings.

The following list includes some of the most popular interventions used in a variety of therapeutic settings (modified from Magyar-Moe et al., 2015; Sommers-Flanagan & Sommers-Flanagan, 2015; Cochran & Cochran, 2015; Corey, 2013):

Detecting and disputing demanding rules

Rigid, demanding thinking is identified by ‘musts,’ ‘oughts,’ and ‘shoulds’ and is usually unhelpful to the client.

For example:

I must do well in this test, or I am useless.
People must treat me in the way I want; otherwise, they are awful.

Clients can be helped to dispute such thinking using “reason, logic, and facts to support, negate or amend their rules” (Nelson-Jones, 2014, p. 265).

Such interventions include:

• Functional disputing
  Pointing out to clients that their thinking may stand in the way of achieving their goals
• Empirical disputing
  Encouraging clients to evaluate the facts behind their thoughts
• Logical disputing
  Highlighting the illogical jumps in their thinking from preferences to demands
• Philosophical disputing
  Exploring clients’ meaning and satisfaction outside of life issues

Identifying automatic perceptions

Our perceptions greatly influence how we think. Clients can benefit from recognizing they have choices in how they perceive things and avoiding jumping to conclusions.

• Creating self-talk
  Self-talk can be helpful for most clients and can target anger management, stress handling, and improving confidence. For example:

This is not the end of the world.
I’ve done this before; I can do it well again.

• Creating visual perceptions
  Building on the client’s existing visual images can be helpful in understanding and working through problematic situations (and their solutions).

One simple exercise to help clients see the strong relationship between visualizing and feeling involves asking clients to think of someone they love. Almost always, they form a mental image along with a host of feelings.

Visual relaxation is a powerful self-helping skill involving clients taking time out of their busy life to find calm through vividly picturing a real or imagined relaxing scene.

Creating better expectations

Clients’ explanatory styles (such as expecting to fail) can create self-fulfilling prophecies. Interventions can help by:

• • Assessing the likelihood of risks or rewards
  • Increasing confidence in the potential for success
  • Identifying coping skills and support factors

• Time projection
  Imagery can help by enabling the client to step into a possible future where they manage and overcome difficult times or worrying situations.

For example, the client can imagine rolling forward to a time when they are successful in a new role at work or a developing relationship.

Creating realistic goals

Goals can motivate clients to improve performance and transition from where they are now to where they would like to be. However, it is essential to make sure they are realistic, or they risk causing undue pressure and compromising wellbeing.

The following interventions can help (Nelson-Jones, 2014):

• Stating clear goals
  The following questions are helpful when clients are setting goals:

Does the goal reflect your values?
Is the goal realistic and achievable?
Is the goal specific?
Is the goal measurable?
Does the goal have a timeframe?

Helping clients to experience feelings

Counseling can influence clients’ emotions and their physical reactions to emotions by helping them (Nelson-Jones, 2014):

• • Experience feelings
  • Express feelings
  • Manage feelings

• Empty chair dialogue
  This practical intervention involves the client engaging in an imaginary conversation with another person; it helps “clients experience feelings both of unresolved anger and also of weakness and victimization” (Nelson-Jones, 2014, p. 347).

The client may be asked to shift to the empty chair and play the other person’s part to explore conflict, interactions, and emotions more fully (Corey, 2013).

How to Craft a Treatment Plan 101

“Counselors and counseling trainees make choices both concerning specific interventions and about interventions used in combination” (Nelson-Jones, 2014, p. 223).

Through early and continued engagement with the client throughout the counseling approach, the counselor and client set specific, measurable, and achievable goals and create a treatment plan with a defined intervention strategy (Dobson, 2010).

The treatment plan becomes a map, combining interventions to reach client goals and overcome problems – to get from where they are now to where they want to be. However, no plan should be too fixed or risk preventing the client’s progress in their ‘wished-for’ direction. Rather, it must be open for regular revisit and modification (Nelson-Jones, 2014).

Counseling and therapeutic treatment plans vary according to the approaches used and the client’s specific needs but should be strength-based and collaborative. Most treatment plans typically consider the following points (modified from GoodTherapy, 2019):

• History and assessment – E.g., psychosocial history, symptom onset, past and present diagnoses, and treatment history
• Present concerns – The current concerns and issues that led the client to counseling
• Counseling contract – A summary of goals and desired changes, responsibility, and the counseling approach adopted
• Summary of strengths – It can be helpful to summarize the client’s strengths, empowering them for goal achievement.
• Goals – Measurable treatment goals are vital to the treatment plan.
• Objectives – Goals are broken down into smaller, achievable outcomes that support achievement during counseling.
• Interventions – Interventions should be planned early to support objectives and overall goals.
• Tracking progress and outcomes – Regular treatment plan review should include updating progress toward goals.

While a vital aspect of the counseling process is to ensure that treatment takes an appropriate direction for the client, it is also valuable and helpful for clients and insurance companies to understand likely timescales.

13 Helpful Therapy Strategies

While there are many counseling strategies and interventions available, some have particular value in dealing with clients presenting specific (and combined) issues, including the following.

Depression

“Depression is one of the most common mental health disorders with a high burden of disease and the leading cause of years of life lost due to disability” (Hu et al., 2020, p. 1).

• Exercise interventions
  Research has shown that even low-to-moderate levels of exercise can help manage and treat depression (Hu et al., 2020).
• Gratitude
  Practicing gratitude can profoundly affect how we see our lives and those around us. Completing gratitude journals and reviewing three positive things that have happened at the end of the day have been shown to decrease depression and promote wellbeing (Shapiro, 2020).
• Behavioral activation
  Scheduling activities that result in positive emotions can help manage and overcome depression (Behavioral Activation for Depression, n.d.).

Anxiety

Anxiety can stop clients from living their lives fully and experiencing positive emotions. Many interventions can help, including:

• Understanding your anxiety triggers
  Interoceptive exposure techniques focus on reproducing sensations associated with anxiety and other difficult emotions. Clients benefit from learning to identify anxiety triggers, behavioral changes, and associated bodily sensations (Boettcher et al., 2016).
• Using a building image
  Clients are asked to form a mental image of themselves as a building. Their description of its state of repair and quality of foundation provides helpful insight into the client’s wellbeing and degree of anxiety (Thomas, 2016).

Grief therapy

Grief therapy helps clients accept reality, process the pain, and adjust to a new world following the loss of a loved one. Several techniques can help, including (modified from (Worden, 2018):

• Creating memory books
  Compiling a memory book containing photographs, memorabilia, stories, and poems can help families come together, share their grief, and reminisce.
• Directed imagery
  Like the ‘empty chair’ technique, through imagining the missing loved one in front of them, the grieving person is given the opportunity to talk to them.

Substance abuse

“There has been significant progress and expansion in the development of evidence-based psychosocial treatments for substance abuse and dependence” (Jhanjee, 2014, p. 1). Psychological interventions play a growing role in disorder treatment programs; they include:

• Brief optimistic interventions
  Brief advice is delivered following screening and assessment to at-risk individuals to reduce drinking and other harmful activities.
• Motivational interviewing
  This technique involves using targeted questioning while expressing empathy through reflective listening to resolve client ambivalence about their substance abuse.

Marriage therapy

Interventions are a vital aspect of marriage therapy, often targeting communication skills, problem-solving, and taking responsibility (Williams, 2012).

They can include the following interventions:

• Taking responsibility
  It is vital that clients take responsibility for their actions within a relationship. The counselor will work with the couple, asking the following questions, as required (modified from Williams, 2012):

How have you contributed to the relationship’s problems?
What changes are needed to improve the relationship?
Are you willing to make the changes needed?

• Create an action plan
  Once the couple agrees, the changes will be combined into a plan, with specific actions to help them achieve their goal.

Helping cancer patients

“There is no evidence to suggest that having counseling will help treat or cure your cancer”; however, it may help with coping, relationship issues, and dealing with practical problems (Cancer Research UK, 2019, para. 16).

Several counseling interventions that have proven helpful with the psychological burden include (Guo et al., 2013):

• Psychoeducation
  Sharing the importance of mental wellbeing and coping with the client and involving them in their cancer treatment can reduce anxiety and improve confidence.
• Cognitive-Behavioral Therapy
  Replacing incorrect or unhelpful beliefs can help the client achieve a more positive outlook regarding the treatment.

Interventions & Strategies for Career Counseling

Career counselors help individuals or groups cope more effectively with career concerns, including (Niles & Harris-Bowlsbey, 2017):

• Career choice
• Managing career changes and transitions
• Job-related stress
• Looking for a job

While there are many interventions and strategies, the following are insightful and effective:

• Creating narratives
  Working with clients to build personal career narratives can help them see their movement through life with more meaning and coherence and better understand their decisions. Such an intervention can be valuable in looking forward and choosing the next steps.
• Group counseling
  Multiple group sessions can be arranged to cover different aspects of career-related issues and related emotional issues. They may include role-play or open discussion around specific topics.

2 Best Interventions for Group Counselors

Group sessions in counseling either involve individual members bringing topics for discussion to share with others or are psychoeducational, where the entire group discusses a subject.

The ultimate goals are usually to “help group members respond to each other with a combination of therapeutic attending, and sharing their own reactions and related experiences” (Cochran & Cochran, 2015, p. 329).

Examples of group interventions include:

• Circle of friends
  This group intervention involves gathering a child’s peers into a circle of friendly support to encourage and help them with problem-solving. The intervention has led to increased social acceptance of children with special needs (Magyar-Moe et al., 2015).
• Group mindfulness
  Mindfulness in group settings has been shown to be physically and mentally beneficial (Shapiro, 2020). New members may start by performing a body-scan meditation where they bring awareness to each part of their body before turning their attention to their breathing.

Resources From PositivePsychology.com

We have many free interventions, using various approaches and mediums, that support the counseling process and client goal achievement.

• Nudge Interventions in Groups
  The group provides a valuable setting for exploring the potential of ‘nudges’ to alter behavior in a predictable way.
• Developing Interoceptive Exposure Therapy Interventions
  This worksheet explores the sensations behind panic attacks and phobias.
• Therapist Interoceptive Exposure Record
  Use this helpful log to track interoceptive exposure interventions.
• Motivational Interviewing
  This template uses the five stages of change to consider the client’s readiness for change and the appropriate interventions to use.
• Breaking Out of the Comfort Zone
  Making changes typically requires clients to step out of their comfort zone. This worksheet identifies opportunities to embrace new challenges.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

• Benefit finding

Psychological research has identified long-term benefits to using benefit finding, with individuals reporting new appreciation for their strengths and building resilience (e.g., Affleck & Tennen, 1996; Davis et al., 1998; McMillen et al., 1997).

• • Begin by talking about a traumatic event.
  • Focus on the positive aspects of the experience.
  • Consider what the experience has taught you.
  • Identify how the experience has helped you grow
• Self-compassion box

Self-compassion is a crucial aspect of our psychological wellbeing, made up of showing ourselves kindness, accepting imperfection, and paying attention to personal suffering with clarity and objectivity.

• • Step one – Begin by recognizing the uncompassionate self.
  • Step two – Select self-compassion reminders.
  • Step three – Redirect attention to self-compassion.
  • Step four – Reflect on creating more self-compassion in life.

Over time, the client should see the gaps closing between where they are now and where they want to be.

• 17 Motivation & Goal Achievement Exercises
  If you’re looking for more science-based ways to help others reach their goals, check out this collection of 17 validated motivation & goal achievement tools for practitioners. Use them to help others turn their dreams into reality by applying the latest science-based behavioral change techniques.

A Take-Home Message

Counseling uses interventions to create positive change in clients’ lives. They can be performed individually but typically form part of a treatment or intervention plan developed with the client.

Each intervention helps the client work toward their goals, strengthen their capabilities, identify opportunities, increase motivation, and modify behavior.

They aim to create sufficient momentum to support change and avoid the risk of the client reverting, transitioning the client (often one small step at a time) from where they are now to where they want to be.

While some interventions have value in multiple settings – individual, group, career, couples, family – others are specific and purposeful. Many interventions target unhelpful, repetitive thinking patterns and aim to replace harmful thoughts, unrealistic expectations, or biased thinking. Others create a possible future where the client can engage with what might be or could happen, coming to terms with change or their own negative emotions.

Use this article to explore the range of interventions available to counselors in sessions or as homework. Try them out in different settings, working with the client to identify their value or potential for modification.

We hope you enjoyed reading this article. Don’t forget to download our three Goal Achievement Exercises for free.