Have you ever met with a counselor or therapist and thought, “This is not a good fit“?
It might have had something to do with the theories they use to inform their practice.
Counselors and therapists worldwide receive training about the theoretical underpinnings of mental health. They learn how to use those theories to support their work with clients. These professionals use diagnostic tools based on old and new theories of wellbeing.
What are these theories, and who created them? That is what you will learn as you continue reading.
Before you read on, we thought you might like to download our three Positive Psychology Exercises for free. These science-based exercises explore fundamental aspects of positive psychology, including strengths, values and self-compassion and will give you the tools to enhance the wellbeing of your clients, students or employees.
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What Are Mental Health Theories?
In the sciences, a theory is more than a simple guess. It is a “coherent group of propositions formulated to explain a group of facts or phenomena in the natural world and repeatedly confirmed through experiment or observation” (Scientific theory, n.d.).
One could create theories about almost anything, but it is rigorous testing that distinguishes simple theories from scientific ones. Not all theories will survive this type of testing. In fact, the acceptance or rejection of parts of theories is not unusual.
Theories in the field of psychology and mental health developed 50-100 years ago fall into six broad categories. They still influence us today. You might recognize them as:
- Analytical/developmental (Freud, Jung, Erickson, Kohlberg)
- Behavioral (Watson, Skinner, Pavlov)
- Cognitive (Tolman, Piaget, Chomsky)
- Social (Bandura, Lewin, Festinger)
- Humanistic (Rogers and Maslow)
- Personality (Erickson’s psychosocial development theory)
From these, many contemporary theories followed. Some are specific to a domain, like development. Others make use of neuroimaging to explain why we do the things we do.
Mental health theories strive to explain human development behaviorally, psychologically, and socially. For many years, researchers focused on alleviating pain or suffering. The approach centered on what was wrong with a person and how to fix it. There was no assumption that a person could strengthen their wellbeing.
A Look at the Models and Methods
Mental health and wellbeing experts draw from other areas to inform their perspective.
They also review a person’s mental health within context. An act could be psychopathological in one cultural context but not in another.
Some of the perspectives from which counselors, psychologists, and psychiatrists gain understanding about mental health are (Dasgupta, 2013):
This approach explains who we are in the world and how we are to act. It also tells us what we can expect after death based on our actions. The spiritual perspective discusses good and evil as they relate to suffering.
- Moral character
This perspective posits that there are certain virtues a person needs to learn. Doing so allows the individual to live a better life free from mental illness.
Based on mathematics, this perspective seeks to define what is “normal” or “average” for populations. Anyone falling outside of the norm is abnormal.
- Disease/medical/biological (genetics, neuroimaging, neurobiology)
This approach explains mental health as it relates to changes in the brain. The well-known case of Phineas Gage is an example. A rod went through his left frontal lobe. This affected his personality and behavior. Before the accident, people enjoyed his company and thought he was reliable. Afterward, they described him as ill tempered, foul, and unreliable.
- Psychological (psychodynamic, behavioral, cognitive-behavioral, existential/humanistic)
Mental health develops along an expected path. People try to adjust to their environment to survive within it. Problems arise when a person learns maladaptive strategies as a response to new situations.
Biology, psychology, and society all affect a person’s mental health. The influence of societal norms is important to the adaptive or maladaptive behavior of the individual.
- Psychosocial (Social learning model)
Researchers in this area study the relationship between a person’s thoughts (psychological) and their social behavior. This includes the meaning a person gives to their psychological processes. According to Bandura, people learn through observation and modeling of other people’s behavior (McLeod, 2016).
The interplay of biological, psychological, and social factors explains mental illness. This depends on the person and their environment.
The diagnosis and treatment of mental illness vary, but many therapists use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This tool provides clear definitions and criteria for more than 265 disorders. Diagnosis usually includes a physical exam, including lab tests, and a psychological evaluation (Mayo Clinic, n.d.a).
There are approximately 20 classes of mental illness covering everything from neurodevelopmental to paraphilic disorders.
Some treatment methods are medications, psychotherapy, brain-stimulation, hospital and residential treatment programs, and substance misuse treatment.
There are three ways to experience therapeutic intervention. Sometimes therapists use a combination of these. Each environment stresses confidentiality and the creation of a safe space for people to share.
This is a one-one session with a trained counselor. Depending on the type of therapy used, these sessions can continue for months or years.
People with similar challenges work together with a trained counselor. The goals are to talk about issues, share knowledge, and solutions.
- Family therapy
This method involves helping a family improve their communication. Through the guidance of a licensed therapist, they learn conflict resolution techniques. Not every family member necessarily participates, and it is often short term.
Recommended read: Conflict Resolution Training: 18 Best Courses and Master’s Degrees
Mental Health Counseling Theories
There are five schools of thought that attempt to explain mental health. Many therapists and counselors operate from one or two of these.
Theories guide the services and interactions therapists have with their clients. This is important to know because it can affect how well you and your therapist “click.”
The five schools of thought are:
Behavior is a result of life experiences, not the unconscious mind. We learn through our experiences with our environment. This approach is all about conditioning. It is present focused.
This is a medical model of treating mental disorders. The idea is that something physical is the cause of mental illness. Symptoms are “outward signs of the inner physical disorder” (McLeod, 2018).
Like behaviorism, psychodynamic therapists view behavior as a result of experiences. One of the differences, though is that psychodynamic therapists focus on past experiences. They assert that unconscious forces drive people’s behavior. The client and therapist revisit explored ground to achieve more understanding. This therapeutic process can take many years.
The emphasis of this theory is on thinking, not doing. A feedback loop exists between the person’s assumptions and attitudes, their resulting perceptions, and the conclusions drawn from them (Grace College, n.d.). These therapists work to assist a person to change their thoughts. Doing this leads to a change in feelings and behavior.
This approach is characterized by three different therapies that can help people achieve their highest potential.
- Client-centered therapy, developed by Carl Rogers, allows the client to investigate who they are at their core. The therapist creates an environment of empathy, acceptance, and genuineness. This encourages the client in their self-exploration.
- Gestalt therapy, created by Frederick Perls, is present focused and involves role-play.
- Existential therapy techniques are about ownership of one’s life, including all its mishaps. The responsibility of one’s life is one’s own.
It is easy to understand how a therapist influenced by one of these theories might interact with a client. Positive psychology practitioners, for example, primarily follow humanistic theories. One would expect these therapists to be empathetic and stress ownership and responsibility. The sessions are likely to include a healthy dose of self-exploration, especially related to developing strengths.
A List of Popular Mental Health Theories
Every theory of mental health comes from one of the above five areas or a combination of them.
Here is a brief overview of theories derived from those broader categories.
Network theory explains that “mental disorders arise from direct interactions between symptoms” (Borsboom, 2017). Biological, psychological, and societal influences facilitate connections between psychopathological symptoms.
Cognitive-Behavioral Therapy (CBT) focuses on assisting the person in changing destructive thoughts and behaviors. It is a type of psychotherapy that helps a client to quickly identify and manage problems. The approach is goal oriented and often involves homework. The homework helps to reinforce the in-person sessions. It is the “gold standard in the psychotherapy field” (David et al., 2018).
Operant conditioning is still a popular approach. Whether used by therapists or physical trainers, it involves identifying the cue–routine–reward pattern. The goal is to change the person’s behavior by changing the routine and sometimes the reward. It is often used in the treatment of obsessive-compulsive disorder through exposure therapy.
Exposure therapy allows the person to engage with the source of their anxiety in a safe space. The goal is to slowly, and incrementally, increase the person’s exposure to their fear. There are several variations of exposure therapy (American Psychological Association, n.d.).
It is useful in the treatment of:
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
- Generalized anxiety disorder
Classical conditioning also remains a popular treatment for phobias through the use of systematic desensitization. This is a variant of exposure therapy (Grace College, 2016).
Popular Mental Health Theories on Wellbeing
The Self-Determination Theory of motivation (SDT), and more specifically, the Basic Psychological Needs Theory (BPNT) posit that autonomy, competence, and relatedness are the primary supports for wellbeing and optimal functioning (Center for Self-Determination Theory, n.d.) If anyone of these is faulty, then the person’s wellbeing decreases. Intrinsic motivation increases through the satisfaction of having these needs met (read more about intrinsic coaching here).
The Broaden and Build Theory of Positive Emotions (Fredrickson, 1998, 2000) changed the discussion around emotions. Many of the psychological theories and research before this dealt with negative affect. These are emotions like anger, fear, sadness, guilt, and shame (Stringer, 2013).
Fredrickson argued that negative emotions create a sort of tunnel vision. Positive affect widens one’s perspective. Positive emotions like awe, joy, and gratitude expand one’s experience within the environment. The theory doesn’t advocate ignoring negative emotions. Instead, it discusses the ramifications of continuing to ignore positive ones.
The focus of the PERMA theory of wellbeing (Seligman, 2011) is helping people to thrive. It promotes building skills that allow one to flourish (Positive Psychology Center, n.d.). Many contemporary theories attempt to help a person reduce suffering. The PERMA theory of wellbeing states that wellbeing consists of five elements:
- Positive emotion
These emotions increase our hedonic happiness.
This is the flow that Mihaly Csikszentmihalyi discussed. Being engrossed in one’s pursuit is the reward.
Support is critical to our survival and emotional wellbeing.
Serving or working in a capacity that contributes to something larger than ourselves gives us a sense of purpose and meaning.
We enjoy pursuing accomplishments for the sake of doing so.
Each of these contributes in varying degrees to a person’s ability to flourish. Positive psychology therapists and coaches often use this as a backdrop for their sessions.
A Take-Home Message
There are several mental health theories, but they all come from one of five schools of thought: behaviorism, biological, psychodynamic, cognitive, and humanistic.
In recent years, there has been a move toward studying how people flourish. This is positive psychology and explores what humans already do well. Doing this type of research helps others to increase their opportunities to thrive.
If you seek the help of a therapist or counselor, it is important to know the basis for their approach. You do not want to see a behavioral psychologist to flesh out how you can find meaning in your life. They are better suited for helping you change, develop, or extinguish a habit.
The continued study of mental health, including the more positive aspects, is critical to each person’s wellbeing.
What are you doing today to flourish in your life?
If you enjoyed reading about mental health theories, why not head on over to mental health books for even more reading material.
We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free.
- American Psychological Association (n.d.). What is exposure therapy? Retrieved August 1, 2019, from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy
- Borsboom, D. (2017 February). A network theory of mental disorders. World Psychiatry, 16(1), 5-13.
- Center for Self-Determination Theory. (n.d.). Overview. Retrieved August 2, 2019, from https://selfdeterminationtheory.org/theory/
- Dasgupta, S. (2013 February 14). Models of mental health and illness. Retrieved July 29, 2019, from https://www.slideshare.net/SudarshanaDasgupta/models-of-mental-health-illness
- David, D., Cristea, I, & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9(4).
- Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2(3), 300–319.
- Fredrickson, B. L. (2000). Cultivating positive emotions to optimize health and well-being. Prevention & Treatment, 3(1).
- Grace College (2016 November 15). 4 popular mental health counseling theories. Retrieved July 26, 2019 from https://online.grace.edu/news/human-services/counseling-theories/
- Mayo Clinic. (n.d.a). Mental illness. Retrieved July 26, 2019, from https://www.mayoclinic.org/diseases-conditions/mental-illness/diagnosis-treatment/drc-20374974
- Mayo Clinic (n.d.b). Family therapy: Overview. Retrieved July 28, 2019 from https://www.mayoclinic.org/tests-procedures/family-therapy/about/pac-20385237
- McLeod, S. (2016). Albert Bandura’s social learning theory. Simply Psychology. Retrieved July 28, 2019, from https://www.simplypsychology.org/bandura.html
- McLeod, S. (2018). The medical model [Web log post]. Retrieved August 1, 2019 from, https://www.simplypsychology.org/medical-model.html
- Positive Psychology Center (n.d.). PERMA Theory of well-being workshops. Retrieved August 2, 2019, from https://ppc.sas.upenn.edu/learn-more/perma-theory-well-being-and-perma-workshops
- Scientific theory (n.d.) Dictionary.com Retrieved July 29, 2019, from https://www.dictionary.com/browse/scientific-theory
- Seligman, M. (2011). Flourish: A visionary new understanding of happiness and well-being. New York: Free Press.
- Stringer, D. M. (2013). In Gellman, M. D., & Turner, J. R. (Eds.), Encyclopedia of behavioral medicine. Springer.
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