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Philosophical Issues in Counseling and PsychotherapyReview - Philosophical Issues in Counseling and Psychotherapy
Encounters with Four Questions about Knowing, Effectiveness, and Truth
by James T. Hansen
Rowman & Littlefield, 2014
Review by Kamuran Elbeyoğlu
Jul 21st 2015 (Volume 19, Issue 30)

Since Lou Marinoff wrote his prominent book Plato Not Prozac Applying Philosophy to Everyday Problems, philosophy's role in counseling and psychotherapy has been a hot topic among philosophers. Peter Raabe, for example, in his recent book with the same title argued that "a philosophically trained counselor or therapist will be a much more capable helper to individuals suffering from emotional and cognitive distress than those whose training is predominantly in the medical approach of psychiatry or the scientific approach of psychology" (2014: 13).

Philosophical Issues in Counseling and Psychotherapy: Encounters With Four Questions About Knowing, Effectiveness and Truth seems to be yet another book to appear by a philosopher in the same tradition, but not quite so. James T. Hansen is a renowned counselor, who regards psychotherapy as an art, more akin to humanities than a science and consequently, takes his clients as struggling with understandable problems of living, not as disordered, sick, ill or deficient.  As a counselor in the humanistic counseling tradition, he knows from his own experiences as a counselor, how hard is to operate in contemporary, technocratic and medicalized mental health culture and how, in such culture, a humanistically oriented counselor, whom he calls "displaced humanist",  feels intellectually frustrated because clients are reduced to simple, technique responsive clusters of symptoms.

 He wrote this book, in his own words, "as a philosophical analogue to books that are written about clinical cases, wherein authors bring their work to life by disclosing the personal and relational elements that animate the helping process" (Preface: x). With the aim of bringing depth and meaning into the counseling process, he overviews various justifications for philosophical inquiry in the helping professions. The heart of the book is four fundamental philosophical questions about knowing, effectiveness and truth that are designed to unite and give meaning to diverse and seemingly contradictory models of helping;  each forming one chapter: 1) What does it mean to know a client? 2) What makes counseling effective? 3) Are truths discovered or created in the counseling relationship? 4) Should counselors abandon the idea of truth? Hansen follows the same structure in each chapter devoted to each question. First, he introduces the issue by noting the personal and professional significance of the topic, then he carefully and thoroughly considers the question and finally presents a discussion of pertinent issues and possible resolutions.

Throughout the discussion of these topics, he discloses many of his own experiences and intellectual struggles that made these topics important to him. Peppering these chapters with self-disclosures, including anecdotes and intellectual struggles to find meaning not only provides the reader with a rich, personal vantage point for appreciating and critiquing ideological positions he advocates, but also makes this book an engaging and highly enjoyable reading experience.

Before discussing philosophical issues, he begins the first chapter with a critical review of the history and current state of mental health culture, which provides an initial cultural frame to contextualize the ideas that are subsequently discussed in the following chapters. After reviewing biological, psychosocial, psychoanalytic and finally medical traditions in mental health culture, he gives a critique of contemporary mental health culture, which is guided by the medical model. He comes to the conclusion that operating within this technocratic, medicalized mental health culture can create tremendous conflicts for practitioners who want to make a living using treatment approaches that are nuanced, relational and based on well-established principles of psychology.

The second chapter, therefore, is devoted to the discussion of the importance of and the need for asking and introducing philosophical questions at this very medicalized mental health culture. His philosophical inquiry centers on the question that what it means to help someone; whether it is just getting rid of symptoms, or changing the psychological constitution of their clients. This main question line leads him into the four questions that forms each of the following chapters. By discussing those questions he primarily relies upon the ideas of Freud, who invented talking therapy and psychoanalysis, Carl Rogers, who is the leader of the humanistic movement in therapy, Thomas Szasz, who is a compelling critique of mainstream psychiatry and an intellectual anarchist and Richard Rorty, who is the founder of a new movement called neopragmatism by synthesizing American pragmatism with European postmodernism.

Chapter Three is the first question: What Does it Mean to Know a Client? He considers this question mainly through a discussion of psychoanalytic and humanistic point of view, since, as comprehensive theories of subjectivity, arguably they have the most complete and compelling answers to the question, "what does it mean to know a client?"

He then continues to investigate the second question, "what makes counseling effective?" in Chapter Four. First stating the personal and professional significance of this question for him, he comes to the conclusion that out of the four fundamental questions this is the most important to consider, because most of the times, the therapists and counselors seem to cling to their dogmatic ties or preconceived beliefs about counseling and forget about their obligation to promote effectiveness of their therapy rather than following a certain, predefined course of therapy.

Hansen believes that counseling is conversational engineering. He then steers to a route which is not conventionally thought as part of effective helping to the client, namely through conversation discovering some truths about the client. So, he devotes the next two chapters to the discussion about how possibly the truth be irrelevant. The fifth chapter is about whether truths are discovered or created in the counseling relationship. This is also related to the very touchy issue of whether it is even reasonable to suppose that counselors can ascertain certain truths about their clients; and also whether this distinction even matter. Hansen thinks that these questions are important to consider, particularly because traditional theories of counseling presume that healing depends on the ability of counselors to discover truths about their clients.

The following chapter, then draws upon the question of whether counselors should abandon the idea of truth altogether. As mentioned in the previous chapter, traditional orientations to counseling were founded upon the Western assumptions about truth and progress. Hansen argues that counselors can provide necessary and sufficient justifications for their interventions without appealing to the problem-ridden area of truth. Replacing discovered truth with ever-evolving justifications is arguably a vital attitudinal shift for professional helpers to make in order for the helping professions to advance to new levels of tolerance for diverse people, practices, and ideas.

The concluding chapter is titled, The Journey Continues. In this chapter, Hansen raises a new line of inquiry and investigates the possibility of structuring helping professions around his conclusions in the future.

         In Philosophical Issues in Counseling and Psychotherapy: Encounters With Four Questions About Knowing, Effectiveness and Truth, James Hansen asks and proposes beginning resolutions to four fundamental questions about knowing, effectiveness and truth. Through exploring the intersection of philosophy, history, culture, power, language and theory, Hansen is able to weave a synthesis of logic that provides counselors, counselor educators and counselors-in-training with a unified view of helping that transcends conventional epistemology. I heartily recommend this book as essential reading for counselors, psychologists and social workers. This book should also be in the reading list of all theories of counseling courses.


© 2015 Kamuran Elbeyoğlu


Kamuran Elbeyoğlu (Ph.D), Toros University, School of Management and Social Sciences, Department of Psychology, Mersin, Turkey


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