Perhaps it was Freud who first looked at imagery as a component of clients' expression (Markell, 2002). Symbolic transformation is one of the founding principles of counseling and is as old as the first word, sound, or picture created for human communication. Freud's psychosexual phallic is, in his theory, represented through objects like guns and gestures such as finger-pointing, although he believed that "a cigar is just a cigar." Symbolism is central to many theories of counseling such as object relations theory, which states that clients seek to establish relationships that symbolize previous or primary interactions in their life. Carl Jung's early and extensive research into symbols best illustrates the therapeutic benefit of attending to the client's subjective reality. Jung believed that symbols were a reality of human existence and consciousness. "Because there are innumerable things beyond the range of human understanding, we constantly use symbolic terms to represent concepts that we cannot define or fully comprehend" (Jung, 1964, p. 4).
The integration of expressive arts, narrative, and symbolism with counseling theory is fundamental to the effective use of these approaches. Using integrative approaches as a component of counseling enhances the therapeutic milieu and in turn fosters sound theoretical practice. Counselors who combine these approaches with their theoretical orientation produce interventions that interact with the true essence of their clients. The integration of nontraditional approaches to counseling with theory must include a rationale for their use with clients (Caldwell, 2005). Simple haphazard mixing and matching of theory and application can lead to measures that actually impede client growth. The use of the integrative approaches in counseling ought to be based on four basic factors:
1. Counselor competency with integrative measures and techniques. The effective and appropriate use of any counseling strategy is supported by the knowledge and familiarity of the counselor with that approach. Competent use of integrative measures ensures maximized therapeutic benefit to the client. Postgraduate education and review are imperative to effective clinical work for counselors.
2. Client openness to integrative approaches and styles. Every approach is not appropriate for every client. For example, the use of symbolic exploration as an integrative technique may be too abstract and ambiguous for more practical clients. It is best to present an integrative approach to the client by explaining its purpose and intended result. This method of intervention presentation is common in the Gestalt approach and is usually prefaced by the classic question to the client, "Would you like to try an experiment?" Remember that a client's objection to a particular intervention is not necessarily an impediment to therapeutic work.
3. The nature of the presenting client issue. Appropriate interventions address client needs. The choice to use an integrative approach must also be made on the basis of the type of problem a client is attempting to work through. Different modalities in the integrative approaches address certain client problems more directly than others. A counselor would be wise to develop a sound case conceptualization of a client's problems and needs before making an inopportune decision to present an ineffective intervention.
4. Therapeutic relevance to the desired outcomes of counseling for the client. There are some counselors who might make the mistake of using an integrated approach because it appeals to their own curiosity or style of counseling. While a practitioner's selection and use of a theoretical orientation ought to be a reflection of her or his beliefs about client change, her or his role as a counselor, the counseling relationship, and interventions ought to be selected on the basis of the client's therapeutic needs. A good question for a counselor or therapist to pose when considering an integrative strategy is, "How will this help my client?" The insight derived from this question can lead to more intentional and effective facilitation of the client's process.
Counseling theory is often integrated with approaches from expressive arts, narrative, and symbolism. The application of these approaches in counseling is conceptually based on the theory of counseling that the counselor practices. The following list describes a few examples of integrative approaches as framed by selected theoretical orientations. These scenarios serve as a representation of what theoretically integrated approaches in counseling and psychotherapy are.
• Narrative integration in Adlerian counseling theory. An Adlerian counselor wishing to conduct a lifestyle assessment of clients may use the narrative approach as a means of encouraging clients' awareness and responsibility. By having clients share their life narrative, the counselor will look for themes centered on the three life tasks of work, friendship, and love. Within the clients' narrative will be valuable therapeutic information possibly concerning feelings of inferiority, their family constellation, and other elements that will be useful as the counselor facilitates the clients' exploration of their own uniqueness.
• Symbolism integration in existential counseling philosophy. The counselor working from an existential frame is likely to use the symbolic approach to uncover themes in the clients' speech and behavior. Concepts of freedom, isolation, and meaninglessness will arise in the session as symbolic references to the client's inner reality. Attending to the symbols that clients produce will make greater strides toward understanding their phenomenological perspective and developing strategies to cope with their angst.
• Visual art integration in Gestalt counseling theory. A Gestalt counselor may ask clients to draw their impasse as an experiment to increase awareness. The drawing, by its artistic design, must include a figure and field or foreground and background that will structure the clients' perspective of their issues. Working in the here-and-now perspective of Gestalt, the counselor may direct clients to make changes to their drawings by adding colors to represent the emotions that arise for clients as they draw. By allowing clients to experience their reality in this artful form, the counselor facilitates the clients' work toward resolving their unfinished business.
There is an innate link among the integrative approaches. The act of writing is seen as an expressive art, just as the creation of narrative form inherently produces symbolic meaning. Art in all of its forms is symbolic. Although there is significant conceptual overlap among these approaches, their applied uses and clinical outcomes vary greatly (Markell, 2002). The integration of these approaches with counseling theory helps in sifting out those elements that, to the naive, seem the same. As the expressive arts, narrative, and symbolism are shaped by theory, they take on their own unique purpose and function in the counseling process. Through a therapeutic lens, the counselor perceives the interconnected nature of these approaches as an opportunity to holistically counsel their client (Rogers, 1999). The benefits of such interrelation mean that each approach is not exclusive to the other, but they are complementary and in their use attend to multiple levels of clients' issues. The power behind integrative approaches, and indeed counseling itself, is in the meaning and insight the client derives from effective and purposeful use of theory and the integrative approaches to counseling.