Theoretical orientation means and counseling

Medically reviewed by Paige Henry, LMSW, J.D.
Updated March 27, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

Research is constantly being done and built on in the field of psychology. Experts are continually discovering new things about the human mind and learning more about different approaches that may be effective in treating various mental health problems. 

Today, there are a wide variety of different theories about how best to approach counseling people who are experiencing different types of mental health challenges. That means each individual therapist or counselor tends to have their own theoretical orientation, or a specific treatment approach that they believe in and primarily practice. When beginning your search for a counselor to speak with, it may be helpful to understand what their theoretical orientation is and if it might be compatible with your needs.

Learn what a theoretical orientation means in therapy
What is theoretical orientation?
A therapist or counselor’s theoretical orientation is an organized set of assumptions or preferences based on specific psychological theories that guides their work.

It provides the clinician with a conceptual framework for identifying client needs and discerning which specific interventions might work best to treat them. It gives them a perspective and a toolbox of tactics to use to help each individual they work with. Note that two counselors who subscribe to the same theoretical orientation may still treat the same individual differently. A theoretical orientation is a broad framework, and a particular treatment provider will use their own experience and professional judgment to treat individuals within that.

Common theoretical orientation examples

Each individual’s mind and situation is unique. That means the treatment a practitioner recommends may be different for two individuals presenting with the same symptoms. However, a theoretical orientation gives the mental health professional a starting point for deciding what to recommend for a given client. Some of the broad therapy types listed below are examples of such theoretical orientations that a counselor might work from.

Cognitive behavioral therapy (CBT)

CBT is an extremely common type of therapy, but the approach behind it represents one possible theoretical orientation. Cognitive behavioral therapy is based on the idea that thoughts influence feelings and behaviors. If an individual’s thought patterns are flawed or otherwise unhealthy, they may experience distressing emotional symptoms and behaviors as a result. Such is often the case with a mental health condition like depression, for instance, as people with this disorder tend to be prone to cognitive distortions. That means a therapist who abides by this theoretical orientation is likely to focus on helping their client become aware of problematic patterns in their lives as a first step toward shifting them in a healthier direction.

Family therapy

Family therapy tends to view an individual and their challenges in the context of the family they come from. In some cases, this orientation means that the therapist may be interested in including other families in sessions. For instance, couples counseling involves both parties in a relationship attending therapy together to work through the challenges they may be facing. This orientation recognizes that an individual changing their own behaviors without the context or sometimes even cooperation of those in their immediate family can be difficult in some cases.

Narrative therapy

The concept behind the narrative therapy orientation is that an individual is an expert in their own life. It’s a non-blaming approach centered on curiosity, where the therapist will tend to rely on asking questions to help the client gain a better understanding of themselves. This orientation is typically very client-led, with the therapist being responsible for asking guiding questions to allow the person to delve more deeply into the way their own mind and emotions work.

Psychodynamic therapy

A psychodynamic approach to therapy typically involves formulating a rationale prioritizing the impact the unconscious mind has on a client's feelings and behaviors. It stems from the idea that uncovering subconscious trauma can help a person heal and engage with themselves, others, and the world from a healthy place rather than one of pain. The object of psychodynamic therapy is usually to promote self-awareness.

Integrative therapy

As the name suggests, a counselor who has an integrative theoretical approach is likely to pull from two or more different orientations to inform their practice. It allows them to rely on a wider variety of approaches to treat a wider variety of clients and disorders. Integrative therapy by nature is individual to the practitioner—so if your provider uses this approach, it’s typically worth asking them which orientations they integrate in their work.

How to choose a theoretical approach as a counselor

If you are new or are about to become a licensed therapist, you may wonder how to choose the right theoretical approach for your future practice. There are a variety of factors to consider. First, it’s usually helpful to take stock of how your own mind works. There may be some orientations that simply don’t click with the way you think about things. Choosing an orientation you’re comfortable with is key. In addition, it can be wise to try and remove biases. The main orientation your professors or mentors in graduate school subscribed to may not be the right one for you, for instance. Finally, do your best to be open to evolving your approach over time as you learn what works for you and your clients and what does not.

How to choose a theoretical approach as a client

If you’re planning to seek therapy, you may be wondering what theoretical orientation you should look for in a counselor. First, you might start by thinking about the main reason you’re interested in pursuing therapy. If you suspect you may have a mental health condition like depression or anxiety, for instance, studies show that cognitive behavioral therapy can be an effective treatment—so finding a provider who practices CBT may be a good first step. If you’re facing challenges in your romantic relationship or with a parent, family therapy could be the right orientation to pursue. 

If you’re unsure, meeting with a general therapist for a consultation is one way to get advice on what type of mental health professional to seek out next. You might also try a session or two with a few different therapists with different orientations so you can see which one seems to click best with you. In the end, there’s typically no right or wrong answer; it’s simply about finding the provider you feel comfortable with and who believes they can offer the most effective treatment and support for you. Remember also that it’s not uncommon to try out a few different therapists before finding the one that feels like the right fit for you.

Getty/Vadym Pastukh
Learn what a theoretical orientation means in therapy

How online therapy can make the choice easier

There are a few unique advantages to pursuing therapy online instead of in person, though keep in mind that it typically just comes down to your own preference and comfort level. Some people simply feel more comfortable speaking with a therapist virtually from the comfort of their own home, while others have trouble finding providers in their area or aren’t able to leave the house and commute to regular appointments. Either way, studies suggest that the two formats can provide similar benefits in most cases. 

Another unique advantage to online therapy is that with a platform like BetterHelp, you’ll be asked to fill out a brief questionnaire about your needs and preferences when you sign up. If you’re looking for couples counseling rather than individual sessions, for instance, you can indicate it on the questionnaire—and the same goes for requesting a therapist who is experienced in LGBTQIA+ issues, trauma healing, or challenges related to grief, intimacy, anxiety, or others. You’ll then be automatically matched with a licensed therapist who is likely to have experience in these areas, which means there’s a good chance that the theoretical framework they use will be compatible with your needs. You can then speak with them via phone, video call, and/or online chat to address the challenges you’ve been facing. Read on for client reviews of BetterHelp counselors.

Counselor reviews

“Finding Cecile was a godsend! She is very professional. I don't feel any judgment from her. Cecile offers a wide range of different therapeutic styles to match me. She responds in a timely manner, is respectful, kind, and overall a great therapist to have. I recommend her to everyone. If you are struggling and need someone who will listen to you, be patient with your progress, and be dependable she is the best match for you! :)”

“Stephanie’s style and approach to counseling fits my needs 100 percent. I feel very validated, understood, and heard every session. She genuinely listens to what you’re saying and takes her time to respond appropriately. Which I appreciate so much. She’s not just there to tell you to meditate and do some breathing techniques while envisioning a calming tree, ya know? Stephanie is down-to-earth, realistic, and genuinely cares. I love working with her.”


The mind is complex, and there is no one therapy or therapeutic orientation that will be right for every individual. Asking prospective therapist about their typical approach to counseling can help you better understand whether it might be compatible with your needs.
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