Therapeutic Models: Adolescents and Addictions - Assignment Example

? Therapeutic Models: Adolescents and Addictions Details: al Affiliation: Adolescents and Addictions The therapeutic models are diverse in cluster and modes of therapeutic approaches. As such, they share the conviction that client problems taken for therapy essentially border unconstructive behavioral orientations that result from faulty learning. Using various unique techniques, therapy models basically apply the principles of learning theory to help troubled clients unlearn ineffective behavioral aspects in their lives and lean more helpful behaviors instead. Also known as "action therapies," behavior modeling therapies emphasize action-oriented techniques to enable clients to adopt new behaviors (Seligman & Reichenberg, 2010). This paper examines Cognitive-Behavioral Therapy, Reality Therapy, and Solution-Focused Therapy models with due reference to the dynamics of changes in attitudes, feelings, as well as self-perception as the principal mode of therapeutic change to behavior. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment approach that emphasizes the role of understanding thoughts and feelings as curative measure of influencing behavior (Corey, 2005). It is a form of patient psychotherapy based on individual cognitions, assumptions, deeply rooted belief systems and behavioral conducts. This approach, as the name suggests, aims at altering negative influences that ultimately shape emotions leading to inaccurate appraisal of events. One of the assumptions that underlie this approach is that cognitive events do affect and cause behavioral conduct to change. In effect, CBT is a psychosocial therapy that assumes that faulty thoughts cause maladaptive behavioral and emotional responses. Indeed, as individuals conceive in their minds, a kind of mediating stimuli response follows in their behavior. In effect, cognitions cause behavior through interpretive reaction mechanisms. Secondly, cognitions are not simply mysterious but are processes that can be assessed, monitored, and changed. As such, a person’s behavior can be well understood through engaging their thoughts and feelings. If cognitions are measureable, then a change is possible. Therefore, maladaptive cognitive behaviors can be altered, which in effect is the goal of CBT. Nevertheless, CBT does not ignore the impact of behavioral change (apart from cognitions) in the therapeutic process. The key aspect of this approach is that a change in cognitions does exert a lot of weight in effecting behavioral change, especially in situations that do not change. This psychotherapeutic treatment approach to patient with distorted cognitions applies various techniques depending on individual clients’ needs or issues in contention. A patient may be required to keep a diary of events associated with their feelings, thoughts and behaviors and through the help of a therapist, practice how to manage similar circumstances should they recur in a patient lifetime (cognitive rehearsal). Alternatively, a patient may be taken through a process of self questioning to test and evaluate cognitions, assumptions and belief systems that might be unrealistic and so unhelpful. Trying out new behavioral aspects in terms of reaction modeling may also gradually help in facing out awkward fears that are avoidable. Additionally, relaxation as well as distraction techniques are also applied approach (Seligman & Reichenberg, 2010). Whereas the model is useful in targeting tackling deviant behavior in a more or less fearless communication environment, which in effect encourages thorough diagnosis to client problems, its attention on the present rather than the past is more likely to create a disconnection of correct perception on the linkage between the motives and inner intentions. Developed by psychiatrist William Glasser, reality therapy is yet another action-oriented patient therapy that emphasizes a change of behavior to enable fulfilling of individual basic needs, namely giving and receiving love in addition to having individual self esteem. That is, a worthwhile feeling to oneself and to others in real world relationships in a manner that guarantees the possibility of all involved in such relationships to fulfill their needs. It is more of a counseling theory whose focus mainly rests with individuals taking responsibility for choices they make concerning their lives. A distinguishing feature to the other two models is that it concentrates on the behavioral symptoms (Seligman & Reichenberg, 2010). Reality therapy rests upon a basic assumption that an individual has a definitive mandate of controlling their lives at the present and not later, a mandate Glasser calls “individual responsibility.” Accordingly, individuals are autonomous beings with specific choices to get what they want which include survival ends, a sense of belonging, power and freedom (ability to influence) and fun. In other words, it takes “here-and-now action-oriented approach” for a better tomorrow. According to Glassers’ reality lenses, individuals’ problems stem from current unsatisfying relationships or mere lack of it.  Contributing to this state of affairs is inability of a patient/client to connect and develop some kind of sustainable intimacy with at least one significant figure in their life. In a sense, reality therapy attempts to draw a line between a client and his or her behavior. Indeed, individual experiences resulting from social problems are not actual sicknesses but just an out of sync phenomenon with certain psychological needs (Glasser, 1985). In helping clients through the predicaments, reality therapy provides a guideline summarized as WDEP – an acronym that defines the road map to action, to mean identifiable client’s wants, direction, evaluation, and plan.  First, a therapist should do an exploratory analysis of a client’s wants and needs, and, if possible, encourage a recognized, refined route of meeting these needs.  Also to be known are the impediments to achieving such goals, that is, what a client does to obstruct his/her own happiness.  This involves becoming aware of client’s choices and the consequences of these actions, a process evaluation.  In other words, given the sum of choices made (total behavioral traits), are there chances that obtaining the desired ends? Together, a therapist should help a client work out a realistic plan to achieve his desired destiny. Like the former, it has the weakness of concentrating on the present rather than the past, hence the likelihood of a dysfunctional disconnection between the motives and inner intentions. Nevertheless, its short term focus makes it well appropriate for healthcare systems. Again, its reliance on accountability makes it client driven and so enhances chances of success. As the name suggests, solution focused therapy is a psychotherapeutic approach based on solution-building as opposed to problem-solving and zero in exceptionally on solutions to client problems. This approach is founded on the premise that there are unique exceptions to every problem. As such, examining these exceptions with clear focused vision into the future, a client with the help of a counselor, can generate ideal solutions capable of steering the client towards prosperity. Another inherent assumption of this model of therapy is that situations are neither all bad nor all good. Consequently, a counselor’s mandate is to help the client, who is assumed to possess the capacity to act effectively, identify only the positives in order to capitalize and maximize the possibilities within those particular situations (Corey, 2005). Solution-focused techniques are well-articulated philosophical expressions meant to alter attitude orientations. Within the SFT model, a counselor begins to relate with a client from a position of “not-knowing” putting aside own value judgments. In other words, solutions are sought through prompting questioning based on client's words rather than counselor’s suggestions. “Miracle Question” technique is applied in this model to ensure that the client's values are engendered in the counseling process. Additionally, counseling sessions are tailored towards recognizing the client as expert to his problems. Furthermore, rating scale questions are utilized to identify progress made and in exploring exceptions to negative circumstances so as to keep focus on the final objective of reaching the solution. Unlike models discussed above that view the counselor as the source expertise to clients’ problems and why such problems persist, solution-focused therapy views a patient as able and shifts focus on identifying their strengths and the vision to an alternate future. Indeed, the idea of focusing on the positive has the possibility of shooting the client to greater heights. However, real dangers lie in how the solution is sought. This is model is pegged on strings of questioning which are largely scripted (Efran & Schenler, 1993). As a result, a counselor may end up white washing the negativity in a clients life-problems in haste to get a solution, thereby blurring the line between a positive outlook and his/her perceptions. In fact, constant praises obviously lessens the effect of the praise, which is what happens in this model. Developmentally, teenage-hood involves numerous changes. It is not only the age of abstract thoughts but also the age of extreme egocentrism with the belief that all eyes are on them and that their experiences are only unique to them. Overall, adolescence can be a painful time. One of the common problems that adolescents face is substance use (drug abuse). Majority at this stage experiment with alcohol and related substances long before high school graduation (Johnston et al., 1997). Many of these cases are products of operant conditioning (Laursen, 1995). In order for families to be more solution focused when a problem arises, juvenile victims need environments of honest thinking and disclosure of feelings. Appropriate therapeutic task would be Automatic Thought Record to track such thoughts and feelings with a subsequent exploratory analysis. Acknowledging and a review of distorted cognitions coupled with the collective will becomes a focal point towards achieving therapeutic goals. Indeed, awareness of these distortions may give room for the teenager, family or the counselor to identify a rational helpline more quickly. Apart from the Cognitive-Behavior Therapy techniques, channeling in solution Focused Therapy may as well work in such cases of substance abuse. Of course, a teenager possesses the inner will to resolve predicaments of this nature because change is always a constant variable. For a family with a juvenile substance abuser, resources and strengths to attaining desired objective must be identified to prevent relapse (Laursen, 1995). For an adolescent, a therapist’s job of identifying and amplifying change would be very much in order. A teenager has all the life ahead and so problems in the past may well fit description of a transition. Because problems are reflected in thoughts, the use of pre-suppositional questioning is a key area of seeking for such a client. Scaling questions, for instance, may be useful in subsequent therapy sessions in rating how successful a client is towards achieving each of their identified goals. A Likert scale of 1-10 may well help reveal areas of weaknesses and help orient energy and time towards trying moments. References Corey, G. (2005). Theory and practice of counseling and psychotherapy. (7th ed.). Belmont, CA: Wadsworth. Efran, J., & Schenler, M. (1993, May/June). A potpourri of solutions: How new and different is solution-focused therapy? Family Therapy Networker, 71-74. Glasser, W. (1985). Take effective control of your life. New York, NY: Harper & Row. Johnston L., Bachman J., & O'Malley, P. (1997). Monitoring the future. Ann Arbor, MI: Inst. Soc. Res.Larson, R., & Richards, M.H. (1991). Daily companionship in late childhood and early adolescence: changing developmental contexts. Child Dev. 62, 284-300. Laursen B. (1995). Conflict and social interaction in adolescent relationships. J. Res. Adolesc. 5, 55-70. Seligman, L., & Reichenberg, L.W. (2010). Theories of counseling and psychotherapy. Upper Saddle River, NJ: Pearson. Read More