Counselling: Contemporary Behavioural and Cognitive Theory - Coursework Example

Counselling: Contemporary Behavioural and Cognitive Theory Development of behavioural and cognitive counselling The contemporary development of the behavioural and cognitive tradition of counselling has managed to undergo complex and dynamic processes. Such processes shall be discussed herein. Cognitive therapy traces its roots to the ancient Greeks wherein they claim that the reality we experience is focused on Platos’s idealism or in a more practical concept, the process of bringing the patient outside the reality he has created for himself (Leahy, 1996, p. 1). These beliefs later developed into categories of thinking through Immanuel Kant’s theories on quantity, intensity, cause, and effect or the association of events which Hume and Bentham later associated with reward and punishment (Leahy, 1996, p. 1). Other developments in cognitive behavioural therapy were seen in the 1950s with the proposals of Hartmann on the ego’s ability to process reality; later Roy Schafer proposed that different personality types experienced reality in different ways (Leahy, 1996, p. 2). The work of Albert Ellis in the 1960s was the work which made the bigger impact on behavioural and cognitive therapy. He proposed the rational emotive therapy by stating that “pathology was entirely diet to irrational distortions such as shoulds – ‘I should be successful at everyone’ or ‘I should be liked by everyone’— awfulizing (It’s awful that I don’t succeed’) and low frustration tolerance (I can’t stand waiting)” (Leahy, 1996, p. 3). Beck’s work followed Ellis and he focused on several specific cognitive distortions and outlines for diagnostic categories. The development of cognitive therapy is different from other types of psychotherapy in the sense that it focuses on the coordination of empirical investigation, reality testing, and problem solving involving the patient and the therapist (Freeman, 2006). It is acknowledged that CBT evolved from the initial work of Aaron Beck who conceptualized different studies involving suicidal thinking through structured cognitive therapy. Since the introduction and development of cognitive therapy, behavioural changes have been included in the therapeutic process – to address patient issues and to modify attitudes and behaviour (Freeman, 2006). Contemporary changes to cognitive behavioural therapy have included behavioural experimentation in order to modify fearful cognitions and to implement exposure therapy and relaxation training (Freeman, 2006). Interventions targeting three focus areas have also been addressed by the contemporary developments in behavioural and cognitive therapy. These focus areas now include cognition, behaviour, and emotion in an attempt to implement sustainable changes and improve cognition (Freeman, 2006). Behavioural theory and therapy was first conceptualized by Skinner through his theory on operant conditioning and this theory was also supported by the previous works of Pavlov (Roeckelein, 1998, p. 69). In essence, behavioural theory emphasizes that the behaviour of people can be changed and modified through adjustments made in the patterns of their behaviour. When such patterns are changed, the behaviour can also be modified. Multimodal theory was developed by Lazarus in response to perceived gaps in behavioural therapy (Nelson-Jones, 2006, p. 368). In essence, he believed that the behaviour of humans is best dealt with through a multimodal approach – not a bimodal or unimodal approach. In effect, sensory, imagery, and cognitive aspects have to be included in the therapeutic process in order to effect adequate behaviour modification (Nelson-Jones, 2006, p. 368). Reality therapy was conceptualized by William Glasser and this type of therapy focuses on what clients can control in the relationship – not on finding fault or on finding what they can control (Grant, n.d, p. 5). Glasser emphasizes that it is important for clients to understand that that they can actually control their behaviour; and for reality therapists, their role is to build strong relationships with their clients and to teach these clients to deal and relate with others. In this case, behavioural and cognitive therapy evolved into teaching clients on how to fulfil their basic needs and to relate to people whom they choose to relate with (Grant, n.d, p. 6). George Kelly developed another theory in relation to behavioural and cognitive therapy through his personal construct theory wherein he emphasized on a person-to-scientist view – which focuses on the emotional experience which can impact on transitions in the main constructs for viewing the world (Neimeyer & Bridges, 2004). “For example, individuals might experience threat when faced with the prospect of imminent and comprehensive change in their core structures of identity (e.g., when facing dismissal from a valued career, or abandonment by a partner they counted on to validate a familiar image of themselves” (Neimeyer & Bridges, 2004). On the other hand, people might view anxiety in the face of events which are alien to them and this delicate condition forms the basis of this therapeutic practice. In essence, after considering the above theories and therapies, cognitive and behavioural therapy is still very much based on the original precepts of Ellis. In effect, thought mediates between stimuli and external events and emotions; stimulus would trigger thought which then gives way to emotions (Mulhauser, 2010). A person’s evaluation of thought is the one which triggers stimulus, and a therapist would then be effective in this form of therapy by becoming aware of the patient’s thoughts and of how to change it. Cognitive therapy seeks to assist the client in becoming more aware of the causes of his distress and of the patterns which reinforce it – and later to correct such patterns (Mulhauser, 2010). The development of cognitive and behavioural therapy as presented above shows the gradual process of development. From the time when cognitive therapy was first conceptualized, it was later improved and its gaps were filled by other theorists. In the process, more dynamic and stronger theories were prepared in an attempt to improve the counselling process. In the contemporary practice, these previous developments now successfully support the current practice and therapy in counselling in the delivery of mental health services. Behavioural modification therapy has gained much support for its application due to these developments in cognitive and behavioural therapy. All in all, this practice has proven to be beneficial to clients suffering from depression, substance addiction, eating disorders, and other mood disorders. Dynamics of counselling Beck and Freeman discuss that cognitive-behavioural therapy is a collaboration between the therapist and the client. The client and the therapist work together in order to establish goals, assignments, measures for success, and ways of maintaining such success (Niolon, 1999). In this relationship, the therapist is open and honest with the client, giving him clear messages, from which he expects feedback. The cognitive and behavioural therapist uses schemes or frameworks in his approach. These schemes or frameworks include beliefs, experiences, and rules of behaviour of people in relation to self and to others (Niolon, 1999). In effect, CBT believes that people may have general beliefs about other people and about themselves which can affect the way they perceive the world in general and other people as well. As a result, even if the therapy would aim to change a person’s behaviour, his current beliefs about the world and about himself may still interfere with the success of the therapeutic process (Niolon, 1999). In this regard, the CBT therapist must therefore be attentive to relationship issues and beliefs which a person might have about himself and about others. He must try to get past such precepts early on in the relationship and try to establish a more trusting relationship with the client (Niolon, 1999). In so doing, the client would not feel frightened about the changes which the therapist might set out to implement as part of the therapy. In instances when change would happen too fast, the client may become less cooperative. His perceptions about himself may overwhelm the therapeutic process and all remedies which the therapist wants to implement. The therapist is called on therefore, to guide the client through the behavioural modification process. The cognitive behavioural therapist implements change through therapeutic means with guided imagery, relaxation training, graded anxiety methods, dysfunctional thought recording, and the discovery of beliefs (Niolon, 1999). He also seeks to understand the relationship of issues in terms of their impact on goals and the effectiveness of therapeutic techniques. CBT therapists view relationships as a secondary element in therapy and these relationships help shape the engaging nature of the different people involved in the process (Niolon, 1999). The therapeutic relationship between the client and the therapist in cognitive and behavioural therapy is based on a strong relationship of trust and honesty. Therapists also emphasize that clients can change their behaviour by thinking differently and acting on what they learn in the cognitive behavioural process. In other words, the therapeutic relationship between the client and the therapist is very much based on rational self-counselling (NACBT, 2007). As the client is starting to trust in the therapist, he is also starting to trust the therapeutic process and therefore, to apply what he needs to implement in his life in order to achieve behavioural changes and modification. The therapeutic process is more than just cooperating, but it is also about collaborating with each other in terms of goals and overall effective processes. CBT has various strengths and weaknesses. These strengths and weaknesses formulate the overall support (or limited support) for the practice. All in all however, the feedback for this practice has been encouraging and promising. For one, CBT is advantageous because it is based on strong research (Pucci, 2010). CBT is also a very instructive process and when clients or patients understand well the counselling process, they also gain confidence in the system. In effect, they become more engaged in the process and eventually gain effective therapy from the process. CBTs are also known to be short-term. It usually covers about 16 sessions and does not disrupt the lives of the clients too much, yet is still able to gain sufficient benefit from the sessions (Pucci, 2010). CBT also emphasize on the clients getting better – not feeling better. A better feeling about oneself does not necessarily mean that the underlying mental health issue has been dispelled (Pucci, 2010). CBT addresses the cause of the problem, not the overall symptoms or physical manifestations of the disorder. CBT is also advantageous in the sense that it is largely cross-cultural (Pucci, 2010). It is based on the overall universal laws of man and is focused on the client’s goals—not the therapist’s goals. CBT is also preferred because it is a structured type of therapy. The structured nature of the therapy helps ensure that individual goals are achieved for each session and the sessions become more than ‘chat sessions’ (Pucci, 2010). CBTs can also be researched and verified. It is based on concrete research and methods which the clients can verify (Pucci, 2010). Clients and other researchers can easily seek support and gain more information on the therapy through evidence established by other researchers and experts on the subject matter. It is therapy which is part of the growing practice of evidence-based research. Finally, CBT is also adaptive, and for which reason, it can be adjusted accordingly based on the individual qualities and preferences of the clients and patients (Pucci, 2010). The weaknesses of CBT are mainly based on the client-centred considerations – CBT, in other words, is not for everyone (Midwest Center, 2009). One criticism being made on CBT is that the empirical data which has been established in its favour has been overstated or exaggerated. Not all of the studies which have been set forth for CBT have gained favour from practitioners, especially those who doubt its overall applicability to the general population. However, CBT supporters are quick to claim that there are hundreds of studies which support the value of CBT (Midwest Center, 2009). Such studies present reliable and strong evidence in favour of CBT. CBT is also sometimes known to be non-humanistic in its approach to treatment. Its methods may sometimes seem mechanical and impersonal. It may be based on strategies which are to be implemented on a technical scale – in some instances this is not what the client needs. Sometimes, the client may need a more empathic approach to therapy – one which he can relate to on an emotional level while also tapping into his emotions and feelings. However, the point of CBT is to cut through the person’s emotions and to target the different rational and emotive processes which may be the very essence of his mental health issues. The processes of CBT have been tried and tested throughout the years, and in relation to other types of therapy it is still potentially the most successful and beneficial type of therapy for various mental health clients. Works Cited Cognitive behavioral therapy (2007) National Association of Cognitive-Behavioral Therapists, 12 December 2010 from http://www.nacbt.org/whatiscbt.htm Criticisms of Cognitive behavioral therapy (2009) Midwest Center, viewed 12 December 2010 from http://www.stresscenter.com/mwc/anxiety-treatment/criticisms-of-cognitive-behavior-therapy.html Freeman, S. (2006) Cognitive Behavioral Therapy in Advanced Practice Nursing: Development of Cognitive Behavioral Therapy, Medscape, viewed 12 December 2010 from http://www.medscape.com/viewarticle/545336_4 Grant, S. (n.d) Reality Therapy: Chapter 11, California State University Northridge, viewed 12 December 2010 from http://www.csun.edu/~hcpsy002/Psy460_Ch11_Handout2_ppt.pdf Leahy, R. (1996) Cognitive-Behavioral Therapy: Basic Principles and Applications, American Institute for Cognitive Therapy, viewed 13 December 2010 from http://www.352express.com/wpm/files/40/Cognitive%20Therapy-%20Basic%20Principles%20and%20Applications.pdf Mulhauser, G. (2010) Underlying Theory of Cognitive Therapy, Counselling Resource, viewed 12 December 2010 from http://counsellingresource.com/types/cognitive-therapy/index.html Neimeyer, R. & Bridges, S. (2004) Personal Construct Theory, PCP, viewed 12 December 2010 from http://www.pcp-net.org/encyclopaedia/pc-theory.html Nelson-Jones, R. (2006) Theory and practice of counselling and therapy, California: Sage Publications Niolon, R. (2007) The Therapeutic Relationship - Research and Theory, Psychpage, viewed 12 December 2010 from http://www.psychpage.com/learning/library/counseling/thxrel2.htm Pucci, A. (2010) Why Cognitive-Behavioral Therapy? National Association of Cognitive-behavioral therapists, viewed 12 December 2010 from http://www.nacbt.org/whycbt.htm Roeckelein, J. (1998) Dictionary of theories, laws, and concepts in psychology, Connecticut: Greenwood Publishing Read More