The Role of Emotion: Focused Therapy in Functional Assessment - Essay Example

THE ROLE OF EMOTION -FOCUSED THERAPY IN FUNCTIONAL ASSESSMENT Emotional growth is a usual progression in life helping humans to psychological grow,and further their understanding of the world and their place in it. However, sometimes life produces difficulties in an individual's life that may hinder this natural development, producing problems in their psychological development. Humans may then ignore these problems rather than facing them, either because they are unaware of their existence, they do not know how to resolve the problem, or because it causes them too much pain to think about it. However, if these psychological problems are not properly worked through then they can produce distortions in emotions and behavior. The emotion-focused assessment and following therapy follows a process, the two main processes being, interpersonal factors, and emotional cycles. Functional assessment has derived from the applied behavior paradigm. In this context functional means the cause of behavior (Carbone & Zecchini, 2008). The process establishes the function, or cause, of the maladaptive behavior before developing an intervention. This intervention is created from the hypothesized function of the maladaptive behavior. If the intervention is unsuccessful in establishing the function then it is very likely that the results will be ineffective in changing the identified maladaptive behaviours (Starin, 2007). These two therapies though from different psychological schools of thought, and therefore have many differences, nevertheless have several similarities as well. Emotion-focused therapy is a structured, short-term therapy, created in the early 1980s. It is historical based in client-centred, gestalt and existential theories. Client-centred therapies are from the humanistic paradigm, they are non-directive, do not search for interpretations, and center on the client actualizing their potential. Gestalt therapy is based on the theory that the brain is holistic, but that 'getting a whole consistent picture and seeing what the structure of the whole requires for the parts' (Wertheimer, 1959, cited in Gestalt Theory, 2008, p.1). Existential therapy stems from the belief that people are on their own in the world. Therefore, people form their own meanings and values, and have the power to make their own choices. For this reason, every individual is responsible for his or her own happiness. Emotion-focused therapy also has an extensive background in attachment theory, which gives the therapy a broader and more in depth understanding of the client's needs and the problems they are experiencing due to past or present family relationships. The approach focuses on how a person is responsible for their own response patterns to emotional processes. A large amount of research has assessed that this therapy is very effective. Research has shown that between 70-75% of clients who enter into emotion-focused therapy will go into recovery and that nearly 90% will significantly improve (ICEEFT, 2008). Greenburg (2004a) states that emotion can be perceived as a form of information processing which is fundamental to a person's survival, and their ability to adapt to the world around them. Research has shown that emotion can improve memory, help to focus attention, and may influence cognitive processing. In addition, emotion can regulate behavior and help to develop healthy attachments. These processes influence why people will perform certain activities and behaviors. It is not just a result of their beliefs and value systems alone, but also because it makes them feel good or bad. Humans seek to control these feelings by trying to maximize the good feelings and minimize the bad ones. The reactions to these pleasant or unpleasant feelings and the attempt to control them are a person's motivation for action and change. Moreover, these emotions are used to evaluate situations that enhance personal well being and happiness, rather than because they are rational or right (Greenburg, 2004a). Therefore, from the emotion-focused viewpoint disorder can be viewed as breakdown in the ability to be able to calculate the affects of certain emotions, and avoidance of unpleasant ones, along side deficiency in emotion processing, rather than a lack of logical and rational reasoning, cognitive processing, or insight (Greenburg, 2004a). People live in a continuous state of trying to understand their emotions; this creates the construction of self. Through self-organization and experience, and through the combining of emotion and reason, the personal meaning of one's own emotions is assessed, thus constructing the 'self' (Greenburg, 2004b, p.3). In the emotion-focused approach, therapists are viewed as emotion coaches who enhance the clients' ability to understand and increase awareness of their emotions, and to make sense of their personal emotional experiences. Emotions signify how a client views themselves, and their place in the world, giving their lives much of their meaning (Greenburg, 2004b). Both the therapist and the client work together taking an active role in the participation of the therapy, the experience of acceptance and positive emotional change for the client is powerful force in their recovery. The relationship between the therapist and the client is seen as a 'mutually accountable relationship' (Lineham, 1993, cited in Greenburg, 2004b, p.6). Some of the objectives for the therapy are for greater understanding of personal emotions, acceptance of emotions that do not feel good, to learn how to transform these emotions, and create a better emotional experience (Greenburg, 2004b). In order to be able to obtain these objectives during therapy, the therapist assists the client to grow a greater awareness, and to gain a greater amount of emotional experience so that the processing of emotions is better understood, and alternative emotional responses are taught. Another aim is to produce an environment that is empathetic and accommodating, this affords a place of safety for the client to develop a sense of openness, where they can explore their new emotional experiences in a supportive atmosphere, that in time the therapist hopes will become internalized by the client (Greenburg, 2004b). In the therapeutic setting, there are two phases: Arriving and Leaving, as one 'cannot leave a place until they have arrived' (Greenburg, 2004b, p.7). The first phase involves four steps that are aimed at emotions. Firstly, the therapy concentrates on the awareness and acceptance of the client's emotions. Secondly, they are taught to look at and allow their emotional experience, and how to bear their emotions. Thirdly, how to verbally express their emotion to help solve the problems. Fourthly, to discover if their feelings are the primary emotions, and if they are secondary feelings, how to discover the primary ones. The second phase also involves four steps, focusing on utilizing the emotions or transforming them, to encourage the client to leave the place where they had arrived in the phase. Firstly, to assess whether the primary feeling is a healthy response to the situation. Secondly, to assist in changing unhealthy primary feelings. Thirdly, to discover different healthy emotional responses where necessary. Fourthly, to challenge unhealthy feelings and thoughts from their primary emotions, and how to implement their new emotional understanding (Greenburg, 2004b, p.7). Primary emotions are the basic reactions to an event, such as grief at a death, secondary emotions are defences to the basic reactions, such as anger towards the person who had died. A different and more complex three-step therapy is deemed necessary where maladaptive primary emotions need changing. Here the secondary emotion is induced first, and then the maladaptive primary emotion, for example shame or fear. Adaptive emotions such as sadness or compassion are introduced to the client to replace the maladaptive ones, and as understanding increases, the client learns to leave the maladaptive primary emotions behind, and to create a positive change in the emotional sequencing, and change to positive primary emotions. A new view of the self is then created by understanding the experiences and emotions, and learning how to transform maladaptive emotions, and changing by changing the clients 'personal narrative'(Greenburg, 2004b, p.14). An alternative therapy, which has the same goal as emotion-focused therapy, i.e. to change maladaptive behavior is functional assessment. However, though the goal is the same the processes are very different. Functional assessment methodology deems to find the causes of maladaptive behavior by using a defined set of procedures (Carbone & Zechini, 2008). This maladaptive behavior is then decreased through educating the client with replacement behaviors, rather than repressing it. Functional assessment looks at the immediate environment and the individual experience of the client to find the causes of the maladaptive behavior. Psychodynamic principles are not involved in this assessment. The result of the assessment shows an analysis of how the client's maladaptive behavior was learnt, also, of how it is currently sustained or continued in their current 'learning environment' (Carbone & Zechini, 2008, p.3). This methodology does not stress an investigating of the symptoms or of making a diagnosis. However, the rationale of the assessment is to categorize the function of the maladaptive behavior and to then decide on an intervention, which will in turn reduce the behavior identified in that functional category, therefore, classification is formed by the functions and not the behavior (Carbone & Zechini, 2008). The core of functionalism is establishing the cause of maladaptive behavior, as opposed to structuralism, which is in describing it. Boring (1957, cited in Miller, Tansy & Hughes, 1998, p.3) stated that functionalism was 'more interested in the future than the past'. In applied psychology, the argument between whether a structural approach or a functional approach is more effective for treating maladaptive behavior continues (Miller et al., 1998). Functional assessments intervene to establish the cause of the maladaptive behavior for that individual. In contrast, a structuralist approach, intervention uses an approach that has been used effectively for many other clients. An example given by Iwata et al. (1982, cited in Miller, et al., 1998, p.3), shows the differences well. In a structuralist intervention a child who has disruptive verbal outbursts may be treated with 'differential reinforcement' if they had no outburst for a certain amount of time, but this treatment is in common with many children would be treated in the same way, therefore, is not behavior specific treatment for that one child. However, a functionalist assessment would first assess the causes of these outbursts; the intervention would be individually modified for that specific child, and their personal experiences, ensuring an effective treatment for the individual (Miller, et al, 1998). Skinner was the first person to imply this meaning for the term functional. He wanted to throw out the term 'cause and effect' and instead implemented functional in an attempt to define behavior in a precise manner (Carbone & Zecchini, 2008, p.2). His research and later on his follower's research focused on the value of determining the environment in which the maladaptive behavior was "functionally related" (Carbone & Zechini, 2008, p.2). Skinner also proposed that consequences and experience are functionally related to maladaptive and adaptive behaviors. Overtime the assessments have been developed to cover behavior disorders of many different types and cognitive abilities, as opposed to its primary development for people with severe self-harm tendencies (Carbone & Zecchini, 2008). Functional assessment uses some core techniques to address problem behavior and find the function, or cause, behind it, such as interviews and rating scales, in addition to situational observation of behavior (Starin, 2007), in trying to identify the reasons for this maladaptive behavior. The assessments have been developed to assess the behavior and to describe it based on five factors. These factors are presenting problem, precipitating factors, predisposing factors, perpetuating factors and protective factors. The form the assessment would take is firstly to identify the problem and the factors that led to the problem, an event or mistreatment, and then to assess the factors resulting from the problem, the maladaptive behavior. These techniques look past the behavior and centre on identifying cognitive and social factors, as well as environmental factors associated with the maladaptive behavior. This broad behavioral-based perspective presents a greater understanding of the reason or function of maladaptive behavior. The intervention is constructed around establishing why the maladaptive behavior is occurring (Starin, 2007). The therapist helps the client to gain greater understanding of their maladaptive behavior, and to be able to find effective alternatives, so that the maladaptive behaviors can be identified and eradicated. In essence, functional assessment looks at the maladaptive behavior, and relationship it has to the environment it is exhibited in, as opposed to emotion-focused therapy that looks at the emotion behind the maladaptive behavior. The roots of functional assessments are grounded within the behavioralist tradition; nevertheless, the assessment-based approach is used in many other paradigms of psychology, from cognitive-behavioral therapy right across the discipline to emotion-focused therapy and psychodynamic therapy. However, emotion-focused approaches seek to understand the emotion behind a maladaptive behavior and functional interventions seeks to establish how the maladaptive behavior is affected by environmental functions. Nevertheless, both seek to understand the client's individual history and personal experiences. In this light, it could be suggested that to use emotion-focused therapy along side functional assessment would enhance the treatment for the clients. Taking this step would increase the therapists understanding of the maladaptive behavior and its causes, or functions. In order to create a process that is all encompassing the two approaches could well be seen as complimenting and enhancing the effectiveness of treatment of reducing maladaptive behaviours and identifies the environmental as well as emotional causes behind it. This would provide a fuller understanding, and assist the change in these behaviours. In marrying the two therapies together, the client has a better chance of significant recovery. Both are processed based, and use assessments to inform the treatment or interventions. It would add an extra dimension of validity to the process, and greater insurance that the root causes could be found. Nevertheless, the role of the therapist in emotion-focused therapy is to help the client identify their goals and needs, provide them with positive imagery, facilitate them to expressively enact the emotion, to create a new cognitive meaning for the emotion, and to make the most of the therapist-client relationship to create new emotion (Greenburg, 2004b). It stems from the humanistic, amongst others, field of psychology. Where as functional assessment is from the significantly different field of behaviorism. While emotion-focused approach stems from the person, functional assessment stems from the environment. To merge the two therapies together may cause a clash of psychological values. However, the similarity of assessment, the same end goal of altering maladaptive behavior through personal experiences, and learning to change cognitive functions may be sufficient to suggest, that as long as the therapist believes in an eclectic approach to enhance therapeutic outcomes for the client, then indeed the combination of both approaches could only enhance the client recovery rate. Research in neuroscience has revealed that emotion is an important variable in many cognitive processes, in particular for modifying emotions and decision-making, which in turn precipitates changes in cognitive processes (Greenburg, 2004b). The client would learnt to understand his emotions better, and how he has the ability to change his cognitive processes through the use of healthy emotions, he will also learn how to identify his own emotions. In addition, the client will learn how his environment can cause his maladaptive behaviors. Again, through cognitive change he will learn how to alter his environment and his place within it to improve his quality of life. Greenburg (2004a, p.1) believes that the problems involved in using a cognitive therapy is that it reduces human 'complexity', as it tries to get people to bring their maladaptive behavior and emotions to rationally conclusions, and that this is not always possible. He suggests that looking at emotions in purely rational terms can in fact cause the client even more anguish. In addition, that if emotions were rational then a human would never do anything that was purely enjoyable, this gives humans meaning and motivation in their lives. Therefore, emotions should be looked at as an 'independent variable' which 'interacts and influences cognition and behavior' (Greenburg, 2004a, p.1). In combining the two therapies, the client will learn how to identify his emotions, also how to apply them with some rationality to his environment. Together the two approaches will assist in improving emotional responses, and in altering cognitive processes, to improve the clients' ability change their maladaptive behavior, to an adaptive one. Therefore, a fusion of emotion-focused therapy and functional intervention will provide the therapist with a better-rounded psychological approach, which will also improve the quality and depth of the therapy given; this in turn will create the likelihood of a more significant recovery for the client. REFERENCES Carbone, V. S. and Zechini, G. (2008). How to conduct a functional assessment and develop behavior plans to reduce problem behavior. Retrieved 15 April 2008 from http://www.shapingbehavior.com/images/FunctionalAssessment.pdf Gestalt Theory (Wertheimer), (2008). Retrieved 15 April 2008 from http://tip.psychology.org/wertheimer.html Greenburg, L. S. (2004a). Introduction emotion special issue. Clinical Psychology and Psychotherapy, 11, 1-2. Retrieved 15 April 2008 from http://www.emotionfocusedtherapy.org/Greenburg Greenburg, L. S. (2004b). Emotion-focused therapy. Clinical Psychology and Psychotherapy, 11, 3-16. Retrieved 15 April 2008 from http://www.emotionfocusedtherapy.org/Greenburg Miller, J. A., Tansy, M., & Hughes, T. L. (1998, November). Functional behavioral assessment: The link between problem behavior and effective intervention in schools. Current Issues in Education, 1(5). Retrieved 15 April 2008 from http://cie.ed.asu.edu/volume1/number5/ Starin, S. (2007). Functional Behavioral Assessments: what, why, when, where and who Retrieved 15 April 2008 from http://www.wrightslaw.com/info/discipl.fab.starin.htm What is EFT (2008). Retrieved 15 April 2008 from the International Center for Excellence in Emotionally Focused Therapy website: http://www.eft.ca Read More