Critical evaluation of two major therapeutic orientations - Essay Example

? Critical evaluation of two major therapeutic orientations In counselling, a number of theoretical frameworks can be applied to solve a client's problems. The choice of the approach highly depends on the client's problems and the intensity of the problems. This essay seeks to explore two main therapeutic orientations in counselling. The essay will provide an in depth discussion of the two approaches, their features, strengths, and limitations of each. In addition, the essay will compare and contrast the two theoretical frameworks. The two theoretical approaches will then be applied to Anthony’s case study. Lastly, the essay will provide which of the two approaches can best be applied in Anthony’s case. The two theoretical approaches to be discussed include the rational emotive behavioral therapy and the cognitive therapy. Critical Evaluation of two major therapeutic Orientations Rational Emotive Behavioral Therapy According to Ellis (2007), rational emotive behavior therapy is grounded on the fact that behavior and emotions stem from processes that have to do with cognition (cognitive processes). The theory holds that human beings can make modifications in such processes in order to behave differently and alter their feelings. This therapy can be regarded as one falling under the category of cognitive and behavioral therapies. Dryden (2003) asserts that the origins of this therapy can be attributed to the works of Dr. Albert Ellis, a clinical psychologist, who had diverse knowledge in psychoanalysis. Ellis observed that his clients used get better upon changing their ways of thinking concerning the world, their problems and themselves. Therefore, he concluded that therapy could be effective when the focus was on the beliefs of the client. Rational Emotive Behavioral therapy (REBT) is a theory commonly used to understand human behavior. The therapy proposes multiple explanations of human behavior based on biological, psychological, and social factors. The theory holds that a significant defining characteristic of human beings is that they have desires. As a result, people may want certain events to take place while they do not want others to happen (Milton, 2010). However, people tend to translate their desires into absolutes terms such as should, ought, and must. These rigid and strongly held beliefs lead to disturbances in the human behavior and negatively affect moods and emotions. In REBT, therefore, rigidity exists at the center of psychological responses that lead to disturbances (Ellis, 2007). The basic premise of this theoretical approach is that human behavior and emotions result from what beliefs, assumptions, or thoughts. To a large extent, emotions and behavior are determined by the beliefs people attribute to the situations they face. Therefore, if people give negative beliefs about a situation, they are likely to have negative feelings and behavior towards such a situation. The approach also purports that the biological make up influences human behavior. Therefore, the therapist should keep in mind that the belief system of the client tends to be a product of both learning and biological inheritance (Geldard & Geldard, 2005). REBT emphasizes the role of cognition in determining human behavior, feelings, and emotions towards a social situation. Ellis proposed the “ABC” model, which demonstrates the role of cognition. In this model, ‘A’ stands for an experience or event as well as the deductions and interpretations of the event. ‘B’ represents the beliefs based on the evaluation of the inferences. ‘C’ stands for the behavior patterns, feelings, and emotions that accompany the evaluative beliefs of the client (Ellis & Dryden, 2007). Therefore, REBT can be regarded as a theory of causation; the events occur through a series. ‘A’ causes ‘B’ and B causes C; as such, events do not occur in isolation since one occurrence triggers the other. Proponents of this theoretical framework suggest that human beliefs tend to be outside the conscious awareness of the client. Therefore, they tend to be habitual, automatic, and entail rules about how the events in the world should be. Irrationality stems from personal beliefs, which tend to be deeply rooted in a person and are unchangeable. The approach proposes that, through practice, human beings can learn to get rid of such core beliefs that tend to be subconscious (Milton, 2010). Rational emotive behavioral therapy mainly aims at assisting clients to replace their absolute philosophies and beliefs with flexible beliefs. Therefore, the framework helps clients understand that all human beings have the capability to overcome frustration and aim at achieving goals. For the occurrence of therapeutic change, REBT considers conditions such as unconditional personal regard and empathy as unnecessary (Dryden, 2003). As such, the counsellor should be not be geared to towards embracing empathy towards the client. Instead, a therapist should work towards helping the client denounce negative beliefs, feelings, emotions, and behavior. According to Ellis & Dryden (2007), the change process begins with acknowledgement on the client's part that a problem exists. Afterwards, the client then identifies the irrational belief that triggers the problem he or she is facing. This way, the client will gain awareness and understanding why the problem is irrational and why it would be preferable to embrace a rational alternative. The client then challenges the irrational beliefs that they have by applying emotive, behavioral, and cognitive techniques, which enhance rationality. These techniques enable clients to practice how to modify their negative emotions into positive ones. Rational emotive behavioral therapy strongly emphasizes on the vitality of human self worth. As a result, the approach concentrates on getting rid of feelings of low self-esteem in clients and encouraging high self-esteem. While using this approach, a therapist should encourage clients to embrace feelings of self-worth and avoid frustration and anger. Further, the approach perceives humans as complex, but changeable (Geldard & Geldard, 2005). Thus, the unconditional acceptance of self can be denounced to enhance self-actualization. The therapeutic process in REBT tends to be informal; this reduces the emotional distance that may exist between the client and the therapist. In addition, this enhances the application of desirable approaches to the dissatisfactions faced by the client. A significant strength of this approach lies in its simplicity; REBT does not include a complex process of reaching a comprehensive solution to a client’s problems. The therapy also lacks both judgemental and moral perspectives. As a result, the therapist deals with the client’s problems as they present themselves. The approach also takes into consideration the behavioral causes of irrational behavior in a client, which are particularly essential while dealing with emotionally disturbed clients (Dryden & Ellis, 2007). However, the approach has some limitations as it can only be used with suitable clients. The approach may also not be suitable to clients who do not portray significant irrationalities. The approach has also faced criticism for its inability to explore comprehensively the emotional aspects of disturbances in clients. Cognitive Therapy This theoretical framework relates to a way of finding out how the client thinks about himself or herself, other people and the world. The theory also deals with how human actions affect their feelings as well as thoughts. Cognitive therapy helps clients to change what they think as well as how they behave. The resulting changes in behavior and cognitive abilities can play an essential role in helping an individual feel better (Crane, 2008). This approach focusses on the difficulties and the problems that a client faces and attempts to propose immediate solutions. Therefore, the approach looks at ways of improving the client’s present state of mind rather than focussing on the past causes of the distress. The psychological problems that can be treated by application of this approach include anxiety, low self-esteem, depression, irritation, and relationship and marriage problems. This approach centers on the interplay of feelings, thoughts, and behavior. The theory mainly focusses on the fact that thoughts, behavior, and feelings combine to affect a person's quality of life. For example, social phobia may emanate from the fact that a person always thinks that others people view him or her as stupid and uninteresting. Such a belief can cause extreme anxiety in social situations (Crane, 2008). According to Wolpe (1978), the focus of cognitive behavior therapy is to change the unhelpful behaviors, thoughts, and emotions. In doing this, cognitive behavior therapy entails a combination of two techniques, which include cognitive therapy and behavior therapy. These techniques are applied on the premise that healthy thoughts and emotions will lead to healthy behaviors and feelings. Cognitive therapy mainly aims at bringing considerable changes in the way the client thinks about the issue he, or she faces. For example, cognitive therapy can be used to challenge the thoughts and emotions of persons who devalue themselves and feel unworthy. Thus, the therapy emphasizes that negative thoughts may lead to behavior and thoughts that are self-destructive. A variety of techniques can be applied in cognitive therapy; one of the techniques entails challenging the client to prove that they cannot be loved. This may include telling the client to acknowledge the friends, colleagues, and family members who love him or her. This helps the client to realize that their beliefs are not true (Wolpe, 1978). In this approach, this strategy is known as cognitive restructuring of the client’s thoughts and behavioral patterns. As a result, the client learns how to realize and confront negative thoughts, emotions, and behaviors, and replace them with positive behavior, emotions, and thoughts (Sanders & Wills, 2005). Behavioral therapy aims at teaching the client skills and techniques that will assist them change their behavior. The client learns behaviors that help him or her in significant ways. For example, they may learn conversational skills, which they can apply in social situations as well as in therapy. As the client realizes that they can enjoy their life, the negative thoughts, behavior patterns, and emotions reduce considerably. Therefore, clients change their behavior because of behavioral therapy. While using cognitive therapy, the therapist may employ several methods, which include assessment, person education, goal setting, homework, and practice of strategies. In assessment, the therapist engages the client in realizing the symptoms that tend to cause distress. The client can be facilitated to fill out forms and questionnaires, which will help the therapist in assessing the client’s progress (Sanders & Wills, 2005). In conducting person education, the therapist provides the client with materials such as brochures, which help the client to gain more insights about their problem. This lies in the belief that an understanding of the psychological problems helps the client to get rid of their negative feelings, fears, and anxiety. In goal setting, the therapist engages the client in situations where the client decides the goals they want to achieve from the counselling process. For example, the client may decide to denounce negative thoughts, feelings, emotions, and behavior by the end of the sessions. Thereafter, the therapist devises practical ways to help the client achieve the goals. Homework entails encouraging the client to engage actively in the therapy (Crane, 2008). It may include telling the client to keep a diary and report progress to the therapist. This helps in knowing how far the client has achieved the set goals. The practice of strategies entails the actual achievement of the goals; the client practices the agreed behavior, which replaces negative feelings, thoughts, and emotions. The cognitive therapy approach has some strengths; one of the strengths include the effectiveness of the approach in treating conditions of depression and anxiety. In addition, the approach can efficiently treat severe as well as moderate depression. Apart from the strengths of the theoretical framework, it also has some limitations. These limitations include the fact that the approach only gives short-term solutions to the client's problems. The approach also emphasizes that the client should approach the anxiety that he, or she faces; this may precipitate anxiety in the client. Comparison of Rational Emotive Behavior therapy and Cognitive Therapy Rational Emotive Behavior therapy (REBT) and Cognitive therapy can be considered synonymous in a number of ways. One of the similarities of these two approaches relates to the goals they strive to achieve in a client. The main aim of the two approaches is to help clients make a change that affects their behavior and emotions. In addition, the two approaches focus on the denouncement of negative thoughts, feelings, emotions and behavior (Ellis, 2003). In helping clients, both Rational Emotive Behavior therapy and Cognitive therapy concentrate on the replacement of negative thoughts with positive thoughts. Moreover, both approaches center on the client as the source of their own change. According to Ellis (2003), the two theoretical frameworks are also similar in their approach to psychological problems of the client. In both the approaches, the therapist engages the client in owning the outcome of the intervention. The counsellor evaluates the progress of the client by emphasizing on clients that they should continually apply the proposed interventions. In addition, the two approaches strive to achieve similar goals and objectives. These goals have to be formulated by the clients with the assistance of the therapist. The goals aim at changing the client’s attitudes and perceptions towards their situation. Another similarity between the two approaches emanates from the fact that they can be considered as having philosophical orientations that seem phenomenological. As such, the two approaches assume that the individual’s perception and the underlying interpretations of social situations play a central role in determining the emotional and behavioral situations (Ellis, 2003). In addition, the two approaches propose that human beings tend to act on their interpretations of the events rather than the events themselves. Therefore, the individual’s perception of an event in his life shapes his behavior towards the situation. Cognitive behavior therapy and rational emotive behavior therapy can be considered similar in their arguments on psychopathology. The two approaches purport that psychopathology stems from distortions, biases, and systematic errors. These psychopathological problems result from the interpretation and perception of events. Proponents of the two approaches also contend that the interpretation of an event may lead to cognitive and behavioral dysfunctions (Ellis, 2007). In the course of therapy, the two approaches strive to understand the exact feelings, behavior, and thoughts that lead to a client’s problems. The approaches use these observations to develop an understanding of the client’s unique problems. Differences between Rational Emotive Behavior therapy and Cognitive therapy Despite the similarities between the two approaches, they tend to vary widely in a number of ways. To start with, although cognitive therapy emphasizes cognitive processes, it does not have a philosophical emphasis as rational emotive behavior therapy. While Rational Emotive Behavior Therapy aims as bringing permanent change, cognitive therapy aims at solving the current problems of the client (James & Michael, 1977). Therefore, Rational Emotive Behavior Therapy (REBT) aims at avoiding the future occurrence of such problems in a client. The other difference has to do with the humanistic outlook of these two therapies. REBT applies other approaches in the treatment of the client’s problems. On the other hand, cognitive therapy tends to be static and only centered on behavior change (Ellis, 2003). Unlike cognitive therapy, rational emotive behavior therapy emphasizes the negative impacts of low self-esteem and negative attitudes towards oneself. As a result, REBT strives to bring deep changes in the client’s perceptions, thoughts, and behavior. In REBT, clients develop and acquire self-direction, self-interest, flexibility, and acceptance of others and oneself (Ellis, 2007). Cognitive therapy employs the use of empirical arguments to help clients denounce negative attitudes. On the other hand, rational emotive behavior therapy holds that clients’ problems stem from absolute musts. Rational emotive behavior therapy aims at establishing the root causes of the problems faced by the client. The approach strives to understand the origins of the client’s problems and solves the problems based on where they arise. On the other hand, cognitive therapy tends to be shortlived and only gives brief solutions (James & Michael, 1977). A significant difference between cognitive therapy and rational emotive behavior therapy stems from their focus on emotions and thoughts. While CBT aims at changing thought processes, REBT dwells more on the emotional processes. Cognitive therapy requires the client to think and reason objectively about a situation he or she faces. On the other hand, rational emotive behavior therapy advocates for the replacement of negative thoughts with positive emotions (Ellis, 2003). Rational emotive behavior therapy relies on the therapist challenging the client and convincing him that his irrational behavior should be changed. Thus, this approach holds that rational thinking plays a central role in eliminating the client’s problems. On the contrary, cognitive therapy strives to create a relationship between the client and the therapist. Thus, in cognitive therapy, the client works with the therapist to solve the problems (Corey, 2005). As a result, the client gets the opportunity to master the appropriate skills and ways to solve their problems. Rational emotive behavior therapy tends to be somehow imposing the strategies on the client. Application of the therapeutic approaches to Anthony’s case Both rational emotive behavior therapy and cognitive therapy can be applied in dealing with Antony’s case. This is because Anthony experiences mood swings and irrational beliefs, which can be solved using the two approaches. In addition, by using rational emotive behavior therapy and cognitive therapy, a therapist can help Anthony deal with the irrational beliefs that he has. Moreover, cognitive therapy can be used to solve marriage problems between Anthony and his wife. This can be done through family counselling where the practitioner helps the couple deal with the cause of their disagreement. The unpredictable emotional changes such as feelings of hopelessness denote negative emotions, thoughts, and feelings.This can be overcome by employing rational emotive behavior therapy. The practitioner can facilitate Anthony to identify the origins of his feelings. This way, Anthony will be able to deal with his negative attitudes effectively (Corey, 2005). Anthony feels unworthy of himself and disappointed. This portrays feelings of low esteem, which can be dealt with by encouraging Anthony to appreciate himself. Moreover, the two theories can be employed in explaining to Anthony the need to appreciate his job, colleagues at work, and social situations. Personal preference of theory and critical rationale for this preference Personally, I would prefer to use rational emotive behavior therapy in dealing with Anthony’s case. I would prefer to use rational emotive behavior therapy for a number of reasons. The approach is appropriate in Anthony’s case since it will help him deal with irrational beliefs, negative emotions, attitudes, thoughts and beliefs. According to Leahy (2003), the approach centers on helping the client change their irrational beliefs and negative attitudes to positive ones. The approach is suitable since it will help him deal with the feelings of unworthiness, low self-esteem and disappointments. Dryden (2003) asserts that while using this approach, the client can be taught to appreciate the significant people in his or her life. The use of this theory can be essential in Anthony’s case since it will bring long lasting and permanent outcomes. Unlike cognitive therapy, rational emotive behavior therapy aims at bringing change that will continue to be witnessed in the client. As such, the approach should be applied with Anthony to help him in the future. The approach is also straightforward as compared to other theories that tend to be complex. Ellis (2007) asserts that REBT seeks to identify the sources of irrational attitudes and behavior in clients, which are essential in dealing with negative emotions and thoughts. Moreover, REBT explains the client’s behavior based on multiple factors such as biological, social, and psychological. Therefore, the theory tends to be all-inclusive in that it addresses all the possible causes of irrational behavior or thoughts. In conclusion, rational emotive behavior therapy and cognitive therapy are approaches that can be applied while dealing with clients who have negative feelings, thoughts, emotions, and behavior. These two therapeutic approaches are applicable in Anthony’s case since he encounters feelings of low self-esteem, irritability, and irrationality. As a client, Anthony seems to encounter family problems and anxiety. This anxiety can be reduced by using rational emotive behavior therapy. The most appropriate therapeutic approach could be rational emotive therapy since it tends to be all-inclusive. References Corey, G. (2005). Theory and practice of counseling and psychotherapy (7th Ed). New York: Brooks/Cole Publishing Co. Crane, R. (2008). Mindfulness-Based Cognitive Therapy: Distinctive Features. New York: Taylor & Francis. Dryden, W. (2003). 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Therapy and Beyond: Counselling Psychology Contributions to Therapeutic and Social Issues. New York: John Wiley & Sons. Sanders, D. & Wills, F. (2005). Cognitive therapy: an introduction.New York: SAGE. Wolpe, J. (1978). Cognition and causation in human behavior and its therapy. American Psychologist, 33, 437-446. Read More