Cognitive Behavioural Therapy and Rational Emotive Behavioural Therapy - Coursework Example

Cognitive Behavioural Therapy (CBT) and Rational Emotive Behavioural Therapy (REBT) The earliest Greek thinker Epictetus, over 1800 years ago, d that men are not disturbed by things themselves, but by the values and sentiments attached to those things. CBT has mainly two effects, the first being behaviour therapy as purported by Wolpe in the 1960s and the second, cognitive therapy approach founded by A.T Beck near around the same time. The former was created as a result of Freudian psychodynamic paradigm, which was the most popular in psychotherapy treatment since the beginning of the nineteenth century. Around the 1950s, the Freudian psychotherapy was being questioned by scientific psychology due to the lack of practical evidence to support its theory and practicability. Behaviourist movement influenced CBT strongly, which supported he view that a person’s inner mind cannot be observed and, therefore, is not open to scientific study. As an alternative, the behaviourists made an effort to look into reproducible associations among visible events, mainly between stimuli and responses. Learning theory, a main feature in psychology during that period, focused on general doctrines that would show the method in which the organisms learn new associations between stimuli and responses. CBT relies on the premise that behaviour has a strong impact on the feelings and emotions of a person. “A useful distinction exists between schools of counselling and therapy as well as theoretical approaches to counselling and therapy” (Harrison, n.d). The article written by Albert Ellis “Rational psychotherapy and individual psychology”, provided a basis for Rational Therapy (RT). Rational Emotive Behaviour Therapy has now become a very popularly practiced and effective type of psychotherapy. “Originally, the approach was called rational therapy (RT) because Ellis wanted to emphasize its rational and cognitive features” (Dryden & Neenan, 2006). According to RT, if individuals want to change between different dysfunctional emotional outcomes, for example a sad mood, they will have to modify their major cognitive determinant that is irrational thinking. Even though RT aimed mainly at emotional consequences, and made use of a huge number of emotive techniques, a lot of people misunderstood it as ignoring feelings. Hence, to make a proper misperception, Albert Ellis changed RT into Rational Emotive Therapy (RET). Though RET used a wide range of behavioural techniques, it was distorted by a number of professionals as being highly “cognitive” and that it ignored the behavioural custom and consequently, its effective behavioural interventions. To correct this misrepresentation, in 1993, Albert Ellis made a change in RET as Rational Emotive Behaviour Therapy (REBT). REBT has been founded on the presumption that when any individuals become sad, this emotion need not necessarily stem from any event in their lives. On the other hand, people can become sad or anxious because of the beliefs that they possess. This idea was first founded by Epictetus around 2000 years ago. According to the views of Albert Ellis, majority of the individuals desire to be happy whether he or she is alone or with anyone else. But a person’s goal of being happy can sometimes be blocked by their beliefs in different situations. Present CBT is not a huge composition, but it is a broad subject that is still being developed and shrouded in controversies. The view taken in this book is based on the Beckian Model created by Beck in the 1960s. Pessimistic automatic thoughts, as Beck stated, are the basis to CBT. This term has been used in order to describe a flow of thoughts, which a person can find if he or she concentrates on them. For instance, if a person is anxious he or she may have had feelings regarding the threat of something bad about to happen. If an individual has been irritated, he or she may have had feelings of being treated in an unfair way by others. When an individual becomes fed up, the results bring about feelings of loss defeat and mostly negative views about oneself. Thus, Simmons and Griffith contend that problems are not the root cause of distress but the way an individual perceives and acts causes psychological issues and hence they suggest “cognitive interventions,” that seek to “produce changes in thoughts and beliefs” (Simmons & Griffiths, 2009). Rational Emotive Behaviour Therapy (REBT) was founded by Albert Ellis, who was an American clinical psychologist. Dysfunctional assumptions can be considered as the water, which nurtures the seeds of NATs. DAs are the rules for living and these are normally specifically applied, but as compared to NATs they are more general. They often take the form of conditional ‘If … then …’ propositions, or are framed as ‘should’ or ‘must’ statements. They often symbolize the living with pessimistic beliefs that are present deep within the minds of individuals. For example, if one believes that he or she is basically unlovable, he or she might develop the belief that even if they try to offer help to others, hey maybe rejected. The client oriented model, which is also known as person centred model, was promulgated by Carl Rogers in the mid 20th century. As the name itself implies, it revolves around customers or clients. Roger believed that it was the clients who will know the proper method to deal with their problems. Thereby, listening to what they express during consultation, the therapist can help them in better ways. Client oriented method respects the clients and their freedom of expression. It is a non directive approach, that is, the psycho therapist does not provoke the clients to be more emotional. Cognitive behavioural therapy, on the other hand, uses consultation tools in order to control and direct. For example, asking questions, making interpretations or directing the client’s feelings. Some of the psychotherapists believe that that cognitive behavioural therapy is manipulative, mainly when it is compared to the client-oriented model. But this can only be claimed when judged as a whole. Cognitive behavioural therapy has two mechanisms, namely: cognitive therapies and behavioural therapies. Cognitive refers to the method in which the clients know the earth in which they are living, the environment and the situation which they are facing and their reaction to these. Cognitive therapy generally focuses on thoughts and beliefs. It analyzes how and why the individuals think in a particular way. They then modify these methods in order to form optimistic and fostering emotional states which can reinstate the present state of dissonance that a client faces. Behavioural therapy can be considered as the second stage that focuses on behaviour rather than thoughts, and helps the therapists to form new behaviour patterns for the individuals who seek help. For instance, the client can be given support and encouragement for the positive change in manners which the client shows while facing a certain problem. In client oriented therapies, the discussion sessions last for an hour and intercession is made among the client and the psychotherapist. In the beginning, client centred therapy will be considered as not directive, which means that the psychotherapist will not direct the individual to a particular topic for discussion but leaves it to the free will of the individual. But many of the psychotherapists feel that a fully non directive method cannot be agreed always and that sometimes the therapists will have to take the lead. But on the other hand, REBT focuses on rational and irrational beliefs. When the belief is rational it will be logically supported and, therefore, generates functional consequences, whereas irrational beliefs will be illogical and may generate unhealthy consequences. The theory of REBT assumes two challenging models and they additionally propose that the first model is a traditional one and also believe that dysfunctional pessimistic feelings like unhappy mood, worry, guiltiness and anger are different from resultant functional negative feelings like sadness, anxiety, remorse and irritation, mainly in terms of intensity. The next model is a unique one, which assumes that differences between functional and dysfunctional feelings, be it optimistic or pessimistic, are mainly qualitative. The psychological disturbances are not caused due to the events and circumstances that occur, but are caused by both rational and irrational beliefs. The irrational thinking, which accompanies the events and circumstances, will distort the ways one interprets external events. It is what a person tells himself about the events and circumstances that cause psychological disturbances to an individual’s mind. An individual can replace and refute irrational thoughts. This can be done by simply replacing the irrational thoughts with fresh rational ones. Through REBT an individual can learn the method of attacking and refuting his or her irrational thinking. By doing so, a client can reduce irrational thinking and attain happiness in his or her life. Hence, when individuals will have to face several activating events, they will approach with their desires since it is because of their desires that they experience different feelings. “While REBT is an approach to counselling and psychotherapy that is rooted firmly in the CBT tradition it does have a distinctive perspective on emotional problems” (Dryden, 2009). The REBT argues that: People create different inferences, the emotional troubles. They allocate themselves by possessing a set of illogical beliefs related to these inferences. The character of these irrational values is that they are extreme and rigid. When a person holds irrational values, he or she is not only aware about distributed emotions, but also know how to perform in certain dysfunctional methods and believe in extremely distorted methods as well. These thoughts and behavioural results of irrational beliefs provide expression to these values that spawn them. “People can hold irrational beliefs at both specific and general levels of abstraction. Their general irrational beliefs influence the inferences they make during the first time and then they bring their specific irrational beliefs regarding inferences in the second, in order to create their emotional problems and the thinking and behaviour that accompany these problems” (Dryden, 2009). Cognitive Behavioural Therapy (CBT) is derived from the Cognitive Model of moving disorders and was first expanded further by Aaron T. Beck. At its first stage, it concentrates on Negative Automatic Thoughts which are protected into vicious cycles with dysfunctional behaviours, emotions and somatic signs. It can also be extended to contain more incomplete dysfunctional underlying cognitions in the structure of statements and core values. “The cognitive case formulation approach is subject to disconfirmation, grounded in empirical research, parsimonious, and readily understandable by clients” (Stephens, n.d). On the other hand, it also reveals therapist bias, does not fully contain cultural effects, can be over-accepting of the customer’s judgement as to its accuracy, and relies on contentious mediating emotional units. It is nonetheless an influential therapeutic and theoretical tool. In CBT, there is always a cognitive case formulation, that is, a hypothesis and plan founded on the Cognitive Model of moving disorders. CBT attempts to recognize and explore the ways of thoughts, how these affect feelings and how people behave as an outcome to these. Learning to end such opinions prevents the thoughts from becoming increasingly distorted, which happens when a person projects different facts onto the other person to describe why they may be performing in a certain way. CBT consequently aims to stop reaching conclusions when these can be wrong. “This prevents some of the unpleasant feelings and behaviours from taking place. Unlike some of the other talking treatments, which may focus on past experiences in conjunction with what is happening currently, CBT mainly pays attention to the "here and now" problems rather than on the causes of those problems” (Karuna Psychotherapy and Counselling, n.d). Cognitive-behavioural therapy incorporates the reorganizing of cognitive therapy with the behavioural changes techniques from behavioural therapy. The analyst works with the patient to identify both the behaviour and the thoughts that cause distress, and to change those thoughts in order to readjust the behaviour. In most cases, the patient has convinced basic core beliefs, called schemas, which are defective and need modification. For instance, a patient suffering from depression may evade any public encounter with others, and may also be subject to significant emotional suffering because of isolation. By making the patient aware of other’s estimation of him, the therapist both boosts the patients confidence and provides a new perspective into the situation. Through this way, people understand their true worth. If sufficient cognitions are transformed, the patient can get enough help for overcoming depression. Various techniques may be employed in cognitive-behavioural therapy to assist patients to examine their opinion as well as improve their behaviours. They are as follows: Behavioural homework assignments: “Homework assignments are a core feature of the cognitive behavioural therapy process” (Kazantzis et al. 2005). Cognitive-behavioural therapists regularly demand that their patients do homework while undergoing therapy sessions. Cognitive Rehearsal: The patient visualizes difficult circumstances and the therapist directs him during the slow procedure of facing those and also effectively dealing with them. “Cognitive rehearsal entails asking a patient to picture or imagine each step involved in the accomplishment of a particular task” (Barlow, 2008). Journal: The patients are asked to maintain a complete diary or journal, describing their feelings, actions and thoughts when particular circumstances arise. This journal helps to make the patient become aware of his or her maladaptive opinion as well as to illustrate their results on behaviour. Modelling: The patient and therapist connect with one another through in role-playing, in which the therapist shows the patient different suitable responses to the given circumstances. Conditioning: “The term conditioning refers to learning, and classical conditioning is the conditioning of reflexes” (Sapp, 2004). The therapist makes use of the process of strengthening in order to support a specific behaviour. For example, a kid with ADHD obtains a gold star always, as he or she stays focused on tasks as well as achieves daily objectives. Systematic Desensitization: “Systematic desensitization is an exposure technique used for decreasing phobic responses with the help of a graduated hierarchy of anxiety evoking stimuli that the client visualizes” (Sundel, 2005). Patients try and visualize circumstances they fear and the therapist utilizes methods to assist them to relax, basically guiding them on how to survive their fear stimuli and, ultimately, eliminating their nervousness altogether. The treatment sessions at the initial stages are spent on naturally explaining the “essential tenets of cognitive-behavioural treatment to the patient and identifying a positive working connection between the patient and the therapist” (Cognitive-Behaviour Therapy, 2013). Therapy is usually managed in an outpatient setting and can also be a group or individual session. Reference List Barlow, D. H. 2008. Clinical Handbook of Psychological Disorders: A Step-By-Step Treatment Manual. Guilford Press. Available at [Accessed on 26 January 2013]. Cognitive-Behaviour Therapy. 2013. The Free Dictionary. Available at [Accessed on 26 January 2013]. Compare and Contrast Two Counselling Theories: Client-Centered Approach and Cognitive Behavioural Therapy. 2011. Academic Help. Available at [Accessed on 26 January 2013]. Dryden, W. 2009. Understanding Emotional Problems: The REBT Perspective. ROUTLEDGE.  Available at [Accessed on 26 January 2013]. Dryden, W. & Neenan, M. 2006. Rational Emotive Behaviour Therapy: 100 Key Points and Techniques. ROUTLEDGE. Print. Harrison, G. n.d. 52175: Comparative Theoretical Models: An Introduction to CBT. Print. Kanura Psychotherapy and Counselling. n.d. Karura Therapy.co.UK. Available at [Accessed on 26 January 2013]. Kazantzis, N. et al. 2005. Using Homework Assignments in Cognitive Behaviour Therapy. Ruotledge Taylor & Francis Group. Available at [Accessed on 26 January 2013]. Sapp, M. 2004. Cognitive-Behavioural Theories of Counselling: Traditional and Non-traditional Approaches. Charles C Thomas Publisher Ltd. Available at [Accessed on 26 January 2013]. Simmons, J. & Griffiths, R. 2009. CBT for Beginners. London: Sage Publications Ltd. Print. Available at [Accessed on 27 January 2013]. Sundel, M. 2005. Behaviour Change in the Human Services: Behavioural and Cognitive Principles and Applications. Sage Publications. Inc. Available at [Accessed on 26 January 2013]. Stephens, E. n.d. A Case Formulation Approach to Cognitive Behavioural Therapy. PCI College & Central for Sexual Addition. Available at [Accessed on 26 January 2013]. Read More