Behavioral Theory or Cognitive Behavioral Theory - Case Study Example

Theory of Change Behavior Theory and Cognitive Behavioral Theory (CBT) in counseling Introduction Counseling is the process of assisting and guiding a client on professional basis to resolve personal, psychological and social difficulties and problems through perceiving things differently (Sapp, 2004). I now understand that the client is expected to focus on their experiences, feelings, moods and behaviors with the aim of facilitating change. The coursework enabled me acknowledge that the counselor plays a critical role in facilitating change through inspiring and motivating change, establishing trust with the client and ensuring equity in the counseling process. Sapp, (2004) asserts that the counselor acts as a partner and guides the client through the counseling process by helping the client to understand the need for change. From my experience as a trainee, the client is expected to accept the reality of the traumatic situations and allow for freedom during the counseling process. According to the coursework, the client should be capable of challenging his or her misconceptions and recognize his or her core strengths that are essential in adapting change (Wright, 2004). According to my theoretical learning from coursework and internship experience, I have learned that confidentiality is critical for success change during counseling process since it helps in building trustful counselor-client relationship. My preferred counseling theory is behavior and cognitive behavioral theory (CBT) since the approach aims at ensuring change through enabling the assisting the clients to develop adaptive and supportive behaviors that address the stressful situation. I agree that adaptive behaviors are essential since the client will eliminate or weaken the undesired behaviors and facilitate the attainment of desired outcomes (Sapp, 2004). The interventions may include role playing, covert modeling, rehearsals, self-monitoring and relaxation training in order to overcome the undesired behaviors (Westbrook, Kennerley & Kirk, 2011). Counselor Role and Function Westbrook, Kennerley & Kirk (2011) outlines that behavioral theory or cognitive behavioral theory (CBT) assumes that the environment determines an individual’s behavior and individuals respond to situations depending on the behaviors reinforced as a child. Behavioral theory evolved from the psychological research that behaviors can be measured and objectively viewed. I agree with behaviorists assert that behaviors can be learned and unlearned unlike the psychodynamic approach that stresses that behavior is determined by instincts. The counselor should understand the undesirable behaviors that lead to client discomfort. For instance, clients who feel anxious and nervous around dogs should be guided to learn appropriate response mechanisms to these animals (Westbrook, Kennerley & Kirk, 2011). The counselor plays various roles in during the therapeutic process in order to facilitate change. The counselor should first establish an environment of trust through understanding the client’s problems and demonstrating empathy (Sapp, 2004). The counselor plays the role of client motivation through guiding the client to set meaningful goals. According to my trainee experience, the counselor is tasked with therapeutic motivation since he or she is expected to create optimism ad energize the clients in order to remain committed in the behavior change process. The counselor must ensure equality through avoiding all manner of bias or prejudices that may hinder the attainment of change (Westbrook, Kennerley & Kirk, 2011). The counselor should acts as a partner in the change process through guiding the client to make their own decisions and set guides and his or her opinion or decision should not dominate the desires or expectations of the client. The coursework has enabled me understand the importance of limited disclosure since the counselor is bound by the professional ethics not to contravene the clients right of privacy and confidentiality (Wright, 2004). The counselor should reinforce the desired behavior through use of rewards that maintain and condition the acceptable and proper behaviors (Sapp, 2004). According to the coursework, the counselor should endeavor to establish an environment where the client feels respected, accepted and understood in order to facilitate communication. In my internship, I have appreciated that counseling requires open exploration of thoughts, beliefs, feelings and behaviors in order to facilitate change. A counselor should have excellent communication skills that include active listening, effective questioning skills and clarification (Westbrook, Kennerley & Kirk, 2011). According to my trainee experience, a counselor should have the ability to establish rapport with clients and should show empathy to clients through appreciating the client’s view rather than being too sympathetic. Client and Human nature The client should be capable of constructing reality by challenging their distorted thoughts, feelings and behaviors in order to facilitate change. The client should be capable of challenging his misconceptions and negative thoughts in order to attain a situation of reality (Westbrook, Kennerley & Kirk, 2011). Some of the client variables that contribute to change that have been identified in the coursework include the ability to find strength during adversity and explore possibilities of dealing with the distorted thoughts and problematic behaviors. The client must be willing to change and remain open to all possibilities. Courage and patience in client-counselor relationship is essential and clients should communicate their beliefs, view points and suggestions to the counselors without fear of prejudice in order to facilitate change (Sapp, 2004). Westbrook, Kennerley & Kirk (2011) asserts that the ability to accept reality and allow freedom in searching for adaptive and supportive behaviors is essentials in facilitating the cooperation between the client and counselor. In addition, the client should be able to set realistic goals and use rewards to reinforce the desired behaviors and thoughts. The client should have strong motivation to change and should be willing to devote enough time towards the therapy sessions. Clients will higher educational levels are capable of benefitting more from short-term care than clients with low cognitive abilities (Willis, 2012). Behind the Theory Cognitive behavioral theory (CBT) was founded by Aaron Temkin Beck in 1921. The theory assumes that distress or problems caused by cognitive distortions affect behavior and emotions (Westbrook, Kennerley & Kirk, 2011). Another assumption is that individuals pay more attention to the anxiety-provoking stimuli rather than positive stimuli. Accordingly, the theorist assumed that behavior is learned and can also be unlearned. The key to changing the problematic behavior will involve exploring the causes of distorted thinking and modifying the thoughts through learning new responses (Westbrook, Kennerley & Kirk, 2011). According to the ABC model, there is an activating event that triggers the existing beliefs thus resulting to the consequent emotions or behavior (Sapp, 2004). CBT combines both cognitive and behavioral therapies and is useful in treating mental health conditions such as eating disorders, relationship issues, anxiety disorders, sleep disorders, alcohol abuse and obsessive-compulsive disorders (Wright, 2004). Behavioral theory focuses on the irrational, distorted and unrealistic thoughts and clients are guided on how to behave rationally. According to Rational-Emotive behavior therapy (REBT), the clients who believe in absolute or irrational belief systems will exhibit emotional disturbances and counselors should guide clients to identify the irrational beliefs and find new life meaning (Westbrook, Kennerley & Kirk, 2011). However, REBT fails to address the cultural associations of the irrational beliefs and context-situation variables that adversely affect the client’s life (Sapp, 2004). The approach ensures humanism since counselors remain non-judgmental and assist the clients through self-awareness in order to understand the reality. Furthermore, the approach integrates existentialism ideals since cultural beliefs of the clients influence their perceptions about death, freedom and responsibility (Westbrook, Kennerley & Kirk, 2011). I agree with the coursework that behavior therapies such as reality therapy is useful in assisting client attain greater meaning and self-awareness through role playing and focusing on planned behaviors that meet the client’s needs. Theoretical basis The distorted thoughts, beliefs and attitudes will trigger or fuel certain health problems. In this case, changing one’s self-statements will change their behavior and thus client is responsible for the change. For instance, harmful thoughts such as suicidal thought will lead to anxiety and depression. The central premise is that conditioning can cause abnormal behaviors thus therapies that focus on behavior change are effective in unlearning the undesirable behaviors (Willis, 2012). For instance, aversion therapy is used in order to associate stimuli and behavior with certain unpleasant situations such as vomiting (Sapp, 2004). The cognition is includes the voluntary thoughts that include the planned activity and automatic thoughts that client has no control over and which depend on the underlying circumstances. Individuals who are biased in their thoughts experience negative interpretations of life events thus leading to distortion. According to Willis, (2012), such individuals usually set unrealistic expectations and expect failure thus triggering depression. The cognitive distortion includes arbitrary inferences, overgeneralization, personalization, labeling, and magnification. In this case, therapeutic goals aim at core belief restructuring in order to change the automatic thoughts and guiding the client on how to make alternative interpretations of the underlying daily events (Westbrook, Kennerley & Kirk, 2011). I have learned that behavioral theory aims to change a targeted problem thus ensuring high degree of ethics and responsibility and clients have the freedom in making decisions regarding the expected outcomes of the counseling process (Wright, 2004). The central basis of the theory is that clients exercise their personal choices and counselors provide the opportunities for learning how to adapt to the problem behaviors. The assessments occur periodically and corrective actions are undertaken if the selected treatment plan does not provide an indication of progress in the attainment of the desired outcomes (Sapp, 2004). In this case, the counselor will discuss with the client the possibility of using an alternative intervention. According to my past experience, reinforcement of desired behavior is critical and rewards or punishments will be essential in maintaining the expected behavior outcomes. Intervention and Treatment Plan The cognitive behavioral therapies aim at addressing distorted thoughts through cognitive restructuring. For instance, clients with social phobia are taught how to challenge their core beliefs that social rejection is inevitable. The therapy strategies are geared at ensuring effective decision-making and problem solving thus enabling clients learn how to gain control of such situations. The counselor emphasizes on the activities that increase pleasure and enjoyable living such as training the client on communication skills in order to enhance the social interactions (Wright, 2004). According to my experience as a trainee, cognitive behavior modification is effective in cognitive restructuring since clients must first recognize their feelings and thought processes before change. The counselor guides the client in self-observation and provides assistance in changing the internal dialogue. In this case, the counselor will teach the client new coping skills through use of techniques such as role playing and reevaluation of the self-statements (Sapp, 2004). Stress inoculation is another therapeutic measure that counselors can utilize in order to ensure change. This entails building client’s confidence in order to counter stressful situations through use of strategies such as self-monitoring, self-reinforcement and modifying environmental situations (Willis, 2012). Relaxation techniques such as daily physical exercises are incorporated in order to reduce sense of stress and depressive symptoms. Context Counseling influences and is influenced in the context in which it takes places such as school, agency or hospital setting. My past experiences confirm that CBT is effective in multiple settings such as hospital setting where the counselors assists patients suffering from mental disorders and in schools were the counselor may assist students suffering from undesirable behaviors such as sleep disorders or phobia (Wright, 2004). The counseling approach is also influenced by the cultural norms, values and belief systems of the client. Counselor must be aware of their own assumptions, biases and values in order to understand the worldview of culturally different clients. Understanding the cultural issues enables the counselor to identify the non-verbal clues such as feelings of frustration and mood changes during the therapy process (Sapp, 2004). Accordingly, the culture influences the role of the client in the society. The culture influences the interpretations of natural events such as death since Asian cultures perceive death as a bad luck (Westbrook, Kennerley & Kirk, 2011). The approach should consider disability since clients with certain physical disabilities may lack confidence or may not be able to participate in certain physical exercises that aim at minimizing stress (Sapp, 2004). Accordingly, the nature of client-counselor contract is essential in influencing the quality of interventions and success in attainment of change. The counselor must ensure collaborative and relaxed environment that fosters long-term and cordial relations with the client. For instance, short-term contracts with the client may not ensure effective therapy since the client may refrain from providing adequate information regarding the undesirable behaviors due to the time constrains (Willis, 2012). Conclusion Behavior theory and Cognitive behavioral theory (CBT) is useful in social, emotional and mental health therapeutic processes that aim at ensuring change of behavior. CBT builds skills that enable an individual to challenge their core beliefs and become aware of their distorted thoughts and emotions in order to identify the situations that influence the disturbing behaviors. The counselor’s personality variables such as being non-judgmental and excellent interpersonal skills facilitate formation of cordial client-counselor relationship that is based on mutual trust and respect. The aim is to ensure the client understands the reality in order to focus on adaptive and supportive behaviors that address the underlying causes of distorted thoughts and emotions thus ensuring change. Behavioral theory and CBT has demonstrated effective in treatment of psychiatric disorders such as eating disorders, anxiety and personality disorders. Accordingly, the theory is useful in medical disorders that have psychological components such as the chronic fatigue syndrome, sleep disorders and somatoform disorders. In addition, therapies can change behaviors in clients facing low-esteem, work-related problems, and compulsive gambling. References: Sapp, M. (2004). Cognitive-behavioral theories of counseling: traditional and non-traditional approaches. London: Charles Thomas Publishers. Westbrook, D., Kennerley, H & Kirk, J. (2011). An introduction to cognitive behavior therapy: skills and applications. New York: Sage Publications. Willis, F. (2012). Cognitive behavior therapy: foundations for practice. New York: Sage Publishers. Wright, J.H. (2004). Cognitive-behavior therapy. New York: American Psychiatric Publications. Read More