Cognitive-Behavioral and Psychodynamic Therapies Critique - Case Study Example

Running Head: Case Study: Cognitive and Psychodynamic Therapies Cognitive and Psychodynamic Therapies Name Course Lecturer Date Introduction Therapy treatment is one of the oldest treatment has continued to be effective in the modern society (McLeod, 2009). Cognitive behavioral therapy has emerged as one of the most effective therapy treatment. It targets at changing conscious observation, thoughts and observable behavior in order to help the patients to b aware of themselves. On other hand, researchers in the field have also supported psychodynamic as equally important. Psychodynamic therapy is said to have it roots from psychoanalysis, a long term so of a talking cure. The therapy aims at recognizing the relationship between circumstances a patient had in early life and the impact on the present life of a patient (Jacobs, 2003). In addition, it targets the patient on the basis that human behavior is easily influenced by both conscious and unconscious motive while the act of speaking it out will assist a patient to s solve the problems. It is also important to note that both psychodynamic and psychoanalysis work under therapeutic alliance. Both cognitive behavioral and psychodynamic therapies will be used in analyzing the case study below find out their similarities and difference and choose which type of therapy between the aforementioned will help Jane overcome the problems that she is facing. Case study At her age, Jane has gone through various challenges. Apart from the divorce, most of her adult life her has been spend caring for her mother who was involved in an accident that lead to the death of her father when she was 29. At the moment she is living alone as her children moved away. Her major problem is that she is not able to make her life move on, have a relationship and restart her career as a nurse which she gave up so as to take care of her ailing mother. Her main worry is whether she will be able to go back to retrain or even hold up to the new treatment practice as now she is 50. From a cognitive behavioral theory, Jane has to change how she is thinks, that is cognitive and what she do, that is behavior. This is attributed to the fact that there is a need for one to improve their mental wellbeing despite the past experience. Jane has gone through various losses which may have resulted to low self esteem and loneliness leading to difficulties in her present life. Undergoing a cognitive behavioral theory will assist to know that it is not about what she has gone through that is supposed to cause emotions but the methods and ways that will use to interpret the happenings (c During the therapy, the counselor should assist the patient to identify her feelings, thoughts and behaviors. At this point, Jane will try to look at what is making the problems to persist. This will be in line with the analyzing the current situations. The counselor should assist the patient to analyze the situations in relation to how she reacted, coped and sought relief. For instance, how she reacted when her parents were involved in the accident, after the divorce, or foregoing her career to take care of her mother. The counselor should then help her to link her feelings, thoughts and behavior. For instance, the fact that Jane feels that she is lonely due to her past losses, the thought of it will make her not be able to meet and interact with people making her depressed. This is quite dangerous given that depressed people tend to think negatively abut themselves leading to situations such as low self esteem. As a result of this, Jane is not able to do what she enjoyed doing. With the above understanding of how her feelings and thoughts are affecting her behavior, it is expected of the counselor to assist her in analyzing how to do things differently in order to have a positive impact on her behavior. This will involve coming up with coping strategies of her negative thoughts and feelings. Basically, the counselor is expected to help Jane to relate her thoughts and her behavior and work out a way of creating an environment that will help her formulate affirmative thoughts in order to help her cope with feelings and behavior. In order to carry out the above, first the counselor need to have an introductory session in order to create a rapport with the patient; carry out the 3 phases of treatment, that is, session one: a focus on the activation of the patient through registering and planning; session two: the cognitive principles are introduced and the patient keeps a thought diary that is challenged in the third session; session three: the patient’s thoughts are challenged and logical reasoning is carried out with the patient. A behavioral experience may be designed. The final session concludes the therapy by evaluating the therapy and work on the strategies of action in case of a reoccurrence (McLeod, 2009). From a psychodynamic perspective which in some cases is referred to as insight-oriented therapy, one may understand Jane situation. This is mainly attributed to the fact that her situation and present behavior is related or being affected by unconscious processes related to the past. In addition, this kind of therapy work so as to identify recurring patterns and themes in a patient thought, self concept, feeling, life experience and relationship. In some cases a patient may either be aware of these patterns and others do not until they visit a therapist who will help them in identifying. In the case, Jane is aware of her past and the patterns of her life experiencing that are clouding her present and to some extent the future. In order to assist Jane using this approach, it is important to have psychodynamic therapy process and techniques which include; a focus of the impact and the present expression of thee patient’s emotions; explore patient’s attempts to engage or avoid activities and topics that will affect the therapeutic progress ; identify patterns in feelings, thoughts, relationships and experience; an emphasis on past experiences ; a focus on the interpersonal experiences ; maintaining an emphasis on therapeutic relationship; while exploring the wishes, dreams and fantasies of the patient (Nye, 2000). A psychodynamic counselor should first have the knowledge of psychodynamic model in order to carry out the treatment effectively. This is attributed to the fact that he or she is expected to create a good rapport with patient while she is undergoing the therapy. There are nine levels to be carried out. The first three levels need to focus on the patient’s psychological and physical complaints and symptoms, influence of relationships and depressive symptoms. The fourth and fifth levels focus on the relational pattern and the patient’s attitude to life. The sixth level will establish how past relations are persisting in the current life of the patient. The seventh level will focus on the impact of this relation on the patient while the eighth and ninth levels will directly deal with issues that manifested between level 4 and 7. The psychodynamic counselor is expected to uncover the unconscious and conscious issues that are affecting Jane. In the case presented, the patient situation is as result of her past, the counselor should encourage her to talk of the past, her relationship with her parents, children, friends and workmate. The main reason or focus for this is for the patient to be able to reveal the unconscious content of the patient which she would be said to be unaware of, and the only way of letting her realize is by talking of her life experiences. At this point, the counselor becomes a blank canvas onto which the patient may transfer deep feelings about herself. As such, the counselor should keep his or her personality out of the treatment. This calls for the counselor to be indeed focus as it will help the patient to speak freely of her past. During the session, the counselor should single out various issues that seem to be affective the patient present behaviors. For instance, in this case, Jane does not feel competent enough to go back to her career, be involved in a relationship or even interact with people. A counselor may notice that the patient has low self esteem which she may be unaware of. As such, the counselor should focus on this and help her build on her esteem. Another issue that the counselor may single out in the presented case is that the patient has experiences losses in her past; the death of her parent, the divorce and the moving out of her children. This has resulted to loneliness which eventually may affect her relationship with other people. the counselor need to bring out the aforementioned issues and other that she or he may notice and help the patient how to effectively deal with them in order to mitigate these issues that are affecting her present life. In dealing with this, she will be in able to identify new opportunities and choices that may make her ready to face change. In cognitive behavior therapy, the counselor leads the discussion while in psychodynamic therapy; the patient is encouraged to talk freely of her desires, dreams, fantasies and thoughts (Nye, 2000). Of important to note is that both approaches differ to some extent in relation to Jane’s situation. The cognitive behavioral therapy mainly focuses on the present behavior and it mainly target what the patient thinks of an event or any happenings (Westbrook et al., 2007). On the other hand psychodynamic therapy focuses on the past and how it has affected the present. In the case study presented, cognitive behavioral therapy deals with the feelings and thoughts that she has on some events and consequences they have on her behavior. Psychodynamic therapy, on the other hand, relates her past, which may be in her unconscious mind with the present. Another difference between the two approaches is that cognitive behavior focuses on beliefs and thoughts while psychodynamic encourages the patient to talk and explore emotions. CBT is structured and homework is a core element while psychodynamic is less structured and lack homework assignments (Wills, 2008). Both therapeutic approaches are similar in that their main results to help the patient cope with the current situation despite the past experiences. Simply, aim to reduce painful impact, bringing out a patient’s experiences that were unclear. In addition, they both aim at making perceptions more accurate than before (Summer & Larber, 2012). In the presented case, the psychodynamic therapy is likely to give better results than cognitive behavioral therapy. This is because the patient is encouraged to talk therefore, revealing possible thought and feelings of the past that may have effect on her present states. Still, this kind of therapy will identify patterns (Jacobs, 2004) that may have recurred in her life so as to mitigate them. Basically, unlike cognitive behavior therapy, the patient is likely to identify her past relationships with people, parents, care givers, authority which in her situation is important given that these are the main areas that she is struggling. Reference Jacobs, M. (2003). Freud's major theoretical contributions. CA : Sage Publications. Jacobs, M. (2004). Introducing the psychodynamics approach. In In psychodynamic counseling in action (pp. 1-24). CA: Sage Publications. McLeod, J. (2009). The socail and historical origins of counselling. In An introduction to counselling (pp. 21-47). Maidenhead: Open University Press. Nye, R. (2000). B.F. skinner and radical behaviorism . In In perspectives from Freud, Skinner and Rogers (pp. 47-95). CA: Brooks/Cole. Summer, R., & Larber, J. (2012). Psychodynamic therapy: a guide to evidence -based practice. New York: Guiford Press. Westbrook, D., Kennedy, H., & Kirk, J. (2007). Cognitive techniques . In In an introduction to cognitive behavior therapy (pp. 105-128). London: Sage Publications. Wills, F. (2008). Assessment, formulation and beginning CBT. In In skills in cognitive behavior counselling and psychotherapy (pp. 16-34). London: Sage Publications. Wright, J., Basco, M., & Thase, M. (2005). Common problems and pitfalls: learning from the challenges of theapy. In In learning cognitive behavior therapy (pp. 203-219). Washington: Amercan Psychiatric Publishing. Read More

This will be in line with the analyzing the current situations. The counselor should assist the patient to analyze the situations in relation to how she reacted, coped and sought relief. For instance, how she reacted when her parents were involved in the accident, after the divorce, or foregoing her career to take care of her mother. The counselor should then help her to link her feelings, thoughts and behavior. For instance, the fact that Jane feels that she is lonely due to her past losses, the thought of it will make her not be able to meet and interact with people making her depressed.

This is quite dangerous given that depressed people tend to think negatively abut themselves leading to situations such as low self esteem. As a result of this, Jane is not able to do what she enjoyed doing. With the above understanding of how her feelings and thoughts are affecting her behavior, it is expected of the counselor to assist her in analyzing how to do things differently in order to have a positive impact on her behavior. This will involve coming up with coping strategies of her negative thoughts and feelings.

Basically, the counselor is expected to help Jane to relate her thoughts and her behavior and work out a way of creating an environment that will help her formulate affirmative thoughts in order to help her cope with feelings and behavior. In order to carry out the above, first the counselor need to have an introductory session in order to create a rapport with the patient; carry out the 3 phases of treatment, that is, session one: a focus on the activation of the patient through registering and planning; session two: the cognitive principles are introduced and the patient keeps a thought diary that is challenged in the third session; session three: the patient’s thoughts are challenged and logical reasoning is carried out with the patient.

A behavioral experience may be designed. The final session concludes the therapy by evaluating the therapy and work on the strategies of action in case of a reoccurrence (McLeod, 2009). From a psychodynamic perspective which in some cases is referred to as insight-oriented therapy, one may understand Jane situation. This is mainly attributed to the fact that her situation and present behavior is related or being affected by unconscious processes related to the past. In addition, this kind of therapy work so as to identify recurring patterns and themes in a patient thought, self concept, feeling, life experience and relationship.

In some cases a patient may either be aware of these patterns and others do not until they visit a therapist who will help them in identifying. In the case, Jane is aware of her past and the patterns of her life experiencing that are clouding her present and to some extent the future. In order to assist Jane using this approach, it is important to have psychodynamic therapy process and techniques which include; a focus of the impact and the present expression of thee patient’s emotions; explore patient’s attempts to engage or avoid activities and topics that will affect the therapeutic progress ; identify patterns in feelings, thoughts, relationships and experience; an emphasis on past experiences ; a focus on the interpersonal experiences ; maintaining an emphasis on therapeutic relationship; while exploring the wishes, dreams and fantasies of the patient (Nye, 2000).

A psychodynamic counselor should first have the knowledge of psychodynamic model in order to carry out the treatment effectively. This is attributed to the fact that he or she is expected to create a good rapport with patient while she is undergoing the therapy. There are nine levels to be carried out. The first three levels need to focus on the patient’s psychological and physical complaints and symptoms, influence of relationships and depressive symptoms. The fourth and fifth levels focus on the relational pattern and the patient’s attitude to life.

The sixth level will establish how past relations are persisting in the current life of the patient.

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