Counseling Methods - Literature review Example

Running Header: Counseling Methods Student’s Name: Instructor’s Name: Course Code: Date of Submission: Counseling methods It’s evident that currently the human race is facing problems whose nature is in such a way that the only way to counteract them is through the intervention of counseling. Many conceptions and general approaches have been developed through studies, research, and each of them being characterized by the method applied in delivering and resolving the problem at hand. This paper tries to focus on two approaches that may be applied in resolving drug and/or alcohol related issue affecting an individual. The paper will significantly attempt to resolve these presenting issues following two therapeutic approaches that has been used in this field of counseling and rendered effective. In a nutshell, the paper will use 1) psychoanalytical therapy and 2) cognitive behavioral therapy. Psychoanalytical therapy as popularized by Sigmund Freud, ‘takes into account personality development and philosophy of human nature. The theory focuses on behavior motivation by unconscious factors. The events taking place in the first six years of life is taken as the determinant of personality and behavior characteristics in an individual’ (Corey, 2005, p.9). The second approach that the paper is going to focus on is cognitive behavioral therapy that was founded by Albert Ellis. ‘The rational emotive behavior therapy, a highly deductive action- oriented model of therapy emphasizes on the role of thinking and belief systems as the root of personal problems. The theory therefore is seen to focus on the role of thinking as a major factor that influences behavior in an individual (Corey, 2005, p.9). The paper will look at how effective these two approaches or therapeutic procedures can be effectively be used to resolve drug and/ or alcohol related problems though counseling. Psychotherapy refers to verbal interactions which aim at altering or changing the emotions, thought and behavior of the patient. Counselors that have adapted to this approach in solving problems have conclusively summarized that alcoholism and drug abuse bahavioural vices usually are reflective of underlying conflicts. Such conflicts may be financial, social or emotional. this means that a more open outlook in many of alcoholism and drug abuse cases, the cure should more or less focus on identifying the nature and origin of conflict and consequently resolving the conflicts rather than the behavior itself. For instance, an individual may get into alcohol and/ or drug dependency because of some recurring family conflicts. Such people will attempt to find solace and comfort in this behavior but they may not realize it before it becomes an issue. When these people seek treatment from a counselor, a psychotherapist will want to identify the reasons which have led to the individual’s indulgence in alcohol and/ or drug related problems. They have also argued that focusing on the immediate vice will only deteriorate the patient’s behavior rather than produce a cure according to Gelso & Fretz (2001, p. 89). The most effective paradigm that has ever since been effective in producing abstinence from alcoholism and drug related issues has been popularized as the ‘12-step recovery model’. It is crystal clear that regardless of the cause, alcohol dependency and drug abuse will finally lead to established life threatening disorder. In the 1980s private treatment of such disorders greatly elevated. Therapists often incorporated the 12-step model in their treatment strategies. Generally, the nature of the model included initial removal of the physiological effects of the alcohol and/ or drugs followed by counseling sessions that would be delivered by a counselor who was a recovered victim of alcohol and/ or other drug disorders. This model put less stress on medical treatment and management of the patient beyond correcting physiological changes and such medical conditions like hypertension and diabetes according to John Orr Crites (1981, p. 56). This historic approach can be seen as a more direct face-off with thinking and beliefs of the patients that lead them to engagement in alcoholism and/ or other drug abusive behavior with adamant denial of the negativity that these behaviors impacted on their work, their families and themselves. During therapy, the patients were required to attend alcohol related seminars for a period of 90 days. The patient’s family was an equally important part and they were actively involved in this kind of therapy. The family was important particularly because the patient spent more time with them and needed to be taken care of. The outpatient treatment of alcoholism and/ or other drug abuse has been effected by effective care strategies, and approved pharmacotherapy especially managing the Patient with antidepressant and tranquilizers to counteract alcohol and/ or drug use (Burnard 1999, p. 132). The psychotherapeutic approaches that evolved in the past can be seen as a blend of behavioral psychology and principles from the social integration theories. It also evident according to this approach that self-monitoring in an individual is paramount as it can be used to identify cravings of drugs in early developments and other vices related to personal behavior. Once such identification is made, relevant procedures to manage these high-risk phenomena can be put in place. A set of psychotherapeutic techniques has been developed into a norm called Motivational Enhancement Therapy as illustrated by Miller (1994, p. 76). This therapy is usually integrated with initial observation then a number of sessions of treatment follow. The second approach- behavior therapy may be classified as experiential or humanistic approach. Cognitive-behavior therapy is one among the many approaches that have been in the frontline in treating many mental disorders including phobias and mental depression just to mention a few. In recent times, in has also been rendered effective in treating alcoholism and/ or drug related disorders. This approach has been taken as a short-term strategy that aims at using the procedures that the patients used to get into alcoholism and drug addiction to help them out of the practices. It is more or less a counteractive procedure or a reverse procedure that similarly can be said to turn back the hand of time so as to get an individual to an original status. This approach is fortified in the belief that a person’s behavior and feelings are induced by a persons mind and his or her thoughts as opposed to the environment surrounding them or even events. This is relevant given that an individual may not be in position to change the circumstances but they may be in a position to change the way they perceive these circumstances and therefore change the way they feel and behave in relation to these circumstances according to Buddy (2008). The aim of cognitive-behavior therapy in treatment of alcoholism and/or drug related disorders are to help the individuals identify the circumstances under which they may be involved in alcohol or drug taking. For instance, one may have experienced a bad day and therefore suffer from some stress. In order to manage this stress, they may decide to drink a bottle of beer or some other drug they might think will help in relieving their stress. Before long, they may become dependent on these drugs and/ or alcohol and without notice. Once an individual has identified these situations, the approach aims at helping them to avoid them and deal with any other related behavior that may be tempting to compel the individual to engage in alcoholism and drug abuse. In a more directed analysis, cognitive-behavior therapy has two main phases’ i.e. 1) functional analysis and 2) skills training. In functional analysis, the patient works together with the therapist in identifying the feelings, thoughts, and situations relating to cases when the patient took alcohol and/ or drugs. Together they analyze these aspects relative to time; before and after the alcohol and/ or drugs were taken. This essentially helps the patient to identify and pinpoint the risk factors that tolerates the vice. This also helps the individual to identify the reasons they may cause them to alcoholism and/ or drug abuse and probably help significantly in offering solutions to help curb or avoid these causes as illustrated by Herlich & Corey (2006, p. 231). Skills training help the individual in learning to undo their old unethical habits and to develop reputable habits and behavior as argued by as illustrated by Buddy (2008). These skills can be referred to as coping skills and can be categorized into interpersonal or intra-personal skills. Interpersonal skills relate to the individual alone while the intra-personal skills are those that involve a second party. Just to mention a few, interpersonal skills include one’s refusal to take alcohol and/ or drugs, heightening socially supportive networks, individual perspective in handling criticism and personal description of intimacy in relationships. Intra-personal skills that this approach popularizes include management of anger, making of decisions, solving of problems and negative thinking as stated by Hay & Kinnier (1998, p. 126). Cognitive-behavior therapy, contrary to other therapeutic approaches is relatively short time as it more goal-oriented focusing on the problems at hand. When many other therapeutic procedures take years to completely reform the patient, this approach requires an average of only 14 sessions where the patient requires the attention of the therapist. Just like in the other approaches, it has been documented and proved that cognitive-behavior therapy works best when the patient gets involved in supportive groups as stated by Buddy (2008). It is clear that these two approaches are focused on trying to curb or eliminate distress and symptoms that come hand in hand with the vices at hand. However, there is a fine line that distinguishes these two approaches. As discussed earlier, the psychodynamic therapy identifies the basis of why a patient thinks the way they do or the way they feel. This is not seen in cognitive-behavior therapy rather, it tries to retract back to times when the individual was free from the alcohol and/ or drug dependency disorder. This it does by training the mind to delete impaired thought forms, behavior and perceptions with more valuable and ethical thought patterns and behavior in an attempt to change a vice. Therapists who prefer psychotherapeutic approaches argue that this approach is more effective by identifying the underlying causatives of alcoholic and/ or drug dependence disorders. On the other hand, advocated of cognitive-behavior therapy indicate that their approach is equally effective through its immediate counteractive strategies to curb the vices as stated by Norcross & Goldfried (2005, p. 85) Just to mention a few features that exemplify each of these two approaches, cognitive-behavior therapy is seen to be time fixed and short taking an average period of less than six months. The psychodynamic therapy takes much longer i.e. more than six months. Also, the psychodynamic approach is less instructional entailing fewer home assignments. The cognitive-behavior therapy involves much more instructions, and home assignments, is highly structured, and depends on mutually set targets between the patient and the therapist. As seen earlier, psychodynamic therapy concentrates on correcting the patient’s behavior but his/ her history is equally important. Cognitive-behavior therapy focus on treating the current prevailing behavior changes and the patient’s history is less significant. It’s also important to understand that with psychodynamic therapy, the relationship of the patient with the therapist is a part and parcel of the treatment strategy. This is not the case with the other therapeutic approach (Corey 2005, p. 273). Studies have shown that the different therapeutic approaches have varying effectiveness relative to the problem being taken care of. It therefore the responsibility of the therapist to ultimately choose the most effective approach to be used in an individual depending on the nature of the issue and the individual. They should also realize that integrating their expertise with mutual responsibility of the patient would work best. In addition, taking care of any physiological challenges that the patient may have been subject to due to alcoholism and/ or other drugs is equally as important as part of the therapy bearing in mind the patient should be in good physical health before their thoughts, feeling and perceptions are changed. References Buddy, T 2008, Cognitive behaviour therapy for addiction, viewed on 9th July, 2011, http://www.alcoholism.about.com/od/relapse/a/cbt.htm Burnard, P 1999, Practical counseling and helping, Routledge, London. Corey, G 2005, Theory and practice of counseling & psychotherapy, 8th edn, Thomson Brooks/Cole, New York. Gelso, C., & Fretz, B 2001, Counseling psychology, 2nd edn, Harcourt College Publishers, Fort Worth. Hay, C.E. & Kinnier, R. 1998, Homework in counseling, Journal of mental health counseling, vol.20, no. 2, pp 122-132. Herlich, B., & Corey, G 2006, ACA ethical standards casebook, 6th edn, American Counseling Association, Alexandria. John Orr Crites, 1981, Career counseling: models methods and materials, McGraw-Hill College, New York. Norcross, J. C., & Guy, J. D 2007, Leaving it at the office: a guide to psychotherapist self-care, Guilford Press, New York. Norcross, J. C., & Goldfried, M. R 2005, Handbook of psychotherapy integration, 2nd edn, Oxford University Press, New York. Read More