Role Played by the Therapeutic Relationship in Psychological Therapies - Case Study Example

Therapeutic Relationship in Two Psychological Therapies The therapeutic relationship is one that can be difficult because of the many factors that go into work between a client and a therapist. The client always comes in search of finding out more about themselves even when they don’t this is one of the goals. It is the therapists job to help the client on that journey and steer them in a direction they want to go. There are a variety of therapies that a client can choose from but not all are effective to treat all situations. Most people come to the therapeutic relationship because they are having challenges with something in their environment. This can be in their family, relationships in school (for children and college students) or in dealing with something in society. As they work through these issues around their pain the therapist has to take into consideration that the healing process is often very complicated when the individual is in the process of individual changes. SOCIAL AND PSYCHOLOGICAL FACTORS In any therapy office social and psychological factors for each individual will be different. Clients bring everything they know to the setting and it is the therapists job to help the client unravel those situations that appear difficult. Socially, they will bring what they were taught as children. These teachings will revolve around beliefs, attitudes and general thoughts about life in general. Many are attempting to move out of limiting beliefs and take hold of a better life. Psychological factors that they bring can also turn into psychological disorders. These disorders can disrupt many of the processes that an individual goes through when attempting to effect individual change. Social issues that are global are characteristic of the world we live in today. Many people are suffering from depression, anxiety and anger. Also, people are dealing with issues around alcohol abuse, aging and attachment. These issues are present in most societies today because of war and other problems within countries. Global disasters will also cause problems. When there is a national or global disaster many people relate to it whether they are personally involved or not. Sometimes a national disaster can create problems that are latent in individuals. For instance, when 9/11 happened many people were faced with feelings about their own mortality. If they lost a friend or loved one, they had feelings of grief. However, some people had feelings of grief for all of humanity. This type of disaster again can cause depression, anger, grief, feelings of hopelessness and post traumatic stress disorder. Some people find themselves wondering, "Whats the use?" or "Why should I even bother when …" The sentence always ends in something that is sad for them. On a larger basis our society is wracked with a variety of issues that enter into the therapeutic relationship. Many people are frightened. In the US gas prices, food prices, utilities and other consumer goods are higher priced than ever before. The War in Iraq has given way to many issues of depression, anger, grief and so forth. People arent able to travel on their own anymore without thinking about Homeland Security issues. All of these problems are very stressful and create a society that is prone to mental challenges, breakdowns and often mental diseases. An individual with physical disease may also develop psychological symptoms that need to come to therapy, but may never enter the process. There are also a variety of cultural issues. Some cultures dont believe in brining these issues to a therapist. Others may only bring certain issues. More people are in therapy now than ever before because of these issues. Many of these things are due to the nature of our human selves and our inability to deal with some things. According to Hunter (2000, p. 1.) psychology brings out human nature and therefore in therapy the individuals behaviour may be impeded in such a way that their "natural creativity, productivity and well-being" is compromised. Hunter also suggests that on a social level, psychology is a better framework for people to understand moral life than standard religion because many people need to sort out their feelings as to moral and ethical issues. Some religions prohibit questioning. Philosophically it is the hope of the therapist that they can assist society in delving into the depths of what makes them unique an individual. The therapists job used to be a big job because people relied on them to help. Today, there are so many different types of therapy that consumers can choose from. Why are so many people turning to therapy? Again, it is because the levels of psychological problems within our societies have changed and people are more prone to needing the help. On the societal level people are feeling lost and disenfranchised. Many are afraid that we will always be in a state of fear. Our nations are fighting against each other and everyone is facing rising costs in many areas. Many people are also dealing with workplace stress as there are layoffs, or they are upset about being in a job they dont like. Often, this is difficult because they are also afraid of changing jobs because of loss of years on the job. The healthcare system is dealing with a need to constantly raise prices but at the same time take care of the consumer. People are stressed and they are having difficulty maintaining their lives through these stresses. Some people have programs through their insurance companies that allow them to go to visit a therapist for a certain amount of visits. Most people are taking advantage of these services. They can usually use them without letting anyone know they are going. As the world continues to produce stress, more people are looking for help. In the rest of this paper, I will outline the comparison of two therapies. In order to look at the specifics of these and what they are supposed to do, I have chosen to look at one problem within our society and see how two programs deal with this issue. I have chosen to look at Psychoanalytic Therapy and Cognitive Behaviour Therapy (CBT). Psychoanalytic Therapy Within this topic there are many different categories. I have chosen to look at Attachment Counselling because it is one way that people are helping people deal with depression. According to a report by the Department of Health, "Treatment Choice in Psychological Therapies and Counselling", psychoanalytic therapies aim to help the client through the vehicle of the relationship with the therapist which is to give the client new opportunities for emotional insight and acceptance of themselves (Parry, 2001, p. 6). Attachment counselling draws on the psychoanalytic therapy because it looks at the relationship of the client to others in their world. These therapies are examining this process because they feel that most people are lacking these attachments which in many cases bring about depression. Many people get into trouble when they attempt to manoeuvre the intricacies of interpersonal relationships. When they are faced with these challenges, they arent sure what to do. Attachment counselling suggests that the way a person relates to others is directly related to how they learn the attachment process (Peluso, et. al. 2004, p. 1). A variety of studies have been done with adolescents, adults and children. All seemed to gain from this work. Attachment theory was first discussed by Bowlsby in 1950 and 1960 and later studied by Ainsworth. The basic premise is that when a person has a secure attachment they have "intense feelings of intimacy, emotional security and [a sense of] safety" (Peluso, et. al. 2004, p.1, par. 3). When an individual is insecurely attached, they will tend to have developmental challenges according to Bowlsby (as quoted in Peluso, p. 1, par. 3). According to Ainsworth, when a child experiences an insecure attachment due to the result of trauma or neglect, the will have challenges in the development of self-esteem and have difficulty relating to the world (Peluso, et.al, p. 1, par 5). The challenge with these issues is when these children become adults; they often are depressed and cant cite a reason for their depression. One of the places where research has been done is the area of grief as it applies to attachment counselling. Servaty-Seib suggests that in grief, individuals with various insecure attachment styles may have a tendency to hold on to grief longer than others (2004, p. 4). Certainly staying in this position will lead to more depression about the individual. The goal for the counsellor than is to help the individual become more solidly attached to something other than the individual they lost. Another area where depression has been studied with attachment is with college students. With college students the issue is moving from home to a college dorm and learning to adjust to that situation. According to Enochs and Roland (2004) students who have a secure attachment are able to develop an adjustment to college life. Having friends and being accepted into college live may be more important to students than academic life. Attachment counselling has also been used with adopted children to help them adjust to their new adopted life. Pros and Cons Attachment counselling is good when the therapist understands that they do not have to be physical to help a child. There is a lot of controversial work being done called "attachment therapy" that is the result of tying a child down or holding them in such a way that they cant get away if stressed. This is not the program we are discussing here. Although many people say this works, it seems to create more traumas with some children. The pros are that this is relatively new to counselling in the form that Bowlsby and Ainsworth created it and there are many studies that are showing the results of how different populations are changing their lives through building better attachments. Cognitive Behaviour Therapy (CBT) According to the Department of Health Cognitive Behaviour Therapy (CBT) is a combination of cognitive and behaviour therapies and they are used to relieve symptoms by actually changing "maladaptive thoughts, beliefs and behaviour" (Parry, 2001, p.6). According to MedineNet (2004) Cognitive Therapy is short term and is based on the concept that the way we think will affect how we feel emotionally, which will also lead to a way of acting out those feelings. CBT has been very good for working with depression and other mental health issues. This therapy has been shown to work with a variety of populations including children and adults. One area that Dia (2001) researched was separation anxiety. Because separation anxiety produces worry in the child, depression can be a part of that worry. He worked with a six year old boy he called "Colt" who had panic attacks when his mother would go from one floor to another in their house. He first educated the parents and the Colt, and then taught Colt coping statements (e.g. "I can be brave"), and then they practiced the work by having the parents leave the room. Colt was given chips when he was able to get through the situation. Through his work he was able to reduce the amount of panic attacks the Colt had and create a space for the parents to leave. Previous to this work, Colt had only received medications. Walsh (2007) researched their program of adding Adventure trips to behaviour management in order to help juvenile offenders "foster social emotional learning" (p. 1). The point is to take children on some sort of adventure where they have to rely on each other. They are not restrained and they are to work together to overcome obstacles while they are there. The group governs itself and they use peer-to-peer counselling. The pre/post tests of their group found that youth experienced more positive comments from parents, decreased feelings of depression and increased feelings of social extroversion (Walsh, p. 5). Turtsi and Cochran (2006) saw that CBT and Person Centered Counseling could work together. They point out that CBT helps the individual by pointing out their cognitive distortions to the events around them. Where Person Centered Counseling looks at unconditional positive regard for the client, CBT asks that judgements not be placed on the client. This work is important because it takes CBT a little further. Franklin (2003) points out that CBT works very well for clients with depression because it directly addresses the feelings of hopelessness, pessimistic ideas and unrealistic impressions that come with depression. Pros and Cons The Department of Health says that CBT effectively reduces symptoms of depression, symptoms of panic and anxiety disorder and has some effectiveness sin bulimia (Parry, p. 5) and there is other literature that reports that it is very affective. The down side of this therapy comes directly from people who have tried it. In looking over a blog at PsychCentral, it was clear that if a person was willing to delve into themselves, this therapy was very effective. However, some people were resistant to the process. I would imagine that this would be the major issue because some people arent willing to change their thinking to accept something. "Sky" (October 2006) stated as her con that "[CBT] requires complete trust and cooperation with therapist who shows you your cognitive distortions. Facing and changing your incorrect way of thinking can be difficult." Sky went on to say that this therapy "wasnt for wimps." Conclusion Depression seems to be the number one challenge for many people today with the global problems of our world. When people have to deal with day to day life, the symptoms of depression, whether chronic or not, can be a result of many stressors. There are a variety of therapies that an individual can choose to deal with just about any mental situation that may come about. The best way to handle this is to check them out before going to a therapist. Today, there are many online programs that can help an individual when they need it. The challenge is to get help when its needed. References Dia, D.A. 2001. Cognitive-Behavioral therapy with a six-year-old boy with separation anxiety disorder: A case study. Health and Social Work. 26(2). Available from Questia: http://www.questia.com (Accessed 04 April 08). Enochs, W. K. and Roland, C.B. 2006. Social Adjustment of College Freshmen: The importance of gender and living environment. College Student Journal. 40 (1). Available from Questia: http://www.questia.com (Accessed 04 April 08). Franklin, D. J. 2003. Cognitive Therapy for Depression. Psychology Information Online. [WWW]. Available from http://www.psychologyinfo.com/depression/cognitive.htm (Accessed 04 April 08). Hunter, J.D. 2000. When psychotherapy replaces religion. Public Interest. Spring. Available from Questia: http://www.questia.com (Accessed 04 April 08) MedicineNet, Inc. 2004. Definition of cognitive therapy. Available from http://www.medterms.com/script/main/art.asp?articlekey=31748 (Accessed 08 April 08). Parry, G., et.al. 2001. Treatment choice in psychological therapies and counselling: Evidence based clinical practice guideline. (Brief Version). Department of Health. Available from http://www.dh.gov.uk/en/Publicationsandstatistics /Publications/PublicationsPolicyAndGuidance/DH_4007323 (Accessed 07 April 2008). Peluso, P. et. al. 2004. A comparison of attachment theory and individual psychology: A review of the literature. Journal of Counseling and Development. 82(2). Available from Questia: http://www.questia.com (Accessed 04 April 08). Sky. O8 October 2006. Cognitive behaviour therapy blog. Available from http://psychcentral.com/reviews/showproduct.php/product/2/cat/3. (Accessed 08 April 2008). Servaty-Seib, H. 2004. Connections between counselling theories and current theories of grief and mourning. Journal of Mental Health Counseling. 26(2). Available form Questia: http://www.questia.com (Accessed 04 April 08). Tursi, M.M. and Cochran, J. L. 2006. Cognitive-Behavioural tasks accomplished in a person-centred relational framework. Journal of Counseling and Development. 84(4). Available from Questia: http://www.questia.com (Accessed 04 April 08). Walsh, J. and Aubry, Peter. 2007. Behavior management through adventure. Reclaiming Children and Youth. 16(1). Available from Questia: http://www.questia.com (Accessed 04 April 08). Read More