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Cognitive Behavioral Therapy.doc

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  • 1. COGNITIVE BEHAVIORAL THERAPY Cognitive Behavioral Therapy is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. The term “cognitive-behavioral therapy (CBT)” is a very general term for a classification of therapies with similarities. There are several approaches to cognitive-behavioral therapy including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy. Most cognitive-behavioral therapies have the following characteristics: • Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations, and events. The benefit of this fact is that we can change the way we think to feel/act better even if the situation does not change. • CBT is Briefer and Time-Limited. The average number of sessions clients receive (across all types of problems and approaches to CBT) is only 16. Therefore, CBT is not an open-ended, never-ending process. • A sound therapeutic relationship is necessary for effective therapy, but not the focus. CBT therapists believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT therapists focus on teaching rational self- counseling skills. • CBT is a collaborative effort between the therapist and the client. The therapist’s role is to listen, teach, and encourage, while the client’s roles is to express concerns, learn, and implement that learning. • CBT is based on aspects of stoic philosophy. The approaches that emphasize stoicism teach the benefits of feeling, at worst, calm when confronted with undesirable situations. So when we learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a better position to make use of our intelligence, knowledge, energy, and resources to resolve the problem. • CBT uses the Socratic Method. Cognitive behavioral therapists want to gain a very good understanding of their clients’ concerns. That’s why they often ask questions. They also encourage their clients to ask questions of themselves. • CTB is structured and directive. Cognitive-behavioral therapists have a specific agenda for each session. Specific techniques/concepts are taught during each session. CTB therapists do not tell their clients what to do – rather, they teach their clients how to do. • CTB is based on an educational model. The goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting. • CTB theory and techniques rely on the Inductive Method. The inductive method encourages us to look at our thoughts as being hypotheses or guesses that can be questioned and tested. If we find that our hypotheses are incorrect (because we have new information), then we can change our thinking to be in line with how the situation really is. • Homework is a central feature of CBT. CBT therapists assign reading assignments and encourage their clients to practice the techniques learned.
  • 2. REALITY THERAPY Reality Therapy was developed by William Glasser MD. Reality Therapy is a counseling method which focuses on the future. Its fundamental idea is that no matter what has happened in the past, our future is ours and success is based on the behaviors we choose. There are two major components to Reality Therapy. • Create a trusting environment • Employing techniques for helping a person discover what they really want CONSIDERATIONS AND PRACTICES • Focus on the present and avoid discussing the past • Avoid discussing symptoms and complaints as much as possible • Understand the concept of total behavior, which means focus on what counselees can do directly – act and think. • Avoid criticizing, blaming and/or complaining and help counselees to do the same. Remain non-judgmental and non-coercive. • Teach counselees that legitimate or not, excuses stand directly in the way of their making needed connections. • Find out as soon as possible who counselees are disconnected from and work to help them choose reconnecting behaviors. • Help them make specific, workable plans to reconnect with the people they need, and then follow through on what was planned by helping them evaluate their progress. • Be patient and supportive but keep focusing on the source of the problem, disconnectedness. • Reality Therapy emphasizes the client’s responsibility and self-empowerment. A positive change in behavior is often realized in clients of Reality Therapy.
  • 3. SOLUTION-BASED BRIEF COUNSELING (SFBC) Solution-focused brief counseling (SFBC) has emerged in the last 15-20 years as a form of brief or short-term counseling and as an alternative to the problem-focused approaches that have prevailed in counseling practice. Solution-focused brief counseling offers the unique contribution of affirming clients’ strengths. SFBC is future-oriented and solution-focused rather than problem focused to resolve current concerns rather than find the cause of the problem. School counselors are becoming familiar with brief counseling interventions because they are finding that it makes sense in the school setting. A study reported by Evans and Carter (1997) indicated that a brief, school-based model made a positive impact on attendance, academic achievement, and classroom behavior of children referred for emotional and behavioral problems. School counselors, working under time constraints, are relieved that brief interventions are available and efficient. The following attitudes and principles are salient: • A view toward the student’s strengths, resources, and what’s possible at the time. • A focus on the present and the positive. • Emphasis on goals, solutions, exceptions, and future visions to facilitate change. • A perspective of goal setting/finding solutions as a collaborative effort among the school counselor, student, family, and teacher. • Use of a time-limited structure to create expectancy for change. • Focus on manageable problems and specific targets for change. • A view of language as a powerful tool through which students are invited into a positive and problem—solved future. • A belief that small change may be enough to ignite hope in the client.
  • 4. PERSON-CENTERED PSYCHOTHERAPY Person-Centered Therapy (PCT), also known as Client-centered therapy or Rogerian Psychotherapy, was developed by the humanist psychologist Carl Rogers in the 1940s and 1950s. It is one of the most widely used models in mental health and psychotherapy. The basic elements of Rogerian therapy involve showing congruence (genuineness), empathy, and unconditional positive regard toward a client. Based on these elements the therapist creates a supportive, non- judgmental environment in which the client is encouraged to reach their full potential1 . Person-centered therapy is used to help a person achieve personal growth and/or come to terms with a specific event or problem they are having. PCT is based on the principal of talking therapy and is a non-directive approach. The therapist encourages the patient to express their feelings and does not suggest how the person might wish to change, but by listening and then mirroring back what the patient reveals to them, helps them to explore and understand their feelings for themselves. The patient is then able to decide what kind of changes they would like to make and can achieve personal growth. Although this technique has been criticized by some for its lack of structure and set method it has proved to be a hugely effective and popular treatment. PCT is predominantly used by certain types of psychologists and counselors in psychotherapy. In client centered therapy the therapists’ role is mainly to act as a facilitator and to provide a comfortable environment NOT to drive and direct therapy outcomes. 1 History and influences

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