Cognitive Behavioral Therapy (CBT), Research Paper Example

There are a number of approaches that are available that impact the decisions that counselors make when working with their clients on a regular basis. These approaches are associated with a number of theoretical perspectives that impact the support and guidance that clients receive, and these factors also demonstrate the importance of selecting an approach that will have the greatest possible impact on clients over time. Therefore, theoretical perspectives must be considered that address the process of counseling in different ways as a form of education for clients in addressing their problems and the issues that are most relevant to clients who require counseling. Some of the most prominent theories of counseling must be addressed as a means of creating an environment that will provide clients with support, guidance, and clarity regarding a number of issues that impact their overall wellbeing. The following discussion will address several critical theories of counseling in greater detail and will emphasize the importance of these theories in supporting client needs and discussion regarding the perspectives that are likely to have the greatest possible benefit during these sessions. This discussion will also consider the role of the counselor in this process and how counselors might be effective in advancing objectives and in determining how to use theories to their advantage in order to achieve the desired outcomes and wellbeing for the client base.

Adlerian Theory

Key Concepts

Adlerian Theory was established by Alfred Adler in the early 20^th Century in order to delve into the concepts associated with psychotherapy, and sought to better understand the different elements regarding why males and females are very different and are unequal on many levels (Stein & Edwards). To be specific, Adler believed that “both men and women suffered from our society’s overvaluing of men and undervaluing of women, and he believed the only positive relationship between men and women was one of equality” (Stein & Edwards). In this context males and females struggled with inequality on many different levels and that the only means of establishing an equal footing is for both genders to be treated in the same way (Stein & Edwards). This was an important step towards the discovery of new ideas and approaches to individual choice and freedom, which were cornerstones of his policies and beliefs regarding each person (Stein & Edwards). Adler sought to better understand how human beings related to the world, and how they responded to their surroundings in different ways in order to accomplish their personal goals and objectives (Stein & Edwards). In Adler’s view, all human beings were valuable contributors to the life span and sought a framework to achieve great success and opportunity through their own experiences (Stein & Edwards). However, this required some adjustments and periods of compromise in order to achieve the intended results, while also considering other factors that played a role in supporting these objectives, such as a sense of community: “If people have developed social interest at the affective level, they are likely to feel a deep belonging to the human race and, as a result, are able to empathize with their fellow humans…At the cognitive level, they can acknowledge the necessary interdependence with others, recognizing that the welfare of any one individual ultimately depends on the welfare of everyone. At the behavioral level, these thoughts and feelings can then be translated into actions aimed at self development as well as cooperative and helpful movements directed toward others” (Stein & Edwards). Under these conditions, therefore, it is important to identify the different resources that are required to support patients and to be proactive in advancing the objectives of each individual within his or her own modicum of experiences (Stein & Edwards). These factors require an understanding of each individual experience and how human beings relate to each other on a daily basis (Stein & Edwards). For Adler, there is a significant need to develop individuality and the support that is required to accomplish a set of objectives, while also considering other characteristics that make each person unique and distinct from the rest, using the entire being of a person as a guide in this practice and in expanding learning to accommodate individual growth (Stein & Edwards).

Therapeutic Process

From the point of view of Adler as a psychotherapist, it is essential to consider the challenges associated with his approach to therapeutic intervention, as this aims to convey the importance of individual perceptions in focusing on areas where the need is greatest (Stein & Edwards). In this context, counselors must be effectively prepared to empower patients and to provide them with an environment that is supportive of their needs and circumstances effectively and without complications; in other words, the counselor must be prepared to address the inferiorities that many patients experience and to dig deeper into these revelations in order to determine how to best improve the lives of patients in this manner (Stein & Edwards). The primary objective of the therapeutic intervention is to transform clients from partial functionality to full functionality through support, guidance, revelations, and acceptance of the human condition (Stein & Edwards). These factors contribute to the overall direction of the therapy sessions and how a client might respond to his or her own state of wellbeing (Stein & Edwards). Typically, therapy is divided into several stages, including the empathy-relationship stage, the information stage, the clarification stage, the encouragement stage, the interpretation and recognition stage, the knowing stage, the missing experience stage, the doing differently stage, the reinforcement stage, the community feeling stage, the goal-redirection stage, and the support and launching stage (Stein & Edwards).

Application: Techniques and Procedures

The therapist and client must be able to engage in role-playing exercises and guided imagery so that the client is able to perceive a possible new direction in his or her life that may contribute to greater psychological wellbeing (Stein & Edwards). It is important for clients to receive consistent direction from the therapist and to be apprised of the different circumstances under which there might be an effective strategy in place to support their growth (Stein & Edwards). One method that is commonly used is Socratic Questioning, whereby clients receive a series of leading questions in order to gain further insight into their motivations and their interpretations of different events, with continuous review of the responses in order to frame the future direction of the therapy (Stein & Edwards). These methods are strong in that they are largely client-focused, which provides them with the new tools and insights that improve their understanding of the activities that have occurred (Stein & Edwards). However, a series of leading questions may also be frustrating for clients to some degree and may deter them from full disclosure of their perspectives in some cases.

Cognitive Behavioral Therapy

Key Concepts

Cognitive behavioral therapy is comprised of the relationships between behaviors, thoughts, and feelings (Duckworth & Freedman, 2012). This type of therapy is often used to improving coping mechanisms in some clients and to be proactive in establishing a mutually beneficial therapist-client relationship (Duckworth & Freedman, 2012). In this capacity, it is important to note that “people who are participating in CBT are encouraged to monitor and write down the thoughts that pop into their minds (called “automatic thoughts”). This allows the patient and their therapist to search for patterns in their thinking that can cause them to have negative thoughts which can lead to negative feelings and self-destructive behaviors” (Duckworth & Freedman, 2012). In this context, clients are the recipients of information that is useful in supporting their current needs and in framing their experiences to the extent that there are significant opportunities to improve personal understanding and growth (Duckworth & Freedman, 2012). This practice supports the concepts associated with thoughts and perceptions as related to the condition and how they impact clients, particularly as they aim to understand why some thoughts occur in a specific manner and why they might occur on a recurrent basis, and how this impacts client outcomes over the long term, particularly as patients experience difficult situations that are not easy to overcome (Duckworth & Freedman, 2012).

Client needs must be addressed in the context of a number of different approaches, and cognitive behavioral therapy operates under the belief 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” (National Association of Cognitive-Behavioral Therapists, 2014). Under these conditions, therefore, clients must be able to demonstrate their ability to learn from a variety of situations and to be proactive in sharing their thoughts with the therapist in a manner that is consistent with the desired treatment objectives (NACBT, 2014). This practice also supports and engages clients in addressing issues that impact their overall wellbeing, such as their fears and apprehensions regarding treatment and how this impacts their lives in different ways in order to achieve success in the treatment phase (NACBT, 2014). From this perspective, clients must be made to feel comfortable in their relationships with clients and must be apprised of the different challenges that they face through trust, support, and guidance (NACBT, 2014).

Therapeutic Process

Cognitive behavioral therapy is not a definitive therapeutic technique in and of itself; on the contrary, it represents a difficult set of circumstances that clients have experienced in their lives and for which the therapist aims to provide guidance and support in framing these arguments in a more definitive and appropriate manner that is easier for clients to understand and to adapt to in their lives (National Association of Cognitive-Behavioral Therapists, 2014). With cognitive-behavioral therapy, it is necessary to effectively adapt to a set of conditions for which there are significant opportunities to overcome adversity and other conditions that have a significant impact on the lives of clients who require treatment for a number of conditions (NACBT, 2014). Most importantly, clients must be able to recognize that thinking about their issues in a different manner is likely to have a lasting impact on their lives and on their ability to achieve successful results within the treatment setting (NACBT, 2014). In many cases, a new perspective or outlook on a given situation is all that is required to accomplish these objectives and to be effective in treating the condition in a manner that is consistent with the desired cognitive outcomes (NACBT, 2014).

Application: Techniques and Procedures

With cognitive-behavioral therapy, there are briefer interactions with therapists that are typically shorter in length and that aim to provide the desired results in a briefer timeframe with less visits, as the average client-therapist relationship with this type of therapy is approximately 16 sessions (NACBT, 2014). This practice requires an effective understanding of the different elements that will have a lasting impact on clients so that their thought processes are modified to the extent that they are able to overcome adversity in this manner (NACBT, 2014). Some models of cognitive-behavioral therapy employ stoicism, while all methods embrace the Socratic method, whereby clients ask questions and begin to recognize patterns of behavior that impact their overall wellbeing in different ways (NACBT, 2014). In addition, client-therapist relationships are focused and structured and tend to go in a specific direction, based upon specific areas of focus that will have an impact on the client in an effective manner (NACBT, 2014). Finally, they aim to provide education to clients and to better understand the differences that exist with respect to client needs in a manner that is not only educational, but that also demonstrates a high level of focus and direction towards client wellbeing as he or she moves on throughout the life span and has additional experiences (NACBT, 2014).

Solution Focused Brief Theory

Key Concepts

A solution-focused approach to therapy was established by Steve de Shazer and Insoo Kim Berg in the late 1970s as a means of developing solutions to problems, rather than focusing on the problems themselves (Institute for Solution-Focused Therapy). This model emphasizes the following objectives: “Described as a practical, goal-driven model, a hallmark of SFBT is its emphasis on clear, concise, realistic goal negotiations. The SFBT approach   assumes that all clients have some knowledge of what would make their life better, even though they may need some (at times, considerable) help describing the details of their better life and that everyone who seeks help already possesses at least the minimal skills necessary to create solutions” (Institute for Solution-Focused Therapy). In this context, it is important to identify the specific tools and resources that are required to accommodate clients so that they are able to focus on overcome adversity and other challenges in the short term, rather than to continue to focus on these issues over the long term (Institute for Solution-Focused Therapy). With the objective to identify possible areas where problem-solving might be achieved, it is important for clients to receive therapy that emphasizes solutions and the manner in which different experiences might be effective in meeting client needs effectively and efficiently over time (Institute for Solution-Focused Therapy).

The primary concepts of this theory include the development of solutions that are based upon a client’s own vision of where he or she would like to go, and how to get there in an appropriate timeframe (Institute for Solution-Focused Therapy). In addition, this model emphasizes the importance of what has worked successfully in the past from a solutions point of view and how these efforts might be applicable to future efforts, particularly as clients aim to better understand their own circumstances and to be cognizant of the issues that they face as they undergo therapy (Institute for Solution-Focused Therapy). Another area that therapists emphasize is exceptions, whereby clients are encouraged to seek exceptions to problems that might have worked successfully in the past and to aim to understand how those issues might have a positive impact on a current set of circumstances (Institute for Solution-Focused Therapy). In addition, this approach also focuses on the future rather than the past and aims to provide clients with a framework that will positively impact their long-term success and achievement, rather than emphasizing what took place in the past that is no longer relevant (Institute for Solution-Focused Therapy).

Therapeutic Process

Solution-focused therapy seeks to provide clients with opportunities to overcome adversity in a manner that is consistent with the achievement of specific objectives and considerations that will positively impact patients as they seek to maintain a balance within their lives and to overcome adversity to the extent that it has a detrimental influence on the present (Institute for Solution-Focused Therapy). With an emphasis on solutions, there are significant opportunities to examine how to overcome problems and to be cognizant of these changes as a client moves forward throughout his or her life (Institute for Solution-Focused Therapy). Furthermore, there are significant issues that must be addressed that provide a basis for examining a client’s needs in a very present and effective manner, rather than focusing on what has already taken place (Institute for Solution-Focused Therapy).

Application: Techniques and Procedures

Clients who receive solution-focused therapy are likely to receive some of the following techniques during therapy sessions: 1) compliments, whereby therapists emphasize what the client has been successful with to date and how that might be utilized in a manner that shows the client that the therapist is paying attention and listening to his or her concerns; 2) miracle question, which emphasizes tasks or thoughts that could be performed almost immediately as a means of improving a client’s perspective, using a potentially small yet effective shift in the thought process in order to improve mood and overall direction; 3) scaling questions to address client’s progress and other issues that they are currently experiencing in order to use these tools to frame future needs and a more positive direction for the client; and 4) coping questions, which are designed to enable clients to perform small tasks as a step towards a larger and more prolific set of goals and objectives (Institute for Solution-Focused Therapy). Each of these tools is prevalent in shaping the learning environment for clients and in determining how to best approach their own therapeutic situation with an open mind and an emphasis on greater health and wellbeing (Institute for Solution-Focused Therapy).

Personal Reflection

From a personal perspective, I believe that clients who seek therapy are coming from a variety of places and that they must emphasize the importance therapy in order to overcome these conditions effectively. However, this practice does not occur quickly and requires an ongoing effort to be proactive in advancing objectives and in determining how to best approach client needs with the intent to improve outcomes, rather than to focus on the negative and what has gone wrong in the past. I believe that therapists must perform a comprehensive evaluation of their clients and strive to be effective in overcoming the issues that are likely to cause problems for clients, while also looking ahead to the future in order to accomplish a new set of objectives and greater wellbeing for clients. Under these conditions, it is expected that clients will benefit from different therapeutic interventions, depending on their specific circumstances. For example, some clients may benefit from cognitive behavioral therapy, while others may do better with solution-focused therapy because it emphasizes the future and hope rather than the past and despair. With all three therapies, clients must be evaluated in a comprehensive manner in order to achieve the desired results and to take the steps that are required to overcome adversity and to become stronger in the process. I believe that clients should be put first above all else and that other distractions should not get in the way of the therapeutic intervention and its potential benefits for these individuals.

A successful therapist must focus on a variety of issues and challenges that will have a significant impact on patient outcomes and on the development of new perspectives that will successfully accommodate clients to improve their lives and overall perceptions of their own experiences. When these situations occur, it is important to identify the resources that are required to accomplish these tasks and to be cognizant of client needs and limitations within this process. These considerations will enable the therapist to select a treatment method that will be most effective for a client, given where he or she is with respect to cognitive and psychological status.

References

Duckworth, K., & Freedman, J.L. (2012). Cognitive behavioral therapy (CBT). Retrieved from http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Treatments_and_Supports/Cognitive_Behavioral_Therapy1.htm

Institute for Solution-Focused Therapy. What is solution-focused therapy? Retrieved from http://www.solutionfocused.net/solutionfocusedtherapy.html

National Association of Cognitive-Behavioral Therapists (2014). Cognitive behavioral therapy. Retrieved from http://www.nacbt.org/whatiscbt.htm

Stein, H.T., & Edwards, M.E. Classical Adlerian theory & practice. Retrieved from http://www.adlerian.us/theoprac.htm