Cognitive Behavioral Therapy and the Person Centred Therapy
Since the late 20th century, psychotherapy has been described as an important aspect in the study of psychology. Due to its importance, psychologists have been actively involved in the identification of the critical approaches in counselling and psychotherapy (Corey 2009). Psychologists have come up with different theoretical models of counselling that are applicable at different situations during psychotherapy (Fall & Holden 2010). The application of these theoretical models of counselling have helped in overcoming the impact of several emotional as well as psychological difficulties such as stress, depression, anxiety, anger, and other emotional problems (Fall & Holden 2010). However, despite the universal application in solving similar problems in human beings, these theoretical models of psychotherapy possess distinct differences as well as similarities. A comparison and contrast of the major theoretical models in counselling is therefore critical in understanding the application of each theory in psychotherapy (Corey 2009).
This paper compares and contrasts three theoretical models of counselling. For comparison and contrasting purposes, the paper has identified three main modalities: Cognitive Behavioural Therapy, the Person-Centred Therapy, and Gestalt Therapy. This paper will describe the underpinning assumptions of each model, the goals of therapy in relation to each model, the therapeutic relationship including the role of the counsellor and the client, the key techniques of each model and the major limitations in relation to each particular model. The paper will describe each theoretical model of counselling while comparing and contrasting with the others utilizing the aforementioned aspects.
Cognitive Behavioural Therapy (CBT), Person-Centred Therapy, and Gestalt Therapy
CBT, Person Centred Therapy and Gestalt Therapies are three theoretical models that have been applied in psychotherapy for many years. Despite their similarities and use in counselling, the three theoretical models hold distinct differences from each other. These differences are realized especially in regard to the assumptions, the goals of each, therapeutic relationship, key techniques of each and limitations (Corey 2009).
Being one of the most preferred theoretical models in counselling, CBT has demonstrated explicit justifications as well as definite rates of success in most of the instances where it has been applied (Brewin 1989). The diversity of its applications in major psychological and emotional problems has also encouraged most psychotherapists to utilize it in therapeutical sessions (Stallard 2002). In contemporary psychotherapy, as described by Stallard (2002), CBT has been integrated with other theoretical models due to its multidimensional nature. CBT has been applied in clinical psychology and other psychological therapies on the basis of its premise of the importance of thinking about individual actions and feelings in relation to psychological and emotional health (Fall & Holden 2010; Ingram & Siegle 2000).
Person-Centered Therapy was developed by Carl Rogers in the 1940’s, and has been a critical theoretical model in counselling. According to Fall & Holden (2010), this theory of counselling developed in three different phases. In the first phase, the theory “focused on how the nondirective counsellor’s conduct differed from that of more “directive” psychotherapists such as psychoanalysts and behaviour therapists” (Fall & Holden 2010, p 171). The second phase focused “away from the counsellor and firmly onto the client as a responsible agent whose nature provided the rationale for the counsellor’s therapeutic conduct” (Fall & Holden 2010, p 171).The third phase emerged when the theory included past counselling philosophies which formed major requirements of conventional psychology (Vacc & Loesch 2000).
Gestalt Therapy, on the other hand, emerged in the 20th century. As described by Fall & Holden (2010), Gestalt therapy “grew from a reaction to classical psychoanalysis that permeated the psychological community of the early twentieth century” (p. 201). “Developed in the 1940’s by Frederick “Fritz” Perls, Gestalt Therapy focused on cultivating growth rather than pathological remediation,” (Fall & Holden 2010, p 202). Actual psychological experiences are the major emphasis of the gestalt therapy.
Cognitive Behavioural Therapy (CBT), Person-Centred Therapy and Gestalt Therapy have differing underpinning assumptions that make each therapy distinct. CBT assumes that the occurrence of behavioural and emotional problems in most individuals is due to the nature of people incorporating faulty thinking (Dryden & Bond 2000). CBT also assumes that the manner in which individuals perform and believe is determined and influenced by individual cognition. The counselling is therefore focused towards the cognition and behaviour of the individual (Ingram & Siegle 2000). During CBT, the importance of decision making, thought, questioning and action is stressed. CBT assumes that counselling is a process that entails learning, acquisition of novel talents as well as learning new coping mechanisms for common psychological and emotional problems (Corey 2009, Stallard 2002).
In person centred therapy, it is assumed that humans are positive and due to this positivity, they tend to be inclined towards the achievement of complete functionality of both their bodies and minds (VanKalmthout 1998). In applying this model in counselling, it is assumed that the immediate experiences in an individual have occurred due to lack of past awareness about the problems. The theory has it that after therapy, the individual will possess actualization that will impact on his or her potential to move from being unaware to being aware of his or her feelings, and will have self trust and think positively in relation to his or her life (Rennie 1998).
Gestalt Therapy assumes that for an individual to achieve personal wholeness in terms of thinking, feelings as well as behaviour, they have to work hard (Brownell 2010). This theory assumes that if an individual is allowed to flashback on past experiences, they will be able to relate them to the present experiences and then connect the two. Fall & Holden (2010) claim this model of counselling utilizes an experiential advance that holds its grounds on the immediate experiences therefore emphasizing on individual responsibilities as well as choices.
Goals of Therapy
The three theoretical models possess different goals. CBT challenges individuals to face the behaviours, norms, and beliefs that affect their psychological and emotional health (Dryden & Bond 2000). CBT also encourages clients to be more aware of their thoughts therefore encouraging clients to change their feelings (Vacc & Loesch 2000).
Person-Centred therapy aims at providing individuals with an environment that is safe and favourable for exploring their well being (Rennie 1998). By encouraging clients to explore well being, Person-centred therapy ensures that clients recognize all the challenges that they have faced in their emotional and psychological growth. Further, this therapy enables clients to realise aspects of self worthiness that had been imprecise during their past (Tudor & Worrall 2006).
The goals of the Gestalt Therapy also differ from those of CBT and person centred therapies. Basically, Gestalt therapy aims at assisting emotionally and psychologically affected individuals in advancing towards self awareness in relation to their day to day experiences (Brownell 2010). This encourages clients to be expansive especially in making choices in regard to their lives. However, the gestalt therapy in contrast with the CBT and person-centred therapies aims at assimilation but not at psychoanalysis which is common in the other two therapies (Fall & Holden 2010).
In relation to therapeutic relationship, the role of the counsellor and client becomes critical in ensuring that the outcome of the therapy is desirable. In relation to the three theoretical models of counselling under discussion, the therapeutic relationships differ from one model to the other. In each model, the client and therapist hold different roles (Corey 2009).
The therapeutic relationship in Cognitive Behavioural Therapy, the therapeutic relationship resembles the relationship between a teacher and a student. The therapist acts as the teacher and the client as the student. According to Romana (2003), the role of the therapist is to give therapeutical instructions to the client who listens and does what the counsellor says. In this relationship, the counsellor employs directive structures to direct clients on behaviour changes (Dryden & Bond 2000). In this case, the counsellor acts as the focal point since he impacts much on the cognitive and behavioural changes in the client. However, for desirable results, collaboration is ensured during therapy (Gilbert & Leahy 2007).
The counsellor utilizes the Socratic dialogue that is critical in supporting clients in tenets such as the identification of the beliefs, norms and values that have impacted on the psychological and emotional functionality (Romana 2003). Further, the counsellor encourages the client to change these beliefs as well as identify an unconventional rule for present and future living. In this case, the counsellor helps in promoting the adoption of remedial skills of learning (DeRubeis, Tang & Beck 2001). In this relationship, the client always gets new insights in relation to the problems he/she is experiencing and therefore decides on efficient and effective means of acquiring change (Gilbert & Leahy 2007).
In the person centred therapy, the therapeutic relationship is distinct from CBT and gestalt. In Person-Centred Therapy, the relationship between client and counsellor is crucial (Tudor & Worrall 2006) because therapy is centred towards the client as the client is the focal point of the therapy. Due to this, the counsellor must ensure that respect, genuineness, and empathy towards the client are maintained. Further, communication is also critical in this model especially between the client and the therapist. The relationship must equal as it is crucial in aiding behaviour change in the client (Wilkins 2010).
Therapeutic relationships in the Gestalt Therapy hold central significance. The counsellor and client establish a relationship that is centrally placed. In this therapy, the relationship only depends on the nature and quality of the therapeutic measures being given (Brownell 2010). In contrast to CBT and person centred therapies, gestalt therapy depends much on the attitudes of the counsellor towards the client. The client is his own interpreter hence the counsellor only helps the client to interpret his behaviours and experiences (Brownell 2010). Therefore the role of the counsellor is as an aid. The client identifies his experiences and works on how to change the experiences that affect his current psychological and emotional health (Fall & Holden 2010).
There are different techniques applicable in the three models of counselling described in this paper. CBT utilizes techniques aimed at personal counselling. The theory utilizes the Socratic model that entails several questions to be answered by the client. Corey (2009) denotes that “therapists utilize a variety of cognitive, emotive, and behavioural techniques; diverse methods are tailored to suit individual clients,” (p. 466). However, the client is also allowed to ask the counsellor some questions. Further, the theory employs the aspect of homework that encourages the clients to practice the skills learnt. Therefore the major technique of CBT is the ABC technique that utilizes the Socratic model (DeRubeis, Tang & Beck 2001). In client centred therapy, the techniques differ from those of CBT. While CBT applies assignments and Socratic model, Person centred therapy makes use of the attitudes of the counsellor as the major technique. The attitude of the counsellor towards the client determines the outcome of the therapy (Tudor & Worrall 2006). However, this therapy utilizes aspects of hearing and listening and clarification of ideas and feelings. This therapy does not utilize techniques that entail directive aspects. In person centred therapy, there is no probing and questioning; common aspects in CBT therapy (Wilkins 2010). In the Gestalt therapy, the techniques used contrast those of CBT and person-centred therapy. As asserted by Corey (2009), this therapy uses “a wide range of experiments designed to intensify experiencing and to integrate conflicting feelings,” (p. 466).
Though the theoretical models of counselling described in this paper are necessary in counselling, each model has several limitations. The CBT is believed to have an aspect of playing down the emotions of the clients. It lacks the focus on determining the underlying unconsciousness in the clients and due to this fails in relating the client’s past with the present experiences. Since it entails confrontation, this therapy may witness cases of termination as most clients may not cope with its expectations (Fall & Holden 2010). The limitations of the person centred therapy are distinct as compared to those of CBT and Gestalt. Since the therapist is a passive entity during this therapy, cases of limited responses are occasional. There is lack of direction for most clients since the counsellor remains inactive (Wilkins 2010). In cases when crisis occurs, the clients will lack support. The theory lacks the application of novel knowledge hence cases of rigidity are common (Tudor & Worrall 2006). In Gestalt Therapy, limitations include expressions of emotion due to the techniques that are employed. Clients in most cases fail to acquire or reach the required thresholds of the therapy since cognitive aspects are not dealt with.
This paper has described three theoretical models including CBT, Person-Centred and Gestalt. The paper has explored the underpinning assumptions of each model while comparing and contrasting the assumptions. It has also identified the goals of each therapy as well as the therapeutic relationships. The paper has also compared and contrasted the key techniques utilized in the three models as well as the limitations of each model. Although it is established that each of the three models is distinct from the other in terms of the described concepts, the three theoretical models are critical in psychotherapy.
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