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Counselling Therapeutic Approaches; Advantages and Disadvantages
Counselling has been developed for over 200 years and continues to evolve to adapt to modern societies: people of all ages, gender, sexual status, religion, cultural backgrounds, have all dealt at some point in their lives some psychological and behavioural issues that may be dysfunctional social norms (McLeod, 2009a). Counselling offers a variety of different therapeutic methods to treat, heal and support individuals. Therefore, this essay will be focusing on two theoretical methods that are widely used in counselling today – Person-Centred and Cognitive Behaviour Therapy. Explaining both the practices and key concepts of each approach and gather some evidence to support the use of their therapies. Where there are advantages, there are disadvantages, so the essay will also outline the negative aspects of these approaches before summarising some critical evaluations and recapping the importance’s.
Person-Centred Therapy helps clients become aware of their inner-self and being able to reflect on their problems and recognising their behaviours and identifying new ways to change (Gendlin, 1996; Rogers, 1965; Watson, Greenberg and Lietaer, 1998). It practices not to solve problems or give advice but to shift client’s ways of repetitive thinking with alternative solutions (Watson, 2006). This approach consists of four key concepts: one of the core concepts is self-actualisation (1), this is when an individual becomes self-aware of their own potentials and abilities (Bulut, 2018). By realising their own innate abilities, they can structure their lives to overcome any future obstacles that may attempt to prevent them from making a positive change and allows them to react in a realistic way (Rogers, 1951., Rogers, 1959., Rogers, 1961., Corey, 2015., Dolliver, 1995., Morgan, 2011, cited in Bulut, 2018). The second concept (2) is positive-regard or moreover, unconditional positive-regard, and Carl Rogers believed for clients to acknowledge their potential and abilities they need an unconditional positive regard of warmth or love, to have an acceptance for the client and their values. (Farber and Doolin, 2011). For these two core concept models to successfully work, counsellor’s needs to have a congruence (3), a genuineness and realness within themselves to create a nurturing environment and an understanding of the client’s problems (Motschnig-Pitrik, 2004., Rogers, 1995 cited in Bryan et al., 2015) – to be self-confident, to have self-esteem and self-acceptance, counsellors can then express an empathetic attitude (4) so that clients know they are being heard, understood and accepted as a person (McLeod, 2009b).
To recognise the effectiveness of Person-Centred Therapy, a trial in 2002 over a five year period, 1098 clients had received therapy that strongly suggests it is effective, according to CORE-OM (i.e. a generic measurement) and given the returns of questionnaires with ninety-percent (988) said to have found the therapy useful and sixty-nine per-cent (737) reported that their feelings and emotions were better or far better than they did before receiving Person-Centred Therapy; the results gives evidence that not only does it work for mild to moderate issues (e.g anxiety and depression) but also to those with more moderate to severe mental problems over a longer duration (Gibbard and Hanley, 2008). Other cases of a client experiencing Social Anxiety Disorder (i.e. a fearful condition as a result of other significance) had participated in twenty sessions of PCT, using the form of therapy from Carl Rogers (1951, 1957 cited in Stephen, Elliott and McLeod, 2011). This client was reluctant, but over the course of therapy there was a change in client’s behaviour because of the empathy and acceptance from the therapist had allowed the client to feel safe and have the willingness to engage with the therapists (Stephen, Elliott and McLeod, 2011).
However strong evidence may be, there are disadvantages to this approach. Person-Centred Therapy does not have any specific technique or specific guidelines that are applied that may be useful for every day situations, as the counsellor themselves use their skills to consider what they feel is more appropriate to discuss (Clarke, 1994 cited in Gatongi, 2007), because it is not a goal-oriented approach (O’Hara, 1995; Vitz, 1994 cited in Gatongi, 2007). Another reason this could be at a disadvantage. It is very difficult and seen almost impossible to achieve; to offer total unconditional positive regard to clients (Liestaer,1984; Clarke, 1994 cited in Gatongi, 2007), and if this were possible it could still lead to the client being dysfunctional (Gatongi, 2007), and this dysfunctional behaviour is what makes way for Cognitive Behaviour Therapy, which is more goal-oriented towards a plan of action to produce a change in clients (McLeod, 2009).
Cognitive Behaviour Therapy (CBT) developed by Beck (1970) and Elliss (1962) and other influences, implemented the core concepts that maladaptive cognitions (i.e automatic thoughts such as general beliefs or schemes about the world, the self and what the future holds) are the consequences of emotional distress and behavioural problems: this original model suggest changing cognition will lead to changes in feelings and behaviour (Hofmann, et al., 2012). This model of CBT was to improve clients functioning by highlighting their thoughts, feelings and behaviours – both the therapists and clients work on the phycological disturbances by critically assessing and analysing the components, to promote ways of adapting to those behaviours (King and Boswell, 2019). However, since these early developments, CBT has changed protocols on several specific disorders, continuing its development with new dimensions and contributions from cognitive and behavioural theorists with increased new ways of understanding the role of cognition and emotional processes (Wells, 2009 cited in Wills and Sanders, 2013). The overall goal of CBT is to reduce the symptoms by improving the functioning of clients and exempting the dysfunctional disorders (Hofmann, 2011; Hofmann, Asmundson, & Beck, 2013, cited in Hofmann et al., 2013). During CBT treatment sessions, the therapists establish clearly to the clients what the rationale and goal orientation framework is; this is found to be the primary goal from the start; by working together, allows an open relationship that is positive in therapeutic treatment to achieve the common goals that are agreed between clients and therapists (Wilson, 1999).
To support the use of CBT with evidence, this section will look at anxiety disorders, again, similarities to the cases in Person-Centred Therapy. Anxiety disorder in youths are a very common mental health disorder which usually arises in childhood or early adolescences (Kessler et al., 2005), and if untreated can lead to an array of problems, such as poor levels of functioning in areas of life and increases the significant risk of developing psychopathy (Copeland, Angold, Shanahan, & Costello, 2014; Swan & Kendall, 2016). A study over fifteen randomised trials were conducted for youth anxiety with a variety of settings cultures and ages ranges between the youths – results were successful with 65% no longer meeting the diagnostic criteria for this disorder (Barrett, Dadds, and Rapee, 1996; Ginsburg and Drake, 2002; Hayward et al., 2000; Kendall, 1994; Kendall et al., 1997; Masia, Klein, Storch, and Corda, 2001). Some of the methods used were positive reinforcement – the therapist had praised the child for effort in communicating for responding back to questions being asked. It is this reinforcement that allows children to engage in next tasks with less anxiousness, as they feel more confident through complimentary self-achievements and rewards such as toys, sweets, games, with a list of things the child likes (Kendall, et al., 2005).
The downside to Cognitive Behaviour Therapy is that the sessions are time-limited (typically of five to twenty sessions) with an aim to change client’s automatic negative thoughts over a short period of time – clients are required to self-help once outside of face-to-face sessions, and they are likely to be provided with homework and report weekly on their own behaviours and moods (Beck, 2011). This can be very time-consuming for clients and may lead to a delay in the progress of theopoetic treatment or worse; a dysfunctional healing. Another problem with CBT. To make a long-lasting change in the client’s automatic negative thoughts, both the therapist and clients must challenge these deeper thoughts persistently (Stewart-Sicking, 2013), and doing so might lead to more distress to the clients.
Person-Centred Therapy and Cognitive Behavioural Therapy are both successful each in their own rights – both methods do its best in therepetuic towards clients.
The large number of clients that had received PCT for five years were indeed successful and felt a positive gain from it. ….
The core models of unconditional positive regard and empathetic understanding
Person-Centred Therapy all about the here and now, allowing clients to self-actualise their own problems with the support and a reflection from counsellors with the showing of an empathic understanding of that person, to feel comfortable enough and discuss their current issues. It is like a caregiver in some ways with expressions of an unconditional positive regard yet remaining professional. With a high percentage of evidence that supports the use of PCT. The client suffering from social anxiety, showed difficulties in adapting to sessions, however, with an empathic attitude and accepts from the therapist allowed this client to open up.
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