Personal Theory of Change - Essay Example

PERSONAL THEORY OF CHANGE Emotional growth is a usual progression in an individuals life helping them to psychological grow, and further their understanding of the world and their place in it. However, sometimes life produces difficulties in life that may hinder this natural development, producing problems in their psychological development. Individuals may tend to ignore these problems rather than facing them, either because they are unaware of their existence, they do not know how to resolve the problem, or because it causes them too much pain to think about it. However, if these psychological problems are not worked through effectively, then they can produce distortions in emotions and behavior. This leads to maladaptive thinking, and negative behaviour, which can lead to much more serious problems, such as depression and anxiety. Negative emotions such as fear, sadness and guilt, especially inappropriate guilt are produced by maladaptive thinking and behaviour (Greenburg, 2004a). To solve these problems cognitive change and emotional growth need to occur. Within psychology the theory of change, and of growth has been widely studied, in order to assist people to led a healthy and adaptive life. Shapiro (2005) states that a theory of change refers to the strategies, actions and processes an individual goes through to bring about change in their lives. Theories of change propose that one of the main goals of therapy is help move the client from a maladaptive frame of mind, and to assist growth towards a more adaptive state (Hayes, 1996). The therapist plays a very important role in this process. They offer a secure, safe and supportive space for the client to be able to lower their defences, and spend time effectively trying to change. While supportive, the therapist also helps to enable the client to confront their maladaptive thinking and to try new ways of acting and reacting. In addition, the therapist encourages the client to tackle and process feelings and events they had avoided, and how to access new modes of thoughts, feelings and behaviors (Hayes, 1996). When a client is ready for change this can be a time of extreme vulnerability for them as they move, with the support of the therapist, through a time of transition from maladaptive behaviors and patterns, to a healthier and adaptive way of living. The therapist also moves away from challenging the clients old patterns of behavior to supporting the new patterns of thinking and behavior (Hayes, 1996). Theories of growth, though similar in many ways to theories of change, to go beyond the therapy aiming for the person to carry on growing, even after the therapy has stopped. The aim of theories of growth is that by using the insights they have gained in therapy they will have the ability to cognitively and emotionally manage their lives, from what they have learnt in therapy (Khong, 2006). This new growth can help the person in their relationships with their families, and in society in general, where they will feel more self-assurance, and be able to be more honest with their feelings (Khong, 2006). The main differences between the two theories are that while theory of change focuses on changing people’s behaviour by looking at how they relate in the world and react to certain stimuli, theory of growth is a more personal and introspective. Theories of growth aim for the individual to carry on growing after therapy has finished, however, theory of change tends to try to complete the change in the individuals thinking and behaviour whilst still in therapy. Growth and change theories, though they have these differences, have their similarities as well. Both aim to move the client forward, away from maladaptive thoughts and behaviors, and towards healthier and adaptive thought patterns, making their quality of life much improved. In order for change and growth to occur in therapy, certain factors need to be present. Firstly, the client has to be ready to change, and willing to grow as a person. Changing behaviour is a complex psychological process, and takes a lot of effort and dedication for the client. For the client to be able to effectively move away from their personal and family problems and to understand the problems, its causes and effects, they must firstly be able to admit to the problem in the first place. Denial is not possible if therapy is to be successful. Within an eclectic theory of change, if the therapist firstly helps the client to start to change their cognitive malfunctions, thereby changing their sense of self, by taking the client from the emotional trauma of their problem the client may be able to see the problem more clearly. This helps end denial of the problem that the client may be experiencing (Wakefield, Williams & Patterson, 1996). Maybe the most important factor after this is that the client and therapist are able to work actively together, the experience of acceptance and positive emotional change for the client is a powerful force in their recovery (Greenburg, 2004b). This enables a sense of safety and security that is paramount for an effective change of thinking and growth of emotion. By helping the client to make positive emotional choices, and helping them to strengthen their relationship, the therapist allows for self-healing and positive reconstruction of the self (Greenburg, 2004b). For change to occur therapy must give the client the ability to become who they really are, and not what they think they are. The therapy needs to enable the client to understand how their cognitive beliefs of themselves and their world, affect their reactions to situations and events. Research has shown that the empathy shown by the therapist during therapy is an important part of establishing the change for this balance to occur (Hammond & Nicols, 2008). Three theories which are consistence with these main themes needed to produce change and growth in an individual are; cognitive behavioural theory, emotion focused therapy and structural family therapy. Cognitive behavioral therapy has been shown to be an effective treatment for many disorders, including depression, panic disorders, alcoholism and substance abuse (Wakefield, Williams, Yost & Patterson, 1996). Cognitive behavioural therapy suggests that you can change how you think or change cognitive processing, which in turn will change what you do, or your behavior. Cognitive behavioural therapy is founded through the theory that by changing maladaptive thought patterns and behaviors, the result will have a profound result on an individual’s emotions (Beck, 1975). The first form of cognitive behavioral therapy was formed by Albert Ellis in the early 1950’s. Aron Beck, independent of Ellis, formed another cognitive behavioral approach, that he referred to as cognitive therapy (Kazantzis & Deane, 1998). In recent years, Beck’s approach has been combined with behavioral techniques, to form cognitive behavioral therapies (Wakefield et. al. 1996). This therapy employs an action oriented approach that allows the client to discover, identify and assess their maladaptive behaviour and thinking patterns. When these maladaptive patterns have been recognised, the therapist helps the client to confront these patterns, and then instruct them on how to correct them. Therefore, thinking patterns and behavior grow to become rational and based in reality (Davison & Neale, 2001). Common tools that are used to help this process along are for the client are to write a journal of significant events and the feelings these give the client, along with their behavior and thoughts around these events. The client is also commonly taught relaxation techniques, and distraction methods (Wakefield et. al., 1996). The second theory is emotion-focused therapy which is a structured, short-term therapy, created in the early 1980s by Greenburg and Johnson. It is historical based in client-centred, gestalt and existential theories. Client-centred therapies are from the humanistic paradigm, they are non-directive, do not search for interpretations, and center on the client actualizing their potential. Gestalt therapy is based on the theory that the brain is holistic, but that ‘getting a whole consistent picture and seeing what the structure of the whole requires for the parts’ (Wertheimer, 1959, cited in Gestalt Theory, 2008, p.1). The approach focuses on how a person is responsible for their own response patterns to emotional processes. A large amount of research has assessed that this therapy is very effective. Research has shown that between 70-75% of clients who enter into emotion-focused therapy will go into recovery and that nearly 90% will significantly improve (Johnson, 2008). From the emotion-focused viewpoint disorder can be viewed as breakdown in the ability to be able to calculate the affects of certain emotions, and avoidance of unpleasant ones, along side deficiency in emotion processing, rather than a lack of logical and rational reasoning, cognitive processing, or insight (Greenburg, 2004a). In the emotion-focused approach, therapists are viewed as emotion coaches who enhance the clients’ ability to understand and increase awareness of their emotions, and to make sense of their personal emotional experiences. Emotions signify how a client views themselves, and their place in the world, giving their lives much of their meaning (Greenburg, 2004b). In the therapeutic setting, there are two phases: Arriving and Leaving, as one ‘cannot leave a place until they have arrived’ (Greenburg, 2004b, p.7). The first phase involves four steps that are aimed at emotions. The second phase also involves four steps, focusing on utilizing the emotions or transforming them, to encourage the client to leave the place where they had arrived in the phase (Greenburg, 2004b). Both the therapist and the client work together taking an active role in the participation of the therapy, the experience of acceptance and positive emotional change for the client is powerful force in their recovery. Some of the objectives for the therapy are for greater understanding of personal emotions, acceptance of emotions that do not feel good, to learn how to transform these emotions, and create a better emotional experience (Greenburg, 2004b). In order to be able to obtain these objectives during therapy, the therapist assists the client to grow a greater awareness, and to gain a greater amount of emotional experience so that the processing of emotions is better understood, and alternative emotional responses are taught. Another aim is to produce an environment that is empathetic and accommodating, this affords a place of safety for the client to develop a sense of openness, where they can explore their new emotional experiences in a supportive atmosphere, that in time the therapist hopes will become internalized by the client (Greenburg, 2004b). The theory of structural family therapy suggests that for a family to be balanced, there needs to a positive flow of energy and communication. The therapist plays a very important part in this. Negative alignments and coalitions can be resolved, and the family can achieve flexible boundaries, rearrangement of structures and an appropriate balance of power (Hammond & Nicols, 2008). This part of the theory allows the family to evaluate how the clients ‘symptoms’ are maintained within the families structure, and to move past these unhelpful rigid structures. Minuchin (1974) developed structural family therapy in order to deal with difficulties in the family system, by assessing the relationships between immediate family members, including parents, siblings and children. The aim of the therapist is to understand the maladaptive relationships held within the family, and guide them back to adaptive behaviour patterns (Minuchin & Fishman, 2004). The focus is the structure of the family and the interpersonal relationships in the various subsystems. Identifying the unbalance in these relationships is essential for change to occur. Another important part of the therapy is the role of the therapist, they are central to the therapy, and act as a vehicle for change within the family (Wakefield et. al., 1996). According to Minuchin (1974) a family can be deemed as dysfunctional or functional depending upon their ability to adjust to stressors. This ability to adapt in a positive and healthy way is based on the boundaries they have formed in their subsystems. Boundaries are assessed by the therapist to be either permeable or rigid. The more rigid they are the more likely the family is to be dysfunctional. Another characteristic that is assessed, is the hierarchy of power within the family. Typically, the parental subset should be at the top of the hierarchy. In functional families, the boundaries are transparent, and semi-permeable, with the parents able to act with ability, and compromise between themselves, as how best to raise their children. In regards to the children, the parents allow them enough autonomy for free communication between, parents and children, and sibling communication (Messina, 2008). Dysfunctional families exhibit inappropriate power hierarchies, and mixed subsets. A personal theory of change and growth including these three selected therapies, suggests that this eclectic mix of therapies will be of greater benefit for the client, enabling them a greater success of achieving change and growth. The theory works on the idea that cognitive change and emotional growth and understanding, along side support and motivation from an empathetic and compassionate therapist and the involvement of the client’s partner and immediate family members, will create an environment where the client can heal, and move past their problems or difficulties. It is an integration of the principles of cognitive behavioural therapy, emotion focused therapy, and structural family therapy Therefore, the therapy within this eclectic theory of change can help to restore the balance within this family with a three-step process. The first of the therapy sessions would be used to access and identify the problems which the client has. These would be used to help the client to start understanding why they have maladaptive behaviors, and to implement cognitive behavioural strategies to reduce stress and to manage stressful situations differently, in a positive way, such as deep breathing techniques and positive cognitive reinforcement (Wakefield et al, 1996). Once the client has learnt how to understand the internal cues that cause their difficulties the therapy can move to step two. The first step, with its cognitive behavioural principles will have addressed the maladaptive behavior and the steps they can take to stop change their behavior and thinking patterns, grow emotionally and to have the skills to resolve stressful situations in a positive way. The next session, would bring in the whole family and to observe and assess family interactions and the balance of power, through the application of emotion focused therapy. The sessions in step two will involve the husband in the therapy as well. This part of the therapy concentrates on their emotional interaction, and their ability to adapt to the world around them. The therapist will help the clients to understand and increase awareness of their emotions, and to make sense of their personal emotional experiences, giving their lives together a greater meaning and understanding (Greenburg, 2004b). Step two with its focus on emotional interaction between the couple will help them to recognize the unhealthy emotional state of co-dependency and re-address the issues, by supporting and interacting together in a positive and healthy way. Now that the wife and husband have started to re-think their cognitive beliefs about each other and their relationship, and they will have started the process of re-addressing their emotional interaction, certain problems, initially identified by the therapist, the couple will be in the process of being resolved. The last step will be to bring in the children. The essence of this last step is in structural family therapy. By addressing the unhealthy coalitions and balances of power that have developed between the mother and father, and the children, the balance of the family can be reinstated. Without this last step to include the children the family would not be able to free itself from the destabilizing effect of the primary clients problems and the resulting problems and power disruptions it caused between the family members. This has to be readdressed for the parent’s power within the hierarchy of the family to be reinstated, and for a true balance within the family to be formed. In step three, which encompasses the children of the couple (if any) or indeed any significant family members, would further enhance the well being of the family and insure a greater likelihood of success for the family and the client to move forward into positive relationships. It endeavors to anchor the new positive cognitions, and a greater understanding of emotions and their role in interpersonal relationships, within the family system. Greenburg (2004a, p.1) believes that the problems involved in using a cognitive therapy is that it reduces human ‘complexity’, as it tries to get people to bring their maladaptive behavior and emotions to rationally conclusions, and that this is not always possible. Therefore, emotions should be looked at as an ‘independent variable’ which ‘interacts and influences cognition and behavior (Greenburg, 2004a, p.1). In combining these aspects with cognitive behavioural therapy, the client will learn how to identify their emotions, also how to apply them with some rationality to the environment. Together the two approaches will assist in improving emotional responses, and in altering cognitive processes, to improve the clients’ ability change their maladaptive behavior, to an adaptive one. By adding structural family therapy at the end of the therapy sessions the work that has been completed in the first two steps can be further reinforced throughout the whole family structure. For the theory of change to be effective in its therapy, an eclectic theory has been advocated. For a person to move from a state of negative thinking, dysfunctional relationships, addictions and anxiety troubles, change and growth on a positive level need to be implemented by therapy. A person cannot change their lives for the better without emotional growth. This theory of change advocates a three-step therapy program. It starts with the individual undergoing cognitive therapy treatment sessions to start the initial change. The second step moves to integrating emotion focused therapy with the client’s significant other. This enables the couple to change the way they relate to one another, to identify unhealthy emotions, and to learn how to grow positively and emotionally within their relationship. The last step integrates structural family therapy, and adds the rest of the family into the therapy sessions. This completes the therapy, and the value is to have the balance of the whole family readdressed. Issues of power and negative coalitions are rebalanced, and the family all benefit from positive and healthy interactions and emotions. For the theory of change to be effective and long-term recovery obtained, it is vital that the whole family are positively changed by this therapy. REFERENCES: Beck, A. T. (1975) Cognitive Therapy and the Emotional Disorders. International Universities Press Inc. Davison, G. C. & Neale J. M. (2001) Abnormal Psychology (8th ed.). John Wiley & Sons, Inc. Family Therapy (Messina), (2008). Retrived 11 August from hppt://www.coping.org/write/c6444/ Family%20Therapy.ppt Gestalt Theory (Wertheimer), (2008). Retrieved 15 April 2008 from http://tip.psychology.org/wertheimer.html Greenburg, L. S. (2004a). Introduction emotion special issue. Clinical Psychology and Psychotherapy, 11, 1-2. Retrieved 15 April 2008 from http://www.emotionfocusedtherapy.org/Greenburg Greenburg, L. S. (2004b). Emotion-focused therapy. Clinical Psychology and Psychotherapy, 11, 3-16. Retrieved 15 April 2008 from http://www.emotionfocusedtherapy.org/Greenburg Hammond, R. T. & Nicols, M. P. (2008). How collaborative is structural family therapy? The Family Journal, 16(2), 118-124. Hayes, A. M., (1996).Dynamic Systems Theory as A Paradigm for Studying The Process of Change in Psychotherapy for Depression.Constructivism in the Human Sciences. Retrieved 10 August 2008 from http://www.highbeam.com/doc/IP3- 1333443861.htm Johnson, S. (2008) What is EFT? (2008. Retrieved 15 April 2008 from the International Center for Excellence in Emotionally Focused Therapy website: http://www.eft.ca/ whatis.htm Kazantzis, N., & Deane, F. P. (1998). Theoretical orientations of New Zealand psychologists: An international comparison. Journal of Psychotherapy Integration, 8, 97-113. Khong, B. S. L., (2006). Personal Growth in and Beyond Therapy1. Constructivism in the Human Sciences. Retrieved 10 August from http://highbeam.com/Search.aspx?q+personal+growth+psychologypublication Minuchin, S. (1974). Families and Family Therapy. Harvard University Press. Minuchin, S. & Fishman, H. C. (2004). Family Therapy Techniques. Harvard University Press. Shapiro, I. (2005). Theories of change. Beyond intractability. In (Eds.)Burgess, G. & Burgess, H. Conflict Research Consortium, Univrsity of Colorado, Boulder. Retrived 10 August 2008 from http://www.beyondintractability.org/essay/theories_of_change/. Wakefield, P. J., Williams, R. E., Yost, E. B & Patterson, K. M. (1996). Couple therapy for alcoholism: A cognitive-behavioral treatment manual. New York: Guilford Press. Read More