Dissection Of Cognitive Behavior Therapy & Solution-Focused Brie Therapy As Effective Counseling Approaches - Essay Example

Dissection of Cognitive Behavior Therapy & Solution-Focused Brief Therapy as Effective Counseling Approaches More and more people are turning to counseling in dealing with their everyday troubles. In the past, going to a therapist or counselor gives one a negative impression of weakness, or being psychologically incapable of withstanding conflicts. However, current trends show that coming to counseling or therapy sessions means that individuals are being more aware of their options in caring for their emotional and psychological health. A lot of counseling approaches have been conceived. This paper attempts to discuss, compare and contrast two approaches that have been gaining popularity as effective counseling methods namely Cognitive Behavior Therapy and the Solution-Focused Brief Therapy. Clients suffering from psychological problems are assumed to focus more on their flaws that pull them down than on their potentials that may spur them up to success. Aaron Beck, founder of Cognitive Behavior Therapy (CBT) agrees that much of our psychological problems are caused by “cognitive distortions” due to our acknowledged human fallibility. “In depressed people, these belief systems, or assumptions, develop from negative early experiences such as the loss of a parent, rejection from peers, an unrelenting succession of tragedies, criticism from teachers, parents or peers, or even the depressed behavior of a parent. These negative experiences lead to the development of dysfunctional beliefs about the world, which are triggered by critical incidents in the future” (Field, 2000). Beck (1987) came up with the concept of “negative cognitive triad” that describes the pattern that triggers depression. In the first component of the triad, the client exhibits a negative view of himself. He is convinced that he is to blame for whatever pathetic state he is currently in because of his personal inadequacies. Secondly, the client shows negative view of the world, hence, a tendency to interpret experiences in a negative manner. He nurtures a subjective feeling of not able to cope with the demands of the environment. Third and lastly, the client projects a gloomy vision of the future. He can only anticipate failure in the future. Beck (1975) developed a model to treat depression. He writes that, in the broadest sense, “cognitive therapy consists of all of the approaches that alleviate psychological distress through the medium of correcting faulty conceptions and self-signals” (p. 214) Specifically, it goes to the root of depressive self-schemata. “Depressive self-schemata have been defined as maladaptive cognitive structures, consisting of networks of information about the self, formed through developmental processes and social learning experiences, that negatively bias information processing and emotional and behavioral responding” (Beck, 1987; Brewer & Nakamura, 1984; Derry & Kuiper, 1981; Kovacs & Beck, 1978; Segal, 1988 as mentioned in Pace and Dixon, 1993, p.288). Once the negative schema is activated this leads to a stream of what Beck called negative automatic thoughts (NATs). Eventually, the person will have no voluntary control over such thoughts. These negative thoughts then become accepted as true, leading to other negative thoughts. It is this negative stream of consciousness that leads to depressive symptoms (Field, 2000). These distorted automatic thoughts, maladaptive assumptions and negative schemas. are what need to be corrected in the perspective of the client with the help of the therapist. From the name itself, Solution-Focused Brief Therapy (SFBT) would easily attract prospective clients who seek solutions to their woes in abbreviated time. It was developed by Steve de Shazar, Insoo Kim Berg and colleagues at the Brief Family Therapy Centre in Milwaukee in the 1980s. These proponents’ work with their counselees and their interest in brevity in therapy made them realize that people were most often inherently capable and resourceful in ‘doing more of what works’ and discussing how they cope with challenges and exceptions to the problem help them go on with their daily lives (Freeman, 2007). Freeman (2007) defines SFBT’s core principles as “a shift of expertise toward the client (who must be recognised as the expert not only in themselves but also in their resources and ambitions)” and “exploring ways in which the client can do more of what works and stop or reduce doing things which do not.” (p. 32). This humanistic view offers much respect to the client and empowers him to recognize his capabilities, which he might seem to have forgotten due to his immersion in his negativity. The therapist’s role is to help him find alternative ways that work for him based on his capabilities, resources and ambitions. The fact that SFBT is results-oriented and time-limited makes it attractive to weary souls who need a boost. The therapist upholds a “get right to the core” and “cut to the chase” attitude and balances it with understanding and consideration. More sensitive and fragile clients may take a longer while to adjust to the no-nonsense techniques, but they will appreciate the processes aimed by the SFBT strategies for clients to undergo. The key concepts of both CBT and SFBT have many similarities. One is to help individuals focus more on their abilities than their inadequacies. It points out to clients that they are not doomed to fail, and that it is in their hands how to turn negative things into positive and more fulfilling ones. Both are very empowering to the clients and work towards their independence from the therapist with confidence that they can manage conflicts on their own. Both Cognitive Behavior Therapy and Solution-Focused Brief Therapy implement strategies in counseling sessions that make clients look into themselves for more awareness and correct whatever faulty reactions or thinking they have of external stimulation. The goal of therapy is to help the client realize that reorganizing the way they view situations will call for a corresponding reorganization in behavior. In CBT therapy, clients are taught Thought Catching or the process of recognizing, observing and monitoring their own thoughts and assumptions and catch themselves especially their negative automatic thoughts when they dwell on it. Once they are aware of how their negativity affects them, they are trained to check if these automatic thoughts are valid by examining and weighing the evidence for and against them. The therapist uses a variety of therapeutic strategies depending on what he decides will work on his particular client. He also delegates responsibility to his client by expecting him to do homework outside the therapy sessions. Homework or Task Assignment is aimed at positive behavior that brings about emotional and attitudinal change (Corey, 2005). Therapists also engage in Socratic dialogues with the clients, throwing questions that encourage introspection with the goal of the client arriving at his own conclusions. Reality Testing lets the client do tasks to disprove negative beliefs such as phoning a friend to disprove the belief that no one wants to speak to him. (Field, 2000) Therapy for depressed clients focuses on their specific problem areas and involves doing activities to deeply process the problem and probable solutions. This can result not only in a client feeling better but also behaving in more effective ways. Clients feel overwhelmed with all their responsibilities and their inability to attend to all the details of their lives lead them to be depressed. The therapist usually needs to take the lead in helping clients make a list of their responsibilities, set priorities and develop a realistic plan of action. “Because carrying out such a plan is often inhibited by self-defeating thoughts, it is well for therapists to use Cognitive Rehearsal techniques in both identifying and changing negative thoughts. If clients can learn to combat their self-doubts in the therapy session, they may be able to apply their newly acquired cognitive and behavioral skills in real-life situations.” (Corey, 2005, p.291) Another technique in Cognitive Behaviour Therapy is Alternative Therapy. It focuses on coping options. Clients are encouraged to generate a number of alternative solutions or courses of action to given situations which might render them helpless. This brainstorming welcomes even ridiculous or counter-productive ideas, as the benefits and costs of each alternative is discussed anyway. This exercise makes the clients realize that they can be in control of situations after all. (Field, 2000) Finally, in Dealing with Underlying Fears and Beliefs, the therapist makes the client go to the core and origin of such beliefs and discuss the vulnerability factors that exist with it. These beliefs are then challenged again using tasks (Field, 2000). SFBT has likewise been known for a number of strategies that have been adopted by other brief therapists. Some of them parallel CBT’s techniques. These are succinctly described as follows: The Miracle question is a hypothetical scenario posted by the therapist to the client to imagine what he thinks will happen if a miracle happened to wipe away his problem as he sleeps at night. What does he expect to notice in the morning when he wakes up? “This introduction is followed by an exercise in respectful curiosity where as much detail as possible is gained about the day after the miracle.” (Freeman, 2007, p. 34) It would help the client focus on a preferred situation and consider what parts of the miracle are already happening. Scaling questions are asked of the client to rate himself as to where he is on a scale of 1 to 10 in terms of his problem situation and what steps can he take in order to bring himself up to the next levels. This helps the client set his own achievable goals which may not be perfect or ideal, but acceptable at that particular point in time. Problem-free Talk is part of the session where time is spent discussing about issues other than the client’s problem. This helps both therapist and client identify client’s resources, strengths and interests that may be useful in helping him overcome his problem (Smith, 2005). Preferred Future is how a client describes a future free of his problem at hand, or at least, more manageable to allow him to enjoy life. It focuses on the positive outcomes instead of the absence of a negative situation. Client’s preferred future is described in concrete (visual and auditory) details to help both client and therapist focus their attention on observable behavior and other factors that could be changed as part of a solution strategy. (Smith, 2005) In Exception Seeking both therapist and client work together to investigate occasions in the client’s past when the problem was still non-existent. This exercise helps “identify the factors that impact upon the presence or severity of the problem including pre-existing client-strategies for dealing with the problem, so that these can be employed as part of the intervention” (Smith, 2005, p. 103) The techniques of both CBT and SFBT involve the clients in introspecting about the sources of their emotional upheavals and thinking of ways to manage them appropriately. For many, visualization is used, and reacted on even before it truly happens, such as in the techniques of Cognitive Rehearsal, Alternative Therapy and Dealing with Underlying Fears and Beliefs for CBT and Miracle Question and Preferred Future for SFBT. When people get used to their visualizations, they can find ways to translate these into realities. After undergoing intensive therapy, relapse prevention is essential. For example, in CBT, all throughout treatment, clients are encouraged to integrate the techniques they have learned in therapy in their daily lives with the goal of keeping CBT effective even when therapy ends (Roth, Eng and Heimberg, 2002). However, clients are also warned that they might still encounter difficult times in the future even after successful treatment but their newly acquired skills at dispelling negative thoughts and reactions must be at their disposal to use whenever they would need them and maintain the belief that a single difficult event is not a failure on their part. “An important goal of therapy should be to ensure that clients can apply cognitive and behavioral techniques on their own, with less reliance on the therapist over time, thus facilitating relapse prevention efforts.” (Roth, Eng and Heimberg, 2002, p. 453). The same also goes for SFBT. SFBT theory does not emphasize the need to understand the original cause of the problem in order to solve it. More time is spent in focusing on the present and future circumstances rather than the past, and on the client’s strengths and resources rather than the problem. It is what makes it stand out from other therapeutic approaches. Such discussions provide the advantage of helping the therapist form better rapport with the client which otherwise may be difficult to establish considering the problematic situation. (Smith, 2005). Giving the client control as to the brevity of the treatment is likewise effective, as most clients aim to get better sooner than later so they are motivated to be cooperative with the therapists’ strategies. Solution Focused Brief Therapy strategies, proven to elicit responses contributory to the client’s realizations of his own realistic preferences are filled with pearls of wisdom in human thinking and behavior. Each strategy was well-thought through, and creates in the client a sense of ownership and accountability. The therapist’s role is to shake the client to introspect and come up with his own solutions to his problem. However, once the client is discharged from therapy, he is not totally let go, as he is free to consult his therapist for follow-up or plain reporting of how he is progressing so far. SFBT may be likened to Cognitive Behavioral therapy in the sense that a client’s thinking and behavior is modified from negative to positive. Goal-setting is essential to the therapeutic process, and the client is assisted by an understanding therapist who keeps him grounded on his own reality. Personally, I am impressed with the key concepts and counseling techniques of both approaches. I do believe in the precept of what you believe tends to happen in reality – like a self-fulfilling prophecy. If one is negative in his thinking, what usually happens is that he encounters negativity in most things… sort of following Murphy’s law which states that if you think something bad will happen, it will. On the other hand, if one keeps a positive outlook, good things usually happen to that person or if a negative thing happens, that person still finds something positive in it. One’s disposition truly affects his thinking and behavior. Both CBT and SFBT focus on helping clients turn inwards and develop such positivity for a more fulfilling, more harmonious, less stressful life. CBT and SFBT are bound to help more and more people see the light in their darkened perceptions and bleak future. In doing so, CBT and SFBT may contribute much to a better and brighter world ahead. References Beck, A.T. (1975) Depresseion: Cause & Treatment. Philadelphia: University of Pennsylvania, Press. Beck, A. T. (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy: An International Quarterly, 1, 5-57. Brewer, W. F., & Nakamura, G. V. (1984). The nature and function of schemas. In R. S. Wyer, Jr., & T. K. Srull (Eds.), Handbook of social cognition (Vol. 1, pp. 119-160). Hillsdale, NJ: Erlbaum. Corey, G. (2005) Theory and Practice of Counseling and Psychotherapy, 7th ed. Brooks/Cole, a division of Thomson Learning Inc. Derry, P. A.. & Kuiper, N. A. (1981). Schematic processing and self-reference in clinical depression. Journal of Abnormal Psychology, 90, 286-297. Field, A. (2000) Cognitive Therapy, retrieved on November 15, 2008 from http://www.sussex.ac.uk/Users/andyf/depression.pdf Freeman, S. (2007) “A focused solution to therapy” Primary Heath Care, Vol. 17, No 7 (September 2007) Kovacs, M., & Beck, A. T. (1978). Maladaptive cognitive structures In depression. American Journal of Psychiatry, 135, 525-533. Pace, T.M. & Dixon, D.N. (1993) “Changes in Depressive Self-Schemata and Depressive Symptoms Following Cognitive Therapy”, Journal of Counseling Psychology, Vol. 40 No. 3, 288-294 Roth, D.A., Eng, W. & Heimberg, R.G., (2002) Cognitive Behavior Therapy, Encyclopedia of Psychotherapy Vol. 1 Elsevier Science (USA). Segal, Z. V. (1988). Appraisal of the self-schema construct in cognitive models of depression. Psychological Bulletin, 103 147-162. Smith, I.C.(2005) “Solution-focused brief therapy with people with learning disabilities: a case study” British Journal of Learning Disabilities, 33, 102–105 Read More