Behavioural Approaches

This essay is written to compare the counselling relationship in person-centred and cognitive-behavioural counselling by outlining both the theory and practice of the counselling relationship. This will be done by outlining the theory of the counselling relationships and the theory in practice. Both person-centred and cognitive-behavioural counselling are widely recognised, successful treatments. There are however many significant differences between the two. Cognitive-behavioural therapy is based on scientific study taking two therapies, cognitive therapy and behavioural therapy, and combining the two.

Behavioural therapy is based on the fact that people can learn behaviours through classical conditioning, which was first recorded by Ivan Pavlov at the end of the nineteenth century, and operant conditioning (Skinner, 1953. ) Therapists believed what the behavioural therapists were helping their clients to do, such as encouraging self- assertion and self-understanding to help develop new approaches to dealing with life, incorporate a wide range of cognitive processes including decision-making and problem-solving.

Beck (1976) founded cognitive-behavioural therapy after becoming disillusioned by psychoanalytic methods. (McLeod J. 2008) Person-centred counselling is a non-scientific therapy developed by Carl Rogers in the 1940s and 1950s. It is a humanistic approach where it is believed that the client needs to feel valued and understood for them to be able to develop a self-awareness so they are able to deal with any difficult situation they feel they are in, giving them the power to change their own lives.

Person-centred therapy is non-direct approach where the therapist and client develop an equal friendship to develop trust between the two, creating a safe therapeutic environment which enables the client to figure out what makes them the way they are. When the client begins to trust their feelings and become emotionally confident they can begin to find the answers to their own problems within themselves. For this to happen a core conditions model is in place. Without these conditions this type of therapy would not be effective (Rogers, C. 1957. ) Therapist-Client Psychological Contact.

A relationship which two people have impact on each other and the therapist needs to be engaged by the client. Client incongruence, or Vulnerability- The client needs to be in a state of incongruence, feel that their real self is not how they would ideally like be. The client is also vulnerable to anxiousness which means they will be motivated stay in the relationship. (McLeod, J. 2008) Therapist Congruence or Genuineness- The therapist needs to be congruent within the therapeutic relationship- needs to be genuine in dealing with the client and use their own experience to enable the relationship.

Unconditional Positive Regard- The therapist needs to have unconditional positive regard for the client. Acceptance, empathy and genuineness without judgement, is needed for the client to feel a higher sense of self-regard so they can realise that their self-worth was distorted by others. The therapist needs to accept the client for who they are now, not what they could become. Empathetic understanding- accurate empathy on behalf of the therapist can help the client believe that the therapist has unconditional love for them.

Client Perception- If the therapist communicates to the client their unconditional regard and empathetic understanding to at least a minimal degree this is effective. In contrast cognitive-behavioural therapy is a direct approach where clients are taught how to think and behave in ways in which enables them to obtain their goals. They are not told what it is they want, but instead how to achieve the goals they may have this develops a student (client) and teacher (therapist) relationship. In order for this to be successful, intervention techniques are used to ensure that the goals agreed with the client is met.

(Haaga and Davison1986, Meichenbaum 1986) These include; Systematic desensitization- a relaxation technique is taught to help the client to overcome anxiety to enable them to extinguish their phobias. Once this has been learnt the client must use this to enable them to overcome these by using a fear hierarchy. Homework assignments- practicing techniques learnt in therapy between sessions. Experimenting with different self- statements in everyday situations. Thought stopping- instead of letting anxious thought take over the client learns to use something to interrupt these thoughts such as flicking a rubber band on their wrist.

Challenging irrational beliefs- the therapist tries to identify the clients’ irrational beliefs that are causing issues in their life and challenges it so that the client develops a less extreme way they view the problem. Reframing the issues – getting the client to perceive a certain emotion as something different. An example of this is perceiving fear as excitement. In vivo exposure- going into highly fearful situations with the therapist whilst they are talking through cognitive-behavioural techniques to help you deal with the situation.

Scaling feelings- placing present feeling of anxiety and rating them on a scale off 0-100 is an example of this. Rehearsing different self-statements in role-play in therapy sessions. Assertiveness or social skills training. Although a therapeutic relationship is important in both practices, cognitive -behavioural therapists believe this is not sufficient enough alone to help clients work through their problems, and while many therapists have different styles the main cognitive behavioural therapy programme have an outlined structure in place.

(Kuehnel and Liberman 1986; Freeman and Simon 1989,) which is the main focus. Cognitive-Behavioural Therapy is more client action orientated to produce a change in the way they think which then will lead to a change in the way the client will behave. However in Person-centred therapy a therapeutic process is put in place as a series of stages. These stages help promote a therapeutic change in the client or a “process of greater openness to experience” (McLeod, J. 2008. ) (Rogers, C. 1951) considered the management of therapeutic growth as including the awareness of the clients of any experiences they have been denied.

They stop seeing the world in a generalised view and begin to see it differently. This enables them to rely on their personal experience to create their own set of values. These personal developments lead to a “reorganization of self” (Rogers, C. 1951) and is vital to develop new behaviours. In conclusion although both approaches to counselling realise that a counselling relationship is important, person-centred therapists believe that the counselling experience and effectiveness of the therapy is determined solely on that of the relationship.

Cognitive-behavioural therapists find, through past experiments other techniques, such as systematic desensitization and behavioural self-control, are equally important to the success of the therapy. (Word count 1072) Throughout the writing of my essay I have changed my mind as to which counselling practice I prefer. I can see the advantages of each therapy. People need a structured outline to enable an understanding of their thoughts and behaviours and how they affect what they do. On the other hand I believe everyone has a desire to feel cared for and accepted.

Person-centre therapy approach does just this, enabling the client accept themselves. From the moment we‘re born we live in a structured world whether you are a baby and have a feeding routine to an adult with a job. We need structure and routine to know what our purpose is. In cognitive-behavioural therapy the client needs structure to change problematic thoughts and behaviours. No matter how much we, as human beings, talk over certain issues it doesn’t always help us overcome our problems.

It can help us understand them clearly but doesn’t necessarily assist with changing thought patterns to deal with difficult situations, however does change the way the client understands problems therefore enabling to look at them from different perspectives. Feeling valued and opening up to a therapist may not be sufficient enough to promote any change. During my teenage years I attended to a few sessions with a therapist because of anger issues. In these sessions I was taught how to control my temper when I felt myself getting angry. Previously to this I had conversations with a teacher to ‘counsel’ me about my anger issues.

I found this less effective. Therefore I conclude that, I feel that cognitive-behavioural therapy is a generally more effective treatment based on the counselling relationship. Word count 275 References McLeod, J. (2008) Introduction to counselling (Ed. D. Langdridge), Maidenhead/Milton Keynes. Open University Press/ The Open University.

Skinner, B. F. (1953) Science and Human Behaviour, New York, NY, Plenum. Rogers, C. R. (1957) ‘The necessary and sufficient conditions of therapeutic change’, Journal of consulting Psychology, 21, pp. 95-103 Haaga, D. A. and Davison, G. C. (1986) ‘Cognitive change methods’ in Kanfer, A. and Goldstein, A. (eds) (1986) Meichenbaum, D. (1986) ‘Cognitive-behaviour modification’ in Kanfer, A. and Goldstein, A. (eds) Helping people change (3rd edn), New York, NY, Pergamon. Kuehnel, J. and Liberman, P. (1986) ‘Behaviour modification’ in Kutush, I and Wolf, A. (eds) A Psychotherapist’s Casebook, San Francisco, CA, Jossey-Bass. Freeman, A. , and Simon, K. M. , Beutler, L. E. and Arkowitz, H. (eds) (1989) Comprehensive Handbook of Cognitive Therapy, New York, NY, Plenum Press.

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