Introduction
Cognitive approach entails seeking knowledge on a specific subject in order to gain understanding. The approach involves dispelling ignorance and embracing factual information on the subject of study. According to Edwards (1990) after an individual gains understanding on his subject he or she becomes enlightened. Most approaches to therapy incorporate the concept of cognitive transformation either explicitly or implicitly.
Cognitive approach is used to foster the way the clients or patients come up with new perspective of their problems. The humanistic approach in behavior therapy focuses mainly on the desire to comprehend conscious experience and the desire to understand one’s self. However, this theory is difficult to study since measuring the core elements of the theory such as self-actualization is hard (Cain and Seaman, 2002).
Cognitive Behavioral Approach
Cognitive- behavioral therapy operates on the assumption that people enjoy freedom, contentment and self-respect. However, these qualities are not inherent in a person but they arise from the external prevailing conditions of an individual. Therefore, from this we can derive that maladaptive behavior occurs due to irrational thinking or distortion in the manner of an individual perceives his or her environment.
With this in mind, it is possible to analyze the study at hand. Sophie lives with her mum but she is unhappy they do not get along. Her unhappiness stems from the fact that she blames her mother for her father leaving. This presents the first instance of distorted perception of the surrounding. Moreover, her thoughts that her mother is the major cause of her father leaving are irrational.
These irrational thought have led to maladaptive behaviors. Sophie shows a general sense of despair. Moreover, she has eating disorders and she is involved in extreme gym activities.
Sophie is significantly underweight. Sophie’s case is a classic case of an individual whose character has been distorted by the external prevailing conditions. Her manner of thinking is distorted to conform to the feeling that she derives from the external environment.
In cognitive behavioral therapy, the therapists try to conceptualize the general behaviors exhibited by the patient. From the general behaviors, the therapist can derive the distortion in character, symptoms, and disorders out of the norm. The norm character is the habitual character that a patient exhibits when he or she is free and contented with one’s life (Ivey et al., 2007).
To discover the norm behavior of patient, therapists analyzes the patient’s general characteristic to uncover the underlying rules and values of a patient that makes them susceptible to depression anger or anxiety.
In the case of Sophie, the therapist has to analyze her character to gain knowledge on what her normal character is and what rules and values distorts her character.
From the explanation given from the case study, it is evident that the matter that distorts Sophie’s character is the fact that her father left and she blames her mother. The rules that and values that makes the predisposed to depression include wanting to be like everyone else, she wants her life to be perfect, and moreover, she wants the approval of others to feel complete/ gain self-confidence.
Sophie feels that she is not like everyone else since her dad left. She feels that the world is judging her. Therefore, she has this inherent need to be perfect. She refuses to eat and overindulges in gym activities to satisfy her need to be perfect. From her behavior, it is clear that Sophie wants her family to be completely again. Sophie’s cognitive schemata are aligned to beliefs rather than reality.
In this case, it is important to recognize that Sophie has her own idiosyncratic values. Therapists are allowed to speculate on the conditions of the patient to a given extend. However, in order to administer treatment to Sophie, she must undertake a series of questioning session to determine her assumptions.
In addition to this, Sophie’s automatic thoughts must be analyzed to come up with a comprehensive means of treat her condition. Automatic thoughts are those thoughts that an individual generates consciously and spontaneously. These thoughts are generally associated with negative effects to the individual. The thoughts can be categorized into according to their typical bias.
For example assuming what someone else’s thoughts can be categorized as mind reading by therapists. In this situation, one creates a negative thought before the other person actually has thought. For example, “that person is not going to like me” is an automatic thought.
The best way to describe an automatic thought is to view it as a bias that one expresses towards another. In Sophie’s case the automatic thought that has developed in her mind is that her mother is the one to blame for her father’s departure.
Using cognitive theory it is possible to establish a relationship among a patient’s schema, automatic thought, and assumption. For example, Sophie feels that she is unloved. Therefore, she assumes that if she impresses people they might end up liking her. She goes ahead and gets involved in activities that she thinks will make people like her like gym workouts.
The automatic thought in this case maybe that people would not like her because of her situation. Establishing a relation between the schema, automatic thought and assumption makes it easier to reach the core of a problem. It is one of the core methods employed to solve a problem psychological problem.
Using cognitive approach to assist Sophie
In order to assist Sophie using the cognitive approach all the elements that play part in building her character. The first step into assisting the patient would involve articulation of the patient’s personal opinion.
After this step, therapists may use various methods to solve the situation at hand. As a therapist, the major task would be to make sure that the patient experiences all the possible experiments so that they can integrate into the system without denial or selection.
Beck and Emery (1985) came up with basic cognitive-behavior therapy principles designed to support the process of exposing the patient to different experiments. There are three basic principles: guided discovery, collaborative empiricism and Socratic questioning.
Under collaborative empiricism, the patient and the therapists work together as a team. In this method the therapist does not take driving seat in the therapy sessions instead they facilitate the patients healing by making them aware of the reality through testing the testing the reality against the experience of the patient.
In the case of Sophie, she can be exposed to several experiments in order to show her the difference between reality and her personal experience. Sophie can be exposed to other kids who have single parents to show her that she is not alone in the. As she interacts with the different people in similar or different conditions.Sophie will be able to differentiate her personal experience and that in the real world.
Another way of assisting the patient would be through use of Socratic questioning. Therapist use Socratic questioning to sow a seed of doubt in the patient’s mind. This principle is designed to bring the patient’s attention to information of other experiences in a non-selective way. The therapists also have the task of confronting the patients with absurdities or cognitive avoidances.
The use of this method on Sophie is also a possible means of helping the patient to face her problems. By a sowing a seed o doubt in the mind of the 17 year old it is possible to make her change her mind.. A good seed of doubt would be a question like: what if it is not your mother’s fault that your dad left?
This question would set the seed of doubt in the mind of Sophie. She would start to ask herself other questions that will finally enable her reach the solutions to her problems.
Cognitive therapy has always been equated with verbal and the process of logical thinking (Ivey et al., 2007). Cognitive therapy therefore understands the process of change in an individual behavior is a series of steps that moves the patient from one-step to another. Therapists therefore use various steps that would finally lead to the final step where the patient is cured.
The first step in cognitive behavior therapy is allowing the patient to accept that he or she has a problem. This step is followed by a step designed to help the patient to identify his or her problems. This stage is recognized as the functional patient analysis.
The importance of this step is to ensure that the patient recognizes how the thoughts and feelings lead to maladaptive character. The steps in cognitive behavior present a trip to self-discovery that allows the patient to sieve the facts from the fiction/ assumption.
The second stage of cognitive behavior therapy is aimed at analyzing the exhibited behaviors. A patient usually exhibits behaviors that contribute to the problem. In this stage, the patient is taught how to adopt new behaviors. It should however be noted that the processes involved in cognitive behavior therapy are gradual and change is not expected to be viewed immediately.
Taking the procedure above it is easy to incorporate it into the case study in order assist Sophie. The first step would be to let he girl understand that she has a problem. However, in this case the step can be skipped since she initiated counseling on her own.
Therefore, the next step would be the functional analysis. This stage would assist Sophie to understand her problems such as eating disorders and excessive gym workouts. The important fact about this step is that it will provide the Sophie with the opportunity to connect the feelings she has against her family set up and the behaviors she exhibits.
After making this connection, the next step would be to analyze the behaviors that Sophie exhibits. Having known the reason for these behaviors, this step would involve taking a look at the behaviors individually and determining whether they are desirable or not. The therapist can do this by asking Socratic questions.
A good example of a question in Sophie’s case would be: do you think you are being fair to your mum by laying all the blame of your dad leaving on her? These questions are usually designed to sow a seed of doubt and create a chain of reaction that would finally lead to the patient unraveling the truth.
This process starts with a question but for it to come to fruition the patient must exorcise her demons. After finally confronting the problem, it becomes easier for the patient deal with the problem or let go of it.
Humanistic perspective approach
The humanistic approach in behavior therapy focuses mainly on the desire to comprehend conscious experience and the desire to understand one’s self. However, this theory is difficult to study since measuring the core elements of the theory such as self-actualization is hard (Cain and Seaman, 2002).
The theory of existential-Humanistic perspective was created as a reaction against the cognitive behavior approach and psychoanalysis. Humanistic psychology focuses on the potential of each patient to grow and attain self-actualization. Therapists practicing using the humanistic approach assume that the humans are innately good and therefore a change in character occurs due to a change in their normal routine.
Carl Rodgers coined the humanistic approach in the 20th century (Sammons, n.d.). He believed that people might fulfill their potential if they had a positive regard towards other people (Sammons, n.d.). Rodgers however realized that people do not see the positive regards of their fellow beings as unconditional.
Rodgers laid this ground for humanistic therapy approach and the concept was advanced further by therapists. Currently therapists using the humanistic approach prefer using qualitative methods that Rodgers proposed.
To be able to reach the patient the therapists use unstructured interviewing in order access the patients views ideas and opinions. In case the therapists use observation then the patient’s observations are the ones that are considered. The therapist on the other hand has to observe the patient in order to determine how he or she perceives his or her surroundings.
The methods mentioned above can be used to analyze the case study. The therapist can use unstructured interviewing to determine the views and opinion that Sophie has regarding her surroundings.
Opinions on why she blames her mother, why she thinks she has eating disorders and the reason she involves in excessive gym behavior should be considered in order to assist Sophie in dealing with her problems. A humanistic approach would assist Sophie to accept that her condition is normal and therefore she has to deal with it before she can actually attain her purpose in life.
Therapists in who use the humanistic approach begin with the assumption that every individual has his or her own way of perceiving and understanding his surrounding and the world at large. The questions asked by therapists using the existential-humanistic approach are different from those that the cognitive behavior therapists use.
Humanistic approach aims at understanding the subjectivity of the people (Cain and Seaman, 2002). In addition to this, they reject objective scientific approach. Endorsed in the humanistic approach is the idea that people operate on a free will and are capable of making their own decisions although the process may be unconscious. Humanistic approach also takes into account that people aim at self-actualization.
Existential-Humanistic interpretation of behavior is centered on an individual (Cain and Seaman, 2002). Therapists using this approach try to find out if the patient is aware or conscious of his identity. Existential-humanistic approach concentrates on the unique characters that define every individual. It places emphasis on the individual choices, responsibility and personal freedom.
It therefore considers each individual as the driver of his or her life. Using the concepts of existential- humanistic theory, it is possible to analyze the case study of Sophie. From a humanistic point of view Sophie aims at self-actualization is the reason behind her excessive gym workouts.
The disorders in eating are due to the fact that there is a factor that prevents her from attaining her goal of actualization. The problems that Sophie faces in her life are limiting her freedom to progress and thus act a barrier to her ultimate goal.
Humanistic approach proposes six basic dimensions of human condition. These dimensions include creating self-awareness, having conflicting thoughts between freedom and responsibility, creating a personal identity by establishing relations, a search for purpose of life, acceptance of anxiety as a norm in life and being aware of death. Using these dimensions therapist can understand the patient’s conditions.
Usually he approach to understanding a patient begins with the assumption that we are usually exposed to a meaningless world and each of us has to find his or her own bearing. The process of finding direction involves undergoing through the six dimensions proposed earlier.
The key elements in Existential-humanistic approach are acceptance and growth. Therefore, for a case like Sophie’s she must be made to accept her situation and move on with her life. The therapist has to ensure that he or she tries to address the underlying factors that affect the client. The humanistic approach is dependent on the empathy of the therapist.
Using the Existential- Humanistic Approach to assist Sophie
In this method, the therapist would allow the patient to be subjective rather than objective. This approach would allow Sophie to make her judgment of her situation based on her personal feelings and impressions.
Existential approach would have Sophie understand that she is free to choose between suffering and attaining happiness. The purpose of the humanistic perspective is to encourage Sophie to look into her life and choose between the various alternatives available.
Using this approach entails making Sophie to passively accept the prevailing circumstances in her life and take control of her life. This would assist her in shaping her future experiences by exploring other options that would enable her to create a meaningful existence.
Generally, the therapy major purpose is to invite the patient to acknowledge how they have allowed the influence from the surrounding environment to control their life. In Sophie’s case, the therapist aim will be to show her that the fact that her father left does not mean she should be affected as well. Instead, she should consider this as an obstacle in her path to becoming fully independent.
Appropriate Therapy for Sophie
Both the methods are viable to address Sophie’s. However, the most suitable method to solve her problem would be the use of cognitive behavioral approach. The reason for choosing this method is that the method addresses the core problems that face Sophie. The cognitive method is highly objective and aims to address the problems that the client is facing.
The cognitive behavior therapy is more instructive and shows the client the best method to use to reach her goal. Therefore, in cognitive therapy the patient learns self-counseling skills that can be used later. The therapy is also short term in that it does not last for a long time but serves the therapeutic purpose. The therapy emphasizes on the idea of getting well rather than the idea of feeling better about self-actualization.
On the other hand, the humanistic approach addresses the general idea of how Sophie would overcome her problems to attain self-actualizations (Neimeyer and Raskin, 2000). Humanistic approach lacks general objectivity. Therefore, the method is vague and is not supported by any scientific evidence.
Moreover, humanistic approach employs the cognitive, psychodynamic, or behavioral approach to accomplish its goals. Majority of the existentialist therapists adopt the use of anxiety as the major cause of maladaptive behaviors and use this concept to administer therapy to the patient. The position of taken by the humanistic therapists about free will is incoherent.
This is because they advance two conflicting theories at the same time. The humanistic approach insist that people have the ability to make a choice on their actions at the same time they explain how behavior is influenced by the treatment we experience at the hands of other people. These two ideas are highly conflicting leading to the incoherency in the approach.
Conclusion
Cognitive approach entails seeking knowledge on a specific subject in order to gain understanding. The approach involves dispelling ignorance and embracing factual information on the subject of study. Cognitive- behavioral therapy operates on the assumption that people enjoy freedom, contentment and self-respect.
However, these qualities are not inherent in a person but they arise from the external prevailing conditions of an individual. In cognitive behavioral therapy, the therapists try to conceptualize the general behaviors exhibited by the patient.
From the general behaviors, the therapist can derive the distortion in character, symptoms, and disorders out of the norm. The norm character is the habitual character that a patient exhibits when he or she is free and contented with one’s life.
The humanistic approach in behavior therapy focuses mainly on the desire to comprehend conscious experience and the desire to understand one’s self. Therapists in who use the humanistic approach begin with the assumption that every individual has his or her own way of perceiving and understanding his surrounding and the world at large.
Currently therapists using the humanistic approach prefer using qualitative methods that Rodgers proposed. To be able to reach the patient the therapists use unstructured interviewing in order access the patients views ideas and opinions. In case the therapists use observation then the patient’s observations are the ones that are considered. The key elements in Existential-humanistic approach are acceptance and growth.
Therapists in who use the humanistic approach begin with the assumption that every individual has his or her own way of perceiving and understanding his surrounding and the world at large. These therapy methods have been use in various counseling sessions.
However, in the case study presented the use of cognitive behavioral approach is recommended since it addresses the problem of the subject comprehensively. Humanistic approach in this case is irrelevant since it does not address the problem instead it tries to make the patient deal with the problem.
References
Beck, T. and Emery, G. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. New York: Guilford.
Cain, D. J. and Seaman, J. (2002). Humanistic Psychotherapies: Handbook of Research and Practice. Washington, DC: American Psychological Association Press
Edwards, D. (1990). Phenomenological Approaches to Therapy: Complementary or Conflicting Paradigms. New York: Springer Publishing.
Ivey, A., D’Andrea, M., Ivey B., and Simek-Morgan L. (2007). Theories of Counseling and Psychotherapy: A Multicultural Perspective. Saddle River: Pearson
Neimeyer, R. A. and Raskin, J. R. (2000). Constructions of Disorder: Meaning Making Frameworks for Psychotherapy. Washington, DC:AmericanPsychological Association Press.
Sammons, A. (n.d). The Humanistic Approach: the basics. Humanistic Psychology, Retrieved from www.psychlotron.org.uk