Introduction
Mental health is quite important in defining the mental well being of a person. This is due to the fact that the mind and behavior are interconnected. Poor coordination or disconnection between the two renders a person in a state of abnormality.
In this context, reality implies what the society has conceived to be acceptable and those who deviate from such standards or do not agree are considered to be abnormal (Plomba, 2010). This approach is psychologically referred to as cognitive behavioral approach. This reflective essay discusses cognitive behavioral approach and how it might be incorporated in a counselor’s work, with reference to several authentic references.
Cognitive Therapy
From a general perspective, cognitive process encompasses a wide range of a person’s mental health and composition. These elements include but not limited to mental images, attitudes, ideas and beliefs. This is to say that cognitive therapy is founded on the argument that some health complications in a person’s life could be attributed to his or her way of thinking. Such health problems may include phobias and depression among others.
In this line of thought, it suffices to mention that therapists are usually charged with the responsibility of explaining the mental patterns of clients for their better understanding (Plomba, 2010).
This is usually important in analyzing the safety, truthfulness and overall nature of one’s thoughts, since thoughts have the potential of causing health problems or worsening a mild and manageable health issue. The main aim of this approach is to allow a person to change his or her way of thinking by avoiding related imaginations and thoughts. It can further augment the ability of a person to adopt more realistic and productive thoughts.
From this analogy, I believe that thoughts play a significant role in defining a person’s overall health status, even though mental health is more profound. In essence, thoughts create a link between stimuli that are commonly evoked in the human body. In other words, stimuli trigger various thoughts, which could be as a result of personal judgment concerning an issue, which in turn generates emotions at any given moment (Counseling Directory, 2012).
Similarly, it is worth noting that under cognitive therapy, an emotional response is always triggered by the stimulus and individual judgment and perception over the stimulus. In addition, there are two assumptions, which emphasize the use cognitive therapy. The first is when the client in question has the mental capability of recognizing personal thoughts and the need of changing them.
The second assumption, which is equally important, is that the reality may be distorted or misrepresented especially in cases where there are stimuli being elicited.
This interference usually affects the accuracy of the reality. For instance, what a person perceives with regard to a given experience and expected emotions may result into him or her being rejected during a job interview. Consequently, one may feel that the outcome of such an interview could have been influenced by his or her fundamental incompetence (Counseling Directory, 2012).
This may result into depression and discouragement from making similar advances and applications in future. On the other hand, if an applicant feels that he did not go through the interview because of the existence of a strong competition, these feelings may breed disappointment that does not have elements of discouragement. This may persuade such a person to reapply for other related jobs.
Essentially, cognitive therapy affirms that psychological disturbance is caused by imaginations that are distorted, leading to the existence of stressful emotions. This theory is based on cases of mental depression, when people experience uncontrollable negative thoughts, when responding to a stimulus, which is expected to arouse positive thoughts (Mulhauser, 2012).
This affirms the fact that distressed emotions may alter one’s response and even future reactions towards similar events in life. For example, a student who is being requested to remain silent in class to minimize noise may feel that whatever he or she is doing in class is wrong and irrelevant. Similarly, the same client may doubt positive statements put across, honoring his name and decide not to perform better in future.
Additionally, one may feel that he was in a pathetic state when it is mentioned to him that he has registered exceptional improvement. Such thoughts are likely to evoke negative feelings of hopelessness and diminished self-esteem in the long-run. This may result into stabilizing or worsening of an individual’s depression status.
In handling such clients, I highly advise councilors to beware of the impact of the behavior of the client towards mental recovery and mental stability (Mulhauser, 2012). Cognitive therapy focuses on the interplay between behavior, thoughts and individual’s emotions with regard to existing external stimuli. Moreover, past experiences may be important in analyzing these cases, which could be essential in lowering stress among clients.
Behavioral Therapy
This has become a common tool for councilors dealing with clients, experiencing behavior change of any nature, including but not limited to anxiety disorders, addictions and phobias. In the understanding of how this therapy functions, it is worth noting that it capitalizes on the fact that behavior can be learnt by a person or altered based on existing circumstances (González-Prendes & Resko, 2011).
Importantly, this approach principally assumes past and future events, which may have impact on a person’s behavior. In this line of thought, a councilor who adopts this approach puts into consideration the existing events alone.
Several efforts have been made in understanding the concept of behavioral therapy. For instance, Ivan Pavlov is highly credited for his experiment that was carried out on dogs and their ability to change behavior depending of present events. In the research, it was found that the sound of a bell affected the behavior of dogs as they associated it with food (Dattilio & Hanna, 2012). As a result, the dogs salivated even in the absence of food.
Although this was the case, it was also noted that the intensity of the dogs salivating dropped remarkably as long as the bell sounded without the appearance of food. This observation denotes the relationship between conditioned response and conditioned stimulus, represented by salivating and the ringing of the bell respectively.
Based on this approach, psychotherapists have always considered it when handling clients with phobias. It involves a gradual exposure of the client to the stimulus, which is responsible for the phobia. As a result, they are able to recondition the manner in which they respond towards the stimulus (Dattilio & Hanna, 2012).
On the other hand, B.F Skinner carried out a research whose main focus was on the relationship between reconditioning and rewards (Wright, 2004). The experiment allowed the automatic feeding of a rat with a dispenser, making it relate food to the noise made by the apparatus. Later on, a lever was raised after the rat had gotten used to the behavior. The purpose of the lever was to allow the food to be dispensed once the rat came into contact with it.
Consequently, the rat regularly engaged the lever since it had gotten used to the noise. How then can this technique be applied among human beings? I found out that the rat analogy can be used to help people who are faced with mental disorders in the society through the reinforcement of acceptable behavior or discouraging undesirable conduct among people (Wright, 2004).
Behavioral therapy is regarded as a very important tool in counseling since it aims at reversing harmful behavior to what is more acceptable in the society. It is vital to mention that there are several techniques, which are commonly applied when using behavioral therapy by psychologists (Sheldon, 2011). Nevertheless, a common approach is avoidance of situations that are likely to expose somebody to anxiety.
As mentioned above, this is common in handling people who have phobias. Such avoidance may sometimes become too severe to affect a person’s daily life. Exposure therapy is commonly recommended in such cases where the avoidance is extreme. Under this, a person is introduced to more fearful scenarios gradually until they become familiar.
During this period, the therapist is usually tasked with teaching the client how to manage anxiety and the ability to face situations, which are considered to be fearful (Corsini & Wedding, 2011). A simple technique like breathing in has been found to work in some cases.
Cognitive Behavioral Therapy
From the analysis of the two therapies commonly applied in psychological counseling, I found out that human thoughts and behavior are crucial in describing the occurrence of anxiety. For example, cognitive therapy defines how our reactions are major contributing factors towards anxiety, while behavioral therapy denotes the behavior and reactions of a person when faced with circumstances, which are known to evoke anxiety (Sheldon, 2011).
When the two therapies are combined to form a blend, the product is referred to as Cognitive Behavioral Therapy, commonly abbreviated as CBT. According to research, Cognitive Behavioral Therapy is one of most applied therapies by psychologists during counseling. Besides its wide-usage, Cognitive Behavioral Therapy is regarded to be more effective as compared to other counseling tools used in handling disorders and phobias among countless conditions, which are related to one’s mental health.
Of importance is the fact that Cognitive Behavioral Therapy focuses on harmful patterns and disturbances, regarding the manner in which we perceive the world and ourselves in general. The basis of Cognitive Behavioral Therapy is that our feelings are predominantly affected with our thoughts and not the events, which happen on a daily basis. Many psychologists agree that Cognitive Behavioral Therapy allows the application of a wider domain in helping anxious and distressed clients to attain normalcy in life (Sheldon, 2011).
This combination is usually preferred because a person’s behavior reflects the mode of thinking towards situations or things in life. However, certain aspects of the two therapies in the mix may vary from one person to another depending on specific cases being handled.
This is to say that a counselor ought to analyze the case first before making a final decision on either combining the two treatment options or adopting one of them. For instance, psychologists prefer using behavioral therapy when handling Obsessive Compulsive Disorder among clients.
By combining cognitive and behavioral therapies, CBT usually aims at changing the thinking patterns of a person, which concern the cognitive part of the body and response to thoughts that determine behavior. Unlike other approaches used in handling mental cases, Cognitive Behavioral Therapy aims at the current situation, without bothering the cause of the existing issue (Sheldon, 2011).
Additionally, Cognitive Behavioral Therapy is known for its ability to break bulky problems into manageable portions that do not exert pressure on the client. This makes it easier for the client and the counselor to attain a point of consensus in finding a solution to an existing problem.
In essence, these sections of the problem can be described as thoughts, actions and physical feelings. Importantly, each one of these elements has the ability to have impact on the other. For instance, a person’s thoughts about something can have physical and emotional impact, which may ultimately alter his or her behavior (Corsini & Wedding, 2011).
Another factor to consider when analyzing the application of Cognitive Behavioral Therapy is that most people tend to learn irrelevant modes of thinking and behaving throughout their lives. Nevertheless, the most important thing is to recognize such thoughts and how they could be a source of trouble in defining one’s behavior and feelings (Sheldon, 2011).
Essentially, this can come into play when an individual is willing to counteract negative ways of thinking, thus leading to acceptable and helpful behavioral changes and feelings. Unlike other therapies, Cognitive Behavioral Therapy can be administered on a one-to-one basis, with close family members, friends or a special group of the society, depending on whether the client is comfortable with the presence of these groups of people.
Ehlers and Clark Model
Like in many other disciplines, several scholars have spent their time and resources in unraveling the truth behind Cognitive Behavioral Therapy. Among these people are Ehlers and Clark, whose work has become instrumental in the understanding of several mental situations, which affect humanity (Corsini & Wedding, 2011).
Ehlers and Clark suggested several modes of approaching this issue, in their 2004 and 2000 findings respectively. Importantly, the suggestions aim at helping psychologists in handling cases of Post Traumatic Stress Disorder, PTSD. The three therapy goals suggested by the two psychologists are: lower intrusions and situations, which would make one to re-experience traumatic memory, modification of negative appraisals and removal of behavioral and cognitive strategies that are considered to be dysfunctional.
The following segments of this essay discuss some of the elements covered by the treatment model proposed by Ehlers and Clark, which could be used by councilors in handling clients who have mental complications (González-Prendes & Resko, 2011).
Detailed assessment interview
The main purpose of this process is to allow the councilor to single out cognitive issues, which have to be dealt with during treatment. Under this, it is vital for the psychologist to identify worst aspects and most painful situations, with regard to the trauma, appreciate common emotions that are connected with the event and identify dysfunctional and problematic behavioral efforts of coping as demonstrated by the client.
Rationale of treatment
The most important aspect of Cognitive Behavioral Therapy, which has to be emphasized by counselors, is the need to ensure that the client comprehends the logic behind the application of certain therapeutic approaches in handling a given situation. The rationale should therefore aim at explaining the nature of PTSD together with related symptoms.
Secondly, the rationale has to show the client’s efforts in fighting the trauma. This may result into a short-lived relief but can as well contribute to the management of symptoms, which may have been observed. For this to be achieved, it is equally important to confront unpleasant memories of the past.
Suppression of thoughts
This enables the client to appreciate the importance of preventing intrusive memories, by eliminating them from the conscious mind and increase their influence. As a result, the client is advised to adopt alternative methods and avoid pushing memories from the unconscious mind through acceptance. This should allow the client to make observations, which would allow it to come and go as if the patient was watching something else (Corsini & Wedding, 2011).
Education
Ehlers and Clark affirmed that the role of information cannot be ignored in the understanding of how Cognitive Behavioral Therapy works. This information is important in helping the client to correct earlier assumptions towards the perceived physical impact of the trauma. Besides education, it is important for the psychologist to help the client in reclaiming his life. In this respect, the client is able to regain certain aspects of his or her life including leisure activities and pursuits (González-Prendes & Resko, 2011).
The reclamation is important because most people take a different course of life when faced with traumatic situations in life. I consider it to be a very important element because it helps the affected person to remain unchanged from the time he or she was affected by the trauma. Instead, the client gets an opportunity to reconnect with the past through social contacts and activities.
Additionally, cognitive behavioral approaches recovery of PTSD clients may involve the revisiting of the trauma. This strategy is essential because it helps the client to acknowledge the significance of the strategy in the treatment process.
In this approach, the client gets an opportunity to revisit the traumatic incident by recounting in a more vivid and detailed manner. Through this process, the client develops a detailed account of what might have happened in the past and also connecting with certain feelings, which could be related with it (González-Prendes & Resko, 2011).
In-vivo exposure
This revolves around re-examining major reminders of the trauma, which may have previously been ignored during earlier efforts of coping with the trauma. This may therefore include a series of events like exposure to the site, sounds, activities, smells and other major reminders of the trauma (Corsini & Wedding, 2011).
Consequently, I believe that the process is necessary during counseling since it allows one to draw a line between harmless reminders of what has happened and the actual danger of the trauma. As a result, the client is able to confront patterns of overgeneralization, which have influenced the client to ignore certain elements that are related to the exact trauma.
Identification of triggers of intrusive memories
This procedure allows the client to differentiate past events, which might have occurred at the actual time of the trauma and present stimuli. During this process, the client should have a closer look at the context within which such intrusions are likely to occur and the triggers that are commonly associated with them.
After this, a comparison between past and present context of the triggers is discussed broadly to allow better discrimination of stimulus (Corsini & Wedding, 2011). The last approach suggested by Ehlers and Clark is the imagery technique. In this context, imagery is used to clarify and change the perceived meaning of the trauma memory. In essence, imagery has the potential of assisting the client to tie loose ends and enable the person to reconnect with the realistic nature of trauma.
Using Cognitive Behavioral Therapy
For a counselor to effectively treat a patient using CBT, it is essential for him or her to understand the cause of the existing problem and its overall nature. This allows the selection of a more reliable strategy in finding the solution.
Based on this, a professional psychologist is supposed to apply professional skills and knowledge in the formulation and evaluation of the issues, which surround a client’s conditions and establish a realistic treatment plan (Branch & Wilson, 2010). It is therefore considered as primary modality in handling mentally disturbed people, together with other treatment strategies.
As mentioned above, educational approach cannot be overlooked when finding the best treatment plan in helping a mentally disturbed person. This gives a practical and helpful sense of dealing with distressed clients. Many psychologists have adopted CBT as the most recommended approach when dealing with people who may have gone through such tough traumatic moments.
Most clients are usually encouraged to embrace cognitive reorientation and change of behavior for effective and positive response towards the situation (Branch & Wilson, 2010). Unlike other forms of oral treatment, CBT focuses on behavior change and lessening the impact of observed symptoms.
Additionally, practical counseling, characterized by information and coaching is paramount in ensuring that severe symptoms are relieved. In handling psychological cases, it is essential for the councilor to have a wider scope of solutions since some cases require one to think far beyond management of symptoms and behavior change. For instance, clients have to be assisted in overcoming feelings and behavior, which may arouse previous stressful moments.
CBT not needed
As much as cognitive behavioral therapy is highly credited for its role in managing psychological problems, there are issues, which are never handled effectively with this model of treatment. Such issues mainly present themselves in a manner that call for a solution that goes beyond addressing the existing symptoms.
They may include complex disorders and higher order issues of development. In some cases, patients may fail to respond positively to CBT or may be put off by the entire technique (Whitfield & Davidson, 2007). This may present a more complicated scenario where the counselor might be forced to consider alternative-stress management options.
In this line of thought, it has also been found that clients may not agree with the fact that common psychological problems are caused by distorted emotions and irrational thoughts. Furthermore, others may have interest in discussing the issues with the counselor and not being taken through the CBT procedure.
Existentialist /humanistic Therapies
These theories were developed in mid 20th century. Some people refer to it as “third wave.” Humanist therapy is used to denote a certain class, which encompasses several therapies like client-centered therapy. It is generally based on a person’s hope and the capability of being self-determined. Like in other therapies applied by psychologists, humanistic counseling focuses on the present situation of a patient and the past, in order to find clarity of how history affects current events in a person’s life.
Importantly, this approach does not allow judgmental conclusions, but rather uses open-ended questions, which are meant to allow the patient to have an inner examination of her thoughts and feelings. This method of counseling has been applauded for its ability to initiate self-awareness in people to allow them to move from a worse mental situation to that which is considered healthy.
Despite its role in psychology, humanistic therapy was not chosen in this case because of its disadvantages, which are widely known. Firstly, this approach exposes counselors to the risk of contracting the problem if it is contagious. This is encouraged by the fact that the method allows closeness between patients and psychologists.
Additionally, this therapy does not have empirical evidence, which is essential in treatment of patients. It can therefore promote narcissistic occurrences. Data can also be used to understand trends manifested by the mental problem (Corsini & Wedding, 2011). As a result of these challenges, Cognitive Behavioral therapy was chosen.
Conclusion
From this reflective analysis, it is evident that CBT plays a major role in helping people with emotional distortions and irrational thoughts about the world and themselves. However, for its effectiveness, there has to be communication between the counselor and the client in order to facilitate effective recovery. Through this communication, the client is allowed to appreciate the approach and techniques applied in attaining a healthy mental status.
References
Branch, R., & Wilson, R. (2010). Cognitive Behavioral Therapy for Dummies. United Kingdom: Taylor & Francis.
Corsini, R. J., & Wedding, D. (2011). Current psychotherapies. Belmont, CA: Brooks/Cole.
Counseling Directory. (2012). Cognitive and Behavioral Therapies. Counseling Directory. Web.
Dattilio, F. M., & Hanna, M. A. (2012). Collaboration in Cognitive-Behavioral Therapy. Journal of Clinical Psychology, 68 (2), 146-158.
González-Prendes, A., & Resko, S. (2011). Cognitive-Behavioral Theory. Sage. Web.
Mulhauser, G. (2012). An Introduction to Cognitive Therapy & Cognitive Behavioral Approaches. Counseling Resource. Web.
Plomba. (2010). Cognitive behavior approach to psychopathology. Slideshare. Web.
Sheldon, B. (2011). Cognitive-Behavioral Therapy. United Kingdom: Taylor & Francis.
Whitfield, G., & Davidson, A. (2007). Cognitive Behavioral Therapy Explained. United Kingdom: Radcliffe Publishing.
Wright, J. (2004). Cognitive-Behavior Therapy. New York: American Psychiatric Pub.