Abstract
The person-centered and cognitive-behavioral theories are common models in counseling and psychotherapy. The two approaches have different theoretical underpinnings and thus, have distinct uses in therapy.
Moreover, a number of factors, such as the client’s age and the setting of the therapy, determine their efficacy and application. However, both theories lead an individual through a journey of self-discovery and self-actualization.
This essay compares and contrasts these two models in the context of counseling. It also reviews five articles that evaluate the efficacy and application of these counseling theories in practice.
Introduction
Both cognitive-behavioral and person or client-based approaches are useful in counseling and psychotherapy. The cognitive-behavioral theory involves a combination of behavioral and cognitive therapy approaches.
The behavioral theory is founded on Ivan Pavlov’s behavior modification concepts of operant and classical conditioning (Lin, 2001). Behavioral therapists urge their clients to be self-conscious and assertive in order to improve their cognitive abilities, such as critical thinking and decision-making.
The cognitive-behavioral theory, as put forward by Beck (1976), explains how thought processes affect a client’s behavior and emotions.
On the other hand, the person-centered therapy (PCA), as formulated by Carl Rodgers in the 1940s, is an approach that is centered on the needs and values of the client. The approach revolves around the belief that self-actualization is the ultimate goal of a therapeutic relationship.
To achieve this, the client has to internalize individual experiences in an honest manner in order to develop a realistic personal image that is devoid of distortions. In this way, the client is able to avoid denial and develop a positive self-concept.
A person-centered counselor knows that a self-actualized individual is better placed to deal with his or her life situation.
The therapist provides a neutral and empathic therapeutic environment that allows the client to share his or her story. The person-centered therapeutic relationship is comparable to a journey of self-discovery for the client.
In contrast, in cognitive-behavioral counseling, the therapist emphasizes on the client’s behavior and mood. This approach revolves around the idea that cognitive processes influence one’s mood and behavior (Lin, 2001).
In this regard, the therapist, unlike in a client-centered setting, challenges some actions of the client, which he or she believes are self-destructive or irrational.
The two theories are effective in different situations. Both models have gained applications in contemporary situations that require individual and group therapy. However, the application and efficacy of either model depends on the age and needs of the client.
This essay will compare and contrast the cognitive-behavioral and the person-centered approaches in the context of counseling. It will analyze the theories underlying the two models through a review of literature.
Literature Review
The person-centered model provides an empathic and non-judgmental environment to the client to facilitate reflective evaluation of the emotions emerging from his or her life situation.
In a counseling setting, the counselor employs active listening to allow the client to reveal his emotional and personal problems and devise ways of handling them. Its efficacy and application depend on the age and life situation of the client.
A study by Gibbard and Hanley (2008), evaluated the effectiveness of the person-centered model in the counseling of patients with mild mental illnesses. In this study, a therapist offered client-based counseling sessions to participants who were suffering from mood and anxiety disorders.
They were allowed to tell their stories and experiences in a non-judgmental setting free of questioning or criticism. The results indicated that the person-centered approach is quite effective in helping people with mild mental disorders to understand their life experiences and learn to manage their conditions.
It is evident that, by helping a client through a journey of self-discovery and self-actualization, he or she understands his or her current situation and learns to manage personal issues emanating from his or her life experiences.
Thus, the aim in person-centered therapy is to enable the client to ‘unravel’ and internalize personal experiences in order to overcome dysfunctional views or actions.
A comparable study by Tursi and Cochran (2006) evaluated the counseling relationship in a person-centered setting. Essentially, person-centered counseling aims at improving an individual’s self-concept.
A person-centered counselor understands that the client’s feelings and behavior emerge out of the need for self-preservation when under distress.
Tursi and Cochran (2006) observe the counseling relationship is enhanced when the counselor provides a “warm and empathic therapeutic setting” that allows the client to control the information related to his or her life. They draw similarities between the person-centered and the cognitive-behavioral counseling.
One of the similarities identified in this study is that both approaches guide clients through a journey of self-actualization. Moreover, both enable clients to improve their thought patterns (cognitions) and self-concept in order to deal with dysfunctional actions or views in their lives.
The authors note that both models recognize the fact that the need to change one’s behaviors or actions emerges from individual insights, not the therapist’s views, or suggestions.
Thus, since the change process involves psychological adjustment to eliminate the perceptual difference between the ‘self’ and ‘life experience’, the person-centered approach draws heavily from the cognitive-behavioral model.
However, the person-centered approach may not be effective in addressing all problems. Some clients, especially children, may find it difficult to talk to a therapist, which can hamper the self-actualization process.
On the other hand, the structured nature of the cognitive-behavioral approach may not be appropriate in some situations, especially where the client’s ‘irrational’ beliefs have no emotional manifestation (feelings).
Unlike the person-centered approach, the cognitive-behavioral model aims at changing the irrational beliefs in a client that cause misbehaviors or disorders to realistic ones. The model challenges some of the client’s actions or views that underlie his or her self-concept issues.
Individual views are largely dependent on cultural and societal factors. In his study, Lin (2001) evaluated the foundations underlying the cognitive-behavioral theory to determine its effectiveness in the counseling of Chinese clients.
The researcher identified the Chinese philosophy (Confucianism), value system (collectivism), self-concept, interpersonal interactions, and socialization as incompatible with the theory’s underpinnings, which are based on Western values (Lin, 2001).
This implies that culture shapes individual behavior, values, and cognitive processes. Since, the cognitive-behavioral approach aims at empowering clients to become more self-assertive and develop a positive self-concept (individualistic), it contradicts the Chinese values of collectivism and Confucianism.
In the Chinese culture, self-assertiveness and public expression of emotions are considered dishonorable (Lin, 20001). Thus, the efficacy and application of the cognitive-behavioral theory in counseling depends on culture.
This means that counselors must identify which elements of the theory may elicit negative emotions from the client and avoid them or use a different model.
The cognitive-behavioral therapy is comparable to the humanistic counseling approach. A study by Shechtman and Pastor (2005) compared the effectiveness of the two models in the counseling of children.
The authors assessed the children’s academic performance and behavior over a specified period using standardized evaluation tools (the client behavior system and the therapist helping skills). They found that the humanistic approach was better than the cognitive-behavioral model in counseling.
They concluded that the structured nature of the cognitive-behavioral model hampers group therapy. Thus, this approach has certain limitations that make it inappropriate in particular settings. Psychotherapy is another common counseling approach that is based on psychoanalysis of the client.
Cognitive-behavioral methods replaced psychoanalytic models that evaluated a client’s emotional and interpersonal attributes as manifestations of their life experiences.
Zamanian and Adams (1997) applied psychotherapy in counseling sexual abuse victims (young children). The results indicated that psychotherapy could help clients develop coping and adaptive skills.
Methods Used in the Studies
The five studies reviewed above use different methods to examine specific measures. Three of the studies use an experimental approach to analyze relevant measures (Gibbard & Hanley, 2008; Shechtman & Pastor, 2005; and Zamanian & Adams, 1997). The other two use a phenomenological approach (Lin, 2001 and Tursi & Cochran, 2006).
The study by Shechtman and Pastor (2005) involved 200 participants, who included children with learning disabilities, conveniently sampled from a children’s home in Israel.
The researchers then randomly selected the participants into two groups: the humanistic therapy and the cognitive-behavioral therapy groups.
The participants were then subjected to group and individual therapy and their academic performance and behavior measured in order to compare the efficacy of the two counseling approaches.
In contrast, Gibbard and Hanley’s (2008) study involved 697 adult participants consisting of 72% women. This prospective cohort study assessed the participants’ level of distress, well-being, and cognitive functioning over a period of five years (2002-2007).
These measures were evaluated before and after each person-centered counseling session using a CORE measurement tool. The participants also gave their views regarding the person-centered approach used to counsel them.
In their study, Zamanian and Adams (1997) employed psychotherapy approach in counseling distressed children. The participants were boys who had fallen victim to child molestation. Despite being traumatized, they were in good mental state, had healthy social life, and did not abuse drugs.
The researchers used a psychoanalytic instrument, the Specialized Treatment and Rehabilitation Services Program (STRSP) to assess the boys’ behavior before and after each counseling session. To achieve this, the participants were made to participate in a number of physical activities during each counseling session.
Tursi and Cochran (2006) used a phenomenological approach to evaluate the efficacy and application of the person-centered and cognitive-behavioral theory in counseling. The aim of the study was to identify the points of convergence of the two models.
To achieve this, the researchers analyzed the theoretical underpinnings of the two theories as well as their assumptions. They found that two theories are effective in different settings and thus, neither can solely address a client’s issues.
Similarly, Lin (2001) used the phenomenological approach to evaluate the efficacy and application of the cognitive-behavioral approach in counseling Chinese clients.
The authors identified various discrepancies between the Chinese and Western cultures that reduce the effectiveness of cognitive-behavioral counseling. Differences in culture, beliefs, and value system make the approach ineffective in non-Western cultures, including Chinese.
The Researchers’ Conclusions
The researchers made different conclusions based on their findings. In Gibbard and Hanley’s (2008) study, the results indicated that person-centered counseling helps clients with mood and anxiety disorders to become ‘self-actualized’ and develop a positive self-concept.
In this regard, they concluded that the person-centered approach is effective in counseling of clients with mild mental disorders. On his part, Lin (2001) found that minor differences between the Western and Chinese cultures hamper the effectiveness of the cognitive-behavioral theory in counseling Chinese clients.
They concluded that cognitive-behavioral therapists should adjust their approach when handling clients from other cultures. In their study, Shechtman and Pastor (2005) found the humanistic group therapy to be more effective in counseling children with learning disabilities compared to the cognitive-behavioral therapy.
Based on this finding, they concluded that the cognitive-behavioral theory cannot be applied in all therapeutic relationships. Moreover, other approaches, including the humanistic group therapy, produce better outcomes than the cognitive-behavioral theory.
In another study, Tursi and Cochran (2006) found similarities between the cognitive-behavioral approach and the person-centered therapy in relation to their theoretical underpinnings. The two theories were found to facilitate self-actualization in individuals.
The authors concluded that both models could be used simultaneously in a therapy session to address the client’s personal and emotional issues. On their part, Zamanian and Adams (1997) found that psychotherapy could improve interpersonal and coping skills in victims of sexual abuse.
From these results, researchers concluded that long-term psychotherapy could help trauma victims to deal with emotional and personal issues as well as improve their interpersonal skills.
Conclusion
The cognitive-behavioral and the person-centered approaches are important models in counseling. Their application and efficacy depend on the age of the client and the setting of the therapy, among others.
The five studies reviewed in this essay have highlighted the differences in efficacy and applicability of the two counseling models. It is evident that the two theories have separate and distinct therapeutic uses depending on client characteristics and the setting.
However, both can be applied simultaneously to address a client’s difficulties. Salient information that may be useful to school therapists is that they should evaluate the validity of counseling theories before deciding which model is appropriate for a particular case.
Otherwise, unsuitable counseling interventions will hamper the self-actualization process by alienating the child.
References
Gibbard, I. & Hanley, T. (2008). A five-year evaluation of the effectiveness of person-centered counseling in routine clinical practice in primary care. Counseling and Psychotherapy Research, 8(4), 215-222.
Lin, Y. (2001). The Application of Cognitive-Behavioral Therapy to Counseling Chinese. American Journal of Psychotherapy, 55(4), 46-52.
Shechtman, Z. & Pastor, R. (2005). Cognitive-behavioral and humanistic group treatment for children with learning disabilities: A comparison of outcomes and process. Journal of Counseling Psychology 52(1), 322-336.
Tursi, M. & Cochran, J. (2006). Cognitive-behavioral tasks accomplished in person-centered relational framework. Journal of Counseling & Development, 84(2), 387-398.
Zamanian, K. & Adams, C. (1997). Group psychotherapy with sexually abused boys: Dynamics and interventions. International Journal of Group Psychotherapy, 47(1), 109-126.