Briefly outline the key features of a cognitive-behavioural approach to counselling and discuss some of the ways in which this approach differs from one of the other main approaches to counselling. In part two reflect on and write about which of the two approaches discussed in your essay you prefer and why. This essay will explain key aspects of a cognitive-behavioural approach to counselling. Revealing how this method of counselling differs from the psychodynamic approach, and demonstrating my preferred method.
The first of these approaches ‘Cognitive-behavioural’ is an umbrella term for a method of counselling comprising several approaches. It evolved from behavioural psychology founded by J. B Watson; an American psychology professor whose 1919 publication entitled Psychology from the standpoint of a Behaviourist largely influenced this approach. (McLeod (2008) p. 132) The first basic premise to cognitive-behavioural counselling involves client and counsellor collaborating, breaking problems down into individual parts, examining, modifying and changing them for a successful outcome.
The second is the value of a scientific approach. Just as scientists employ hypotheses, experimentation and evaluation in their work; the cognitive-behavioural counsellor does the same. This is demonstrated in the counsellors’ constant observation and evaluation of change in clients. The third is closely monitoring the cognitive process through which people observe and control their behaviour. (McLeod 2008 p132) The aim of Cognitive-behavioural counselling is to empower clients to recognise irrational thoughts, modify feelings and behaviour by changing thought processes.
The Client aims to focus on specific goals but thinks in an illogical fashion, producing detrimental emotions. The connection between thought and behaviour are the epicentre of this approach; the founder of Cognitive therapy; Beck, concluded; observing how patients viewed themselves was more important than traditional psychoanalytic tactics he’d previously practised. Beck explains “I was struck by the fact a patient’s cognitions had an enormous impact on his feelings and behaviour” (McLeod 2008 p143) Beck believes a client’s emotional and behavioural problems aren’t shaped by certain events, instead; ersonal interpretation of events are key to feelings and behaviour. Albert Ellis created RET- rational emotive therapy. Focusing on the resolution of emotional-behavioural difficulties not only affecting the client but also impinging upon others and empowering people to experience lives that are more positive. To illustrate; the A-B-C method used in RET states: A stands for the activating event leading the client to feel C, which represents the emotional or behavioural consequence of the event.
Yet; Ellis believes A is not responsible for C instead, it is the individuals’ B or beliefs about the event that could include past or present or future internal or external events. The role of the cognitive-behavioural counsellor is akin to a coach encouraging clients to improve, stating confidence in clients’ abilities to succeed, motivating, praising alongside clients. There is homework, writing and role-play that must be adhered to in cognitive-behavioural therapy and failure to do so results in the counsellor assuming the client is unwilling to change their behaviour for the better. (Word count 440)
The psychodynamic approach to counselling has its roots in Sigmund Freud’s psychoanalytical theories in which Freud’s analysis of clients link these premises: One-Emotional difficulties lie in a person’s childhood events. Two-We are not consciously aware of childhood experiences due to repressed memories that we cannot recognise as they live in the ‘unconscious’ part of our brain (Freud categorized the unconscious as a ‘part’ of the brain). Three-unconscious matter presents itself surreptitiously during therapy, in our fantasies and dreams and as an emotional response of transference (redirection of feelings) towards the counsellor. McLeod 2008 p130) Anna Freud; the youngest of Freud’s children; and psychoanalyst, updated her father’s theory on ‘defence mechanisms’- seven stages of forces determining behaviour manifesting themselves through defence mechanisms. Within the psychodynamic approach are various considerations and decisions regarding how to best to help the client when the counsellor is aware of a client displaying the mechanisms of defence and the conflict it causes a client. (McLeod 2008 p 96-97) The psychodynamic counsellor will use various strategies to assist clients.
One such method is ‘Transference’, the counsellor’s presenting themselves as neutral; encouraging clients’ to project feelings or behaviour onto the counsellor, brought about by experiences or relationships. The reason for neutrality is for the counsellor’s assurance that whatever feelings are projected towards them, it’s not anything the therapist has caused due to remaining detached, the client ‘transfers’ an image of a family member or someone who influenced them onto the counsellor.
Transference enables the counsellor to make clients aware of such projections so the client can recognise this and prevent it happening in future relationships. Transference is a feature of psychodynamic methodology, useful in determining clients’ histories that aid counsellors in seeing why clients repeat unhelpful patterns behaviourally. Just as a client can project transference, the therapist can experience ‘counter-transference’ whereby a client evokes feelings from the therapist akin to those of others in contact with the client.
It is useful to the counsellor because counter-transference provides an insight into relationship commonalities and lifestyle of a client. There will be focus on specific issues or life events that their client has sought counselling to resolve. A client’s problems can be interpreted as developmental, childhood issues that need resolving. The person will repeat patterns of problematic behaviour and thoughts until gaining enlightenment on how to resolve recurrent difficulties. (Word count 389) As this essay has demonstrated, the two approaches outlined lead to conflicting interpretations by counsellors regarding clients.
In psychodynamic counselling, a reasonable, connection between counsellor and client is regarded as an ending achievement. By contrast, cognitive-behavioural counsellors assume clients’ can be ‘taught’ practical strategies as opposed to psychodynamic methods, which use an enriching, therapeutic approach by analysing clients’ early lives. Within Cognitive-behavioural, there is little focus on (past) problems unlike psychodynamic theory, instead; ‘solution-focused’ (current) techniques help clients manage their moods quickly with new thought patterns aiming to replace irrational thoughts for rational.
Psychodynamic rationale sees the counsellor as a ‘specialist’ with the knowledge to analyse people and treat accordingly consequently there’s no overt collaboration of client with counsellor as in cognitive-behavioural. Transference is a feature of psychodynamic methodology, useful in determining clients’ histories that aid counsellors in seeing why clients repeat unhelpful patterns behaviourally whereas cognitive-behavioural doesn’t recognise childhood and the unconscious and turns to the here and now. (Word count 160)
I prefer the cognitive-behavioural approach because I’ve spent too much time focussing on my past that’s often hazy in memory, especially early childhood memories which are therefore difficult to recount and analyse. Although the past is relevant to who I am, I need to learn coping strategies presently. I was diagnosed with depression and anxiety 12 years ago and manage it with mild medication. To me, it is logical to change one’s cognitions in order to achieve happiness. I can’t envisage any resolution without changing something. Once learned, I could employ new techniques of CBT when needed.
It would be convenient, practical and immediate which gives me hope and confidence in its potential success. I haven’t experienced a useful outcome from previous counselling that I’ve undergone for depression. I believe the reason for this is because I’m only eligible for up to a maximum of 12 sessions on the NHS and can’t afford to self fund further counselling. Although CBT is not perfect, as I‘ve demonstrated in this essay, I respect its value of the scientific approach. I like that; if a technique isn’t serving its purpose, I could re-evaluate or try another with the guidance of a CBT counsellor.
The idea of positive praise, encouragement and the aforementioned immediacy, greatly appeals to me. I have a wealth of life experience, empathy and a yen to help people overcome psychological distress, or cope better with mental illness. This is what has motivated me to study a psychology degree with a view to becoming a psychologist. (Word count 255) References McLeod, J. (2008) Introduction to counselling [Ed. D. Langridge], Maidenhead/Milton Keynes, Open University Press/The Open University. Introduction to counselling, ibid, p. 132
Introduction to counselling, ibid, p. 143 Introduction to counselling, ibid, p. 130 Introduction to counselling, ibid, pp. 96 to 97 Self-evaluation The parts of the material I feel I have gotten to grips with best are the summaries and appraisals at the end of the chapters of the course book, as they are a good reminder and great clarification for anything that I might not have understood at a first read. I have found the book very deep and overly detailed in places which can sometimes confuse me. I may need help on TMA 2. I would have preferred one or two tutorials too.