Summary of the perspectives of two different modalities: PCT and CBT
Since the 20th century, there have been significant developments in the field of psychotherapy. For instance, psychologists have come up with numerous models and frameworks which could be used in counselling. As a matter of fact, application of these theories have helped counsellors in treating several challenging and complicated mental ailments which include anxiety, stress, depression and so on. Two of the most commonly used methods of psychotherapy would be cognitive behavioral therapy (CBT) and person centered therapy (PCT) (Leichsenring et al., 2013). In the case study provided, the patient is Hung, a 46 year old Vietnamese man who has a 19 year old twin son and daughter. Hung had healthy functional relationships with his children until they left for different colleges. Once they did, Hung felt that they had changed and that he was no longer able to identify with them. As a result, he is plagued by feelings of lack of control and this has affected his eating habits, sleeping patterns and taken a toll on his daily life. The following essay will study the two different approaches and examine which approach would be most suitable.
According to the cognitive behavioral therapy principles, emotional problems and negative behavioral tendencies in human beings are due to the effect of faulty thought processes in people. In other words, CBT assumes that the way in which individuals act or behave would depend on individual cognition (Dobson & Dobson, 2018). Therefore, counselling that is based on CBT would be more focused on cognition and the thought processes of the individuals. The core purpose of using CBT as part of a counselling practice is to treat the issues that an individual might be facing and boost happiness by modifying the various emotions, thoughts and behaviors of a person which could be having adverse effects (Hans & Hiller, 2013). CBT is a solution oriented therapy mode, which encourages the patients to challenge and face the distorted cognitions and alter the destructive behavioral patterns. In this case, CBT would focus on the negative feelings associated with Hung’s children going off to college. CBT would assume that his lack of control is due to a few factors. One, he wanted desperately to cling on to his remaining immediate family and believed that his children would remain as close to him as they were before they left. Two, the cultural factor is another aspect which would be addressed by CBT. What irks Hung is the fact that his children are slowly moving away from their morals and values and adopting the values and cultures that they are being exposed to at college. Being solution oriented, CBT would focus on trying to modify the behavioral patterns of Hung. The counsellor in this case would enable Hung to diagnose his own problem. This would be done by establishing a suitable therapist – client relationship. If Hung is able to talk about his feelings out loud or write them down, he would be better able to deal with them. Since the main issues have been identified, as mentioned before, the therapist could help the client evaluate, identify and respond to his own dysfunctional thoughts which have been taking a toll on his own health.
Difference in techniques used in CBT and PCT
On the other hand, in the case of PCT, it is assumed that human beings are inherently positive in nature and would thus be more inclined towards getting better and achieving positive results. PCT would be helpful in this scenario because in this mode of counselling, the therapist acts as a facilitator – not a teacher. The client would be encouraged to share his feelings and thoughts without fear of judgment (Person, 2017). Unlike CBT, in PCT, the client would not be pushed in a direction that is deemed fit by the therapist. This particular approach would help the client feel confident about himself, regain his lack of control, build a stronger sense of self identity and also improve his ability to develop healthy and strong interdependent relationships (Joseph & Murphy, 2013). PCT would recognize that till this point, Hung’s identity has been intertwined with that of his children and as a result, he feels a lack of control and helplessness when his children develop their own identities and have lives outside of the home. After his wife’s death, Hung’s life had revolved entirely around his children. Owing to this distance that has developed between them, Hung feels lost and out of place.
As part of CBT, it is first important to identify the cognitive distortions evident in the patient, Hung. It can be said that he suffers from a case of polarized thinking, since he sees the world and people around him in black and white, without the probability of grey between them. He also suffers from control fallacies. He is under the impression that everything that has been happening to him has occurred due to external forces. A few techniques could be used in this case. For instance, cognitive restructuring is one method which may be used (Linehan, 2018). It is a technique in CBT where the client is compelled to reevaluate his negative thinking patterns and then come up with new ways of dealing with problematic situations (Johnco, Wuthrich & Rapee, 2013). For example, Hung would have to use the trial and error method to find out which techniques could help him deal with conflicts with his children in a more effective way. He could also try journaling where he would note down his thoughts and feelings. This would help him work out his emotions and get to the bottom of his negative emotions.
While CBT is a time bound therapy program, PCT is more relaxed and the client can take his time to address his issues. It is also important to acknowledge and accept the negative emotions of the client. Although PCT is centered around positive emotions and reinforcing positivity amongst the client, it is first important to understand the negative emotions which the client expresses. PCT is a more client oriented kind of therapy, where the emotions of the clients are given due importance (Quinn, 2013). The first step in applying PCT to Hung would be strengthening the client – therapist relationship. Next, Hung would be encouraged to talk about exactly what he is feeling or why he has been feeling that his children have distanced themselves from him. Unconditioned positive regard is one technique which can be used. Such a technique is based on the principle of acceptance, respect and care for the client’s needs.
The two modes of counselling, PCT and CBT, have two distinct approaches when it comes to dealing with clients. As the name suggests, the person centered therapy is entirely based around the client’s needs and requirements. It is based on a foundation of empathy and unconditional positive regard. PCT is based on the principle that each individual is naturally inclined towards positivity and that every human being has tremendous capacity for self growth and understanding and modification of attitudes and behavior if they are provided with the right environment and support. On the other hand, cognitive behavioral therapy suggests that any issue that a person might be facing would be due to negativity in thoughts and feelings and focuses on eradication of these feelings in order to restore normalcy (Johnco, Wuthrich & Rapee, 2013). While CBT is a time bound therapy, PCT involves as many sessions as the client may require.
PCT was first introduced by Carl Rogers in the twentieth century. Rogers was of the opinion that every individual is perfectly aware of his or her own problems and would know best about how to deal with them. Rogers was also of the opinion that by allowing the client to express their own feelings, speak their minds, being empathetic and creating an environment of warmth and authenticity, it would be possible for the clients to heal themselves (Rogers, 2013). The approach used in PCT is a non directive one, which means that the therapist is not expected to direct or steer the client in the direction he sees fit. Instead, the client is allowed to evaluate for himself and come up with his own solutions – thus evolving and growing in the process (Rogers, 2015). CBT, on the other hand, is more directive in nature. It is based on directive consulting tools and guides and similar exercises which seek to modify the behavior of the client. In fact, some critics have mentioned that the approach used in CBT is often manipulative in nature. In other words, the therapist in this case is expected to listen to the client, highlight major problem areas and prescribe them ways of dealing with it. The approach in the case of CBT is twofold – cognitive therapy and behavioral therapy (Gu et al., 2015). In CBT, the therapist analyzes how the client perceives the world around him and the environment and the conditions in which he or she is living and how that shapes his cognitive or emotional responses (Beck, Davis & Freeman, 2015).
Although CBT and PCT are distinct in terms of approach and techniques, there is one basic similarity between the two. Both PCT and CBT are concerned with the thinking patterns and the behavioral patterns of the client, Hung in this case. Both the counselling techniques delve deep into the underlying issues which may have resulted in emotional turmoil and behavioral problems in the case of the client. PCT and CBT acknowledge that negativity in a person’s behavior may be the result of past incidents and that there is always scope for improvement. Every individual is naturally desires to get better and thus would be willing to analyze his own problems and come up with relevant solutions (Cujipers et al., 2013). Yet, it must be mentioned that in the case of the two kinds of therapies, a difference exists as to how these problems are identified and dealt with.
The most suitable mode of therapy for Hung would be the person centered approach. This is because PCT entirely revolves around the needs of the client and Hung at this point needs a sounding board and a safe environment where he can express his feelings. Using the PCT approach, Hung would be able to open up about his feelings about his children and how he is losing control over them. Through PCT, Hung would be able to understand that his children are bound to change as they grow older and that he is too interdependent on them. He needs to be able to devise an identity of his own, distinct from his children, and find ways of accepting the harsh reality. Since PCT would place Hung at the center of the therapy, it would be possible to highlight his exact cause of emotional troubles and deal with them from a grassroot level. Through the process, Hung would be able to gain confidence and also independence when it comes to solving his issues without external guidance. By the end of PCT, he would be better equipped to analyze his own thoughts and emotions, identify destructive ones and rid himself of thoughts which act as obstruction to his peace of mind.
Conclusion
To conclude, it can be said that in the given scenario, there are two methods of therapy which may be used – PCT and CBT. Both methods have their own set of advantages and disadvantages and use different techniques and approaches while dealing with the client’s issues. However, as the above report shows, PCT would be most appropriate for the client, since it would help Hung in understanding his emotions and coming up with appropriate solutions for the same.
References:
Beck, A. T., Davis, D. D., & Freeman, A. (Eds.). (2015). Cognitive therapy of personality disorders. Guilford Publications.
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. The Canadian Journal of Psychiatry, 58(7), 376-385.
Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy. Guilford Publications.
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical psychology review, 37, 1-12.
Hans, E., & Hiller, W. (2013). A meta-analysis of nonrandomized effectiveness studies on outpatient cognitive behavioral therapy for adult anxiety disorders. Clinical Psychology Review, 33(8), 954-964.
Johnco, C., Wuthrich, V. M., & Rapee, R. M. (2013). The role of cognitive flexibility in cognitive restructuring skill acquisition among older adults. Journal of Anxiety Disorders, 27(6), 576-584.
Johnco, C., Wuthrich, V. M., & Rapee, R. M. (2014). The influence of cognitive flexibility on treatment outcome and cognitive restructuring skill acquisition during cognitive behavioural treatment for anxiety and depression in older adults: Results of a pilot study. Behaviour Research and Therapy, 57, 55-64.
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Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., … & Ritter, V. (2013). Psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder: a multicenter randomized controlled trial. American Journal of Psychiatry, 170(7), 759-767.
Linehan, M. M. (2018). Cognitive-behavioral treatment of borderline personality disorder. Guilford Publications.
PERSON, F. O. (2017). Person-centered therapy. Integrating the Expressive Arts Into Counseling Practice: Theory-Based Interventions, 155.
Quinn, A. (2013). A person-centered approach to multicultural counseling competence. Journal of Humanistic psychology, 53(2), 202-251.
Rogers, C. R. (2013). A Theory of Therapy and Personality Change: As Developed in the Client-Centered Framework”. Perspectives in Abnormal Behavior: Pergamon General Psychology Series, 341.
Rogers, C. R. (2015, January). Rogers, Kohut, and Erickson: A Personal Perspective on. In Evolution Of Psychotherapy……….: The 1st Conference (p. 179). Routledge.
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