Underlying Assumptions and Goals
Discuss about the Cognitive Behavioural vs. Person Centred Therapy.
Psychotherapy has emerged as an important facet in psychological studies over the last one century. Different theoretical approaches of counseling and psychotherapy have been developed to deal with various situations during psychotherapy. However, Serfaty et al. (2009) contend that psychologists have had difficulties in deducing which among the different counseling and psychotherapy methodologies fits different clinical situations. This is because these different approaches exhibit similarities and differences and only their comparison and contrast can decisively inform their precise application in psychotherapy. Even as such, whichever approach is employed, their application have been instrumental in helping patients to overcome psychological and emotional difficulties including stress, anger, anxiety, depression (Cloninger, Zohar, and Cloninger, 2010). In this paper, the focus will be on comparing and contrasting the application of Cognitive behavioral therapy and Person-Centred Therapy by underpinning the underlying assumptions and goals of either models; therapeutic relationships between caregivers and patients; and key approaches of and processes of change as well as limitations of either therapies. In doing so, the paper will explain the practical and philosophical perspective of each therapy using clinical examples.
The Person-Centred Therapy whose formulator is Carl Rodgers (1902-1987) is premised on the philosophical belief that humans are born with innate capabilities of psychological growth when in rightful external conditions. To this end, as the name of the therapy suggests, the model revolves around the patients themselves in which case Rodgers envisaged that clients know how best to deal with their psychosocial concerns. Therapist can only effectively assist clients to recover by carefully listening to their concerns and being emphatic. Prever (2010) assert that Roger foresaw the significance of carefully understanding the clients in the best way possible by comparing their understanding and interpretation of patients’ words as a critical yardstick towards advancing the most effective therapy. In practice, the Person-Centred Therapy aid therapist to advance the most empathetic psychosocial care to patients by being overly cognizant that patients possess within themselves the solutions to their own concerns (Tudor et al. 2004). This is especially the case for clients suffering from depression, anxiety, alcohol and drug abuse disorders, and mental concerns due to aging, dementia among others.
The Person-Centred Therapy gives a lot of importance to respecting the clients and their fundamental freedoms. This includes opportunities to express their concerns comfortably beside suggesting how best they feel their conditions ought to be addressed. The therapy, therefore , is a good example of a non-directive approach in which case the therapist do not literally steer clients or provoke them into being more emotional. As such, Cloninger, and Cloninger, (2011) insist that the counseling relationship between the client and the therapist is by and large purely based on empathy, congruence as well as unconditional positive regard. With the approach’s emphasis of prizing and valuing clients, the clients easily learn to acknowledge and reconnect with their true selves. This virtues advance the Person-Centred Therapy as a good example of recovery/strength-based practices that more or less bank on the clients’ conditions and strengths in advancing favorable psychosocial solutions to their mental and behavioral concerns.
Therapeutic Relationships
On the other hand, Kendall et al. (2008) posits that the Cognitive Behavioral Therapy whose origin can be traced from Ellis 1913 and Beck 1921 is concerned with our thoughts, perceptions and viewpoints and how they affect our emotions and the way we behave. The theorist envisaged that humans are overly receptive beings who will always respond to external stimuli and that their behaviors emanate from learning and conditioning. Since behaviors can be leaned, they can as well be unlearned. To this end, by the therapist actively being involved in assisting clients to recognize negative thought orientations, they can as well learn positive ways of thinking. In doing so, positive thinking ultimately affect the client’s feelings as well as their behaviors effectively changing their overall life attitudes. The philosophical banking in this type of therapy is on assisting clients recover from their retrogressive conditions and attitudes by being oriented systematically by their counselor to a psychologically and behaviorally elevated positive position. Cognitive Behavioral Therapy is instrumental in uplifting mentally challenged clients under the influence of drugs, patients under stressful and anxious situation such as terminal illnesses among others. Cognitive Behavioral Therapy, unlike its Person-Centred Therapy counterpart, is more or less a scientific evidence-based psychological treatment that overly banks on past medical and scientific research in advancing its treatment approaches.
Cognitive behavioral therapy, therefore, is premised on the employment of consulting tools in controlling and guiding clients in adopting more positive behaviors. These include conducting inquiries and asking questions, deriving and making interpretations besides directing and manipulating the patient’s attention and emotional expressions (Leahy, 2008). Clients are directly taught skills necessary in the change process and which would by extension minimize emotional distress and effectively change negative attitudes and behaviors. While some psychologists may perceive that Cognitive Behavioral Therapy as being overly manipulative, and especially when compared to its Person-Centred counterpart, this is not be the case as such. The therapy consists of two components that help to reinforce one another. These are cognitive therapies and behavioral therapies.
While cognitive therapy is inherently involved with how clients interpret the world around them and how these cognitive interpretations impact on their emotional experiences, behavioral therapy, on the other hand, is concerned with actions as opposed to thoughts (Manber et al. 2008). Cognitive therapy is overly concerned with the thinking process in which case it analyses how and why patients pursue a certain thinking orientation. This assists clients to focuses at altering these thinking patterns to more positive ones that can nurture emotional orientations they have earlier adopted. Behavioral therapy equips therapist with effective tools that assist clients to adopt new behavior patterns through the stimulation of certain positive “rewards” such as praise and encouragement. This by extension helps initiate positive changes in behavior in clients when confronted by certain life challenges.
Key Approaches and Processes of Change
From a theoretical rationale viewpoint in contrasting the two therapies, Cognitive Behavioral Therapy perceive behavior as a learning response while the Person-Centred Therapy view the absence of positive behaviors as a result of lack of self-actualization (Stephen, Elliott and Macleod, 2011). The Cognitive behavioral viewpoint of human experience is seen to be a by-product of the interactions of cognition, emotions, elements of physiology, and behavior. To this end, how we perceive and structure our experience directly inform how we feel and behave. The Person-Centred approach, on the other hand, advances the notion that a client develops a certain personality as a result of having been exposed to various experiences.
In comparing the two models, the role of the therapist can be perceived as being way less significant in the case of Person-centred Therapy than for the case of Cognitive Behavioral Therapy. However, this perception is rather far-fetched as it can be seen that Person-Centred Therapy, by and large, is involved in assisting client to open up by advancing congruence. Therapist showcase congruence by aligning their emotional orientations to those of the clients and in doing so motivates the virtues of being self-aware, and self-accepting. Lock et al. (2010) contend that therapists are obliged to be overly honest and natural while assisting clients with their emotional concerns by being empathetic in nurturing the patients’ inner abilities towards being healed. Since there is minimal therapist involvement in the healing process of the client, the Person-Centred Approach may take time to bear fruits.
On the contrary, the Cognitive Behavioral therapy in which clients’ contact with their therapist is more intact is more or less short-lived and is often viewed as a short-term treatment method. Therapists just need to be actively involved in continuous dialogue with their clients in which case they just require promoting their clients to develop their own thoughts and feelings to realize results more quickly. Unlike its Person –Centred counterpart, Cognitive Behavioral Therapy is more or less structured and goal oriented which provides which provides clients and their therapist to work as a team towards realizing particular goals on a step by step basis. This virtue allows the practitioner to track, monitor and evaluate progress towards realizing the set goals further motivating the client in believing in the change process.
While deciphering on the differences between the two approaches with regard to the process of change, change is bound to occur in Cognitive Behavioral Therapy through the continuous guidance of clients to first identify retrogressive thoughts patterns before eventually changing any irrational beliefs they may possess (Hofmann et al. 2012). In changing thoughts, this can take the form of altering the way clients react to different situations and events. Cognitive Behavioral Therapy can achieve this through education and training besides bridging the thought patterns into awareness behavior change.
Limitations of Either Therapy
Since the philosophical backing of the therapeutic relationship in Cognitive Behavioral model assumes a teacher/student viewpoint, practical clinical approaches in assisting depressed and anxious clients lies with continuous effective monitoring and evaluation of the same. This can be achieved through approaches such as reality testing. Reality testing is instrumental in challenging a client’s negative thoughts and beliefs effectively curtailing resultant negative emotions. Moreover, the utilization of Socratic dialogue is instrumental in supporting clients in assuming tenets such as positive beliefs, values, norms, and traditions to positively impact psychological and emotional functionality. Therapists are also tasked to help patients to bridge the gap between the present and future life by boosting their self-esteem. The adoption of remedial and learning skills is very practical to this end (Gilbert, 2010).
On the other hand, for Person-Centred Therapy, change like has been highlighted is nurtured by empathy, unconditional positive regard, and congruence ( Wilkins, 2015). With these facts in place, clients can learn to live their lives from an elevated new viewpoint and move ahead to self-actualize and attain personal growth. Rogers emphasized that, in a specific psychological environment, the achievement of personal potentials constitute sociability, interactions with other human beings and the desire to appreciate and to be appreciated. This is especial the clinical backing employed by rehabilitation efforts for patients under extreme alcoholism. Alcoholics in their rehabilitation process need to be advanced with an environment that by and large motivates their own recovery process. This includes advancing an environment in which social relations are vibrant, empathetic and respectful. Moreover, in doing so, the virtues of openness in communication, trustworthiness, curiosity, creativity, and compassion are very critical (Hayes, 2015). Therapist ought to strive to achieve these virtues if their assistive role in person-centered therapies is to bear any fruits.
While Cognitive Behavioral Therapy and Person-Centred Therapy showcase vivid differences in their model assumptions and change processes approaches, the two are by and large successful in their own right in offering clients reprieve from their conditions. They also share an array of similarities in effecting the emotional change process. First, both therapies deal with the cautious mind of the clients in dealing with the current concerns that may be troubling them. While being faced with imminent and threatening life concerns, clients tend to retract and relapse to earlier mental conditions that can easily further jeopardize their conditions (Stiles et al. 2008). To this end, therapists can use either of the therapies to quickly quench immediate concerns before moving ahead to exploit more sophisticated recovery approaches. Secondly, both therapies exhibit a positive viewpoint of humanity and perceive clients as not being by-products of their past experiences. However, instead, they give appreciation that clients can be sources of solutions to their own troubles and that they can effectively forge their own futures. This philosophical viewpoint is basically the basis of both Cognitive Behavioral Therapy and Person-Centred Therapy (Tolin, 2010).
Thirdly, both therapies are geared toward elevating the well-being of clients by means of collaborative therapeutic associations which by extension assist in expediting healthy coping mechanisms. This is especially the case for clients undergoing extreme psychological discomfort, pain, and disharmony in their lives. The philosophical gesture advanced by this similarity borrows from the vivid realization that humans are social beings who are always ready to interact. In doing so, Elliott, and Freire (2008) observe d that people are able to practically share what is troubling them with others and therefore able to solicit viable solutions. Fourthly, with regard to therapeutic interventions, the two therapies employ core virtues mainly empathy, congruence, and unconditional positive regard. For the Cognitive Behavioral Therapy, these virtues are used up to establish a working alliance between the client and the therapist. This is instrumental especially for clients with stress, depression, anxiety, personality disorders, and drug-induced mental disorders. Moreover, the association between the client and the therapist in both therapies is fostered by congruence in which case the skills of reflections, summarizing and paraphrasing come in handy. These virtues practically align the therapist to the client’s situation and thereby effectively offer clinically informed solutions (Mohr et al, 2012).
In addition to the similarities and differences highlighted here, the limitations of Cognitive Behavioral Therapy and Person-Centred Therapy inform further differences that either model can be able to fill. The Cognitive Behavioral Therapy is often floated by the psychologist as having aspects of playing down on the emotions of clients in which case it fails to recognize the underlying emotional unconsciousness of clients. Because of these aspects, the model fails to bridge the gap between the client’s past, present, and future emotional experiences. To this end, there is likelihood for clients under therapy to drop from the same for failure to cope up with the session’s expectations (Beck, 2011). This limitation is however filled by the Person-Centred approach in which the clients are allowed to actively lead their change process. However, Person-Centred Therapy exhibit the limitation of occurrence of limi9ted responses since the therapist assume a passive orientation. Clients are bound to lack direction since the counselor overly remains inactive only tasked with journeying with the client in the recovery process. This aspect poses the danger of lack of support to clients in the event of crises.
The foregoing comparison and contrast of the two therapies have by and large showcased that the two are indeed different in their approach in advancing therapeutic solutions to clients with different health conditions. However, the two possess significant similarities that may be used to reinforce each other if jointly applied. The main foundations of both therapies are similar. The two advance mutual understanding and cooperation between the client and the therapist as the most relevant yardsticks towards the healing process of the former. The two are premised on the philosophical viewpoint that clients themselves are by a large extent the solution to their own concerns (Clark, 2011). As such, both therapies allow clients to actively contribute to their healing process and indeed for Person-centred therapy they are supposed to assume a leading role on the same. To this end, Wilkins, (2015) observe that it is prudent for the therapist to be properly versed with both therapies in order to be able to choose one over the other depending with different client’s conditions and nearness regaining control of their own life.
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