Term Paper: Cognitive-Behavior and Reality Therapies Cognitive-Behavior Therapy

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Cognitive-Behavior and Reality Therapies

Cognitive-Behavior Therapy

Behavior Therapy began with Dr. Joseph Wolpe in the United States and his parallel in England, Hans Eysenck. Later, combined with Cognitive Therapy, it was termed Cognitive- Behavior Therapy by Ellis (1962), Beck (1975) and Meichenbaum (1977). There are several approaches to Cognitive-Behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy (What, n.d.). Behavioral Therapy is based on the stoic philosophy and uses the Socratic (teaching) method.

The theory and practice, developed from years of frustrating experiences, was that a person can change their own maladjusted thinking with the consequence that feelings and behavior changes occur (Westchester, n.d.). Interruption of thought processes can be learned and, if relaxation training, assertiveness training and stress inoculation are used, negative behaviors and thoughts are replaced by positive thoughts and behavioral strategies. This highly successful technique was made popular by David Burns in his book Feeling Good - the New Mood Therapy (1980). In his book, which has been updated from time to time, Dr. Burns claims that his simple, effective mood-control techniques using cognitive therapy provide rapid symptomatic improvement, understanding of why one is moody, self-control by using coping strategies, prevention of future mood swings and personal growth. He claims that cognitive therapy is at least as effective as, if not more effective than an antidepressant drug therapy, based on a study of 40 depressed people done at the University of Pennsylvania School of Medicine. The drug that cognitive therapy won out over was Tofranil (imipramine hydrochloride). (p 14)

When one speaks of cognitive-behavioral therapies in general, most have the following characteristics: They are based on the cognitive model of emotional response, since thoughts, not external things, cause feelings. These therapies are the "fastest" type of treatment in terms of positive results obtained. The average number of sessions to effect a change is 16, while other forms of therapy can take years, and behavioral therapy does not require a strong or positive relationship with a therapist. Most of the work is done by the client, in practicing their "homework." (Burns, 1999)

The best thing about cognitive-behavioral therapy is that it is structured and directive. It focuses on helping the client to achieve the goals they have set. Therapists simply teach their clients exercises in how to think positively. Based on the inductive method of rational thinking, one learns to base one's thinking on facts, rather than assuming that some things are true which may not be true (What, n.d.). This appeals to me, along with the idea of present and rational thinking and it being the result of the correct assessment of facts. I like the idea of looking at thoughts and finding out how these thoughts (one's ideas about what one observes) affect emotions and subsequent actions. It has been shown that when there are changes in maladaptive thinking that changes in feelings and behavior will occur (Westchester, n.d.).

The hardest and most effective part of Behavioral Therapy is that the client must practice his or her homework for the method to work. If one is not used to studying and practicing, in other words disciplining, oneself, then the method is less than successful. If one is not used to examining one's own thinking, then this method demands a therapist who is a good teacher, because one must not only learn to think correctly, but to "unlearn" incorrect thinking. This might be a challenge to even the most thoughtful of clients and asks that the therapist deal with clients mainly as "students." This is the part about cognitive-behavioral therapy that I prefer the least. I prefer dealing with clients on a one-to-one basis, helping them probe their innermost thoughts in a caring manner. Assigning homework and making sure the client practices exercises is not appealing, even though rapid change may be effected. The fact that the therapy does not last very long to get results is both attractive and frightening, as the methods practiced that solved problems so rapidly may be retained and practiced only temporarily.

Reality Therapy

Reality Therapy was founded by Dr. William Glasser in the United States in the 1960s, who set up the Institute of Guidance Counselors in Ireland, in 1985. Glasser believed that changing what we do is the key to changing how we feel and to getting what we want. Based on a broad range of theories and therapies, Glasser said that Reality Theory was based on "Choice Theory," that is, based on internal motivation to try and fulfill the wants and needs outlined by other theories, but behavior is "total" and made up of the interlocking components of acting, thinking, feelings and the physiology, (acting and thinking being voluntary). The wants and needs of other theories are outlined as Power (which includes achievement and feeling worthwhile, as well as winning), Love and Belonging (which includes groups, families or loved ones), Freedom (which includes independence, autonomy, and having one's own "space"), Fun (which includes pleasure and enjoyment) and Survival (which includes nourishment, shelter and sex). (Glasser, n.d.) friendly and people-centered approach, the proponents claim that we all act to meet the needs outlined above, and that we can make plans to obtain these goals with the help of a therapist certified in Reality Therapy. When the client is in control of what he or she does, workable strategies to reach obtainable goals in each of these areas can be made and implemented. So positive actions are at the heart of the therapy that, in theory, admits that emotions are the measuring rod that tells us whether we are being successful or not. Control is considered the key to what is called "Choice Theory" and the only person that one can control is him or herself. The theory is called Choice Theory because one chooses to control oneself rather than to control others, or have others control him or her, both of which lead to frustration, anger at others and loss of respect for oneself. Loss of control may involve drinking or taking drugs, which in Choice Theory are replaced by doing something positive, rather than in an activity that results in loss of control over oneself. With Choice Theory one chooses one's plan, rather than using external control psychology. (Rogha, 2006)

The counselor is one who helps the client look at his or her past for successes, as well as failures that have brought the client to this point. This is a very positive and forward-looking therapy that helps the client develop a positive image of him- or herself, and gain hope that one is not a victim, but in control. This idea of hope and positive steps reminds me of the Christ-centered theory of "loving oneself," and how one acts positively towards others if one loves oneself. The idea of taking one step at a time to gain control over and respect for oneself is a workable plan, for if one doesn't forego all pains (such as feeling sorry for oneself) and indulgences at once, one can gradually bring oneself into a state of self-control.

On the other hand, a client who is severely depressed or an addict (as many clients of this type of therapy are), would take a great deal of time and work to be brought, step-by-step, into a positive view of him- or herself. If clients' past lives conditioned them to act in self-negating manners, it would be difficult to bring them into a conscious state in which they agree that their whole life is based on satisfying the basic five needs and relearn how to act to satisfy those needs with positive actions. Dr. Glasser quotes the saying "the truth shall make us free," but the truth is difficult to believe unless one discovers… [END OF PREVIEW]

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