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The research paper is an in-depth analysis of practices of cognitive behavioral therapy and effectiveness in treatment. Cognitive behavioral therapy abbreviated as CBT has been thought of as a psychotherapeutic mechanism, a talking therapy with the ultimate goal of solving various problems relating to dysfunctional emotions, health disorders, behaviours as well as cognition via a step by step process that is foal centered. Ideally the approach uses the synergy of using both behavior and cognitive therapy. Cognitive Behavioral Therapy is a proven treatment for a variety of mood and eating disorders as a supplement to medications and for that reason has been considered as a form of psychotherapy for numerous disorders (Kazantzis, et al. 2007).
It is worth noting that more often than not the treatment is manual having certain briefs, directions as well as time specific aimed at a certain disorders. It is applicable on individual as well as group basis. Additionally, the merging of cognitive therapy and behavioral therapy is attributed to creation of CBT. Similarly, it is interesting to have in mind that CBT has been preferred over certain approaches such as psychodynamics treatments. For instance, the United Kingdom through National Institute for Health and Clinical Excellence recommend CBT for mental illnesses such as bulimia nercosa, post-traumatic stress disorders among others (Carroll, 1998).
Brief History and Development of Cognitive Behavioral Therapy in counseling
Historically, CBT was first used between the 1960 and 1970. As previously stated the process entails an approach where psychotherapist influences patients' behaviours as will as emotions. This is done in a systematic manner. It was during this period that the two aspects were merged. However, philosophical origin of cognitive therapy can be coined to stoic philosophers. On the other hand, behavioral therapy origin dates back in 1924 where Jones Cover worked on unlearning of fears in young individuals. 13 year later Low, A. came up with a cognitive training mechanism aimed at car8ng for patients immediately after under going treatment. This was used to help individuals suffering from mental illness.
Broad application of behavioral therapy was experienced between 1950 and 1970. For instance, in UK behaviorists such as Ivan Pavlov, Watson, B. among others influenced what happened in UK whereby, the center stage was in dealing with neurotic disorders. It is worth noting that despite the fact that the approach was successful in dealing with neurotic disorders, it failed to adequately tackle depression. The failure is attributed to emergence of cognitive therapy which was first portrayed by Ellis A. in the beginning of 1950. Ellis came up with Rational Emotive Therapy as a reaction to the unsuccessful approach of psychoanalysis which was in-direct and in-efficient. The central focus for the development of the approach is from these statements; "Men are disturbed not by things, but by the view which they take of them" and "I am convinced that a person's behavior springs from his ideas" by Epictetus and Adler respectively (Beck, et al., 1979). The ABC which was later modified to ABCDE model was the effort of Ellis, his approach was later renamed Rational Emotive Behavior Therapy.
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In 1960s, Beck, A. came up with the cognitive therapy which was effective in curbing issues relating to depression. During the same period, student of Ellis Maultsby is credited for developing rational behavior therapy which emphasized on customers rational self-counseling skills as well as therapeutic homework. It was during the years of 1980s and 1990s that the two approaches were merged, cognitive and behavioral therapies. This is attributed to contributions of Clark, D and Barlow, D. in treating disorders relating to panic. Later, Lazarus, A. was propelled with the quest to improve effectiveness of treatments came up with what was dubbed multimodal therapy which was mainly based on CBT including physical sensation, biological attributes, visual factors as well as interpersonal attributes relation to associations (Rodriguez, 2007). Currently there are numerous scholars who are trying to broaden the application of the approach. For instance, Yochelson, S. was of the idea that the same can be used to help individuals who have engaged in criminal activities.
Introduction of CBT and its importance in the field of counseling
Counseling is an activity that is usually undertaken in human day to day existence. Counseling usually aims at increasing individual or group senses of their well being. There are various ways used by counselors to attain this. Among the mechanism include communication, behavior change, dialogue and empirical building of relationship that will ultimately help improve mental status of targeted individuals. It is important to remember that individuals qualifying from various fields including clinical social work, psychoanalysis, occupational therapy, clinical psychology among other related fields can work will in applying CBT in helping affected individuals. However, based on jurisdiction, the practice can be regulated or unregulated and even voluntarily.
The introduction of CBT referring to a number of processes that are centered in constructing as well as reconstructing human beings cognitions, sentiments as well as behaviors. The approaches have helped consumers of the services not only to adequately handle and recognize but also assessing the problems they are facing. Additionally issues relating to how they think, react and behave are of essence.
As suggested by Wampold et al., 2002, one notable importance of CBT is tat it can be applied to tackle a number of issues such as depression, anxiety, drug abuse, poor relationships, insomnia, low self esteem, panic related problems, eating disorders, obsession to mention but a few. Having n mind that it is a short term initiative and has the potential of yielding positive results if implemented in the most rational manner, it is a cost effective initiative to both the customer and the therapist. More importantly, the approach has been hailed to be dealing with here and now. This plays a major role in making individuals learn to be therapists for themselves. With search skills, they can also help member in the society who are suffering from the previously mentioned problems. Similarly, the approach when used to identify a core schema, it further covers a wider range of cognitive errors in clients thinking. This goes further in helping them to manage a variety of problems they face. However, it is worth noting that this does not always happen.
Additionally, the technique helps customers to point out the fundamental reasons as to why they usually behave or feel in give situations. More importantly, CBT works well even if individuals are under medication. A number of scholars have proved that the mechanism does not in any way interfere with medication. Lastly, CBT has been credited for the following, attempting to respond to varying to negative scenarios or cases, reducing strain of depression, raising individual self esteem, tackling issues relating to panic and fear in a calm manner and more importantly revering the negative patterns of individual thinking as well as emotions.
It is wrong to think even for a second that CBT is a simple process. It calls for several painstaking and a long term plan or process of psychoanalysis as well as treating the brain so that the old thinking as well as feeling of desperations is taken away. To render one happy again and enjoy life to the fullest without regrets is thus a task that needs determination from both parties (Robert, 2003).
The major themes covered with regards to CBT include how it works, criticism it has received, personal centered approach and group approach, home work and structure and finally the difference with other approaches. It has been noted that there are two main approaches to using CBT, personal centered and group centered approach. The former will be the center of discussion. When employing CBT to personal centered counseling the client is viewed as the boss since they are capable of fulfilling their own growth and change. To acquire success, counselor is fully aware that there is need to have a favorable environment in which the two both client and therapist will open up and help the former in quickly recovering. Clients are provided with an environment in which they feel totally acceptable. Aside from this personal centered approach, group counseling has also proved to be fruitful in certain situation especially in familial settings or group of individuals sharing same problems for instance drug abuse. However it is worth noting that this is only applicable only in the initial stages of CBT implementation. In such an environment, participants are allowed to openly share what they have.
On the same line of reasoning, the therapist has an opportunity of reaching a larger number of individual with a given problem hence getting to help majority within a shorter time. It is worth noting that the therapist only acts as facilitators and notes some incidences of information being held back. From there, the therapists and the respective clients sit down and plan on the way forwards in solving the problem at hand. It is worth noting that the whole scene will then change to be personal centered where the client is central and his/her requirements are placed in the forefront (Wampold et al. 2002).
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The issue of home work and structure has been used in CBT for a long time and ha proved to be an integral part in attaining the desired goals for the clients. Additionally what is expected during CBT is of essences and opts to be discussed. During a CBT session, both the relevant parties; client and therapist engage in discussion on issues affecting the former. This is attained by the later crating a conducive atmosphere in which the client will be free and share all vital information at their own pace. Additionally, the therapist work towards delving beyond conscious thoughts of the clients aimed at giving a succinct explanation of how the client is feeling or rather behaving. During the time, the aim is to closely examine problems faced by individuals and breaking them into small manageable sections (Rodriguez, 2007). Additionally, this helps the two parties to be able to see the problems in a new angle ultimately resulting to addressing the problem in a positive manner. The following are done at this stage; identifying the problem, establishing thoughts and emotions related to the problem, physical reaction and the action to be taken.
As suggested by McKay et al. 2007 using homework in between the sessions of CBT has numerous advantages. For instance, it gives clients an opportunity to not only actively take place in the initiative but also learn how to be therapists of their own. Additionally, results from homework also make the therapist know what kind of efforts need to be added and whether the client is changing towards attaining the desired goals. It has also been noted that CBT entail creation of a plan to be followed. The structure is of significance as it helps the team to effectively and creatively use time. Following the plan ensure that no step is missed which would later jeopardize attainment of predetermined goals and objectives. More importantly, the structure play an integral; part in ensuring that the client feels empowered as there is a balanced participation between the two parties.
According to Aldo, 2009 CBT is indeed different from other approaches aimed at helping individuals address problems arising from their emotions and thinking. Most of the approaches give client a bigger role in the whole process, however, with CBT a more equal relationship between therapist and therapist is advocated for. The scenario is made to be like business, practical and centered on the problem. There is adequate sharing of information between the two involved parties.
Although the initiative has been hailed to curbing serious problems such as depression, there are critics of CBT. One major criticizes is on how the improvement of client is measure. The use of questionnaire which asks clients to rank how they felt before and after treatment has been viewed as not being scientific and evidence based. For that matter the effectiveness of the whole process is nothing but opinions (Brambilla, 2010). Additionally, since the whole initiative is a new, there are needs to critically evaluate the long term effect of CBT on psychiatric disorder. There is no need of championing it before a long term follows study is carried out to exhibits its long term effectiveness and success (Harrington, et al. 1998).
Important elements of counselor identity, function, and ethics
It has been argued that for one to successfully work as a therapist there is need to first get academic qualification. Fields that one can study and became an effective therapist include clinical social work, physical psychotherapy, and clinical therapy among others (Neale & Davison, 2001). A part from academic qualification, exhibiting of certain leadership qualities such as being able to accommodate others, leading by example, being tolerant, understanding, acting assertively, having strong interpersonal skill to mention but a few. Counselors in CBT engage in a number of activities but the major ones include being a facilitator, crating a favorable environment in which the client will feel comfortable to open up and share vital information, help make clientss feel accepted in the eye of others (Ellis, 2001). Together with the client, the counselor helps in problem identification, alternatives to be taken, setting goals and developing plan of action. It is worth noting that counselors are bound by ethics. They are called upon by laws to respect their clients and always act ethically during the time they are handling clients and even when they are not. For instance, they are supposed to keep information they are provided with by clients confidential and not to disclose it unless compelled by law or share it only with the tam of counselors helping the client.
Biblical Values and insights related to topic
In the book of Philippians 4:8 "Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable--if anything is excellent or praiseworthy--think about such things". This expression clearly shows that there is a close link between CBT and religion. McMinn, 1996 acknowledges that most of the counselors who have Christian background in most cases do not use bible as they engage in counseling clients. An explanation of how Christians deemed to be hard cores rarely used the bible in psychology. However, it is apparent that the present Christian counselors only use the scripture as a backing to the way they offer counseling (Beck, 2005). The author holds a very strong believe that for one to be effective and successful in counseling, one opt to acknowledge that the profession is deeply a personal initiative and process that mirrors his/her Christian way of living. Additionally it reflects the counselors experience as well as educational background. On the same note raying for clients outside of the counseling session or in counseling sessions quietly is strongly urged as it can help and does not put the client at any risk.
Open prayer, however, with the client can be both helpful and harmful. On the positive, clients can learn how to pray and can grow closer to God by petitioning in prayer or by worshiping God. On the negative, clients may grow too intimate with the counselor or may not pray by themselves believing the prayers in the counseling sessions suffice. McMinn (1996) emphasizes it is critical for the counselor to have his or her own prayer times to remain strong with the Lord. Scripture is rarely used in counseling according to McMinn (1996) despite its healing potential. Psychologists help clients find the truth within themselves and to count on themselves to solve their problems. Christian counselors, however, look to God for this and to Scripture for the Truth. Depending on the client's mental and spiritual well-being, a counselor must determine the appropriate use of Scripture. Some clients blame themselves for their choices in life while others blame everyone else. By accenting the concept of origin of the problem, those clients who blame themselves can be given hope. By accenting personal problems, those who blame everyone else can be shown their own part to play and can be redirected towards God (Burns, 1999).
Confession of their feelings and behaviors can lead clients into a new relationship with God and those people around them. Some who think poorly of themselves resist confession due to the discomfort it brings while others who think too highly of themselves resist it out of sheer pride. Psychologists use confession to come to a place of comfort while Christian counselors use it so clients can see themselves and God in the right light. Forgiveness, as with confession, can be used by psychologists to free clients of the pain and memories which have held them back. Christian counselors encourage forgiveness as a Christian duty. God tells us to forgive and so we should. However, true forgiveness comes when Christians are aware of their own inequities and forgive their perpetrators out of kindness and compassion (Ashford, et al., 2008).
Redemption of the client occurs when God cleans the slate of all the client's sins and provides him or her with a new Christ-centered life. "What you think about in your unguarded moments reflects what your mind dwells upon. What you speak about when your guard is down is a good gauge of what is in your heart" Mt 12:34 shade more light on the basis of how CBT works, hence the later deriving values from religious background. Counselors can play a role in this process by providing comfort to their clients and perspective on their clients' lives. God ultimately provides the redemption. The views are thus in line with studies which have established that religion offer clients with a number of strategies to coup with problems which entail concepts from religion backgrounds to help improve the outcomes of CBT (Aldo, 2009).
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Personally, I agree that CBT is one best option in curbing various problems facing mankind. The benefits derived from such an approach can go an extra mile in making individual reconstruct their lives and live a happy one without regrets. However, there is need to carefully plan everything during the process to ensure that the predetermined goals are attained. I have also learnt that there is a close relationship between biblical values and CBT (Rodriguez, 2007). For that matter, I would strive towards acquiring further knowledge aside from medical knowledge to be able to adequately in corporate biblical views and insight in my counseling activities. I intend to enroll for maters degree in counseling that also has some theological background. With regards to ethics, I will strive to familiarize my self with existing laws in my state as well as others and the federal regulation with regards to counseling and CBT.
From the review of practices of cognitive behavioral therapy and effectiveness in treatment, it is apparent that the approach came to lime light in early 1960 throughout 1980s. There are numerous benefits associated with CBT for instance reducing depression, increasing personal esteem among others. When compared to Gestalt Therapy in correlation studies, CBT was rooted in empirical methods for treatment in the average population. Biological differences in the level of neurotransmission in patients treated by CBT compared to patients who do not receive the treatment were shown to be present.
The origins of CBT, together with empirically validated research support the use of CBT as the primary form of psychotherapy for many clinical disorders. Nonetheless, there are critics of the approach who claim that it has not yet stood the taste of time and there is need to initiate studies that aim at evaluating the long-term effect of the approach. On the same note CBT has a close association with biblical values and insights. Ethics is equally important in being a counselor or therapist.
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