Cognitive Behavioral Therapy - Dicussion Post COUN 835

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University of Colorado, Denver *

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835

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Psychology

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Feb 20, 2024

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What I like about Cognitive Behavioral Therapy is that it feels like what teachers do with students every day, and therefore feels very natural to me. We encourage students to engage in some behaviors and try to deter them from engaging in other behaviors, using positive and negative consequences, using various forms of punishment and reinforcement is what teachers do all day. Like teachers, Cognitive Behavioral Therapy also expects clients to “do”, and believes that by taking action – often independent action beyond from the office / school – is the best way for the client (or in my case, student) to really learn the concepts and effectively incorporate new skills, attitudes, or behaviors into their daily life. As a school counselor, there are opportunities to work with students to help them change their behavior in order to discover the possible differing resulting emotional response. For example, Opposite action wherein “behaving oppositely of the automatic response or action tendency (e.g., for shame the response tendency is to hide, whereas opposite action involves exposing oneself ), the emotional response and associated thoughts, images, and/or memories attached to the emotion may automatically change” (Lynch et. al., 2006, p.472). I am currently working with a student to get him to talk without constantly covering up his mouth because he is worried if anyone sees his teeth he will be teased. We practice talking without covering his mouth first in a mirror, then at home, then one-on-one with trusted teachers and peers, and eventually in class during a presentation in front of the entire class. After each new experience of speaking without covering his mouth, we discussed about the positive effects he was experiencing such as feelings of confidence instead of shame, knowing others are able to understand him better, seeing that no one criticized or mocked him, and even positive feedback from peers. All of that changed his behavior and even how he conceptualizes himself. Like school, Cognitive Behavioral Therapy focuses on getting the client / student out of therapy or school and into the real world, functioning independently without the therapist or teachers who have supported them and taught them the skills. The goal for this student was not for him to do his class presentation without covering his mouth, the goal was for him to be able to do so in the real world at work, on dates, and in his everyday life. I also like that it is heavily research and evidence based in terms of outcomes, and that there is great flexibility in method and mode of therapy. “A unifying factor in behavior therapy was its basis in derivation from experimentally established procedures and principles. The specific experimentation varied widely but had in common all of the attributes of scientific investigation including control of variables, presentation of data, replicability, and a probabilistic view of behavior” (Krasner, 2001, p.405). For all novice and inexperienced clinicians, I see the value in relying on reliable data, evidence, and even manuals in the absence of years of experience when making decisions about therapy and treatment. Because Cognitive Behavioral Therapy differs from Psychoanalysis in all the aspects that I find the most questionable or that I dislike most. For example, Cognitive Behavioral Therapy rejects the Psychoanalysis conceptualization of Personality as a consistent aspect of one’s identity and therefore behaviors and actions can be predicted. “Rather than explaining behavior in terms of stable characteristics or traits, behaviorists believe that behavior is influenced primarily by variables in the environment (reinforcement, punishment, classical conditioning, etc.) and that individuals behave differently across situations” (Wedding & Corsini, 2019, p.206). This is in alignment with what I see with my students every day, that the way they behave in school is different from the way they behave at work or at home. I also believe that how we behave is often influenced by the circumstances and the environment in which that behavior was learned – and I see evidence of this every day with my

three-year-old son. Instead of personality traits, Cognitive Behavioral Therapy focus on temperamental characteristics and how those natural characteristics “are influenced both by an individual’s learning history and by biological makeup. [while recognizing] that much of our behavior varies across situations and is determined by immediate situational cues” (Wedding & Corsini, 2019, p.207). Focusing on the environment in which the behavior or belief is manifested and then using those conditions to encourage or discourage a behavior without analyzing the original impetus or trying to go back in time to deconstruct an event, seems far more practical to me in terms of School Counseling and working with teenagers. I like the experimental factor and feel like that helps clients see a value and the results of the changes they are trying to implement. Cognitive Behavioral Therapy seems very goal oriented, as am I, and I think that is a good fit for School Counselors who have limited time to help student / clients, as well as a lot of opportunities to work with students outside of traditional therapy – like observing them in classrooms, facilitating learning experiences and opportunities to practice skills outside of the clinical office, and different methods of implementing treatment. Consequently, I think the opportunities to customize treatment to fit the unique needs of each cline / student are prolific with Cognitive Behavioral Therapy if the clinician do not focus on “whether a treatment works for a particular diagnosis but rather which treatment and by whom is the most effective for a particular individual with a particular problem as well as under what circumstances” (Wedding & Corsini, 2019, p.225). One of the potential pitfalls of Cognitive Behavioral Therapy is any clinician who is not very sensitive to the differences clients from diverse cultures might experience or interpret different events or even therapy itself, not to mention the very different ways they might conceptualize a problem or manifest a behavior. “The majority of well-known cognitive and behavioral therapies in the first and second wave are relatively mechanistic” (Hayes, 2016, p. 872). It would be easy to rely too heavily on the literature and statistics because there is so much many manuals available prescribing various Cognitive Behavioral treatments complete with scripts. But such a focus on the data detracts from really seeing and hearing the patient. “When behavior therapists think about the effects of the environment on a client’s behavior, they need to incorporate cultural influences into their definition of what constitutes the environment, including both positive and negative cultural influences” (Hays, 2006 as cited by Wedding & Corsini, 2019, p.226). Taking extra precautions to be sensitive and have empathy when working with clients / students from culturally diverse backgrounds, because the focus on facts and statistic does not emphasize the individualization and unique factors such clients / students face. One of the common criticisms of Cognitive Behavioral Therapy seems to be that some clinicians “presuppose that the form, frequency, or situational sensitivity of the thought itself leads directly to emotional and behavioral effects–an inherently mechanistic assumption” (Hayes, 2016, p. 872). To challenge that mechanistic assumption, the clinicians need to focus on the individual client and not the research, which is something I think I am good at doing as a teacher. “Several of the concepts seen as critical in client-centered therapy (e.g., including having a therapist who is supportive, warm, trustworthy, and congruent) are now known to be important in all psychotherapies, including behavior therapy” (Kazantzis, Dattilio, & Dobson, 2017, as cited by Wedding & Corsini, 2019, p.202). My natural inclination to be supportive and empathetic would facilitate using Cognitive Behavioral Therapy if I can capitalize on my innate skills in order to treat the patient and not the diagnosis, while capitalizing on the vast amount of data from Cognitive Behavioral research to inform my choices on therapies and treatments, especially as someone who is new to the role of therapist.

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