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Due to the availability of numerous counseling modalities, those specialists, who engage with this practice, often face the necessity of adjusting the general concept and ideology underlying the sessions to the patients needs and become extremely selective in applying the approaches to specific cases. The present paper is designed to provide a brief summary and evaluation of cognitive-behavioral and existential counseling modalities.
Summary of Cognitive Behavioural Counseling
Cognitive Behavioural Therapy is basically intended as a synergy of the cognitive and behavioral perspectives in psychotherapy and normally includes the modification of cognitions, beliefs, and assumptions, which is to be followed by the behavior change or alteration in emotion expression (Corey, 2005, p.297). In fact, this modality is an umbrella term gathering various sub-modalities, but its general concept is the interdependence between thoughts, emotions, and overall social and psychological functioning, which implies the negative impact of certain beliefs on the performance in the specific context (career, education, interpersonal relationships and so forth) (Corey, 2005, p. 301).
Due to the fact that the given modality needs a specific algorithm reflecting the relationship between human mental events and the subsequent behaviors, it includes Albert Elliss ABC Technique of Irrational Beliefs (Reynolds, 1999, p.166), which requires that the counselor analyze the three aspects of the disturbing belief in a three-column table. The first column contains an activating event or the objective situation, that is, even an event that ultimately leads to some type of high emotional response or negative dysfunctional thinking (Moore, 2000, p.45). The second column contains the precise belief that derives from the objective situation as well as the parallel negative thoughts.
The third column includes the consequences of thinking in the specific direction, including negative emotions, dysfunctions, and a decrease in human productivity (Moore, 2000, p. 46). Furthermore, Cognitive Behavioural Counseling necessarily involves self-observation and self-reflection, i.e. writing diaries of emotions, counting the intensity of obsessive thoughts, evaluating behaviors or feelings during the periods of abstinence, which are carefully discussed with the counselor and gradually transmitted into the real-life matrix, i.e. turned into helpful styles of self-perception, skills and more neutral emotions (Reynolds, 1999, p. 165; Jacobson et al, 1996, p. 295).
As one can understand, Cognitive Behavioural Therapy is a collaborative effort, involving the participation of both patient and counselor; the ideal counseling should include minimal pressure (e.g. advice) from the latters side, as the growth of awareness, realization, and understanding are the major prerequisites for its success (Reynolds, 1999, p. 166; Young et al, 2003, p. 118).
Another influential framework to be taken into consideration in Cognitive Behavioural Therapy is attribution theory, designed specifically to conceptualize the development of mood problems: First advanced by Lyn Abramson and her colleagues in 1978, this approach argues that depressives have a typical attributional style they tend to attribute negative events in their lives to stable and global characteristics of themselves (Jacobson et al, 2001, p. 252). Therefore, the Cognitive Behavioural modality necessarily focuses on attribution as a key to breaking the problem circle and constructing less biased causal relationships between external and internal events.
Summary of Existential Psychotherapy
Existential Psychotherapy is based upon the enormous legacy, mostly belonging to the philosophers of the 20th century (Corey, 2005, p.143) and thus maintains a philosophical view on human psychology. Its major purpose is the development of the users self-awareness through looking more carefully into the issues like solitude, the meaning of life, and mortality. Therefore, the given perspective focuses on subsistence as a spiritual process; for instance, it is assumed that individuals are alone in this world and thus seek to be connected to others (Corey, 2005, p.145) and thus the understanding of ones own meaning of life greatly involves social interactions (Frankl, 1986, p. 241; Hoffman et al, 2004, p.28).
Nevertheless, in order to set appropriate priorities and identify the meaning, it is first necessary to validate and recognize the solitude and the initial purposelessness of ones own subsistence so that the conceptualization of the meaning is a conscious process. According to Frankl, the meaning can be formulated from three sources. First of all, through taking from the world what is there, learning to savor and appreciate what is already given to us, as in aesthetic enjoyment of nature or the pleasures of the senses (Frankl, 1986, p. 198). Secondly, to give to the world and add new enjoyments to it through acts of our own creativity and by giving to the others in this way (Frankl, 1986, p. 221).
Thirdly, suffering and disappointment can be both edifying and toughening. In addition, the meaning could be found by juxtaposing life and physical fading, which finally brings the substantiation of the persons relevance in this world and the presence of meaning regardless of the lifestyle and earlier experiences (Daniels, 2005, p.165). On the other hand, individuals are responsible for choosing the meaning and thus should learn to solve their problems in at least relevant autonomy and without assigning the blame to their environment.
Existential therapy operates in four interrelated dimensions, all of which require the application of meaning. First of all, there is our involvement in a physical world of objects, where we struggle between survival and death. Secondly, there is our activity in a social world of other people, where we struggle with the contradictions between our need to belong and the possibility of our isolation (Daniels, 2005, p. 187).
Furthermore, there is also the personal dimension, in which individuals grapple with the tension between integrity and disintegration (Daniels, 2005, p.187). Finally, in the spiritual dimension, individuals search for meaning, with respect to the initial pointlessness of existence. The spiritual dimension is a residence of values, priorities, religious beliefs, and other tools which allegedly allow surpassing mortality.
Strengths and weaknesses of the CBT
Prior to evaluating the given modality, it is necessary to recognize the presence of the decades of experience and powerful empirical foundation, clearly demonstrating the advantages of Cognitive Behavioural Therapy (Corey, 2005, p. 297). Due to the fact that the given approach to a great extent employs rational inductive thinking, it substantially enhances the persons view on their future and is thus advantageous for the cases of behavior change. It involves a thorough analysis of the patients thoughts, emotions, and wishes as well as the logical generation of more realistic ideas, and the subsequent broadening of the persons worldview so that they can use the behaviors they previously could not even imagine (Moore, 2000, p. 47).
Behavior change is also facilitated by careful planning, especially in the cases with the direct necessity of systematic desensitization (liberation from addictions, unhelpful habits as well as from the anxieties, preventing the person from certain vital activities). For instance, in the present day, the Cognitive Behavioural modality is widely praised for its success in treating bulimia nervosa: Stage one focuses on educating the patient about the disorder and trying to replace dietary restraint with a more normal eating routine . Stage two highlights cognitive distortions that the patient might have toward body shape and the behaviors that may result due to these dysfunctional schemes.
Stage three concentrates on maintenance of change (Young et al, 2003, p. 124). This allegedly simple algorithm is often used in the cases of addictions and requires the utilization of countless techniques like the Socratic method (asking questions in order to achieve the core of emotion of thought), reframing, cognitive restructuring.
Clearly, this modality tends to bring the behavioral pattern into the objective social reality and thus normally provides a very relevant and constructive replacement that might contribute to the solving of minor problems, which relate either directly or indirectly to the specific focus of the therapy. Moreover, Cognitive Behavioral Therapy makes a dual influence on the human mind and actions, which points to its success in behavioral relapse prevention as well. As one can assume, behavior change is the initial realm for the Cognitive Behavioural modality and the precise demonstration of its strongest features in action.
Although the CBT employs certain research of the past experiences for the purpose of identifying triggers that initiate undesirable behaviors, this analysis is usually not deep, as the main area of effort is the thoughts and actions originating from the event (Reynolds, 1999, p.167). Moreover, due to the fact that little attention is paid to the context of the event, Cognitive Behavioural Therapy is less effective in healing and resolving the past.
The given modality initially strives for correcting the patients prospects, so the orientation to the past is limited; hence, it will succeed in restructuring the patients response to the traumatic triggers, but it is unlikely to untie the core attitude towards the trauma itself so that the person might not change their view on this experience to positivist (from the perspective of the knowledge that could be synthesized from the event).
Furthermore, given the reliance upon the relaxation and distraction techniques, this therapy might result in the conservation of specific negative emotions associated with the past event, especially taking into consideration the fact that the particular past experience is normally interrelated with the other experiences, past situation and the pressure of the environment. Therefore, through bringing the past event into the present-future dimension, Cognitive Behavioral Therapy simplifies and reduces it to the specific thought/pattern to be re-shaped, whereas the defining landmarks of the past are to be revised in their original context if the problem of resolving the past is apparent.
As a result, the processes of healing, spiritual regeneration, and reconciliation to ones past remain unfinished and might involve the patients autonomous work over their reminiscences, which might appear much less productive than the collaborative effort in the counselors office and even bring about additional anxieties and irrational conclusions (depending on the complexity of the past trauma or experience).
Strengths and weaknesses of Existential Psychotherapy
Due to its emphasis upon the spiritual dimension and the construction of meaning, the given modality allows managing with the challenge of spiritual development, which often appears as an unexpressed need. For instance, Frankls Logotherapy helps the patient comprehend themselves, develop deeper self-knowledge and liberate from the social, personal, or other subjective or objective restraints of freedom in the search for meaning.
The most important aspect of Existential Psychotherapy, in this sense, is its comparative independence from the temporality, from the here and now context, as it seeks to develops a more abstractive perspective on their existence from above , i.e. the patient in certain moments becomes an impartial observer of their own life and appears to some extent aside so that the analysis becomes more comprehensive (Hoffman et al, 2004, p. 18).
Therefore, the given modality implies changing the distance between the person and their own existence from personalized focus to the mental ascension over the life into the more abstractive and spiritualized dimension. Due to the fact that most aspects inherent to spirituality are intrinsically abstractive (religion, the fate of the human soul after physical expiration, inspiration, and insight), the Existential modality is particularly successful in approaching the patient to the relationship between the past, present, and future in the four dimensions and the distraction to more universal philosophical dilemmas and challenges such as Why am I not somebody else? , What would happen if I were somebody else? , Are humans entitled to kill other homo sapiens? , Do I have the right to kill myself? and so forth (Daniels, 2005, p. 182).
Philosophizing is actually amongst the most enlightening activities and thus fruitful in terms of the utilization of inner intellectual and moral resources; as a result, it facilitates the process of deciding upon the boundaries between good and evil, truth and falsehood, i.e. laying the personal spiritual foundation apart from the collective consciousness.
Due to the fact that the given modality often requires that the specialist take a less active role in the conversation, the spiritual development appears to the patient as a deliberate rather than forceful process and thus belongs to their personal advancements. On the other hand, given that the multidimensional perspective is employed, Existential Psychotherapy still keeps the patient in the social frames, i.e. the spiritual development does not make a destructive impact upon social functioning or reasonable social interest (Daniels, 2005, p.188).
On the other hand, the given approach is barely applicable to the necessity of skills development. Skills are an integral part of human behavior, and due to the fact that the given perspective is not directed specifically at re-shaping specific activities, it might not bring the desired effect.
On the one hand, the modality actually leads the patient to the good life, through the concepts of loneliness, freedom, and responsibility and constructs a worldview; on the other, it implies little control over the manifestation of willpower, a vital component of skills development. In this sense, the patient receives freedom of self-determination, which might urge the formation of additional skills, but overlook the formation of self-discipline and self-control, as Existential Psychotherapy normally does not alter personality traits. Therefore, skills development as a responsibility should be completely carried out by the patient themselves and thus depends precisely upon the service user, whereas the counselors role relates to guiding and facilitating the patients reflections upon the concepts, mentioned in the summary section.
Summary of Gestalt therapy
Gestalt therapy in counseling actually refers to putting the patients experiences into the social context in which they took place, however, it also emphasizes current reflections upon the reviewed and reconsidered remembrances(Corey, 2005, p.195). According to the two basic Gestalt premises, developed by Nevis (Corey, 2005, p.196), individuals actually live in the present, but remain caught by the webs of relationships and influences and thus need a bridge, uniting the past and the future.
On the one hand, perceiving and feeling are placed to great extent apart from the judgments, based upon earlier attitudes; on the other, the distinction between the pure episode of higher nervous activity (e.g. current emotions) and its interpretation and analysis is emphasized in the given modality and thus can be viewed also as a link (due to the fact that the service users awareness in the presence of the given relationship grows); therefore, the implicit nature of Gestalt therapy is this peculiar dualism.
Given that this modality also relies greatly upon the 20th-century philosophy (phenomenology), the role of epoche, or unbiased and pure perception, not yet touches by the human processor , is clearly identified and logically supplemented with description and horizontalization. The final goal of this interesting vector of counseling is the construction of self-image, granted with freedom and at least relative novelty in each particular case of perception.
Due to the fact that the given perspective was first intended for patients with neurosis (Corey, 2005, p.195), who, as one knows, almost automatically develop high nervous tension in response to certain situations and thus need to operationalize by themselves (yet with the professional assistance) the invalidity of their fears as earlier experiences, applied to the newer situations. Those counselors, who utilize the mainly phenomenological method, also carefully trace the patients body language and provide continuous feedback upon it, stressing the points of incongruence and encouraging the interlocutor to learn and express their inner epoche more accurately.
Conclusion
To sum up, the present paper once again confirms the importance of the attentive and careful selection of the counseling modality from the position of its relevance to the particular life situation. In this sense, the unquestionable strength of Cognitive Behavioural Therapy consists in its success in behavior change due to the presence of reasonable control, assistance, and empowerment from the counselors side, but the given approach is less workable in healing and reversing the past with regard to its implicit orientation to the present and future.
Existential Psychotherapy, in turn, has a powerful philosophical framework that can be adjusted for the cases of spiritual development through taking a more theoretical look at the human condition, whereas its usefulness for skills development is doubtful because of the lack of counselors assistance in the given aspect of change.
Reference list
Corey, G. (2005). Theory and Practice of Counseling & Psychotherapy (7th. Ed). USA: Thomson Brooks/Cole.
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Frankl, V. (1986). The doctor and the soul. New York: Vintage.
Hoffman, I., Grimes, C. and Mitchell, M. (2004). Transcendence, suffering, and psychotherapy. Bi-Annual Conference of the International Network for Personal Meaning working paper. Canada: Vancouver.
Jacobson, N., Dobson, K., Truax, P., Addis, M., Koerner, K., Gollan, J., Gortner, E and Prince, S. (1996). A Component Analysis of Cognitive-Behavioral Treatment for Depression. Journal of Consulting and Clinical Psychology, 64 (2): pp. 295-304.
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Young, J., Klosko, J. and Weishaar, M. (2003). Schema Therapy: A Practitioners Guide. New York: Guilford Publications.
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