A Theory Based Evaluation of Cognitive Behavioural Therapy Sample Essay

The intent of this essay is to supply a theory based rating of Cognitive Behavioural Therapy ( CBT ) . The first portion of this essay will concentrate on specifying CBT including a brief description of its derived history and the therapies that have contributed to its development. I will so travel on to reexamine the tools used in the four measure procedure of CBT ( appraisal. preparation. intercession and rating ) . I will besides integrate how my acquisition of theoretical constructs relates to my work based pattern.

Cognitive Behavioural Therapy is a psychotherapeutic attack that aims to work out jobs refering with dysfunctional emotions. behaviors and thought ( knowledges ) through a goal-orientated. systematic process. Harmonizing to Craddy. CBT helps clients to alter their behavior and their thought forms. He states that clients can larn to ‘tolerate unpleasant feelings and discover that they are likely to decrease with time…they can be persuaded that avoiding experiences of any degree of anxiousness in the short term is non needfully advantageous to their mental health’ ( Craddy. 2006 p. 28 ) . CBT is a brief and clip limited therapy which is extremely effectual for a figure of upsets including phobic disorder. anxiousness. depression. eating upsets. drug or intoxicant jobs and kiping upsets.

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From the 1970’s CBT became politically appealing in the United Kingdom. At that clip there was a big figure of the population being in reception of sickness benefits and on medicine doing a fiscal load on the economic system. The Government’s purpose was hence to turn to these issues by utilizing CBT. This therapy suited the political docket as CBT was cost effectual. mensurable and was a short term intercession peculiarly when compared to other therapies. However. it is of import to recognize that CBT does non run into the demands of all persons and will therefore non ever be effectual. Other types of therapy should non be dismissed. In add-on to this. CBT has been criticised as being a ‘simple minded “cookbook” attack to therapy: if the client has this job. so use that technique’ ( Westbrook et al. 2011. p1 ) . Very frequently. CBT clients will return to a CBT healer a figure of old ages subsequently after it was foremost received. This can therefore raise the inquiry. how effectual was this therapy the first clip it was accessed?

CBT was developed through the meeting of two therapies. Behaviour Therapy and Cognitive Therapy. I will non travel on to discourse Behaviour therapy in more item.

Behaviour Therapy developed in the early twentieth Century with its three distinguishable points of beginnings in South Africa ( Wolpe ) . United States ( Skinner ) and the United Kingdom ( Rachman & A ; Eysenck ) . Behaviour Therapy is based on larning theory which aims to handle the client through techniques designed to reenforce desired and extinguish unsought behaviors ( McGuire. 2000 ) . Classical and Operant Conditioning are seen as the primary theories of larning. Classical conditioning ( Pavlov ) is described as acquisition that is achieved through association. for illustration a fright of the tooth doctor possibly associated with the feeling of uncomfortableness and hurting. Operant conditioning ( Skinner ) is described as a procedure of acquisition responses through positive and negative supports. Skinner describes positive support as wagess which are given every clip a right response is given to a stimulation e. g. fondness may be given as a ‘reward’ to a kid. That kid will reiterate that behavior to endeavor to derive that fondness once more. Negative support is described as the remotion of the unpleasant stimulation once the correct response has been elicited. In other words. negative support is if something such as hurting that is relieved through analgesics is removed from us. we would make for the analgesics once more if the hurting returned. Harmonizing to Skinner. both positive and negative supports beef up our behaviors but penalty weakens it.

It is of import to admit that conditioning can sometimes be imposed upon us without us gaining. The media for illustration could make this through advertisement. This could be peculiarly damaging for vulnerable and immature persons. for illustration they may believe that they must look or act in a certain manner which could be damaging to themselves and/or society ( e. g. young persons – ‘hoodies’ . anorectic – free more weight ) .

Although it has been argued that the early work of behavioral attacks were successful in handling many neurotic upsets. they had small success in handling depression ( Clark et al 1997 ) . Whereas behaviour therapy sees behaviour as learnt which can hence be unconditioned. in contrast the psychodynamic attack sees behaviors to be governed by pent-up unconscious idea and by the ego’s effort to cover with psychic struggles which is caused by twenty-four hours to twenty-four hours life. Person Centred Therapy sees human behavior to be ‘motivated by an unconditioned thrust towards growing and integrity. Disturbed behavior is seen as an indicant that growing is blocked either through deficiency of consciousness or distorted perceptual experience. or both’ ( Hough. 2002. p158 ) . It would look that Behaviour Therapy does non let clip for growing. which in bend leads to the client’s deficiency of deeper understanding into their jobs.

I will now travel on to discourse Cognitive Therapy. Beck’s theoretical account of Cognitive Therapy is agued to be one of the most influential CBT theoretical accounts ( Wills. 2006 ) . It was in the 1960’s that he developed his attack which became best known for its effectual intervention of depression. Harmonizing to Wills. Beck’s theoretical account suggests. ‘there are specific cognitive profiles of ideas and beliefs that typically accompany job countries such as depression & A ; anxiousness. Once these profiles have been formulated. healer and client engage in a collaborative. empirical procedure to prove out these ideas and beliefs and their attendant emotions and behaviors to advance digesting curative change’ ( Wills. 2006. p11 ) . In other plants. Cognitive Therapy aims to assist the client overcome troubles by placing and altering dysfunctional/distorted thought. behavior and emotional responses. This involves developing accomplishments to alter beliefs and behavior. recognise distorted thought and to associate to others in different ways. ( McGuire 2000 ) . Beck’s work was strongly influenced by Ellis’ Rational Emotive Therapy ( subsequently known as Rational Emotive Behavioural Therapy ) . The philosophic beginnings of Ellis’ therapy go back to the Stoic philosophers ( Epictetus & A ; Marcus Aurelius ) for illustration. Epictetus wrote ‘Men are disturbed non by things. but by the position which they take of them’ ( cited in Westbrook et Al. 2011. p5 ) ’ .

Cognitive Therapy is an educative therapy which aims to learn the client to be their ain healer. By making this. it can learn the client to place. measure and react to their distorted ideas and beliefs. It aims to be clip limited and its Sessionss are structured. This type of therapy has been really effectual for a batch of clients peculiarly with those enduring with depression. However. Cognitive therapy has been criticised as being a superficial and mechanistic attack ( Sloan. 1997 ) . Furthermore. Genova states Cognitive Therapy ‘does non reflect current cognition of how the encephalon works’ . ‘it is non rational’ and ‘it gives patients no agencies of reacting to insolvable jobs: to the inherently tragic nature of life’ ( Genova. 2003. p2 ) .

To summarize. the integrating of Behaviour and Cognitive Therapies became know as Cognitive Behavioural Therapy. As antecedently mentioned. Beck’s theoretical account is one of the most influential CBT theoretical accounts ( Wills 2006. Westbrook et al 2011 ) . Others include Ellis’ Rational Emotive Therapy. Meichenbaum’s stress vaccination therapy ( SIT ) and Young’s schemas-focused therapy ( McGuire. 2000 ) .

The following subdivision of this essay will concentrate of discoursing the four measure procedure of CBT ( appraisal. preparation. intercession and rating ) and the tools that can be used in each procedure. I will besides integrate how my acquisition of theoretical constructs relates to my work based pattern.

The first phase used by the healer in CBT is the assessment procedure. The intent of this phase is to set up a starting point ( or establish line ) to help both parties to recognize and hold where the client is. They besides need to make a shared understanding of what the job is. Westbrook et al suggest that in the this phase. ‘the healer is invariably seeking to do sense of the information coming from the client and edifice up probationary thoughts about what procedure might be of import in the formulation’ ( 2011. p67 ) . In add-on to this. the assessment procedure allows for information to be recorded which enables the healer to do comparings and ratings about the client’s alteration during and at the decision of therapy. This is peculiarly of import as it provides grounds for measuring which in bend can impact support for administrations. In my old employment as a Probation Officer. I can place this phase in relation to piquing behavioral group work programmes which were underpinned by CBT or REBT. Comparisons and ratings were done via pre and station psychometric testing ( questionnaires ) . Another cardinal constituent in the appraisal phase is the curative working confederation between the healer and client. This is indispensable in being able to pass on and dispute in a reciprocally trustful and esteeming manner.

Tools which can be used in the appraisal phase will include accomplishments that the healer may already possess as a consequence of preparation and experience such as active hearing accomplishments and narrative relation. These tools allow for the client to open up and can avoid misinterpretation. Nadig respects active listing accomplishments as jussive mood in all interaction. He states ‘we are given two ears but merely one oral cavity. because listening is twice every bit difficult as talking’ ( Nadig. 1999 ) . I can see the relevancy of active hearing accomplishments and believe that I use this accomplishment in all facets of my personal and working life. I am cognizant for illustration that I will reflect back what my client or squad member has said to guarantee that I have non misunderstood or misheard what they have said.

Other tools which are used by the healer are FIDO ( Frequency. Intensity. Duration and Onset ) and BASIC ID ( Behaviour. Affect. Sensations. Image. Cognitions. Interpersonal & A ; Drugs ) . FIDO is used specifically to research how frequently. how bad and how long the issue has been a job every bit good as happening out when it foremost began. With respects to BASIC ID. I understand that this gives the healer a clear and concise indicant of the jobs that are happening ( including knowledges and behavior ) . These tools have been. and will go on to be incorporated into my function as a line director peculiarly during supervising Sessionss and when I work with clients. I have found that they have both allowed me to derive focal point and have a better apprehension of the job. However. I am cognizant that if my relationship with a client or squad member was non good. so possibly they may non react to these tools.

After the assessment phase. is preparation. Harmonizing to Simmons et Al. preparation ‘provides the overall image of the development and care of the client’s jobs. It enables the healer to develop an apprehension and individualized intervention program based on the cognitive-behavioural theoretical account of psychological distress’ ( p. 64 ) . In other words. it is a design to assist the healer and the client figure out what is traveling on. Formulation needs to be collaborative. holistically approached. simple. logical. clear and helpful in footings of what to make next with the client. A preparation is non a diagnosing. It is an understanding. In footings of work based pattern. I have used the preparation phase during supervising with one of my squad members. After finishing the assessment phase. together we were able to set in topographic point an action program to travel frontward in turn toing her anxiousness which resulted in hapless public presentation when easing ‘Family Group Meetings’ ( action program included: she would detect other co-workers. brooding logs and finish a idea record ) . I found that this manner of working embowered the person and she felt supported.

Intervention is the 3rd phase used in CBT. This is where you implement the action program by the active engagement of the client ( and therapist if needed ) . skillfully utilizing a scope of cognitive and/or behavioral methods to learn them in the acquisition of improved accomplishments in their usage of more adaptative cognitive. behavioral and physiologically antiphonal schemes for the relief of hurt and development of personal effectivity. ( McGuire. 2000 ) . Interventions can include function drama. idea record. relaxation and command & A ; pleasure chart. These can be used and completed together or put as prep for the client. If in understanding. the healer can reach the client for an update on their prep. A benefit of prep undertakings can guarantee that the Sessionss remain on path in being a brief and clip limited therapy. It besides allows the client to set their acquisition into pattern outside of the therapy room. In footings of function as a Family Meeting Co-ordinator. I have implemented this phase a batch with my clients who experience anxiousness in go toing a Family Group Meeting.

After collaborative treatment. the client has a screening of the venue/room of where the meeting will take topographic point. In add-on to this. siting agreements. issue paths and advocators are agreed. I have besides used idea records in supervising which has allowed my squad member to enter the state of affairs. ideas and feelings which have impacted on their behavior. They have them disputed the distorted ideas and replaced them with rational/healthy 1s. In footings of relaxation. I have used this as portion of the choler direction class when I was a probation officer. For a figure of wrongdoers. this method worked truly good in assisting them to wind off and to eventually recognize tenseness which they had antecedently failed to detect. I’m besides aware that relaxation techniques do non work for all persons. Again. some wrongdoers who were capable to this frequently reported experiencing higher degrees of choler compared to before utilizing this technique.

The concluding phase is Evaluation. This is an of import phase for two grounds. First. it allows the healer to measure the client’s alteration. This could be done by comparing the same ‘tools’ used in appraisal that can besides be used at the decision of therapy ( e. g. questionnaires. choler record. statement cards. psychometries ) . This phase can be peculiarly of import for administrations if their support is target/outcome driven. Second. it acknowledges the new accomplishments that the client has learnt to turn to their jobs. The intended intent of this is to authorise the person to go on accessing these new accomplishments whenever they are need in the hereafter.

To reason. this essay has provided a theory based rating of Cognitive Behavioural Therapy ( CBT ) . I began by specifying CBT which included a brief description of its derived history and the therapies that contributed to its development. I so went on to reexamine the tools used in the four measure procedure of CBT ( appraisal. preparation. intercession and rating ) and I incorporated how my acquisition of theoretical constructs related to my work based pattern. Using my acquisition of CBT to my work base pattern has been priceless peculiarly the tools that can be used ( e. g. FIDO & A ; BASIC ID ) .

I am to the full cognizant that CBT is structured. clip limited. mensurable and directing compared to Person Centred Therapy which is non–directive and believes the client has his or her ain replies. I am besides cognizant of the Transactional Analysis attack which can be peculiarly utile for clients fighting with relationships. Overall. I believe that there is no base entirely therapy that offers better consequences than the other – they all have their strengths and failings. The effectivity of any therapy could be attributed to the fact that single respond to therapy in different ways. In other words. what works for one person may non for another.


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4. Genova. P ( 2003 ) . Cognitive Therapy’s Faulty Schema in Psychiatric Times. October 2003

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