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EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 1 Beyond Symptoms: Exploring the Dynamics of Cognitive-Behavioral Therapy Karen Sopchak School of Behavioral Science, Liberty University Author Note Karen Sopchak I have no known conflict of interest to disclose. Correspondence concerning this paper should be addressed to Karen Sopchak Email: Ksopchak@liberty.edu

EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 2 Human Nature and Change Personal Background Relationship Building and Assessment To have a successful relationship with clients, therapists must first build trust. I would begin by discussing goals with the client and listening to what they hope to accomplish through CBT. I would also set boundaries and actualize therapy goals, including the therapy's direction. A calm, inviting, and uncluttered setting can help the client feel comfortable. According to Corey (2016), since CBT is a cognitive and directive behavioral process, a warm relationship between the therapist and client is not required, but it may enhance the process. At the very least, a respectful relationship is recommended (10-4d). My career goal is to work with veterans who suffer from both addiction and post- traumatic stress disorder. As a recovering addict, there are a few things I must be mindful of that other therapists may not. First, I must be cognizant that I do not use clients as a proxy for my recovery. Second, I must be consciously aware that I am not avoiding my intimacy or avoiding my issues while counseling others in recovery. From a psychodynamic perspective, counselors in recovery have the potential to use the profession as a psychological defense against their conscious awareness or self-loathing (Keene, 2015). Having been through CBT, I can attest that the counselor-client relationship is one of the most imperative aspects of a successful outcome. At the beginning of therapy, the therapist and client should discuss four key elements to determine a treatment plan. What does the client wish to get out of the sessions? What is inhibiting them from achieving their goals? What are their expectations for the sessions and their

EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 3 motivation to make these changes (Riopel, 2019)? Having the answers to these questions allows the therapist and client to refer to them and track the progress of the client's goals. Tracking is one of the most valuable tools to assess a client's progress throughout treatment. Through self-reporting, homework, journaling, and mood tracking, the therapist can gauge where the client is during therapy. In terms of CBT for addiction, relapse prevention, and cognitive restructuring help determine the client's progress. One of my rehab therapist's best techniques was a goal-setting workbook. I will also implement this, as it is an incredible way to monitor progress and goals in therapy. Nothing in this life is perfect, and that includes therapy techniques. One critique specific to CBT is that techniques are emphasized over the client-therapist relationship. As mentioned earlier, the therapeutic relationship is essential to any therapy (Cervantes & Robey, 2018). However, unlike Rogerian or humanistic styles, the relationship between a CB therapist and a client may survive even if there is turmoil between the two parties. Another contention over CBT is that it treats a person's symptoms rather than focusing holistically on the individual. Unfortunately, certain psychotic disorders, such as schizophrenia, may not benefit from this type of therapy. Individuals who suffer from delusions, hallucinations, or idealizations and feel disconnected from reality may not test the validity of their thought process (Cervantes & Robey, 2018). There is also work outside of the client-therapist session, such as homework, so it requires the client's dedication to be proactive. Another limitation is that CBT may sometimes fail to incorporate outside relationships that might influence the client (Cervantes & Robey, 2018). Lastly, since CBT focuses on present and future life events, it may not be the best therapy for people who suffer from childhood trauma.

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