Critical Analysis of Three Psychotherapy Approaches: Client-Centered Therapy, Cognitive Therapy, and Psychodynamic Therapy

As a professional social worker, the main goal is to help a client in a positive and respectful manner. Unfortunately, client experiences and behaviors can make this task seem extremely difficult. It is important to find yourself before trying to help someone else. Therapy is essentially attempting to make something better, and our personal values determine what is valuable in therapy. Also, thinking

Cognitive-behavioral therapy is considered among the most rapid in terms of results obtained. The average number of sessions clients receive is only about 16. CBT is structured, directive, and time-limited in that clients are helped to understand at the very beginning of the therapy process that there will be a point when the formal therapy will end. The ending of the formal therapy is a decision made by the therapist and client. Therefore, CBT is not an open-ended, never-ending process.

Cognitive behavioral therapy differs in several respects from more traditional forms of therapy. It focuses on two specific elements: cognitive restructuring and behavioral activation. The client and therapist work together in cognitive restructuring with the goal to restructure thinking patterns. In behavioral activation, the client overcomes barriers to participating in activities. The main focus is on the present and on specific problems. cognitive behavioral therapy is a goal oriented and educational therapy, because goals for both the short and longer term are identified and it teaches the client to modify mood en behavior. The client has therefore an active role in learning e.g. coping skills. Multiple strategies are used in cognitive behavioral therapy, like imagenary, role

My role as the clinician is quite important. The primary task is to engage the client in identifying cognitive errors, refuting them, and replacing them with more adaptive thoughts. A sound therapeutic relationship is necessary for effective therapy, but not the focus of the therapy. Many forms of other counseling believe that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but I know that is not nearly enough. We believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT tries and focuses on teaching rational self-counseling skills. CBT is the teamwork that exists between the therapist and the client. This form of therapy is used to seek ways of learning what their clients want out of life and then helping their clients achieve those goals. The therapist's role is to listen, teach, and encourage, while the client's roles is to express concerns, learn, and implement that learning (Pucci1).

Cognitive-behavioural therapy is widely short-term and concentrates on enabling clients to deal with very particular problems. Often six weeks to six months sessions of course depending upon the problem it is pacifically goal directed and places great weight upon self-help as a long term coping tool that the client can take away with them and successfully use. Cognitive-behavioural therapy believes that clients can learn the wrong ways of developing and making sense of information during their cognitive development. This can often lead to distortions in the way they identify reality, it’s the job of the therapist to enable them to work this out.

Social workers must strive “for a full understanding of the complex interactions between the client and all levels of the social and physical system as well as meaning that the client assigns to each of these interactions” (Andreae, 1996, p. 605).

Social workers use engagement to develop therapeutic relationships to support positive treatment outcomes for clients. The engagement process permits the social worker to assess the client’s commitment to be involved, in order for a collaboration between the practitioner and client to develop an agreement on the goals and tasks of treatment. Engagement helps social workers to identify the client’s true desire to receive treatment by how the client demonstrates he or she’s level of motivation, commitment to treatment, their readiness, and potential treatment outcomes. Treatment strategies such as the Stages for Change can be implemented to assist and encourage clients in the engagement process.

Cognitive behavioural therapy is a structured style of therapy requiring direction from the clinician. Studies have found that the skill of the therapist is directly related to the outcomes of therapy (Strunk et al., 2010). As this style of therapy involves collaboration, as well as gentle direction by the therapist (Sudak, 2011), an incompetent therapist can lead to therapy not being tailored to the individual, therefore reducing therapeutic gains. Studies have found clients reported that at times they have felt under pressure to give particular answers when receiving CBT, or that therapy was not flexible (Barnes et al., (2013). Therefore a style of therapy that is flexible in nature, and directed toward areas that the client most wishes to work on may be more appropriate.

Psychodynamic and client-centered therapy can both help clients with their life stressors. I do find myself conflicted on which one to lean more into. I believe that it is important for me to learn about a client’s childhood experiences to help me better understand them and get an idea of how it might like to live in their world. Furthermore, I also believe that a client has the right to choose what he or she wants to work on and should have control on their session. I am aware that in order to provide good service to the client, I need to be aware of my thoughts and feelings in order to be able to recognize potential countertransference situations. I need to check myself if a client ever makes me feel certain way about a particular situation.

When using Cognitive Therapy all session must be carefully planned and structured to have an impact and efficiency for the client (Seligman & Reichenberg, 2010). During the session the clinician should have formed a positive therapeutic alliance with trust, rapport, and build hope and optimism with the client. Each session of Cognitive Therapy has clear goals with an agenda and should follow a 10 procedure for a session. The 10 procedure for an initial session according to Seligman and Reichenberg (2010) is the

CBT focuses on the client learning, utilizes homework assignments for therapy and client collaboration with the therapist (MHAP, 2013). Focus of this therapy is on the client's goal and the therapist is required to listen and work together with the client to make his/her goal a success (NACBT, 2014). It is a structured and directive type of therapy that could be applied in different forms such as; Rational living therapy, cognitive therapy, dialectical behavioral therapy, and rational emotive behavior (NACBT,

Feedback Informed Treatment (FIT) is a pan-theoretical approach that allows researchers to view/measure the therapeutic alliance between practitioners and their clients. Research informs us that those practitioners often rely on their own perspective when assessing the strength of the relationship. It has been proven that the client’s perspective is a better predictor of outcome. Feedback Informed Treatment (FIT) requires the social worker to routinely solicit feedback from clients acknowledging the therapeutic alliance and the outcome of care that the client is receiving. A benefit to this EBP model is that it allows social workers to see/learn what they need to do in order to fully serve their clients. The results of this EBP model not only inform the social worker of his/her progress but it allows the social worker to tailor his/her service delivery through utilizing two scales… The Outcome Rating Scale (ORS) and The Session Rating

The use of cognitive therapy is a 15 - 20 one hour therapy over a three month period which

In the field of psychology there are several sub categories that tie into psychology. These sub categories may include but are not limited to psychiatry, counseling, biopsychology etc. Now, when a client decides to come into a counseling session, the effectiveness of the counselor depends on the psychotherapy method used. Psychotherapy is, according to apa.org, “is the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable". A psychotherapy is needed in order for the counselor to be effective in understand how to help the client out of the situation/problem he or she is in. Now there are many different types of psychotherapies. These different type of psychotherapies differ in many different ways, but it is also up to the counselor and how he or she chooses to use such a method to help the client our of their problem. Psychotherapy in particular is Cognitive Behavioral therapy, also known as CBT. This method is used today, and has had a huge impact in the field of counseling.

To be honest I was quite shocked that around 87% of “the variability in therapeutic outcomes is associated with client and external or situational factors” (Cournoyer, 2017, p.32). After reflecting on this I realized how embarrassed I was of my ignorance, for I feel as though it implies that I thought, albeit unconsciously, that I inherently had more power than my future clients. This conflicts with my enduring stance against the word “helping” when it comes to social work practice, because I feel as though this word implies that the social worker is better than the client, that the social worker is doing the client a favor. I prefer the words “working with” the client, because I believe this establishes a mutual, respectful relationship between the social worker and client, which in turn will provide better outcomes for both individuals involved. Therefore, I vow from this moment on to never ignore the person-in-environment principle when working with and on behalf of clients. Acknowledging and understanding the external environmental, both physical and social, that the client operates in is essential if we wish to bring about positive social change.