Discuss the key concepts of Behavior Therapy and how they may be used to assist Stan with his anxiety, depression, and excessive drinking. Include your own ideas (not only the ideas included in the Case of Stan Summary at the end of the chapter.
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The key concepts of Behavior Therapy begin with view of human nature, which is a technical view of human behavior that entails a methodical and well thought-out tactic to counseling. Furthermore, this view does not depend on a deterministic hypothesis that a person is a consequence only of their sociocultural conditioning; the present view suggests a person is the manufacturer and the product of their environment. The next concept of Behavior Therapy is Basic Characteristics and Assumptions, which incorporates “Six key characteristics of behavior therapy.” (, p. 237)
To begin with, behavior therapy includes the philosophy and events of the scientific method. This method uses “experimentally derived principles of learning which are systematically applied to help people change their maladaptive behaviors.” (, para. 5) Furthermore, the therapist makes an observed assessment, and then the therapists assert their therapy objectives in order to determine what interventions might be used. Then the therapist and the client agree upon the treatment method to be used and finally certain research methods are used to evaluate the effectiveness of both the assessment and the treatment.
In the next characteristic of behavior therapy, the client’s existing problems along with the factors that are affecting these problems are examined. The focus is on the “specific factors that influence present functioning and what factors can be used to modify performance.” (, p. 238) In the third characteristic, the client plays a functioning role in certain actions in order to deal with their problem, and monitor their behavior both during the therapy session and once they have returned to their life outside therapy. Finally, during the therapy sessions clients practice coping skills, and conduct role-playing of new behavior. During the fourth characteristic, it is understood that change can happen even without a clear perception of the hidden dynamics, the fifth characteristic “focus on assessing overt and covert behavior directly, identifying the problem, and evaluating change. There is direct assessment of the target problem through observation or self-monitoring.” (, para. 4) Finally, the sixth characteristic involves tailoring the interventions to the particular problems of the clients, also incorporating several techniques in order to assist the problems of a certain client.
In the case of Stan in the textbook, the therapist begins by having Stan identify those areas where he feels the need to make changes, and then the therapist helps Stan to understand the reasons for his behavior, and educates him on the therapy process. Furthermore, the therapist uses such techniques as modeling, role-playing, and behavior rehearsal and eventually incorporating In vivo exposure with Stan once she has explained the process and received Stan’s consent.
I feel that these techniques are all effective techniques that can allow Stan to heal, as I revisited some of these techniques I found myself thinking about the chapter on Gestalt Therapy, and the section on “The Now” (, p. 202) and “Unfinished Business” (, p. 203). Some of the techniques I feel could be used to take events from the past that are affecting the present and dealing with those events in the present. In Stan’s case, perhaps there are feelings and even things he wished he could have expressed to his mother if he had not been so intimidated by her.
Discuss the key Concepts of Cognitive Behavior Therapy and how they may be used to assist Stan with his anxiety, depression, and excessive drinking. Include your own ideas (not only the ideas included in the “Case of Stan” Summary at the end of the chapter.
In Cognitive Behavior Therapy, there is a combination of “cognitive and behavioral principles and methods in a short-term treatment approach.” (, p. 274) Cognitive behavioral methods incorporate many of the essential characteristics and hypothesis of conventional behavior therapy; even though there is a large diversity in cognitive behavioral methods, they all share certain traits. These traits are “(1) a collaborative relationship between client and the therapist, (2) the premise that psychological distress is largely a function of disturbances in cognitive processes, (3) a focus on changing cognitions to produce desired changes in affect and behavior, and (4) a generally time-limited and educational treatment focusing on specific and structured target problems.” (, p. 275)
In Cognitive Behavior Therapy, there is a couple of renowned method s discussed in the textbook such as, Albert Ellis’s rational emotive behavior (REBT), Aaron T. Beck’s cognitive therapy (CT), and Donald Meichenbaum’s cognitive behavior therapy (CBT) . In REBT, the focus is on “thinking, judging, deciding, analyzing, and doing,” (, para. 3) furthermore, in REBT the fundamental hypothesis is that people are a factor in creating their own psychological dilemmas, including their particular symptoms, because of their interpretation of events and situations. The therapist uses certain interventions such as cognitive methods, emotive techniques, and behavioral techniques in order to help the client realize and accept that they are human and humans will continue to make mistakes while teaching the client to live a more peaceful life.
In cognitive therapy, the perception is that psychological issues arises from “commonplace process such as faulty thinking, making incorrect inferences of the basis of inadequate or incorrect information, and failing to distinguish between fantasy and reality.” (, p. 275) In addition, much like REBT, CT uses insight-focused therapy that gives emphasis to acknowledging and altering pessimistic thoughts and maladaptive thinking. A couple of techniques used in CT are cognitive techniques and application to family therapy since core beliefs can stem from a person’s family environment. Cognitive Behavior Therapy is very similar to both REBT and CT, it incorporates many of the same techniques, assumptions, interventions and educating the client on such things as understanding their behavior, behavior modification, and coping skills.
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In the case study of Stan in the textbook, the therapist begins by educating Stan on the significance of re-examination of his automatic thoughts and self-talks, and then the therapist works with Stan on monitoring and evaluating his self-defeating statements by challenging these statements with certain questions. Such a question would be “you are not your father; I wonder why you continue telling yourself that you’re just like him?” (, p. 302) In my opinion, I think the therapist uses these types of questions to try to make Stan aware of the fact that he is making such negative statements, and once he is aware then they can incorporate certain techniques to change such negative statements that can cause damaging behavior.
Once Stan has an understanding of his cognitive misrepresentations, then the therapist can incorporate such techniques as “Socratic questioning, guided discovery, and cognitive restructuring” (, para. 8) in order to aid Stan in reviewing the facts that both sustain and oppose his core perspectives. In my personal opinion, perhaps the most effective tools for Stan after the breakthrough of understanding the reason for his behavior, is the education on coping skills, and the homework assignment that he and his therapist create. My thought on the reason behind this belief is that once an individual finally understands the reason behind their unhealthy behaviors, then there is this void between understanding the reasons for such behavior and understanding how to change such behavior. Learning copying skills gives an individual the necessary tools to overcome such emotions as fear and anxiety that can be paralyzing therefore, assisting in the journey between understanding and changing. In addition, the homework assignments assist in taking an individual outside their comfort zone and placing them in an area that is new and a little frightening, however, with repetition this frightening area becomes less frightening creating a new and healthier comfort zone.
Discuss the key concepts of Reality Therapy and how they may be used to assist Stan with his anxiety, depression, and excessive drinking. Include your own ideas (not only the ideas included in the “Case of Stan” Summary at the end of the chapter.
In Reality Therapy, the therapists believe that there is only one reason for the issues of the majority of their clients. This belief is that the client either lacks a relationship or is in an unhealthy relationship, and that it is this longing of this individual to have a healthy relationship, the need to be close to or connected with another individual in a healthy relationship that creates his or her problems. Furthermore, in choice theory it is believed that when we are born we are born with five genetically encoded needs, these needs are “survival, love and belonging, power and achievement, freedom or independence, and fun.” (, p. 317) In reflecting on this belief, I found myself thinking of Maslow’s hierarchy of needs and the basic needs all individuals are born with for survival, so perhaps we are not born a blank slate just waiting for our environment to shape us.
Some of the key characteristics of Reality Therapy focus on the therapist emphasizing choice and responsibility; I believe that what this is saying is that we have freedom of choice and that we must take responsibility for those choices. Furthermore, the therapist focuses on “rejecting transference, keeping the therapy in the present, avoiding focusing on symptoms, and challenging traditional views of mental illness.” (, pp. 320-321) after all, Dr. Glasser believed that the only true mental illnesses were “Alzheimer’s disease, epilepsy, head trauma, and brain infections,” (, para. 1) everything else is because of our choices and not a true mental illness. Therefore, the reality therapist incorporates two major components “(1) creating the counseling environment and (2) implementing specific procedures that lead to changes in behavior.” (, p. 323) An interesting procedure used by the reality therapist is the use of the acronym WDEP that assist the therapist in helping the client to explore their desires, the possible things they can do to create change, opportunities for self-evaluation and to design a plan for improvement of their choices and therefore, changing their behavior.
In the case of Stan in the textbook, the Reality therapist focuses on Stan’s behavioral dynamics and decides that Stan has fallen into the role of the victim, continually blaming others revisiting the past, and focusing on his symptoms. Even though the counselor listens to Stan, and emphasizes with his suffering the therapist explores the idea that perhaps Stan will come to the realization that if he choices differently then change can occur. Therefore, the therapist sets out to first create a relationship with Stan, and then have Stan describe how he feels his life would be different if he was symptom-free. Then the therapist helps Stan to realize that he is continually reliving areas in his life that he cannot change and that by doing this he is making choices that bring on these negative symptoms, and the therapist helps Stan to realize that by making the choices he is he is moving farther from where he desires to be.
As I read the chapter on Reality Therapy, I find myself having mixed feelings as to the effectiveness of reality therapy in the case study of Stan. I do agree that our choices have consequences and that if those choices are creating undesirable consequences then we need to change the choices we are making. However, in the case of Stan in my personal opinion I feel that first, he has to recognize the reasons for these choices, and then learn how to transition from making the unwanted choices to making healthier choices and then becoming comfortable with these choices before the total concept of reality therapy is put into effect. Perhaps I do not have a total understanding of Reality therapy, I understand about the readings and working with the therapist, however I do believe that Stan does have the desire to change, if not then why would he bother to go to therapy. Finally, I was wondering what the accountability would to ensure that Stan read what was assigned to him, the emotions of fear and anxiety can be very strong emotions. Then again, this is only my opinion and as I said maybe, I am not getting the full perspective of Reality Therapy.