Comparing the Cognitive-Behavioral and Psychodynamic Counseling Models

This essay will discuss the similarities and differences between the cognitive-behavioural and psychodynamic models of counselling. I shall begin by investigating the ways in which the two models view the person and their experience of mental life; how they explain the problem(s) experienced by individuals and, finally, how help is offered to those in psychological distress. The assignment will reach the conclusion that, while the two approaches are very different in their origins and techniques, they can be seen as similar in that, through talking, they both focus upon changing the client 's negative cognitive content and both approaches rely on the skill of active counsellors. The psychodynamic model views the person and their mental life as decided by their childhood experiences and whether they had consistent, long-term, trusting relationships. By contrast, the cognitive-behavioural approach is a blend of two techniques – behavioural and cognitive and focuses on enabling people to change their destructive learned behaviour or, 'crooked thinking ', as Ellis described it, (cited in Mcleod, chapter 5, p.143). The psychodynamic approach views the person and their experience of mental life as a product of disrupted childhood relationships which has meant that, as an adult, they have encountered difficulties in forming long-term, trusting relationships. The cognitive-behavioural approach views the person as being rather like a computer which responds to certain situations in a particular way. There is a major difference in these two viewpoints as the psychodynamic model views past experiences as the key to unlocking the problems of the present while the cognitive-behavioural model does not focus on the past but concentrates on current behavioural problems and teaches the client practical skills to help them to cope with life. It could be argued that the foundations of negative cognitive content could be embedded during childhood by a parent or carer and therefore a mixture of the two approaches might be beneficial in order to allow the client to gain insight into their childhood problems and also to learn coping strategies to deal with the consequent behavioural problems. In this way, the two approaches are similar as well as different because they both have limitations in respect of their 'ideal ' client groups. The psychodynamic model explains the problems experienced by individuals as a repetitive pattern in which the client has transferred the destructive elements of earlier relationships onto new friendships. Disrupted relationships in childhood may mean a person enters adulthood unable to form long-term trusting relationships. The effects these early experiences have on behaviour are mainly unconscious and the counsellor will need to bring the unconscious information to the surface in order to decipher it and empower the person with the perception to deal with their feelings. The cognitive-behavioural model explains the problems experienced by individuals as a cycle of negative thinking and irrational beliefs about the world and about their place within it. An important similarity between the two models can be gleaned from the following two quotations from Freud, in respect of the psychodynamic approach, and from Ellis, in respect of the cognitive-behavioural approach. Freud summarised his theory saying, ' where id was, let ego be ', meaning that the irrational, repressed and potentially destructive memories stored within the 'id ' should be replaced with the rationality and logical thinking of the 'ego ' (cited in Mcleod, chapter 4, p.95). Ellis believed that a negative outlook on life which sees everything in terms of 'shoulds ' and 'musts ' means that the individual can never live up to their potential (cited in Mcleod, chapter 5, p.143). Both approaches, therefore, recognise the impact of negative and irrational thinking on the client 's attitude to life and relationships. The psychodynamic therapist will offer help to the individual in psychological distress by using himself or herself as a neutral party onto whom the client can transfer deeply embedded feelings about earlier relationships. This is called transference and is seen as a useful tool by the therapist who can use it to gain a deeper insight into what happened in the early experiences of his or her client. The cognitive-behavioural therapist will offer help to the individual in psychological distress by assessing the problem(s), listening to the client 's aims and setting structured targets which include a range of intervention techniques. Progress would then be monitored regularly until the goals have been achieved. A particular difference between the two approaches is the way in which the relationship between counsellor and client is viewed. A trusting relationship between counsellor and client in psychodynamic counselling is of key importance as individuals often engage in psychodynamic counselling because of relationship anxieties therefore the forming of a meaningful and trusting relationship with the counsellor is of vital significance in order to explore the foundations of the problems. Within the cognitive-behavioural model a rapport and relationship of trust are needed as the client needs to have faith in the counsellor 's ability to teach them practical tasks and coping strategies. Other similarities between both approaches are aims for the therapeutic purpose. The client goes to the counsellor with a specific problem or set of anxieties. Goals and aims will be agreed depending upon which type of counselling is being applied. For example, a psychodynamic counsellor would concentrate on insight whereas a cognitive-behavioural counsellor would concentrate on behaviour change. In conclusion, the two approaches have several similarities and differences. The main difference can be seen in the weight of significance the two approaches attach to early childhood experiences. The psychodynamic model views these experiences as critical in the ability to develop relationships in adulthood whereas the cognitive-behavioural model does not recognise these experiences as being significant. The psychodynamic approach is based on acceptance and empathy, with an emphasis on developing a good working relationship that fosters trust and uses past experiences to explain current behaviours and anxieties. By contrast, the cognitive-behavioural approach is more directive and is based on the effects of the client 's present problems, concentrating on moving forward into the future with a set of internal tools which can be used in difficult 'trigger ' situations.
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Part two
I prefer the psychodynamic approach although I find the techniques used in cognitive-behaviour counselling fascinating. I think that one main reason why I prefer this model is that, rather than simply fixing the symptoms, it investigates what has prompted the changes in the client 's behaviour or contributed to their anxiety or depression. I would want to know if something in my childhood had disturbed my development so that I could deal with it and move on. Perhaps some people do not want to know the reasons for their poor mental health and just want strategies to cope with the symptoms. It appears that, in some cases, a mixture of the two approaches would be beneficial to uncover the reasons for the emotional problems and then, once the client has gained insight and understanding, coping strategies could be taught to deal with the negative thoughts and behaviour. I think that it must be a huge step for an individual to take, to admit that there is a problem and then to risk having their past experiences unpicked and unravelled by someone who is, after all, a stranger. When a client first visits a therapist they may have no idea what is making them feel anxious or depressed, they may not know where to start as the problem has become so overwhelming. The therapeutic relationship is clearly of vital importance and I think that, when faced with a vulnerable client, the therapist undertakes a role which involves great privilege and courage.
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References

McLeod, J. (2008) What is counselling? in McLeod, J. (2008). Introduction to Counselling [Ed. D. Langdridge], Maidenhead/Milton Keynes, Open University Press/The Open University.

References: McLeod, J. (2008) What is counselling? in McLeod, J. (2008). Introduction to Counselling [Ed. D. Langdridge], Maidenhead/Milton Keynes, Open University Press/The Open University.