Counseling Juveniles Utilizing Cognitive Behavior Therapy

Counseling juveniles Utilizing Cognitive Behavior Theory
Walter H. Scott, II
PC6000 Counseling Theory
Dr. Pamela Wright
April 16, 2010

Introduction
In today’s society, there are various ways to treat disorders and adapt to everyday life. Cognitive therapy is clearly defined as process of thinking and being able to apply the knowledge from past or present experiences or courses. Clients struggle to use their prior experiences and knowledge to learn new concepts or skills. The behavior of the client becomes intense or uncontrollable when life or situations are unpredictable. The behaviors of clients can affect learning and coping in society, which lead to receiving behavior therapy. Cognitive therapy and behavior therapy are integrated to provide effective care to individuals who display abnormal behaviors internally and externally. Therefore, cognitive behavior therapy (CBT), a psychosocial therapy used to cure unhealthy behaviors by looking closely at the mental thoughts of the mind and using behavior techniques. Cognitive behavior therapy is used to treat a variety of mental disorders that clients may portray
such as depression, dissociative identity disorder , eating disorders, generalized anxiety disorder , hypochondriasis , insomnia , obsessive-compulsive disorder, and panic disorder without agoraphobia. Cognitive behavior therapy may not be the appropriate approach to meet the needs of clients if they are not willing to play an active role in treatment. Aaron T. Beck developed cognitive behavior therapy in the 1960’s. He was recognized as the most influential psychologist in psychotherapy (). Beck initially attempted to advance Freud’s theory of depression; however, Beck research strayed him away Freud’s theory and towards an approach where faults in reason creates cognitive distortions (). This psychologist believes that individuals respond automatically to their distorted view of circumstances. Beck experienced challenges, which were life threatening at a young age in which he conquered (Corey 2009). Beck was instrumental in developing the theory because he faced many fears in his past such as: fear of suffocation, tunnel phobia, bloody injury fears, and public speaking anxiety. Albert Ellis is known as the grandfather of cognitive style therapies (Boerre 2006). Ellis was raised in New York City and he experienced adversity in his childhood years by overcoming a kidney disorder which changed his focus from sports to books. The divorce of his parents led Ellis to grasp the understanding of others. Initially, Ellis initially supported psychoanalysis approach, however after evaluating minimum progress of clients, Ellis began to interject and take a more active role in his sessions by giving advice and direct interpretations to clients (Boerre 2006). Ellis notice moderate improvement, therefore by 1955 Ellis began to focus on changing individuals behaviors by challenging them with their irrational beliefs and influencing them to implement rational ones (Boerre 2006). This paper will explore the techniques of cognitive behavior therapy, the role of the therapist and client within the CBT process, and the implementation of cognitive behavior therapy with an adolescent who has been sexual abused.
Cognitive Behavior Therapy Techniques Clients who receive treatment utilizing Cognitive Behavior Therapy (CBT) learn how to reframe negative thought patterns in order to understand their environment in a less prejudice way. Therapist utilizes various techniques in the treatment process to assist the clients to explore and alter their thought process and behaviors. Therapist utilize various cognitive, emotive, and behavioral techniques to address clients life tribulations. Such as: Socratic dialogue, which allows clients to reflect and ponder autonomously and seriously. One of the most techniques that therapist utilize is actively disputing client’s irrational beliefs and teaching clients how to challenge on their own without assistance or being guided. In order to encourage self-discovery and reinforce what was taught during sessions the therapist may ask the client to do homework.
Cognitive homework is a technique that focuses on clients carrying out positive actions that encourage emotional and attitudinal change. Homework may consist of journaling, note-taking during sessions, reading books or articles pertaining to identified goals or related to therapy. Therapist implement the A-B-C Model to address various problems that clients encounter. The A-B-C model is a tool for understanding the client’s feelings, thoughts, events, and behavior. It is important for the therapist to grasp the understanding of the clients feelings and thoughts to utilize role playing technique.
Modeling is a cognitive behavior technique that therapist use to demonstrate role playing exercises which focuses on reacting in a suitable way to conquer the client’s problems. Modeling technique allows the client an opportunity to learn and observe how to appropriately respond to life obstacles. Alder believed that emotional reactions and lifestyles are related to individuals beliefs. Therefore it is vital for clients to be able to visualize their responses. Clients’ behaviors are often times awarded by therapist which is known as positive reinforcement. Systematic positive reinforcement is a technique where positive behavior of the client is rewarded by positive reinforcement. The therapist will establish guidelines as to how the reinforcement will be arranged. Adolescents may receive positive reinforcements that may consist of specific logical items that motivate youths to excel. In efforts to eliminate or decrease inappropriate behaviors therapists often refuse to reward a client is a common method that therapist use, which is called extinction. Another technique therapist uses in cognitive behavior therapy is aversive conditioning. This technique emphasizes the principals of classical conditioning to minimize the appeal of a behavior that is hard to alter because it is either usual or momentarily rewarding. Classical conditioning is defined as a form of learning which neutral stimulus is repeatedly paired with a stimulus that naturally elicits a particular response. Clients that are receiving treatment for a particular behavior or thought that has to be treated, is exposed to an unpleasant stimulus. The unpleasant stimulus connects with the thoughts and behaviors, therefore the client demonstrate aversive behavior toward the therapist. The relationship between the therapist and client is not essential in cognitive behavior therapy however a comfortable working relationship is vital in achieving a successful outcome in treatment.
Client Therapist Relationship in CBT Over the years there has been a debate as it relates to the therapeutic relationship of the client and therapist in psychotherapy.
The debate questioned which is more important? The technique or relationship? Research found that both technique and relationship has proved to be effective in psychotherapy (Niolon). The therapeutic relationship in cognitive behavior therapy is based on guided discovery between the therapist and client (Niolon). Guided discovery is when the therapist assists the client in understanding their cognitive distortions (Corey 2009). The therapist usually schedules an initial consultation session with the client, which benefit both parties. The consultation session is beneficial for the client and therapist because it allows the client to gain an understanding of the counseling and treatment
process.
The therapist and client work collaborative toward establishing realistic goals and home work assignments. Cognitive behavior therapists view the therapeutic relationship as a secondary factor in the treatment process. Therapists also utilize schemas which is a collection of beliefs, past experiences, and guidelines for behavior regarding themselves, others, and the world.
Implementation of CBT with Troubled Youth This writer chose cognitive behavior therapy as the therapeutic approach to work with troubled youth who has challenges with depression, anxiety, and poor problem solving skills. This writer agrees with the cognitive behavior therapy philosophy of alternative ways of thinking and behaving . This therapy was created to assist individuals alter cognitions allows the youth