Dialectical Therapy Essay

RUNNING HEAD: Types of Therapy

Types of Therapy

Abstract
To be an effective Christian counselor one must be able to utilize different forms of therapy based on their client’s needs as well as diagnosis. Research has shown the importance of utilizing different forms of therapy and how they can be used to treatment clients with different mental health issues to include depression, borderline personality disorder and anxiety. To be an effective Christian counselor, I will use the following forms of therapy dialectical behavioral therapy, cognitive behavioral therapy, brief psychotherapy, play therapy and person-centered therapy. Individuals with depression and anxiety receive cognitive
therapy; whereas, individuals with borderline personality disorder utilize dialectical behavior therapy. Studies have proven cognitive behavioral therapy to assist individuals with changing their self-defeating thought pattern and identify change (Andrew, 2010). Play therapy has been identified as an effective method of therapy for children. Person-centered therapy focuses on change starting with self- disclosure. Brief psychological therapy has been identified as an effective treatment of psychological utilizing 12 to 25 therapeutic sessions. The development of different forms of therapy utilized in therapy sessions has evolved to meet the needs of the client and their diagnosis as well as the mental health care services. Biblical values have influenced forms of therapy. According to Rollins (2002) “Bible can be seen as part of an historical process, a social process, and a literary process, it can also be seen as part of a psychological process in which unconscious, as well as conscious factors, are at work” (p. 102).

Types of Therapy and its Importance in the Field of Therapy To be an effective Christian counselor one must understand the importance of types of therapy methods and there importance to the field of therapy. Research has shown that dialectical behavioral therapy, cognitive behavioral therapy, brief psychotherapy, play therapy and person-centered therapy are importance forms of therapy utilized in the field of therapy to address different client treatment needs. Dialectical behavioral therapy is an approach developed to treat overemotional disorders to include borderline personality disorder and other conditions involving self-harming behaviors (Piotrowski, 2010). Prior to the development of dialectical behavioral patients with borderline personality disorder were difficult to treat effectively. Counselors attempted to use cognitive therapy; however, found it to be ineffective. Cognitive behavioral therapy is a form of psychotherapy that combines cognitive therapy and behavioral therapy approaches together. The combination of the two approaches together allows the therapist to assist clients in changing their self-defeating behaviors and negative thought patterns by setting goals throughout the treatment process. Studies have shown cognitive behavior therapy to be an effective form of treatment for depression and dysthymia (Andrews, 2010). Brief psychotherapy is a form of psychotherapy; however, consisting of 12 to no more than 25 sessions. Cameron (2006) states “limited financial resources often dictate that treatment be administered using the most cost-effective, short-term strategies” (p.147). Studies have found brief psychotherapy to be as, effective and in some cases more effective, than long- term psychotherapy (Cameron 2006). Play therapy has been show to be an appropriate method of psychotherapy to utilize with children. Therapist use toys and other media to help children with communicating their feelings, reactions to experience, perceptions about themselves and others (Carson, Watts & Maniacci, 2006). Play therapy has been effective in establishing and maintaining therapeutic alliance with children and helping the therapist with understanding the child (Carson et al., 2006). Person-centered therapy was developed by Carl R. Rogers. Person-centered therapy is an approach to psychotherapy. Piotrowski (2010) states “Rogers’s focused on personality functioning rather than on personality structures” (p.1377). Person-centered therapy has influenced several therapeutic approaches to include nondirective play therapy. Counselors must be able to familiar themselves with different types of therapy techniques. Not all therapy techniques fit all clients’ treatment needs and diagnosis. Dialectical behavioral therapy is most effective with individuals with borderline personality disorder; whereas, cognitive behavioral therapy in not effective with individuals with borderline personality disorder mainly individuals with depression and anxiety. Brief psychotherapy allows individuals to participate in therapy for shorter amount of session. Play therapy allows the counselor to utilize toys and other media to assist the child with communicating their thoughts, feelings and events. The listed techniques are few of many therapy techniques utilized throughout treatment. All serve as effective forms of therapeutic treatment to meet the various clients’ treatment needs.

Major Themes for Types of Therapy
Dialectical Behavioral Therapy Dialectical behavioral therapy was introduced in 1987, by Dr.
Marsha M. Linehan. Dr. Linehan utilized dialectical behavioral therapy for treating borderline personality disorder. Strategies utilized in dialectical behavioral therapy allow the therapist to accept the client at their current state (Piotrowski, 2010). Dialectical Behavioral Therapy techniques draws from cognitive behavioral therapy as well as person-centered therapy (Piotrowski, 2010). Dialectical Behavior Therapy adds two additional strategies to include acceptance and dialectical strategies. Prior to the development of Dialectical Behavioral Therapy there was no effective treatment for individuals with borderline personality disorder. According to Piotrowski (2010) “ people, with borderline personality disorder are emotionally flammable and fragile, unable to reliably regulate their inner states, have conflict-ridden relationships, frequently consider suicide, and often engage in self-harming behaviors such as cutting” (p.602). Andrews (2010) mentions “studies have shown that dialectical behavioral therapy can reduce depressive symptoms, suicide attempts self-injury, and hospitalizations”
(p.154). Dialectical Behavioral Therapy consists of four levels of treatment. The first level of treatment involves establishing a target hierarchy which involves reducing the self-harming behaviors to include cutting. The second level involves moving the client from being emotionally shut down to experiencing emotions fully after the client has developed the skills in level one. The third level focuses on reducing/eliminating behaviors that interfere with the clients’ experiences to include happiness and personal meaning. The fourth and final level focuses on addressing higher-order of psychological values (Piotrowski, 2010).
Cognitive Behavioral Therapy Cognitive behavioral therapy helps improve people’s moods and behavior by changing the way they think, also, how they interpret events from their life experiences and thought process. Cognitive behavioral therapy consists of different therapies that utilize both cognitive and behavioral techniques. According to Romana (2003) “cognitive behavioral therapy is an action- oriented form of psychosocial therapy” (p.33). Cognitive behavioral therapy assist individuals with becoming aware of their distorted thought process by assisting the individual with recognizing a particular situation, identifying what happened during the situation, identifying their response to the situation as well as their feelings to include but not limited to anger, rage depression and anxiety. Romana, (2003) mentions the behavioral component assumes that individuals become aware of their unwanted behaviors and replace them with healthier ones. Individuals participating in cognitive behavioral therapy should come with identified behavioral goal with a wiliness to change the negative behavior. A cognitive therapist assists the client by directing attention to their "automatic" thoughts, the things people say to themselves that result in unpleasant feelings (Beck, 1979). Romana (2003) identifies techniques used for cognitive behavioral therapy to include behavioral homework assignments, modeling, journaling and validity testing. Along with the listed techniques and a healthy therapeutic relationship with the therapist are components of cognitive behavioral therapy. Studies have shown that cognitive behavioral therapy to be an effective form of treatment for various forms of mental health disorders to include anxiety, depression, post traumatic stress disorder, obsessive compulsive disorder and panic disorder.
Brief Psychotherapy Brief psychotherapy is a form of mental health treatment that usually where individuals participate in 12 to no more than 25 sessions (Cameron, 2006). Cameron (2006) mentions “brief psychotherapy is a form of mental health treatment that most closely corresponds with what many clients expect when they voluntarily seek mental health care” (p. 148). Individuals seeking to participate in brief psychotherapy are looking for assistance to resolve a specific problem (Cameron, 2006). Brief psychotherapy speeds up the process by intensifying the individual’s involvement; however, not all individuals meet the criteria for brief psychotherapy (Greenberg & Drewan, 2009). Brief psychotherapy might not be considered appropriate for individuals with long-standing or chronic problems to include borderline personality disorder (Greenberg & Drewan, 2009). According to Cameron (2006) “several forms of brief psychotherapy exist” (p.148). For the therapy to be considered brief psychotherapy specific characteristics must be present during treatment to include: maintenance of a clear and specific treatment focus by helping the client select goals; conscious and conscientious use of time by using the time to meet the client’s needs; limited goals with clearly defined outcomes; rapid assessment and integration of assessment into treatment by addressing the issues right away; and finally a high level of client therapist activity (Cameron, 2006). Studies have shown brief psychotherapy to be as effective form of therapy of therapy. Research has also shown that individuals that participate in brief psychotherapy have been able to resolve their issues and accomplish their goals within the set amount of session of 12-25. Counselors utilizing brief psychotherapy are said to have common values with a desire to use an less intrusive means as well as promote a therapeutic alliance.
Play Therapy According to Landreth & Bratton (1998) “play therapy is a learning experience for children and, as such, is viewed from a developmental perspective with an overall objective of assisting children to learn about themselves and their world” (p.5).
Play therapy is described a process to help children grow, rather than solve their problems (Landreth & Bratton, 1998). Carson, Watts and Maniacci (2006) state “most children under the age of 10 do not have the abstract reasoning and verbal ability to clearly express their thoughts, feelings, reactions and attitudes” (p. 228). Play therapy assists the therapist with understanding the child’s feelings, interactions and relationships as well as helps them express their feelings of frustration by creating a safe environment. Children having difficulties with expressing how they feel or an incident may utilize toys and play to reveal their feelings. According to Landreth & Bratton (1998) “play is a way of being, a way relating, a vehicle of communication, and a form of personal expression” (p.11). In order for a therapist to be consider a play therapist one must be adequately trained. Play therapists have a master’s in counseling or related field such as social work of psychology. According to Landreth & Bratton (1998) “training should incorporate the areas of child development and basic counseling skills including acquisition of a theoretical approach incorporating a rationale for behavior change consistent with the play
therapy approach utilized” (p.12).
Person Centered Therapy Carl R. Rogers developed person- centered therapy. Roger’s focused on the centrality of the therapeutic relationship. According to Tuscott (2010) “ Rogers worked for 12 years as the director of a child guidance clinic, a position in which he developed the basic principles of what would eventually become person-centered therapy” (p.68). Rogers’s person-centered therapy is considered a humanistic approach. Rogers’s person-centered approach allows the client to set the goals, rather than the therapist which allows the client to decide for themselves how to cope with the problem. The person-centered therapy process focuses on change starting with self-disclosure allowing the client to disclose their thoughts, feelings problems, and so forth (Tuscott, 2010). According to Piotrowski (2010) “the concept of self is also considered to be an organized, consistent, and learned attribute composed of thoughts about self” (p.1377). The next step self-discovery allowing the client to create awareness of what they are really like to better identify their potential. The following step consists of self –understanding resulting in the client having an increase in self-regard. According to Tuscott (2010) “person-centered therapy is such an important influence on psychotherapeutic practice with the respect to the importance if the therapeutic relationship that it has become integrated into most approaches (p.75). Various therapy approaches have developed from the basis of person-centered therapy to include Robert Carkhuff human technology approach and Virginia Axline nondirective play therapy.
Important Elements of Counselor Identity, Function, and Ethics in Types of Therapy Counselor identity, functions and ethics are important for counselors to recognize in types of therapy. According to Gibson, Dollarhide and Moss (2010) “ the therapeutic self creates frames of references for counseling roles and decisions attitudes concerning responsibilities and ethics, modes of thinking and patterns of problem solving” (p.21). Counselors must be able to recognize what types of therapy are appropriate for their clients treatment needs. Counselors must also be aware of their own personal biases to meet the clients’ treatment needs. Gibson et al. (2010) mentions that professional identity emerges as a result of training experiences. According to Spurgeon (2012) “Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals” (p.4). Counselors must be able to recognize their ethical responsibility when it comes to their clients’ treatment needs and selecting types of therapy. Ethical practices have changed in the field of counseling throughout the years due to the complexities of issues counselors have come against during treatment with clients’.

Biblical Values and Insights Related to Types of Therapy Research has shown that spirituality and religion has been incorporated into clinical practice since the mid- 1990s. Biblical values have contributed to many scholars to include Carl Jung, William James, Viktor Frankel and Sigmund Freud to name a few. According to Rollins (2002) “Though biblical psychology fell away as the primary preoccupation of biblical scholars addressing psychological issues in scripture in the late twentieth century, new uses of psychology and new insights into the psyche were forthcoming with the gradual insinuation of the thought of Sigmund Freud and Carl Jung into the popular and the biblical scholarly mind” (p. 107). Tan and Brad (2005) state “Clients from most religious traditions are familiar and comfortable with belief-oriented language and share the assumption that what one believes is an essential component of feeling and behavior” (p.80). Cognitive behavioral therapy often utilizes homework assignments and readings for client to use during treatment. Adding a spiritually oriented approach to include scripture readings, prayer, medication and fasting contribute to growth and change of the client.
Personal Reflection and Conclusion In conclusion, I was able to identify the importance of Christian counselors utilizing different forms of therapy to meet their clients’ treatment needs and diagnosis. During the research of this paper I have been able to recognize the importance of being knowledgeable of different types of therapy to become an effective Christian counselor. As a Christian counselor I would utilize different forms of therapy to include but not limited to dialectical behavioral therapy, cognitive behavioral therapy, person-centered therapy, brief psychotherapy and play therapy. I was able to gather from the research that not all forms of therapy meet the clients’ treatment needs or diagnosis. I was also able to gather the importance of recognizing what form of therapy to use. For example cognitive behavioral therapy and brief psychological therapy might not be an effective form of treatment for individuals with borderline personality disorder. During the research I was able to recognize the role of ethics and counselor functions in types of therapy in treatment. I was able to recognize that some forms of therapy require specialize training to include play therapy and how it would be unethical for a counselor to utilize the form of therapy without taking the specialized training. I gained a greater understanding as a Christian counselor how to go about selecting forms of therapy to use to meet the clients’ treatment needs as well how to incorporate biblical standpoints. I was also able to recognize the importance of self examination and have an awareness of my own spiritual struggles and conflicts.

References
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