Timothy Richardson.

OUPI: C3632876 D171 TMA 01

Compare and contrast the cognitive-behavioural and person-centred approaches to counselling by outlining the similarities and differences between these two models. You are asked to focus your essay on how these approaches understand the person (their 'image of the person'), and how they explain problems experienced by individuals.

Introduction.

Despite being a relatively new social science, there has already been several schools of thought as to the best approaches to conducting counselling. This essay will compare and contrast two schools of thought, the cognitive-behavioural approach and the person-centred approach, be looking at four different areas separately. Firstly, the philosophical roots of the two approaches. Secondly, how the two approaches each view the person. Thirdly how the two theories understand mental health problems, before finally drawing conclusions.

Philosophical roots of the approaches.

The roots of the cognitive-behavioural approach lies in the scientific world, and is due largely to the work of J. B. Watson (1878-1958). In his 1913 article 'Psychology as the Behaviourist Views It' (also known as 'The Behaviourist manifesto') he laid out the foundation of what was to become known as the cognitive-behavioural approach, that through self conditioning and self control a client has the ability to change their ideas, thoughts and

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outlooks. He took the 'introspection' of Wundt (1832-1920) and Titchener (1867-1927) and in the light of Pavlov's (1849-1936) research into behaviour, applied scientific principles to it. Several later experiments (such as Watson's Little Albert experiment) seemed to prove, under laboratory conditions, that behaviours are learned. The scientific nature of the research does however almost force an emphasis on to visual effects, rather than their 'hidden' causes. By teaching new behaviours, the unwanted behaviours can be 'written over'. The cognitive part of the approach began to appear in the works of Ellis and Beck (especially 'How to Live With a Neurotic', Ellis, 1979.) By understanding and changing cognition, and any irrational beliefs they cause, these learned behaviours can be completely and permanently changed.

If the cognitive-behavioural approach relies on scientific methodology, the person centred approach is more philosophical, going through the ideas of Aristotle and John Locke. The counsellor is a facilitator in this approach. Just as the Greek philosophers would ask their pupils questions to examine their logic, so a person centred practitioner asks their patients to examine their own behaviours. Carl Rogers, (1902-1987) the founder of this school of thought, stated that 'the therapist could be of most help to clients by allowing them to find their own solutions to their problems'. (OU handbook p171). The core belief is that the persons experiences and ideas that make up their view of the world, and by encouraging clients to discuss and explore the origin of these feelings and ideas clients can change this 'core programming ' away from the problem causing elements, thus aiding them in their process of recovery. Large numbers of psychologically damaged returnees from World War Two meant an approach was needed that would take the focus off the practitioner, allowing them to assist multiple patients at once. This is not to say that the cognitive-behavioural

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approach casts the patient adrift, but, the facilitator is required only to create a space (both physically and emotionally) where these ideas can be explored and ask probing questions, rather than proscribing a specific 'regimen'.

General view of the person.

The cognitive-behavioural approach is often seen as being one of teacher/pupil, the counsellor providing a framework, often with formal tasks for the client to perform out of contact. An example of this is given in the OU Handbook on page 138 (box 5.1), tasks given including; keeping being food journals, weighing and reporting and continued self monitoring. The patient is very much the driver of their own therapy, and thus become their own healer. It is their responsibility to perform these tasks, their responsibility to record the results accurately. This is not a problem for the cognitive-behaviourist as they will have explored with their client the importance of viewing oneself, not only from their present circumstances, but also from where they wish to end up, emotionally and behaviourally. If they fully engage with this, it will provide full motivation to the client to perform their tasks.

This all stands in stark contrast to the person centred approach. At the centre of which, according to Rogers, is the belief that only by the practitioner creating the correct setting, actualised in his six points, (OU handbook p182) and establishing a doctor patient relationship can effective counselling be actualised. The view of the person is, perhaps unsurprisingly, at the core of the person centred approach. By exploring their reasoning for holding the beliefs they do, they can change their actions thus it is that the client is not only the driver of the cure,

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but also the originator of the problem! In this way, the client is in complete control of the process throughout, which can in itself provide limitations. This approach is only effective if the client has a sense of self worth in the first place. It relies on the client having an idea of where they are now, and where they would like to be, with the latter being a distinct and 'better' place. This means that the client has to be mentally self aware and cognitive. The person centred approach practitioner believes that this 'self awareness' is the natural condition of people, and so effective treatment can usually be carried out.

Understanding of mental health problems.

In order to treat problems, the two philosophies first must understand from where these problems originate. Cognitive behaviourism, focuses on the belief that behaviours (both good and ill) are learned. In the early days of the the approach, practitioners looked to discover 'the laws of learning' (OU handbook p133) and by discovering them, practitioners believed that they could understand what caused undesirable behaviours and thus execute a change in them. These problems can only be altered by the client themselves, with the assistance of a skilled and motived counsellor. Problems can originate because of behaviours learned not being positive ones or, after seeking assistance, by any of Marlatt and Gordon's three relapse triggers (OU handbook p151). By scientifically analysing patients cognitivebehavioural practitioners believe that it only is the actual behaviours that are important.

For the person centred counsellor the reasons for 'bad' behaviours are deep seated. Understanding why a client behaves in a certain way involves understanding what reasons

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they have for doing so. Maslow places at the core of the person centred approach two needs at the core of his 'organismic value', the need for self actualisation and the need to be valued. Any loss of these is called 'incongruence', and can occur for a number of reasons. Roger's himself had an innately positive opinion of humanity, demonstrated by his belief that an inner sense of morality drives people more than external factors (such as what others might think of their actions), and yet they still choose to view certain behaviours as undesirable.

Conclusion.

At the core of both approaches is the effective treatment of the client. The cognitive behavioural practitioner achieves this by exploring which areas of behaviour or thought the client wishes to change and putting in place a programme to achieve this change. It is highly dependant on the skill and motivation of the counsellor, and the client, with the majority of work being carried out away from the counselling location by the client. The person centred approach however places a larger emphasis on the physicality of the counselling space and most of the 'work' is carried out with the counsellor, perhaps taking away from the skill required by the counsellor, they are nothing but a cipher to the process. This work consists of identifying root causes for problems the client is experiencing, and by dealing with them, changing the undesirable outcome. While both approaches have results to back them up, the older and more scientific nature of the cognitive behavioural-approach has led to that strand having the stronger body of evidence. As more studies are carried out, and with the increase in the social acceptability of receiving counselling, it seems that both approaches will endure long into the 21st century.

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Word Total: 1299.

Referencing.

Ellis, A. (1957) How to live with a neurotic. Oxford, Crown Publishers. McLeod, J. (2008) Introduction to Counselling, [Ed D. Langdridge] Maidenhead/Milton Keynes, Open University Press/The Open University. Rogers, C. R. (1951) Client-centred therapy, Boston, MA, Houghton Miffin. Watson, J. B. (1913) Psychology as the Behaviourist Views It, http://s-f-

walker.org.uk/pubsebooks/html/Watsonviews.htm (first accessed 28/11/12)

Wundt, W. M. translated by Titchner, E. B. (1902) Principles of Physiological Psychology.

Green York University, Toronto, Ontario.

Word Total: 1299.

Reflect on and write about which of the two models of counselling, with their different understandings of the person and explanations of individual

distress, you feel most drawn to and why? OUPI: C3632876

I am more drawn towards the person centred approach. I see the cognitive-behavioural approach focusing on treating the symptoms of the problem, not the root of the problem itself. That is to say that I think there is no merit in the cognitive-behavioural approach, and I believe that the two are in no way mutually exclusive.

Word total: 56.