The cognitive approach says that thinking and feeling come between the stimulus and the response and in order to help people who have problems with their behaviour, counsellors need to help them examine what they think and feel.
The cognitive approach assumes that what people think and what they believe are quite rational, but sometimes their thinking is distorted and this can lead to social, emotional and behaviour difficulties.
In behavioural therapy people learn to change certain behaviours and cognitive therapy focuses on thoughts, assumptions and beliefs. With cognitive therapy, people may learn to recognize and change faulty or maladaptive thinking patterns.
“The two therapies often are used together because they are beneficial to each other. For example, in the midst of extreme anxiety, it may feel impossible to gain control over your thoughts and apply cognitive therapy techniques. Therefore, a behavioural technique such as deep breathing may help you calm down and focus on your thinking.” (, 2007)
The humanistic approach, which is also known as the person-centred approach, focuses on the individual person’s thoughts, feelings, and experiences. It is based on the idea that a person has a natural tendency to grow and develop as a person in a psychological sense.
Two key figures within the humanistic approach are Abraham Maslow and Carl Rogers. Maslow is best known for his hierarchy of needs and this describes the needs which have to be met in order of priority for a person to become fully complete as a person. There are six levels of needs, which are; Physiological needs, which are a person’s most basic needs like food, air and water, Safety needs, which is to avoid pain and harm, Belongingness which is a person’s need to belong and feel secure, Love needs, which is to love and be loved in return, Self-esteem needs, which is the need to feel that a person is worthwhile, and finally Self-actualisation needs, which is at the very top and it is the need to become a whole and intergraded person.
“The Humanistic Approach began in response to concerns by therapists against perceived limitations of Psychodynamic theories, especially psychoanalysis. Individuals like Carl Rogers and Abraham Maslow felt existing (psychodynamic) theories failed to adequately address issues like the meaning of behaviour, and the nature of healthy growth. However, the result was not simply new variations on psychodynamic theory, but rather a fundamentally new approach.” (The Humanistic Approach)
believe that it is necessary to study the person as a whole, especially as an individual grows and develops over the lifespan. The study of the self, motivation, and goal-setting are also areas of special interest.
Person-centred therapy is taken from the humanistic approach and used within counselling. The important part of it is the relationship between the client and the counsellor and Carl Rodgers identified three features of this relationship which are; unconditional positive regard, empathy and genuineness. These are the necessary and sufficient conditions for therapeutic change.
In conclusion one can see that each of the three approaches are extremely different from the other. Each theory was designed from a theorist discovering different ways to help people through talking and each of them are used for different purposes of counselling.
Developing Counselling Skills
Compare the contribution of major theorists to the different perspectives used in counselling.
Within each of the approaches there are theorists that have designed a theory which added together completes it. The theorists that contribute to the psychodynamic approach are; Sigmund Freud and Erik Erikson.
Freud’s ideas have been applied to many areas in psychology like people who are aggressive, gender development, mental disorders and personality. There are a number of ideas that Freud used to form the basis of his theory, the concept of the unconscious mind, the principle of psychological determinism and the importance of childhood in determining adult behaviour.
“Freud's suggests that our behaviour is influenced by , and . We are born id, and acquire ego and superego by puberty. also has a , where he says our personality develops in stages during childhood. If we fail to resolve conflicts associated with a particular (, , , and ) stage of personality development Freud said we could develop .” (Keegan, 2003)
The id operates on a pleasure basis and it is present at birth. It tries to get immediate gratification to avoid pain and it is the source of the psychic energy libido.
The ego is developed during childhood from the id when a person learns that immediate gratification is not always possible because pain cannot always be avoided. The ego works on the reality factor and it decides on which actions are appropriate and which id impulses will be satisfied. The ego tries to balance out the demand of the id and the superego. The superego consists of a person’s values and beliefs. Many of the ego decisions are conscious but some can be preconscious and others, like ego defences are unconscious.
Within a care setting Freud’s theory of psychoanalysis would be used to uncover unconscious conflict and help the clients to understand the causes of it so then they can come to terms with their problems. The types of counselling therapies that would be used to uncover unconscious conflict are; dream analysis, slips of the tongue, free association, regression, hypnosis and transference.
Erik Erikson was a psychoanalyst as well as Sigmund Freud. Erikson concentrated on the ego which is known as the conscious part of the personality and how a person develops their adult identity.
“Erikson proposed that the child has to work through various tasks, and what these tasks are depends partly on the child’s maturation and partly on the demands of the society in which he or she lives. Like Freud, Erikson said the task, or problem, has to be successfully resolved at each stage, or there may be problems for the individual later on.” (Woods, 1995)
Erikson proposed that there are eight stages of developments through which a healthily developing human should pass from to late . In each stage the person confronts, and hopefully masters, new challenges. Each stage builds on the successful completion of earlier stages. The challenges of stages not successfully completed may be expected to reappear as problems in the future.
The eight stages of development are; infancy, younger years, early childhood, middle childhood, adolescence, early adulthood, middle adulthood and later adulthood
Infancy is between birth and 12 Months which is the psychosocial crisis of trust versus mistrust. Younger Years is between 1 and 3 Years and it is the psychosocial crisis of autonomy versus shame and doubt. Early childhood is between 3 and 5 year and it is the psychosocial crisis of initiative versus guilt. Middle childhood is between 6 and 10 years and is the psychosocial crisis of industry versus inferiority. Adolescence is between the ages of 11 and 18 years and is the psychosocial crisis of identity versus role confusion. Early adulthood is between the ages of 18 and 34 years and it is the psychosocial crisis of intimacy versus isolation. Middle adulthood is between the ages of 35 and 60 years and it is the psychosocial crisis of generativity versus stagnation and finally the later adulthood which is between the ages of 60 years and death which is the psychosocial crisis of integrity versus despair.
Erikson states that the degree that each person experiences these qualities in each stage, will determine the kind of person they are.
The theorists that contributed to the behavioural approach were John Watson and Ivan Pavlov.
Pavlov worked with dogs and from this he knew that they salivated even when they seen their food dish empty. Salivation is a reflex and gradually the dog had learned to associate the dish to food. He called the food the unconditioned stimulus because this would automatically make the dog produce saliva and the saliva was the unconditioned response because there was no control over it. The dish was called the conditioned stimulus because after a while of being presented with the food in the dish the dog relates the dish to the food.
Pavlov found that dogs could be conditioned to produce saliva to other factors like a bell ringing or a buzzer if the food was produced with it.
In 1920 Watson conditioned an 11 month old boy to show fear. The boy played with a rat while a metal bar was struck to an area that was close to him so as the noise would frighten him. This noise was the unconditioned stimulus and his fear was the unconditional response. The boy learned to associate the rat with the fear and eventually when he was given the rat to play with he showed fear towards it and the rat had become the conditioned stimulus and his fear was the conditioned response.
This kind of unconditioned stimulus can be used within a care setting through dinner bells and the unconditioned response is the action that the clients would take which would usually be to move over towards the area that the food is served.
The theorists that contribute to the humanistic approach are Carl Rogers and Abraham Maslow. Rogers’ aim is to enable people to integrate all of their experiences and this usually involved getting people to acknowledge parts of themselves that they have denied. Maslow’s skills and techniques, like his hierarchy of needs, are used in counselling for the person-centred approach.
A counsellor would offer unconditional positive regard and acceptance while their client would go through a process of integration. If it is successful the person will have high positive regard
Pavlov’s theory of classical conditioning is put into a counselling therapy. It is called therapeutic application of classical conditioning and it is used to treat phobias or irrational fears.
Operant conditioning is also used by counsellors and it is often used to encourage children to show wanted behaviour. An example of this is if a child is given a sweet or a sticker if they have help their parents tidy up. Due to this the child will be more likely to help in the future as that particular behaviour has been positively reinforced.
proposed a theory of human motivation. His theory contends that as meet basic needs, they seek to satisfy successively higher needs that occupy a set . Maslow's hierarchy of needs is often shown as a pyramid consisting of five levels. The four lower levels are grouped together as deficiency needs associated with physiological needs and the top level is termed growth needs associated with psychological needs. The basic concept is that the higher needs in this hierarchy only come into focus once all the needs that are lower down in the pyramid are mainly or entirely met.
are; physiological needs, safety needs, love, belonging and social needs, esteem needs, cognitive needs and aesthetic needs. Growth needs are; self-actualisation and self-transcendence.
When comparing the theorists above, one can see that each of them had their own views about personality and behaviours. By comparing Freud and Maslow together one can see that Maslow states that a person cannot achieve self esteem and self-actualisation without meeting their safety needs and belongingness needs.
Freud states that a person cannot unconsciously move forward in their lives without confronting their previous unwanted experiences. By looking at the two theories one can see the similarities as both theorists state that a person cannot move forward until they have achieved or overcome everything that is past them.
Developing Counselling Skills
Analyse the advantages and disadvantages of different theoretical perspectives in health and social care
There can be advantages and disadvantages in the application of various therapies within a health and social care setting.
The psychodynamic approach focuses on problems that have taken place in previous experiences. The theorist works on bringing the problem from the person’s unconscious mind to their conscious mind so as they can work through the problem.
While using the psychodynamic approach, counsellors carry out short term analyses on their clients. Effective psychotropic medication was not available in the early years, but it is well known that Freud believed that biological, constitutional factors were an essential aspect of the person and anticipated the future discoveries of chemical substances which would alter the personality and the problems.
Zippin-Knijnik (2007) note that the psychodynamic approach can be used for group treatment for social phobia and they state:
“One potential advantage is that there is no change in the figure of the therapist, which is known to influence all kinds of psychotherapy. The potential disadvantage would arise from the possible affiliation of the therapist to a certain kind of therapy in detriment of the other. This could lead to a systematic bias, which would favour, consciously and unconsciously, one of the interventions.” (Zippin-Knijnik, 2007)
The disadvantage of this approach is that it does not always work due to the type of therapy it consists of because if a client is unwilling to talk about their past experiences that are causing them problems then they will be unable to work through them.
The behavioural therapy is widely used when dealing with fears and additions. Classical conditioning can be used to stop addictions like smoking and drug taking within clients. The main advantage of this approach is that the treatment for it is available on the NHS so as everyone who is in desperate need for it can receive treatment.
There is a disadvantage to Ellis and Beck’s behavioural theory as well because the client is in need of a lot of supervision to constantly apply the stimulus so as they can have an immediate response to the situation. To do this a counsellor would need to be available at all times so as the client would have the same response to the stimulus.
The humanistic approach is person-centred and an advantage of this is that most counselling organisation nowadays uses the person-centred approach to help their clients with their problems.
A disadvantage of the humanistic approach is that it can be criticised for being culture bound. Also some people do not like the person-centred approach because they have to speak about themselves and some people may not feel comfortable talking about their feelings and they may prefer a structured approach.
“Cultural difference can also influence they way clients perceive those who help them, and person-centred counsellors may sometimes be seen as passive or lacking in initiative by people who value advice or other more directive forms of intervention.” (Hough, 2003)
In conclusion one can see that there are positive and negative aspects to each of the three approaches. Each of these aspects depends on the type of person that the client is and the problem that they need support with and this is because there are not two individuals that are exactly the same within a counselling situation.
References
Cox, E (2000) Psychology for AS Level, University Press, Oxford
, C (2007) An Introduction to Cognitive-Behavioural Therapy, New York Times Company, [online] [accessed 18/03/07]
Hough, M (2003) Counselling Skills and Theory Hodder and Stoughton, London
Keegan, G (2003) The Psychoanalytic Approach, [online] [accessed 18/03/07]
The Humanistic Approach, [online] [accessed 18/03/07]
Woods, B (1995) Basics in Psychology, Hodder and Stoughton, London
Zippin-Knijnik, D (2007) Psychodynamic group treatment for generalised social phobia, Brazil [online] [accessed 20/03/07]
Bibliography
Davenport. GC (1996) Essential Psychology Collins Educational, London
Seden, J. (1999) Counselling Skills in Social Work Practice. Open University Press, London
Wikipedia (2007) Erikson’s stages of psychosocial development, [online] [accessed 20/03/07]