Cognitive Behavioral Therapy and Gestalt Therapy - Essay Example

Compare and contrast two of the alternative approaches to therapy (Cognitive Behavioral therapy and Gestalt therapy) Introduction CBT comes from a combination of cognitive and behavioural. Cognitive therapy is a kind of therapy that pays close attention to the sense of thoughts. It looks at the relationships between the thoughts, feelings and moods. Behavioural therapy looks at how behaviours are affected by problems and thoughts. CBT entails changing one’s perspective of life and how the behaviour can be changed. It helps in changing one’s emotion to positive thinking. Essentially, CBT notes that an external phenomenon is not what causes disturbance to an individual but it is the phenomenon’s judgement of the individual (McKewn, 2004). Gestalt therapy was founded in the 1940s. It focuses on the present events rather than the discussions taking place. It is a method of creating awareness on what is going on at that moment rather than the past or future events. It emphasizes the fact that people can determine their behaviors by making their choices through self awareness process. It capitalizes on the fact that an individual can make a choice that suits his or her depending on the level of awareness he or she is exposed to. Cognitive Behavioral Therapy CBT’s origin dates back to 1960’s. Aaron Beck who is am American psychiatrist came into a conclusion that patients his had some feelings within themselves which they only revealed a bit of it. For instance, during a therapy session, a client might think that the psychiatrist is tired of him or her. The client will never reveal this thought to the psychiatrist. This thought will have an impact on the client’s feelings. Beck discovered that there is a relationship between thoughts and feelings. He subsequently came up with 'automatic thoughts' which define thoughts cropping in the mind which others had no idea of. However, it was possible for people to learn about them and find a way of reporting these thoughts. Therefore, Beck realized that the most important aspect is for the client to understand his or her feelings and tries to overcome them. Due to the fact that the concept emphasizes on thinking, he coined the term cognitive therapy (McKay & Rogers, 2000, 23). He called it Cognitive behavioural therapy since it also delves on behavioural aspect of an individual. In CBT, treatment always varies depending on the patient’s problems. Generally, CBT includes the following: Assessment; the patients sometimes have to fill questionnaires in order to assist in the description of the problem he or she is suffering from and to be able to identify the symptoms. The patient will fill these forms from time to time. This will assist the therapist in plotting the patient’s progress and also identify problems that need high level of attention. Person education; this is where the therapist provides the patient with written materials. These materials will help the patient in learning about the problem she or he is going through. Whenever the patient understands the problem, it will help in dismissing fears hence eliminating the negative feelings thereby quickening recovery. Goal setting; the therapist helps the patient in coming up with a list of goals that should be achieved at the end of the therapy process. The list will be used by both the patient and the therapist in ensuring that they work towards achieving the set goals. Without goals then it might be difficult to work on the recovery process. Practice of strategies; during the therapy process there are strategies that are put into place to aid in recovery. This will help in the replacement of negative feelings that the patient has always been experiencing. Homework; the patient is given a lot of work to do during therapy process. For instance a patient may be required to keep a diary of the feelings that come up in the mind. These feelings will be used by therapist to accelerate the therapy process and healing (Herbert, Rheingold & Goldstein, 2002). Gestalt Therapy Gestalt therapy inculcates some basic pillars as listed below; The Phenomenological Perspective Phenomenology is useful in devising new thinking methodologies and empowers them to have a clear difference between their present perception and the post perception. The approach is to create insight within the patient by ascertaining that the patient is fully aware of the situation in place. This is done by ensuring that there is much awareness of the situation in place and its processes. It also focuses on the process by which the therapist and the patient relate to each other. Field Theory Perspective This describes the entire field on which a situation is part of. It does not describe a situation based on any grouping rather the entire field of occurrence. It is worth noting that the approach usually works on the concept of here and now hence sensitive to current events. It is worth mentioning that the approach centers more on what is happening that is the process as and not on the content (Gary Yontef 1993, 15). All these parts of the field are influenced by whatever situation goes on in other parts of that particular field. All actions are believed to occur in a field and no action can occur further than in the field. In this pillar, there must be an observer whose position is known. Gestalt therapy mainly focuses on dialogue between the patient and the therapist. This is very important since it provide the later with data or information that cannot be obtained through observation (Gary Yontef 1993, 34). Existential Perspective This pillar focuses on existence of people and their relationships with others. This therapy provides a means of self realization and appreciation hence awareness of the need to a meaningful existence. It notes that people are always discovering new things about themselves hence new problems (Burns, 1999). Dialogue Relationship between the client and the therapist is very important in any therapy. Relationship is developed from people who had never interacted before. Gestalt therapist ensures that there is a dialogue with the client for the therapy to be effective. In this therapy there is a goal to be achieved and can only be possible if the therapist and the client resonate in constructive dialogue. It is from the contact that the relationship between the patient and the therapist develops (Perls, 1992). The therapist at no time should manipulate the patient towards any therapeutic goal. The relationship between the two is characterized with high standards of acceptance, care as well as personal responsibility. More importantly, the dialogue is based on the reality of the other person as well as depicting the true self of the patient as well as the therapist. The patient is encouraged to open up and share his or her experiences in totality (Yontef, 1993: 40). There are four concepts that must be fulfilled during dialogue, they include; Presence The patient must feel the presence of the therapist. The therapist shares experiences, feelings with the patient. From the interaction, the patient will feel the presence of the therapist. Commitment to dialogue There should be an established contact between the therapist and the patient. This contact should be automatic and not manipulated. Similarities of the two therapies The two therapies emphasizes on a person as a whole. CBT focuses on the cognitive and behavioral change of an individual whereas Gestalt focuses on creating awareness of a patient on the present situations. Both the therapies put importance on the interactions between the therapists and the patients. In CBT, the therapist ensures that the feelings of the patient are clearly identified. The behavioral changes accompanying these feelings are delved into. This assists in determining what behavioral change is essential in order for the patient’s feelings to change. In Gestalt, therapists must create presence during the therapy. This will assist in creating awareness within the patient. The two therapies acknowledge the importance of life events. CBT investigates how the behavior of the patient affects his or her feelings. Since the well being of the patient is essential, CBT influences the thinking of the patient. It helps the patient to develop a positive thinking of any situation that might occur. Gestalt ensures that a patient is well informed of the situation and the surrounding. The occurrence in any field is of importance during this therapy. The two therapies are applicable to group or families. Essentially this illustrates how Gestalt therapy is used within a group of people. CBT can also be used with group of people since it incorporate a series of exercises which can be done in groups (Herbert, Rheingold & Goldstein, 2002). These two therapies are used in treatment of disorders faced by both the adolescent and the elder people of the society. In a case of a problem experienced by an adolescent, any of these therapies can be used as well as for problems experienced by elder people. There is no age discrimination in the two therapies which make them applicable to most of the problems that need therapy. The differences between the two therapies CBT therapy focuses on behavior and moods as at the time of therapy. This helps in identifying the feelings of the patient regardless of the past. Looking at behavior and moods of a patient is an easy exercise as compared to creating awareness of the situation at hand as in the Gestalt therapy. CBT sessions have procedural structures that are followed. According to Association for Behavioural and Cognitive Therapies, the patient before doing anything else provides the therapists with all the information deemed necessary and together they develop goals that must be met at the end of the therapy. It is worth noting that the problems of the clients varies from lacking sleep, not being social, dealing with problematic adolescents to problems at place of work (Joyce & Sills, 2001). Sessions are subsequently planned basing on the problems to be addressed and the goals to be achieved. These procedural structures helps in managing of the therapy time effectively bearing in mind that CBT takes a shorter time as compared to gestalt therapy. In CBT there is homework assigned to the patient in between the sessions. The assignments vary depending on the therapist and the nature of the problem to be solved. For instance a therapist may task the patient to keep a diary of some of the issues that contributes to depression or anxiety (Craske, Meadows & Barlow, 1994). These records can then be used in the subsequent sessions to analyse the thoughts that cause such feelings. These records will also be useful in determining the exercise to be done in order to avert such a feeling. CBT is suitable for groups and families, especially on the onset during therapy (Butler, Fennell & Hackmann, 2008). There is sharing of different experiences among the group members. This essentially relieves the burden of the problem from the patient. There is also the effect of advice from the group members on how to deal with the problem at hand. Since a group is composed of a number of people, a therapist can attend to a number of people at the same time. This means that many people can be attended to by this method. According to Better Health channel, CBT may not be a suitable therapy for those patients who are suffering from brain diseases or injury that cause impairment to their rational thinking. Since CBT is cognitive, then a patient with brain impairment would not reason rationally. This therefore will be difficult for the therapist to administer CBT (Dattilio & Freeman, 2007). In Gestalt therapy process, the patient is responsive to the therapist’s presence hence being able to solve whichever problem the patient is experiencing. Transference is discouraged and issues dealing with patient's character are approached by the use of the dialogical and phenomenological approach. Gestalt therapy allows for experimenting of something new during the therapy session. This allows for self discovery of the patient as compared to CBT where there are sessions outside the therapy session (Segal, Williams, Teasdale & Kabat-Zinn, 2007). In Gestalt therapy, there is ‘dimensionality’. According to Joyce & Sills, 2001 Gestalt therapy leaves nothing to chances; it gives patient the opportunity to freely express their feelings, emotions, ideas and behavior. Additionally the therapy acknowledges that the environment, society, mental state as well as other variables needs to be incorporated when helping clients. Applications of CBT CBT has been used in many parts of the world to treat disorders. Some of these disorders are; Anxiety For this problem, the patient is exposed to the stimuli. This treatment tends to help the patient face that fear that they have avoided which continuously leads to more fear. Phobia such as fearing spiders can be treated by exposing the patient to spiders. Exposing such a patient to CBT will help in changing their moods into positive. Other problems that can be treated using CBT can vary from depression, low self-esteem, smoking, drinking or other drug use problem, insomnia, relationship problems (White, 1999). Applications of Gestalt therapy Gestalt therapy is useful in a society in which the therapist understands the population. The therapists are supposed to experiment new behaviors and then share the effects of the new experiment. It is worth mentioning that this type of therapy has been successfully used to help individuals suffering from migraine, neck and back aches as well as ulcerative colitis. It has also been successful in the marriage conflicts where there is a continuous disagreement between the husband and the wife. Gestalt has been effectively used in handling character disorder drug abuse, wildness and other character disorders (Latner, 1989). Conclusion CBT and Gestalt therapy processes have been looked into illustrating their applications, advantages as well as the disadvantages. It is worth noting that these two therapies have been used to treat a range of problems. It is prudent that the patient looks into each of the two therapies and decides on which one to use. Then together with the therapist, they begin the therapy process. Gestalt therapy has been used in most part of the world in treating disorders. This therapy has been used in the United States schools for the purpose of treating problems that students are going through. The two therapies have had various applications including treatment of behavior disorders. Most adolescents are engaged in drug abuse and other behavioral changes that must be addressed through therapy. Therefore, in the current situation, most youths have gone through therapy to solve these problems. References Burns, D. (1999). ‘Feeling Good: The New Mood Therapy’ (Revised Edition). Avon. Burns, D. (1999). The Feeling Good Handbook. NY: Plume. Bush, J., (2002). A Manual for the Delivery of Cognitive Self-Change, Vermont Department of Corrections. Butler, G., Fennell, M., & Hackmann, A. (2008). Cognitive-Behavioral Therapy for Anxiety Disorders. New York: The Guilford Press. Craske, M., Meadows, E. & Barlow, D. (1994). Mastery of your Anxiety and Panic. New York: Psychological Corp. Herbert, J., Rheingold, A., & Goldstein, S. (2002). Brief Cognitive Behavioral Group Therapy For Social Anxiety Disorder. Cognitive and Behavioral Practice, 9, (1); 1-8. Joyce, P. & Sills, C. (2001). Skills in Gestalt Counseling & Psychotherapy. London: Sage. Latner, J. (1989). The Gestalt Therapy Book: A Holistic Guide to the Theory, Principles and Techniques of Gestalt Therapy Developed by Frederick S. Perls and Other. New York: The Gestalt Journal Press. McKewn, J. (2004). Developing Gestalt Counseling. London: Sage.  Perls, F. (1992). Gestalt Therapy Verbatim. New York: The Gestalt Journal Press. Segal, V., Williams, G., Teasdale, D. & Kabat-Zinn, J. (2007). The Mindful Way through Depression. New York: Penguin. White, J. (1999). Overcoming Generalized Anxiety Disorder. Oakland CA: Harbinger. Yontef, G. (1993). Gestalt Therapy: An Introduction. New York: The Gestalt Journal Press. Read More