CBT and REBT Application Comparison

u6d1-CBT and REBT Application Comparison

How each theory would conceptualize Henry’s problem, and how they differ

CBT

A cognitive behavioral therapist(CBT) would conceptualize Henry’s problems from the standpoint of viewing his inaccurate or faulty thoughts as behaviors that can be modified (Corey, 2013). Thus, the CBT practitioner would try to help Henry become aware of his self-talk and the stories he may be telling himself. In essence, CBT practitioner cause Henry to bring awareness to his faulty self-statements and work towards getting him to modify or change the statements hemakes to himself so that he can cope more effectively with the problems he is encountering.

REBT

A rational emotive behavior therapist (REBT) would conceptualize Henry’s problem from the standpoint of viewing his irrational thinking. This practitioner believes we learn irrational beliefs early in life and recreate those beliefs throughout life. The REBT practitioner would work with Henry to actively dispute his irrational beliefs, using different cognitive, behavioral, and emotive techniques as part of his/her process. REBT would work with Henry to get him to understand his irrational thoughts, and how they are causing him harm. Ultimately the goal would be to get Henry to replace his irrational thoughts with more rational, healthy beliefs.

Differences between each theory

The two theories differ in that REBT can be more “highly directive, persuasive, and confrontational”, and the therapist acts more like a teacher (Corey, 2013 p. 305). In contrast, CBT uses a more Socratic dialogue posing open-ended questions to clients with the aim of getting clients to reflect on personal issues and arrive at their own conclusions. CT places more emphasis on helping clients identify their misconceptions for themselves than does REBT (Corey, 2013). In that sense, CBT is more collaborative than REBT.

Another difference is in how REBT and CBT view faulty thinking. Through a process of rational disputation, REBT works to persuade clients that certain of their beliefs are irrational and nonfunctional. Whereas the CBTpractitioner views the clients’ beliefs as being more inaccurate than irrational. Further the CBT practitioner gets clients to conduct behavioral experiments to test the accuracy of their beliefs, with the therapist continuing to ask the client for evidence to support a certain belief system(Corey, 2013).

A final difference is that clear that CBT believes in establishing a warm, empathic therapeutic allegiance, along with technical competence required in CBT practices. However an empathetic therapeutic relationship is as “being necessary, but not sufficient, to produce optimum therapeutic effect” (Corey p. 305-306). In contrast, practitioners of REBT do not believe a warm, empathetic relationship is important or necessary.

What each theory would suggest needs to be changed for Henry

CBT

CBT would view Henry’s problem as faulty thoughts arising from self-talk in social and work situations that ‘people will look at him like he’s stupid and walk away’, and that he ‘avoids talking with people because nobody understands his situation’. These faulty thoughts influence Henry’s behavior. He is nervous, afraid, anxious and depressed in social situations and relationships. Because of self-talk that ‘people see him as weak because they think he can’t move on from his breakup’, he engages in behavior that causes him to avoid the few friends that he does have.

CBT would challenge Henry’s self-talk with open-ended questions in a Socratic manner, by questioning Henry’s beliefs and conclusions. Is it really true that people will look at you like you are stupid and walk away? Does everyone do this to you? Does it happen all the time? Has it happened anytime? If it’s happened, how do you really know the person thought you were stupid? Is it possible they were having a bad day? How do you know your friends see you as weak? Have they told you this? If so, is it all of your friends? Is it possible, that maybe they really feel bad for you?

By challenging Henry’s faulty thoughts and self-talks, CBT will demonstrate to Henry how he is overgeneralizing, and catastrophizing. While CBT is more of a here-and-now type therapy, the past is explored when doing so will aid in the therapeutic process (Corey, 2013). There is no question that his past history of being bullied, and his inability to speak to his father about it, can serve as the well spring for his present deeply embedded current maladaptive thoughts and anxious, depressive behavior in social situations and relationships. So the CBT practitioner may point out to Henry that shutting down may have been appropriate adaptive techniques at the time, but they no longer work for him.

REBT

REBT would explore how Henry responds to situations and his difficulty being present in social situations, relationships and in the work environment. It would do this by focusing on Henry’s irrational beliefs. In Henry’s case that would involve a more direct confrontation of explaining to Henry to see that it is unrealistic to believe that everyone ‘will look at you like you are stupid and walk away’, that ‘nobody understands (or is capable of understanding) your situation’ or that his friend really see him as “weak because he can’t move on from a breakup”. The point would be made to Henry that

Two specific interventions that would be used with Henry from each approach

CBT

One important intervention the CBT can use with Henry is cognitive restructuring. Cognitive restructuring plays a central role in CBT’s self-instructional training. Corey (2013) states that practicing cognitive restricting “the therapist and client practice the self-instructions and the desirable behaviors in role-play situations that simulate problem situations in the client’s daily life. The emphasis is on acquiring practical coping skills for problematic situations such as impulsive and aggressive behavior, anxiety in social situations, fear of taking tests, eating problems, and fear of public speaking” (p. 311).

Another useful intervention would be to use stress inoculation training, where Henry would be given gradual exposure to stressful situations. During the process the therapist would work to modify his beliefs and negative self-statements (Corey, 2013). Other interventions that can be used are to give Henry homework designed to have him choose new thoughts when he is generalizing or catastrophizing, and role-play to act out better ways to handle himself in approaching anxiety producing situations.

REBT

One final cultural consideration, given the importance of understanding the client’s cultural history also comes the responsibility of the therapist to explore issues of oppression and discrimination, and how these experiences relate to Henry’s current problems. Since it is mentioned that Henry, suffered multiple incidents of bullying, his maladaptive behaviors may also stem from past incidents of racism. Any feelings he may hold as a result of past discrimination should be considered.

References:

Corey, G. (2013) Theory and Practice of Counseling and Psychotherapy, 9th Edition. Cengage Learning, 20120101. VitalBook file.

Kim-goh, M., Choi, H., & Yoon, M. S. (2015). Culturally responsive counseling for asianamericans: Clinician perspectives. International Journal for the Advancement of Counselling, 37(1), 63-76. doi:http://dx.doi.org.library.capella.edu/10.1007/ s10447-014-9226-z

Sue, D.W., & Sue, D. (2016). Counseling the culturally diverse: Theory and practice (7th ed.). Hoboken, NJ: Wiley.

Sue, S., Zane, N., Hall, G. C. N., & Berger, L. K. (2009). The case for cultural competency in psychotherapeutic interventions. Annual Review of Psychology, 60, 525–548.