This paper presents a comparison of two therapeutic concepts, person-centred approach and cognitive behavioural therapy in terms of the role of counsellor and client. It specifically describes the role of the client and counsellor and then compares them accordingly. The paper will also discuss the strengths and limitations of the two approaches in order to differentiate them better.
IntroductionBoth person-centred therapy and cognitive behavioural therapy provide support and help to patients by addressing individual matters. Both practices share the common therapeutic goal of welfare improvement. The necessity of an integrated approach to person-centred therapy and cognitive behavioural therapy has called for numerous researches to investigate the roles of the different parties (Moon, 2006). In the comparison of the two therapeutic concepts in terms of the role of counsellor and client, there is a clear difference that is well defined in the subsequent discussions. In person-centred, the patient is the expert on himself and finds his or her own way, while in CBT the counsellor is the expert and leads the patient (Branaman, 2001). The approaches also have strengths and limitations that are discusses comprehensively.
Therapeutic relationship The role of the client and the counsellorIn terms of the therapeutic relationship, it is critical to make sure that the result of the therapy is effective and desirable. In relation to these two approaches of counselling, the therapeutic relationships are different from each another. In each approach, the therapist and the client have different roles to play in the processes. Therapeutic relationship in the cognitive behavioural therapy resembles that between a student and his or her teacher (Burkitt, 2008). The role of the counsellor is to provide therapeutic instructions and recommendations to the client who listens and then does exactly as they are told by the therapist. In this kind of relationship, the therapist uses directive structures in directing clients on the changes in behaviour. In this instance, the therapist acts as the point of focus since they impact much on the client’s cognitive and behavioural changes (Branaman, 2001). However, for the purposes of desirable and effective outcomes, collaboration is emphasised in the process of the therapy.
The therapist employs Socratic dialogue, which is essential in supporting clients in tenets like the identification of assumptions, values and norms that have affected the emotional and psychological functionality. It involves a disciplined questioning or probing that can be used in the pursuing of thought in various directions and for several purposes, which include exploration of complex ideas (Timulak, 2005). The therapist in this approach questions the client to find out the reality of things, to open up matters together with problems, to reveal presumptions and beliefs and to find out what they know and what they do not know, as well as following out rational meanings of thought and managing the discussion (Burkitt, 2008). The technique is important in the relationship between the client and the therapist because it is disciplined, methodical and normally focuses on critical principles, matters and problems. In addition to this, the client is encouraged by the therapist to change these assumptions and identify an unconventional concept for the present and future living (Timulak, 2005). The therapist, in this instance, assists in the promotion of the adoption of remedial learning skills. The client, in this kind of association is always presented with new insights in relation to the matters they are experiencing and thus chooses the most effective and efficient ways of acquiring change.
The cognitive behavioural therapy employs the methods that are aimed at individual counselling. It employs the Socratic Method that comprises of numerous questions to be responded to by the client. Counsellors employ various techniques of behaviour, emotion and cognition; different techniques are tailored to fit individual clients (Wetherell et al 2001). Nevertheless, the client is also given chance to ask the therapist some questions. The approach utilises the aspect of homework or coursework that encourages the patients to practice the skills acquired. Therefore, cognitive behavioural therapy’s major technique is the ABC one, which employs the Socratic concept.
On the other hand, the therapeutic relationship in the person-centred therapy is very different from the cognitive behavioural therapy. Here, the relationship between the therapist and the client is critical because the therapy focuses on the client as they turn to be the point of focus of the therapy. As a result of this, the therapist has to make sure that there is maintenance of respect, empathy and honesty towards the client (Timulak, 2005). Communication is also important in this approach particularly between the counsellor and the client. The relationship should be equal since it important in enabling change in the client.
The client centred therapy approach utilises the attitudes of the therapist as the main technique. The therapist’s attitude towards the patient determines the result of the whole process. The approach makes use of the aspects of listening and hearing and clarification of feelings and ideas (Timulak, 2005). This approach does not employ the methods that encompass directive aspects. In this therapy, there is nothing like questioning or probing, which are commonly seen or done in the cognitive behavioural therapy.
Strengths of cognitive behavioural therapyOf all the known psychological therapies, cognitive behavioural therapy is the most clinically researched and examined and is generally considered as one of the most effective means of dealing with anxiety (Wetherell et al 2001). The approach is affordable and the overall procedure of treatment can last for as few as six sessions of one hour each for minor cases of anxiety, though normally in the area of 10-20 sessions. It has more appeal or attraction in the sense that it is exclusively natural and different from medication, there are no harms or side effects. The therapy is most commonly provided as a face-to-face remedy between the counsellor and patient but there is more evidence to demonstrate that its principles can be used in several other frameworks (Denscombe, 2007). For instance, interactive computerized cognitive behavioural therapy is on the rise, however, it can be given in groups or in the self-help books. These alternatives are very appealing to people that find the practicalities or ideas of frequent meetings with a counsellor not suiting them. CBT is an approach that is highly structured and involves the patient and the counsellor collaborating on the objectives of treatment that are specific, quantifiable, time-limited, attainable and actual or real. The patient is motivated to break down the behaviours, feelings and thoughts that confine them in an undesirable cycle and they get to learn strategies and skills that can be used in the daily life for the purposes of helping them cope better (Burkitt, 2008).
Weaknesses of cognitive behavioural therapyThere are some problems with cognitive behavioural therapy that make it undesirable and unsuitable for some individuals. The concept might not be effective for individuals with mental health problems that are more complex or for those that have difficulties in learning. The major focus of the concept is usually about the patient and their capacity to change their behaviours. Some individuals feel like this is a focus that is too narrow, and disregards too many significant matters such as family, histories of self and extensive emotional issues (Moon, 2006). There is no scope within the concept for individual examination and exploration of emotions, or even of looking at the challenging issues from different angles or perspectives. For these matters to be dealt with in a proper manner, a patient would have to turn to another method, probably along the lines of the psychodynamic counselling.
In order to fully gain from the cognitive behavioural therapy, the client has to make sure that they give a substantial level of commitment and dedication as well as participation. Those who argue against the therapy claim that since it only deals with the present issues, and focuses on issues that are very specific, it does not adequately address the probable causes of the mental health problems like a child who is not happy (Furedi, 2004).
Sceptics of the concept claim that just by an individual being told that their perceptions of the world do not correctly reflect the reality by the concept’s counsellor are not enough to change the cognition of a patient. A criticism that is more salient for some patients might be that the counsellor initially may accomplish something of a specialist role, in the sense that they offer expertise or experience that is problem solving in the cognitive psychology (Palmer, 2001). Some individuals might also feel that the counsellor can be playing a leading role in their probing and somehow commanding in terms of their suggestions. Patients who are okay with self-examination, who readily employ the scientific approach for the exploration of their personal therapy and who put confidence in the basic theoretical method of cognitive therapy, might find the concept an important one (Gillon, 2007). However, patients that appear to be less easy or contented with any of these, or even whose suffering is of a more common interpersonal nature, to an extent that it cannot be in a position of easily being framed as an interplay or interaction between behaviours, thoughts and emotions within a particular environment might find this kind of therapy useful to them and their conditions. Cognitive behavioural therapy has always proved to be helpful to the people that suffer from serious conditions, such as depression, uneasiness, fear or obsessive compulsive and panic (Denscombe, 2007).
Strengths of person-centred therapyThe concept of the approach is that the patient is the best professional or expert on themselves and has the best position of helping themselves. Its strengths include the fact that the patient is the one guiding the experience whereas the therapist reflects on what the patient is doing or saying and can paraphrase the ideas together with practices (Giddens, 2001). The therapist does not judge the patient as being right or wrong. The objective of the person-centred therapy is improving the trust of the patient in themselves and their self-confidence. It also helps them in becoming more able to live in the period, and letting go of the emotions that are unproductive and negative, such as guilt regarding the past events that are difficult to change (Branaman, 2001).
Weaknesses of person-centred therapyThe fact that the approach is client-led is one of its biggest weaknesses since it is up to the patient to be in a position of processing information and making rational decisions for their personal well-being. In case the client is not capable of doing this as required by the concept, the cornerstone of a therapist not making judgments about the information provided or processed by the client can turn out to be counterproductive to the patient’s welfare (Robb et al, 2004).
The approach requires creation of an extended and honest relationship with a counsellor (Bolton, 2001). The advocates of this therapy would claim that the counsellor could work faster, if that is their wish. However, if they are less than one hundred per cent committed to working via their issues, the required duration of the treatment can seriously exceed or surpass the money and time of the patient. Still the counsellors would cite that unlike cognitive behavioural therapy, the major focus of the treatment or approach is about ‘being in the period’ and the concerns of today, instead of upon long-ago past excavation (Branaman, 2001).
ConclusionIn the discussions above, it is apparent that these two therapies have different approaches to treating patients of the same and different problems. Both of them focus on the conscious mind, the current issues and problems that the patients might have. Both of them have a positive perception of the nature of human beings and perceive the person as not essentially being an outcome of their past experiences, but recognise that they are capable of determining their individual futures. Both approaches try to improve the welfare of patients by way of a collaborative therapeutic relationship, which allows and enhances health adaptation techniques in patients that are having psychological pain and distress in their lives. The biggest differences in the two approaches include the fact that the relationship between clients and therapists differ. The role of the counsellor in cognitive behavioural therapy is to provide therapeutic instructions and recommendations to the client who listens and then exactly does as they are told, while in the person-centred therapy, the relationship between the therapist and the client is critical because it on the client as they turn to be the point of focus.
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