Psychology

The cognitive-behavioral model is described in some detail by Corey (2000). Its basic concepts are the linkages between cognition, affective behaviors and emotions. The understanding here is based upon two propositions
Irrational and pathological behaviors are based on a thought process that is distorted
The human mind is capable of restructuring those thought processes in order to lead to more rational and social behaviors (Corey, 2000 338).
    Attached to these propositions are several assumptions
That it is behavior that is the problem and must be changed
That emotions can be learned and unlearned
That behavior is linked comprehensively with thought processes.
That the distorted thought process of the patientclient does not cohere with reality.
Reality is always much better than the thought process that interprets that reality

    All of these form the basic conceptual apparatus of the cognitive school. Therefore, the purpose behind cognitive therapy is the restructuring of the internal, mental process to more carefully and realistically reflect the real world. In the Corey book, the cognitive model is seen as more or less a rationalist and mechanistic model. It seems to want to break down thoughts into their components and see what components are irrational and hence lead to cognate behaviors. Then the thoughts are put back together with rational premises included where before, irrational premises led to irrational conclusions. Hence, thought is made up of well defined ideas, propositions and concepts that are lined together with each other and with behavior. The cognitive model sees thought, behavior and feeling to be a) well defined and quantitative and, b) linked together in one large chain. Once the  bad  parts of the chain are replaced (i.e the client is habituated to think differently), behaviors will change.

    The clients that can benefit from such an approach are those clients who are professionals, those who have a live that is worth living but insist that it is not. This writer refuses to believe that the cognitive model works for those whose lives are miserable. In this case, their depression (or whatever the ailment) is not irrational, but a faithful reflection of what is. Clients whose lives are clearly above par, yet still are convinced of their worthlessness are pathological cases. It is likely that cognitive models can assist them.

    Putting this differently, ordinary folk with ordinary problems can begin distorting these to make them far larger than they are. They take on a vividness that is far and away from their actual significance. In such cases, the problem is cut and dry   the mind has taken vividness for significance, and therefore, the cognitive process is preventing the mind from reflecting reality from what it really is. This is the classic relevance of cognitive theory.

    One of the great benefits of cognitive theory is that cultural barriers often do not matter. Behavior is behavior. No culture countenances depression as rational. No culture considers thought that does not reflect reality a good thing. No culture countenances anti-social forms of behavior. If anything, coming to seek help itself becomes a barrier, where some cultures might consider this  form of weakness, a sort of  confession  that provides an institution with power over the individual. This might not be so much a cultural as an ideological issue. Needing therapy as  weakness  is a common stereotype of many traditional cultures. I foresee no serious cultural barriers in cognitive therapy. It remains, however, a limited approach that can only work with those lives (objectively speaking) are far better than their perceptions (subjectively speaking).

    The vocabulary of the cognitive school is purely Enlightenment it is scientific in the materialist sense of the word, where all thought and emotion must have a physical or behavioral counterpart ideas do not exist in themselves, but both have materialsocial sources and consequences. A  thought,  to use a simple example, is the mirror of an action, and vice versa. Action is preceded by thought and is then justified by thought. The thought is cognate with action, in that the thought is fully competent to explain the action, and the action is fully explained by the thought. Thought is internal, action is external   this is the only significant distinction. These are two pieces of  puzzle and the dividing lines are more or less neat and clean.  Emotion is another matter. While conceptually foggy, it can be defined with some level of clarity. Negative emotions derive from a distorted form of thought connected to proportionally distorted actions. Using an example
    a. The client, outwardly successful, begins to view himself as a failure
    b. The successes that the person has are  flukes  or based on  luck,  and can never be placed at the doorstep of the client. The client is a failure, his success is based on other factors that have nothing to do with the building of self esteem or even on skill. The client clearly has self-esteem issues.
    c. The result of this is that the person becomes sullen, withdrawn and anti-social.

    What does all of this say It says that, for some reason (and that will be dealt with in therapy), the thought process of this person has become irrational. Somehow, premises of ones failure have become so powerful that they can overcome all the objective evidence to the contrary. The job of the therapist here is cut and dry   replace these irrational premises with rational (i.e. realistic ones).

    Both in terms of the vocabulary of the school as well as the skills of the therapist, Corey has reduced these to five, and is as mechanistic as the cognitive school itself
Assess and define problems   given the above example, the therapist must find out what experiences have suddenly brought this successful man to view himself a failure. Marriage Family Mid-life crisis issues Trauma Health  What is the root of this sudden depression and sense of failure, especially in light of all objective criteria of success.

Formulate goals   we can assume that the client is interested in begin cured. Therefore, goals must be precise. The client should agree that eventually, his depression will wither away once he is able to see what he really is, not how he (or others) interpret him to be.
Alternative Solutions   in this case, the client and therapist brainstorm in order to consider approaches to his eventual cure. Self-affirmation exercises  are important here. The facts and just the facts should serve as the basis of the clients sense of self.

Some form of decision must be made as to what kinds of solutions will work. Outside of medications, various forms of self-esteem building exercises must be used. Facts must be put in the place of feelings. Reason must have pride of place over emotion. 
These must be implemented and results evaluated (Corey, 2000 349-350)

    These are the pieces of the cognitive skill set that a therapist must use. It is a highly rationalistic approach that works only with certain clients. In the simple example given above, the fact that this client is highly successful in an outward sense in very important. The objective reality and subjective assessment are clear. There is a distortion in the thought process. Of course, not all cases will be this clear, but the example brings out the spirit of the school and the nature of the questions.

    The humanist, or person-centered approach to therapy is another important school of counseling. Since it does not depend on simple mechanisms and linkages to operate, it is much more complex, foggy conceptually and easier to misinterpret. It is a complex approach to human problems that cannot stop at the therapists office. It is holistic at root.

    The basic conceptual apparatus here is defined by Rogers (1980)
Human beings have the internal resources necessary to find purpose and see that purpose unfold.
Clients who are cared for with a maximum of empathy will be those clients that will eventually learn to see inside themselves. There is no mechanism here, the person and the person alone is in charge of giving herself purpose.
Rogers writes  . . all things move to the instinctive fulfillment of all potentials  (118). If this is true, then the therapists job is laid out   how can therapy show the person their purpose and modes of achieving this.

All personal development includes and is performed in the context of the whole of human life
    The basic approach therefore is the opposite of the mechanistic approach of the behaviorist. There is no cut and dry objective. Reason, emotion and action are not links in a chain, but are conceptually included in each other and among the community the client works and lives in, there are no borders, at least, no borders that are therapeutically relevant.

    Similar to Rogers (and in fact, citing him regularly), Corey writes  when therapists experience genuineness, acceptance and accurate empathy for clients. . .therapeutic personality change and growth will occur  (249). In this case, he is speaking about the role of the therapist. There is no obvious goal as mechanistic as the behaviorist school the client must learn to see inside himself and find both the purpose important for their lives and the means to get there, in other words, to actualize the potential that exists, but is unseen due to the patients present pathology.

    Corey comes up with five conceptual points that summarize the difficult to summarize elements of humanist theory
Self-awareness is the central key, both for clients and for therapists. Without self-awareness, no cure can be seen. Self awareness is about finding purpose and a reason to live and function.
Important as well is phenomenology, that is, the respect necessary to the fact that objects only becomes objects once they are reflected upon and become a part of consciousness. Therefore, the subjective becomes important while the objective becomes less so, since nothing is truly objective in this approach.

Self-awareness should lead to self-actualization
Human beings are free and self-directing. They do not necessarily exist at the mercy of logic.
The therapist must support, given the above, the subjective experience and awareness of the clients (Corey, 2000 247-249).

    This last portion is important for cultural differences, since culture is one great phenomenological approach. Culture pre-digests external experience even before it is digested by the person. Culture is a form of humanization and interpretation that is not objective, but inter-subjective. Therefore, this approach in particular takes culture as seriously as consciousness itself. One theoretical problem is the very nature of culture in our work, in that pure and particularist cultures are hard to come by, most are  Americanized  to one extent or another. It may be the case clinically that getting deeper into ones native tradition is a good way to begin the curative process the sense of belonging and solidarity that cultures bring to the person should never be underestimated.

    The vocabulary of this school is far richer than the cognitive approach. Words like love, freedom, relatedness, awareness, purpose, growth are to be seen throughout this literature, each overlapping with the others and creating a tapestry of subjective experiences that must be taken as a whole (Corey, 2000 247). For Corey,  all masks and pretensions should be dropped  in therapy, whether group or individual, so that these experiences and the therapists understanding of them can flow freely (Corey, 2000 259).

    Rogers holds that it is not stability that is the goal of therapy, but the ability to grow, to develop in a healthy and self-aware sort of way. For Rogers, the final end of therapy is to help the client find the  freedom to become  rather than the static focus of the behaviorist school (Rogers, 1980 133). Rogers uses a cosmological and evolutionary approach to his idea of therapy (and often borders on theoretical overkill in the process) based around the constant development of all things. This does not apply to human beings, however.

The use of evolutionary and cosmological (and even metaphysical) metaphors eventually get lost in contradiction. Evolutionary biology exists according to fixed rules of conflict, survival and development. DNA is proof of this. Yet for Rogers, the ability for human beings to participate in this is the fact that human clients can choose any life path they want. If this is the case, then the evolutionary metaphor breaks down, since that is the precise opposite of what happens in nature. Nothing in nature is free to become, or chart their own territory. Rogers, without mentioning it, posits an immaterial soul that can abstract from any material object confronting it, and thus choose to accept it or reject it. Only an immaterial soul can do what Rogers says the client should be taught to do   to find for herself a sense of purpose and direction without preconditions or judgment (Rogers, 1980 118).

    Regardless of this, this writer cannot see any client group that cannot benefit from this approach, regardless of Rogers scientific overkill. It rejects the very simplistic approach of the cognitive school, replacing its pure logicbehavior nexus with one that more subjectively and reflectively absorbs (rather than perceives) the world around it. Reality (social and otherwise) is really seen as a set of symbols with concurrent emotional and rational reactions. Each symbol, memory and feeling is a part of a complex personal history and reveals itself gradually in an unpacking of an almost endless content. While this is true (and all of us have experienced this relation with symbols), Im not so sure how this can be approached from the point of view of therapy. Therapy, like any other part of life, is partial, abstract and must be incorporated into life as one set of symbols along side other sets.

    It is almost as if Rogers has obfuscated the issues to such an extent that the simple approach of seeing potential and worrying about manifesting that potential is lost in the epistemological categories of Rogers school. One need not accept Rogers evolutionary argument to hold that manifesting potential is just as valuable as proper thought patterns. These, of course, are not exclusionary, but complimentary. The real difference between the two is in the relation between objectivity and subjectivity. For the cognitive school, the two realms are separate. Logic is a means of making sense out of objective data. For the humanist school, these two realms are radically indistinct, since our pre-existing ideas are always imposing themselves upon external reality. Where one begins and the other ends is impossible to say, therefore it goes beyond the cognitive school because there is no clear demarcation between thought, perception, action and emotion.

    To conclude, one might be able to say that the distortion of thought so central to the cognitive school is precisely this lack of demarcation between objective and subjective. The subjective vision of the person is thrust outward into external objects and situations, hence distorting them. Cognitive therapy wants to maintain the radical distinction between inner and outer, with the former taking its data from the latter. The humanistic school rejects that they are, in fact, two different things, and hence,the approach to therapy should be radically different.