Download 'n' Read - The Therapeutic Relationship In Rational Emotive And Cognitive Behaviour Therapy9/17/2017 Cognitive-Behavioral Therapy Definition Cognitive-behavioral therapy is an action-oriented form of psychosocial therapy that assumes that maladaptive, or faulty. Rational emotive behaviour therapy focuses on uncovering irrational beliefs which may lead to unhealthy negative emotions and replacing them with more. Theoretical Approaches Adlerian Therapy. Adlerian therapy is based on the Individual Psychology theory of personality and system of counselling developed by Alfred Adler. Rational emotive behavior therapy (REBT), previously called rational therapy and rational emotive therapy, is a comprehensive, active-directive, philosophically and. Welcome to the Albert Ellis Institute (AEI), a world-renowned psychotherapy training Institute established in 1959. AEI is committed to promoting emotional well-being. General or nonpreferential rational-emotive therapy (RET)is synonymous with cognitive behavior therapy (CBT).Specialized or preferential RET, however, differs from. A Systematic Review of the Literature on the Use of Rational Emotive Behaviour Therapy in Criminal Justice Work to Reduce Re-offending. An explanation of Guided Discovery in Cognitive Behavioural Therapy. Neel Halder ST6 Psychiatrist, Medical Education Fellow, North Western Deanery. Introduction. Cognitive Behavioural therapy (CBT) has come to be associated with a set of guiding principles. These are methodological assumptions, or defining characteristics of the approach. One of these focuses on collaboration; that is the therapist encourages the client to view therapy as teamwork. Another, which is somewhat linked to the first, focuses on the use of guided discovery. This is in contrast to some other forms of psychotherapy where communication via interpretations is the norm. This article aims to provide a clear explanation of what guided therapy is, and how it is incorporated in CBT, using examples and personal perspectives, as well as from noted therapists in the field. The technique can be used in many other settings including psychiatric consultations. What is Guided Discovery?- Historical perspective. Guided discovery is based on asking a series of questions that allows information to be brought into the client’s awareness. The client is therefore encouraged to discover things for herself. Guided discovery is sometimes also known interchangeably as Socratic questioning as it is derived from the method of teaching employed by Socrates, as recorded in the Socratic Dialogues (Cooper, 1. This consisted of asking questions, which then promoted reflection, which in turn produced knowledge. These terms are often used interchangeably, which can be misleading. Socrates tended to know exactly where he was going with his questions, which is not a necessity for guided discovery, as detailed below. Originally, Socratic questioning involved a questioning style similar to that of a cross- examination (Sieple, 1. Repetitive questioning was used to force people to admit their ignorance (Nelson, 1. This would often result in humiliation of the client (Chessick, 1. Socratic questioning can be a component for guided discovery, but there are other factors that are required, like collaboration and genuine curiosity (Padesky, 1. Padesky (1. 99. 3) argues that using Socratic questioning as a method for changing beliefs is not necessarily the same as guiding discovery (see below). Therapists need not necessarily know the endpoint at the start of the dialogue with the client. Padesky (1. 99. 3) states that if therapists are too confident with where they are going, “you only look ahead and miss a detour that can lead you to a better place”. Wells (1. 99. 7) writes “. If a therapist asks a question with an answer already in mind, the client may perceive this as manipulation. Guided discovery incorporates one of the other underlying principles of Cognitive therapy, namely its empirical nature. There is the data gathering element, looking at the data in different ways with the client, and inviting the client to devise her own plans for what to do with the data and information (Padesky, 1. Beck, Rush, Shaw & Emery (1. This notion of the client and therapist working together via collaboration and negotiation comes from Kelly’s idea of both working as “personal scientists” (Kelly, 1. Beck, Wright, Newman, Liese (1. Padesky (1. 99. 3) suggests that Socratic questioning consists of 4 stages. She goes on to state that for guided discovery to occur, then the questions asked should be within the client’s knowledge base, should draw attention to the relevant issue under discussion (but may be outside the client’s focus) and generally move from concrete questions to more abstract. By the end, the client should be able to apply new information to a previously held belief or generate a new one. Overholser (1. 99. Socratic method itself, used for guiding discovery. He suggested the method uses three main elements; systematic questioning, inductive reasoning and universal definitions. Systematic questioning is used to guide the interview process and help the client seek answers independently. Inductive reasoning helps clients generate broad, logical conclusions based on limited experience. Universal definitions help clients develop abstract generalisations that remain the same over time and different situations. Why is it used? Cognitive therapists invest a lot of time in guided discovery. As well as eliciting negative automatic thoughts, this technique can be used to help client develop alternative interpretations of their problems. Guided discovery is a 2- way process, incorporating the principle of collaboration. This can aid the therapeutic relationship, by helping the client feel respected, accepted and valued as part of a team. Merely telling someone what to do would not have the same impact. Guided discovery would be more productive in therapy in that the client is more engaged to consider the problem under discussion, as well as the solution. For guided discovery to work there must be a genuine curiosity on the therapist’s part to understand the client’s viewpoint. If the curiosity feels false or manufactured, then the client may withhold important information. The psychiatrist Beck (1. The client not only thinks about the problem at hand, but also possible solutions. The client is more likely to learn from, understand, and remember the interaction if she comes up with her own answers with the therapist’s help. Piaget’s (1. 97. 2) cognitive model involved the concept of hierarchical structuring of knowledge. Overholser (1. 99. He argues that even when told by an expert, clients are less likely to understand, remember, value or use this information as it has been obtained by passively listening. Guided discovery involves the client working actively and therefore more likely to be effective. By doing this, clients learn a new way of examining problems and finding alternative coping strategies. Dobson (2. 00. 1) suggests a good way of practising guided discovery is to audiotape the sessions; to stop the tape each time the therapist has given a declarative statement or a closed- question, and then to think how it could be re- phrased into a Socratic question. Therapists should not be drawn into responding too quickly. Socratic questioning requires the client to think about the answers. It may seem like the client is struggling for the answer, but any premature intervention “interrupts the client’s thought processes and disrupts the purpose of the Socratic question (Di. Giuseppe, 1. 99. 1). Guided discovery enables the client to provide her own answers instead of relying on the therapist for his interpretations that could be wrong. Conversely, the therapist may become convinced that the client’s thoughts or interpretations are mistaken, and tell her so, but this may well leave her with doubts and concerns. These doubts can be minimised and eliminated altogether if they were addressed in discussion between the therapist and client through guided discovery. This can put the client in a “compromising position- in that it is simpler to agree than disagree, or seem ungrateful or difficult” (Blackburn and Twaddle, 1. So clients provide answers that they think the therapist wants to hear instead of learning to think independently. Also the therapist may only hear what he is expecting the answers to be. Assumptions can distract from the process of guided discovery as the therapist’s own cognitive distortions and thinking errors may be at play. Even if the interpretations are correct, it is the therapist doing the cognitive work and the client may not be learning how to identify patterns and use skills to solve similar problems in future. If the client perceives the interpretation as inaccurate, it can leave her feeling misunderstood and damage the therapeutic relationship. Overholser (1. 99. Levy agrees that clients should be helped to arrive at their own interpretations (Levy, 1. Direct advice can lead to the client blaming the therapist of the advice is ineffective. There are different ways in which discovery can take place.
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