Major Counseling Theories Comparison Paper

According to Paris (2017), there are diverse counseling theories that have been developed over time such as the rational emotive behavior theory (REBT), cognitive behavior theory (CBT), psychoanalysis, and the solution-focused brief theory (SFBT). Each of these theories plays an integral role in addressing the needs of patients, and it is important to appreciate their history and application in modern mental health settings. This essay will discuss how the REBT theory compares with the SFBT, psychoanalysis, and CBT theories, as well as, the similarities and differences in their applications in different therapeutic environments.

Part 1: Rational Emotive Behavior Theory (REBT)

This is a philosophical and empirically-based psychotherapy approach that seeks to alleviate irrational beliefs that cause mental distress to patients. 

Founding Theorist

Inspired by the Greek, Roman, and Asian philosophers, Albert Ellis, an American psychologist and psychotherapist developed the theory during the mid-1950s (Ellis, 2001).  Ellis is considered as the person who has had the greatest influence over modern psychotherapy in history. 

Major Concepts

The main concept of this theory is that when human beings experience unfortunate circumstances, they become emotionally disturbed.  They internalize such experiences through meanings, beliefs, language, and philosophy about the world (Turner, 2016). This means that people do not develop dysfunctional behaviors and emotional behaviors due to the events they experience, but rather, through the irrational beliefs and attitudes they hold towards that event.  The REBT model has three aspects – the first is the Activating Event (A), which is an experience that occurs within the environment one lives in. The second aspect is the Beliefs (B), which encompass the perspectives held by a person about the situation or event. The third aspect is the Consequence (C), which is the emotional response influenced by an individual’s beliefs (Turner, 2016).  The Consequence (C) faced by patients is a determinant of the Event (A) they experienced, and the beliefs (B) that they hold as individuals.  The goal of the theory is to enable clients to reduce the irrational beliefs they have developed following adverse events that they have experienced so that they can attain healing.

Standard Interventions and Goals

There are certain interventions applied in the Rational Emotive Behavior theory to help clients attain healing. The first step is to identify the irrational beliefs and thought patterns that a person holds since holding on to them makes it difficult to respond to events in a psychologically healthy manner (Turner, 2016).  The second step is to challenge the irrational beliefs, which involves the use of direct and confrontational language by the therapist towards the client.  This step entails challenging and discounting the mistaken beliefs that the client holds about himself/herself.  The therapist should be honest, blunt, and logical to push the patient towards changing their behaviors and thoughts. The last step is gaining insight so that one can recognize the irrational thought patterns, and change them before they manifest themselves into destructive behavior. 

Part 2: Cognitive Behavior Theory (CBT)

This theory is based on the principles of cognitive and behavioral psychology, and it takes an ‘action-oriented’ and ‘problem-focused’ approach in treating mental disorders.

Founding Theorists

Aaron Beck founded the theory in the 1960s when he founded cognitive therapy (David et. al., 2018). The theory development was influenced by Aaron’s study on depression. Notably, B. F. Skinner and Pavlov also contributed to the general cognitive and behavioral theories development (Chand & Huecker, 2019). 

Goals and Interventions 

The theory seeks to teach patients how to avoid negative thoughts by changing the way they deal with and interpret things within their environment. The standard intervention used involves an active role by the therapist who helps the client to perform the functional analysis. This involves identifying how feelings, thoughts, and situations affect maladaptive behavior (David et al., 2018). The second intervention focuses on specific behaviors that aggravate the problem facing the client (Chand & Huecker, 2019). This involves teaching the patient new coping skills that will reduce the likelihood of experiencing recurrent negative behavior. For instance, a patient who is addicted to drugs should change his/her social environment to avoid triggers that can lead to relapse. 

Similarities and Differences between REBT and CBT

The main similarity between REBT and CBT is that both approaches link the negative thoughts held by patients to destructive behavior. They both reaffirm the need to alter the irrational or negative beliefs that patients hold and motivate them to embrace positive thoughts so that they can overcome the psychological issues they face. Moreover, the strategies used by the therapist in both approaches are similar, since a strong patient-therapist relationship is needed to encourage the patient to freely share his/her issues.

On the other hand, a major difference between both approaches is that CBT requires a softer approach that encompasses active listening by the therapist so that the client can open up to the issues facing him/her. REBT requires therapists to be blunt and somewhat confrontational so that they can trigger the client to identify and discard the mistaken beliefs that cause their destructive behavior. 

Part 3: Solution-Focused Theory

The theory is based on the use of precise questions and application of social constructionist to understand the goals that clients want to attain. 

Founding Theorists

The Solution-Focused Brief Therapy (SLBT) can be traced to two social workers – Insoo Kim and Steve de Shazer during the 1980s (Stermensky & Brown, 2014). They also collaborated with other psychotherapists from the Palo Alto Mental Research Institute.  Most of the concepts they used were developed by prior therapists in the 1950s, such as Milton Erickson. 

Goals and Interventions 

The main goal of the theory is to support patients to understand their strengths and use them to achieve their goals. In implementing the interventions, the first step involves identifying and clarifying client goals, and this involves the use of questions by the therapist to ascertain the changes that clients want to see in their lives. By setting clear goals, the client is able to develop tangible solutions and plans that will help him/her achieve the objectives (Stermensky & Brown, 2014). The theory assumes that individuals are motivated to obtain solutions to their problems, and by observing the steps that patients are currently taking to manage their challenges, the therapist is able to reinforce support and help the client achieve his/her goals. 

Similarities and Differences between REBT and SFBT

The main similarity between both approaches is that they seek to help the patient to identify solutions to the problems he/she faces while mitigating negative influences in their lives. REBT achieves this by identifying irrational beliefs and discarding them so that the client can focus on rational and positive beliefs. SFBT attains these goals by evaluating the changes that the client wants to implement in his/her life and developing a plan to attain their goals.  

The main difference in the two approaches is that REBT focuses on past beliefs that affect the client’s behavior, while SFBT focuses on the present and future circumstances. REBT begins by evaluating the client’s irrational beliefs that he/she has held to in the past, which have influenced their present behavior. This is the starting point towards generating solutions to the problem by encouraging him/her to embrace rational thoughts. Moreover, SFBT starts at the present and the therapists evaluate the conscious actions that the client has taken to alter his/her behavior, and then reinforces these efforts by setting clear goals. Another difference is that in REBT, there is one-on-one contact between the patient and the therapist while the SFBT approach may involve different therapists who work in teams. 

Part 4: Psychoanalysis

 This theory represents therapeutic interventions and theories that evaluate the unconscious mind as a means of treating mental disorders. 

Founding Theorists

Sigmund Freud founded the theory in the 1890s, motivated by the need to cure patients with hysterical and neurotic symptoms. Theorists such as Alfred Adler and Harry Sullivan later redeveloped it (Paris, 2017). 

Goals and Interventions 

The main goal of psychoanalysis is to release the experiences and emotions that have been suppressed so that patients can attain healing (Paris, 2017). The theory assumes that psychological problems facing patients can be traced to the unconscious mind.  These may involve repressed trauma or unresolved challenges during development.  Interventions used involve discussions between the patient and the therapist on the former’s childhood experiences (Paris, 2017). By reflecting on their childhood memories and dreams, the therapist helps clients to understand the symptoms and behavior they exhibit. He/she can then link the problems facing the client to repressed childhood experiences and emotions. The therapist may use therapeutic techniques such as resistance analysis, dream analysis, parapraxes, and transference analysis. Moreover, this form of therapy takes a long time to attain tangible results. 

Similarities and Differences between REBT and Psychoanalysis

The main similarity between REBT and psychoanalysis is that both approaches seek to highlight how past experiences have affected the client and caused destructive behavior. Psychoanalysis probes childhood experiences to reveal repressed emotions that affect current behavior, while REBT evaluates past unfounded/mistaken beliefs, which adversely affect behavior. Both approaches seek to inspire behavioral change so that the patient can attain healing. 

On the other hand, the main differences between them are that psychoanalysis triggers unconscious thoughts to understand the client’s present behavior, while REBT focuses on conscious but negative beliefs held by the patient, which cause destructive behavior. Moreover, psychoanalysis takes a very long time since it involves unraveling suppressed emotions that may be traced to the early years of development. Moreover, REBT requires relatively few sessions since the therapist’s role is to trigger and discount irrational beliefs held by the client. 

Conclusion

Evidently, the REBT, SFBT, psychoanalysis and CBT theories play an integral role in defining how therapists view the problems facing their clients and the appropriate interventions that will help patients to attain healing. These theories share similarities as they all strive to understand human experiences and motivations as predictors of psychologically destructive behavior. However, they also share certain differences including their causalities of emotional conflict in humans, as well as, in the therapeutic techniques used to treat patients. It is important for therapists and the public alike to understand counseling theories since they have the potential to address most of the psychological challenges facing many people in modern society.

References

Chand, S. P. & Huecker, M. R.  (2019). Cognitive Behavior Therapy (CBT).  StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470241/

David, D., Cristea, I., & Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Journal of Frontiers in Psychiatry, 9 (4). doi:10.3389/fpsyt.2018.00004. 

Ellis, A. (2001). Overcoming Destructive Beliefs, Feelings, and Behaviors: New Directions for Rational Emotive Behavior Therapy. New York: Prometheus Books

Paris, J. (2017). Is Psychoanalysis Still Relevant to Psychiatry? Canadian Journal of Psychiatry, 62(5), 308-312.  

Stermensky, G., & Brown, K. S. (2014). The perfect marriage: solution-focused therapy and motivational interviewing in medical family therapy. Journal of family medicine and primary care, 3(4), 383-7.  

Turner M. J. (2016). Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs and the Mental Health of Athletes. Journal of Frontiers in Psychiatry 7. doi:10.3389/fpsyg.2016.01423.