Comparing gestalt and behavioral therapies in counseling practice

Gestalt and Behavioral Therapies

The purpose of this paper is a comparison of gestalt and behavioral therapies. The research paper provides an overview and assessment of each therapy, and the ways each are used in the field of counseling. The researcher proposes the gestalt approach to therapy is more patient-focused and may lead to quicker positive outcomes than behavior therapies, though the two therapies are much the same in terms of their purpose and ideals.

Gestalt Therapy

Gestalt "theory" and "therapy" are terms often used interchangeably. They focus on the individual in the present moment; combining their identity with the relationship, they have with the therapist to emphasize responsibility for one's behaviors and actions (James & Jongeward, 1996, p.30). Among the first theorists to believe in the gestalt approach were a Jewish psychologist and analyst known as "Fritz Perls" who incorporated many psychological influences when forming the idea that therapy should be holistic in its approach, and emphasize the client's responsibility for all actions and consequences personally (James & Jongeward, 1996). Using this line of thinking, a gestalt therapist would encourage someone who committed a crime for example, to take responsibility for their actions by recognizing the motives behind their actions and the consequences their actions had on others. This approach today is more common among therapists interested in integrated therapy, something gestalt therapy shares with many behavioral therapies, which attempt to adopt a mind/body approach (Fine & Schwebel, 1994).

Behavioral Therapy

Much like gestalt therapy, behavioral therapy encourages the patient or client to take charge of their lives and outcomes by identifying underlying behaviors leading to unwanted situations or outcomes (Fine & Schwebel, 1994). Behavioral therapy also encourages participants to identify the relationships that exist between individuals and their family, community and immediate surroundings, as well as their relationship with their therapist, but less so than gestalt therapy (Fine & Schwebel, 1994). The behavioral approach incorporates a systematic approach to therapy that enables individuals in counseling to "live in ways they find acceptable" and often fulfilling when possible (Fine & Schwebel, 1994, p.4).

Major Differences in Approach

Palme (2006) demonstrates the similarities and differences in approach using gestalt therapy vs. cognitive behavior therapy when approaching clients with eating disorders. Palme (2006), a certified psychologist and therapist as well as health educator, notes behavioral therapy always assumes disturbances of the psyche are learnt behaviors, but have no real intent or positive purpose in one's life. This assumption is backed by research in behavioral therapy (Cleland, et al., 2005). The aim with patients for example, that have an eating disorder, would be to assess the ways people think and interpret life experiences and attempt to help them think in a more useful way or in a manner that promotes greater utility (Palme, 2006). Gestalt therapy as defined and described by Fritz & Perls however, would attempt to teach a patient to become more aware of the relationship between the body, mind and spirit, so one is more likely to explore their inner feelings and world, their perceptions and beliefs. This would allow them to be more assertive when faced with issues that may lead to problems like an eating disorder (Palme, 2006; Diemer, et al., 1996). Palme (2006) suggests that the differences in approach gestalt therapists adopt when compared to behavioral therapists is not easily distinguished, as both attempt to help the patient become more aware of their belief systems, behaviors and habits. Behavior therapy however, is more likely to point out how some behaviors an individual may engage in are pointless, and therefore will work to eliminate those behaviors, encouraging the client to adopt behaviors with positive utility or outcomes (Palme, 2006).

Using the case of a client with an eating disorder, Palme (2006) compares the Gestalt approach to the behavioral approach. The behavioral approach would encourage the patient to eat regularly, up to five times daily, whereas with gestalt therapy a client would be encouraged to eat by paying attention to their hunger cues, and to eat when hungry and stop thereafter (Palme, 2006).

Behavioral therapy would work to encourage patients that are bulimic to delay purging of any food they consume, whereas gestalt therapy would work to increase the patient's awareness of the circumstances of their environment and inner conscious that encourage them to vomit (Palme, 2006). For example, with Gestalt therapy, the therapist may ask a patient to define what feelings cause them to desire purging, such as one's inability to achieve a goal, or their feelings of perfection (Palme, 2006; Diemer, et al., 1996).

Both therapies focus on changing client's attitudes toward a harmful event or life circumstance, or the client's beliefs in this example toward eating disorders and body image (Palme, 2006). The subtle distinguishing factor is a behavioral therapist is more likely to identify why conceptions or beliefs about body image or food may be incorrect and change them, whereas gestalt therapy might encourage the client to look within and identify what image makes them feel happy and complete.

Both therapies also enable patients to identify the connections existing between life experiences and inappropriate behaviors; behavioral therapy does this more literally, by enabling a patient to identify actual connections. A gestalt therapist however, is more likely to encourage a patient to be more aware of internal and external factors that lead to the need to engage in wrongful behaviors. An example may be anxiety or stress within one's body for example (Palme, 2006).

Perhaps the single most distinguishing factor between the two approaches is behavior therapy takes a more literal approach, and gestalt therapy a more holistic and conscious approach. A behavior therapist will ask a client to identify problems and then find new ways to cope with problems. A gestalt therapist will also encourage the patient to identify problems in their behavior or actions, and find alternatives, however they will encourage the patient to select the solution that is most appropriate to them (Palme, 1996).

Conclusions

One can conclude by saying that Gestalt therapies and Behavior therapies are very similar in their approaches, encouraging patients to identify problems and solve them by using alternate approaches. The primary difference between the two however, is gestalt therapy concentrates more on the ability of the individual to make proper choices regarding their care. This theory or approach to therapy reminds the client of the connection between mind, body and spirit. The behavior approach is less concerned with the paradigm of holistic health, and more concerned with a therapist-driven approach to identifying problems and selecting appropriate solutions.

In this sense, gestalt therapy seems like it is a more effective approach, because it encourages the individual to make judgments about their health and understand the connections existing between their behaviors and emotions. Because gestalt therapy is patient-driven more so than psychotherapist drive as behavior therapy, many believe patients are able to realize relief and successful outcomes more quickly, as well as retain greater self-esteem (James & Jongeward, 1996; Palmer, 1996). If a patient wants patient-centered care that provides effective relief, they might find a gestalt therapist better equipped to help them identify their personal feelings about life and their purpose in life.

References:

Cleland, C., Foote, J. Kosanke, N., Mabura, S., Mahmood, D. & Rosenblum, a. (2005). Moderators of effects of motivational enhancements to cognitive behavioral therapy. American Journal of Drug and Alcohol Abuse, 31(1): 35.

Diemer, R.A., Hill, C.E., Lobell, L.K., & Vivino, B.L. (1996). Comparison of dream interpretation, event interpretation, and unstructured sessions in brief therapy. Journal of Counseling Psychology, 43(1): 99.

Fine, M.A. & Schwebel, a.L. (1994). Understanding and helping families: A cognitive-behavioral approach. Hillsdale: Lawrence Erlbaum.

James, M. & Jongeward, D. (1996). Born to win: Transactional analysis with gestalt experiments. Cambridge: Perseus Publishing.

Palme, G. (2006, Nov). Cognitive behavioural therapy vs. gestalt therapy for eating disorders. Web4Health Health and Psychology. Retrieved 30, July 2007: http://web4health.info/en/answers/ed-treat-compare.htm