Introduction to guidance and counseling

Cognitive behavioral therapy focuses on changing ineffective behavioral and thought patterns through intense self-examination. For example, if a person says: "I'm not good at anything," cognitive behavioral therapy challenges such categorical statements. Cognitive behavioral therapy, unlike psychoanalysis or Rogerian therapy, is not dependant upon the analytical training or emotional support of another person: the patient is in control of the process in CBT, and must set goals and challenges for his or her own thoughts and behaviors.

Engaging in a sexual relationship with a patient. Quite often, patients with severe psychological difficulties due to past sexual abuse are wrestling with issues of self-worth and trust. The client might feel as if he or she has to 'please' the therapist in exchange for treatment and only was worthy of someone's interest in a sexual manner. Any semblance of a neutral therapeutic relationship between patient and therapist would be destroyed.

Q3. An adolescent forced to engage in therapy upon the prompting of his or her parents might want to resist the therapeutic process as a form of rebellion. Furthermore, the adolescent might wonder if the therapeutic sessions were confidential, given that the parent was paying for the session. The adolescent must be assured that the sessions are designed to help his or her own development, not to serve the parent's needs and expectations for the teen.

Q4. Rogerian or person-centered therapy seeks to heal the patient by offering unconditional acceptance of the patient. This does not mean accepting Jake's right to hurt others: but it does mean accepting the validity of Jake's right to feel anger. Jake's sense of self and acceptance by others has been made contingent upon him constructing a false self of a person who is never angry. This lack of authenticity makes him afraid to get close to other people, and he sublimates his anger about his false self. By prompting Jake with questions, the therapist can help him find other ways to express his anger. For example, if Jake says "every time I see my boss, I'd like to punch him," the therapist might state "your boss makes you angry?" "Yes, he hasn't given me a raise in five years." The therapist would then explore why Jake had not taken proactive actions to ask for a raise, possibly due to Jake's feelings that he was really not 'good enough' as a person or that his boss would belittle him. Through unconditional acceptance of Jake's emotions, Jake would be able to feel a greater sense of self-esteem. The therapist would explore why Jake felt angry at his wife and was unable to tell her why he felt angry. By acknowledging the validity of his emotions, Jake would learn not to be afraid of them and learn that he could express anger and embrace conflict without losing close relationships. He could be intimate with other people and express anger without the anger leading to violence.

Q5: Cognitive behavioral therapy questions the client's false assumptions about himself and the world, such as Herb's feeling that his divorce was his fault. Herb is living in the past, and dwelling on things he cannot change. The behavioral therapist would focus on Herb's core assumptions: "why was the divorce your fault? Why would things be better if she returned?" Cognitive behavioral therapy's focus on the present would make it extremely useful for Herb's inability to move his life forward. It focuses on actions and setting goals for behavior, which is useful if a client is mired in too much self-examination.

Q6.1: There is a strong matriarchal tradition in the family. Maria and Shelia are divorced, Veronica is pregnant but unmarried. Angelica is a strong role model for her children, and despite her conflicts with her ex-husband, her children were able to have a relationship with their father. This positive pattern is seen in Shelia's divorce, as her children still have contact with their father. However, because of Angelica's dominant presence, some of her children seem to have difficulty establishing their independence from her control: this was true of Angelia's own relationship with George, as her marriage was strongly opposed by her father. The fact her father was a minister indicates a strong religious influence within the family over generations.