Integrating psychodynamic and cognitive-behavioral approaches in psychotherapy

Personal Theory of Therapy

The field of psychotherapy sees therapists employing several kinds of theories and techniques currently. These theories come from different types of approaches to therapy and practice. Consumers of mental health services do require information on these different types of approaches to therapy and practice. Overviews tend to miss many things as they generalize information. Yet, they do provide relevant information. It must be noted that irrespective of the background or actual training any therapist can claim to be a practitioner of any of the major school of thought in the field of psychology. The educational degree of the therapist does not ensure that the theoretical or treatment orientation belongs to any one school of thought. An overview of some of the more significant theories is discussed first in an attempt to select ways and means of integrating these therapies to provide a suitable answer. (Theoretical Orientations and Practices of Therapists)

Psychodynamic and Psychoanalytic Theory and Therapy

This theory represents the oldest school of thought in psychology and looks at patients from within a model of illness. This theory is based on the belief that individuals are seen constituted from a dynamic state, that starts from the early childhood and continues progressively throughout the life of the patient. This makes the psychodynamic school of thought a more diluted version of the more conservative and stiff Psychoanalysis which stresses that any problem seen in an adult can be traced back to the childhood of the patient. In today's world there are hardly any therapists that strictly practice this school of thought and may be seen typically with psychiatrists who have ample time for them to spend on being analyzed themselves or for going to sessions at a psychoanalytic institute. The concept of a visit to a shrink stems from a visit to a session with this kind of a therapy.

Psychodynamic therapists are prone to emphasize the significance of the frame, insight and interpretations. Interpretation is the strength of this therapy and when done in the right manner over an appropriate period of time it could lead to an insight of the patient. This insight makes the patient understand the unconscious motivation that was the causing the patient actions and reactions in a certain manner. Though other therapists also employ interpretation in their therapy the psychodynamic therapists are the best as it is their predominant weapon in their armory of treatment techniques and the most potent in almost all of therapy. The problem lies in the fact that many interpretations and insights do not cause any difference in behaviors, thoughts or feelings of patients and more true when interpretation is done badly. In addition research support for this type of treatment is too little and leaves a lot to be desired. (Theoretical Orientations and Practices of Therapists)

Cognitive-Behavioral and Behavioral Theory and Therapy

This theory lays stress on the cognitions or thoughts of the patient provides an explanation for how the patient has developed and sometimes is capable of providing the answer to the cause of the patient's mental disorder. This theory proposes that the personality of a person is a result of experiences in which they were part of in critical learning, identification of the proper thoughts and feelings, mimicking of these behaviors, thoughts and expressions. These therapists therefore tend to believe in the role of social learning during the development from childhood and the ideas of modeling and reinforcement. Cognitive behavioral therapy attempts to bring about a positive alteration in a person's irrational or wrong thought process and behavior by education of the person and reinforcing positive experiences that can cause a basic change in the way that person copes. Therefore these therapists tend to be more directive in their approach and act more as teachers sometimes. This mode of therapy has been successful in a several disorders and this has been supported by research. (Theoretical Orientations and Practices of Therapists)

Eclecticism Theory and Therapy

This theory is based on practical approach to therapy and requires a meshing of the earlier three approaches to together to suit the individualistic human being having a particular problem and this theory is getting to be quite popular with therapists today. There is a bit of confusion in understanding the theory as it is based on individualism and pragmatism. To remove this confusion the citing of an example of a typical eclectic approach would prove useful. A typical eclectic approach in therapy would require the therapist to view the individual from a psychodynamic perspective but to employ the more active interventions as seen in the cognitive-behavioral therapy. This is what eclecticism is all about. It attempts to use different bits and pieces of different theories to suit individual needs. The therapist tries to see things from the perspective of the patient and thus try and get to the root of the problem. (Theoretical Orientations and Practices of Therapists)

The therapists attempt to find out what might be reinforcing behavior that are unhealthy for the behavioral school of thought and also unhealthy thought as in the cognitive school of thought and how all these can be put together to create the individual faced with problems as in the humanistic school of thought. Eclecticism thus does not believe that there is any one right way and approach to any given problem. Each and every problem has been tainted and altered by the history of the individual and the way of seeing the individual's problem. Thus the therapists in this theoretical approach are very flexible and may be a teacher for one patient, but a guide for another or yet again a combination of teacher and guide for a third patient. The key to their choice of therapy is to provide assistance to the patient as rapidly as possible rather than look at them in a rigid manner with a single pattern of approach and therapy. (Theoretical Orientations and Practices of Therapists)

Personal Theory of therapy: A Detailed Look at the Cognitive-Behavioral and Behavioral Theory and Therapy

The Behavioral therapy and Cognitive- Behavioral Theory, which is an extension of the behavior therapy, was a result of theories of learning. Learning may be roughly considered as the process whereby behavior gets modified or added to any living beings repertory or the ability to do something new or different. To be considered as learning the addition needs to be comparatively permanent and come about as a result of experience. (Learning theory: A fuller-fuller explanation of CBT) There was a time when behavior therapy paid scant attention to cognitions including perceptions, evaluations or expectations. Behavior therapy restricted itself to only what was observed and measured. Psychology is a scientific study of human thoughts, emotions and behavior and hence all these have their effect on the behavior of a human being. This necessitated the advent of the cognitive behavioral theory and therapy which takes into account, both the behavior and cognitive experiences of a human being. (Cognitive Therapy for Depression)

Thus cognitive -behavioral therapy focuses on the processes of thought, behavior, and communication in an individual as seen today rather than on the early experiences of childhood. Several studies have shown that cognitive therapy has proved to be more useful than medication in the treatment of depression, anxiety obsessions, and other fears and has the additional benefit that it is free from the side effects of medication. In addition it has proved to be more useful than other treatments in prevention of a relapse as patients are taught self-help in the therapy. (Welcome: What is cognitive therapy?)

Another application of the cognitive-behavioral therapy that is gaining popularity is in the case of substance abuse. The original behavioral theory centered round classical conditioning and operant learning. Cognitive social learning provided the ideas regarding observational learning, the influence of modeling and the part played by cognitive expectancies in the determination of behavior. These three seminal perspectives may possess a lot of similarities, yet each of them has contributed novel ideas that are consistent with its theoretical underpinnings. In many of the substance abuse treatment arenas, the significant aspects of all these three approaches are blended to provide for a cognitive-behavioral model that gives the best result in terms of all the other therapies. (Brief Cognitive-Behavioral Therapy)

Three theorists who have influenced the behaviorist theories are:

1. Watson J.B. - One of the originators of behaviorism and a proponent of the reductionist approach to the study of human behavior.

2. Skinner B.F. - He was the one most responsible for the spread of the behaviorist philosophy.

3. Wolpe, Joseph. The method of systematic desensitization to deal with fear was created by him. (Theories and Theorists)