A Perspective on Cognitive Behavioral Therapy

by Beth Horwin, LPC

Cognitive-Behavioral Therapy:

Cognitive-behavioral therapy (CBT) is a type of counseling aimed at teaching the client how
to become healthier and experience a more satisfying, fulfilling lifestyle by modifying
certain thought and behavior patterns. It is based on the theory that thought and behavior can
affect a persons symptoms and be an obstacle to recovery. CBT can be helpful in treating a
variety of problems, including depression, anxiety and panic disorders, dealing with life event
such as: death, divorce, disability, unemployment, issues with children and mounting stress.

In CBT, the therapist and client work together to identify and change negative thinking and
behavior patterns that may contribute to emotional and/or physical illness. The focus in therapy
is to alter and change these thoughts or self-talks which express ones beliefs and perceptions.
Cognitive approaches focus on replacing one thought, belief, or form of self-talk with another
(e.g. My life is miserable to I have purpose in life). Therapy also focuses on teaching the client
more positive ways of thinking about and coping with not only illness but also life events and
relationships.

To Provide a Simple Definition: Cognitive Counseling focuses on Monitoring and Managing

your thinking patterns. This counseling would focus on reducing negative thinking and changing
the content of thoughts so that it results in more positive emotions. Behavioral Counseling
focuses on what actions the client takes, what rewards are in place that encourages the client to
act a certain way and what unpleasant consequences prevent the client from behaving in other
ways.

The process of CBT helps the client identify and correct specific errors in what he or she is
thinking that results in painful and negative feelings. These distorted thoughts influence the
client on an emotional and behavioral level. In treating a person who is experiencing
psychological difficulties, I find that the most effective point of intervention is at the level of the
persons thoughts that are causing pain. If changes are made in thinking process, (e.g.
assumptions, beliefs, values) changes in emotions and behavior will follow. I utilize various
behavioral techniques and strategies as needed to enhance the treatment outcome (e.g., anger
management, meditation, relaxation training, and assertiveness training). Unlike many traditional
counseling processes, CBT focus on outcomes and goals. Results include a briefer counseling
process in which the client experiences relatively rapid relief and enduring progress.

CBT is a simple model and has proven to be a powerful and successful type of psychological
treatment in outcome studies conducted over the past several decades. Currently enjoying
widespread popularity, CBT is practiced by many qualified professionals throughout the United
States and internationally. I believe this type of counseling is most effective in dealing with
individuals who are bright, rational and desire to have passion and enjoyment in their life. It is
my opinion that this counseling does not work with individuals who want to stay in a victim role
or spend their time blaming others for whats not going right in their life. It takes courage and a
willingness to say, Whatever happened to me before I couldnt do anything about, it is as it is,
but now I am responsible for how I react to what has happened to me, what is happening to me
and how I want to continue living my life. The work, the effort, the fortitude of my clients
continues to amaze and humble meeven after all of these years.

History:

CBT can be traced to early pioneers of psychology, but cognitive counseling, as it is practiced
today was developed in the fifties and sixties. Throughout the seventies, the cognitive and
behavioral schools were joined by thinkers and practitioners into cognitive-behavioral
counseling. Beginning in the eighties and continuing through today, there has been a growing
interest in cognitive-behavioral counseling because of its proven effectiveness and because this
form of treatment can be administered in a briefer amount of time than traditional psychoanalysis
or psychotherapy. For example, Dr. Phil is a cognitive behavioral therapist. Of course, he doesnt
provide treatment during his successful TV show, but only identifies the problem and sometimes
presents therapy options (even offering to pay for them) to his guests.

Process:

CBT, the therapy process takes many forms. In fact, there are at least 60 variations depending on
who you talk to. If you are doing TRADITIONAL cognitive-behavioral work, you do a lot of
writing. The writing involves recording thoughts and counting behaviors, scaling emotions (e.g.
on a scale of 1 to 100, where 1 is completely calm and 100 is out-of-control angry, where are you
on this scale?), labeling categories of thoughts or behaviors, and writing alternative ways of
thinking. I realize that cognitive-behavioral counseling is research proven; however, the rigidity
of a strictly traditional method doesnt work for me or my clients. Yes, my clients do a lot of
writing, journaling, taking their thoughts from their mind and concretizing them on paper, setting
clear goals and outcomesthey do that, but every client will resonate to their own method of
working through the process and I must and will stay flexible to what works for them.

My focus in the counseling process includes:

Assisting a client in recognizing, analyzing and managing their beliefs

Allowing the client to rely on his or her memory, and validate that memory
Placing a large emphasis on the clients belief in who they are and what their purpose and
place is in this world
Keeping the focus on increasing satisfaction with life rather than on decreasing
negative emotions
 Teach, Educate, Teach-giving them the opportunity to re-examine what they have been
told (e.g., you arent going to amount to much) to what in reality is true about
themselves
Identifying and practicing skills (e.g., including goal-setting and problem-solving)
Continuing to do this work on a long term basis after the counseling process is over

Conclusion:

As I was pursuing my education in Psychology, I hit a road block because back in the 60s the
education system that I was involved in wanted me upon graduation to ascribe to a particular
theory of counseling that I would practice once I graduated. I couldnt find one that I could
totally follow. I was someplace between Gestalt, Client-centered counseling, Jung and Cognitive
Therapy. Since completing my education and working in corporate American for over thirty
years, I have taken bits and pieces from different counseling theories, to provide services as a
counselor, consultant, teacher and trainer.

In my private practice the core model that I ascribe to is cognitive behavioral therapy, but not in
the traditional sense. I incorporate what I consider the best outcomes from various counseling
theories and adapt them to the CBT model that best services the needs of the individual or family
I am serving.

In order to assess whether the counseling service I offer is beneficial and will help the individual
or family, I offer to potential clients an initial complimentary consultation to discuss the process
and objectives of cognitive behavioral counseling, to determine if my services can help them and
to discuss compensation for these services.

Terapi Kognitif-Behavioral (TKB) merupakan proses terapi yang mengambil banyak

bentuk, sedikitnya terdapat 60 variasi. Secara ringkas, Beth Horwin mengemukakan proses
konseling kognitif- behavioral ini, sebagai berikut:

Membantu klien dalam mengenali, menganalisis dan mengelola keyakinannya.

Membiarkan klien bersandar pada memorinya, dan berusaha untuk memvalidasimya.
Menempatkan dan menitikberatkan pada keyakinan klien, tentang siapa dirinya dan apa
tujuan hidup dia di dunia ini
Menjaga fokus pada upaya meningkatkan kepuasan hidup secara menyeluruh, bukan
pada upaya penurunan emosi yang negatif
 Membelajarkan dan mendidik yakni memberikan kesempatan kepada klien untuk
memeriksa/memguji kembali apa yang telah diucapkannya dengan kenyataan dirinya.
Mengidentifikasi dan berbagai keterampilan praktis (misalnya, tentang penetapan tujuan
dan pemecahan masalah).
Melanjutkan untuk melakukan pekerjaan ini untuk waktu jangka panjang, setelah proses
konseling selesai.