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PSYC 113X 1:30- 3:00 MW

Submitted by:

Abellana, Shairah Jhane T.

Submitted to:

Ms. Kim Ganzo

October 9, 2017
Psychoanalytic Therapy

Psychoanalysis grew out of the famous psychoanalyst Sigmund Freud (1856-

1939). He believed that people could be cured by making conscious their

unconscious thoughts and motivations, thus gaining insight.

Psychoanalytic Theory the intellectual foundation for modern scientific inquiry

into the workings of the mind.

- Human behavior is deterministic and governed largely by the subconscious, as well

as biological drives, such as the human sex drive.

Human Personality:

1. The Id seeks pleasure and avoids pain

2. The Ego balance between the id and superego, seeking to achieve the ids desires

by rational means

3. The Superego concerned with morality and ethics to guide behavior towards the


Conscious and Unconscious

- Are the keys to understanding behavior and the problems of personality

- The unconscious cant be studied directly but is inferred from behavior.

This includes:

1. Dreams
2. Slip of the tongue

3. Post hypnotic suggestions

4. Material derived from free association techniques

5. Material derived from projective techniques

6. The symbolic content of psychotic symptoms

Psychoanalytic Therapy

- The aim is to make the unconscious motives conscious

- Unconscious processes are at the root of all forms of neurotic symptoms and

behaviors. A cure is based on uncovering the meaning of symptoms, the causes

of behavior, and the repressed materials that interfere with healthy functioning.


- The state of tension that motivates us to do something

- Develops out of a conflict among the id, ego, and superego over control of available

psychic energy

- Warn of impending danger

3 kinds of Anxiety:

1. Reality anxiety fear of danger from the external world and the level of such

anxiety is proportionate to the degree of real threat

2. Neurotic anxiety fear that the instincts will get out of hand and cause one to do

something for which one will be punished

3. Moral anxiety - fear of ones own conscious. People with a well-developed

conscious tend to feel guilty when they do something contrary to their moral code

- Neurotic and Moral anxieties are evoked by threats to the balance of power within

the person. They signal to the ego that unless appropriate measures are taken, the

danger may increase until the ego is overthrown. When the ego cant control the

anxiety by rational and direct methods, it relies on indirect ones ego-defense


Defense Mechanisms

Defense Mechanism reduces anxiety by unconsciously pushing away, denying, or

distorting reality. These are tactics which the Ego develops to help deal with the Id

and the Superego.

All defense mechanisms share two common characteristics:

They either deny or distort reality; and

They operate on an unconscious level

REPRESSION - When the mind takes the trail from the conscious area or the

preconscious are and pushing it into the unconscious.

One of the most important Freudian processes, it is the basis of many other ego

defenses and of neurotic disorders. Freud explained repression as an involuntary

removal of something from consciousness. It is assumed that most of the painful

events of the first five or six years of life are buried, yet these events do influence

later behavior.

Repressed memories do not disappear. They can have an accumulative effect and

reappear as unacceptable anxiety or dysfunctional behavior. This may be caused by

the repression of one particularly traumatic incident.

To Freud, the goal treatment example of psychoanalysis, was to bring repressed

memories, fears and thoughts back to the conscious level of awareness.

Example: A child who is abused by a parent later has no recollection of the events.

But has trouble forming relationships.

DENIAL - claiming or believing that what is true to be actually false.

Denial of reality is perhaps the simplest of all self-defense mechanisms. It is a way of

distorting what the individual thinks, feels, or perceives in a traumatic situation. This

mechanism is similar to repression, yet it generally operates at preconscious and

conscious levels.

Closing ones eyes to the existence of a threatening aspect of reality

Example: A man hears that his wife has been killed, and yet refuses to believe it, still

setting the table for her and keeping her clothes and other accouterments in the


REACTION FORMATION - overacting in the opposite way to the fear

By developing conscious attitudes and behaviors that are diametrically opposed to

disturbing desires, people do not have to face the anxiety that would result if they

were to recognize these dimensions of themselves. Individuals may conceal hate with
a facade of love, be extremely nice when they harbor negative reactions, or mask

cruelty with excessive kindness.

Actively expressing the opposite impulse when confronted with a threatening


Example: Using exaggerated friendliness when the person is actually feeling


PROJECTION - attributing uncomfortable feelings to others

This is a mechanism of self-deception. Lustful, aggressive, or other impulses are seen

as being possessed by those people out there, but not by me.

Also, appears where we see our own traits in other people, as in the false consensus

effect/ Thus, we see our friends as being more like us than they really are.

Example: I do not like another person. But I have a value that says I should like

everyone. So, I project onto them that they do not like me. This allows me to avoid

them and also to handle my own feelings of dislike.

DISPLACEMENT - redirecting emotions to a substitute target.

Displacement is a way of coping with anxiety that involves discharging impulses by

shifting from a threatening object to a safer target. For example, the meek man

who feels intimidated by his boss comes home and unloads inappropriate hostility

onto his children.

Directing energy toward another object or person when the original object or person

is inaccessible.

Phobias may also use displacement as a mechanism for releasing energy that is

caused in other ways.

Example: A woman, rejected by her boyfriend, goes out with another man on the


REGRESSION - going back to acting as a child

In the face of severe stress or extreme challenge, individuals may attempt to cope

with their anxiety by clinging to immature and inappropriate behaviors. For example,

children who are frightened in school may indulge in infantile behavior such as

weeping, excessive dependence, thumb-sucking, hiding, or clinging to the teacher.

Regression involves taking the position of a child in some problematic situation,

rather than acting in a more adult way.

Example: A person who suffers a mental breakdown assumes a fetal position,

rocking and crying.

Development of Personality:

The delineation of the stages of psychological and psychosexual development from

birth through adulthood.

Provides the counselor with the conceptual tools for understanding key

developmental tasks characteristic of the various stages of life.

Three areas of Personal and Social Development:

(1) love and trust,

(2) dealing with negative feelings, and

(3) developing a positive acceptance of sexuality.

Freuds Psychosexual States of Development

Fixation- it is the persistent focus on an earlier psychosexual stage. It occurs if

certain issues are not resolved at the appropriate age.

Oral Stage: Birth-18 months

-it is when the Infants pleasure centers on the mouth. The child receives

oral gratification by sucking at its mothers breast. By doing so, the child

receives both the nutrition and love it needs. Children who do not bond

with a parent, or ones who do not receive proper nutrition may become

orally fixated, possibly resulting in mistrust of others, fear, loss of love

and relationship difficulties.

Anal Stage: 18 months-3 years

-the childs greatest pleasure involves the anus or the eliminative functions

associated with it. The child becomes potty trained. During this period the

child learns independence and personal power. A child who does not

successfully complete this stage may feel inferior, and depend on others

instead of themselves.

Phallic Stage: 3 years-6 years

-phallic is a Latin word which means penis. The pleasure focuses on

the genitals as the child discovers that self-stimulation is enjoyable. This

stage is when the child experiences unconscious desires for the opposite

sex parent. This often resolves itself through wanting love and acceptance

from the opposite sex parent. The child may also possess anxiety or fear

from the same sex parent.

For boys, it is known as the Oedipus complex, and for girls it is known as

the Electra complex. Oedipus/Electra Complex is the childs development

of an intense desire to replace the parent of the same sex and enjoy the

affection of the opposite-sex parent.

Latency Stage: 6 years-puberty

-The child represses all interest in sexuality and develops social and

intellectual skills. The child moves from sexual desires to ones of

belonging and acceptance from others. Interests in friends, school, and

socialization are the main drives here.

Genital Stage: Puberty-death

-It is the time of sexual reawakening, but the source of sexual pleasure

now becomes someone outside the family. This stage is the time when a

child will likely form their sexual identity

What is Psychoanalytic Therapy?

Psychoanalytic theory looks at how the unconscious mind influences

thoughts and behaviors.

Freud described the unconscious as the reservoir of desires, thoughts, and

memories that are below the surface of conscious awareness.

The human behavior and mind investigation can be done with the help from

psychoanalysis and this is something that most therapists are doing.

Emotional and psychological illnesses are mostly examined by this therapy.

They are based on the thoughts, unconscious feelings and events from the

childhood. There are topics the patient discusses about with the therapist

and some of them are fantasies, dreams, feelings and thoughts responsible

for the development of mental problems. The problem is also created due to

the unconscious conflicts and this is something the therapist will show to the

patient and hopefully understand the problem. Borderline personality

disorder, anxiety disorder and other problems may be treated with the help

from the psychoanalytical therapy.


1) To make unconscious motives conscious

2) To strengthen the Ego to be more aligned with reality

How does psychoanalytic therapy work? (THE THERAPEUTIC PROCESS)

Clients Experience in Therapy:

Classical psychoanalysis - Clients must be willing to commit to an intensive and

long-term therapy process.After some face-to-face sessions with the analyst, clients

lie on a couch and free-associate (saying whatever comes to mind without self-

censorship).Clients report their feelings, experiences, associations, memories and

fantasies to the analyst.Lying on the couch encourages deep, uncensored reflections

and reduces the stimuli that might interfere with getting in touch with internal

conflicts.The client cannot read their analysts face for reactions and the analyst is

freed from having to carefully monitor facial clues.

Clients are asked not to make any radical changes in their lifestyle during the period

of analysis, such as getting a divorce or quitting their job.

Termination is mutually agreed upon by the client and the analyst when it is felt that

symptoms and conflicts that were amenable to resolution have been clarified by

understanding the historical roots of their difficulties, and integrating their

awareness of past problems with the present relationships.

Relationship Between Therapist and Client:

Transference is at the core of the psychoanalytic approach.Transference is the

clients unconscious shifting to the analyst of feelings and fantasies that are

reactions to significant others in the clients past.Transference allows clients to

understand and resolve unfinished business from past relationships.As therapy

progresses, childhood feelings and conflicts begin to surface from the depths of the

unconscious.Clients regress emotionally.Some of their feelings arise from conflicts

such as trust versus mistrust, love versus hate, dependence versus independence,

and autonomy versus shame and guilt.Transference takes place when clients

resurrect from their early years intense conflicts relating to love, sexuality, hostility,

anxiety, and resentment, bring them into the present; re-experience them; and

attach them to the analyst.In essence, the analyst becomes a current substitute for

significant others.The transference relationship must be worked through which is a

process where unconscious material and defenses primarily originating in early

childhood are explored.Working through is achieved by repeating interpretations

and by exploring forms of resistance.It results in a resolution of old patterns and

allows clients to make new choices.If this phase of analysis is not properly worked

through, clients simply transfer their infantile wishes for universal love and

acceptance to other figures they deem powerful.All infantile conflicts may not be

fully resolved, even though many aspects of transference are worked through with a

therapist.We may need to struggle at times throughout our life with feelings that we

project onto others as well as with unrealistic demands that we expect others to

This intense therapeutic relationship is bound to ignite some of the unconscious

conflicts within therapists.Counter transference is the phenomenon when there is

inappropriate affect (emotion), when therapists respond in irrational ways, or when

they lose their objectivity in relationships because their own conflicts are

triggered.Counter transference also refers to the reactions therapist have toward

their clients that may interfere with their objectivity.Counter transference can be

seen as potentially useful if it is explored in analysis.What is of paramount

importance is that therapists develop some level of objectivity and not react

irrationally and subjectively in the face of anger, love, adulation, and other intense

feelings expressed by clients.

Psychoanalytically oriented therapist

1.Therapy is geared to more limited objectives than to restructuring ones


- The therapy is limited to its objectives which is, to make unconscious motives

conscious and to foster change by helping you understand your past and how events

from your early life could be affecting you now, than to restructure ones


2.Therapy is less likely to use the couch

- Psychoanalytic sessions before would let the patient lie down on the couch with

the therapist sitting down behind, jotting down notes on a pad. Because this

physical arrangement seem to facilitate the most important process of

psychoanalysis which is the free association.

3.Typically fewer sessions

4.More frequent use of supportive interventions

- like reassurance, expressions of empathy and support and suggestions

5.The focus is more on pressing practical issues than on working with fantasy


Therapeutic Techniques:

There are therapeutic techniques in psychoanalysis and these techniques are aimed

to increase awareness and fostering insights into the clients behavior in

understanding the meanings of symptoms.

1.Free association- It involves talking about whatever comes into the mind without

censoring or editing the flow of memories or ideas. This is the basic tool used to open

the doors to unconscious.

2.Dream Analysis - investigation of repressed feelings that can be expressed in our

dreams. Psychoanalytic theory believes repressed feelings often manifest themselves in

our dreams. This happens because our defenses are lowered when we sleep.

Two levels of content:

1.Latent content or hidden motives, wishes or fears

2.Manifest content refers to the dream as it actually appears

3.Analysis of Transference - is the transfer of feelings from the past to someone in the

present. Usually, it involves these feelings being transferred from the client onto the
therapist. This situation is considered valuable to the therapeutic process because it

allows the client to re-experience feelings that need to be resolved.

4.Analysis and Interpretation of Resistance - Resistance is loosely defined as a clients

unwillingness to discuss a particular topic in therapy. (like for example, if a client in a

therapy is uncomfortable talking about his or her ex boyfriend, they may show

resistance around this topic. If the therapist continues to probe this topic, the client may

even show resistance by missing therapy appointments or even discontinuing it). They

serve as devices that defend against anxiety but that interfere with the ability to accept

change that could lead to experiencing a more gratifying life.

Goals of Psychoanalytic Therapy:

- Release repressed emotions and experiences

- Make the unconscious conscious

- Strengthen ego to be more aligned with reality

- Lessen dependence on the instinctual cravings of the Id or the irrational guilt

provided by the Superego


Background of Alfred Adler

Alfred Adler was a physician, psychotherapist, and the founder of Adlerian

psychology, sometimes called individual psychology. He is considered the first community

psychologist, because his work pioneered attention to community life, prevention, and

population health. Adlerian psychology emphasizes the human need and ability to create

positive social change and impact.

Adlers work stressed the importance of nurturing feelings of belonging and striving

for superiority. He held equality, civil rights, mutual respect, and the advancement of

democracy as core values. He was one of the first practitioners to provide family and group

counseling and to use public education as a way to address community health. He was

among the first to write about the social determinants of health and of mental health. His

values and concepts drive our mission, work, and values at the Adler University today.

History of Adlerian / Individual Psychology

Adler began his professional life as an ophthalmologist in 1895, before entering the

world of psychiatry in the early 1900s. He was intrigued by Sigmund Freud's theories of

human behavior and bravely defended Freuds much criticized concepts of psychoanalysis.

In 1907, an appreciative Freud invited Adler to join his inner circlean exclusive

Wednesday evening discussion group thought to be the foundation of the psychoanalytic

Ultimately, Adler and Freud parted ways due to theoretical differences, and Adler

established himself at the forefront of his own emerging approach to therapy and soon

founded the School of Individual Psychology. In this new system, the importance of

studying the entire individual was stressed. Adler's theory was institutionalized into The

Society for Free Psychological Thought, which began publishing the Journal for Individual

Psychology soon after.

Adlerian Psychotherapy

Adler was a pioneer in the area of holistic theory on personality, psychotherapy, and

psychopathology, and Adlerian psychology places its emphasis on a persons ability to

adapt to feelings of inadequacy and inferiority relative to others. He believed that a person

will be more responsive and cooperative when he or she is encouraged and harbors feeling

of adequacy and respect. Conversely, when a person is thwarted and discouraged, he or she

will display counterproductive behaviors that present competition, defeat, and withdrawal.

When methods of expression are found for the positive influences of encouragement, ones

feelings of fulfillment and optimism increase. Adler believed strongly that a misbehaving

child is a discouraged child, and that childrens behavior patterns improve most

significantly when they are filled with feelings of acceptance, significance, and respect.

Adler believed that feelings of inferiority and inadequacy may be a result of birth order,

especially if the person experienced personal devaluation at an early age, or they may be

due to the presence of a physical limitation or lack of social empathy for other people. This

method of therapy pays particular attention to behavior patterns and belief systems that

were developed in childhood.

Clinicians who use this form of therapy strongly believe that these strategies are the

precursors for later self-awareness and behaviors and are directly responsible for how a

person perceives themselves and others in their life. By examining these early habitual

patterns, we can better develop the tools needed to create our own sense of self-worth and

meaning, and ultimately create change that results in healing.


An Adlerian therapist assists individuals in comprehending the thoughts, drives, and

emotions that influence their lifestyles. People in therapy are also encouraged to acquire a

more positive and productive way of life by developing new insights, skills, and behaviors.

These goals are achieved through the four stages of Adlerian therapy:

- Engagement

A trusting therapeutic relationship is built between the therapist and the

person in therapy and they agree to work together to effectively address the


- Assessment

The therapist invites the individual to speak about his or her personal

history, family history, early recollections, beliefs, feelings, and motives. This

helps to reveal the person's overall lifestyle pattern, including factors that

might initially be thought of as insignificant or irrelevant by the person in

- Insight

The person in therapy is helped to develop new ways of thinking about

his or her situation.

4. Reorientation

The therapist encourages the individual to engage in satisfying and

effective actions that reinforce this new insight, or which facilitate further



Adlerian individual psychotherapy, brief therapy, couples therapy, and family therapy

all guide people to release their unproductive feelings and to refocus their attention toward

forming corrections in perceived values, feelings, and behaviors that prohibit further

positive growth. The Adlerian technique uses Socratic dialogue to inspire the development

of productive and beneficial attitudes in the areas of confidence, self-worth, and

significance that result in a persons increased ability to naturally cooperate and form

cohesive relationships. The paramount goal of this type of therapy is to remove destructive

self-directed beliefs and behaviors and to replace them with tools that will allow a client to

become confident and socially empowered.


Individuals often enter therapy to gain better insight into their own behaviors and

responses to circumstances that occur in their lives. Adlerian psychotherapy uses a process

of Adlerian values clarification, through which a person in therapy is introduced to

personal life organization, including birth order, social context, and other external

dynamics, including parental influences.

By understanding this organization, and how it has influenced self-worth, acceptance,

and expectations, an individual can begin to accept the emotions they have relative to the

events they experienced as a child. This process of perception allows the person in therapy

to identify maybe for the first time their true inner value, independent of others. Adlerian

values clarification allows one to look at prior beliefs in a new way that encourages positive


Values clarification is all about doing what matters, knowing what matters to you

personally, and taking effective action guided by those values. Various exercises are

employed to help identify chosen values that act like a compass from which to direct

intentional and effective behavior. People who are fused with their thoughts and tend to

struggle with or avoid painful emotions often struggle with choosing purposeful and

values-guided action. Through mindful liberation from such struggles, they find acting

congruently with their values natural and fulfilling.


Comprehensive Assessment using:

1. Family Constellation-questionnaire-social world


1. Early Reflections-single incidents from childhood

1. Lifestyle Assessment-develop targets for therapy by identifying major

successes and mistakes in the clients life

The Question -- If I had a magic wand that would eliminate your

symptom immediately, what would be different in your life?


Establishing the Relationship

Therapist get to know the client as a person

Therapy is collaborative

Goals established together prior to start

1) Awareness of goal discrepancies during

1.Scripts (Have you ever seen a patient like me before?)

1.Games (My previous therapist said the opposite)

1.Realignment of goals, when necessary

Supportive, caring human connection




Exploring Individuals Dynamics

Subjective interview

Client tells own story as expert on own life

Therapist listens for clues to clients coping and approach to life

The Question:

Objective interview ~ Life Style Assessment

Family constellation

Early Recollections
Personality Priorities

Integration and Summary

Encouraging Self Understanding and Insight

Insight = understanding of motivations (the whys) that operate in clients life

Therapist offers open-ended interpretations to:

Bring conscious awareness to unconscious processes

Identify and confront resistance

Explore purposes of symptoms, feelings, behaviors or blocks

Types of interpretation

Of nonverbal behavior: to bring the clients nonverbal behavior to

the attention of the client and interpret it.

Of the therapeutic process: Dealing with what is in the here and now.

Active Wondering: Proposes an alternative to the presenting


Helping with Reorientation & Reeducation

Encouragement process to build courage personal growth is

encouraged and reinforced

Change and search for new possibilities

Making a difference-through change in behavior, attitude or perception


Adlerian therapy is widely used in the treatment of adults, children,

couples, families, and groups. Although many variations of Adlerian therapy exist,

they differ primarily with respect to the duration of therapy, the focus and scope of

treatment goals, and the strategies and techniques that are afforded by the

therapeutic modality. Adlerian therapy has traditionally been long term and

comprehensive in focus, but clinicians have successfully adapted the approach for

short-term and brief therapy.

Adlerian therapy with couples emphasizes how complementarity (i.e.,

compatibility) in the life goals and lifestyle of the partners can perpetuate relational

discord. Therapy with couples is aimed at increasing the partners awareness of the

way in which their choices lead to disagreements and unhappiness instead of goal

alignment, mutual support, and encouragement.

Adlerian therapy with families emphasizes the importance of a democratic and

supportive family atmosphere, the role of the parents as leaders and caregivers, the

individual responsibility of each family member, and the necessity for each person to

contribute meaningfully within the family system. Adlerian therapists often include

the Systematic Training for Effective Parenting (STEP) model that was created by Don

Dinkmeyer, Sr., Gary McKay, and Don Dinkmeyer, Jr. as an important component in

primary and secondary prevention efforts with families.

Adlerian therapy with children uses a variety of play and other nonverbal

techniques to examine the sources of a childs symptoms and goals. In addition to

resolving symptoms (e. g., school refusal or aggressiveness),

Adlerian therapy emphasizes the importance of orienting children toward

cooperation (versus competition), and of encouraging them to become socially

interested (versus self-interested). Adlerian interventions with children frequently

involve parents and family members.

Adlerian group therapy, with suitably-screened clients, provides an active

therapeutic forum in which the social manifestations of clients problems (e.g., goals for

dominating others, hesitating lifestyle tendencies) can be explored and changed. Adlerian

groups accentuate the clients social embeddedness, the interpersonal nature of problems,

and ways in which social interest can be cultivated.


Adlerian therapy takes time, and the approach may not be best suited to individuals

who are seeking a briefer form of therapy or quick solutions to their concerns. In addition,

a large part of this approach is the exploration of early childhood events, and individuals

who do not wish to explore family history or material may not find this approach ideal.

Another critique of the approach is its potential decrease in efficacy with people who may

be less insightful and/or challenged by concerns that impact their ability to function.

While Adlerian therapy has been supported by some research, more testing will likely

provide more extensive evidence backing the benefits of the approach. The Adlerian

approach tends to focus on the self as the locus of change and responsibility. This primary

emphasis on changing the autonomous self may be problematic for some clients.

Many clients who have pressing problems are likely to resent intrusions into areas of

their lives that they may not see as connected to the struggles that bring them into
therapy. Members of some cultures may believe it is inappropriate to reveal family



Adlerian psychotherapy is both humanistic and goal oriented. It emphasizes the

individual's striving for success, connectedness with others, and contributions to society as

being hallmarks of mental health. Birth order is considered important in understanding a

person's current personality, yet the therapy is future-minded, rather than retrospective.

Adler stressed the unity of personality, contending that people can only be understood as

integrated and complete beings. He emphasized that where we are striving to go is more

important than where we have come from. Adler believed that people develop a unique

style of living that is a movement toward and an expression of their selected goals.

In this sense, we create ourselves rather than merely being shaped by our childhood

experiences. Adler holds that the individual begins to form an approach to life somewhere

in the first 6 years of living. According to Adler, humans are motivated primarily by social-

relatedness rather than by sexual urges; behavior is purposeful and goal-directed; and

consciousness more than unconsciousness is the focus of therapy. Unlike Freud, Adler

stresses choice and responsibility, meaning in life, and the striving for success, completion

and perfection.

Adlers theory focuses on inferiority feelings.He sees these as a normal condition for

all people and as a sources of all human striving. Feelings of inferiority can be the
wellspring of creativity rather than being considered a sign of weakness or abnormality.

They motivate us to strive for mastery, success (superiority) and completion.


Adlerian therapy lacks a strong supportive research base. There is a lack of clear and

solid proof regarding the effectiveness of Adlerian counseling. Adler was also very vague

in his approach on how to work with clients as well as the use of his general approach to

therapy. His approach is continually being clarified by many who have studied and use

Adlerian therapy, but many of his concepts and ideas still remain unclear. Additionally,

many view Alders approach as being overly optimistic about the human nature. Some feel

that Alders methods exclude the use and view of the unconscious mind. This is in regard

to the powerful effect that many believe the unconscious plays on the mind beyond ones

social cooperation and interests.


Flexibility and its integrative nature. Adlerian therapists can be both theoretically

integrative and technically eclectic. The Adlerian therapy approach tends to lend itself to

short-term formats. One of Adlers most important contribution is his influence on other

therapy systems. Many of his basic ideas have found their way into other psychological

schools: family systems approaches, Gestalt therapy, learning theory, reality therapy,

rational emotive behavior therapy, cognitive therapy, person-centered therapy, existential

therapy, and the post-modern approaches to therapy.

This means that personality is studied from the point of view of the individuals

subjective experience. Humanistic psychology begins with the existential assumptions that

phenomenology is central and that people have free will. Personal agency is the humanistic

term for the exercise of free will. Personal agency refers to the choices we make in life, the

paths we go down and their consequences.


Adlerian therapy is based on helping people gain insight into their own behaviors,

through a process-oriented program of therapy. The approach is holistic, because it

considers the totality of the personality, including cognitive, emotional and lifestyle

elements (Hutterer-Kirsch, 1996). Adlerian therapy is based on helping people gain insight

into their own behaviors, through a process-oriented program of therapy. The approach is

holistic, because it considers the totality of the personality, including cognitive, emotional

and lifestyle elements (Hutterer-Kirsch, 1996).


Carl Rogers Bio

Four Periods of Development of the Approach

- First period (1940s)

o Rogers developed what was known as nondirective counseling

o Published Counseling and Psychotherapy: Newer Concepts in Practice

o Rogerss theory emphasized the counselors creation of a permissive and

nondirective climate. His theory took away from the therapist and honored

the inherent power of the client

o Nondirective counselors focused mainly on reflecting and clarifying the

clients verbal and nonverbal communications.

- Second period (1950s)

1. Rogers wrote Client-Centered therapy and renamed his approach client-

centered therapy, to reflect its emphasis on the client rather than on

nondirective methods.

2. This period was characterized by a shift from clarification of feelings to a

focus on the phenomenological world of the client.

3. He focused more explicitly on the actualizing tendency as the basic

motivational force that leads to client change.

1. Third period (late 1950s to the 70s)

a. Addressed the necessary and sufficient conditions of therapy

b. A significant publication was On Becoming a Person, which addressed the

nature of becoming the self that one truly is, an idea he borrowed from


c. Rogers studied the qualities of the client-therapist relationship as a catalyst

leading to personality change.

2. Fourth period (1980s and 1990s)

a. Because of Rogers ever widening scope of influence, including his

interest in how people obtain, process, share, or surrender power and

control over others and themselves, his theory became known as the

person-centered approach.

Existentialism and Humanism


View of Human Nature

1. Actualizing Tendency


2. Therapeutic Goals
a. The person-centered approach aims toward the client achieving a greater

degree of independence and integration. Its focus is on the person, not on

the persons presenting problem. The goal is to assist clients in their

growth process so clients can better cope with problems as they identify


3. Therapists Function and Role

a. The role of person-centered therapists is rooted in their ways of being and

attitudes, not in techniques designed to get the client to do something.

Research on person-centered therapy seems to indicate that the attitude of

therapists, rather than their knowledge, theories, or techniques, facilitate

personality change in the client.

4. Clients Experience in Therapy

5. Relationship Between Therapist and Client

a. Rogers based his hypothesis of the necessary and sufficient conditions for

therapeutic personality change on the quality of the relationship. He

hypothesized further that significant positive personality change does not

occur except in a relationship.

b. Therapeutic core conditions

c. Congruence

refers to the therapists capacity to be aware of the full extent of her

own organismic experiencing

The more the therapist is himself or herself in the relationship, putting

up no professional front or personal facade, the greater is the

likelihood that the client will change and grow in a constructive


Unconditional Postive Regard

involves basic acceptance and support of a person, regardless of what

the person says or does

allows clients to express how they are thinking without feeling judged,

and help to facilitate the change process by showing they can be



Empathy is a skill used by person-centred therapists to show

understanding of the clients emotions

This means that the therapist senses accurately the feelings and

personal meanings that the client is experiencing and communicates

this understanding to the client

Accurate empathic understanding



Offers a perspective that is up-to-date and The approach may lead therapists to just be

optimistic supportive of clients without challenging

them (Corey, 2005).

Many aspects are relevant to a Difficulty in therapists allowing clients to

multicultural perspective (Seligman, find their own way (Corey, 2005).


Has provided a basis for many other Could be an ineffective way to facilitate

therapies such as the emphasis on the therapy if the therapist is non-directive and

client-therapist relationship (Seligman, passive (Corey, 2005)


Research has substantiated the importance Simplistic and unrealistically optimistic

of the client-therapist relationship (Seligman, 2006).

Clients have a positive experience in Person-centred therapy does not draw on

therapy when the focus is on them and developmental, psychodynamic or

their problems behavioural therapy thus limiting the overall

understanding of client
Clients feel they can express themselves Listening and caring may not be enough

more fully when they are being listened to

and not judged

Clients feel empowered from Not appropriate for those who

personcentred therapy as the responsibility are not motivated to change.

is on them to make decisions.

May not be useful with

significant psychopathology

(Seligman, 2006).

Fails to prepare clients for the

real world due to the

unconditional positive regard

of the therapist (Seligman,


Lacks techniques to help

clients solve problems

(Seligman, 2006).
Person Centered Approaches

1) Make a Connection

1.By making a connection you will help your clients feel accepted and

important. This technique should enhance your ability to interact with

your clients.

2) Establish Safety

2.Practitioners must be sensitive to the possibility that certain clients may fear

that professionals may physically harm them

For example :

1.Sitting farther away from the client

2.Leaving the door open

3.Not taking notes

3.practitioners must create an emotionally safe environment

3. Ask Open Ended Questions

4.Such questions give your clients the space to share their own perspective on

problems and opportunities

5.During the engagement stage, you are seeking a better understanding of

their thoughts and feelings about several topics:

1.the problem for which they are seeking help history, consequences,

and implications

2.feelings about seeking help

3.efforts to solve the problem in the past

4.motivation to work on the problem and move forward with his or her


4. Actively Listen

Active listening conveys unconditional positive regard for the client.

It is also necessary for empathic understanding, which leads to

empathic responding

Create an environment as free from distractions as possible

Be aware if your mind starts to wander and refocus your attention on

the person and what he has to say

5. Provide Validation & Feedback

The person-centered approach emphasizes the need to create an emotionally safe

place where your clients can feel accepted and one way to do that is to regularly

provide validation and feedback when clients share their experience

Validating a persons sense of helplessness, anger or sadness lends recognition of

what the person is experiencing, and can also normalize it

6. Express Empathy
Empathy is the art of imagining the clients experience or feeling state, of putting

ones self in the shoes of the client

One is not just listening and responding but attempting to see the world from the

perspective of the client in a highly human manner

7. Explain How Helping Process Works

This can be useful in setting up realistic expectations about the helping

relationship and the recovery process.

This is an opportunity to discuss roles and responsibilities, negotiate boundaries,

and inspire hope by leading an open and honest discussion about these issues, you

will exemplify genuineness, which is an essential part of the person centered


5 factors to consider

role expectations,

clinical concerns

clients expressed preferences

personal limitations

ethical considerations


Early Emphasis on Reflection of Feelings

Rogerss original emphasis was on grasping the world of the client and

reflecting this understanding.

Evolution of Person-Centered Methods

Contemporary person-centered therapy is the result of an evolutionary

process that continues to remain open to change and refinement. Rogers

expected his model to evolve and was open to receptive change.

Immediacy, or addressing what is going on between the client and

therapist, is highly valued in this approach.

The Role of Assessment

Application of the Philosophy of the Person-Centered Approach

The person-centered approach has been applied to working with

individuals, groups, and families and has also been applied extensively in

training both professionals and paraprofessionals who work with people in

a variety of settings.

Application to Crisis Intervention

The person-centered approach is especially applicable in crisis

intervention such as unwanted pregnancy, an illness, a disastrous event, or

the loss of a loved one.

Application to Group Counseling

The person-centered approach emphasizes the unique role of the group

counselor as a facilitator rather than a leader. The primary function of the

facilitator is to create a safe and healing climatea place where the group

members can interact in honest and meaningful ways.


Principles of Expressive Arts Therapy

All people have an innate ability to be creative.

The creative process is healing. The expressive product supplies

important messages to the individual. However, it is the process of

creation that is profoundly transformative.

Personal growth and higher states of consciousness are achieved through

self-awareness, self-understanding, and insight.

Self-awareness, understanding, and insight are achieved by delving into

our emotions. The feelings of grief, anger, pain, fear, joy, and ecstasy are

the tunnel through which we must pass to get to the other side to self-

awareness, understanding, and wholeness.

Our feelings and emotions are an energy source. That energy can be

channeled into the expressive arts to be released and transformed.

The expressive artsmovement, art, writing, sounding, music, meditation,

and imagerylead us into the unconscious. This often allows us to

express previously unknown facets of ourselves, thus bringing to light new

information and awareness.

Art modes interrelate in what I call the Creative Connection. When we

move, it affects how we write or paint. When we write or paint, it affects

how we feel and think. The creative connection is a process that brings us

to an inner core or essence which is our life energy.

A connection exists between our life forceour inner core, or souland

the essence of all beings.

Creativity and Offering Stimulating Experiences

Contributions of Natalie Rogers


Motivational Intervewing (MI) is a humanistic, client-centered, psychosocial,

directive counseling approach that was developed by William R. Miller and Stephen

Rollnick in the early 1980s.


Unlike the nondirective and unstructured person-centered approach, MI is

deliberately directive and is aimed at reducing client ambivalence about

change and increasing intrinsic motivation.


There are five basic principles of MI formulated by Miller and Rollnick.


Precontemplation (Not Ready) "People are not intending to take action

in the foreseeable future, and can be unaware that their behaviour is


Contemplation (Getting Ready) "People are beginning to recognize that

their behaviour is problematic, and start to look at the pros and cons of

their continued actions"

Preparation (Ready) "People are intending to take action in the

immediate future, and may begin taking small steps toward behaviour


Action "People have made specific overt modifications in modifying

their problem behaviour or in acquiring new healthy behaviours"

Maintenance "People have been able to sustain action for at least six

months and are working to prevent relapse"

Termination "Individuals have zero temptation and they are sure they

will not return to their old unhealthy habit as a way of coping


Before we head on to the specifics of this certain topic, this part would serve

as a brief history on how Existential Therapy all began. It all started with early

philosophers whose names are: Friedrich Nietzsche and Kierkegaard. Kierkegaard,

being one of the first existential philosophers, theorized that discontent, could only

be overcome or fulfilled by internal wisdom. A few years later, Nietzsche further

elaborated on the field by introducing free will and personal responsibility. By the

1900s, other philosophers began to investigate the interpretation and healing

processes of this field which, as years go by, enticed other fellow contemporaries

and acknowledged the importance of experiencing and understanding as a method

to achieve balance in our psychological state and well-being. The first ever

paychologist to adapt to this method was Otto Rank. After this, writings of Rollo May

and Paul Tillich & Irvin Yalom made existential therapy a mainstream approach.

Soon after, British philosophers began to expand existentialism by the foundation

called "The Philadelphia Association" (an org which helps with psychological issues

by experimantel therapies)

Definition of Existential Therapy

- a unique form of psychotherapy that looks to explore difficulties from a

philosophical perspective, rather than taking a technique-based approach.

Focusing on the human condition as a whole, existential therapy applauds human

capacities and encourages individuals to take responsibility for their successes.

- Emotional and psychological difficulties are viewed as inner conflict caused by an

individual's confrontation with the givens of existence. Rather than delve into the

past, the existential approach looks at the here and now, exploring the human

condition as a whole and what it means for an individual.

Brief History of Existential Humanistic Therapy

The existential-humanistic approach to psychology and therapy originated in the

writings of Rollo May, who is generally considered the father of American existential

psychology. May was influenced by existential psychologists in Europe (i.e., the

Daseinsanalysis tradition) as well as existential philosophers; however, the approach he

developed also had some unique features. One of the unique aspects of Mays approach to

existential psychology was the integration of ideas from humanistic psychology, which

was developing concurrently in the United States. However, the label existential-

humanistic did not come from May, but rather from James F. T. Bugental. Along with

May, Bugental became one of the important influential figures in the development of

existential psychology and therapy in the United States.

Existential-humanisitc psychology, like all the existential psychology traditions,

was heavily influenced by philosophy. The different existential traditions often reflect

different philosophical influences. While the existential-phenomenological tradition, for

example, draws heavily from Heidegger, the existential-humanistic tradition was more

influenced by Nietzsche, Kierkegaard, Jaspers, Buber, and Tillich. This is not to deny the

influence of Heidegger on the existential-humanistic tradition; however, his influence is

not as dominant in the existential-humanistic approach and is balanced by other

A number of new scholarly and clinical voices continued to build on the early

influence of May and Bugental, including Kirk Schneider, Myrtle Heery, Stephen A.

Diamond, Orah Krug, Ed Mendelowitz, and others. In recent years, I (Louis Hoffman)

along with several colleagues, such as Mark Yang, Nathaniel Granger, Xuefu Wang, and

others, have been working to continue to advance existential-humanistic psychology.

Irvin Yalom has powerfully influenced the development of existential-humanistic

psychology and therapy as well; however, it is not clear that he would be properly classified

as an existential-humanistic practitioner. In many ways, Yalom developed his own

approach. Furthermore, Yalom (1980) did not see existential therapy as a stand-alone

approach to therapy, which is different than most who align with the existential-humanistic


The four realms

1. four different levels of experience and existence with which people are inevitably


1. can often help individuals understand the context of their concerns

2. person's orientation towards the world and the four realms defines their reality

1. The physical realm

- centred around physicality

- world we share with animals, the world of bodily needs

- world that stores desire, relief, sleep/awake cycles and nature

- Birth, death and physical feelings/symptoms are also part of this realm
2. The social realm

- relationships, culture, society and language are here as well as work, attitudes towards

authority, race and family.

- Emotions, friendships and romantic relationships are also part of the social world.

3. The personal realm

- concerned with issues of the self

- this includes intimacy (self and others), identity, personal characteristics and overall

sense of self

- Personal strengths and weaknesses are also important as well as the question of being


4. The making realm

- 'ideal' world

- within it are religion, values, beliefs and transformation

- dimension where we make sense of our lives and is considered the realm of


Accepting Fears and Overcoming Through Existential Psychotherapy

1. encourages people to address emotional issues that theyre facing

2. -people who undergo this form of therapy are guided to accept fears

3. And given the skills necessary to overcome them through action.

4. By gaining control of the direction of ones life, the person in therapy is able to

design the course of his or her choosing.

5. creates in the individual a sense of liberation and a feeling of letting go of the

despair associated with insignificance and meaningless.

teaching the person in therapy to grow and embrace his or her own life and to

exist in it with wonder and curiosity.

6. a person is able to view his or her life experience as a journey rather than a trial,

and can eradicate the fear associated with death.

Existential Therapists' Process

Therapists who practice existential psychotherapy do not focus on an individuals

past, rather they work with the client to discover and explore the choices that lie

before him or her.

understand the implications of past choices and the beliefs that led those to take

place, only as a means to shift to the goal of creating a keener insight into oneself.

The emphasis is not to dwell on the past, but to use the past as a tool to promote

freedom and newfound assertiveness.

coming to the realization that they are not unique nor are they destined for a

specific purpose, the person in therapy is allowed to release the obligatory chains

that encumbered him or her from existing in fullness from moment to moment.

When that happens, he or she is truly free.

Existential psychologists evaluate an individuals experience in four dimensions

of existence: the physical, social, psychological and spiritual. They believe that

conflict stems from confrontations with the givens or ultimate concerns of

existence. These include:

The inevitability of death

Freedom and the responsibilities associated with it

Existential isolation


What Mental Health Conditions Can Existential Psychotherapy




Substance dependency

Posttraumatic stress resulting from exposure to military combat, interpersonal

violence, or other life-threatening experienced

When It's Used

Psychological problemslike substance abuseresult from an inhibited

ability to make authentic, meaningful, and self-directed choices about

how to live, according to the existential approach. Interventions often

aim to increase self-awareness and self-understanding. Existential

psychotherapists try to comprehend and alleviate a variety of symptoms,

including excessive anxiety, apathy, alienation, nihilism,

avoidance, shame, addiction, despair, depression, guilt, anger, rage,

resentment, embitterment, purposelessness, psychosis, and violence. They

also focus on life-enhancing experiences like relationships, love,

caring, commitment, courage, creativity, power, will,

presence, spirituality, individuation, self-actualization, authenticity,

acceptance, transcendence, and awe.

What to Expect

1) Therapists help you find meaning in the face of anxiety by choosing to think

and actresponsibly and by confronting negative internal thoughts rather than

external forces like societal pressures or luck.

2) Fostering creativity, love, authenticity, and free will are common avenues that

help move you toward transformation.

3) when treating addiction disorders, the existential therapist coaches you to face the

anxiety that tempts you to abuse substances and guides you to take responsibility.
The goal: You learn to make more willful decisions about how to live,

drawing on creativity and love, instead of letting outside events

determine your behavior.

How It Works

This practicedue to its focus on existence and purposeis sometimes perceived as

pessimistic, but its meant to be a positive and flexible approach. At its best, according to

20th-century philosopher Paul Tillich, existential psychotherapy fairly and honestly

confronts lifes "ultimate concerns," including loneliness, suffering, and meaninglessness.

Specific concerns are rooted in each individual's experience, but contemporary existential

psychotherapist Irvin Yalom says that the universal ones are death, isolation, freedom,

and emptiness. Existential therapy focuses on the anxiety that occurs when you confront

these inherent conflicts, and the therapists role is to foster personal responsibility for

making decisions. Yalom, for example, perceives the therapist as a "fellow traveler"

through life, and he uses empathy and support to elicit insight and choices.

And because people exist in the presence of others, the relational context of group

therapy is an effective approach, he says. The core question addressed in this kind of

therapy is "how do I exist in the face of uncertainty, conflict, or death?

Procedures of Existential Therapy

Existential therapists are free to draw from techniques that flow from many other

orientations. They have a set of assumptions and attitudes that guide their interventions

with clients. The main guideline is that the existential practitioners interventions are

responsive to the uniqueness of each client. The use of the therapists self is the core of

therapy. Therapy is a creative, evolving process of discovery that can be conceptualized

in three general phases.

1.The initial phase, counselors assist clients in identifying and clarifying their

assumptions about the world. Clients are invited to define and question the ways

in which they perceive and make sense of their existence. The counselor teaches

them how to reflect on their own existence and to examine their role in creating

their problems in living.

2.The middle phase, clients are encouraged to more fully examine the source and

authority of their present value system. This leads to new insights and some

restructuring of their values and attitudes. Clients get a better idea of what kind of

life they consider worthy to live and develop a clearer sense of their internal

valuing process.

3.The final phase, focuses on helping clients take what they are learning about

themselves and put it into action, to find ways of implementing their examined
and internalized values in a concrete way. Clients typically discover their

strengths and find ways to put them to the service of living a purposeful existence.

Areas of application

Existential therapy is especially appropriate for clients who are struggling with

developmental crises, doing grief work, confronting death, or facing a significant

decision. Some examples of these critical turning points that mark passages from

one stage of life into another are the struggle for identity in adolescence, coping

with possible disappointments in middle age, adjusting to children leaving home,

coping with failures in marriage and work, and dealing with increased physical

limitations as one ages. It tends to work well with people who are at a crossroads

and who question the state of affairs in the world and are willing to challenge the

status quo. It can be useful for people who are on the edge of existence, such as

those who are dying, who are working through a developmental or situational

crises, or who are starting a new phase of life.

Strengths of Existential therapy

1.Their ability to enable clients to examine the degree to which their behavior is

influenced by family, culture, social conditioning.

2.Can be very useful and practical solution to solve psychological issues.

3.It places a lot of emphasis on four different themes; death, meaningfulness and


Weaknesses of Existential therapy

1.Cannot claim to treat everyone in different ways if they place them into one of the

four themes of existentialism.

2.There are some patients whose problems may not fall into any of the themes.

3.Psychologists might treat the patient incorrectly believing they fall into a category

they dont belong to.

Common Concerns and Limitations

There is one distinctive, united existential theory which is free of internal tension

and covers all the basic assumptions of existential psychology.

There is no difference between existential psychology and existential philosophy.

Existential psychology takes an antireligious or anti-spiritual approach, for example,

denying the existence of God.

Existential and humanistic theories are the same thing.

Existential psychotherapy involves taking a negative, dark, or pessimistic view of


The approach is fundamentally an intellectual one.

It is only beneficial to people of high intellect, who are not experiencing chronic

behavioral or mental health conditions.

What to Look for in an Existential Therapist

existential therapists often have a background in philosophy. Licensure varies

state by state, but many existential therapists complete graduate degrees in psychology

or counseling, for example. They also complete additional supervised fieldwork in

existential therapy.

Brief Summary of Existential-Humanistic Psychology

Existential-humanistic psychology seeks to be honest about the human condition,

including the challenges, potentials, and limitations inherent.

Existential-humanistic psychology recognizes the individual, relational, and

cultural aspects of being human and ones identity, including the potentials and


Existential-humanistic psychology has an appreciation for the paradoxical nature

of being human.

Existential-humanistic psychology has an appreciation for the existential givens,

variously defined and understood. The existential givens include death/finiteness,

freedom/responsibility, isolation/connection, meaning, and emotions/embodiment.

The givens are sometimes viewed as universal challenges; however, I view them as

universal issues that all people experience. They may or may not be perceived as a

challenge. The response to the existential givens are influenced by personal and

cultural aspects. Existential-humanistic psychology does not espouse that there is

one correct way to respond to the givens.

Existential-humanistic psychology recognizes what May (1969) referred to as the

daimonic. According to May, the daimonic refers to any natural impulse or

tendency that has the potential to take over the whole personality.

Existential-humanistic psychology, particularly in regards to therapy, is a relational

approach. However, what is meant by relational can greatly vary. From the

existential-humanistic perspective, relational is rooted in a valuing of the individual

and their potential, personal agency, empathy, and compassion.

Existential-humanistic psychology values conscious awareness. While there are

various perspectives on the unconscious or, as it sometimes preferred, subconscious

in existential-humanistic thought, there is a general valuing of striving to be more

consciously aware of oneself and what influences oneself.

Behavioral Therapy


People generally go through numerous kinds of sickness and illnesses throughout

their entire lives, be it a mental illness or a physically-related one. When these things strike,

people would naturally want to get rid of them. Countless methods and remedies have

already been created by different people throughout the century, and many diverse

medicines and herbal medication have already been manufactured in the past just to get rid

of these illnesses. However, what cannot be easily cured by medicines are: mental illnesses.

Mental illnesses require special kinds of therapy, and these therapies are, for the

most part, psychological in nature. However, as psychology evolved through the years

adapting various approaches, the quality and style of how most of these therapies were

conducted, have also heavily changed. For example, Freud's controversial psychoanalysis

was later on replaced by the then more experiment-based therapies under behaviorism.

It is important to note that before psychoanalysis as an approach was replaced by

behaviorism, the therapies formulated under it were already subjective in nature and had

lacked enough empirical research for its methodologies, such that it was highly criticized

by the scientific community and was a subject of controversy for many years. Nevertheless,

psychoanalysis served as a good start for many psychological therapies to come.

In the next following pages, we will tackle why behaviorism replaced the old norm

which was the psychoanalysis, why behaviorism is more grounded on scientific basis, why

using the behavioral approach in therapy is much better as a whole, as well as talk about

the different therapies under behaviorism that we still use today.

I. Short Overview on Behaviorism

As psychology evolved from philosophy and physiology thousands of years ago to

the more sophisticated science we have now, it also developed with it many changes and

different perspectives in explaining human mental processes and behavior. One major

paradigm shift- and one of the most defining moments in psychology, was the emergence

of behaviorism.

Behaviorism fundamentally challenged the notions of unconscious & conscious

mind and outright refuted it by basically saying that the study of consciousness goes back

to the ancient days of superstition and magic (Watson, 1924). Instead, behaviorism argues

that scientific discipline should and only be focused purely on observable and therefore

quantifiable behavior. To behaviorists, abstract things were of little to no importance, and

were usually negligible. This meant that they essentially spent most of their time doing

experiments and measuring their data using precise measurements, tools, and other

scientific means.

Arguably one of the most famous - if not the most famous -work of a behaviorist

that used proper scientific method and application of precise measurements , is that of Ivan
Pavlov's. Pavlov's work set the door for many behaviorists to demonstrate that behavior

could be learned through conditioned associations.

He coined and defined the term classical conditioning, as a learning process that occurs

through associations between an environmental stimulus and a naturally occurring

stimulus. Basically, four parts can be identified when Pavlov experimented on his dog to

demonstrate classical conditioning. The first part consists of the unconditioned stimulus

(UCS) - such as dog food - which functions to automatically elicit a response called

unconditioned response (UCR) - such as the dog's salivating response to the food. The

second part consists of only the neutral stimulus (NS) such as a bell, which does not

normally elicit a response. On the third part however, the unconditioned stimulus -which

is the dog food - is paired up with the neutral stimulus - the bell - to elicit an unconditioned

response. This pairing of the UCS and NS is then done across multiple trials. Eventually in

the fourth part, the dog will then learn to associate the dog food (UCS) with the bell (NS),

such that the bell itself replaces the UCS and now becomes the conditioned stimulus (CS)

which elicits a conditioned response (CR), which is the salivation. It is good to take note

however, that this learning does not last forever. Pavlov further identified a concept called

extinction, which is a process wherein the previously conditioned response could go away

if the neutral stimulus (the bell) isn't presented along with the unconditioned stimulus

(food) continually. Nevertheless, in the likely event that the neutral stimulus is presented

along with the unconditioned stimulus, spontaneous recovery would occur and the dog

will again, learn to associate the bell with the food and elicit a conditioned response.
In addition to this, Pavlov identified two more concepts in classical conditioning, namely;

generalization, which occurs when dogs are able to associate the bell with the different

stimulus producing the same kind of sound as the bell ( such as forks ) as long as the tones

were similar, and stimulus discrimination, which occurs when dogs are able to selectively

and accurately distinguish a tone from other tones, done by pairing a food with a note and

playing other notes without pairing them with the food.

Since Pavlov primarily worked with dogs, Watson expanded classical conditioning

by showing - in one the most controversial experiments in psychology history - that the

learned process through associations could be applied to humans as well. Famous for his

little Albert Experiment, Watson demonstrated that a child could be conditioned to fear a

previously neutral and that this fear could be generalized to other similar objects.

Years later, B.F Skinner further contributed to the behaviorist perspective through

his concept of operant conditioning, which is basically the effect of punishment and

reinforcement on behavior. In operant conditioning, behavior is either reinforced or made

to occur more likely through adding/applying a satisfying stimulus - termed as positive

reinforcement - or, through taking away of an unsatisfying stimulus - termed as negative

reinforcement. Conversely, behaviors which were made to be suppressed by applying an

unsatisfying stimulus and behaviors which were made to be suppressed by taking away a

satisfying stimulus were termed as positive punishment and negative punishments,


Watson, Pavlov, and Skinner together laid the foundation and groundwork of

behaviorism. Their different works on classical and operant conditioning further

exemplified the fact that psychology really should only rest upon observable behavior, in

order for it to be truly scientific.

One last central idea in behaviorism, aside from focusing only on observable

behavior, is the concept of tabula rasa or a " blank slate of mind". According to

behaviorists, people were born with virtually no idea of anything and everything of the

world. This meant that to behaviorists, all behavior is learned from the environment-

including acquired psychological disorders - through classical and operant conditioning.

Psychology is always evolving, and the shift from psychoanalytic perspective to

behaviorism is an evident example for this. Until now, psychology is still growing,

expanding research through different means. Classical conditioning, operant conditioning,

and tabula rasa are just important terms that were made in the process of change. These

terms are still pretty much important and relevant today, especially in understanding

behavioral therapy which exists even in our contemporary society.

II. Behavioral Therapies

First of all, in order to grasp what behavioral therapy is, one should always go back

to the basics. What is therapy in psychology? In most sources, therapy or counseling is the

act of meeting with a trained individual like a therapist or a psychologist to attempt to fix

problematic behaviors, beliefs, feelings, relationship issues, and/or unusual somatic

responses. Regardless of what type of therapy a person will choose to go through, therapies

always establish the goals and determine the steps needed to go through to achieve the goal.

To differentiate, behavioral therapy then is a type of therapy that uses the

behavioral approach in its processes. As it is based on behaviorism, behavioral therapy

largely focuses on the observable behavior of a person and sees psychological disorders as
the result of learning the wrong response to something, as it believes people are born tabula

rasa (as previously mentioned) and thus might have learned the wrong response from

someone in their environment.

Because of this, behavioral therapies rests on the fact that if something is learned

from the environment, then that thing then, can be unlearned. However, it also important

to note that different cultures have their own view and perspective on what behavioral

therapies are (discussed more later).

To foster positive behavior change, behavioral therapies are action-based

and usually involve increasing a persons engagement in positive or socially reinforcing

activities more often than not, through rewards. Basically two principles underlie the

methods of behavioral therapies, and these are: classical conditioning and operant

conditioning. As such, systematic desensitization and aversion therapies are all types of

therapies resting on the principle of classical conditioning, and token economies,

contingency management, modeling, and extinction on the other hand, rest upon the

principles of operant conditioning.

Summarizing, the goals of most behavioral therapies is to (1) increase a

person's engagement in positive or socially reinforcing activities, (2) to get rid of or to treat

behavioral issues such as phobias, panic disorders, and obsessive compulsive disorders,

and (3) finally, to help an individual develop new skills or strategies to be used in either a

social setting or to help the individual cope up with his/her behavioral issue. Some

techniques used in behavioral therapies are primarily used in conjunction with the concept

of rewards and punishment, albeit neglecting the punishment part and instead prioritizing

giving rewards to a patient for each engagement of positive behavior.

Behavioral therapy can practically be applied to all age groups, although

some specific type of behavioral therapies such as token economies and modeling are more

applicable to children and adolescents.

Moreover, research shows that 2-5 year olds with ADHD are especially receptive

to this type of therapy. Below are some examples of the mentioned behavioral therapies,

and their corresponding definition and procedure:

Systematic Desensitization

This behavioral therapy applies the principles of classical conditioning. It basically

involves having a client make a list of fears and then teaching him/her to relax while

concentrating on these fears. This method usually works on treating phobias, as it utilizes

counter conditioning techniques to desensitize and eliminate the fear response. The entire

process basically follows three steps: (1) the client is first taught relaxation techniques,

then (2) he/she creates a ranked list (ascending order) of fear-invoking situations, lastly

(3) the client confronts his/her fears with the help of the therapist, working from the least

scary situation to the most intense one.

One example of this, is eliminating fear of cockroaches. An individual may stare at

a picture of cockroach, then pictures of cockroaches, then actually seeing a dead cockroach,

then being exposed to a live one, all the while using relaxation exercises such as breathing,

working up the ladder by increasing intensity.

The logic behind this therapy is that, the client may pair the fear-invoking situation with

the relaxation technique, causing the phobic response to be reduced or eliminated.

Aversion Therapy
This behavioral therapy also applies the principles of classical conditioning.

Basically, this process involves pairing an undesirable behavior with an aversive stimulus

in the chance that the unwanted behavior will be reduced.

An example for this might be, hypothetically putting a certain foul-smell on a

cigarette butt, such that when it is used, it produces an odor similar to defecating. The logic

behind this is that, the person will learn to associate the addictive behavior ( smoking ) with

the foul odor such that to avoid the foul odor, he/she must stop smoking.


One last behavioral therapy that applies the principles of classical conditioning, is

the use of flooding. The process usually involves trapping a person with his/her fear for

longer periods of time. During the first part of the process, the fear presented must not be

harmful at all, but will not allow the person to escape. Then the person is presented with

large quantities of his/her fear in which he cannot escape. The logic behind this is that, the

person will learn to associate his/her fear to safety, thinking upon the fact that his/her fear

is not harmful at all.

One example of this would be, allowing a person to confront his/her fear of heights.

The person in this therapy must actually jump from a medium height down to a ground

below, with a cushion or water at the bottom for example.

The safety of the cushion or water will be then associated to the fact that height isn't scary

at all - assuming the distance from where you are standing and the ground is minimal (

some people are afraid of heights even if the distances are small).

Token Economies
This behavioral therapy applies the principles of reward and punishment in operant

conditioning. Token economy is a contingency management based on the systematic

reinforcement of target behavior. The reinforcers are symbols or "tokens" that can be

exchanged for other reinforcers.

In a way it uses operant conditioning but instead of a reward given right after the

desired behaviour, a token which can be later exchanged for a more desirable prize is given.

In other words, token economy is a form of behavior modification designed to increase

desirable behavior and decrease undesirable behavior with the use of tokens.

Contingency Management

This behavioral therapy also applies the principles of reward and punishment in

operant conditioning. This therapy is characterized by a formal written contract between

the client and the therapist that outlines the behavior change goals, reinforcements and

rewards that will be given and the penalties for failing to meet the demands of the

agreement. Contingency contracts can be very effective in producing behavior changes

since the rules are spelled out clearly in black-and-white, preventing both parties from

backing down on their promises.


Another behavioral therapy which also applies the principles of reward and

punishment in operant conditioning, is by extinction. In extinction, change in behavior is

done by stopping a reinforcement of a behavior in order to eliminate the response. Time-

outs are a perfect example of the extinction process. During a time-out, a person is removed

from a situation that provides reinforcement. For example, a child who starts yelling or

striking other children would be removed from the play activity and required to sit quietly

in a corner or another room where there are no opportunities for attention and

reinforcement. By taking away the attention that the child found rewarding, the unwanted

behavior is eventually extinguished.


Compared to the other behavioral therapies mentioned, modeling uses a different

kind of principle, which involves learning through the desirable behavior of others.

Modeling is based on Albert Bandura's social learning theory which rests upon the fact that

in order to learn new skills, one should watch others (models) who have desirable

behaviors. It is still behavioral in nature because first of all, it focuses on the individual

learning from his environment. Also, modeling focuses on the desirable behaviors of

others, these desirable behavior are already positive rewards in their selves in the sense

that good actions are always rewarding.

Cognitive Behavioral Therapy

This behavioral therapy is not founded upon by either of the two basic principles

of behaviorism, but rather focuses on the cognitive aspect, or how we perceive things in

our own. The underlying concept behind CBT is that our thoughts and feelings play a
fundamental role in our behavior. For example, a person is bad in romantic relationships

(e.g. breaking up after 3 months) , may find themselves unable to and unwanting to find

another intimate relationship in the future.

The goal of cognitive behavior therapy is to teach patients that while they cannot

control every aspect of the world around them, they can take control of how they interpret

and deal with things in their environment.

No one perspective works best with dealing on all types of mental illnesses and

disorders. Behavioral therapies particularly, may be good with dealing with phobias

because they are usually physical in nature and constitute a physical stimulus paired with

a fear. However, serious mental illnesses such as depression, are outside the boundaries of

behavioral therapies, as depression is usually characterized by long episodes of stress and

restlessness, stemming from virtually vague sometimes abstract stimulus (such as


More advantages and disadvantages of using the behavioral approach in therapy

will be mentioned later on.

III. Cultural Implications on Behavioral Therapy

As previously elaborated, behavioral therapy is a type of therapy that mainly uses

the premise of behaviorism in administering its therapeutic techniques. Though

psychotherapies in psychology are highly specified in terms of what approach they are
applying, most cultures around the world do not distinguish behavioral therapy at all as a

form of psychotherapy. Most of the population will generally term it as Mental Health,

giving no discernment between the different types of therapy and counseling that

psychologists practice.

In a recent survey conducted by Buzzfeed, it was found out that most westernized

countries are beginning to be more open-minded about mental health issues, including

countries such as France, Germany, the United States, and Canada. In more third world

countries however, there is still a social stigma when it comes to talking about mental health

problems. In countries like Brazil or Mexico on the other hand however, people prefer

keeping problems to their selves as they aren't too comfortable talking about these problems

to other people. Lastly, in China, psychotherapy in mental health is a relatively new concept

which they are trying to adapt, stemming from the fact that it was banned in 1996 due to

their strict medicinal approach in psychiatry.

As seen, attitudes around mental health and access to treatment vary widely within

each country by culture experience and other factors, producing different views on

behavioral therapy and mental health as a whole. In the end, the usefulness of

behavioral therapy nevertheless does not lie on what different cultures think about it, but

by the person himself subjected to the therapy.

No matter how many therapeutic techniques an individual has gone through, behavior

change will always largely depend on the environment, and concepts of extinction and

reinforcement will always be applicable throughout a person's lifetime.

IV. Advantages of Using the Behavioral Approach In Therapy

Cultural differences aside, behavioral approach in therapy will always have its

advantages and disadvantages. One of the very first benefits of using the behavioral

approach, is that it takes a relatively short amount of time to conduct compared to other

types of psychotherapy. While psychotherapists require to maintain a close personal

contact with their clients to talk about their past and current self, a behavioral therapist will

often have treatment goals done in weeks. This saves time and cost of going to the clinic

in the part of the client. In the perspective of the behavioral therapist on the other hand, the

concepts in behavioral therapy are quite easy to understand and execute, requiring less

effort for both parties to finish their goals.

Another advantage of using this approach in therapy , is that eliminates unwanted

or inappropriate behavior of people and learn to deal with stress and frustration, which may

last a lifetime if done effectively. One last advantage in using behavioral therapy in treating

mental illnesses, is that it can be combined with other perspectives to produce maximum

desired effect.

In one of the examples above, behavioral therapy is combined with the cognitive

approach in psychology, which reinforces a person's behavior through both actions and

perception of the person to his/her surroundings.

V. Disadvantages/Limitations of Using the Behavioral Approach in Therapy

As with any approaches in therapy, behavioral approach also has its drawbacks.

One major drawback in using behavioral approach in therapy, is the fact that it cannot treat

serious mental illnesses, such as depressions and suicidal tendencies. The problem with
using behavioral approach solely in therapy, is the fact that it is too focused on the

observable behavior. As much as behaviorism changed psychology, turning it more

scientific through its experiments, one cannot deny that mental illnesses are real and that

some illnesses are really psychological, and abstract in nature. Abstract meaning that, it

may involve cognitive aspects such as perception, memory, and problem solving, and not

just simple phobias and obsessive compulsive disorders.

Another drawback using the behavioral approach in therapy, is the fact that the

consultation times are not as lengthy as other psychotherapies. In behavioral approach, the

client and the therapist usually set goals in about several weeks. These goals are realized

in a short span of time, and may even risk a relapse, or a point in time where the client is

no longer in therapy with his therapist, resulting in his problems coming back. Modifying

behavior also takes an ample amount of time, and the time provided for in the therapy isn't

always enough.

VI. Conclusion

Behavioral therapy has stood its ground as a successful and reliable treatment in

psychology, opening up opportunities to erase maladaptive or harmful behaviors in both

children and adults.

However, as in any other psychotherapies, it follows one major approach, thus having its

own set of edges and drawbacks. As mentioned, since behavioral therapy roots its

techniques on behaviorism, it largely neglects non-observable (yet still highly influencing)

factors such as freewill and self efficacy, and internal forces such as mood, thoughts, and

feelings. This means that while is useful for taking away undesirable habits and managing

phobias, it is considerably weak in evaluating severe psychological disorders and more

serious mental illnesses such as depression.

To remedy behavioral therapy's one-dimensional approach, modern therapeutic

techniques have combined behavioral approach with other perspectives in order to achieve

high validity. One good example of this combination is; the previously mentioned cognitive

behavioral therapy, which combines cognitive approach with behavioral approach in order

to cover internal aspects of the human mind ( such as mood and freewill) which behavioral

approach alone does not cover.

To end, using the behavioral approach in therapy is only just a single way in fully

diagnosing, understanding, and modifying the very complex behavior and thought

processes of individuals, even when coupled with other approaches in psychology.

As much as concepts such as rewards & punishment, and learned associations between

stimuli are fully applicable to people of all ages, the concept of extinction is also genuinely

true. This means that in the context of a changing environment, people would always

manifest innumerable complex behavioral pattern changes throughout the course of their

life, and therapies may only be as effective as the stimulus surrounding the individual ( one
cannot fully change his/her alcoholic behavior if he/she lives in an environment/culture

wherein drinking alcohol is the norm, such as being a son of a bar-owner, or hanging out

with alcoholic friends).

Behavior Therapy, Cognitive Behavioral Therapy, Rational Emotive Therapy

History of CBT

We can trace back the beginnings of Cognitive Behavioural Therapy from the earliest

forms of psychology. From Wilhelm Wundt who cemented psychology as a science, by

introducing the concept of experimental psychology in 1879. Through this, psychology

practitioners slowly innovating theories to explain an observable behaviour. Several

years from Wundt, here came Sigmund Freud who reached United States in 1911 where

psychoanalysis dominated the field of psychiatry and almost all psychiatrists and

psychologists took up psychoanalytic training but underwent some crisis on

1950s(Trigona,2016). The crisis began because of psychoanalysis questioned capacity

to give answers and ability to cure in line with the birth of different psychotherapeutic

models such as Behavioural Therapy. This therapy was under the influence of Ivan

Pavlovs classical conditioning and later developed by B.F. Skinner (operant

conditioning) and other behaviourists works on behaviourism and its applications. Its

influences are fast to dominate because it was very open to change, assimilating and

integrating ongoing research giving rise to new forms of analysis and intervention. These

behaviourists believed that psychological disorders are results of maladaptive learning as

people are born with blank slates (tabula rasa). They emphasized the role of classical and

operant conditioning as treatment for different mental disorders. Classical conditioning,

which involves learning by association is where behavioural therapies are based. The

primary assumption is that, all behaviours is learned, and mistakes in learning is the cause

of different mental disorders.

The first generation of Behavioural Therapy which arises from Psychodynamic

Therapies was soon innovated by considering all of those cognitive concepts that was

being neglected - the fusion of Behavioral and Cognitive Therapies (second generation

of Behavioural Therapy)- the Cognitive Behavioral Therapy. It was introduced by Dr.

Aaron T. Beck in 1960s. That time, he was a psychiatrist in University of Pennsylvania

and a practitioner of psychoanalysis. He ran several experiments to test psychoanalytic

concepts of depression. It came out that what was expected was different from the results,

therefore, he began to look for other ways to explain or conceptualize depression. Dr.

Beck began helping depressed patients by identifying and evaluating their automatic

thoughts or the streams of negative thoughts that seemed to arise spontaneously. The

result of that evaluation was the construction of realistic thoughts by the patients making

them more emotionally stable therefore they could behave functionally. Dr. Beck said

that once the patients changed their underlying belief about themselves, to their world

and to other people, therapy resulted in long lasting change. He termed this approach

cognitive therapy, which later known as cognitive behavioural therapy.

Albert Ellis- Rational Emotive Behaviour Therapy

Rational Emotive Behaviour Therapy (REBT) is also a kind of cognitive therapy

first used by Alber Ellis which emphasis is on resolving emotional and behavioural

problems. The primary goal of this therapy is to transform irrational beliefs into rational

ones. Albert Ellis (1957,1962) proposed that human beings possess unique assumptions

about themselves and the world guides them to through life and determine their reactions

to different situations they encounter.

Unfortunately some of the peoples assumptions are irrational making them to act

and react in an inappropriate ways and that hinder their chances for happiness and

success. He termed these as basic irrational assumptions. Ellis (1957, 1962) listed

several basic irrational assumptions namely; (1) The idea that one should be competent at

everything. This is a good way of viewing competence but if it crosses the boundary that

an individual might push his limits just to surpass other people, this might not be good.
(2)The idea that it is catastrophic when things are not the way an individual want it to be.

Of course, not all things will go smoothly as what an individual wants it to be, everything

has its dynamics and no one could accurately predict what will happen in the future and

a healthy individual should know this basic logic. (3) The idea that people have no

control over their own happiness. This idea might be connected with those individuals

who have dependence issue. There are really people who rely their happiness from

someone else, they may forgot to realize that they are the one who can control their basic

emotions, not the other people around them. (4)The idea that you need someone stronger

than yourself to be dependent on. This idea is also close to the later, this is for those

individuals who have dependence issues, for those individuals who cant stand on their

own feet and rely on other peoples guidance. (5)The idea that your past history greatly

influences your present life. This idea is for those people who chose to standstill or those

who chose not to move their life forward. This is the prevalent reason why it takes time

for people to assemble themselves together, to pull their emotions together and form

themselves as a whole.

It is because they always blame their past as the cause of their miserable present, without

realizing that hating their past cannot help them improve their present. (6)The idea that

there is a perfect solution to human problems and its a disaster if you dont find it.

This idea might also explain why people are not contented, because of their

continues strive for the perfection, or for the solutions that can satisfy them, they

happened to consider those tiny important solutions that they neglected in search of those

they believed that are perfect.

Ellis (1957) also introduced a major aid in cognitive therapy, the ABC Model

(ABC Techniques of Irrational Beliefs). Letter A stands for Activating event or

Objective situation, it is the record of the events that causes high emotional response or

negative dysfunctional thinking of an individual. Letter B stands for Beliefs This is

like the step two, where the client is tasked to write the different negative thoughts

associated by the list of Letter A. Letter C, Consequence ,it stands for the negative

feelings and dysfunctional behaviours that results from the negative thoughts in Letter

B. For example; Casey got a low mark on her long exam. The activating event A , is

when she failed her long exam. The belief B might be she must have good grades or

she is worthless. Consequence C might be Casey feels depressed. After irrational

beliefs have been known, the therapist will often work with the client in challenging the

negative thoughts on the basis of recorded evidences from the experience of the client by

reframing it. Reframing here means to reinterpret the data collected by the therapist into

more realistic ones. These strategies or methods might help the client to build and

develop more rational beliefs and to cope up in a healthy way.

The therapist in the said example might suggest and help Casey to realize that

there is no enough evidences that could make her have good grades to be worthwhile, or

that getting bad grades is disappointing. That even she wanted good grades because it is

good to have them doesnt make her worthless. If the therapist would succeed on his

attempt to let Casey understand that getting bad grades is just disappointing, not awful,

that she is not good in math or in studying only, not as a person, she might feel sad and
frustrated but not depressed because through these realizations, these can uplift her self

worth. Through this, She may increase her study habits by knowing her true potential.

Overview on CBT

Cognitive Behavioural Therapy (CBT) can be used to treat a wide range of

mental health problems, not just depression. It is based on the idea that our thoughts,

feelings and actions (behaviour) interact with each other and therefore our thoughts

determines our feelings and actions. A negative thought can be a predictor of a negative

action. Generally, CBT help people to become aware of their thoughts, that may affect

the patterns of their behaviours and could result in a distorted thinking. The main purpose

of CBT is to help people reduce psychological distress by developing alternative ways of

thinking and behaving. There are three assumptions under CBT namely: (1) The cognitive

approach, believes that abnormality stems from faulty cognitions about others, our world

and us. This faulty thinking may be through cognitive deficiencies or cognitive

distortions. (2) This cognitions cause distortions in a way we see things. (3) We interact

with the world through our mental representations of it. If our mental representation is

inaccurate or our ways of reasoning are inadequate then our emotions and behaviour may

become disordered.

Dr. Aaron Beck widely used this therapy for treating depression. Cognitive

therapy helps clients to identify their feelings and thoughts that cause them to be

depressed. The therapist also guides the clients to challenge their negative thoughts and

apply different thinking alternatives that could help them on their daily lives. Beck

identified three mechanisms that were responsible for depression ; (1) the cognitive triad

of negative thinking, (2) negative self schemas (3) errors in logic (Mcleod,2008). The
first mechanism, cognitive triad, are three forms of negative thinking that are primarily

present to all depressed patients; namely negative thoughts about the self, the world and

the future. These are what Beck termed as automatic thoughts because it always appear

spontaneously to depressed patients. As these three thoughts interact, together they

impair the normal cognition of the person and slowly causing problems in perception,

memory and other mental processes. Then next mechanism, negative self schema, Beck

believed that depressed individuals have low self worth and increased negative and

pessimistic beliefs about themselves. He further added that these negative beliefs can be

traced back to childhood traumas and unpleasant events including;(1) death of a parent or

siblings (2) parental rejection, criticisms, overprotection, neglect and abuse (3) bullying

at school or exclusion of peer group. The third and last mechanism, errors in logic,

refers to several numbers of illogical processes or distortions of thought processes. Dr.

Beck stated that these six illogical processes are self-defeating and can cause anxiety and

depression for the individual. First is arbitrary interference. It is a process of relying to

an irrelevant evidence to form a conclusion. An example might be; an individual thinks

that he is worthless because an open air concert he were going to see has been rained off.

Second is selective abstraction.

It is a process of ignoring other aspects of the situation and focus only in a single

aspect. For example if, the individual blaming himself for the defeat of their team even

though there are six of them on the field. Third is magnification. It is the way of

exaggerating the importance of an undesirable events. For example if someone scrape a

bit of paint on his car and therefore see himself as an awful driver. Fourth is

minimisation. A process of underplaying the importance of an event. For example, if an

individual was praised by his teacher for a good team work but he only view it as trivial.

Fifth, overgeneralization, it is a process of drawing broad negative conclusions of a

basis of single insignificant event. For example, If someone usually get high scores in

exams and then failed in one of his exams he therefore think that he is stupid. Sixth and

last illogical thinking process is Personalisation. It is a way of attributing the negative

feelings of others to oneself. For example if the teacher comes inside the room angry, an

individual thinks that the teacher must be angry with him.

Methods /Techniques on CBT

There are different types of CBT techniques or methods. Here are some of them

that are considered as an effective CBT techniques by a CBT practitioner Boyes (2012).

First technique is Behavioural Experiments. It is used in the therapy to test thoughts.

According to Lebon (2012), this technique is the most effective method for bringing

change in cognitive therapy. These are planned activities, based on experimentation and

observation, undertaken by clients in sessions. They test existing beliefs.

An example for this is, when a client overeats he should evaluate his behaviour; If he

criticize himself after overeating, then he will eat less vs. If he talks to himself kindly

after overeating, then he will eat less. By doing this , a client should monitor his

behaviour in these different approach to really reduce his overeating disorder.

It is just like a testing of hypotheses, if which behaviour is more effective. Second

is Thought Records. It is quite similar to the first method since it is also about the test of

validation of the thoughts. It is one of the fundamental tools in CBT. It is a seven-column

thought record that can be used to; (1) identify negative automatic thoughts, (2) help

client identify the links between thoughts and emotions, (3) examine the evidence for and

against a selected negative automatic thought, (4) challenge a negative automatic thought

(5) generate more realistic alternatives to a negative automatic thought. An example of

this is when a psychology student who gets negative feedback from her adviser might

jump to the conclusion that his adviser might think that he is useless. The student could

do a thought record evaluating the evidence for and against that thought. Evidence

against the thought might be things like his adviser gave him a positive feedback the

other day, if his adviser thinks that he was useless then, the adviser would rather not give

him a positive feedback. The idea of this method is more on gathering several balancing

of thoughts to avoid quick negative conclusions. Third is Pleasant Activity Scheduling.

Boyes (2012), emphasized this CBT method as significant in individuals who suffered

depression. This method tries to reciprocate the depressive behaviour through engaging

the depressed individual into pleasant activities that he would choose. The assessor or

therapist might say

As a homework write the next seven days on a piece of paper starting tomorrow. For each

day, schedule one pleasant activity, (or anything that you enjoy which is not unhealthy)

that you do not usually do.

Simple tasks can be considered pleasurable such as, reading a novel, eating and

enjoying lunch without rushing or anything that is away from stressors. An alternative for

this technique is to schedule the days of an individual with different activities that can

challenge his memory, competence or any forms of accomplishments. The main goals of

this method are to regain self-worth, self focus and hope by eliminating the excessive
negative thoughts. Fourth is Situation Exposure Hierarchies. It is commonly used as a

tool for anxiety. This is a kind of worksheet used to gradually introduce to clients the

feared stimuli. It is started by creating several fear-inducing situations or anxiety-

producing situations and estimating the amount of anxiety that the client produced. Then

it will work through slowly exposing the stimuli to the client beginning with the least

anxiety-producing stimuli and ending with the most anxiety- producing stimuli. For

example if the assessor or therapist lists ten high calorie foods that being avoided by a

patient with eating disorder and the patient would rate it from scores 1-10. Fifth is

Imagery Based Exposure. This technique is usually used to treat Post Traumatic Stress

Disorder (PTSD) and phobias. According to Grohol (2016), this is a safe and proven

technique when the therapist who uses this method is experienced and licensed that also

specializes in these kinds of conditions and treatments. Its main intention is to help

patient face and gain control of the fear and distress that brought by the trauma and must

be done with spontaneous carefulness in order not to re-traumatize the patient.

For example, the same as mentioned earlier about that psychology student who thinks

that his adviser might think that he is useless. In imager exposure, the person would bring

the situation of being given the feedback to mind and remember it in lots of sensory detail

(e.g., the advisers tone of voice, or what the room looked like.)

The student/client would also attempt to label his emotions regarding the

different stimuli exposed (e.g., to run out of the room and cry, or to get angry). By this

method , the client might prolong visualizing the image therefore reducing the feeling of

anxiety he feels from that recurring situations.

Strengths of CBT
1.Model has great appeal because it focuses on human thought. Human cognitive

abilities has been responsible for our many accomplishments so may also be responsible

for our problems. One of the strength of the CBT is about the emphasis of human

cognitive abilities. It is one source of humans achievements due to the fact that humans

are generally an intellectual and rational beings. Many people succeed because of their

cognitive advancement compared to other individuals (e.g. intelligence). Cognitive

abilities is not always limited to its advantages but it can also cause certain distortions

that can lead to pathological conditions. (e.g. a single thought of being worthless can

affect an individuals responsiveness to his environment and can decrease his general

function as a human being).

2. Cognitive theories lend themselves to testing. When experimental subjects are

manipulated into adopting unpleasant assumptions or thought they became more anxious

and depressed (Rimm & Litvak, 1969).

In the opposite way, the subjects or patients can therefore be manipulated by adopting

pleasant assumptions that can stimulate positive responses in their thoughts to overcome

anxiousness and depression.

3. Many people with psychological disorders, particularly depressive , anxiety , and

sexual disorders have been found to display maladaptive assumptions and thoughts (Beck

et al., 1983).

These maladaptive assumptions and thoughts are the underlying reasons of different

psychological disorders. People with psychological disorders as mentioned above are not
usually aware that they are possessing these maladaptive assumptions and thoughts.

Therefore they allowed themselves to be influenced by unrealistic, unhelpful and

pessimistic beliefs. The way they react or respond to these situations lead them to an

unfortunate conclusion that everything is threatening and negative.

4.Cognitive therapy has been very effective for treating depression (Hollon & Beck,

1994), and moderately effective for anxiety problems (Beck, 1993). As mentioned

repeatedly, the main reason why CBT was formed is because of the depression

treatment. The goal of this therapy is to teach people to handle the distressing thoughts

in a healthy way, as well as reducing avoidance or other problematic behaviours and

actions (e.g. substance abuse). Its main goal is centered on the development of an

individual to cope with different problems (e.g. depression, anxiety, addiction etc.) in

order to function well as an individual.

Limitations of CBT

1. The precise role of cognitive processes is yet to be determined. It is not clear whether

faulty cognitions are a cause of the psychopathology or a consequence of it.

Lewinsohn (1981) studied a group of participants before any of them became depressed,

and found that those who later became depressed were no more likely to have negative

thoughts than those who did not develop depression. This suggests that hopeless and

negative thinking may be the result of depression, rather than the cause of it.

2. The cognitive model is narrow in scope - thinking is just one part of human

functioning, broader issues need to be addressed.

This is one of major criticism of CBT since it only focuses on the cognitive factor that

can influence or cause humans behaviour. Many suggest that there are other different
factors that are neglected by the CBT approach in explaining human pathologies, such as

environment, biology etc.

3. Ethical issues: RET is a directive therapy aimed at changing cognitions sometimes

quite forcefully. For some, this may be considered an unethical approach.

According to one of the well known author and psychotherapist, Miles (2015),

Therapeutic relationship is the relationship and connection between a client and a

professional psychotherapist, without this, there is no meaningful therapy. This is in

favour of the early practice of Beck who stresses the importance of the quality

therapeutic relationship unlike Ellis who viewed the therapist as the teacher and does not

think that a warm personal relationship to a client is essential.


Choice Theory, developed by Dr. William Glasser, is the explanation of human

behavior based on internal motivation. As Dr. Glasser explains in the most recent of his y

read books, Choice Theory, all of our behavior is chosen as we continually attempt to meet

one or more of the five basic needs that are part of our genetic structure.

An understanding of these needs as well as the other major components of Choice

Theory (the Basic Needs, the Quality World, the Perceived World, the Comparing Place,

and the Total Behavior System) can help us build and maintain better relationships with

the important people in our lives and lead happier, more satisfying lives.

The Ten Axioms of Choice Theory

1 .The only person whose behavior we can control is our own.

2. All we can give another person is information.

3. All long-lasting psychological problems are relationship problems.

4. The problem relationship is always part of our present life.

5. What happened in the past has everything to do with what we are today, but we can

only satisfy our basic needs right now and plan to continue satisfying them in the future.

6. We can only satisfy our needs by satisfying the pictures in our Quality World.

7. All we do is behave.

8.All behavior is Total Behavior and is made up of four components: acting, thinking,

feeling and physiology

9. All Total Behavior is chosen, but we only have direct control over the acting and

thinking components. We can only control our feeling and physiology indirectly through

how we choose to act and think.

10. All Total Behavior is designated by verbs and named by the

part that is the most recognizable.

The 1998 book, Choice Theory: A New Psychology of Personal Freedom, is the

primary text for all that is taught by The William Glasser Institute. Choice theory states


- all we do is behave,

- that almost all behavior is chosen, and

- that we are driven by our genes to satisfy five basic needs: survival, love and belonging,

power, freedom and fun.

In practice, the most important need is love and belonging, as closeness and

connectedness with the people we care about is a requisite for satisfying all of the needs.
Choice theory, with the Seven Caring Habits, replaces external control psychology and

the Seven Deadly Habits. External control, the present psychology of almost all people in

the world, is destructive to relationships. When used, it will destroy the ability of one or

both to find satisfaction in that relationship and will result in a disconnection from each

other. Being disconnected is the source of almost all human problems such as what is called

mental illness, drug addiction, violence, crime, school failure, spousal abuse, to mention a


Relationships and our Habits

Seven Caring Habits Seven Deadly Habits

1 .Supporting 1. Criticizing

2 .Encouraging 2 .Blaming

3. Listening 3. Complaining

4. Accepting 4. Nagging

5. Trusting 5. Threatening

6 .Respecting 6. Punishing

7. Negotiating differences 7 .Bribing, rewarding to control



What is Music therapy?

- It is a type of expressive arts therapy that uses music to improve and maintain the

physical, psychological, and social well-being of individuals.

- Music therapy involves a broad range of activities, such as listening to music,

singing, and playing a musical instrument.

- This type of therapy is facilitated by a trained therapist and is often used in

hospitals, rehabilitation centers, schools, and etc.

Goals of Music Therapy

1. A music therapy goal is a broad statement if the desired long-term outcome of


Following are examples of goals that may be established with music therapy clients:

1. Cognitive goals

a. Improve cognitive skills- such as learning, perception, recognition,

discrimination and etc.

b. Improve communication

c. Increase alertness

2. Motor development goals

a. Improve motor functioning skills- movement, range of motion,

coordination, muscle control, strength and flexibility

b. Improve general stamina and endurance

1. Sensory goals

a. Improve sensory functioning- such as auditory, visual, tactile and


b. Decrease sensory sensitivity such as pain and discomfort, management of

pain, stimulation of neurochemicals as natural pain killers

c. Improve body awareness

2. Psychological/emotional goals

a. Increase emotional awareness

b. Increase and improve appropriate emotional expression

c. Elevate mood

d. Reduce distress, trauma, apprehension and fear of illness or injury

e. Enhance awareness of self and environment

f. Improve self-esteem and self-image

g. Improve coping skills

Social goals

Establish relationships

Increase involvement and participation

Increase peer interaction

Foster a sense of belonging

Promote group cohesion

Communication/speech goals

Change the rate of speech

Building strength and endurance

Facilitate speech production

Train voice control

Who can benefit from music therapy?

The diverse nature of music means it can be applied in the treatment of concerns

both physical and psychological.

In some instances, the music has a therapeutic use that has been able to help

people in ways that therapy cannot, as it can sometimes elicit responses that may

not appear through more traditional forms of treatment.

People may show a greater degree of interest and engagement in music therapy

when people find it difficult to express themselves verbally.

People who can benefit are the people who have the following:

2. Depression

3. Anxiety

4. Schizophrenia

5. Autism

6. Personality issues

7. Insomnia

8. Dementia
The positive effects of music therapy are not limited to those coping with severe

or long-lasting physical and psychological problems and this therapy can benefit

people in a variety of situations.

Music is frequently used to reduce stress levels and pain perception. One example

is a mother in child labor.

What happens in a Music therapy session?

There are two different modes of music therapy---- receptive and active.

Receptive Music Therapy- listening music while engaging in other activities.

For example, they may do art work, make crafts, or spend the time meditating.

Active Music Therapy- involve activities directly connected to music. For

example, singing, playing an instrument, writing song or improvising.

Music therapy can be conducted with individuals or in groups, and the music may be

chosen by the therapist or by the client in therapy. A therapist will make sure that the type

and mode of the chosen form of music, as well as the timing of the music intervention,

are appropriate for meeting the needs and goals of the individual in therapy.

Techniques and activities used in Music Therapy

The therapists have many different techniques and activities they can use to help their

patients and clients. Their choice(s) will depend on their clients needs and the goals of


Playing instruments- playing an instrument is often a bit less nerve-wracking.

Instruments may include just about anything that makes a sound, such as piano or

keyboard and etc. Playing instruments with other therapy clients can help improve

social skills and foster aspects of team work.

Rhythmic activities- the clients will tap their hands or fingers on something, snap

their fingers, clap their hands, or move their body rhythmically. This is a great

technique for reducing anxiety, improving coordination, and promoting


Singing- most people enjoy singing, especially in a group. Singing alone, with the

therapist, or as part of a group can help boost self-esteem and self-confidence,

enhance social skills, improve the articulation of words and sounds, and develop

better breath control. In group session, it teaches team work, improve cooperation

and increase social skills

Song writing and composition- this can be very therapeutic forms of expression.

Song lyrics have been used for centuries to tell stories. Song lyrics, melodies and

musical style all provide a glimpse into the heart and mind of the person who

wrote them. This technique can provide valuable information for a music


Listening- simply listening to music can be very therapeutic. It can help reduce

anxiety, facilitate emotional healing, and boost cognitive and attention skills.

Listening to soothing music can also calm a busy mind and reduce stress.

Discussion- discussion can include how the music makes them feel, whether or

not it brought up any particular thoughts or memories, or what they thought about

the meaning of the words.

Strengths and Limitations

Music therapy provides benefits to the patients who undergo this therapy.
It is able to address a variety of client needs such as social, emotional,

psychological, behavioral, communication and spiritual.

Like every therapy, there are strengths and limitations of music therapy.


1) It will reduce isolation or withdrawal behavior and provide an engaging

experience to improve socialization.

2) It will encourage exploring and expressing feelings and provide emotional support

and music associated counselling.

3) It will reduce restlessness and wandering, and promote appropriate behavior.

4) It will improve communication and self-expression.

5) It will improve motivation, increase self-esteem, and provide an uplifting and

enjoyable feeling.


1.Some old forgotten feelings may resurface and this may increase depression instead

of providing relief.

Music therapy is considered very expensive due to lack of general awareness

Dance Therapy

Its a well known fact that moving is good for the body and mind. The mental and

emotional benefits of movement are plentiful. The same endorphins that make you feel
better when moving also help you concentrate and sleep better, have more energy, and can

help you become more resilient when faced with the mental or emotional challenges of life.

Moving regularly is an investment in your mind, body, and soul. One of the more

expressive ways to integrate movement into your eating disorder recovery is through dance


What Is Dance/Movement Therapy?

Defined, dance/movement therapy (DMT) in the US is the psychotherapeutic use of

movement and dance to support intellectual, emotional, and motor functions of the body.

As a form of expressive therapy, DMT looks at the correlation between movement and


Also called movement psychotherapy there is no single fixed type of movement

style used within this therapeutic exposure. Programs range from traditional dances like

ballroom to more subtle forms of movement like yoga and stretching to calm the body.

[2] Its important to note that a DMT licensed practitioner would lead a session within

a therapeutic setting. Therapy sessions are focused on movement behavior as it comes

forward through the guided session.

Through this exposure, a therapist will use movement to help a client achieve

emotional, cognitive, physical and social integration. The benefits include stress reduction

and mood management. Within eating disorder recovery, it can also help improve body
image and self-esteem. Founded within the idea that motion and emotion are

interconnected, this creative expression can also help improve communication skills for

better relationships. Movement can express aspects of a personality that a licensed

therapist can be in tune with for deeper connection in recovery therapy.

Why Dance Therapy is Different from Regular Dancing

Movement in a dance therapy setting is more than just exercise. The actions, fluidity,

and movement are interpreted more like a language. People who utilize dance therapy

within an eating disorder treatment setting utilize movement to communicate conscious

and unconscious feelings through dance. The therapist responds to the movements,

assesses body language, nonverbal behaviors and emotional expressions to develop

interventions to address the specific needs of the client. Movement is the primary way

dance therapists observe, evaluate, and implement therapeutic intervention.

Some interventions include:

1.Mirroring. Matching and echoing the persons movements to show empathy and

validate what the person is feeling.

2.Using a movement metaphor or prop to help a person physically and expressively

demonstrate a therapeutic challenge or achievement. For example: a therapist may

give a person in treatment a white flag to help celebrate emotional surrender.

Important skills that can be acquired during the process of dance movement therapy

1.Learning how to develop and trust your ability to be present empathetically.

2.Being able to respond authentically and truthfully.

3.Learning how to translate the nonverbal movements into insights that can be used in


Susan Kleinman, a board certified Dance/Movement Therapist, National Certified

Counselor and Certified Eating Disorder Specialist has shared that dance movement

therapy is a little like talking through your body quite different from talking only

through your head.

How Dance Movement Therapy can be Beneficial

Feelings and life experiences live inside the body and can get trapped there. You dont

have to be a dancer to benefit from dance movement therapy. The body can be the key to

unlocking profound levels of healing. DMT is not a dance class. It is a therapeutic exposure

that can be used in conjunction with other eating disorder therapies to help access genuine,

long lasting change.

Having a means to feel safe to understand and experience the sensations and feelings

of your disorder are all part of the journey to recovery. Dance movement therapy can play

an integral role in helping you re-claim an authentic connection between your actions and


Accessing Dance Movement Therapy

Many eating disorder treatment centers across the country offer this therapy option.

Be sure to inquire during your research as to all of the therapeutic exposures that may be

available to you. There is no one-size fits all approach to recovery and it is important to


Art Therapy is an integrative mental health and human services profession that enriches

the lives of individuals, families, and communities through active art-making, creative

process, applied psychological theory, and human experience within a psychotherapeutic

relationship. Art Therapy, facilitated by a professional art therapist, effectively supports

personal and relational treatment goals as well as community concerns. Art Therapy is used

to improve cognitive and sensory-motor functions, foster self-esteem and self-awareness,

cultivate emotional resilience, promote insight, enhance social skills, reduce and resolve

conflicts and distress, and advance societal and ecological change.


As a mental health profession, art therapy is employed in many clinical and other

settings with diverse populations. Art therapy can also be found in non-clinical settings, as

well as in art studios and in creativity development workshops. Closely related in practice

to marriage and family therapists and mental health counselors, U.S. art therapists are

licensed under various titles, depending upon their individual qualifications and the type

of licenses available in a given state. Art therapists may hold licenses as art therapists,

creative arts therapists, marriage and family therapists, counselors of various types,

psychologists, nurse practitioners, social workers, occupational therapists, or rehabilitation

Art therapists may have received advanced degrees in art therapy or in a related field

such as psychology in which case they would have to obtain post-master's or post-doctorate

certification as an art therapist. Art therapists work with populations of all ages and with a

wide variety of disorders and diseases. Art therapists provide services to children,

adolescents, and adults, whether as individuals, couples, families, or groups.

Using their evaluative and psychotherapy skills, art therapists choose materials and

interventions appropriate to their clients' needs and design sessions to achieve therapeutic

goals and objectives. They use the creative process to help their clients increase insight,

cope with stress, work through traumatic experiences, increase cognitive, memory and

neurosensory abilities, improve interpersonal relationships and achieve greater self-

fulfillment. The activities an art therapist chooses to do with clients depend on a variety of

factors such as their mental state or age. Many art therapists draw upon images from

resources such as ARAS (Archive for Research in Archetypal Symbolism) to incorporate

historical art and symbols into their work with patients. Depending on the state, province,

or country, the term "art therapist" may be reserved for those who are professionals trained

in both art and therapy and hold a master or doctoral degree in art therapy or certification

in art therapy obtained after a graduate degree in a related field. Other professionals, such

as mental health counselors, social workers, psychologists, and play therapists combine art

therapy methods with basic psychotherapeutic modalities in their treatment. Therapists

may better understand a client's absorption of information after assessing elements of their

Basic tenets

The purpose of art therapy is essentially one of healing. Art therapy can be successfully

applied to clients with physical, mental or emotional problems, diseases and disorders. Any

type of visual art and art medium can be employed within the therapeutic process, including

painting, drawing, sculpting, photography, and digital art. Art therapy stands in contrast

with other kinds of creative or expressive arts therapies that use dance, music or drama.

One of the major differences between art therapy and other forms of communication is that

most other forms of communication elicit the use of words or language as a means of

communication. Studies have demonstrated the efficacy of art therapy, as applied to clients

with memory loss due to Alzheimer's and other diseases; stroke residuals; cognitive

functioning; traumatic brain injury; post-traumatic stress disorder (PTSD); depression;

dealing with chronic illness;[53][54][55][56] and aging. However, the potential healing

power of art therapy has not been thoroughly studied in certain patients, such as trauma

victims with disorders such as PTSD. "....Art therapy is not being properly reviewed. Art

therapists report remarkable results from work with combat veterans, traumatized victims,

sexual abuse survivors and survivors of natural disasters... Published case stories and

research projects also support the efficiency of the approach. Yet no major clinical studies

have been launched to scientifically examine the outcomes of art therapy as treatment for

PTSD." One proposed learning mechanism is through the increased excitation, and as a

consequence, strengthening of neuronal connections.This process is known as long-term

potentiation (LTP). Another purpose of art therapy is determining existing disorders.

Trauma, depression, schizophrenia, and PTSD are just a few mental illnesses that can be

detected through art therapy.

"Sixty-four renal transplant recipients, 6-21 yr of age, were evaluated using self-report

measures (CDI and Davidson) and art-based assessments. Subject art was analyzed by art

therapists using seven of the 14 elements of the (FEATS), to assess depression. Unlike CDI

and Davidson self-report testing, all patients were able to complete the art-based directives.

When self-report measures and art-based assessments were combined, 36% of the study

population had testing results consistent with depression and/or post-traumatic stress. The

FEATS assessments identified a subset of patients who were not identified using the self-

report measures. There was a correlation between CDI and Davidson scores (p < 0.0001),

Davidson scores correlated with hospital days (p = 0.05), and FEATS correlated with

height Z score (p = 0.04) and donor type (p = 0.01). Patients who required psychological

interventions including antidepressant therapy, psychological counseling and psychiatric

hospitalization during the year after the study were identified as depressed."[61] As art

therapy grows in popularity and gains recognition, the purpose will become more clear and

branch out to different patients. The purpose of art therapy is to provide a new healing

opportunity to those who will benefit most from alternative therapy methods. In

conclusion, art therapy is one of multiple medicines to create peace in the patience's mind.

As a mental health profession, art therapy is employed in many clinical and other

settings with diverse populations. Art therapy can also be found in non-clinical settings, as

well as in art studios and in creativity development workshops. Closely related in practice

to marriage and family therapists and mental health counselors, U.S. art therapists are

licensed under various titles, depending upon their individual qualifications and the type

of licenses available in a given state.

Art therapists may hold licenses as art therapists, creative arts therapists, marriage and

family therapists, counselors of various types, psychologists, nurse practitioners, social

workers, occupational therapists, or rehabilitation therapists. Art therapists may have

received advanced degrees in art therapy or in a related field such as psychology in which

case they would have to obtain post-master's or post-doctorate certification as an art

therapist. Art therapists work with populations of all ages and with a wide variety of

disorders and diseases. Art therapists provide services to children, adolescents, and adults,

whether as individuals, couples, families, or groups.

Using their evaluative and psychotherapy skills, art therapists choose materials and

interventions appropriate to their clients' needs and design sessions to achieve therapeutic

goals and objectives. They use the creative process to help their clients increase insight,

cope with stress, work through traumatic experiences, increase cognitive, memory and

neurosensory abilities, improve interpersonal relationships and achieve greater self-

fulfillment. The activities an art therapist chooses to do with clients depend on a variety of

factors such as their mental state or age. Many art therapists draw upon images from

resources such as ARAS (Archive for Research in Archetypal Symbolism) to incorporate

historical art and symbols into their work with patients. Depending on the state, province,

or country, the term "art therapist" may be reserved for those who are professionals trained

in both art and therapy and hold a master or doctoral degree in art therapy or certification

in art therapy obtained after a graduate degree in a related field.

Other professionals, such as mental health counselors, social workers, psychologists,

and play therapists combine art therapy methods with basic psychotherapeutic modalities

in their treatment. Therapists may better understand a client's absorption of information

after assessing elements of their artwork.

Benefits and Weaknesses of Art Therapy

Art therapy has some definite strong points, but it is not necessarily suited to all

situations. First of all, it is highly beneficial for situations where the patient can benefit

from a different form of communication and where they are maybe struggling to

communicate normally through speech. For instance then this can be highly useful for

children who are having developmental problems and children in general who enjoy art

and who may not be able to articulate their feelings well. Likewise it can be highly useful

where the person doesn't feel quite able or ready to talk about their experiences and

therefore use the art therapy as an alternative way to communicate feelings. It may even be

useful as a way of uncovering things that the person did not want to disclose, or even in

some cases that they weren't aware of.

Another benefit of art therapy is that, as discovered by Hill, it is a highly useful coping

tool that is expressive and distracting as well as somewhat meditative. This gives it use for

cognitive behavioral therapists who teach their clients and patients coping strategies that

they can use to address negative feelings. Art therapy has also been used in psychological

testing and diagnosis and has been successful in addressing the IQ of children to the

presence of severe personality or developmental disorders.

However there are also downsides to art therapy. For instance many forms of art

therapy rely heavily on psychotherapy the school of psychology that uses Freud's

theories. This is a problem for some as many modern psychologists disagree with several

points of psychotherapy and it proves less effective than more 'hands on' methods of

treating conditions like depression or anxiety disorders such as cognitive behavioral

therapy. In such cases a more scientific approach is preferred by many.

Meanwhile another issue with art therapy is that it can vary quite a lot in approach

from therapist to therapist. Unlike a cognitive behavioral therapist who will use a very

predefined approach that is the same across the board, an art therapist might be successful

or not depending on the individual that you encounter.

Limitations of Expressive Arts Therapy

One of the major criticisms of expressive arts therapy is the fact that the primary reason

for healing is not clearly discernible. It is not clear whether healing occurs from the creative

process or if it is due to positive interactions with the therapist. As currently published

studies tend to focus on immeasurable qualitative benefits, a lack of empirical evidence in

support of the effectiveness of the approach is a concern.


Art therapy can be a particularly useful treatment tool for children, who often have

limited language and communications skills. By drawing or visually expressing their

feelings, even if they can't identify or label the emotions, younger patients have a starting

point from which to address these issues. Art therapy is also valuable for adolescents and

adults who are unable or unwilling to verbalize thoughts and feelings.

Beyond its use in mental health treatment, art therapy is also employed as an adjunct

(or complementary) therapy to traditional medicine for the treatment of biologically based

diseases and conditions. The correlation between mental health and physical health is well

documented. Art therapy has been used in the healing process to relieve stress and develop

coping mechanisms, in an effort to treat both the physical and mental needs of the patient.

Although art therapy has traditionally centered on visual mediums (paintings,

sculptures, drawings, etc.), some mental healthcare providers have broadened the definition

to include music, film, dance, writing, and other artistic genres.