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tonyamcbee
Respond to this post with a minimum of 400 words. Please do not…
Respond to this post with a minimum of 400 words. Please do not copy and paste any aspects of this response and apply it with your reply. Original reply ONLY. Please use in-text citations as well as listing your references that were used in your response. Please list your references as shown in this post.
As a therapist with experience in utilizing both Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT) in treating clients, I have encountered various benefits and challenges associated with implementing each modality.
Benefits and Challenges of CBT:
CBT has been shown to be effective in treating a variety of mental health conditions, including depression, anxiety, and post-traumatic stress disorder (PTSD) (Ricciardi & McNally, 2020). It emphasizes the importance of identifying and challenging negative thoughts and beliefs that can contribute to psychological distress. For example, I had a client who suffered from social anxiety and held the belief that they would always be judged negatively by others, leading to avoidance of social situations. Through CBT, I was able to help the client identify and challenge these beliefs, leading to a reduction in anxiety and an increase in social functioning. One challenge of CBT is that I have found that depending on the client it can be time-consuming and may require a significant commitment from the client. This is particularly true for those with chronic or severe mental health conditions, where a longer duration of therapy may be needed to achieve significant improvement (McEvoy et al., 2016). Another challenge that has come up when treating some clients is that some have have difficulty identifying their negative thoughts and beliefs, making it more challenging to implement CBT techniques effectively. For example, I once treated a client struggling with depression and anxiety for several years. They sought out therapy to address the symptoms but always had difficulty identifying their negative thoughts and beliefs. I recall during the first session, the client expressed frustration with their inability to identify negative thoughts and beliefs. The client explained that they often feels overwhelmed by their emotions and finds it difficult to separate their thoughts from their feelings. I continued to work with the client to help them identify specific situations where they had felt depressed or anxious and asked them to describe their thoughts and feelings during those situations. Despite this, the client still had difficulty identifying specific negative thoughts and beliefs. The client often reported feeling a general sense of sadness or anxiety without being able to every pinpoint exactly what was causing it. I found it very challenging to implement CBT techniques effectively, as the therapy relies on identifying and challenging specific negative thoughts and beliefs. In the end I had to focus more on behavioral techniques, such as activity scheduling and relaxation training which was able to improve the clients mood and reducing anxiety even in the absence of clear negative thoughts or beliefs.
Benefits and Challenges of REBT:
REBT is similar to CBT in that it focuses on identifying and challenging negative thoughts and beliefs. However, it places a greater emphasis on identifying and challenging irrational beliefs, which are believed to underlie many emotional and behavioral problems (DiGiuseppe & Doyle, 2019). For example, I once treated a female client who presented with symptoms of depression. She reported feeling overwhelmed by daily responsibilities, and frequently experiencing negative thoughts about her self-worth. She shared that she was an only child, and had grown up in a household where her parents placed high expectations on her academic and personal achievements. She had internalized these expectations and believed that she must be perfect in all areas of life to be valuable and worthy of love. In the early stages of therapy, the client had difficulty identifying her negative thoughts and beliefs, and often dismissed them as “just the way things are.” It became clear that her irrational belief of perfectionism was deeply ingrained, and had become a core part of her identity. I was able to use REBT to help the client identify and challenge her irrational belief. We explored the evidence supporting her belief, and the consequences of holding onto this belief. I encouraged her to identify alternative beliefs that were more realistic and less rigid, and to actively challenge her negative thoughts when they arose. We also practiced cognitive restructuring techniques such as examining evidence for and against her negative thoughts, and generating alternative thoughts and perspectives. Over time, the client began to recognize the impact of her irrational belief on her emotional well-being, and was able to adopt more flexible and realistic beliefs. She reported feeling less overwhelmed by daily responsibilities, and was able to approach tasks with a greater sense of self-compassion and self-acceptance. Her depressive symptoms reduced significantly, and she was able to engage more fully in her life and relationships. One challenge of REBT is that I found out that it may not be appropriate for all clients, particularly those who have difficulty recognizing and challenging their irrational beliefs as with CBT. Additionally, some of my clients found the confrontational nature of REBT challenging because they didn’t like me challenging their beliefs.
Christian Worldview & Lingering Question:
When working with Christian clients, I have found that both CBT and REBT can be effectively adapted to a Christian worldview. I encourage clients to focus on the truth of God’s Word and replace negative, irrational thoughts with positive, biblical truths. For instance, if a client struggles with anxiety, I suggest focusing on verses such as Philippians 4:6-7, which states, “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” Additionally, I encourage clients to focus on gratitude, referencing verses like 1 Thessalonians 5:18, which advises to “give thanks in all circumstances; for this is God’s will for you in Christ Jesus.” Incorporating prayer and meditation is another technique I find helpful for Christian clients. I suggest that they pray and meditate on biblical truths to reframe negative thoughts and emotions and find peace and strength in God. By integrating Christian worldview aspects into CBT and REBT, a holistic approach to mental health treatment can be achieved, and Christian clients can find healing and hope through their faith.
Question: How can therapists effectively address resistance or difficulty in identifying negative thoughts and beliefs with clients during CBT or REBT, particularly when these thoughts and beliefs are deeply ingrained and/or closely tied to their sense of identity?
References:
DiGiuseppe, R., & Doyle, K. A. (2019). Rational emotive behavior therapy (REBT). In Handbook of cognitive-behavioral therapies (pp. 187-216). Springer, Cham.
Holy Bible, New International Version. (2011). Biblica.
McEvoy, P. M., Burgess, M. M., & Nathan, P. (2016). The effectiveness of cognitive behavioral therapy for major depression in adults: A systematic review and meta-analysis of randomized controlled trials. Cognitive Behaviour Therapy, 45(3), 178-195.
Ricciardi, L., & McNally, R. J. (2020). Cognitive-behavioral therapy for posttraumatic stress disorder: An overview of systematic reviews and meta-analyses. Clinical Psychology Review, 82, 101925.
