Counseling: Comparing Models


Over the years, different scholars have come up with different ways of dealing with psychological problems depending on the situations at hand. One of the ways adopted in treating psychological related problems is the use of behavioral techniques. These techniques seek to change or modify certain behaviors in people as identified by the behavior therapist. The observable behaviors may include peoples’ feelings, experiences, and thoughts (Murdoch & Barker, 1991, p. 1).

This paper focuses on behavior therapy and will outline the model’s key features, how it can be applied in solving Angela’s case, and also shows the comparison between the model and the effective model.

Behavior Therapy

Behavior refers to those actions which are used by people to realize their goals and objectives. Different people behave differently when faced with different situations and as such these behaviors are interpreted to determine their feelings, thoughts, and who they are as human beings. People are in most cases connected by such behaviors, which also determine the outcome towards achieving their goals such as success or failure.

Behaviour Therapy, therefore, refers to the therapeutic approach to the treatment of psychological problems, through the use of different techniques to bring out the desired behavior in a person and do away with unwanted behavior (Erwin, 1978, p. 44).

According to Mischel, three key features are common in behavior therapy and they include the following:

Behavior therapy techniques seek to transform those behaviors that are considered a problem, the main focus of behavior therapy is the individual’s present behavior and not where the problems originate from, and the third is that it is mainly believed that by following normal behavior principles, deviant behavior can be understood and thereby transformed into acceptable behavior (Murdoch and Barker, 1991, p. 5).

Some of the methods used in behavior therapy include contingency management, cognitive behavior modification, and counter-conditioning therapy. Contingency management involves the use of rewards to patients to influence the direction of their behavior. In very limited cases, punishments may be used especially where the patients in question fail to adhere to the set rules and regulations. Counter conditioning involves invoking negative feelings towards a certain behavior that would normally elicit positive feelings from the patient. For example, if the patient enjoys taking alcohol, the therapy is applied in such a way as to invoke negativity towards alcohol. Cognitive behavior modification refers to the use of behavior therapy techniques that are aimed at changing or altering a person’s behavior and the way he/she reacts to certain situations through the use of positive stimulation and the extinction of negative behavior (Meichenbaum, 1977, p. 229).

Behavior Therapy about Angela’s Case

A person’s past experiences by and large affect the present behavior and this may be negative or positive. In Angela’s case, her experiences with her boyfriend and what she expected to amount from her previous relationship are affecting her present mental state. The fact that she has also not been able to find a job has further affected the way she views herself and as such, she has developed low self-esteem and thereby avoids interacting with people who she feels have accomplished their goals such as her brother, sister, and parents. These behaviors are a problem and as such should be changed to enable Angela to get back on track as far as her life is concerned.

Before moving back to her hometown, Angela worked in a different environment as a nurse as she used to perform her duties in peoples’ homes whereas in her hometown she would be required to perform these similar duties in a hospital, an environment she is not comfortable working in. As such she will have to deal with the anxiety she experiences when she is in a hospital setting. It is also important for the therapist to determine what Angela associates hospitals with as in most cases such fears and anxieties are a direct result of experiences that create associations between the object of anxiety and negative outcomes. For example, some people fear hospitals because they associate them with death.

Behavior Therapy Approach to Solving Angela’s Problem

To help Angela overcome her anxiety disorder, the behavioral therapies approach can be used.

Desensitization Method

One of the methods available in the systematic desensitization method where the patient is taught various skills on relaxation that help one reduce his/her anxiety levels when faced with a situation that elicits such anxiety (Hackney & Cormier, 2008, p. 246). Angela will be exposed to the hospital environment in a step-by-step manner which will eventually have the effect of helping her get rid of her anxiety or until she is comfortable enough to work in the hospital environment. The following steps are necessary to help Angela overcome her anxiety (Westbrook, Kennley, & Kirk, 2007, p. 179)

Relaxation Skills: According to Hackney and Cormier (2008, p. 246) learning relaxation skills involves training the patients on how to handle mental and muscular reactions that impact their stress levels. Angela will be trained on different relaxation skills that are specific to the kind of anxiety she experiences when she is in a hospital, and these skills will help her in eliminating her fears. After these skills are taught to her, she will be required to use them whenever she is in a hospital to elicit the expected reaction from her which in this case is the lack of fear and the ability to cope in the given environment.

Fear Hierarchy: Angela will then be helped to come up with a list highlighting the arrangement of her fears depending on the kind of exposure she has to a hospital setting. For example, the different levels of exposure will be used to practice her relaxation technique. For example, the therapist may drive her past a hospital and have her rate the level of fear she experiences during the drive-by. She may also be taken to a hospital compound and asked to rate her level of anxiety.

Coping Technique: This should take place after Angela has learned all the coping skills and it involves practical exposure to the environment that normally generates anxiety in her. After such continued exposure, she will realize that being in a hospital environment will not harm her and as such be able to cope when she is in a hospital. At this point, the fear will fade away.

Cognitive Behavior Therapy

To treat her depression, the therapist should apply cognitive behavior therapy as this is known to be the most effective method. This is because it offers supportive counseling to the affected individual and helps to cope with depression and the feelings associated with it (Corey, 1991, p. 9). It also transforms pessimism into optimism for the patient, helps the individual get rid of the unrealistic goals that have been set, and also avoids critical evaluations of him/herself that prolong depression and its consequences. For Angela, this will help her realize that there is little or no possibility for her former boyfriend to change his ways, and as such she is better off forgetting these expectations and letting go of the idea that they might get back together in the future. She will also be able to view herself in a positive light and as such come out of her depression and change the current state of affairs. Therapy will also enable her to sort out her problems and group them according to their relevance, which is whether they are minor or critical in her life. From the therapy, she will be able to come up with goals and objectives that will have a positive impact on her life thereby enabling her to see herself in a positive light. Cognitive therapy is also important in solving problems that lead to major stress in a person and as such depression. Angela will thus be helped by her therapist to come up with skills that will enable her to cope with her current situation and solve issues related to different relationships in her life such as those between her and her parents, siblings, and friends (Franklin, 2003, para. 1).

Contingency Management

Even though Angela is at the moment not using drugs or alcohol, measures should be taken to ensure that she does not revert to the original behavior. Here contingency management will work best as it will ensure she does not revert to her previous behavior of alcohol consumption and drug abuse behavior. Contingency management helps promote and encourage changes in persons as far as drug use is concerned as it discourages such behavior (Higgins, Silverman & Heil, 2008, p. 2)

Advantages and Disadvantages of the Behaviour Therapies Model

This model is chosen above the affective paradigms model as it focuses on the behavior of the individual with regards to the current prevailing situation and problems. Based on such current problems, the model can create optimism in the patient and get rid of the pessimism and as such the problems being experienced.

Behavior therapy is advantageous in that it can be used to treat patients with different psychological problems without the use of medication as it focuses on transforming their behavior using positive influences and rewards. This kind of therapy helps to get rid of the negativities individuals hold thereby enabling them to adopt a positive approach to life which helps accomplish individual goals and in maintaining positive relationships with people who matter.

One of the main disadvantages of behavioral therapy is the fact that it addresses the issues that the patient is experiencing at the specific time he/she goes for help and does not deal with the underlying causes of the problems being experienced. The therapy requires a lot of commitment especially on the part of the patients which is in most cases lacking thereby making it ineffective in the long run. This kind of therapy may also not apply to patients with complex and prolonged psychological problems.

Comparison and Contrast between Behavior Therapy and Affective Models

Behavior Therapy is based on the behavior of the individual and is based on the theory that different situations elicit different behaviors among people. Such behavior can be transformed from negative to positive through the rewarding process which should be maintained in the long run so that the acquired behavior may not fade away. The Affective model is based on the premise of the actualizing tendency which is said to account for all forms of behaviors in a person. This tendency shows that people can develop from one stage to another and as such shape who they become in the future.

Similarities and Differences in the Application of the Two Models

The two models follow specific steps that portray progressive development from one stage to another in which a person gets better and better. The two models have different techniques which are applied to the patient to achieve intended results. For example, behavior therapy has the contingency management technique, behavior modification, and counter-conditioning techniques among others whereas the affective model follows personal-centered techniques, gestalt, and experiential therapies among others. Both models focus on the present behavior and do not look into the history of the individual to determine the origin of their problems.

The two models are different in that behavior therapy focuses on specific attributes at hand and as such deals with those specific problems while the affective model focus on the whole person and as such seeks to change him/her as a whole.

Reference List

Corey, F. (1991). Theory and Practice of Counseling and Psychotherapy. California: Books/Cole Publishing Company.

Erwin, E. (1978). Behaviour Therapy: Scientific, Philosophical and Moral Foundations. New York: Cambridge University Press.

Franklin, D. (2003). Cognitive Therapy for Depression. Web.

Hackney, H.L. & Cormier, L.S. (2008) The Professional Counselor: A Process Guide To Helping. (6th Ed.) Massachusetts: Allyn and Bacon.

Higgins, S. T. Silverman, K. & Heil, H. S. (2008). Contingency Management in Substance Abuse Treatment. New York: The Guilford Publications, Inc.

Michenbaum, D. (1977). Cognitive Behaviour Modification: An Integrative Approach. New York: Plenum Press.

Murdoch, D. & Barker, P. (1991). Basic Behavior Therapy. Oxford: Blackwell Scientific Publications.

Westbrook, D. Kennley, H. & Kirk, J. (2007). An Introduction to Cognitive Behaviour Therapy: Skills and Applications. London: Sage Publications Limited.

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