EVALUATING the BEHAVIORAL & COGNITIVE MODELS of Therapy
There are several virtues of behavior therapy and cognitive therapy: they are effective in a number of discrete disorders; therapy is generally brief and inexpensive; they seem to be based on a science of behavioral and cognitive psychology; and their units of analysis, stimuli, responses, reinforcers, expectations, and attributions can be measured. Behavior and cognitive therapy, however, are not without problems. Perhaps the most serious allegation is that they are superficial.
Are humans more than just behavior and cognition? Are psychological disorders more than disordered action and disordered thinking? Must therapy, in order to be successful, do more than merely provide more adaptive actions and more rational ways of thinking? Because behavior therapists and cognitive therapists restrict themselves to an analysis of the discrete behaviors and cognitions of the human being, they miss the essence: that individuals are wholes, that individuals are free to choose. A phobic patient is more than a machine who happens to be afraid of cats. He is an individual whose symptoms are deeply rooted in his personality and psychodynamics.
Alternatively, he is an individual who has made bad choices but who can still choose health. An autistic child who treats other human beings as if they were pieces of furniture may be taught by behaviorists to hug other people in
order to receive food or to escape from shock. But in the end, all we have is an autistic child who hugs people. Merely changing how one behaves fails to change the underlying disorder.
Those who object to the behavioral and cognitive theories feel that there are deeper disorders that produce symptoms. Because of this, seemingly superficial behavioral change may be short-lived, as in the case of what had been highly successful behavioral treatments of obesity. After one year and three years, obese individuals who had undergone behavior therapy had kept their weight down. But after five years, their weight returned.
Although behavior therapy had led to change by removing the symptom of obesity, the underlying problem remained and ultimately sabotaged the therapy.
How might behavioral and cognitive therapists respond to these charges of superficiality? A militant response might be to deny the concept of the "whole person." To radical behaviorists such a concept is romantic; it
makes sense in literature arid in poetry, but not for human beings in distress and in need of relief. We would make a less militant reply. Removing symptoms-either behavioral or cognitive-at least helps. Symptom substitution
has rarely, if ever, followed successful behavioral or cognitive therapy.
Some disorders are highly specific, peripheral to the heart of an individual's being and amenable to behavioral and cognitive therapies.
Eating Disorders, Phobias, obsessions, stuttering, and some sexual problems are such disorders.
On the other hand, there may be deeper disorders left untouched by behavior and cognitive therapy: schizophrenia and psychopathy, perhaps.
For these disorders, change of personality, uncovering dynamics, and drugs are probably necessary.
We believe that human misery, including problems of psychological disorder, is sometimes but not always, produced by an unfortunate set of environmental circumstances or by distorted cognition. To counteract such circumstances by applying behavioral and cognitive laws does not diminish or devalue human wholeness or freedom, but rather enlarges it. An individual who is so crippled by a phobia of leaving his apartment that he cannot work or see those he loves, is not free. By applying behavioral and cognitive therapy to such an individual, one can remove this phobia. Such an individual will then be free to lead a rational life.
If you are serious about changing,
I encourage you to schedule a FREE CONSULTATION with the treatment method I recommend:
http://www.theliberatormethod.com/Welcome.html
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NOTES:
I encourage you to schedule a FREE CONSULTATION with the treatment method I recommend:
http://www.theliberatormethod.com/Welcome.html
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NOTES:
Acronyms
AN: see Anorexia nervosa
ADD see Attention deficit disorder
ADHD see Attention deficit hyperactivity disorder
BDD: see Body Dysmorphic Disorder
BED: see Binge eating disorder
BMI: see Body Mass Index
BMR: see Metabolic Rate
BN: see Bulimia nervosa
BPD: see Borderline personality disorder
BSFT: see Behavioral Systems Family Therapy
CBT: see Cognitive behavioral therapy
CBT-E: see Enhanced Cognitive behavioral therapy
CRT: see Cognitive remediation therapy
CFT: see Conjoint family therapy
CFS: see Chronic fatigue syndrome
COE: see Compulsive Over-eating disorder
CW: Current weight
DBT: see Dialectical Behavior Therapy
ED: see Eating disorder
EDNOS: see Eating disorder not otherwise specified
FGW: Final goal weight
GW: Goal Weight
HW: Highest weight
IBW: see ideal body weight
IP: see Inpatient hospital treatment
IOP: see Hospital based outpatient treatment
IT: see Interpersonal Therapy
LTGW: Long term goal weight
LW: Lowest weight
MET: see Motivational enhancement therapy
MFDT: see Multiple-Family Day Treatment
MFT: see Multifamily therapy
NES: see Night eating syndrome
NG : see Nasogastric feeding
OCD: see Obsessive-compulsive disorder
PHP: see Partial hospitalization program
RC: Residential Care
RAN: Recovered anorexic patient
RBN: Recovered bulimic patient
SI: see Self injury
SIB: see Self Injurious Behavior
SFT: see Separated Family Therapy
SSRI: see Selective Serotonin Reuptake Inhibitor
STGW: Short term goal weight.
TB: see Targeted Behavior
TW: see Target weight
AN: see Anorexia nervosa
ADD see Attention deficit disorder
ADHD see Attention deficit hyperactivity disorder
BDD: see Body Dysmorphic Disorder
BED: see Binge eating disorder
BMI: see Body Mass Index
BMR: see Metabolic Rate
BN: see Bulimia nervosa
BPD: see Borderline personality disorder
BSFT: see Behavioral Systems Family Therapy
CBT: see Cognitive behavioral therapy
CBT-E: see Enhanced Cognitive behavioral therapy
CRT: see Cognitive remediation therapy
CFT: see Conjoint family therapy
CFS: see Chronic fatigue syndrome
COE: see Compulsive Over-eating disorder
CW: Current weight
DBT: see Dialectical Behavior Therapy
ED: see Eating disorder
EDNOS: see Eating disorder not otherwise specified
FGW: Final goal weight
GW: Goal Weight
HW: Highest weight
IBW: see ideal body weight
IP: see Inpatient hospital treatment
IOP: see Hospital based outpatient treatment
IT: see Interpersonal Therapy
LTGW: Long term goal weight
LW: Lowest weight
MET: see Motivational enhancement therapy
MFDT: see Multiple-Family Day Treatment
MFT: see Multifamily therapy
NES: see Night eating syndrome
NG : see Nasogastric feeding
OCD: see Obsessive-compulsive disorder
PHP: see Partial hospitalization program
RC: Residential Care
RAN: Recovered anorexic patient
RBN: Recovered bulimic patient
SI: see Self injury
SIB: see Self Injurious Behavior
SFT: see Separated Family Therapy
SSRI: see Selective Serotonin Reuptake Inhibitor
STGW: Short term goal weight.
TB: see Targeted Behavior
TW: see Target weight