| Personal Theory of Counseling:Applying Cognitive Therapy to the Case of Donetta | | | Background
The theory of cognitive therapy resonates with me because of my personal belief in the power of the mind. It is my opinion that without the process of changing mindset, behaviors will not change. The mind has control over every single action and tells your entire being how to respond in every single situation.
As stated in the Corey (2009) text, I believe that people with emotional difficulties often times tend to “commit characteristic logical errors that tilt objective reality in the direction of self-deprecation” (p. 288). Through my own therapy experience I came to understand the connection between my thinking, my feelings and my actions. I learned to identify distorted thinking, engage in realistic thinking, and to employ problem-solving and coping skills. This method helped me through my own difficult times and therefore I know it works and would like to help others through its use.
View of Human Nature

People possess faulty beliefs and maladaptive information processing (automatic thoughts) which can lead to cognitive distortions and depression (Chadwick, 1994). In cognitive therapy clients learn to identify these distorted cognitions through evaluation. Corey states (2009) that once clients gain insight into how these unrealistically negative thoughts affect them, their feelings, and behaviors; they can begin to “use their automatic thoughts to reach the core schemata and then begin to introduce the idea of schema restructuring” thus easing the depression (p. 288).

Key Tenets
Cognitive therapy is based on three tenets: (1) you feel the way you think, (2) thoughts are dominated by a pervasive negativity, and (3) negative thoughts related to depression are almost always irrational and distorted. Therapy includes the recognition and identification of these negative thoughts (automatic thoughts) and the type of cognitive distortion they represent. Another major principle of cognitive therapy is in relation to our schema or core beliefs. The way we feel about things such as love, acceptance, perfectionism, etc. affects our perceptions of our world (Burns, 1980).
Therapeutic Goals

The primary goal of cognitive therapy is to uncover the underlying assumptions that predispose symptoms of depression, anxiety, and anger. Once insight is gained into these negative thoughts, clients can begin to work toward changing the way they think. Other goals include providing symptom relief, assisting clients in resolving their present problems, and teaching clients relapse prevention strategies (Corey, 2009).

Client-Therapist Relationship
The quality of the therapeutic relationship is basic to the application of cognitive therapy. Corey (2009) believes that an emphasis should be placed on therapists’ ability have a “cognitive conceptualization of cases, be creative and active, be able to engage clients through a process of Socratic questioning, and be knowledgeable and skilled in the use of cognitive and behavioral strategies aimed at guiding clients in significant self-discoveries that will lead to change (p. 291). There must be a warm, empathic relationship as well as the use of cognitive therapy techniques that will enable clients to change their thinking, feeling, and behavior.

There is a partnership in that therapists educate clients about the nature and course of their problem, the process of cognitive therapy, and how thoughts influence their emotions and behaviors. This education process can be through bibliotherapy and/or homework which serves as self- help and a continuation of issues addressed therapy sessions.
Techniques and Methods

Mindfulness-Based Cognitive Therapy (MBCT) is one method that focuses on helping those suffering from depression and/or anxiety to relate to their experience in a new way (Segal et al., 2002). Segal et al. (2002) further explain that this approach helps clients “recognize and disengage from mind states characterized by self-perpetuating patterns of ruminative, negative thoughts” (p. 75). In MBCT clients are taught to become aware of mood swings enabling them to decenter from patterns of depressive thinking activated by sad moods (Hathaway et al, 2009).

Socratic questioning is a technique often used in cognitive therapy. It involves the use of provocative questions to challenge clients’ underlying beliefs about themselves. Edleman (2002) provides the following examples of Socratic questions: what are facts and what are perceptions, what evidence supports or contradicts perceptions, are there any cognitive distortions, and how else can I view or perceive this situation. This type of questioning helps challenge negative thoughts, provides a healthier perspective on problems, and trains the mind to think differently.

Application
The therapeutic approach will focus on the dysfunctional thinking which is the core of the symptoms of depression. The therapist will take the lead with helping clients set priorities and develop a realistic plan of action. The client will be probed with Socratic questioning and cognitive rehearsal techniques used to identify and change the negative thoughts. In other words, clients will learn to combat their self-doubts during therapy sessions and then apply their newly acquired skills in real-life situations (Corey, 2009).

There will also be the use of the mindfulness technique in which the client will practice becoming more aware of bodily sensations, focusing on breathing as an anchor. The principle of acceptance will be taught to alleviate judgmental thoughts. By applying non-judgment and acceptance of thoughts and feelings, a client will become more mindful in the moment and be able to identify other behaviors to engage in other than acting out of emotions (Hathaway et al, 2009).
Multicultural Perspectives

Cognitive therapy lends itself to multicultural applications in that it places an emphasis on the individual and tailoring the therapy to the particular situation of the client. Additionally, there is a focus on client empowerment. Clients are in control of their thoughts and emotions and therefore able to make changes themselves. This respect for the clients contributes to the creation of a collaborative relationship in which individual and cultural differences are appreciated rather than negated.
Limitations

Cognitive therapy has been criticized for too much focus on the power of positive thinking; being too superficial; denying the importance of the client’s past; and being too technique oriented. These myths and misconceptions have been debunked and while there are limitations, it remains one of the most efficacious and well-researched modalities in existence (Corey, 2009).

Case of Donetta
Donetta is a 36-year-old twice divorced female. She is currently in a relationship with Steven and they have been together for about a year. Donetta has come to counseling with multiple concerns. She feels tired and lethargic most of the time and simply does not enjoy her life as she once did. In her relationship with Steven, she feels that he ignores her and puts everything else first, and only stays with her because it’s familiar and comfortable. She loves Steven but is not sure she wants to stay in the relationship due to her lack of trust (even though she has no reason not to trust him). Her goal is to develop a positive self-esteem and to work through feelings of depression and despair.

Social History: Donetta was married at age 27 to her first husband (Troy) of which they were married for 6 years. She divorced Troy because she felt bored and unfulfilled in the marriage. (Troy was paralyzed from the chest down when they married) She then remarried three years later to Mark who was verbally, mentally, sexually, and physically abusive. She dealt with the abuse for about a year before running away with nothing but the clothes on her back. She is now in the process of rebuilding her life and regaining her independence.
Family History: Donetta grew up in a two parent home with her mother and stepfather and four siblings. She is the oldest. Donetta feels she is the black sheep of the family and that she must deal with her challenges and problems in life on her own.
Occupational/Educational History: Donetta has both a Bachelor’s and a Master’s degree. She has done well in her career as an educator but now feels the zeal and zest she once possessed has been somewhat extinguished. She’s not sure what exactly she would like to do with her remaining years but has thought a lot about a career change. She is interested in Social Work and would like to work with youth and the elderly.

References
Burns, David D. (1980). Feeling Good: The New Mood Therapy. New York, NY: New American Library.

Chadwick, Paul D.J. (1994). Examining Specific Cognitive Change in Cognitive Therapy for Depression: A Controlled Case Experiment. Journal of Cognitive Psychotherapy, 8(1), 19-31.

Corey, G. (2009). Theory and Practice of Counseling and Psychotherapy. Belmont, CA: Brooks/ Cole.

Edleman, S. (2002). Change Your Thinking. Cambridge: Marlowe & Co.

Hathaway, W. (2009). Religiously Oriented Mindfulness-Based Cognitive Therapy. Journal of Clinical Psychology, 65(2), 158-171.

Segal, Z. V.; Williams, M. G.; & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Theory for Depression: A New Approach to Preventing Relapse. New York, NY: Gulliford Press.