Comparison of Cognitive Behavioural Therapy and Family Therapy in Social Work

This essay compares Cognitive Behavioural Therapy and Family Therapy in Social Work, highlighting their advantages and disadvantages. It also applies CBT to a case study and discusses the relevance of counseling skills to social work.

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Contents
Introduction......................................................................................................................................3
Two counseling approaches.............................................................................................................3
Behavioural approach......................................................................................................................3
Humanistic approach.......................................................................................................................4
Relevance of the use of counseling skills to social work................................................................8
References......................................................................................................................................10

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Introduction
The theory of psychotherapy theories gives a framework for counselors and therapists to define
the feelings, behavior and thoughts of the client and facilitate them to find a way the journey of
client from analysis to post-treatment. This essay will highlight the two counseling approaches
and make a comparison between them in an appropriate manner. The advantages and
disadvantages of each counseling approach will be mentioned in this essay. The case study will
be considered to apply the counseling approach on them in order to bring a better understanding.
After that, one of the counseling approaches in the context of the case study will be demonstrated
under this assignment. At last, the relevance of the use of counseling skills to social work will be
elaborated effectively.
Two counselling approaches
The two counselling approach of Cognitive Behaviourial therapy and family therapy of
counselling are mentioned below with advantages and disadvantages in the relation of the
selected case study.
Cognitive Behavioural therapy (CBT)
CBT is considered as the behaviour therapy that can facilitate the company to manage the issues
by amending the way of others’ thinking and behave. The main aim of this therapy is to deal
with overwhelming issues in a more effective manner by breaking them down into tiny parts.
The focus of this approach is on behavior- amending undesired behavior by reinforcements,
rewards and desensitization.

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The key concept of the CBT is on the focus is on explicit behaviour, improvement of certain
treatment plans, and aim to analyze the evaluation of the outcome therapy. CBT is effective
approach of counselling that is applicable for all ages, involving children, adults and adolescents.
It is the approach that facilitates in getting number of benefits such as anxiety disorders, eating
disorders, depressive disorders and obsessive compulsive disorders. CBT can be provided by
online and through face to face therapy sessions. There are 9 tools of CBT that facilitate in
providing better therapy to people. These includes journaling, unravelling cognitive distortions,
cognitive restructuring, Exposure and Response Prevention, Interoceptive Exposure, Nightmare
Exposure and Rescripting, Play the Script Until the End, Progressive Muscle Relaxation (PMR)
and Relaxed Breathing. These tools have significant benefits in the context of allowing people to
communicate their emotional without getting hesitated (CBT clinic, 2019).
CBT would be helpful in increasing the attention of the client towards problem and reinforce
them to take initiative in resolving the issues as soon as possible. The counsellors of this
behaviour theory uses the skills of listening and reflection, but rather than consider them as a
process of defining clarification about their thought and feelings of the client, the skills are
considered by the counsellor to entail all factors relating to the unwanted behaviour.
With respect to the advantages of Cognitive behaviour approach, it shall be noted that it is the
realistic approach which is relied on the empirical validations of outcome. CBT has benefits in
various terms and well suited in some problems such as depression, sexual disorders, phobic
disorders, children’s behavioral disorders, and stuttering. The advantage of this therapy is to
Focuses on re-training of the clients’ thoughts and altering their behaviours, in order to make
changes to how you feel (Claes, 2017).

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In the context of the case study, it has been found that the CBT of counselling is helpful in
understanding the behaviour of Lelia because she had to face a number of difficulties since her
marriage. It has been found that James dominated Lelai emotionally, and sometimes physically.
She got disappointed due to external marital affair of his husband. The life of Lelai is full of
struggle as she is struggling since her birth. With the help of this approach, the behaviour of
Lelai can be determined towards their children and husband so that messed things can be sorted.
On the other hand, CBT has disadvantages as well because the main focus of this approach on
the capacity of individual to change themselves, and does not tend to focus on huge issues in
families that have significant impact on individual’s health and well being (Wilson, 2018). By
taking consideration of the case study, it can be said that this approach would be not beneficial
for warren’s case. Warren is refusing to go to school without saying the reason behind this. His
parents forced them to do the same but he is unhappy and cries frequently. This theory is not
approachable in the case of warren as it fails to focus on fundamental reasons such as what
occurs in the mind of human. This approach is narrow as well as deterministic.
Family therapy
Family system therapy is a form of psychotherapy that facilitates individuals to handle their
issues with respect to their family units, where number of concerns is likely to start (Williams,
Foye and Lewis, 2016). The main focus of this therapy is to force each family member to work
together, to get better understanding regarding the group dynamics. It makes them feel that how
each family person’s behave has significant impact on others’ behaviour in the family

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(Minuchin, 2017). There are numerous forms of family therapy that are relied on the family
systems theory. There are some categories in which family system approaches usually fall.
 Structural family therapy
This therapy was formulated by Salvador Minuchin. The main focus of this therapy is to
evaluate the structure of the family by relationships, patterns and behaviour among family
members. The role of therapists is huge under this therapy in which they prefer role play in
order to examine subsystems within the structure of the family (Colapinto, 2015).
 Strategic family therapy
This therapy was developed by Jay Haley, Milton Erickson, and Cloe Madanes, who
investigates the processes and activities of the family, such as problem solving patterns and
activities, like problem solving patterns, by focusing family behaviour outside the therapy
session. Strategic family therapists consider revolutionize can occur swiftly, without
exhaustive analysis of the basis of the difficulty.
 Intergenerational family therapy
It is the therapy that acknowledges generational impact on individual behaviour as well as
whole family. It helps in recognizing the multigenerational behavioural patterns can
facilitate people look how their ongoing issues can be rooted in earlier generations
(Fishman, 2017). This theory include some techniques in order to resolve the issue by
elaborating the reactions of individual family members in spite of reactive over them, and
motivating members of the family to answer with “I” statements instead of using harsh
statements.

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The advantages of a Family Therapy approach in the context of the case study that it amplifies
emphatic understanding of the frame of the client for subjective experience. It is the approaches
that respect the value of thoughts of each member of the family and allow them to speak up
about their issues (Pybis, Cooper, Hill, Cromarty, Levesley, Murdoch and Turner, 2015). The
benefit of this theory in the context of case study is that the family projection process of a
relationship difficulties, emotional concerns and anxiety to the child within the emotional
triangle. With the help of this therapy, the parents can focus on anxiety on the child (warren) and,
when Warren responds on the same in turn, can either try to “fix” these issues with the help of
professionals. Also, it enables people to let go of the emotions that put negative impact over
them (Lancaster and Stead, 2017). As per case study, it has been found that the behaviour of
Warren is different in comparison of another child; it seems that it got affected due to less
attention of his father towards his behaviour as he always shouted at Warren without considering
his fondness. With the help of this theory, the behaviour of warren can be improved along with
his father James.
Every coin has two aspects that present negative and positive factors, same goes with the
approach of the Family therapy of counselling. It has some disadvantages as well because when
children depend on the parent, they increase problems for them which cannot be fixed on urgent
basis. It has been argued by some mental health experts that due to remain unaffected and
neutral, practioners of family system therapy can be providing approach endorsement to
destructive behaviour of individual in therapy which can be revealing themselves (Krause, 2018).
In the context of the case study, it has been evaluated that Lelai, Warren and James are facing the
issue in understanding the behaviour of each other. This theory would not be helpful for in case
because it is seemingly unwavering neutrality of its practitioners.

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Apply one counselling approach on a case study
In the context of the case study, CBT can be considered as it is helpful in determining the
behaviour of the individual in the context of his daily life. Above-mentioned techniques of CBT
are helpful in making better position of the family of James so that one can co-operate each
other. The cognitive theory is useful for the case study as it is clinically examined that it is one of
the most effective means of handling with depression and anxiety (Neenan and Palmer, 2018).
This approach is affordable by the counsellors and can last for six sessions of one hour and can
be completed in the range of 10-20 sessions (Scott, 2015). It is different approach and has
exclusively nature that is differ from medication. There are no any issues and side effects from
medications. It is highly structured approach that involves the patient and counsellors co-
operating the aim of treatment that time limited, obtainable, flexible and real.
The main focus of this theory is on behaviour instead of feelings which is compatible with many
cultures. Strengths involve a combined bonding between client and counsellor in completing the
task towards constant assessment to decide if the strategies are compatible with unique situation
of the client. It has been found in the case study that the behaviour of warren and Lelia is
different from others as they get afraid and do not speak up. Cognitive behavioural theory is
generally used to develop huge range of disorders entailing depression, anxiety and phobias
(Trower, Jones and Dryden, 2015). It is the theory that has short term range in dealing with
people with a specific issue. This theory has some characteristics as well which would be helpful
in applying the case study. Cognitive behavioural theory is based on the model of emotional
response that represents the idea regarding situations, causes and people. It is time limited
approach from which it would be helpful for the counsellors to understand at the very beginning

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of the therapy process that it is the point over there, formal therapy will finish (Cowie and
Pecherek, 2017).
By applying this theory on the family of James, it can be stated that this would be helpful in
analysing the behaviour of Lelai and Warren as these two personalities are introvert and
emotionally weak, from which they have to suffer a lot in their life. In the context of Warren it
has been analyzed that he was the first child of James and Lelai. He got pampered from her
mother in depth manner and suddenly after the birth of Mhairi, the attention of his mother got
diverted towards Mhairi. According to this theory, it has been found that Warren’s nature is
attention seeker and he wants his mother to back with same nature when she used to pamper him.
He denied going school because he does not want to go far from his mother and over pressure on
them by his parents demotivate them. It is necessary for the family to keep concern on such
scene as it can be problematic for Warren to live his life without stress. It has been found in the
context of Mhairi that she is closed to Warren and share about her mother characteristics. It
shows that they can see the ongoing issue with her mother in the family and her situation affect
the behaviour of Warren. According to the cognitive behaviour theory, the mother should focus
on over care to warren and acknowledges his issues patiently (Rowan, 2016). However, child for
every mother has kept equal position but in Warren’s case, it is necessary for her to have a look
at this concern proactively and support him enthusiastically.
The ethical dilemma can be seen here because when Lelai starts to give better care to Warren, it
can be problematic for another child. It is the ethical dilemma for Lelai as the decision for one
child can bring the problematic situation for her as well in the context of Mhiari and Susie. It has
been found in the case study that Warren is not well and returns home mid-morning complaining
of being unwell. His mother thinks he should see a doctor for his "problem" and his father tried

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to get Warren interested in his favourite pursuits, football, shooting and fishing, and was angry
when Warren showed little liking for any of them. Along with that, his father shouted at him
when Warren got influenced by his uncle Gordon, whose interest in books. The nature of Gordon
with the family of James is gentle and Warren and his mother like him, but James had a difficult
relationship with him. James’s mother had been ailing following a number of strokes lately and
is now confined to bed. Her care could not be considered at home but James insisted his wife to
take care of her at home only. For this kind of behaviour, cognitive behaviour theory can be
applied as it is directive and structured. This theory will let James know about the right treatment
of her mother so that she gets well soon. After that, Lelai would be able to give proper time to
her children. In the context of Warren, it has been found that Warren started to think that he did
not like by his father. Warren needs special care from his parents but the potential ethical
dilemma can be taken place in such case because it would be hard for James to change his
behaviour toward Warren.
With respect to address the ethical dilemma in relation to social work practice, the theory of
cognitive behaviour therapy would be taken as the main focus of this therapy is on the bonding
between feelings, behaviours and thoughts. To address the potential ethical dilemma as
mentioned above, this theory can be helpful in making changes in the behaviour of Warren’s
parent towards him so that he get special attention from his parents. In the context of addressing
ethical dilemma, it has been found that Lelai is too conservative and it is necessary for her to
speak up. She already suffered many issues in her life since birth. There are various techniques
of the therapy such as cognitive, behavioural technique and diverse methods of changing the
behaviour. There can be another technique as well such as debating irrational beliefs, engaging in
Socratic dialogue and keeping a record of activities that would be helpful in bringing change in

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the behaviour of James and Lelai that put automatically impact over the behaviour of Warren and
he could be normal further.

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Relevance of the use of counseling skills to social work
There is a lot of confusion regarding the adaptability and meaning of counseling in the term of
social work. Monopoly is not there in the context of social workers in counseling. There is a
difference between the counseling and social work because the main focus of counselor is to help
individuals and families who are facing specific issues and need treatment for the same. On the
other hand, the role of the social workers is to provide a huge range of services within huge
social service systems. The process of counseling relies on the exchange of emotions between
the client and the counselor whose objectives are to develop an alliance (Nelson-Jones, 2013). It
includes the counselor utilizing skills in which they enjoy in terms of communicating effectively
with clients. The use of counseling skills to social work keeps significant value as it is helpful in
increasing the motivation of the client in describing his issue in front of counselor. The
counseling skills consist basic empathy, listening, integrating communication skills, goal setting,
genuineness, summarizing and questioning (Sue, Sue and Corey, 2011).
The role of the counseling skills plays a crucial role in this. Communication and counseling skills
are taken into consideration everyday to develop such bonding for the purpose of working to
happen. All processes of social work such as planning, intervention, assessment, interviewing
and evaluations, get positioned in the reference of meeting people, their anxiety and their life
issues (Miller, 2011). The depth of the issues and quality of what occurs depends hugely on
conversations between people. Bad services are frequently ticked by conflict and argumentative
relations between their workers and families. Quality services depend on the capability to
develop co-operative partnership where service users and social workers participate together.
Booysenm and Staniforth, (2017), highlights that social workers require some counseling skills

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to capably interact and competently engage with clients. Further, it depicts by Kabir (2017), that
communication has significant social work skills that employ in the shared evaluation of
emotions, thoughts and beliefs in the process of helping goal change and attainment.
Mheducation, (e.d.), elaborate the micro skills as non-verbal and verbal communication with
others. The micro skills concerned with this framework including responding, empathy,
reflecting and paraphrasing. It is necessary for social workers to have micro skills in dealing with
clients. Social work can be accomplished in an effective manner with counseling skills.
Counselors and social workers both have same tendency to satisfy individuals in adjusting the
change in life circumstances or develop new opportunities and resources (Northern Western,
2015). Social work refers those activities that are helpful in increasing social functioning and
entire well-being. The use of counseling approach to social work is necessary as without having
micro skills, one cannot be successful in bringing change in the behaviour of individual. It is
necessary that social workers take responsibility for improving those skills which help them to
develop relationships (Culley and Bond, 2011).
It can be concluded from above discussion that there is a significant value of the counseling
theories in entertaining the issue of individual or family. For this essay, the case study of Jackson
family has been considered. The two approaches of counseling such as CBT and Family therapy
approaches have been elaborated under the assignment. CBT approach has been applied to the
case study in which a potential ethical dilemma is also defined. At last, the discussion has been
made on the relevancy of the counselling approach in social work practices.

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Claes, B., 2017. Play In Family Therapy /Play Therapy With Children And Adolescents In Crisis
/Short-Term Play Therapy For Children. Journal of Psychology and Christianity, 36(1), p.88.
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Fishman, H.C., 2017. Treating troubled adolescents: A family therapy approach. Routledge.
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Minuchin, S., 2017. 7 The Inquiries of Salvador Minuchin, John Sigal and Marie-Anik
Gagné. Trauma, Shame, and Secret Making: Being a Family Without a Narrative.
Williams, N.D., Foye, A. and Lewis, F., 2016. Applying structural family therapy in the
changing context of the modern African American single mother. Journal of Feminist Family
Therapy, 28(1), pp.30-47.
Wilson, J., 2018. Child-focused practice: A collaborative systemic approach. Routledge.
Claes, B., 2017. Play In Family Therapy /Play Therapy With Children And Adolescents In Crisis
/Short-Term Play Therapy For Children. Journal of Psychology and Christianity, 36(1), p.88.

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