The literature review of this study is a comprehensive review of Psychodynamic therapy and Cognitive Behavioral Therapy. The literature will involve empirical support, description of the available treatment, theoretical aspects as well as historical perspectives of these therapies. The research concurs with the conclusion that CBT is an adequate treatment modality for minimizing symptoms and boosting functional results among the patients with psychodynamic therapy. Thus, makes it a vital framework for clinicians working with clients with psychodynamic symptomology.
The cognitive behavioral theory was developed by Aaron Beck in 1960. Currently, this theory is one of the most frequently used forms of psychotherapy. The cognitive theory centers on helping people to learn how their personal thoughts shape and can their behaviors and feelings. In essence, it is normally time-limited and goal-oriented as practiced by a number of psychotherapists both in the U.S and globally. On the other hand, the psychodynamic therapy which also referred to as insight-oriented therapy, stresses on unconscious processes manifested in an individual's present behavior. Precisely, the core goals of psychodynamic therapy include a client's understanding and self-awareness of the impacts of the past on the present behaviors. In short, a psychodynamic technique allows the client to assess unsolved conflicts as well as the symptoms that emerge from the previous dysfunctional relationship. In this regard, they manifest themselves in the desire and in the need to abuse substances. Cognitive behavioral theory can be depicted by a combination of behavioral therapy and psychotherapy. Psychotherapy focuses on the significance of the personal meaning that people place on some things and how the thinking patterns start in childhood. Thus, behavioral therapy takes the relations between thoughts, problems and behavior into consideration.
Cognitive Behavioral Therapy, as developed by Beck, suggests that information found in the human brain is well organized in particular patterns simply called schemata. Beck opted to call Cognitive therapy due to the significance it places on thinking. In addition, it referred to as cognitive behavioral therapy because of the therapy utilizes behavioral approaches as well. The balance that exists between the behavioral and cognitive elements is comparatively different from different therapies of this kind, but all are termed as cognitive behavioral therapy (Sassaroli & Ruggiero, 2010). Since its development, cognitive behavioral therapy has encountered successful scientific trials in various places by distinct teams and has been employed in a broad variety of problems. These patterns comprise of general knowledge concerning the world as well the person itself. As such, the organized schemata are used to reduce, select and interpret information. Basing on the theory of Cognitive theory, mental disorders arise from the dysfunctional thought of schemata. Often, dysfunctional schemata illustrate themselves in dysfunctional and logical errors giving rise to all behavioral and emotional problems. According to Beck, depressive disorders, and general thinking is preoccupied with hopelessness and hopelessness. The depressive schemata are associated thoughts regarding an individual's guilt and worthlessness, the world's future desperateness, and injustice. Primarily, Beck asserts that Cognitive theory focuses on identifying and correcting the automatic negative thought. In addition, the theory aims at correcting errors, changing the schemata thus enhancing the depressive symptoms.
Historically, the cognitive behavioral adaptations can be viewed to have originated through the convergence of distinct historical factors. The first was the realization emerging in the 1950s that the old theories could not account for human behaviors. The onset of the theory was influenced by various psychologists. These psychologists include Kelly’s (1955) psychology of personal constructs, Mischel’s (1972) on delayed gratification and Bandura’s (1969) work on vicarious learning. These people influenced the development of cognitive behavioral therapy. Another key factor that initiated the formulation of this theory is psychotherapy which is drawn from the increased number of scientific investigations of the therapy efficacy and psychoanalytic theory (Rush, 1982). Nonetheless, these theories appeared not to take into consideration important issues. For that matter, lack of empirical support resulted in some practitioners to shift away and develop rational options. The final key historical impact of the occurrence of cognitive behavioral approaches to psychotherapy was the work of Beck. Despite the fact that it is historically noted that cognitive behavioral therapy and theory is known to have developed from traditional behavior, it should not be overlooked. Beck’s decision to oppose psychoanalysis was relatively significant during to the prevailing prototype those days.
In most cases, Cognitive behavioral therapy is utilized to help treat a broad range of issues in an individual's life, right from sleeping difficulties and drug, as well as drug abuse. Others include relationship problems and personal issues that can cause disturbances in one's mind. CBT functions by changing people's behavior's and attitudes by focusing on the images, attitudes and thoughts that holds and how it relates to the manner in which people behave as one way of dealing with emotional problems.
It is important to note that one of the existing advantages of cognitive behavioral therapy is that it inclines to be short. It takes four to seven for most emotional issues. It is recommended for clients to attend about one session week with each session taking about 50 minutes. At this time, the therapist and the client work together to comprehend what the problems are and to create a new strategy for handling them. As such, it is the role of CBT to introduce them to a set of basic concepts that they can apply anytime they need.
On its part, psychodynamic therapy has originated from psychoanalytic theory. It has been clinically utilized to a broad range of psychological disorders. There is a body of extensive study that generally concurs with the efficacy of these approaches. Psychodynamic therapy is regarded as the oldest modern theories. Therefore, it is grounded in a highly multifaceted and developed theory of human interaction and development. The theory that supports psychodynamic therapy emerged from and is specifically informed by psychoanalytic theory. Virtually, there are four core schools of psychoanalytic theory. Each of the schools of thought has impacted psychoanalytic in one way or another. The four schools include; Ego psychology, object relations, Freudian, and Self psychology (Leahy, 2004). To be more specific, Freudian psychology is grounded on the theories that were first formulated by Sigmund Freud. Freud developed this theory during the early years of the 20th century. This theory is also referred to as the structural model. The significance of Freud's theory is that aggressive energies and sexual energies which has its genesis in the id and are modulated by ego. Indeed, these are a set of activities that moderates between external reality and id. In the same note, defense mechanisms are structures of the ego that function to reduce pain as well as to maintain psychic equilibrium. It is also noted that the superego created during latency starting from 5 and puberty drives to regulate id forces through guilt.
Essentially, Ego psychology is drawn from the Freudian psychology. Its exponents center their work on maintaining and enhancing ego function according with the demands of reality. Ego psychology emphasizes the one’s capacity for defense, reality testing, and adaptation. On the other hand, Object Relations psychology was first expressed by a number of British analysts such as Harry Guntrip, Klein Melanie, Winnicott, and Fairbairn (Leahy, 1996). Basing on this theory, human kind is shaped in relation to their surroundings. People’s goals and struggles in life aim at maintaining relations with their colleagues, whereas on the other hand differentiating themselves with others. The representation of others and self internally acquired since childhood are later expressed in the adult relations. In this respect, it is noted that individuals repeat old object relations in an attempt to master them and therefore becoming freed from them.
Self-Psychology was developed by Heinz Kohut in 1950s, in Chicago. Kohut noted that the self illustrates an individual’s view of their experience according to the establishment of the differentiations and boundaries of self from other people (Leahy, 1996). Of note, each of the four schools of psychoanalytic theory puts forth discrete theories of psychopathology formation, and personality formation. Thus; psychodynamic therapy is differentiated from psychoanalysis in many particulars involving the fact that psychodynamic therapy does not need to include all analytic approaches but it is not conducted by trained analyst.
The change and healing process envisioned in the long-term psychodynamic therapy classically needs not less than two years of sessions. This is because to the fact that the key objective of therapy is to change an aspect of personal identity or personality to incorporate core developmental learning that were skipped during the patient at an earlier phase of emotional development. Often, the practitioners of psychodynamic therapy hold that some can occur through a more prompt process or that an initial brief intervention will begin an ongoing process that does not involve a therapist. The main point to consider in short therapy is that should be a single main focus for the therapy instead of the more traditional psychoanalytic practice. In this case, in a brief therapy the main focus is developed during the initial process of evaluation.
The therapeutic relationship is a focal aspect of psychodynamic therapy as it illustrates the way in which the affected person interacts with their colleagues. The cognitive behavioral therapy is to change an individual’s habitual ways of processing forms of information in order to reduce the client’s general bias towards certain interpretations and attributions. These are associated with phobic, depressive as well as re-evaluating the client’s basic beliefs. The emphasis of cognitive mechanisms to influence behavioral change is the primary difference between the cognitive-behavioral techniques to therapy. Cognitive behavioral therapy is based on a theory not just events but the meaning that people give. It is postulated that if the thoughts of an individual are negative, then can block them from seeing doing or seeing things that cannot fit them.
Scientific studies and researches of CBT have established its importance for a broad variety of mental illness including anxiety disorders, mood disorders, eating disorders, psychotic disorders, and personality disorders. According to studies, CBT changes the brain activity especially for people with mental illness receiving this treatment indicating that the brain is registering some improvements in terms of how it functions (Gilson, 2009). Moreover, CBT has been illustrated to be important antidepressant medications for some people with depression. And as such it might be superior in attempting to prevent relapse of symptoms. The clients receiving CBT for depression are recommended to plan positive activities into their day-to-day calendars so as to maximize the amount of pleasure experience.
There are distinct differences between Cognitive behavioral therapy and psychodynamic therapy. The main aspect that distinguishes the two forms of therapies is the nature of their focus. As a matter of fact, CBT is focused on modifying and comprehending specific behaviors or process. Indeed, for CBT, the central focus lies on how a person reacts and feels. In essence, CBT mainly majors on changing and identifying dysfunctional patterns of thought (Higdon & Higdon, 2012). On the other hand, psychodynamic therapy emerged out of the practices and theories of Freudian psychoanalysis. Subsequently, psychoanalysis is grounded on the ideology that an individual’s behavior is influenced by the unconsciousness mind as well as by past experiences. Usually, psychoanalysis comprises of an intense, open-ended exploration of client’s feelings, often with multiple sessions within a week. The sessions involve an assessment of the feelings the client is aware of and that the clients are unaware of prior to the therapy.
Additionally, psychodynamic therapy is relatively less intense as compared to the formal psychoanalysis. This is because sessions happen once in a week and are normally about 50 minutes each. Here patients are allowed to sit on a chair rather than lying on a coach together with the therapist out of sight. Contrary to CBT where sessions adhere to a comparatively formal, defined structure, with specific learning agendas (Gerwe, 2010). It is also important to note that psychodynamic sessions are usually open-ended and are based on a process of free interaction. In psychodynamic therapy, the clients are given freedom to talk freely concerning the current state of their minds as well what caused their condition. Through this, the patient can develop an appreciation of their past life and attempt to venture into the future. Different from this, CBT does not allow the patient to talk freely regarding their previous lives.
Indeed, psychodynamic therapy comprises of exploration of the wider range of client's emotions. Through the assistance of a therapist, the client can find a way to share their feelings that involve threatening feelings, contradictory feelings that the client could not have recognized. On the other hand, CBT provides the client with a chance to focus on activities that can help them to avoid emotions that can affect them psychologically or emotionally (Cole, 2005). In psychodynamic therapy, there is close interaction between the client and therapist. For this matter, the therapist can observe how the patient reacts. In most cases clients are encouraged to be free in speaking about their state as well as their past lives so that the therapist can understand how to help them.
Recently, it there was a considerable support for CBT that it can be used to treat depression. One of the key reasons for supporting this type of therapy over psychodynamic therapy is that psychodynamic therapy was not considered to be as focused as CBT, IPT and forms of therapies. Nonetheless, over the past decades changes have been noted and more studies have been done to improve each form of therapy. Irrespective of the fact that there are some notable differences between the two therapies stated in this paper, some similarities also exist. Typically, psychodynamic therapy and CBT therapy are two main forms of therapies used to help patients with psychological or behavioral issues. Thus, it is evident that practitioners in this field employ these approaches to mitigate problems in the society.
The future research can be focused on quantifying the methods in which treatments vary to enable the differences to be tested directly. Instead of the initial ways which was based on the outcomes of the comparisons of the general treatment packages, for instance, it has been claimed that CBT is relatively structured as compared to other approaches. In this respect, researchers should be in a position to quantify the magnitude of the structure for any therapy. Another future research would involve studies in naturalistic settings where therapists can use principles rather than manuals. At the same time, research propagating treatment manuals to test whether the community treatment would be boosted by increasing reliability. Again, research ought to anticipate changes to the PD taxonomy as suggested by various previous researches. This would place more emphasis on dimensional personal traits such as impulsivity, neuroticism and domains of impairment.
References
Cole, M. B. (2005). Group dynamics in occupational therapy: The theoretical basis and practice application of group intervention. Thorofare, NJ: Slack.
Gerwe, C. F. (2010). The art of investigative psychodynamic therapy: The Gerwe Orchestration Method (G-OM). New York: Algora Pub.
Gilson, M. (2009). Overcoming depression: A cognitive therapy approach : therapist guide. Oxford: Oxford University Press.
Higdon, J., & Higdon, J. (2012). Psychodynamic theory for therapeutic practice. Basingstoke: Palgrave Macmillan.
Leahy, R. L. (1996). Cognitive therapy: Basic principles and applications. Northvale, NJ: J. Aronson.
Leahy, R. L. (2004). Contemporary cognitive therapy: Theory, research, and practice. New York: Guilford Press.
Rush, A. J. (1982). Short-term psychotherapies for depression: Behavioral, interpersonal, cognitive, and psychodynamic approaches. New York: Guilford Press.
Sassaroli, S., & Ruggiero, G. M. (2010). Cognitive therapy of eating disorders on control and worry. New York: Nova Science Publishers.
