The Psychodynamic Perspective
The primary focus of this approach in the treatment of patients is to reveal the subconscious and unconscious elements of the client’s or patient’s psych in an effort to treat the patient. The approach heavily relies on the interrelationship between the patient and the therapist. The approach involves several steps in a continuum where the peripheries are the interpretive pole and the supportive pole. From the onset, the therapist takes the patient through seven stages namely; Interpretation, Confrontation, Clarification, Encouragement to elaborate, Empathetic validation, Advice and Praise and finally to Affirmation that is anchored of the supportive pole.
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In addressing the problems faced by Jane’s predicament, the councilor should observe that Jane is a depressed and anxious individual and that her anxiety and loneliness are the main factors that are deterring her from moving on with her life. In employing the Psychodynamic approach in treating Jane, a councilor, must recognize that Interpretation of her predicament is the first step in ensuring that Jane develops insight into her problems. For instance, Jane is optimistic that she can meet someone whom she may share her life with and, therefore, address her state of loneliness. However, she is fearful of being away from her home for long periods of time. For this reason, she rarely leaves her home and has been incapable of making new friends or meeting new people for that matter.
The councilor should, therefore, assist Jane in interpreting her repetitive behavior of avoiding new people as a factor that is sustaining her problem of loneliness since she doesn’t meet these new people. Thus, the councilor, should focus on elaborating to Jane that her problem lies in her avoidance of people for her to think of changing this and perhaps suggest ways that she can improve on this.
Secondly, at the other periphery of the interpretive-supportive continuum the therapist should come up with supportive interventions that aim to strengthen the abilities that are temporarily inaccessible to Jane due to acute stress. An example of acute stress on Jane’s case could encompass the loss of her mother and the fact that her career and life sacrifice have left her depressed and lonely. The councilor employing the psychodynamic treatment should, therefore, suggest actions that Jane can take to meet new people for instance, by attending church service on Sundays or visiting neighbors to address her state of loneliness. Similarly, in offering Jane support, the therapist could develop a therapeutic alliance with Jane where they set goals that they can achieve and evaluate their success in doing so.
The CBT perspective
The Cognitive behavior approach in therapeutic treatment is particularly concerned with dysfunctional emotions, maladaptive behaviors as well as cognitive processes. It is effective in treating patients who are undergoing anxiety and depression. Cognitive Behavior Therapy (CBT) employs both cognitive and behavior therapy methods in treatment of patients. The fundamental premise of the CBT approach is an acknowledgement that there are certain behaviors that cannot be controlled through rational thought. Therefore, it is problem focused and action oriented where the therapist working with the patient tries to aid the patient in selecting strategies that would with effect address the problems at hand.
CBT approach incorporates a wide range of methods that a councilor can employ in treating a patient that encompass scientific models of human behavior cognition and emotion. The central of a therapist using the CBT approach is to identify the symptoms reduce distress and revaluate thinking by developing helpful behavioral responses by the patient ultimately addressing the concerns of the patient.
In evaluating Jane’s condition from a CBT perspective, it is apparent that Jane is an individual faced by trauma from the mere fact that she lost her father in an accident that eventually paralyzed her mother who she had to take care of till her death. She feels that her life has been taken away from her since she had to give up her career as a nurse so that she could take care of her mother. Although it has not been disclosed whether she has a husband who fathered her two adult children, it is apparently mentioned that she is lonely and that she would want to start a relationship with someone. However, she is deterred from doing so by the mere fact that she is afraid of meeting new people and is not also comfortable staying far from home for a long time. We also observe that Jane is in her 50s an age where most people retire at. She is optimistic that she can go back to her career as a nurse but is afraid that she is too old to undergo training that is required in the current nursing practice. All these symptoms from a CBT approach can be categorized to be reflective of two major issues; anxiety and depression.
First, Jane is depressed because she has children they are all grown up and live on their own. Secondly, she is depressed because she lost her mother whom she gave up everything to care of including a career in nursing. Thirdly, Jane is anxious to meet new people in addressing this loneliness, her anxiety affects her to the extent that she cannot comfortably leave the confines of her home for long periods of time. Lastly, she is anxious to get back to her career as a nurse but this anxiety is worsened by the fear of failure as she deems her age as a limiting factor in meeting the requirements of the contemporary nursing industry
Therefore, a councilor employing CBT approach in treating Jane must be cognizant of the fact that the treatment that is used in this approach must place into consideration and focus on addressing Jane’s fundamental problems that are anxiety and depression. For instance, avoidance is a symptom of anxiety that is characteristic of Jane’s fear of not venturing away from her home and, therefore, she is incapable of meeting new people that she could share her life with and address her state of loneliness. A councilor employing the CBT approach must make every effort to encourage Jane not to avoid going out of her home as by addressing this fear she will overcome her anxiety in meeting new people ultimately solving her problem with respect to loneliness that is a symptom of depression.
Similarities between Jane’s therapy through CBT and Psychodynamic Methods
The analysis of the two methods in the case of Jane, suggest several similarities. First, both methods can effectively be used in addressing the problem at hand that is particularly concerned with Jane’s anxiety and her depression. These form the basic foundations of her problems that present symptoms such as loneliness, fear and indecisiveness among others. For this fundamental fact the case of Jane’s treatment with respect to the CBT and the Psychodynamic approach it is apparent that the two methods are both equally effective in addressing Jane’s problems and, therefore, both equally capable of treating her adequately.
A conspicuous similarity between the CBT and the Psychodynamic methods is that both of them are concerned with the patients’ emotions, patterns of behavior, incongruence, external circumstances and the ability of patients’ to make decisive steps regarding their predicament. More importantly, both methods are focused on defining the causes of the existing problems and use this to guide the patient in developing an amicable solution to address these problems.
Differences between Jane’s therapy through CBT and Psychodynamic Methods
The most notable difference between CBT and the Psychodynamic methods if the former is more concerned about action by the patient compared to the later in treating the ailment. Studies conducted to evaluate the efficacy of CBT in treating depression in adults found that CBT is effective in treating depression in adults. Consequently, it is recommended by most psychiatrists in ailments related to depression. However, on the other hand, psychodynamic approach to treatment is more effective in addressing problems related to anxiety with better results that it achieves in treating depression. Therefore, with respect to the mode of treatment used in treating Jane it is worth noting that whereas the CBT approach proves effective in treating Jane’s depression, the Psychodynamic approach promises success in treating her anxiety.
Studies advanced by Driessen et al. (2013) concur with the fact that Psychodynamic treatment is effective in treating ailments related to depression, but they observe that this takes a considerably longer period of time to achieve as compared to the treatment of depression employing other methods such as the CBT approach.
Similar studies advanced by Yager (2013) confirm that both CBT and Psychodynamic methods present the same effectiveness level when it comes to the general results achieved in the treatment of patients but observes that with respect to depression CBT patients exhibited higher percentages of success in treatment when compared to Psychodynamic treatment. These results suggest that a patient such as Jane stands a better chance in employing the CBT approach to treat her depression while, on the other hand, the Psychodynamic approach presents her with the most chance of success in treating her anxiety.
A notable difference between CBT and Psychodynamic therapy is that the former is concerned with the present in addressing the problem that the patient is faced with. CBT is particularly hinged on behavioral transformations that can assist the patient in tackling the problem at hand. For instance in the case Jane, the CBT approach is concerned with behavioral solutions to her current demeanor in avoiding to get out of the house and, therefore, avoid meeting new people which is the root of her problem as pertains to her loneliness.
On the other hand, the former (Psychodynamic approach) is particularly concerned with understanding the past in terms of the events that led up to the current predicament faced by the patient. In essence the Psychodynamic approach attempts to aid the patient interpret the root causes of their predicament and, therefore, develop solutions to address them later on.
Another salient difference between the two methods of treatment is also presented by the duration that they take in treating the patient. According to Beutel et al. (2012) the difference in the duration taken for treatment employing CBT and Psychoanalysis is a wide margin that is estimated at the ratio of 1:1.75 for CBT and Psychodynamic treatments respectively. For this reason, the case of Jane being that she is an elderly lady in her 50s it is advisable that a method that produces results in good time is used so that she may have time to evaluate her progress practically in her life. Further, being constrained by time and the fact that she is elderly may serve as an indicator that more time spent in therapy would only serve to deter her from her life and slow her down. However, it is note- worthy that the success of the therapeutic sessions and the values that can be achieved from the sessions should not be compromised by the time duration spent in therapy. Consequently, CBT is appropriate for the former case while Psychodynamic treatment is appropriate in the case of the later.
Conclusion
The general concept that the paper is concerned with is the presentation of both the CBT approach and the Psychodynamic approach in evaluating the therapeutic treatment that suits Jane best. Essentially, it is crucial that the merits of each approached be weighed against each other to identify the most appropriate one that can effectively address Jane’s predicament. First, the CBT approach present benefits such as the duration spent in therapy that is considerably short compared to that spent in Psychodynamic therapy. Further, the method teaches or employs practical techniques that would engage her directly in making steps towards addressing her problems due to the fact that the therapist and Jane work as a team to develop these solutions.
On the other hand, the Psychodynamic approach is particular in addressing the root causes of the problem by inferring into the past events that led up to the present state of affairs with respect to the problems that Jane faces. Secondly, the benefits of the therapeutic treatment may take time though promise to appreciate with time. Moreover, the mode encourages free expression of the patient that may reveal useful information with respect to themes of therapeutic relationships affecting the patient and, therefore, effectively address the problems at hand. More importantly, the Psychodynamic approach gives the patient the power to direct what is talked about during the therapeutic sessions with effect making the patient a direct contributor to the success achieved in treatment.
Primarily, the best mode for the treatment of Jane’s problems lie in the CBT approach since it promises results in good time. In addition, the CBT approach engages the patient in practical goals and targets that can be made to achieve successful treatment. Therefore, for these reasons it is my opinion that the most appropriate therapeutic approach to treat Jane’s ailments.
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