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Limitations

The union of cognitive and behavioral counseling and therapy into "cognitive-behavioral" has been able to overcome many of the limitations of either type of therapy alone. However, those individuals who are more inclined toward psychodynamic interpretations continue to object to the lack of attention to unconscious factors in determining behavior and to concepts such as ego strength and insight, which are not included in this approach. In addition, experiential counselors and therapists indicate that cognitive-behavioral strategies do not pay enough attention to feelings. Insight and an emphasis on the past are features of other types of counseling and therapy that do not fit within the purview of cognitive-behavioral theory.

The behavioral therapy roots of current cognitive-behavioral theory may be criticized as lacking attention to the role of thoughts and feelings, ignoring the historical context of the present problems, and allowing the counselor or therapist too much power to manipulate the client. Because the origins of behavioral theory emphasized operationally defined behaviors and functional analysis, these are features that define the approach and that make behavioral counseling behavioral. The idea that behavioral counselors and therapists are manipulative comes from the use of external reinforcers and stimulus control types of treatments. It seems that this notion is maintained by token economy systems. In individual practice, behavioral counselors or therapists use informed consent to make changes in the contingencies of behavior.

The cognitive therapy roots may be described as too difficult to study empirically and as paying too much attention to cognitive factors while minimizing affective ones. Cognitive therapies focus to a large extent on internal events (thoughts), which cannot be directly observed. Although the radical behaviorists object to this, most other types of counseling or psychotherapy would also fit this criticism. Cognitive therapy researchers have continued to develop thought-listing and monitoring strategies to alleviate this criticism. In addition, the cognitive strategies have been challenged for the lack of sufficient attention to affective factors. It seems that the emphasis on cognitions may lead to an intellectual understanding of the problem but may not help change the feelings associated with the thoughts. This limitation is related to the fact that the mechanism for understanding how behavior, thoughts, and feelings change is still not understood.

 
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