Submitted by tomrue on
With Cognitive Behavioral Therapy
(Theoretical Orientation)
By TOM RUE
The approach to counseling that I take most frequently is Cognitive-Behavioral Therapy. CBT is a form of psychotherapy proven in numerous clinical trials to be effective for a wide variety of disorders. The therapist and client work together as a team to identify and solve problems. Therapists help clients to overcome their difficulties by changing their thinking, behavior, and emotional responses. I also rely on motivational interviewing and advocate person centered care.
People Can Change.
I believe people can change any time they choose, health and mortality permitting. Even these constraining factors can often be strengthened or delayed when we choose to change our behavior. Change is an inevitable process. In fact, the only thing in life that is truly constant is change. How and when we change, until the moment of death, almost always involves some degree of personal choice.
In helping clients determine what their will is and choose between alternatives, I focus on subjective experience, positive individual traits, coping skills, and innate human strengths, to build upon and broaden those emotional assets to nourish resilience. This approach has been described by psychologists (Seligman & Csikszentmihalyi, 2000) this way:
"At the individual level, it is about positive individual traits: the capacity for love and vocation, courage, interpersonal skill, aesthetic sensibility, perseverance, forgiveness, originality, future mindfulness, spirituality, high talent, and wisdom. At the group level, it is about the civic virtues and the institutions that move individuals toward better citizenship: responsibilities, nurturance, altruism, civility, moderation, tolerance, and work ethic."
Examples of these strengths which empower change include hope, wisdom, creativity, courage, spirituality, responsibility, and perseverance.
Free Will.
I believe in free will. I recognize as a natural law, and wholeheartedly support the exercise of Free Will. No one can ever take that from you. There is accountability, of course, but natural laws are more powerful than civil legislation or compulsion.
Some people deny, even to themselves, that restoration of one's mental health involves choice, but it is true. In counseling people with addictions, for example, I don't know how many times I have heard clients claim they are in treatment because they "have no choice".
Of course they have a choice! They may not know it, but "mandates" to engage in treatment really do not exist. With all due respect to the legal system, treatment "mandates" are a legal fiction.
And at the same time, everyone who enters treatment of any kind does so because they are faced with a "mandate" of one sort or another in which one or more alternatives are worse, and one or more choices lead to getting better.
Read this definition that I wrote for Wikipedia a few years ago. It has been left unchanged by the editors since I first posted it. I had never seen it defined quite this way before, but when I have shared this perspective with clients, they rarely disagree.
Cognitive-Behavioral Therapy.
As a mental health counselor, I most often use what is described as a cognitive-behavioral approach. I enjoy helping people recognize that they do have choices, identify what they are; and to recognize that they have the power to select which of countless paths their future can take, commencing today.
Multi-disciplinary Treatment
I also support and collaborate with physicians and psychiatrists, and other professionals, recognizing that people are complex social and physical organisms. For example, those who are prescribed medications by a physician, I urge to follow their doctor's advice. This may include taking antidepressants or mood-stabilizers, just as it might taking other medication for diabetes, hyperthyroidism, or other conditions.
The Whole Person
I also respect and support non-pharmaceutical interventions that can enhance mental health.
There are more levels to you, as there are also to me, than cells, hormones, and neurotransmitters. Each of us is a blend of flesh, spirit, and mind. While therapy has its greatest impact in the latter two realms, the connection between the body and the mind is undeniable.
Accepting Things We Can Not Change.
Of course, sometimes the fates intervene at the most unexpected moments. Although we are free agents, there are things in our lives over which we are utterly powerless. These require acceptance. Recognizing the difference between things that we can control and those that we can not takes practice, and sometimes the support of another human being.
Admitting vulnerability can especially difficult for men, who are acculturated to be tough and stuff our emotions. But at the deepest core, humans share many aspects in common.
Accepting this fact can mark a major turning point for a person who desires to change. By admitting that the road we have been taking is not leading to a desirable end, we can choose to surrender our own agendas to the Will of something or someone more than ourselves.
Spiritual Capacities.
This power is called by a multiplicity of names. In the understanding of some it may have no gender, such as "the interdependent web of the universe". Or the ground of being might be referred to as "She" or "He", depending on one's understanding.
At times, if it seems to me that it might have meaning to you, I might at times refer stories or myths if it seems to convey meaning, or possibly give reading or homework assignments, if you are willing and it seems like they might carry meaning in your situation.
For example, reading the drama of the kidnapping of Persephone and the grief her mother Demeter endured until her child was returned by Hades to the land of the living is a perfect metaphor not just for modern mother-daughter connections, but for the human condition without regard to gender.
What Is Your 'True Will'?
Putting our self second is the first step to discovering our own true will. I believe all disease can be defined in spiritual terms, and even if a physical cure is not on the horizon, spiritual connectedness can ease the process.
Spirituality transcends all religions. It may be supported by religious practices, but religion is not a necessary ingredient for a rich spiritual life. It is a vehicle that works, and if it works for you, with no one harmed in the process, I support it, no matter what it is.
As a counselor, I try to enter your world-view and understand life as you experience it, and as you wish it to be, to help you to discover and reach your goals.
Czech psychiatrist Stanislov Grof wrote:
"It is possible to undergo a profound crisis involving non-ordinary experiences and to perceive it as pathological or psychiatric when in fact it may be more accurately and beneficially defined as a spiritual emergency."
Ready To Change?
The opposite of health (mental, physical, spiritual, interpersonal, or otherwise) is death. The choice is yours.
Very often (perhaps always) people seek counseling have mixed emotions about changing their lives. Ambivalence is worked through in the counseling, and choices made.
Healthy social and intimate relationships are always based on ethics of justice and love. A book that I might recommend to couples suffering the effects of a power imbalance that they read together a book like The Partnership Way by Riane Eisler, and process their findings together.
I take a person-centered approach to counseling. There are a lot of levels of meaning to "person-centered", but mostly it has to do with respect. I respect my clients' right to make choices.
Some of my work involves making a recommendation to civil authorities, such as to a court or a school. If this is what you come to me for, I take the responsibility seriously and I use all the tools and skills that I can, including humility and the ability to listen and observe and try to understand differing perspectives. However, in making life-changing recommendations, health and safety considerations (yours and of others around you) come first.
Counseling can help you to accomplish major changes, if you will.
Where do you want to go today?
Bio-Psycho-Social (Holistic) Approach
I have spent over 25 years counseling with individuals, groups, families, and couples.
A biopsychosocial view of human development involves referring patients to other healthcare providers (with the client's consent, of course) for differing perspectives. For example, if depression seems to be a common theme, I might recommend that a client get an annual exam by their physician. Maybe discovering and treating a thyroid or other organic imbalance, along with continuing counseling, might create the right synergy to bring desired changes.
I work with ordinary people adjusting to normal life changes like grief, trauma, loneliness, relationship issues (which often stem from a power imbalance and poor communication), stress, anxiety, social or gender inequities, depression, spiritual crises; and people suffering from serious and persistent mental illness, or chronic addiction, alcoholism, or chronic medical diseases like cancer (newly diagnosed or long-term survivors).
It is a privilege and a pleasure to assist someone choose mental, behavioral, and spiritual directions that can literally save their own lives, or make give the time that their life is made of more meaning and fulfillment.
My orientation includes not just personal, but also social action, as with the aphorism that "faith without works is dead," and exercising "the courage to change the things I can" by helping make our corner of the world more transparent and just through public discourse and service. Get up and do something.
Go somewhere. Talk to someone. That alone will help.
These are my values. I don't press them on clients. I share them here to help you decide what you want to do next.
Contact Me.
I invite you to contact me for an appointment. If you e-mail me, please leave a phone number and tell me a good time to reach you.
Martin E.P. Seligman & Mihaly Csikszentmihalyi (2000). Positive Psychology: An Introduction, American Psychologist, Vol. 55, No. 1, pp. 5-14.