1
FAMILY COUNSELING APPROACH
Family Counseling Approach Research Paper
Sara Ruckdeschel
Liberty University
2
FAMILY COUNSELING APPROACH
Abstract
This paper will discuss the different aspects of Behavioral and Cognitive-Behavioral
Family Therapy models. It will discuss the leading figures of this theory as well as the history
behind the models. Additionally, basic assumptions, key concepts, techniques, and similarities as
well as dissimilarities between Behavioral and Cognitive-Behavioral Family Therapy and other
models. The author will also discuss how she feels about integrating spirituality into counseling.
Finally, the author will discuss the results of the SYMBIS assessment.
3
FAMILY COUNSELING APPROACH
FAMILY COUNSELING APPROACH RESEARCH ASSIGNMENT
Cognitive-Behavioral Family Therapy (CBFT) combines behavioral and cognitive
methods and is applied to family systems. CBFT focuses on encouraging transformations among
individuals within the family as well as improving family relations. CBFT incorporates
behaviorism into the model, behaviorism employs operant conditioning as the primary tool for
change. The integration of social learning theory involves interpreting symptoms as learned
responses and emphasizing the influence of social reinforcers on behavior. CBFT also
incorporates social exchange theory, which suggests that individuals aim to maximize rewards
and minimize costs in their relationships. Directly changing behaviors is possible through the
maximization of positive exchanges and the minimization of negative exchanges (Lan & Sher,
2019).
Leading Figures
The leading figures in cognitive-behavioral therapy are Robert Liberman, Gerald
Patterson, Richard Stuart, Albert Ellis, and Aaron Beck. Using positive behavior strategies as
well as offering problem-solving or communication skills, behavior therapists take on the role of
teacher, coach, or model (Goldenberg et al., 2017).
Psychologist Albert Ellis came up with a theory called the ABC theory of dysfunctional
behavior. Ellis went on to say “it is not the activating events (A) of people's lives that disturbing
consequence (C), but the unrealistic interpretations they give to the events, or the irrational
beliefs (B) about what has taken place that cause them trouble (Goldenberg et al,. p.317.2017).”
Ellis termed this cognitive restructuring as teaching clients to come up with new positive
statements about their different situations (Goldenberg et al., 2017).
4
FAMILY COUNSELING APPROACH
Aaron Beck was a leading figure in Cognitive Behavioral Therapy. Beck considered that
thought patterns come from emotions, rather than the psychoanalytical theory that thoughts and
emotions are brought on by the unconscious mind (Rosner, 2022). Beck’s perspective is more
comprehensive and pays closer attention to how families interact. Beck's perspective is more in
line with the system's perspective because family relationships, cognitions, emotions, and
interaction behavior are all considered as having mutually impacted one another. After
conducting research on depressive individuals, Beck concluded that their feelings were caused
by thinking negatively about oneself, the world, and the future. Beck proposed that these
depressed people had, earlier in life, acquired negative schemas which are reactivated when a
new circumstance arises that, in their thinking is similar to an earlier, traumatic experience
(Goldenberg et al., 2017).
When comparing Ellis’ rational-emotive therapy and Beck’s cognitive-behavioral therapy,
with more complex theories, family therapists found them too basic,and they did not receive
much attention at the time. The use of cognitive interventions in marital and family therapy,
however, has grown over time as a result of systems-friendly research on the significance of
views, ideas, and expectations surrounding one another’s behavior. Today’s leading figures
include Frank Dattilio, Norman Epstein, David Baucom, and Brian Doss (Goldenberg et al.,
2017).
Development of Theory/Historical Events
The purposeful and theory-based combination of cognitive therapy, behavior therapy, and
family therapy is what the term "CBFT" refers to. As a result, its history can be compared to the
development of cognitive-behavioral therapy (CBT) as a whole. CBFT has its foundations in
behavior therapy at its most fundamental level. Behaviorists used learning theory, with a focus
5
FAMILY COUNSELING APPROACH
on stimulus and response, to family systems in the 1960s and early 1970s to instruct parents in
behavior modification. Behavioral family therapy quickly changed to cognitive-behavioral
family therapy with an added emphasis on the need for attitude adjustment to support behavior
modification, in a similar way to the addition of a cognitive component to traditional behavior
therapy procedures. Here, the family structure, rather than just behavioral regimens, was the
focus (Lan & Sher. 2019).
Basic Assumptions and Key Philosophy
Cognitive-behavioral therapy and behaviorism serve as the foundation for the primary
ideas of CBFT. First, the primary process of change in the behaviorism model is operant
conditioning. By viewing symptoms as learned reactions and highlighting the influence of social
reinforcers on forming habits, social learning theory is introduced. A key idea in CBFT is the
social exchange theory, which holds that individuals seek to maximize benefits and reduce costs
in interpersonal interactions. Thus, by focusing on positive interactions and reducing negative
interactions, behaviors can be modified immediately. Second, according to the viewpoints of
cognitive therapy, CBFT holds that a person's perceptions and inferences are shaped by a
generally stable underlying schema, which can be learned early in life from primary sources and
affects a person's automatic thoughts and emotional reactions in important relationships. People
frequently form common beliefs that make up a family schema as a result of the numerous
shared experiences that occur within a family. Interactions may become dysfunctional if the
family paradigm contains cognitive errors (Lan & Sher, 2019).
Family systems are dependent on CBFT, which applies cognitive-behavioral theories and
methods. Assessment and education are fundamental, crucial, and a focus of the entire treatment
in CBT for individuals. For CBFT, the same is true. We may categorize the main therapies within
6
FAMILY COUNSELING APPROACH
CBFT into two groups: those that evaluate and change behavior patterns and those that evaluate
and change distorted and exaggerated cognitions.
Key Concepts
CBFT sees thoughts and behaviors as crucial to the dysfunction of the family and
integrates behaviorism, CBT, and system theory. The fundamental tenet of CBFT is that each
member of the family acts in a way that influences the other members' actions, thoughts, and
feelings. The initial family member's cognitive and behavioral processes are then impacted by
those other family members in a process known as a feedback loop. As a result, the most
effective change routes are those that directly transform problematic thought and behavior
patterns in a family system by altering interactions between people (Lan & Sher, 2019).
The fundamental idea behind behaviorism is that actions are perpetuated by the results of
those actions. As a result, when the conditions for reinforcement are changed, behavior will
change as well. The main goal of therapy, according to behaviorism, is to stop undesirable
behavior and promote beneficial alternatives. Similar to this, a key assumption of a cognitive
approach is that how we interpret the actions of others influences how we react to them.
Therefore, the main goal of CBFT is to assist family members in identifying thought distortions,
reshaping their thinking, and changing their behavior in order to enhance their interactional
patterns. Additionally, by using systems theory, CBFT keeps the emphasis on the interacting
parts of the family rather than on an individual's internal processes (Lan & Sher, 2019).
Techniques
The two primary subcategories of interventions in this category are operant conditioning
and contraction and skills training. They share the traits of being precisely defined, measurable,
7
FAMILY COUNSELING APPROACH
and operationally definable. They are typically used in tandem so that family members can
collectively and individually learn how to reward healthy actions rather than encourage
unhealthy ones. These core behavioral ideas can result in major change quickly. In parent-child
relationships, where the purpose is to increase children's desirable behavior patterns by changing
the conditions of reward coming from the adults, operant conditioning is most effective (Lan &
Sher, 2019).
Operant conditioning interventions come in a variety of forms. A detailed, generally
written plan or contract that specifies the conditions for the exchange of actions and reinforcers
amongst family members is known as a contingency contract. One action is dependent upon or
contingent upon another. For instance, parents may utilize a point system or "token economy" to
reward kids for certain actions, such as doing their chores or being polite. Along with the kids,
the parents decide which behaviors need to change and which ones are less important. Families
are taught the "charting" skill, which involves accurately recording the children's unacceptable
behavior. They are instructed on how to define the behavior specifically and how often it should
be noted, such as every day or each time it occurs. When parents wish to create a baseline of the
occurrence of the targeted behavior before and after the intervention to evaluate it over time, they
might use this method. Because behavior changes frequently occur as a result of behavior
charting alone, it should be recognized that charting serves as both an assessment tool and an
intervention. The "Premack principle," which states that family members must first perform less
pleasurable chores before they are permitted to partake in pleasurable activities, is another
illustration of an operant behavioral strategy. Here, the more enjoyable jobs act as motivators for
the less desirable ones. Finally, "behavior-change agreements" are employed to bring these
operant strategies to the family level. Each member of the family learns that when they engage in
8
FAMILY COUNSELING APPROACH
one behavior, another member of the family will be encouraged to engage in a different activity,
and so on. It is used to outline how each person's behavior impacts and is affected by the
behaviors of the other family members, rather than setting this up as a "tit for tat" discussion.
(Lan & Sher, 2019).
The three skill-building programs that are most frequently employed are parenting,
problem-solving, and communication. Training in communication enhances one's ability to
properly listen to others as well as convey one's thoughts and emotions. With the aid of handouts
outlining the rules of communication, therapists first train family members on the precise actions
associated with each sort of expressive and listening competence. Then, during the session, they
coach the families and frequently serve as good role models. In order to maintain and further
improve performance, homework assignments are given to reinforce session abilities. For
effective problem-solving with family members, therapists in problem-solving training employ
verbal and written instructions, modeling, behavioral rehearsal, and coaching. The phases
involve defining the issue clearly and specifically, coming up with behavioral solutions that are
particular to the issue, weighing the benefits and drawbacks of each potential solution, and
choosing and deciding to apply one solution. Finally, the primary goal of parenting skills training
is to change parents' responses to children by educating parents about the principles of operant
learning, enhancing their capacity to systematically observe children's behavior, and coaching
them in the use of developmentally appropriate skills to set constructive limits on children's
behavior and reinforce positive behaviors. Children acquire better ways of acting out as parents
become more effective at asking for good behavior. Parents are also instructed that more
significant behavioral changes are more likely to be adopted if they stop emphasizing less
significant actions (such as wearing a coat in colder weather). Here, the therapist starts by
9
FAMILY COUNSELING APPROACH
identifying a particular issue behavior and tracking it in relation to its causes and effects. Then,
using verbal and performance training techniques, the parents get social learning theory
instruction. In order to influence ideas and messages, verbal approaches use written materials
and didactic training. Role-playing, modeling, behavioral rehearsal, and prompting are some
performance training techniques that can be used to enhance parent-child interactions that are
simple for the kids to understand given their stage of development. Parents are requested to track
the problematic behavior over the period of treatment, regardless of the training method. The
therapist encourages and appreciates successful attempts as a reward (Lan & Sher, 2019).
Interventions to Modify Distorted and Extreme Cognitions include (1) cognitive
restructuring techniques that are meant to help family members better monitor the
appropriateness (how useful one's beliefs are) and the validity (how accurate one's thoughts are)
of their cognitions, and (2) self-monitoring skills that are meant to teach family members how to
actively and intentionally evaluate and intervene their cognitions in any given situation.
Child and family-focused cognitive behavioral therapy (CFF-CBT) combines
psychoeducation, cognitive restructuring, emotion monitoring and regulation, and problem-
solving, with interpersonal skills training (Bäckström et al., 2023).
Similarities and Dissimilarities
The idea that practitioners strive to aid in the decrease of anxiety symptoms through
emotional regulation and the reduction of maladaptive thinking is the first similarity found
between behavior and cognitive behavior therapy model and Bowen's family systems therapy
model (Erdem & Safi, 2018). The idea that the counselor encourages a collaborative approach to
10
FAMILY COUNSELING APPROACH
help the client adapt to positive ways of thinking and recognition of strengths within their
treatment is depicted as the second similarity between behavior, cognitive behavior therapy, and
solution-focused therapy (Seponski, D., 2016). The fact that Bowen's model primarily focuses on
emotional regulation rather than cognitive control is the first difference between behavior and
cognitive behavior therapy and Bowen's family systems therapy (Erdem & Safi, 2018). Finally,
the second difference illustrates that solution-focused therapy
New Knowledge
I have discovered via scientific and educational study that behavior and cognitive
behavior therapy comes in a variety of ways that can benefit people of all ages, and family
members. Additionally, a person needs to start concentrating on their intellect in order to support
beneficial changes. Cognitive behavior therapy is shaped by the strong effects of key figures like
Albert Ellis and Aaron Beck to assist clients develop good thought processes and minimize bad
behavioral patterns.
Spiritual Integration
The degree of acceptance of scientific discoveries in faith-related psychotherapy and
counseling, with a continuum of acceptance between the different views, is one of the main
distinctions in viewpoints. The Levels of Explanation group considers each aspect of the client's
or counselee's comprehension to have its own place, with various approaches to each level,
including the spiritual and generally accepts scientific literature as applicable across these levels
to a greater extent than other groups. The degree of acceptance of scientific discoveries in faith-
related psychotherapy and counseling, with a continuum of acceptance between the different
views, is one of the main distinctions in viewpoints. The Levels of Explanation group would
11
FAMILY COUNSELING APPROACH
describe each component of the client's or counselee's understanding as having its own place,
with different approaches to each level, including the spiritual. In comparison to other groups,
they generally accept a higher percentage of scientific literature as applicable to all of these
levels. The integrationist would define their work as a fusion of science and faith with a Christian
worldview applied to science. The Christian Psychologist would characterize their perspective as
a scientifically informed understanding of humans with a biblical foundation, but only when
done from a Christian perspective. The Biblical Counselor group would argue that only
knowledge that is directly from God, such as the Bible, should be considered as relevant for
helping persons with faith-related issues. Science has no place in the subject of helping with
faith-related issues, according to the Biblical Counsellor group. However, because it doesn't
make a firm claim on the inclusion of scientific literature and instead places a strong emphasis on
interpersonal connections and spiritual development, the sixth view, known as transformational,
slightly straddles the argument over the acceptance of science (Karl et al., 2021).
Personally, I would consider myself an Integrationist accepting both Christianity and
science from a Christian worldview. The Bible tells us to seek knowledge, such as in Proverbs
18:15 (NIV) which says, “The heart of the discerning acquires knowledge, for the ears of the
wise seek it out” and again in John 8:32 which says, “Then you will know the truth, and the truth
will set you free.” The Bible also warns us to not believe everything but to seek God’s truth
within the context of the subject. 1 John 4:1 says, “Dear friends, do not believe every spirit, but
test the spirits to see whether they are from God, because many false prophets have gone out into
the world.” (Bible Gateway. 2023).
SYMBIS Assessment
12
FAMILY COUNSELING APPROACH
SYMBIS is an online application that enables engaged or newlywed couples to log in
separately and take an assessment. It also works for couples who have been married for a time.
Numerous questions regarding personality, upbringing, financial attitudes, sex, and a great deal
more are included in the assessment. A printout of the outcomes is then produced. When I get
the results, I schedule at least six sessions to discuss any strengths, flaws, or red flags that the
evaluation tool reveals. We discuss the individual growth and improvement areas that each
person needs to focus on. We also talk about the aspects of the relationship that they must
improve (Fogg, 2018).
Marriage Mindset
For my SYMBIS assessment, the marriage mindset that represents me is the romantic
mindset. I believe that is pretty accurate for how I feel about marriage. When I was younger, I
always romanticized marriage and thought that there was the perfect person out there who would
become my husband one day. I also believe that marriage should be forever.
Five Issues in Real Relationships
My partner and I both had honesty first, on how we define love. I believe this is so
important because, without honesty, it is hard to continue building love in a relationship. In the
attitude category, our level of resilience could be better. My level of resilience can be a struggle
and I often have a hard time maintaining an upbeat attitude. My partners was low, at 67%, and
mine at 72%. In the category of communication, I was categorized as a deliberating spouse,
where my partner was categorized as a pioneering spouse. I believe that my category is accurate
as when I am communicating with someone, I want to be careful with my words so that there are
no misunderstandings. I don’t want feelings to be hurt so I choose my words carefully and often
13
FAMILY COUNSELING APPROACH
will think about what I am going to say before I say it. In the category of gender differences, it
says that I need to be cherished more than my partner thinks, I think this is very accurate
because I want to feel cherished and that I am wanted. In the category of conflict, it says that I
am slow to make decisions and I often want to think through options and choices and when it
comes to making quick decisions I will need assistance. I find this to be accurate because I have
a difficult time making decisions because I want to be sure that the person I am with will be
content with the decision I make.
Walking Together with God
I agree that I feel closest to God when I am signing and listening to worship music.
There is something about the energy you can feel from the entire congregation singing and
praising God that makes me feel that He is standing right next to me.
To be sure that our marriage is God-honoring I feel the 3 most important things are
attending church weekly, communicating about spiritual issues, and practicing the same religion.
I believe these are important because when done regularly we will be able grow closer to God.
Theory and Spiritual Integration
The SYMBIS examination offers appropriate clarity, reduces negativity, and invites
positive mental states, communication, and thinking styles. Through the application of
constructive cognitive thinking, which can lead to positive adjustments in behavioral patterns
within a relationship, this evaluation is correlated to the model of behavior and cognitive
behavior assessment.
Conclusion
14
FAMILY COUNSELING APPROACH
Albert Ellis, Aaron Beck, Gerald Patterson, Robert Libermann, and Richard Stuart
are just a few of the influential figures who have a big impact on the behavior therapy and
cognitive behavior therapy approaches. These diverse fields included psychiatry, social work,
and psychology. The impact and development of behavior and cognitive-behavioral therapy were
strongly influenced by each field. Social worker Richard Stuart was the first to link behavior,
cognitive-behavioral therapy, and operational functioning. Albert Ellis and Aaron Beck invented
cognitive behavioral therapy. A connection behavior and cognitive behavioral therapy model is
made possible by factors including the origin, historical moments, fundamental assumptions,
impacting concepts, knowledge gathered through research, spiritual integration, and the
SYMBIS online couple's examination.
15
FAMILY COUNSELING APPROACH
References
Bäckström, B., Rask, O., & Knutsson, J. (2023). Adolescent and family-focused cognitive-
behavioral therapy for pediatric bipolar disorders: An open trial and individual
Trajectories Study in routine psychiatric care. Child Psychiatry and Human Development,
https://doi.org/10.1007/s10578-023-01504-1
“Bible Gateway - New International Version.” Bible Gateway, www.biblegateway.com/passage/?
search=1+john+4%3A1. Accessed 7 Oct. 2023.
Erdem, G., & Safi, O. (2018). The Cultural Lens to Bowen Familyt Systems Theory:
Contributions of Family Change Theory. Journal of Family Theory & Review, 10(2),
469- 483. https://doi.org.10.1111/jftr.12258
Fogg, Christy. “What Is Symbis for Marriage, and Why Is It Important?” Journey to Joy
Counseling, 5 July 2018, www.journeytojoycounseling.com/2018/06/06/what-is-symbis-
for-marriage-and-why-is-it-important/.
Goldenberg, I., Stanton, M., & Goldenberg, H. (2017). Family therapy: An overview (9th ed.).
Brooks/Cole Publishing Co.
Karl, K. F., Weinberg, C. M., Bullock, L. M., Wallace, E. K., & Pettway, A. N. (2021).
Integrating faith and practice: A descriptive study toward an operational definition of
christian therapy and counseling practice. The Journal of Psychology and Christianity,
40(4), 298-316.
Lan, J., Sher, T.G. (2019). Cognitive-Behavioral Family Therapy. In: Lebow, J.L., Chambers,
A.L., Breunlin, D.C. (eds) Encyclopedia of Couple and Family Therapy. Springer, Cham.
https://doi.org/10.1007/978-3-319-49425-8_40
16
FAMILY COUNSELING APPROACH
Rosner, R. I. (2022). Aaron T. beck (1921-2021). The American Psychologist, 77(6), 791-792.
https://doi.org/10.1037/amp0001007
Seponski, D. (2016). A Feminist-Informed Integration of Emotionally Focused and
SolutionFocused Therapies. Journal of Family Psychotherapy, 27(4), 221-242.
https://doi.org.10.1080/08975353.2016.1235430
