FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
Behavioral and Cognitive Behavioral Family Research Models
Tristen Dudley
School of Behavioral Sciences, Liberty University
May 1st, 2025
1
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
Behavioral and Cognitive Behavioral Family Research Models
Abstract
Behavioral and cognitive-behavioral approaches to family therapy focus on adjusting and
modifying the distorted thought patterns and subsequently dysfunctional behaviors within family
systems. This therapeutic approach is rooted in the concept of stimulus, response, and
consequence. While combining a model of operant conditioning and cognitive mediation,
behavior modification, problem-solving skills, and conflict resolution skills are developed within
the family system to improve overall functioning. This paper will explore the foundation of
behavioral and cognitive behavioral therapy, through providing education on important figures
and their contributions to the therapeutic approach, important events, philosophy of the
approach, concepts and techniques, a comparison and contrast to other approaches to family
therapy, as well as a final overview of new knowledge obtained throughout research on this
therapeutic approach to family therapy.
Keywords: behavioral, cognitive-behavioral, family therapy, family systems, therapeutic
approach.
2
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
Introduction
Family therapy is a recognized approach for addressing and providing assistance in
navigating family system issues or concerns, such as behavioral issues, emotional unrest, and
relational issues between family members. While there are various approaches to addressing
familial issues, the behavioral and cognitive-behavioral approach are the primary focus for the
purpose of this research. Behavioral and cognitive-behavioral approaches to therapy draw upon
the notion that cognitions (emotions and beliefs) drive behaviors. Behavioral and cognitive-
behavioral therapists promote positive change and improve family functioning, through
identifying possible cognitive distortions and modifying negative core beliefs to change
maladaptive behaviors and dysfunction within the family system.
Part I
Leading Figures
According to Nichols and Davis (2020), “The early principles of behavior therapy were
developed by Joseph Wolpe and B.F. Skinner. Each of these individuals had different
contributions to the development of Behavioral Therapy. Wolpe’s contribution to the approach
was rooted in systematic desensitization, while Skinner’s contribution was operant conditioning
(Nichols and Davis, 2020). Wolpe was able to aid individuals in overcoming specific phobias,
through deconditioning anxiety. Skinner’s contribution was greater; teaching us that “behavior is
regulated by its consequences,” (Nichols and Davis, 2020). Between the 1960’s and 1970’s, Ellis
and Beck emphasized a need for attitude change to promote behavior modification (Nichols and
Davis, 2020), thus providing the cognitive-behavioral component to CBFT. By the late 1980’s
and the early 1990’s, there was a wider implementation of the cognitive-behavioral therapy
approach applied to family therapy. Additional names that have aided in pioneering the
3
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
behavioral and cognitive-behavioral approaches to family therapy are as follows: Epstein,
Schlesinger, and Drayden (1988), Huber and Baruth (1989), Schwebel and Fine (1992), Dattilio
(1994 1997 and 1998), and Teichman (1992), (Nichols and Davis, 2020).
Development of the Theory/Historical Events
While the initial foundation of CBFT was rooted in social learning theory, reinforcing
that behavior is maintained by the consequences associated with the applied behavior; this
approach has been broadened to include the cognitive component. This component includes the
concept that our emotions and actions are dictated by cognitions. Further development of the
theory led to what is historically known as, “the second wave” of the behavioral model,
comprising the integration of the clinical with the cognitive (Caselli, et. al, 2018). Through the
1970’s, several texts on CBT became available to the public; it is one of the most widely adopted
approaches to treating various mental health conditions, supported by more than 325 published
studies (McDowell and Parker, 2017). Additional information from Newman, et. al, asserts, “By
the close of the 1990s the cognitive and behavioral camps were highly associated with one
another. Currently, various new forms of CBT are taking shape and gaining a significant
following. Many of these new interventions emphasize work on the client's impact on the
therapist, interpersonal problems, emotion regulation, acceptance, mindfulness, and behavioral
activation, as well as the integration of methods from different domains,” (2017). Additional
“behavioral therapies” have developed over the years, such as DBT and REBT, from the
foundation that behavioral and cognitive-behavioral therapy has laid.
Basic Assumptions and Key Philosophy
One initial premise of behavioral and cognitive-behavioral therapy is that behavior is
maintained by its consequences (Nichols and Davis, 2020). Through the development of the
4
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
theory, further conceptualization came to this central tenet: our interpretation of other people’s
behavior affects the way we respond to them (Nichols and Davis, 2020). In essence: we respond
to the behavior of others based upon how we perceive the behavior to be. This can lead to
cognitive distortions, negative core beliefs, and familial dysfunction.
Key Concepts
Lan and Sher state: “…CBFT posits that an individual’s perceptions and inferences are
shaped by relatively stable underlying schema, which can be learned early in life from primary
sources which then influence an individual’s automatic thoughts and emotional responses in
significant relationships,” (2019). This idea reaffirms the previously mentioned philosophy that
interpretation of behavior informs responding behavior. One additional core component of
behavioral and cognitive-behavioral approaches includes the theory of social exchange. This
theory suggests that people strive to maximize rewards and minimize the costs in a relationship
(Nichols and Davis, 2020). If human behavior is based upon perception of other behavior, this
theory makes sense: behave in a way that will elicit desired results. Further information from the
American Psychological Association (2017) also identifies the following important concepts of
behavioral and cognitive behavioral approaches:
1. Psychological problems are based, in part, on faulty or unhelpful ways of thinking.
2. Psychological problems are based, in part, on learned patterns of unhelpful behavior.
3. People suffering from psychological problems can learn better ways of coping with them,
thereby relieving their symptoms and becoming more effective in their lives.
Through the identified misconception that assumptions have a significant impact on perceptions
of and reactions to behavior, cognitive-behaviorists have added richness and depth to the
behavioral model of therapy (Nichols and Davis, 2020).
5
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
Techniques
Specific techniques that are utilized within the behavioral and cognitive-behavioral
approaches to family therapy include some of the following: Socratic questioning, imagery and
role-playing, communications training, problem-solving training, and homework assignments
(Nichols and Davis, 2020). Additional techniques that are commonly used within the
implementation of behavioral and cognitive-behavioral therapy include the following: relaxation,
behavioral activation and pleasant event scheduling, thought stopping, positive self-statements,
and focus on control (Melton, 2017). Implementation of these techniques in therapy sessions
have been found to promote positive behavior change within the family system.
Similarities and Dissimilarities
Taking a look at how behavioral/cognitive-behavioral therapy when compared with
psychodynamic therapy, one of the largest differences between these two approaches is the
foundation on which the approaches are based upon. As previously stated, behavioral and
cognitive-behavioral therapy have their foundations based upon the works of Skinner, Wolpe,
Beck, and Ellis, while Psychodynamic therapy is based upon the theories and works of Freud
(Jacobson, 2023). Freud’s work primarily focused on the trauma behind the behavior, while
behavioral and cognitive-behavioral focus on the behavioral response as a result of perceptions
of others’ behaviors. Despite the major difference in causation behind the behavior, each
approach to therapy offers benefits to addressing how our inner voice affects our outward
behaviors, that help to increase interpersonal function.
Another therapeutic approach that one might take when engaging in or studying family
therapy, would be Bowen’s Family Systems Therapy. This therapeutic approach is rooted in
perceiving the family as a unit, and that, “emotional processes from previous generations pass
6
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
onto next generations,” (Jain et al., 2023). Similarly to behavioral and cognitive-behavioral
approaches, Bowenian family therapy can be beneficial in improving overall family systems
communication, while also developing a deeper understanding of behaviors (Marschall, 2025).
New Knowledge Acquired
Through completion of this assignment, there are quite a few pieces of enlightening and
helpful information that can be taken away, as one develops their career in counseling and family
therapy. One of the first pieces of information that may be helpful to carry throughout the
development of a counseling career would be that there is not a “one-size fits all” approach to
therapy, and that an integrative approach may even be needed. Throughout completion of the
research required for the assignment, it was evident that there were some gaps that needed to be
filled in the approach chosen. For instance, when taking a look at the comparison and contrast of
behavioral and cognitive-behavioral therapy with psychodynamic/psychoanalytic and Bowenian
family systems therapy, it was frequently referenced that an integrative approach may be
preferred, due to the different foundations that each approach is rooted in. While there may be
inter-familial conflict based upon preconceived notions of behavior, there may also be a more
long-term, deep-rooted cause of the behavior or thought processes that are causing the turmoil
within the family.
Another area of information that was insightful throughout completion of the research
was that with the behavioral and cognitive-behavioral approach, there is an integration of both
behavioral and cognitive techniques into the implementation of the interventions utilized. Each
intervention plays on one of the two foundations that the cognitive-behavioral approach was
founded on, alluding to either the reinforcement of behavior or the distorted thought processes
7
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
that lead to the behaviors. Through use of various and/or multiple interventions, familial issues
can be addressed thoroughly and through multiple facets.
Part II
Integration of Faith and Family Counseling
My Story of Faith
Growing up, my family and I went to church every single Sunday and Wednesday. This
tradition was absolutely one of my favorites that I looked forward to every week. My favorite
part of church was listening to the gospel and signing along. I even had a CD-rom in the car that
I could sing along to and read my children’s bible with simultaneously. Unfortunately, around
the time that I was in fourth grade, we stopped going to church weekly, or even at all. My family
drifted apart from our faith and, ultimately, one another. During this time period, my family had
undergone a lot of change, a lot of tragedy, confusion, turmoil – all of the reasons that a family
should stay in church, you would think. My dad joined the Army to get my mom away from
negative influences that he believed were fueling her substance use, affecting their relationship,
and her presence in my brother and I’s lives. We moved around quite a bit, left what was
familiar. We joined churches here and there, but it was never quite like it was before. Because of
the tragedies that had befallen our family, all of us had lost sight of our faith. We went from
saying the blessing at dinner, saying our prayers every night, and going to church weekly, to
blaming God for everything bad that happened in our lives.
After enduring the several years of separation within my family and from God; feeling as
if something was missing in my life but unable to identify what exactly it was, I began to
reintegrate myself into the Christian Faith. I started slowly; listening to gospel music; podcasts
that told stories of lost faith that were similar to mine, applying and getting accepted into Liberty
8
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
University to continue my education in Counseling. I have found my way again and have
become more aligned with what used to be a major driving force in my day-to-day life.
Integration of Faith and Behavioral Therapy
As I have laid the foundation of my story and journey with faith; including a tidbit about
my family history with my mother’s struggle of addiction, it may come to you as no surprise as
to why I chose the behavioral and cognitive-behavioral therapy approach.
Behavioral and cognitive behavioral therapy are the go-to modalities when addressing
substance use and substance use disorders. Substance use is often a coping skill that is used to
avoid addressing other trauma and mental health symptoms. When we think about substance use
and treatment, alongside CBT, it is highly recommended that individuals engage in AA, NA, or
other recovery programs, such as Celebrate Recovery. Research from Grim and Grim asserts,
“We find that 73% of addiction treatment programs in the USA include a spirituality-based
element, as embodied in the 12-step programs and fellowships initially popularized by
Alcoholics Anonymous, the vast majority of which emphasize reliance on God or a Higher
Power to stay sober,” (2019). The article further states, “While negative experiences with
religion (e.g., clergy sex abuse and other horrendous examples) have been a contributory factor
to substance abuse among some victims, given that more than 84% of scientific studies show that
faith is a positive factor in addiction prevention or recovery and a risk in less than 2% of the
studies reviewed, we conclude that the value of faith-oriented approaches to substance abuse
prevention and recovery is indisputable,” (Grim and Grim, 2019).
As a counselor, it is my hope to work with individuals who are suffering from addiction
and are on the path to recovery. I find that engaging in addictions counseling, based on the
aforementioned statistics, is a great way to integrate faith and counseling. While I understand
9
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
that not every client is of faith or even the same faith that I am, I feel that I would be able to best
support these clients wherever they are in their faith, with my own personal understanding of
how addiction, family history, and trauma can impact faith-orientedness.
Part III
SYMBIS Report Questions
For the SYMBIS portion, my boyfriend of three years and I, completed this portion
together. Our results of taking the SYMBIS will be detailed in the answering of the questions
below.
1. Marriage Mindset: Do you agree with how the assessment depicts your “Marriage
Mindset” on page 3? Why or why not?
The marriage mindset that was provided for my boyfriend and I, as depicted in the SYMBIS
report, was that we each have a Romantic Mindset when it comes to marriage. This
information was not at all a surprise to me. We both tend to describe ourselves as hopeless
romantics, and we both carry ourselves that way in our relationship. We both see eye-to-eye
on the “big things” and thus we focus on the small surprises that give that romantic feel, like
surprises out of the blue, sweet messages, a small gift here and there.
2. Five Issues in Real Relationships: Pages 10 to 14 of your SYMBIS Report look at
five important issues in a marriage relationship: love, attitude, communication,
gender differences, and conflict – all through the lens of your specific personality.
What is your greatest insight from EACH of these five issues?
My greatest insight from each of the five issues, initially was, “holy cow, this is scary accurate”.
The takeaway from having completed this assignment, though, was that communication is the
utmost important aspect you can have in a relationship. Communication is the foundation for
10
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
everything else that he or I may need. Without communication, issues cannot be resolved.
Without communication, trust cannot be built. Without communication, needs cannot be met. At
the end of the day, we are each other’s best friends, and we are partners, but we are not mind-
readers, no matter how well we know one another. In order to address any of the areas that were
highlighted in the subsections, we need to ensure that we communicate well, often, and
effectively while keeping the other persons needs in mind.
3. Walking Together with God: Page 15 is dedicated to walking together with God as
a couple. Based on this information, what do you plan (identity 3 things) to do to
ensure that your current/eventual marriage is God-honoring?
Three things that I/we intend to do ensure that our eventual marriage is God-honoring are the
following:
Discuss spiritual issues together: whether this be a spiritual issue concerning our own
alignment with faith, or spiritual issues that we have become aware of through other
channels, like social media, podcasts, television, etc. Just maintaining a focus on faith and
discussing any new or current feelings, thoughts, and ideas surrounding faith.
Praying for each other: praying for the safety, health, and happiness of the other. We do
not need to necessarily pray together, but we both agree that praying for one another is
important to both of us.
Going to church together weekly: we both agree that going to church together weekly is
of importance to maintain a healthy and close relationship with God. While we each feel
that we feel closest to our faith in different ways, we each feel close to God whenever we
are in church, and this is a specific activity that we each enjoy doing together as a couple.
11
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
4. Theory and Spiritual Integration: How do you see the SYMBIS Assessment as an
effective tool considering your chosen family systems theoretical approach/model
AND your spiritual/faith integration?
I see the SYMBIS Assessment as an effective tool in helping families understand why they
may engage in the specific behaviors that they do. For instance, the SYMBIS tool obtains
information about each individual’s personality, which may assist in providing insight as to
why each individual exhibits specific behaviors. This may help inform the other participant
in the session in a way that may help overcome any negative thoughts associated with the
other participant’s behavior.
This can also be helpful in understanding why I may have struggled with my faith but can
also inform me of ways in which I feel closest to my faith, if I were to ever stray or struggle
with that again.
Conclusion
While there are many approaches and theories that are effective in family therapy,
behavioral and cognitive-behavioral therapy is one of the most researched and supported theories
that therapists can implement. Backed by decades of research and supporting documentation,
behavioral and cognitive-behavioral therapy can help families transform their relational dynamic
to promote healthier functioning, through reframing. Identifying appropriate integration of faith
and taking a look inward at self, can help us become better therapists and counselors, as we
check our own biases, values, and discover what is important to us as we navigate our careers.
12
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
References
American Psychological Association. (2017).LWhat is Cognitive Behavioral Therapy?. American
Psychological Association.
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioralL
Darcy, A. M. (2023, March 7).LPsychodynamic psychotherapy vs CBT: Which to Choose?.
Harley TherapyTM Blog. https://www.harleytherapy.co.uk/counselling/psychodynamic-
psychotherapy-vs-cbt.htm
Grim, B. J., & Grim, M. E. (2019). Belief, Behavior, and Belonging: How Faith is Indispensable
in Preventing and Recovering from Substance Abuse. Journal of religion and health, 58(5),
1713–1750. https://doi.org/10.1007/s10943-019-00876-w.
Jane, V., & Aparna, J. (2023).LIntegrative use of cognitive behavior therapy and Bowen’s Family
Systems Therapy with an Adult Man with Anxiety Concerns. LWW.
https://journals.lww.com/jpmh/fulltext/2023/01020/integrative_use_of_cognitive_behavior
_therapy_and.5.aspx
Lan, J., & Sher, T. G. (2019, October 10).LCognitive-behavioral family therapy. SpringerLink.
https://link.springer.com/referenceworkentry/10.1007/978-3-319-49425-8_40L
Marschall, A. (2025, March 20).LWhat is Bowenian Family Therapy?. Verywell Mind.
https://www.verywellmind.com/bowenian-family-therapy-definition-and-
techniques-5214558
13
FAMILY COUNSELING APPROACH: BEHAVIORAL AND CONGITIVE-BEHAVIORAL MODEL
Melton, PhD, ABPP, L. (2017). Brief introduction to cognitive behavioral therapy for the
advanced practitioner in oncology.LJournal of the Advanced Practitioner in Oncology,L8(2).
https://doi.org/10.6004/jadpro.2017.8.2.6
Newman, M., LaFreniere, L., & Shin, K. E. (2017). Cognitive-behavioral-therapies-in-historical-
perspective. ... https://www.researchgate.net/profile/Michelle-Newman-2/publication/
305611660_Cognitive-Behavioral_Therapies_in_Historical_Perspective/links/
58d030bd92851c8841c28182/Cognitive-Behavioral-Therapies-in-Historical-
Perspective.pdf
Nichols, M. P., & Davis, S. D. (2020).LFamily therapy: Concepts and methodsL(12th ed.).
Pearson.
Parker, E. O., & McDowell, T. (2016). Integrating social justice into the practice of CBFT a
critical look at family schemas.LJournal of Marital and Family Therapy,L43(3), 502–513.
https://doi.org/10.1111/jmft.12205
Ruggiero, G. M., Spada, M. M., Caselli, G., & Sassaroli, S. (2018). A historical and theoretical
review of Cognitive Behavioral Therapies: From structural self-knowledge to functional
processes.LJournal of Rational-Emotive & Cognitive-Behavior Therapy,L36(4), 378–
403. https://doi.org/10.1007/s10942-018-0292-8
14
