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Emerging “Working Theory” of Counselling: Cognitive Behavioral Theory of Counselling
Tanisha Terry
Liberty University
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3/9/24
Table of Contents
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Introduction......................................................................................................................................2
Background: Factors Influencing Distress.......................................................................................3
Content: Theory-Based Treatment Strategies..................................................................................4
Underlying Mechanisms for a Meaningful Change.....................................................................4
Treatment Strateges and Intended Outcomes...............................................................................6
Integration of CBT into Christian Worldview.................................................................................6
Christian Worldview and Faith-Based Eclectic Working Theory...............................................6
Biblical Principles and Addressing Worldview Issues................................................................6
Example of Integrating a Christian Worldview into Counseling Practice...................................7
Conclusion.......................................................................................................................................9
References........................................................................................................................................9
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Introduction
Cognitive Behavioral Therapy (CBT) ranks as the best theory in counseling today
because of its perceived effectiveness in reducing mental health symptoms. First proposed by
Aaron Beck in 1960s, this counseling theory has been ranked effective by several studies in
managing mental disorders including anxiety disorders, depression, substance abuse, eating
disorders, and personality disorder. Several other researches consider this theory effective in
managing schizophrenia, bipolar disorder and other non-psychiatric disorders such as migraines,
irritable bowel syndrome, insomnia, and other related conditions. According to Luvira et al.,
(2023). CBT is a combination of two schools of psychotherapy namely behavioral therapy and
cognitive therapy. Behavioral therapy is founded on the notion that behaviors are learned and
therefore can be unlearned. Behavioral therapy seeks to identify the behaviors causing an
individual problem and then replace such behaviors with good behaviors through behavior
modelling or other conditioning techniques. On the other hand, cognitive theory places emphasis
on changing the thoughts that are often the basis of such behaviors (Chand et al., 2023). This
theory argues that the cognitive space is the center of thoughts, emotions, and behaviors; and that
people develop psychological problems due to inappropriate thoughts. Reshaping the
inappropriate thoughts should therefore be the starting point for this theory to work. While this
paper describes CBT as an emerging “working theory”, it does so from a wider perspective
starting from factors contributing to distress ( i.e., background, emotions, thoughts, actions, and
family) to theory-based treatment strategies and to the integration of a Christian worldview (CW)
into the counselling profession and to the examination of how biblical practices can inform our
overall understanding of human nature thus guiding therapeutic options and approaches.
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Background: Factors Influencing Distress
According to life experiences distress is a result of a myriad of causes, with the most
common ones being background, emotions, thoughts, actions, and family or cultural systems.
Whenever a mental case is brought forth, counsellors first assignment is to understand the
client’s life experiences and personal histories, as the two play a key role in a patient’s
psychological wellbeing. Luvira et al., (2023) writes that family background issues are major
predictors of mental health. For example, mental illness in parents or guardians often represent
huge risk for children and the wider family. The risk as a result of background worsens when
close people such as parents have complications such as anxiety disorder, Bipolar disorder,
alcoholism and other drugs or depression. In worst case scenario, some mental health risk is
inherited. Staying in an inconsistent environment increases the risk of developing mental
illnesses almost two-fold. Knowing a client’s background in details is crucial for effective
intervention.
Secondly, emotions or sensations play a crucial role in triggering experiences that often
impact an individual’s mental wellbeing. Ability to steer and regulate one’s emotions determines
one’s feelings and reactions in life. Instances of emotional dysregulation such as easy
frustrations, impulsive behaviors, mania, mood swing, losing temper, and anger during outburst
triggers symptoms that often disrupt an individual’s social relationships, quality of life, work,
among other (Tan, 2011). In worst cases, emotional dysregulation triggers mental health
conditions such as disruptive mood disorder, personality disorders, post-traumatic stress
disorders, depressive disorders, among others. Understanding that emotions and sensations play a
role in triggering distress among clients forms the basis for effective intervention.
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Thirdly, 70% of people suffering from mental disorders state that they think too much.
Their thinking often revolves around key issues namely negative experiences or life problems.
Ehring (2021) states that repetitive negative thoughts is a causal mechanism in development of
psychopathology. More so, induced rumination triggers problems such as biased information
processing, poor problem solving, and overall impairment in one’s interpersonal functions.
Recurring instances of maladaptive thoughts such as negative self-talk have a tendency to
accelerate depression, anxiety, low self-esteem, and a wider range of disorders such as substance
use disorder, eating disorder, PTSD, among others. Any instance of maladaptive thoughts or
repetitive negative thinking causes distress in a client, which can culminate to mental disorder
over time.
Fourthly, a client’s behavioral patterns and actions often serve as contributors to distress.
In most instances, client’s resort to maladaptive behaviors such as substance abuse and stress
avoidance, which temporary relief them from problems, but rarely solve the underlying issues. A
constant repeat of such maladaptive behaviors over time does not only causes distress but also
exacerbates the underlying problems.
Finally, family and cultural systems play a significant part in creating a client’s distress.
Intergenerational patters, family experiences, beliefs and intergeneration patterns shape one’s
interpersonal relationships and worldview thus impacting clients' overall mental well-being. For
example, underlying beliefs shape people’s perceptions and overall interpretation of events.
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Content: Theory-Based Treatment Strategies
Underlying Mechanisms for a Meaningful Change
According to Chand, Kuckel, & Huecker, (2023) CBT is a straightforward treatment
strategy that revolves around cognition, emotion, and behavior. With cognition three aspects play
a role among individuals namely the automatic thought process, cognitive distortions, and
underlying schemas. Ideally, automatic thoughts influence an individual’s emotions and actions
in response to occurrences. If a for example, a friend runs past you without greeting, two
instances of automatic thought occurs. First, there is the possible thought that, “he has not
greeted me because he hates me” which possible impacts ones thought process negatively. The
second thought which is often ideal is thinking, “he must be in a hurry to class.” This kind of
thought does not impact the mood in any way as compared to the first automatic thought. With
CBT, the dysfunctional and automatic thoughts which are often mistaken, unrealistic and
exaggerated cause psychopathology. Secondly, cognitive distortions, a highly prevalent
occurrence among patients of psychological disorders forces individuals to arrive at erroneous
conclusions with common examples being overgeneralization, disqualification of the positive,
selective abstraction, mind reading, minimization, blame, emotional reasoning, and fortune
telling. Managing all these types of cognitive distortions is critical in distress reduction.
Kellemen & Viars, (2021) states that finding meaningful change through CBT starts with
cognitive restructuring and behavior modification. Through cognitive restructuring one is taken
through patterns of their behaviors while identifying which one contributes to maladaptive
behaviors. Once the behavior is identified the goal is to replace such behaviors with realistic and
adaptive ones. CBT does not stop at thoughts but proceed to behavior remodification based on
new and healthier goals set. CBT’s behavior modification strategy reshapes behavior through
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reinforcement, exposure and skills building activities. Through exposure techniques clients are
thought on how to face situations with control, reduce any avoidance behavior, and reduces
instances of anxiety (Luvira et al., 2023). Through reinforcement a client is rewarded to engage
in adaptive behaviors as long as the reinforced behaviors reduce occurrences of maladaptive
behaviors. Other behavioral means include skill building activities which equip clients with
necessary problem-solving skills as well as helping them cope with life stressors in an effective
and efficient manner. Overall, CBT offers the anchoring skills and support necessary to manage
emotions and urges without resorting to new habits. CBT's flexible and balanced perspectives,
allow the clients to experience relief from mental health illnesses such as depression, anxiety,
and other issues.
Treatment Strategies and Intended Outcomes
CBTs treatment strategies are designed to sole a specific cognitive and behavioral pattern
that contributes to varying degree of mental distress among client. As noted by Nakao (2021)
CBT promotes the elimination of avoidant and safety seeking behaviors which often present
altered beliefs, thus reduced stress and increased quality of life. For example, a client faced with
symptoms of social anxiety is challenged to abandon irrational behaviors (i.e., people do not like
me) to realistic and reaffirming statements and thoughts such as I am strong and can do all these.
Integration of CBT into Christian Worldview
Christian Worldview and Faith-Based Eclectic Working Theory
My Christian worldview develops a responsible faith based eclectic working theory
through the recognition of the inherent dignity of every patient as created in the likeliness and
image of God. While CBT theory reduces symptoms through behavioral and cognitive
restructuring, they are never enough especially when handing a Christian client. As such, my
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Christian Worldview brings into play crucial biblical tenets that serve as the foundation in a
Christian like therapeutic process. Clearly, a responsible faith based eclectic working theory
must integrates the four factors into Christian like counselling interventions, thus creating an
involving and holistic approach which addresses clients psychological and spiritual problems
during distress.
Biblical Principles and Addressing Worldview Issues
I hold the belief that biblical counselling must emphasize key principles when dealing
with the client: (1) developing of Christ like character from the counsellors side as is the case in
Ephesians 5:1 and Mathew 22:37-40; (2) strong leverage of the spiritual resources such as
salvation, local church for spiritual growth, and the word of God; (3) faith of the client because
long term change only happens when the client believes in Christ and subscribes to the goal of
bring God and Jesus closer; and (4) bringing in the whole self-including the physical and
spiritual self as seen in Corinthians 4:16-18. All these principles are based on the understanding
that human nature as fallen but capable of redemption necessary in addressing the problems of
sin, shame, guilt and reconciliation. According to Knabb, Johnson & Garzon, (2020) illness is
often a result of a wider array of factors including hopelessness, fear, lack of spiritual growth,
maladaptive thoughts, poor relationship with other people, and the lack of personal relationship
with God. Long lasting satisfaction comes when there is a total realization of the biblical,
spiritual, psychological, relational and physical being. This is because sins affect human health
and good approach starts with the realization that personal action never solve all sins, other than
having a pure relationship with God.
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Example of Integrating a Christian Worldview into Counseling Practice
In biblical counselling, integrating Christian worldviews involves incorporation of
scriptures, prayer, spiritual reflect and spiritual interventions into counseling sessions, as dictated
however by the client’s beliefs and religious preferences. In promoting cognitive restructuring
with a Christian counselling framework, scriptures offer the stewardship necessary in reshaping
clients thought patterns. Scriptures from the bible are typically rich in wisdom, guidance and
moral teaching. For example, Colossians 2:1-10 reiterates that God has the solutions to heal
human natures brokenness and that unlike secular options, Gods solutions are effective and long
lasting. Solutions offered by God to man through the scriptures offer the guidance necessary to
live a life that is not just complete but abundant. Secular therapy seeks to alter behavior and
thoughts as seen in CBT, but biblical teaching offers the right therapy session that challenge
one’s belief, offer mental comfort and promote positive and Christ-like living (de Abreu Costa et
al., 2022). Integrating cognitive restructuring practices in religious truths, clients find hope,
grace, strength, love, and the sense of purpose which often lacks in secular theories of
counseling.
More so, spiritual interventions such as the healing memory of prayer or the inner healing
prayer works well in biblical counselling. Inner healing prayer has the goal of healing past
traumatic experiences, healing emotional wounds, and erasing negative experiences through
prayer. Prayer opens room for clients to seek guidance and restoration from God which then
makes them clean through the blood of Jesus which was shed on the cross. Christian therapists
and counselling can facilitate inner prayers by creating a supportive and safer space for their
clients to explore inner spiritual beliefs, memories, and feelings. As a divine intervention, prayer
allows clients experience profound emotional and spiritual transformation, through forgiveness
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and Godly resolution of their past experiences. Besides prayer, recognizing and acknowledging
God-given talents and gifts is important for building confidence and self-esteem from a spiritual
perspective (Prout et al.,2021). In counselling therapy sessions, therapists may help their clients
identify their unique strengths, abilities, and talents as the manifestations of God divine grace.
Ideally, shifting the focus from self-reliance as was the case in secular theories, to reliance on
God's provision and empowerment, helps individuals cultivate a deeper sense of fulfilled,
gratitude, humility, and confidence in their day to day abilities. Prayer and recognizing the God
given talent offers the perspective the true confidence comes not from one's efforts alone but
from acknowledging and embracing the gifts that God bestowed upon us.
Finally, prayer and spiritual guidance serve as powerful resource in counselling as it
offers the right comfort and hope for individuals facing all types of challenges or adversity.
Through prayer, individuals have the space to talk to God about their fears, desires, and
struggles, thus finding the much-needed solace, guidance, and divine intervention, especially in
difficult times (Dumulescu et al., 2022). Counsellors can incorporate prayer into therapy
sessions, thus encouraging clients to draw upon their faith to find the much-needed strength,
support and resilience. By nurturing a deep spiritual connection with God and seeking guidance
from religious teachings and the community, clients easily find a renewed purpose, inner peace,
and lasting healing in their faith-based journey, as supported by the counselor.
Conclusion
In conclusion, the integration of cognitive behavioral therapy with a Christian worldview
offers a comprehensive approach to counseling that addresses the multidimensional needs of
clients. By understanding the underlying mechanisms of change in CBT and incorporating
biblical principles into therapeutic interventions, counselors can facilitate meaningful and lasting
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transformation in clients' lives. This holistic approach honors the dignity and worth of each
individual and fosters healing and growth in mind, body, and spirit.
References
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