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[Title of Paper Here]
[Your First/Last Name]
[University/Institution Name]
[Professor’s Name Here]
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Abstract
When pursuing a career that goes into the counseling and therapy field, it is important to
consider that someone may encounter many different people from various walk of life with a
mental health disorder. Mental health disorders do not have a color or race. Some mental
disorders include anxiety, PTSD, borderline personality disorder, and depression. A therapist
must be sensitive, caring, and understanding towards their client and their needs. Also, a
therapist should be able to motivate clients to meet their goals. It is important to first understand
what these disorders are, how a therapist should respond to these individuals with the disorders,
and what the best method of treatment would be for them in a respectable manner. Certain
therapy treatments can be beneficial for an individual depending on how they respond to the
treatment. It is also important for therapists to assess their clients which will help them know
what types of treatment is needed. Some clients will have been abused, neglected, traumatized,
which can lead them to seek psychological help. A few theories of therapy and treatment which
will be discussed will be Gestalt therapy, dialectical behavior therapy, and cognitive behavioral
therapy. Looking through the lens of a Christian worldview, the role and importance of a
therapist will also be discussed. Also, from a worldview point will be discussed.
Keywords: therapist, psychological issues, treatment, gestalt, Cognitive behavioral treatment
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Introduction
The world that exists today has many people who struggle with psychological issues.
These people need support which include children, husbands, wives, mothers and fathers, sisters
and brothers, grandmothers, grandfathers, etc. Someone who has a psychological problem does
not depend on their race, sex, or color and they can be rich or poor. A counselor or therapist must
be aware of various types of therapies to help clients feel better about themselves and live a
happy, healthy life. Therefore, they must seek help from a licensed therapist or counselor who is
specialized in that field. Being a Christian therapist, there is a duty to help clients as Christ
would have helped them. There are various theorical approaches as well, a few favorite theories
being Cognitive therapy, Gestalt therapy, and Rational Emotional Behavior Therapy (REBT). I
chose these theories because I am a school counselor and have some experience using these
therapies on my clients. As counselors, it is important to obtain the knowledge in all these
various therapies; within secular settings, these theories are not implementing with prayers in the
therapy. However, Tan (2011) stated in the biblical approach that the counselor will pray with
their client and read scriptures and also will encourage them to live a holy Christ-like life and be
open to God’s word. Various biblical interventions can be implemented and put in place for
clients. The counselor’s ultimate goal is to help the client get better and continue living a
Christian life while seeking the holy spirit daily for help.
Understanding Human Nature, Emotions, Thoughts, Actions, and Family/Cultural Systems
Some people have unhappy thinking and dysfunctional lives, for instance, people who
have borderline personality disorder, depression, and/or anxiety. A person with a personality
disorder is not always aware of their behavior. There are many factors that contribute to a
person’s cognitive ability to be dysfunctional and usually these factors can be either through
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environmental, biological, or genetic predispositions. Some people have a hard time
understanding why they feel a certain way which can lead them to act negatively towards others
(Seligman & Reichenberg, 2014). Sadly, some things happen in life for other reasons; for
instance, children who are taken away from family members to live with foster parents due to
neglect or abuse can lead to severe depression. Other risk factors include past family history of
depression or past episodes of depression. Statistic stated genes such as gender, personality, and
family history, as well as environmental influences i.e. stress, abuse, neglect, and adverse family
relations, across the lifespan together likely underlie vulnerability for depression (Heim &
Binder, 2012). Sometimes people develop depression later in life or early in life which can lead
to psychological issues. Some onsets for later life stress can be abuse from a spouse, financial
stress, job loss, poor financial management, loss of family members, or witnessing a traumatic
event; all of these factors play a major factor in humans to get depressed, developing PTSD, or
having suicidal thoughts in which they should then seek some type of psychological help.
Evidence has shown that adult women who were sexually or physically abused showed
increases in their neuroendocrine and autonomic responses to psychosocial laboratory stress,
particularly those with depression. Due to early life stress, some people struggle with feeling less
energy which can lead them to participate in less activities in their lives. The article also stated
that having a reduced medial prefrontal cortical volume in adults with emotional maltreatment
experiences reduced their orbital-frontal cortical volume in previously institutionalized children
(Heim & Binder, 2012).
Cause of Emotions and Sensations
People make up their minds about beliefs according to certain situations they are in. As a
counselor, one must try to understand a person’s automatic thought process which will help them
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look at things differently and lead to them changing their emotions and feelings. There are
intermediate beliefs and core beliefs. Intermediate beliefs often reflect extreme and absolute
rules and attitudes that shape people’s automatic thoughts. For instance, one example would be a
woman named Lisa whose brother came home but did not call her. Lisa had the automatic
thought of her brother simply being fine and not wanting to hang out with her. However, this
made Lisa feel unhappy (Seligman & Reichenberg, 2014).
A therapist is supposed to encourage their clients to view their core beliefs as idea rather
than truths. After this, the clients can work together with the therapist by expressing this belief
which the therapist can help them change. Examples of core beliefs are central ideas people have
about themselves that underlie many of their automatic cognitions and usually are reflected in the
intermediate beliefs. Core beliefs can be described as global, rigid, and overgeneralized. This is
due to a person’s upbringing events when they were a child and sometimes, they can believe
false assumptions which can be identified and change. The person’s view of life is his/her views
of the world, other people, themselves, and their future. Their mindset is positive. One example
of this type of mindset is if people say that if other people are like and can do something, then
they can too and there are many opportunities available. On the other side of thinking, they can
have a fixed mindset and say that some people can be negative and say that others do not like
them and that people in general are selfish and only think about themselves (Seligman &
Reichenberg, 2014).
In relation to psychological disorders, someone may be diagnosed with borderline
personality disorder which is a mental illness that affects thinking and feeling regarding an
individual and others, hence, affecting their daily lives. The disorder is characterized by
variations in mood patterns resulting in impulsive actions and challenges on interacting with
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other societal members (National Institute of Mental Health, 2020). Thus, people with the
disorder experience seasons of anger, depression, and anxiety. Individuals with this disorder
doubt themselves and find it challenging to control their emotions and behavior, hence why there
can be fluctuation in their relationships. As a result, individuals who have borderline personality
disorder show an intense fear of abandonment, instability, and difficulty tolerating being alone.
People suffering from the disorder show a high sensitivity level, as small things trigger them to
overreact, and once upset, they take time before calming down. Intense response to minor issues
affects their relationship with others because they react and act without weighing option sand this
can be seen as irritating to present parties. The disorder usually begins from early adulthood with
severe conditions, although the severity can reduce as one advance in age through adaptation and
treatment.
Family/Cultural Systems
A person’s cultural background refers to their ethnicity but can be influenced by their
social class, religion, migration, geography, gender, sexual orientation, race, and family
dynamic. McGoldrick (2005) stated that African American men like to be in control in the
household when it comes to gender roles and male violence against women is a frequent
presenting problem in family therapy. When it comes to emotional and physical abuse, African
Americans refused seeking help due to concerns about exposing men to a racist criminal justice
system or confronting negative attitudes about their domineering behavior towards black women.
Within African American culture, homosexuality is considered forbidden and most of them are
physically and emotionally abused which leads them to be depressed, struggle with anxiety, and
have post-traumatic stress disorder. African Americans experience internalized rage that is due to
a lifetime accumulation and may have a hard time expressing their emotions to a therapist. A
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therapist which is culturally competent can serve a crucial role in helping families of African
decent to reconnect with their unique histories and values (McGoldrick et.al. 2005).
Apart from this, single parents have a higher stress level which may lead them to
experience depression or anxiety and this may cause them to seek some type of counseling, In a
dysfunctional household of children with the parent not interacting and a family going through a
divorce, children are being abused which can lead them to possibly abusing drugs. McGoldrick’s
article also stated step parents increase the risk of being abused by a staggering factor of 20-40
times in contrast to living with single mothers where the risk was about 14 times compared to
living in biologically intact family (Behere, et.al. 2017). These are some examples of family
dynamics and cultures which can lead to many psychological issues which will lead these clients
to seek help from a therapist or counselor. Therapists and counselors must be sensitive to clients
needs, which will help them build a positive and productive client and counselor relationship.
Also, by being skilled with handling various cultures, counselors and therapists can be sensitive
to the needs of clients without stereotyping them due to their race, color, or background.
A person with borderline personality disorder is also associated with various
environmental triggers due to the family system they came from; this is common with their
defect. The environmental triggers include being a victim of emotional, physical, and social
abuse, having exposure to prolonged fear, and experiencing distress as a kid; thus, it may become
part of their growth life (NHS, 2019). In some instances, children abandoned by either or both
parents may suffer from this disorder as they will be distressed as they grow up questioning why
their parents were not there for them. The environmental factors associated with staying with a
relative with a mental complication such as bipolar disorders or drug and substance abuse addicts
can have a negative impact on individuals dealing with them. Family plays a crucial role in the
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socializing of their young ones into societal life and are responsible for their psychological well-
being. A relationship between a child and a parent has a significant role in their well-being and
influences their worldview as well as how they perceive other people. When parents fail to
resolve fear, anger, and distress in their children in early stages, such issues can result in
distorted thinking patterns such as stereotyped conceptions about others.
Theories and Treatment
There are many theories available regarding strategies that therapists can use to treat
patients and clients with certain psychological disorders. The theories that I decided to pick were
difficult to decide on since each theory has its own benefits and disadvantages but most of them
are good. I personally had the chance to use some of these theories with adolescents and
children, and other theories I learned about through reading and learning about them. The
following theories and treatments and their descriptions will be discussed to help understand
what psychological needs a client requires in order to improve their mental health.
Gestalt Therapy
This particular therapy focuses on gaining awareness about the present moment and
context involving a therapist and a client. Through therapeutic sessions, patients learn to discover
their suppressed feelings and to accept and trust their emotions. It utilizes creativity and
experiential techniques to enhance awareness, freedom, and self-control (Guberman, 2017). This
therapy’s objective is about core principles and addresses why and how people are attached and
influenced by their environment; thus, people always strive to grow and attain balance in their
undertakings. Hence, it uses a person-centered therapy and the use of empathy, understanding,
and acceptance of the client as they are to enhance the therapeutic sessions' outcomes. The theory
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asserts that context impacts individual experiences; thus, a full understanding of a patient
demands a comprehensive understanding of their background and environment.
According to this theory, patients should not feel compelled to change, resulting in more
distress and anxiety. Thus, a therapeutic process should involve cooperation between the
therapist and the client (Guberman, 2017). Patients should change by accepting situations and
gaining self-awareness to accept and trust their feelings and experiences to rid of their distress.
The objective of the sessions is to enlighten and sensitize the patient on self-awareness of the
present moment based on their interactions. Therapy enables the BPD patient to learn about their
feelings and discover the suppressed feelings they may have, accept them, and trust their
emotions. This allows them to gain a new sense of self-awareness.
Therapists can adopt creativity in their approaches, depending on the client's personality
and the environment they are in. Creativity methods allow for a flexible schedule to fit each
client's needs and preferences. Clients desire a trustable process and incorporate their views and
concerns, which are vital for the success of the therapeutic sessions. The goal is to create direct
contact to ascertain what the client is doing and how he is doing it (Guberman, 2017). The
therapist evaluates the client's actions at the moment and the desired end; this helps to enlighten
the client on their emotional and physical bodies are connected since understanding the internal
self is fundamental in establishing behavior, reaction, and actions. Gestalt therapy ushers the
clients into the first phase of gaining self-awareness to acknowledge and admit their actions,
responses, and behavior.
The therapeutic approaches can be applied to an individual or a group through exercises
or experiments. Exercises are used in the sessions to arouse emotions, actions, emotions, and
goals from the client. Groups can examine the results of the exercise to increase awareness and
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understanding of the person. Experiments are also used in the therapeutic processes and
relationships to enlighten the client to know various aspects of a mental health complication. In
some instances, therapists use an empty chair technique to conduct the sessions where the client
is made to assume that someone is seated on the empty seat (Guberman, 2017). The therapist
induces a conversation between the chair and the client to engage their thoughts, emotions, and
behavior. The strategy enables patients to become mindful of the scenario. Finally, therapists
may utilize exaggeration exercises where the patients are made to exaggerate specific actions,
movements, or expressions to create an emotional awareness attached to the trait. These
approaches can trigger the clients, providing an opportunity for the therapists to examine how
they respond to various situations providing an avenue to design an appropriate recovery plan.
Treatment of the Disorder
Borderline personality disorder is a complicated illness that affects an individual's daily
functioning and impacts their interaction with others. The disorder is hard to treat, but
contemporary evidence-based treatment reduces the severity of the symptoms, thus, improving
the patients' quality of life (Steffen, 2013). Evidence-based treatment is necessary from mental
health professionals who understand the dynamics of the disorder (National Institute of Mental
Health, 2020). The severity of the symptoms impacts the duration that clinicians take to help the
patients improve and gain self-understanding. Thus, its treatment demand patient as a client
gradually transforms from one step to another. The condition poses difficulties in treatment
because it is complex, stigmatized, and the symptoms portray ingrained thoughts and behavioral
patterns (Harvard Mental Health Letter, 2010). The defect does not depict uniform signs in all
the clients; instead, it demands closer examination to ascertain each client's condition before
prescribing a containment treatment. The clinical practices examine temporal relationships,
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impulse, and emotional variation resulting in mood swings or post-traumatic stress disorder
(PTSD). Drugs may minimize depression and anxiety, but do not address main personality
challenges and behavior. Hence, psychotherapy is regarded as a better option for treatment.
Dialectical Behavioral Therapy
This type of therapy was designed for BPD patients and is anchored on mindfulness,
acceptance, awareness, and attentiveness to the client's current situation and emotional state. It
helps control intense emotions and minimizes destructive tendencies to enhance how patients
interact with others (National Institute of Mental Health, 2020). Dialectical behavioral therapy is
the common type of psychotherapy used in treatment, although therapists utilize other options to
assist their clients. The approach is based on the premise that BPD makes patients incapable of
regulating emotions when they become hypersensitive (Arellano, et. al., 2014). The trait is linked
to growth in a home without adequate emotional support, especially when children are neglected
by parents. Dialectical therapy is used to reconcile weird traits, causing contradiction between
the patients and other society members (Harvard Mental Health Letter, 2010). Thus, it facilitates
accepting the patient's viewpoint while teaching them to change and adopt acceptable practices
within mainstream society.
Treatment of the disorder
The sessions for therapy regarding BPD should last for twelve months and entails group
and individual sessions. Each of the sessions have an intended objective; group sessions
ultimately enable the client to learn acceptable behavior and responses by taking part in problem-
solving sessions, muscle relaxation, meditations, and breath training (Harvard Mental Health
Letter, 2010). Individual sessions are designed to assist patients in incorporating lessons from
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group training into their routine activities. Research carried out at the University of Washington
affirmed the effectiveness of this therapy and it was said that it reduced the chances of self-harm
and suicidal tendencies. The research involved more than 100 women who had attempted
suicidal acts at least twice within the previous five years. The investigators subjected 50 percent
of the sample population to dialectical behavioral therapy and the remaining to clinical practice
for 12 months. The findings indicated that those who underwent dialectical behavioral therapy
had lower chances of suicidal attempts, harm, and hospitalization chances compared to clinical
practice.
Cognitive behavioral therapy
Cognitive behavioral therapy was first created by Aaron Beck who provided a structured
treatment of depression. Clients with dysfunctional or unhealthy mindsets learned to reconstruct
their thinking which helped them live a happier and healthier life. Data has showed that cognitive
behavior therapy has been successful with clients rather than them taking medication. When
client thinks negatively about themselves, it can affect their moods and behavior; therefore, if
clients learn to reconstruct their thinking in a positive manner, they may be able to change their
way of thinking and their overall mood. Most people who are sad or angry struggle with low-
self-esteem, and if they are depressed, they can sometimes think negative things about
themselves due to life experiences and family dynamics. If they learn to find their strengths
within themselves and see things in a different way, they may be able to change the way they
think. A dysfunctional cognition can include a person’s biology and genetic predispositions, life
experiences, and an accumulation of knowledge. Altered thoughts start during a person’s
childhood and are reflected in people’s fundamental beliefs (Seligman & Reichenberg, 2014).
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Treatment of Cognitive therapy
Cognitive therapy can be conducting into various sessions of at least 4-6 meetings with
clients. These sessions should be constructed in a fashion that is well organized and planned; the
therapist will advise the clients to complete a questionnaire before beginning treatment.
Cognitive therapy relies on specific goals for each client; these goals help clients recognize and
correct errors in their information processing systems. The therapist will have 10 procedures for
each session. The client and therapist will begin to build trust and rapport with each other while
encouraging realistic hope and optimism. During the beginning of the sessions, the therapists
will want the client to focus on changing the way they think. Clients will be given homework at
the end of each sessions and they will be able to provide feedback on sessions which they will be
encouraged to promote in a positive manner to provide motivation (Seligman & Reichenberg,
2014). Throughout treatment, the clients learn to focus on specific goals to complete. They write
there goals down are able to see their progress as they proceed with treatment.
Cognitive Behavior Treatment
Zalta’s articke (2015) on CBT talks about clients with PTSD and how they need
treatment for their trauma. Clients are given homework which helps them to create
improvements to change. These treatments are divided into therapy techniques and patient
events. The therapy techniques are the main purpose for change and patient events are the patient
behaviors or experiences that result from the therapy. The example given in the article says that
there were vivo exposures in which the therapist encouraged the clients to approach objectively;
The exposures were safe, but reflected a fearful situation in the real world and the patient event
that could result would be learning from the therapy technique and reducing the experience of
fear in the client and to build their trust in being faced with those experiences later on (Zalta,
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2015). This treatment helps the clients face their fear, which clients will be able to respond to
certain situations in a positive way in the future.
Scientific Research on Treatments
All of the theories stated from above have been successful with many different clients.
Conducting assessments and interventions put in place contributed to clients meeting their goals
and helping them live a positive and peaceful life. Seligman & Reichenberg, (2014) stated that
cognitive treatment has been very affective for clients who have suffered with depression,
anxiety, PTSD, borderline personality disorder, or traumatic events. Cognitive behavioral
treatment does not focus on the past or on the patient’s emotions, but is more so a broad array of
various interventions which are combined with various approaches. Cognitive behavioral
treatment has made many contributions to counseling and psychotherapy. Also, case
formulations and treatment planning has been compatible with today’s emphasis on goal setting
and accountability in treatment and has established a standard that other treatment systems are
expected to follow. Another contribution cognitive therapy has had in helping clients change is
through helping them develop more realistic cognitions to be effective and efficient in ways that
they can succeed and reach their goals. Gestalt therapy has many strengths; studies have stated
that by using the empty chair method and the two chair experience, these methods has been
successful outcomes with clients because they learn to be aware of their situations and emotions.
This technique helps to mend marital conflicts and problems between parents and children. Both
the cognitive therapy and gestalt therapy have shown consistent positive outcomes.
Christian Worldview
Religion is an integral institution within human society to nourish individuals spiritually
by restoring hope, peace, and comfort. Thus, an appropriate counseling approach should factor in
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the body, mind, and spiritual needs of the clients (Corey, 2006). However, most professional
counselors have focused more on body and mind ignoring spiritual consideration, which is also
necessary for psychological assessment, treatment, and the healing process for clients. Religious
principles and values are vital in the therapeutic process. It enlightens the clients to view their
challenge on the Biblical perspective; hence, restoring hope in situations where the affected had
lost hope once before can be a transformative process. Tan stated in their article that the biblical
approach encourages the clients to focus on hope, love, and peace rather than negative aspects of
life. Also, Christians believe that clients can call upon the Holy Spirit for help and continue
reading the scriptures to help them live more of a peaceful life.
Professional mental health workers and the entire counseling fraternity must incorporate
religious needs as an essential component in their approach of attending to clients to heal from
traumatizing situations. Karl Max defined religion as an umbrella for the masses; thus, it should
be treated as part of an individual's life significant in their progress from one level to the other
and is part of their well-being. Counseling experts should assess the spirituality impact on an
individual’s life and mental health (Avent & Cashwell, 2020). Hence, an individual’s religious
status can determine a suitable treatment plan to alleviate them from a struggle or disability.
In the United States, most African Americans lean on religion as a source of comfort
when they face various struggles such as racism, oppression, and family struggles. It is estimated
that 75 percent of blacks in the U.S. consider religion as an integral part of their society and they
prove this by attending weekly church services and participating in community events (Avent &
Cashwell, 2020). Thus, among this community, God is regarded as the Supreme Being
responsible for all undertakings; hence, when they face trouble, they will ask God for help.
Attending religious exercises like Bible study, sermons, and listening to gospel music is
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consolation, and it enables these individuals and societies to gain hope and strength despite their
difficulties.
Commitment to religious doctrines, values, and principles serve as a cardinal point to
counselors, who may come to assist them in certain areas. This is because most believe that the
various challenges are spiritual, and God is the one to intervene. Hence, research confirms that
only a small percentage of African Americans seek counseling services as they use their religious
leaders to find help in several areas, including mental health issues (Avent & Cashwell, 2020).
Counselors and mental healthcare services, who may attend this group, should familiarize
themselves with historical context and practices to gain trust among the black population to trust
their services.
Integration of spiritual and religious intervention measures into the psychotherapeutic
process entails encouragement through Biblical verses, praying together, and relating their
stories to Biblical narratives to give them a new perspective of understanding their scenarios.
The theological basis serves as the final authority for Christians as they believe that what God
says is final. Religion can help BPD patients to avoid self-destructive activities, suicidal
attempts, and threats as it teaches on adopting a Christ-like life. This perspective enables clients
to balance their views with Biblical demands (Corey, 2006). It also serves as a source of strength
and can be essential in facilitating a client’s healing and well-being. Tan stated Gestalt therapy
from a Christian perspective that as humans with psychological issues, they have to learn to face
certain experiences truthfully and set them free from darkness (John 8:32). Apart from this,
Christians need to take accountability for their choices and behavior, focus on here and now, and
believe that Christ will give hope when one turns to prayers, fasting, and reading the Bible daily.
As Christians, one must live by renewing their mind into something healthy, positive, and in the
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present moment. 2 Corinthians 5:17 states that if a person is in Christ Jesus, then that person is
considered to be a new create where the old things have gone away and new things have arrived.
Therefore, humans should be living and focusing on the present for the here and now and not the
past or future.
Conclusion
There are various types of psychotherapy to help clients see change in their life to live a
happy productive life. I believe with therapy, God, and some medication, a person’s cognitive
thinking can be developed in a positive way. For instance, with the disorder of BPD, many
clients need medications to help out with this condition. This disorder should be ascertained
earlier to facilitate the adoption of an early intervention strategy. Care providers should involve
the patients in finding a better solution to their life challenges. The professionals should instill
optimism in them that there is hope at the end of the processes to guarantee their recovery.
Therapists and support service providers should be impartial, consistent, and reliable in gaining
trust. Finally, the plan should be collaborative with other agencies during transitions stating how
patients could access the services in cases of a crisis. The condition causes an intense fear within
patients as they object being left alone through inappropriate methods. Impulsivity results in
unstable relationships as individuals with the condition readily accept other people into their
lives, although the friendship does not last. Clients with anxiety, depressions, self-esteem, and
trauma, also will benefit with cognitive therapy or gestalt therapy, theses clients can also focus
on the “here and now” and learn to manage stress and their emotions and reconstruct their mind
in a positive way. Everyone needs to live a healthy, peaceful life. While working with clients in
the secular and Christian setting, all people must learn about various types of theories and
conduct assessments with clients because this will help the therapist know what type of
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interventions should be put in place for the client. It is wonderful to image how a therapist would
feel when his/her clients meets their goals and responds well with interventions which are put in
place. Also, the clients will be able to live a happy, productive, and peaceful life better than
before. I tell my students that the mind is like a trickster where sometimes negative thoughts try
to attack the mind, but we have the authority to control what comes into our mind, by switching
it off. If it is not something nice, try self-talk and change the negative thoughts to something
positive, or put your mind in a happy place which will help you think about something positive.
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