Jenny Lynn Goodrich
Mr. Brian Cook
Core ___: Counseling and Psychotherapy
Detailed Essay
20 July 2017
Comparing and Contrasting Two Therapies
Though contrary to standard mental health protocol, I believe there are two very important behavioral therapies, which include compassion-focused therapy (CFT) and trauma focused cognitive behavior therapy (TF-CBT), because they are very effective for both a healthy outcome and the overall well-being of a patient.
Compassion focused therapy is a therapy treatment used to help support the mental and emotional state of the being by encouraging individuals to be compassionate towards not only others, but also themselves. Compassion is a natural emotional response towards others concerning sympathetic feelings, such as love in action, but rather at times influences, such as trauma and the environment of being brought up in, can interfere (Braehler, C).
Compassion focused therapy was established in the early 21st century, by Paul Gilbert. This therapy method includes many theories and techniques from various schools and workings of psychology such as cognitive focused therapy, developmental psychology, and social psychology. The base of CFT is grounded in the present understanding of basic emotion regulation systems: the threat and self-protection system, the drive and excitement system, and the contentment and social safeness system. In therapy sessions the goal of CFT is to bring all systems of human thought and behavior together to be in equilibrium (Leaviss, J).
The way CFT works may seem like a complicated process, but is actually very simple. According to the theory, the threat, drive, and contentment systems try to help reach a survival, which has also been proved in the past. Primitive humans would usually choose to avoid or overcome threats, seek resources, such as food, and enjoy being part of a social society. It has been proven that these systems of CFT are still effective, even today, irrelevant to how much generations have changed. In a threatening situation for example, an individual may experience feelings, which can include fear or anger, having the fight or flight response or create their own biases, such as jumping to conclusions and stereotyping (Braehler, C).
There are numerous techniques and exercises used in CFT, but the primary therapeutic technique is compassion mind training. This involves using different strategies used to help individuals experience compassion and other levels of such, for themselves and others. Compassion minded therapy, which aims compassion through incentive, compassion, understanding, and pain tolerance through use of specific training and focused exercises designed to help further develop non-judgmental attributes (Gilbert, Paul).
Individuals learn a variety of ways to help with their transitioning way of thinking in compassion, but there are three that are best. Gratitude exercises are the first, which are activities that the individual enjoys, which can include a trip to the beach to just generally taking the time to savor the moment. The second is mindfulness, which involves the ability to pay attention to the present moment in a compassion-focused mindset, which would be non-judgmental, in this case. The last includes compassion-focused imagery exercises, which is the use of directed memories and fantasies to stimulate the mind and later on incorporating physiological systems. The goal of this is to produce a relative image in the mind that stimulates the soothing system (Leaviss, J).
When individuals experience feelings of self-attack, the therapist can support them by analyzing the situation rationally, looking at functions and possible origins of these attacks, as well as possible reasons individuals may agree or disagree with them. This process may include picturing the self-attacking aspect (Gilbert, Paul). The individual in therapy may be asked to describe what the "person" looks like and any feelings that are evoked in order to better understand the self-criticism. Those who have difficulty experiencing and/or expressing compassion may be asked questions intended to help them explore and cure any reasons for potentially contributing to the prevention of the expression of compassion.
Like any therapy, there are various issues that can be treated. CFT can be helpful to anyone who has difficulty trying to understand, feel, or express compassion, as therapy can be a protected place to learn any reasons behind this challenge and explore approaches for changing, in a positive manner. CFT can also be effective towards helping others manage upsetting thoughts, behaviors, and feelings of any kind but may be mostly helpful when dealing with feelings associated with self-attack and others that struggle with anxiety, self-criticism, depression, anger, and psychosis. Individuals who seek treatment for those, may want to see if the therapist they are seeing offers CFT, as it could benefit greatly, which can assist in helping with improving the overall well-being, but does not always suit all situations (Leaviss, J).
Experts whom are interested in specializing in CFT can attain certification succeeding graduation. This training offers a virtual classroom, live seminars, demonstrations, and source materials. Candidates to the program are also required to have a postgraduate degree or the equivalent in a psychological health-related field such as mental health or therapeutic counseling. They must also first be qualified as a therapist or in the process of doing so, as they will need to access individuals in therapy to whom they can provide individual or group CFT.
As compassion focused therapy is effective many times, it also has its limitations. This therapy is usually only applicable for the concept of being cared for, and not everyone wants to possess this kind of character. Some may be afraid of compassion, while others may feel unworthy of being treated with compassion and some even find it difficult to understand compassion itself (Gilbert, Paul).
Issues may ascend in CFT while doing exercises, such as performing mindfulness and compassionate imagery. Some find it difficult to enter a state of mindfulness, in which a failure of doing so may lead to self-criticism, while many may not be able to focus on or even sense compassion imagery. The use of images of known people or events may also bring about undesirable associations and negative past experiences and being that, treatment may be less effective with those who are experiencing intense anger or rage (Gilbert, Paul).
Second is trauma-focused cognitive behavioral therapy. Trauma-focused cognitive behavioral therapy is an evidence-based treatment and is rounded towards aiding children and adolescents and their families in overcoming the negative effects of a traumatic experiences. This therapy has been proven effective after multiple traumas or even a single traumatic event, and therapists trained in this therapy are usually able to help individuals experiencing the emotional effects of trauma and the fill to address and resolve these effects.
The development of TF-CBT was led by the by Judith Cohen and Anthony Mannarino. Out of a desire to want to better comprehend the struggles faced by traumatized individuals, they protracted traditional cognitive behavioral methods by lengthening their reach by incorporating family therapy and using a trauma-sensitive approach in the therapy’s application to children and youth, such as trauma informed care (Weiner, D).
Because TF-CBT is merely rounded towards the needs of children and adolescents whom are experiencing both emotional and psychological difficulties, the result of trauma are integrated with compassionate, cognitive behavioral, and familial approaches to help cope through such events. TF-CBT usually works in a short-term time frame and generally lasts no more than 16 sessions, and more than 80% of traumatized children see improvement from this.
Both parents and children may be able to better process emotions and thoughts relating to traumas through TF-CBT, which can provide the necessary tools to lessen the overwhelming thoughts causing stress, anxiety, and depression. This can help traumatized individuals learn how to manage and cope challenging emotions in a healthier way. Once a safe and steady environment is in place in order to open up about details of trauma and enable and success, the time of cognitive and learning theories of treatment should be applied. Individuals are shown how perceptions may be distorted and are given the tools to redesign those perceptions through techniques, such as reframing (Trauma-focused).
TF-CBT is skilled-based, but is necessary for both the child and parent to practice the key components to be fully effective. Both are commonly asked to practice skills at home so that the goal is met; this kind of therapy is to allow both parties to develop their skills and communication techniques in a healthy manner (Cohen, J). The essential components of TF-CBT include: education and parenting skills, cognitive processing of trauma, and ensuring future safety and development.
The success of TF-CBT relies heavily on a trusting and open therapeutic relationship between therapist, child, and parent. The therapist integrates one-on-one child and parent sessions as well as joint sessions using family therapy values. Professionals of TF-CBT strive to provide parents the resources and skills necessary to help their children cope with the psychological effects of trauma (Cohen, J).
Although there are many successes, there are also many failures with TF-CBT. The main use of this treatment is for posttraumatic stress; therefore, the goal of this therapy is to help survivors of trauma bring forward and resolve pain resulting from these dealings to eventually reduce the negative behavior patterns and emotional responses often developing as a result of any trauma. Children and adolescents who have experienced these traumas may find this therapy to be an effective method in the process of returning to a healthy state of overall functioning of the well-being.
Childhood traumas such as abuse, domestic violence, or neglect can often lead to symptoms of post traumatic stress disorder, depression, and anxiety. Young individuals between the ages of 3 and 18 who have been exposed to such traumas may also benefit from TF-CBT, no matter the number of traumas encountered. Children who are learning to cope with the death of a loved one have also shown to benefit from this kind of therapy; Also no matter the living situation, of living with parents, in foster care, or even group homes, there is always hope to be helped with trauma-focused cognitive behavior therapy.
Experienced therapists with knowledge and training in child development, who can evaluate and treat a variety of mental health disorders, are typically the recommended providers of TF-CBT. Training is necessary in order to use in a trauma-focused framework, such as informed trauma care, and therapists who have received this training are also encouraged to seek other professionals who have experience with this therapy.
Therapists can access training in TF-CBT through first achieving a master's degree or greater, then later taking the intensive training. The training itself takes about 2 days and includes many other consultations thereafter and supervisory sessions provided by a treatment developer or graduate of the TF-CBT. As a practitioner, it is also required to complete three different TF-CBT cases, and pass a knowledge-based exam once those requirements have been met (Weiner, D).
Research shows both children and adolescents experiencing severe emotional impacts, due to trauma, frequently respond well to this technique. To date, 11 experimental studies conducted on the impact of TF-CBT on adolescent survivors of trauma have demonstrated its usefulness in reducing symptoms of depression, anxiety, and PTSD. Randomized experiments comparing TF-CBT to different therapies such as play therapy and supportive therapy show that TF-CBT benefits more over a few sessions. Studies backed this up even two years after the conclusion of TF-CBT demonstrated these advantages to be continuous over time.
As there are successes, there are also limitations. The trauma-focused cognitive behavior therapy may not be appropriate for all children and adolescents who have major behavioral concerns present before the trauma. Some may not benefit from this therapy and may see greater improvement with other approaches in which they are first helped to overcome these difficulties.
Adolescents who abuse substances or who are suicidal may temporarily see a worsening of symptoms when exposed to TF-CBT. Although this may still be helpful when treating children who are thus affected, often the pace of therapy must first be altered. Dialectical behavior therapy, another stabilizing therapy approach, is often used before TF-CBT is attempted with adolescents who have a history of self-destructive behaviors, like running away and severe self-harm. TF-CBT may still be of benefit and is not always negated in these cases. (Trauma-focused).
Both therapies have been proven to be very successful, but are still not as commonly used as they could be to be maximally effective. Used more and more compassion-focused therapy is an adjunct to trauma-focused cognitive behavior therapy. Both therapies have been shown to be more effective if used together, according to studies, compared to TF-CBT alone; both combined have shown to reduce symptoms of trauma, depression, and compassion of the self. CFT has a focus geared to all individuals, mostly adults who have a mature mentality, whereas TF-CBT focuses on children and adolescents.
In conclusion, I believe that both concepts have many merits and share many similarities but are different in some operations and techniques. I feel they are two very important therapies which should receive further consideration by the medical establishment because of how effective they are for the overall well-being of the patient.
References:
Braehler, C., Gumley, A., Harper, J., Wallace, S., Norrie, J. & Gilbert, P. (2013). Exploring
change processes in compassion focused therapy in psychosis: Results of a feasibility randomized controlled trial. British Journal of Clinical Psychology, 52, 199-214.
Cohen, J.A., Mannarino, A.P., & Deblinger, E. (2006). Treating trauma and traumatic grief in
children and adolescents. New York: The Guilford Press.
Gilbert, Paul. (2010). An introduction to the theory and practice of compassion focused therapy
and compassionate mind training for shame based difficulties. Retrieved from http://www.compassionatemind.co.uk/downloads/training_materials/1.%20Workbook_2010.pdf
Leaviss, J., & Uttley, L. (2014, September 12). Psychotherapeutic benefits of compassion-
focused therapy: An early systematic review. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413786
Trauma-focused cognitive behavioral therapy for children affected by sexual abuse or trauma.
(2012). Child Welfare Information Gateway, 6. Retrieved from https://www.childwelfare.gov/pubPDFs/trauma.pdf
Weiner, D. A., Schneider, A., & Lyons, J. S. (2009). Evidence-based treatments for trauma
among culturally diverse foster care youth: Treatment retention and outcomes. Children and Youth Services Review, 31(11), 1199 1205.