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EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 1 Beyond Symptoms: Exploring the Dynamics of Cognitive-Behavioral Therapy Karen Sopchak School of Behavioral Science, Liberty University Author Note Karen Sopchak I have no known conflict of interest to disclose. Correspondence concerning this paper should be addressed to Karen Sopchak Email: Ksopchak@liberty.edu

EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 2 Human Nature and Change Personal Background Relationship Building and Assessment To have a successful relationship with clients, therapists must first build trust. I would begin by discussing goals with the client and listening to what they hope to accomplish through CBT. I would also set boundaries and actualize therapy goals, including the therapy's direction. A calm, inviting, and uncluttered setting can help the client feel comfortable. According to Corey (2016), since CBT is a cognitive and directive behavioral process, a warm relationship between the therapist and client is not required, but it may enhance the process. At the very least, a respectful relationship is recommended (10-4d). My career goal is to work with veterans who suffer from both addiction and post- traumatic stress disorder. As a recovering addict, there are a few things I must be mindful of that other therapists may not. First, I must be cognizant that I do not use clients as a proxy for my recovery. Second, I must be consciously aware that I am not avoiding my intimacy or avoiding my issues while counseling others in recovery. From a psychodynamic perspective, counselors in recovery have the potential to use the profession as a psychological defense against their conscious awareness or self-loathing (Keene, 2015). Having been through CBT, I can attest that the counselor-client relationship is one of the most imperative aspects of a successful outcome. At the beginning of therapy, the therapist and client should discuss four key elements to determine a treatment plan. What does the client wish to get out of the sessions? What is inhibiting them from achieving their goals? What are their expectations for the sessions and their

EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 3 motivation to make these changes (Riopel, 2019)? Having the answers to these questions allows the therapist and client to refer to them and track the progress of the client's goals. Tracking is one of the most valuable tools to assess a client's progress throughout treatment. Through self-reporting, homework, journaling, and mood tracking, the therapist can gauge where the client is during therapy. In terms of CBT for addiction, relapse prevention, and cognitive restructuring help determine the client's progress. One of my rehab therapist's best techniques was a goal-setting workbook. I will also implement this, as it is an incredible way to monitor progress and goals in therapy. Nothing in this life is perfect, and that includes therapy techniques. One critique specific to CBT is that techniques are emphasized over the client-therapist relationship. As mentioned earlier, the therapeutic relationship is essential to any therapy (Cervantes & Robey, 2018). However, unlike Rogerian or humanistic styles, the relationship between a CB therapist and a client may survive even if there is turmoil between the two parties. Another contention over CBT is that it treats a person's symptoms rather than focusing holistically on the individual. Unfortunately, certain psychotic disorders, such as schizophrenia, may not benefit from this type of therapy. Individuals who suffer from delusions, hallucinations, or idealizations and feel disconnected from reality may not test the validity of their thought process (Cervantes & Robey, 2018). There is also work outside of the client-therapist session, such as homework, so it requires the client's dedication to be proactive. Another limitation is that CBT may sometimes fail to incorporate outside relationships that might influence the client (Cervantes & Robey, 2018). Lastly, since CBT focuses on present and future life events, it may not be the best therapy for people who suffer from childhood trauma.

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EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 4 Ethical and Biblical Considerations Therapists must approach their work with sensitivity and ethics, especially when dealing with deeply personal issues like pain, hope, self-esteem, love, and disappointment. Since therapy involves much personal discretion, a therapist's conscience is a crucial guide (Prasko et al., 2023). Even if a therapist lacks extensive experience, ethical considerations, and responsibility for their actions drive them to make the right choices. The attitudes and values of individuals and groups play a significant role in therapy, affecting the strategies chosen and how the therapist interacts with the patient. These influences often operate at unconscious levels, making it essential for therapists to be aware of their own attitudes and ethical dimensions (Prasko et al., 2023). Recognizing how these factors impact their practice is a crucial skill for a responsible therapist. Therapists must be honest about their reactions to patients and not underestimate their emotions. Recognizing discomfort is vital, as studies show that many clinicians work when they feel uneasy or ineffective (Prasko et al., 2023). Training therapists to focus on their emotions and self-reflection can enhance their ability to recognize discomfort and prevent negative patient impacts. Self-reflection is important for beginner therapists, as it not only aids in recognizing discomfort but also helps develop critical thinking and ethical decision-making skills (Prasko et al., 2023) It is a vital part of good psychotherapeutic practice to avoid behaviors like responding to aggression or favoring certain patients, as these can be unethical and driven by countertransference. Transference, a natural part of relationships, can affect a patient's autonomy. Addressing and processing transference can increase patients' understanding of themselves and their

EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 5 behavior patterns, allowing them to decide how they want to navigate relationships more freely (Prasko et al., 2023). However, if mishandled, psychotherapy, like any treatment method, can be harmful. Ethical decision-making, along with self-reflection, is a crucial skill for therapists and supervisors. This is especially true in cognitive-behavioral therapy, where issues related to transference, countertransference, and ethical reflection are essential, especially when therapy faces challenges or risks of unnecessary prolongation (Prasko et al., 2023). A therapist's personality is their primary tool, emphasizing the importance of self-education, personal and professional growth, and a positive self-concept in psychotherapy ethics. Based on cognitive-behavioral therapy (CBT), my theoretical stance harmonizes well with my Christian beliefs, combining psychological concepts with scriptural truths. Fundamental to CBT is the understanding that people are capable of self-awareness, making decisions, and changing unhelpful beliefs and actions. This emphasizes individual accountability and the possibility of redemption, which is in line with my Christian understanding of free will. The quasi-determinist viewpoint of CBT respects the impact of experiences while enabling people to use their divinely granted agency to make decisions consistent with moral principles and ethical standards. Recognizing the transformational power of spiritual insights and incorporating them into the therapeutic process is necessary to integrate biblical principles into counseling within a CBT framework. For example, the Christian concept of forgiveness can be woven into the CBT approach, encouraging healing and reconciliation to address issues of guilt and shame. Scriptures can be a source of knowledge and direction, providing moral and ethical underpinnings for clients that enhance the cognitive restructuring components of cognitive behavioral therapy. Furthermore, integrating prayer and spiritual practices can offer clients a comprehensive healing

EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 6 approach that cultivates resilience and a sense of purpose. Ultimately, incorporating biblical ideas into the CBT framework enables a thorough and spiritually aware therapeutic process that respects Christian principles and psychological insights. Conclusion To summarize, the advancement and extensive adoption of cognitive behavioral therapy (CBT) have unquestionably transformed the field of psychotherapy since Aaron Beck's pioneering research in 1960. The therapy's demonstrated effectiveness in addressing a myriad of mental health issues, from depression and anxiety to substance misuse and personality disorders, underscores its pivotal role in contemporary therapeutic practices. CBT's quasi-determinist perspective, which carefully navigates the delicate balance between free will and experiential determinants, underscores its nuanced approach to comprehending the complexities of human nature. Personal narratives, such as mine, serve as examples that illustrate how CBT not only acknowledges the influence of experiences and behaviors but also actively empowers individuals to recognize, question, and alter detrimental patterns. In doing so, it offers a source of inspiration for those contending with the intricacies of mental health and addiction. As the therapeutic community continues to discuss CBT's strengths and limitations, it is crucial to emphasize the ethical considerations integral to its practice. The therapeutic relationship, a cornerstone of CBT, requires ongoing attention to adaptability, empathy, and effective communication. Ethical considerations extend beyond the therapeutic space, causing therapists' self-reflection, awareness of personal biases, and a commitment to maintaining the highest standards of professional conduct. In navigating the delicate intersection of determinism, free will, and ethical responsibility, cognitive behavioral therapy stands as a powerful and

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EXPLORING THE DYNAMICS OF COGNITIVE BEHAVIORAL THERAPY 7 transformative force, offering individuals a path to symptom relief and a journey toward profound self-discovery and resilience.

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