Social work has been influenced for decades by the ideologies of human behaviour which do not help up the challenges of reality (Bourn, 1998). Within the field of social work there are several theories in place, theories used within the practice of social work are fluid and have the room for change and adaptation. The several theories and models in practice today, have significant differences due to the adaptations from different theorists and research conducted. This assignment will compare the theories of psychodynamic theory and cognitive behavioural therapy addressing their historical context and their assumptions. It will also discuss how these two models differ in their understandings and approach to the assessment of clients.
The term ‘psychodynamic’ first used in the 1890s by Sigmund Feud, Psychodynamic indicates the interactions between different parts of the mind and events that occur in childhood and adulthood. Psychodynamic used within practice today is often used as an adjective rather than a noun, used to describe a broad approach to explaining psychological phenomena with a reference to unconscious mental process, both interpersonal and interpersonal. (Jarvis, 2004). Freud believed events that happened during childhood shape the individual into who they are as an adult, the events may also have an impact on the person in later adulthood from the trauma faced as a child without the individual recalling that specific memory (McLeod, 2018). Freud compares the brain to an iceberg with the theory of the most important mind being the unconscious mind the underneath of an iceberg as it is the part that you cannot see (McLeod,2017). The psychodynamic theory believes behaviour is caused entirely by our unconscious factors of which we have no control. Freud believed that slips of the tongue provided an insight into the unconscious mind and they were in fact not accidents meaning all behaviour is significant and determined (McLeod, 2017). Psychodynamic theory also believe that the personality is made up of three parts or tripartite. The ID is our instincts and pleasure which seeks instant gratification, this is present at birth and consists of all things inherited. The ID is irrational and illogical, it is based on what it wants and what it needs being self-focused. The superego works from the preconscious and unconscious parts of the brain. This is the morals based part of a personality, it works in making people feeling guilty. It is logical and rational based on the morals we have learnt from society and other influences. The superego puts limits onto the ID which can cause conflict between the two. The superego is present at the age of two when a child is starting to say and understand the word “no”. The final part of our personality is the Ego, which is present in the preconscious and conscious minds. This is the reality principle and is responsible for helping an individual to deal with reality. Ego balanced the demands of ID and super ego, it is unrealistic to be perfect also unrealistic to be irrational so therefore the Ego works by balancing the tensions between the ID and superego (McLeod, 2017).
Freud developed a collection of theories in which formed the basis of the psychodynamic approach, Freud’s theories are clinically based from what his clients have told him during therapy. During the period of 1800 to 1882 Freud’s mentor and friend Dr. Joseph Breuer had a patient who suffered from hysteria. In 1895 with the assistance from Freud, Breuer wrote a book on hysteria. In this they explained their theory: Every hysteria is the result of traumatic experience, and once that cannot be integrated into the personals understanding of the world (McLeod,2017). By 1896 Freud had found his out system calling it “psychoanalysis” in this he abandoned the use of hypnosis to practice a process he had termed “Free association” where he had his patients talk about what was on their minds. This led Freud to the development of hid theory on the human mind being a system that is complex and comprise of three components, ego, superego and ID. The theories set by Freud originated the psychodynamic therapy. Freud believed that individuals behaviour was based on a combination of unconscious sexual and aggressive drives, defence mechanisms and guilt. Freud’s theory and practice were also known as the psychoanalytic therapy. The psychoanalytic therapy involved a large amount of sexual exploration, particularly regarding identifying any sexual frustrations in his patients (Gaskin, 2012).
Cognitive behavioural therapy (CBT) is a short term, goal oriented psychotherapy, cognitive behaviour therapy approaches are based upon the theory that thought processes occur, and they matter. Dobson and Dozois proposed that all forms of CBT share three assumptions, that cognitive activity affects behaviour, cognitive contents and processes may be monitored and changed and that behavioural or emotional change may also be affected through cognitive change (Clark, 2004). Cognitive behavioural therapy aims to teach people that it is possible to have control over their thoughts, feelings and behaviours. Therefore, helps the person to challenge and overcome automatic beliefs and use practical strategies to change or modify their behaviours giving a result of more positive feelings. The approaches used in cognitive behaviour therapy believe abnormalities stem from faulty cognitions about others or the world. CBT also assume of behavioural theories that they are abnormal behaviours that are learnt and can therefore be unlearnt and in place new behaviours can be learned.
CBT focuses on a client’s thoughts, feelings and actions. If a client is thoughts of being a failure that would lead them to feeling hopeless or anxious in turn their actions result in avoidance or isolating themselves. CBT works by changing the way we think rather than feeling like a failure turning that negative thought into a positive by focusing on a thought of being successful resulting in a feeling of confidence and the action of being outgoing. CBT also works with removing our Negative automatic thoughts or NAT which live in our heads and can appear at any time. These are negative thoughts of which we have no control over and can happen regardless if something positive or negative happens. A NAT can just pop in and out r can stick around for many days. CBT works by changing these NATs into positive automatic thoughts. An advantage of CBT is that it gives a client a chance to interpret their feelings and respond appropriatley, this is especially useful within anger management. If a client believes they go from 0-100 within seconds and they snap CBT gives an option for them to test and see if they get angry to allow themselves a five second rule to think about what their response will be to either react or walk away, which shows the client they do not in fact go from calm to snapping within seconds and they are able to stop and think before reacting. CBT also allows the client to reflect that they may have been told in the past that they are an angry person and can go from one extreme to the next by being told from another person for example their parent or partner which leads to a negative thought of “I am an angry person, I go from one extreme to the other within seconds”.
CBT is an umbrella term for several therapies that share common elements. Rational Emotive Behaviour Therapy (REBT) developed in the 1950s by Albert Ellis, CBT was invented in the 1960s by psychiatrist Aaron Beck which stemmed from Ellis’ theory of REBT focusing on the quality of a therapeutic relationship with the client where Ellis in his theory did not think a warm personal relationship with the client was an essential part. REBT often is highly directive and confronted, where CBT Beck has more of an emphasis on the clients discovering misconceptions for themselves (Clark, 2004). Parker defines CBT as the approach in which involves alteration of behaviours or thoughts by increasing, decreasing or maintaining them (Parker, 2017). CBT approaches are based on the idea of behaviour is learnt therefore it can be unlearnt, or new behaviours can be learnt to take the place of the less useful ones.
These two models of Psychodynamic theory and CBT differ in their understanding in many ways. Freud’s psychodynamic theory approach takes a focus on an individual’s unconscious thoughts that have stemmed from their childhood which now have and effect on their behaviour and thoughts in adulthood. In comparison, the cognitive behavioural therapy takes a focus on how the individuals thoughts and perceptions affect their emotions and how they behave. Freud’s psychodynamic approach encourages the client to consider their childhood to trigger any suppressed memories, where the cognitive behavioural therapy is goal orientated and based on the now rather than past events (Trower, 1988).
There are many different theories, those of which are fluid and ever changing and adapting, different researchers have their own interpretations and adaptations to these theories. As social workers, there will be many theories we will encounter and need to have a basic understanding of these. Regardless of some similarities within the different theories, they also differ in understandings and approaches. It is important for us as social workers to have a basic knowledge of these different models to conduct an assessment for our clients and tailor the way in which we work with that client as social work is not a one size fits all profession within our client base and we need to be able to draw on all our theories and models.