Running head: MODALITIES 1

Modalities

Nathaniel Herrera-Bernal, Latoya Wright, and Elkie Carter

University of Phoenix

Individual Counseling

CNSL 547

Theresa Linville

July 30, 2010

 Modalities

Which modality is the most effective to treat depression? Team B researched various

modalities of therapy from Gestalt, Cognitive Behavioral Therapy, Behavioralism, Alderian,

Client Centered Therapy, and Reality Therapy. As a group, we analyzed how these different

theories treated similar and different mental health disorders. As a group, we decided that it

would be interesting and enlightening for us to examine both Cognitive Behavioral therapy and

Gestalt theories’ affect on depression as these theories are closest to our preferred methods of

conducting counseling. This paper will compare and contrast Gestalt and Cognitive Behavioral

Therapies modalities, methods of use, benefits to the mental health community, and what their

purpose for development are. What is Gestalt and Cognitive Behavioral Therapy, or C.B.T.?

Modalities

Cognitive Behavioral Therapy or CBT was primarily developed by Albert Ellis in the

1950’s and Aaron Beck in the 1960’s. This psychotherapeutic approach brought together

behavior and cognitive therapy to form a teaching model that focused on the present behaviors

and what results the client was getting and then re-educating the client on their negative thoughts

and as a result behaviors to begin to think differently and in turn make more positive, beneficial,

and non-destructive life choices. This type of treatment, as well as many other therapeutic

approaches can be used to treat a variety of disorders from depression, anxiety, and even eating

disorders. Another benefit of CBT is that it has been proven to work and does not call for a long

treatment period. CBT does not believe that events or people contribute to our feelings of

negativity. When therapists are using this type of therapy, their role is that of a teacher more

than a counselor that listens and works their way into the clients past to find the core issues

causing the distress as in Gestalt therapy. The therapist will teach the client to learn new ways of
dealing with their situation so the client can benefit from it instead of suffering through the

decisions. “Gestalt Therapy is a phenomenological-existential therapy founded by Frederick

(Fritz) and Laura Perls in the the 1940s” (Yontef, 1981 p. 1). The definition in the Merriam-

Webster Dictionary for the German derived word gestalt is: “a structure, configuration, or pattern

of physical, biological, or psychological phenomena so integrated as to constitute a functional

unit with properties not derivable by summation of its parts” (http://www.merriam-

webster.com/dictionary/gestalt, 2010 p. 1). This definition describes the Gestalt Therapy well.

In comparison with a person, the person is so integrated (a whole) that he or she could not be

summarized by just one part of them. For this reason, Gestalt Therapy deals with the whole

person and not pieces of them. Gestalt Therapy is used for counseling individuals, couples,

families, and groups. Gestalt Therapy can be used for many issues a person may be having.

These issues include but are not limited to are, depression, anxiety, guilt, sadness, low-esteem,

and relationship issues. Because of its wide usage the Gestalt approach is acknowledged by

therapist to be effective and used with other methods of therapy such as hypnotherapy. It is best

used for unfinished business a person may have that is presently effecting his or her satisfaction

in life (Middleton, 1996). Gestalt and Cognitive Behavioral Therapy are both open to treat any

individual of any race, sex, or age, with their therapeutic process to achieve the goals of the

client.

Method
 One of the many and most well know Cognitive behavioral Technique is rational emotive

behavior therapy, which was first developed by Albert Ellis. In one of the texts it simply states,

“ REBT’S basic hypothesis is that our emotions stem mainly from our beliefs, evaluations,

interpretations, and reactions to life situations”. (Corey, 2005, p. 272) Therefore, when

therapists are doing this type of therapy they are working with the client to change any irrational

beliefs they may have. For example if we are working with a client that is depressed, whose

thoughts are that they are worthless, this approach would be reframing those thoughts into

something more positive. Beck also developed what is known as Becks depression Inventory,

which is tried and true tested self-done assessment to gauge if one is depressed and to what

extent. Beck was best known for his work with depression and his effective treatment of the

Major Depressive Disorder. Although Gestalt deals with the whole person, a Gestalt therapist

also deals with the here and now as like Cognitive behavioral therapy. The belief is that a

person’s reactions and behaviors to situations or stimuli introduce and integrate their experiences

and beliefs. Unfortunately, many people’s past way of reacting is no longer valid in new

relationships and situations. Therefore, without having to dwell into a person’s past and

awareness of who they are and why he or she respond in certain ways is what the therapist and

client work through. The therapist may confront the client in an effort to gain insight from a

client’s response to a different perspective, often the content of the dialogue is not of importance.

Ultimately, the goals for the client is to become aware of how they perceive and feel what they

are confronted with along with his or her actions and how they respond making a complete

gestalt. (Yontef, 1981). To achieve their goals both modalities have a similar yet different

approach. Both aim for changing the thinking patterns and confronting the irrational beliefs of
their respective clients, but in different ways, as well as Gestalt take more time to learn about the

clients past and holds value in that.

Benefits

Gestalt therapy has many techniques or experiments to use, one of the two of the main

techniques or experiments as Gestalt therapist call them, used in Gestalt Therapy is exaggeration

exercise that is used when confronting the client on his or her non-verbal cues and body language

habits. Examples of these would be fidgeting with the fingers or hand, constant moving of the

legs, etc. Although some may believe that fidgeting is not communicating, in Gestalt Therapy it

is actually the best communication because it is out of person’s control. As stated by Perls, “The

state of non-communication develops into a state of inhibited communication. This means the

patient feels something; he wants to cry; he has secrets but is ashamed to tell you this. This is

the moment of the state of inhibition; he holds something in: inhabile (that cannot be handled or

managed). In addition, there you can always see the personal conflict: one part is turned against

the other (Perls, 1957 p. 1). A gestalt therapist will have the client exaggerate the body language

as in with a shaking leg, ask the client to throw the leg up and down as they speak, to really make

the client see the body movement, and make them aware of it. The second technique or

experiment is the empty chair. In which the therapist facilitates the client through a dialogue

with an imagined person whom the client has conflict or unresolved issues and verbally or

physically engages with the person as if they were actually present in the session. The empty

chair can be very effective with traumas, and depression to name a few to attempt to allow

unresolved issues with individuals who have caused the pain that causes the depression or the

negative thought processes or behaviors. Both exercises bring the client to the here and now

where they can become aware of their feelings as the situations are happening. When working
with a client in the Cognitive Behavioral model there are many treatments that one may use to

aid in educating the client. The therapist may require that the client began doing homework

assignments. These assignments may include journaling, or to do challenging tasks related to

their issue. The therapist may also have the client make a list of all their irrational beliefs, and

develop multiple disputes for them. With the help of the talk therapy and the homework

assignments, the client may leave feeling better, and more able to understand how to dispute

irrational thoughts that may enter into their mind. If a therapist is using REBT at the end of the

therapy, the client and the therapist may make plans and set strategies on how to deal with

potential problems that may arise in the future. Cognitive behavior therapy is an effective

modality, as it can be useful with all types of situations and populations. The client can be male,

female, child, middle-aged individual, elderly, any socioeconomic class, or any sexual

orientation. CBT can be effectively used during individual and group therapy. This type of

therapy can be used with all cultures as well, but it is important to remember that the therapist

has to be culturally educated and willing to learn about cultures from the client’s perspective.

Both modalities techniques focus on unveiling the irrational beliefs of their clients in different

ways, and both therapeutic approaches have and continue to be effectively used in the field.

Purpose

Many people may not agree with this modality because it does not focus on ones past

history, behavior focused, working with dreams, or free association. (Corey, 2005) It is believed

by some theorist that, how you can help someone if you do not understand where they have come

from in their past. That is one of the major differences between CBT and other modalities. Ellis

believed that in the other types of therapy a person may feel better, but rarely aids them in

getting better in the long term, CBT has the ability to prove working effective long-term changes
in a short amount of time. Compared to what Ellis believed that other modalities provide a

feeling of being better over a long period of therapy but not a long-term solution that would

allow the client to not need therapy. The Gestalt modality is different compared to many other

forms of therapy, which focus on interpreting and revisiting experiences and attitudes. Trying to

explore and understand why a person responds as they do. Gestalt also opposes behavioral

therapies in which just the behavior itself is isolated and corrected, similar to Cognitive

Behavioral Therapy. The Gestalt method should bring the client toward an answer to change

their coping strategies for their benefit, while confronting unresolved issues in the present. In the

process of the clients awareness he or she should also learn to appreciate and accept him or

herself. Therefore, while both modalities want to help their clients each use different methods of

confrontation. For CBT there would be education and the working process of identifying

irrational thoughts and developing new ways of thinking instead of identifying why those

thought originally exist, as one would do using Gestalt.

Findings

In conclusion, this paper covers what Cognitive Behavioral Therapy and Gestalt therapy

is. In brief some of the differences and similarities of Cognitive Behavioral Therapy and Gestalt

in Modality, method, beliefs and purpose. While CBT and Gestalt have similarities and

differences that allow them to be different, both models are at the mercy of the ones who use

them and are effective with using CBT and Gestalt’s methods, purpose and benefits to their

clients. Often these models are used unknowingly in conjunction by therapists to effectively

treat a client. With depression, both these models from the information given have the core

values to help a client suffering with depression, and have proven to be an effective tool against
depression. One modality may not work for every client, so it is beneficial for everyone that

there are two if not more modalities that can help. Therefore, which is the most effective

treatment for depression; it is not for us to say as it is whichever modality works for the client.

.
 Reference

Corey, G. (2005). Theory and Practice of Counseling and Psychotherapy (7th

ed.). Pacific Grove, CA: Thomson Learning.

Perls, F.S. Cooper Union Forum -- Lecture Series: "The Self" "Finding Self Through Gestalt
Therapy" 1957 p. 1. http://www.gestalt.org/self.htm

http://www.merriam-webster.com/dictionary/gestalt, 2010 p. 1

Middleton, J. D. How you might incorporate Gestalt techniques into your work as a
hypnotherapist, October 2, 1996. http://www.hypnosis.demon.co.uk/old/gestalt.htm

Yontef, Gary Gestalt Therapy: An Introduction, 1981 p. 1 hppt:// www.gestalt.org/yontef.htm