Combining Existential and Cognitive Behavioral Therapy
- Kaelyn Flairty
- May 23, 2021
- 6 min read
Personal Theory Integration: Combining Existential and Cognitive Behavioral Therapy
Kaelyn K. Flairty
Ripon College
The integration of therapies is a newer practice among many professionals, which contributes to the effectiveness of treatment for many clients by combining two or more therapeutic models instead of taking a single-schooled approach. But how do practicing therapists effectively integrate these varying therapies, and which of the many therapies should they choose to combine? Many professionals and psychotherapy enthusiasts, including myself, form their integrations on the basis of their own beliefs and what they wish to see in therapy. The field of psychotherapy includes a diverse set of models, which can be integrated in various ways.
In my studies, I strongly connected with both existential therapy and cognitive behavioral therapy (CBT). Due to this connection, my personal theory integration combines techniques from both of these therapies. Existential therapy takes a philosophical approach in which the therapist asks deep questions about human nature regarding anxiety, values, loneliness, etc. In addition, the therapist aims to help the client shape their life by realizing and accepting their circumstances (S. Thom, personal communication, March 5, 2021). Cognitive behavior therapy takes a more goal-oriented approach by focusing on the thoughts, behaviors, and feelings of the client (S. Thom, personal communication, April 2, 2021). Overall, both of these therapies focus on improving the client’s self-awareness in order to live a more meaningful and mindful life. Therefore, the integration of existential therapy and CBT is practicable due to their shared focuses on change, views of human nature, and the client’s own beliefs.
Personal Overview
As I mentioned, practicing therapists and those with psychotherapy interests formulate their integrations on various terms including their own beliefs. These beliefs stem from the cultural upbringings and practices of individuals. In conjunction, our culture and experiences influence the ways in which we view others. I was raised in a primarily white area, and was not exposed to a wide variety of cultures. Likewise, my family is white and follows Western dominant cultural values. Due to the little cultural exposure I have received, I have had to educate myself about the ways in which I can be increasingly culturally competent. I feel that I have a strong base within this realm, but I still have much to learn. I have taken classes with focuses on diversity, cultural competence, and cross-cultural communication. These classes have strengthened my understanding of cultures other than my own by teaching me about their social contexts, body language, time importance, etc.
My selected therapeutic models strongly reflect my values based on my cultural experiences. For example, being raised in an individualistic culture is directly related to both existential and cognitive behavioral therapy due to their client-centered focus. Additionally, I am a very goal-oriented and philosophic person, which fits well with both of these therapies as they focus on changing behavior, identity, and meaning. However, I feel this therapy integration can still be applied to many clients as long as the relationship between the therapist and client is strong. The relationship must take into account the client’s beliefs, while the therapist recognizes their own biases and prejudices.
Personal Theory Selection
I chose this theoretical orientation due to the similarities between existential therapy and CBT; I feel they have a lot of potential when paired together. As I mentioned, both therapies take a client-centered approach which helps for better integration. However, unlike existential therapy, CBT focuses on the symptom and represents a more medical approach. By integrating these two therapies, therapists are able to use both medical and philosophic techniques. The evidence-based approach of CBT provides a solid base for therapists to build upon when developing an existential plan. In addition, both of these approaches focus on the, “here and now,” which aim to propel the client towards a better future (Proti, 2016).
Personal Application
These aspects would help me and clients alike due to our goal-centered and more individualistic attitudes. Additionally, this integration would be beneficial to myself and individuals who are more interested in therapies that utilize empirical research, which is offered through the use of CBT techniques. The philosophical techniques used in existential therapy would help individuals live more authentically, and become more self-aware. This is tailored towards people who are more individualistic rather than collectivist, which in turn would attract them more.
Perfectionism is also something that I struggle with. CBT works to remove those parasitic thoughts by changing our behavior. By combining existential therapy in this situation, the therapist is helping the client still look towards the future, which many perfectionists would be drawn to. This idea also ties in with rational emotive behavior therapy (REBT), which is a technique used within CBT that focuses on the cause-and-effect relationship of our cognitions, thoughts, behaviors, and emotions interacting together (Corey, 2016).
Therapeutic Example
For example, if a client is struggling with perfectionism thoughts such as, “My mom thinks I’m stupid because I did not get an A on my exam,” the therapist can use the A-B-C method. The A-B-C method takes into account the activating event, behavior, and consequences. Then, the therapist would help the client determine whether these thoughts are logical or not. The therapist can also incorporate humor, however, this depends on the therapeutic relationship and client’s attitude about the belief. The therapist would work to help dispute this perhaps irrational belief through the use of journaling, exposure, or bibliographies. These techniques would work well for a client like myself who is “Type A.”
When combining this example with existential therapy, the client would be asked questions such as, “Five years from now, how do you want to look back on your relationship with your mother,” or, “With these intense feelings about your relationship with your mother, how do you get through your day,” which help propel the client towards more rational thinking. Furthermore, the therapist provides an empathetic source of energy, which helps the client feel supported. This may help clients who struggle with family relationships, or relationships in general.
Multicultural Analysis
While these therapies are great for individualistic cultured clients, these may not suit those who originate from more collectivist cultures. Collectivist individuals may have a hard time focusing on themselves during the integration of CBT and existential therapy due to the client-centered approach. In addition, these types of therapies do not take into account societal oppression. While clients may be able to change their own behavior and thoughts, it is difficult to take into account societal behavior and thoughts.
However, there are also strengths to this integration. For example, these therapies focus on the client’s belief systems instead of a Western-dominated view. Likewise, CBT focuses on cognition, which appeals to individuals with diverse backgrounds. The existential approach also focuses on human nature, which is applicable to all beings.
Being the “Change Agent”
As the therapist utilizing these approaches, I would be the “change agent” by holding an emphasis on the therapeutic relationship between myself and the client. It is important to remain professional, but also relay empathy towards the client. In terms of integration, CBT is directive and focused on the active therapeutic pursuit of change, while existential therapy aims to change as a by-product of the in- depth exploration and clarification of the individual’s way of being in the world (Claessens, 2016). So, it is important to get to know the client well, and be interactive with them in the sense of exploration. For example, by getting to know the client, I am better able to gear existential questions towards the client’s beliefs and help them reach change. In a hypothetical situation where the client is a practicing Christian, I could ask questions such as, “How have you been connecting with God recently,” which help the client relate more to their therapy. Lastly, getting to know the client is important in CBT because I would be focusing on the symptoms the client is experiencing.
Therapist Self-Care
As a therapist, I would take care of myself in various ways. First, I would go to therapy for myself at least once every two weeks or more if needed. This is important for the therapist to address their own problems, and can also serve as an educational experience. Therapists are not perfect, and will become better at their profession by learning from other therapists. In addition, being a therapist can be overwhelming, so it is important to talk about the issues that may be stemming from being a therapist that is affecting their lives. It is also crucial for therapists to continue doing the things they love. For example, I would make sure to make time for family, friends, being active, etc. To ensure that I am able to do the things I love, I would block time in my schedule everyday to do the things I enjoy.
Conclusion
In conclusion, the integration of existential therapy and CBT should be considered by therapists due to their shared focuses on change, views of human nature, and the client’s own beliefs. However, when integrating these therapies, it is important that therapists take into consideration the multicultural limitations and strengths. This can play a crucial role in the therapeutic relationship and process due to biases and societal oppression associated with clients. Furthermore, therapists should be the “change agent” for their clients by getting to know their clients and implementing strategies that work for them. Lastly, therapists should never forget to take care of themselves in order to be effective therapists regardless of the approach that they are using.
References
Australia, C. L. (2016). Theory and Practice of Counseling and Psychotherapy. Cengage Learning US.
Claessens, M. (2010). Mindfulness Based-Third Wave CBT Therapies and Existential-Phenomenology. Friends or Foes? Existential Analysis: Journal of the Society for Existential Analysis, 21(2), 295–308.
Proți, L. E. (2016). Aspects of Existential Psychotherapy in Cognitive Behavioral Approach. Romanian Journal of Cognitive-Behavioral Therapy & Hypnosis, 3(3), 11–18.
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