Different approaches

The difference between Cognitive Behavioural Therapy (CBT) and Gestalt psychotherapy lies in their methods, what their aims are and how they consider people to operate. This article is designed to help you decide between these two orientations of psychological help.

CBT works on the premise that thought precedes emotions: that your difficulties are therefore solvable by addressing the way that you think. CBT also claims to be more specific, by following SMART goals. SMART stands for Specific, Measurable, Achievable, Relevant and Time-based. I will initially look at where the two approaches stand in relation to SMART.

CBT is considered a short-term approach, in the sense that you and your CBT counsellor initially discuss your specific problem; you agree a time-frame and the treatment plan must be relevant to the particular problem that you agreed to work with from the onset. Part of the CBT process is dependent on measuring your progress so that you can gauge from measured data as to whether you are (at least in theory) improving.

Gestalt psychotherapy and counselling, on the other hand, does not readily lend itself to being quantitatively measured because people's difficulties are seen as too complex to be condensed into a linear scale. The set time-frame of CBT can occur in Gestalt treatment, but is usually seen as a hindrance to the client’s progress since the Gestalt therapist works with what unfolds during therapy, a bit like opening up a Russian doll (matryoshka) and not knowing for awhile how many further parts will emerge.

Another difference between the two approaches go back to their origins. Behavioural psychology (dominant during the mid 20th century) established themselves as a scientific discipline, hence the need to measure, limit and instruct; whilst Gestalt therapy (established around the same time) emphasises perception, the conscious as well as the unconscious and contact. And, whilst CBT operates on the scientific premise that people are rational beings, Gestalt therapy sees some of our difficulties as happening precisely because people are not entirely rational.

So far, these approaches sound rather opposite. However, the difference between CBT and Gestalt is not that Gestalt discards the importance of investigating behaviour and cognition; the difference lies in how these functions are investigated therapeutically, hence the visit to a cognitive behavioural psychologist differs from sitting on the psychotherapist’s couch. Perhaps your decision as to whether to embrace one or the other of these two approaches depends on how you would like to work.

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