Comparing and Contrasting Client-Centered Child Therapy and Cognitive Behavioral Therapy
Therapy is a personal part of an individual's life. Very often, it is difficult to find the right fit in a therapist and the type of theory they use. While therapists may mix their theories and understand that not every client needs the same treatment, it is important to be educated on the types of therapy and how each is similar and different.
In client or person-centered therapy when treating both children and adults, it is important to first look at the creator of the concept, Carl Rogers. Rogers’ theory allows his clients to take the lead, process, and find their own solutions. The approach can be beneficial to patients seeking more self-confidence, stronger interpersonal relationships, and confidence in their decision-making skills (Hazler, 2016). It is required in this type of therapy to allow the client to take the lead and not direct the discussion. The therapist’s job is to provide no judgment and to acknowledge the patient’s experience while not interrupting the patient’s process toward self-discovery and healing (Hazler. 2016).
However, when working with children, it is important to include the aspect of play in the session. Client-centered play therapy (CCPT) can be done at any age, including adulthood, when involving the aspect of play. Most of the time, CCPT is done in ages 3-10 when the client is experiencing emotional, social, behavioral, and relational problems. CCPT provides a safe place for the child to process their experiences and feelings through toys and symbols. Kathryn de Bruin (2022), a registered play therapist, wrote an inspiring article regarding the themes shown throughout play that the child is communicating such as power and aggression, familial relationship and nurturance, control and safety, exploration and mastery, interaction, and sexualized play.
In my experience using client-centered therapy with children/adolescents, I found it was most helpful when using another theory to gain rapport with my patients as it is often their first time in therapy, and don’t know how to begin a conversation with a stranger. The directions I like to take are asking things like “how is school going?” “What is life at home like?” “Is anything bothering you or on your mind today?” and “What are some things that made you smile this week?” More often than not, the child finds that I have an interest in their daily life and actively listen. This has shown to be comforting to the child and a nice change of pace in a lot of cases. Using an approach such as this with my clients has helped them lower anxiety symptoms and reduce depression.
When including play in client-centered therapy, I often take a step back in the playroom and utilized reflection to assist the child in understanding that this is their space, I am only an invited participant if they so wish. I allow the child to utilize any toy they want and set boundaries only when necessary. The child makes the rules and I do not interrupt play. This has been found to be successful, and every client has eventually invited me into play with them. I have discovered sexual abuse, physical abuse, verbal abuse, positive family relationships, and more through play. In many cases, for my younger clients, these sessions allow them to play out what is happening in their custody case, identify their stable guardians in their life, and provide insight into their trauma. It’s an honor to be invited into their world.
Cognitive Behavior therapy (CBT) is a type of talk therapy that can be performed at all ages. CBT is used to help with a range of disorders and can be beneficial if a disorder is not diagnosed. When a child enters into CBT, the client and clinician agree upon a goal or multiple goals and have an idea of how long therapy would last. The child learns to replace negative thought patterns with more productive thoughts which in turn, helps children learn to handle stressful situations.
Through CBT, children will learn how to recognize unhelpful thoughts and behaviors as well as learn how to change them. This type of therapy focuses less on the past and more on the present and future. This may also be helpful for those who are not ready to take on trauma from their past but who still want to make progress defeating the demons that are haunting them from their trauma, if there is any. However, if trauma is not identified or present, CBT for kids can be applied every day. In CBT, children can learn how their thoughts negatively impact them and discover new outlooks on life that have realistic long-term solutions (Pietrangelo, 2019).
CBT can be utilized in multiple techniques such as play therapy, trauma-focused CBT, modeling, restructuring, and exposure. CBT can also be in conducted in a number of ways such as individually, parent-child, family, and group settings (Pietrangelo, 2019).
Looking at Client-Centered Child Therapy and Cognitive Behavioral Therapy, both may seem like completely different therapies while they may overlap. Both therapies allow for the child to come to their own conclusions. While both therapies can be used as talk therapies, toys may be included with a purpose. Both child-centered therapy and cognitive-behavioral therapy use play in a way that reaches the child’s goals. Often, both therapies can bring out stressful situations from the child and while neither are meant to “cure” the patient, both are meant to alleviate stressful symptoms.
Despite their multiple similarities, Child-Centered Therapy and CBT are drastically different. Simply put, child-centered therapy is a form of humanistic therapy and CBT is an evidence-based therapy. Child-centered therapy often helps a child express themselves without using words but instead play. In this type of therapy, it is not the clinician’s role to interpret the child’s feelings but their role to support the child in whatever they may be going through. CBT, however, allows the clinician to take a more hands on approach while also allowing the child to practice their newly learned skills.
While it is important to be educated on the type of therapy you are going to, it is also important for therapists to be educated on the multiple types of therapy so they can incorporate specific styles that may be beneficial to the client. Every clinician’s style is different but every patient’s needs are unique. Overall, it is important for everyone to choose what fits best for them whether it be client or clinician.
de Bruin, Kathryn. “Play Therapy Themes.” Family Therapy | San Diego | Kathryn De Bruin, 22 Jan. 2018, https://www.kathryndebruin.com/2018/01/22/play-therapy-themes/.
Hazler, Richard J., Counseling and Psychotherapy Theories and Interventions. Chapter 7: Person-Centered Theory. 6th Ed. 2016. American Counseling Association.
Pietrangelo, Ann. “Cognitive Behavioral Therapy (CBT) for Kids: How It Works.” Healthline, Healthline Media, 5 Dec. 2019, https://www.healthline.com/health/mental-health/cbt-for- kids.
Ms. Powell is a Pre-Doctoral Intern at Cognitive Behavior Therapy Center in Chesapeake, VA. She is currently completing her Doctorate in Clinical Psychology through Saybrook University.