Different mental health care theories with a look at Gestalt Therapy and Behavior Therapy

Part One

How is Gestalt Therapy similar to Person-Centered Therapy, Adlerian Therapy, Existential Therapy, and Behavioral Therapy?

Part Two

Behavioral self-control

Discuss how you might use behavioral self-control procedures to help a client study more and Gestalt Theory’s empty chair technique to teach assertiveness training.

Part Three

Answer the following questions

• Name and describe two ways people avoid contact with the here and now, according to Perls. Give client examples for each. 120 x 2 = 240
• What did Fritz Perls mean by “unfinished business”? Give an example. 120 words
• Describe the cycle of awareness. Create a client example. 2 x 100 = 200
• Evaluate Gestalt therapy’s utility for clients who are of diverse backgrounds. What are its strengths and potential pitfalls? 2 x 100 = 200
• Evaluate Behavior Therapy’s utility for clients who are of diverse backgrounds. What are its strengths and potential pitfalls? 150 words
• Describe how you might use modeling procedures in helping a client learn a specific social skill. 100 words

Total around 1100 words total.

MENTAL HEALTH CARE THEORIES:

A Focus on Gestalt Therapy and Behavior Therapy

PART ONE: Gestalt Therapy and Its Similarities to Other Therapeutic Approaches

Gestalt Therapy and Person-Centered Therapy

Both Gestalt therapy and Person-Centered therapy (Rogers, 1951) share a deep respect for the client’s subjective experience and a commitment to the therapeutic relationship as a vehicle for healing. Both approaches reject a directive, prescriptive stance and emphasise the therapist’s authentic presence, empathy, and unconditional positive regard. Gestalt therapy’s concept of the ‘I-Thou’ relationship — a genuine, non-manipulative encounter between therapist and client — closely mirrors Rogers’ core conditions. Both models trust in the client’s innate capacity for growth and self-regulation, viewing the person as fundamentally oriented toward wholeness when the right conditions are provided.

Gestalt Therapy and Adlerian Therapy

Both Gestalt and Adlerian therapy are holistic in orientation, viewing the individual as an integrated whole rather than a collection of discrete symptoms or drives. Adler’s emphasis on social interest, striving for meaning, and the individual’s unique lifestyle resonates with Gestalt’s focus on awareness of one’s total field of experience — including relationships, environment, and self. Both therapies also explore how early experiences shape present functioning, and both encourage clients to take responsibility for their choices and behaviours. Adler’s teleological view — that behaviour is goal-directed — parallels Gestalt’s belief that every human act carries intentionality and meaning.

Gestalt Therapy and Existential Therapy

Gestalt and Existential therapy share perhaps the most substantial philosophical overlap. Both are rooted in phenomenology and existential philosophy, particularly the work of Heidegger, Buber, and Sartre. Both prioritise present-moment awareness, authentic existence, and personal responsibility. Existential therapy’s emphasis on confronting the ‘ultimate concerns’ of existence — freedom, isolation, meaninglessness, and death — complements Gestalt’s insistence that clients engage fully with their immediate experience rather than retreating into avoidance or intellectualisation. Both approaches view anxiety not as pathology but as an inevitable feature of human consciousness that must be confronted rather than suppressed.

Gestalt Therapy and Behavioral Therapy

While Gestalt and Behavioral therapy appear philosophically opposed — the former rooted in phenomenology, the latter in empiricism — they share important functional overlaps. Both emphasise observable, present behaviour rather than deep unconscious processes. Both are action-oriented: Gestalt uses experiments and role-play; Behaviour therapy uses structured exercises and skill rehearsal. Both also recognise the environment as a critical factor in shaping experience and behaviour. Additionally, techniques such as systematic desensitisation in Behaviour therapy and the empty chair technique in Gestalt both involve exposing clients to anxiety-provoking material in a structured, controlled way, with the aim of facilitating change.

PART TWO: Behavioral Self-Control and the Empty Chair Technique

Behavioral Self-Control: Helping a Client Study More

Behavioral self-control procedures are grounded in the principle that individuals can learn to manage their own behaviour systematically through self-monitoring, goal-setting, reinforcement, and environmental modification (Cormier & Nurius, 2003). Applied to a client struggling to study consistently, the following steps would be employed:

• Self-Monitoring: The client tracks their current study behaviour — when, where, for how long, and under what conditions — using a daily log. This builds awareness of patterns and triggers for avoidance, such as phone use or environmental distractions.
• Goal-Setting: Together, the therapist and client establish specific, realistic, and measurable goals — for example, studying for 45 minutes per session, four times per week. Goals are broken into manageable steps to build self-efficacy progressively.
• Environmental Control: The client restructures their environment to support studying — designating a study-only space, removing phones, and setting consistent study times. Stimulus control reduces the competition between studying and more immediately reinforcing behaviours.
• Self-Reinforcement: The client identifies meaningful rewards — a favourite meal, leisure time, a film — to be enjoyed after achieving study goals. This creates a positive contingency between effort and reward that is internally regulated rather than dependent on external approval.
• Self-Evaluation and Relapse Planning: The client reviews their weekly progress, identifies obstacles, and adjusts strategies as needed. Building in a relapse plan — what to do when a session is missed — prevents all-or-nothing thinking and sustains motivation over time.

This approach is particularly effective because it transfers control to the client, building long-term self-regulation skills rather than dependency on the therapist.

The Empty Chair Technique: Assertiveness Training

Fritz Perls’ empty chair technique is a powerful Gestalt intervention in which the client engages in dialogue with a symbolic ‘other’ — a person, a part of themselves, or an unresolved experience — represented by an empty chair. In the context of assertiveness training, this technique can be used to help clients who struggle to express their needs, set boundaries, or confront others directly.

The client is invited to imagine that the person with whom they find it difficult to be assertive — a domineering parent, a demanding employer, or a critical partner — is seated in the empty chair. The client is guided to speak directly to this imagined presence, expressing what they feel and need rather than suppressing or deflecting. The therapist may then ask the client to move to the empty chair and respond as the other person, facilitating a dialogic exploration of both sides of the relational dynamic.

Through this enactment, the client externalises an internal conflict, making it available for examination and transformation. They practice the act of assertive communication in real time, building both linguistic fluency and emotional confidence. The technique integrates cognitive, affective, and behavioural change: the client does not merely learn what to say but experiences the act of saying it, in a safe and supported environment. Over successive sessions, this rehearsal generalises to real-world assertiveness, as the emotional charge associated with direct expression is progressively reduced.

PART THREE: Short Answer Questions

1. Two Ways People Avoid Contact with the Here and Now (Perls)

Perls identified several mechanisms by which individuals deflect awareness of their present experience. Two of the most significant are:

Retroflection occurs when a person turns back onto themselves impulses or feelings that were originally directed toward the environment or another person. Rather than expressing anger at someone who has hurt them, for example, they direct that energy inward, resulting in self-criticism, self-harm, or psychosomatic symptoms. A client who consistently blames themselves for relationship breakdowns — saying ‘I always do something to push people away’ — when in reality they feel deeply hurt and angry at a former partner, may be retroflecting. The therapist’s task is to help the client redirect this energy outward through expression and appropriate confrontation.

Deflection is the process by which a person avoids meaningful contact by diffusing the intensity of an interaction — using humour, vagueness, abstraction, or changing the subject whenever conversation becomes too direct or emotionally charged. A client who, whenever asked how they feel about their estrangement from their father, launches into a philosophical monologue about the nature of family relationships, or makes a joke to lighten the atmosphere, is deflecting. They are physically present but emotionally unavailable. The Gestalt therapist would gently draw attention to the deflection and invite the client to return to direct, felt experience.

2. Unfinished Business — Fritz Perls

Perls used the term ‘unfinished business’ to describe unexpressed emotions, unresolved conflicts, or incomplete experiences that continue to intrude on a person’s present awareness and functioning. Drawing on Gestalt psychology’s concept of the incomplete gestalt — the mind’s tendency to seek closure — Perls argued that when emotional experiences are left unresolved, they persist as background noise that depletes energy, distorts perception, and interferes with present relationships. A client who lost a parent without ever expressing grief or saying goodbye may find themselves reacting to the losses of others with disproportionate intensity, or developing a pervasive sense of sadness they cannot explain. The therapeutic task is to bring the unfinished business into present awareness — through the empty chair technique, body awareness, or dialogue — so that it can be experienced, expressed, and finally completed.

3. The Cycle of Awareness — with Client Example

The Gestalt cycle of awareness (also called the cycle of experience) describes the natural sequence through which an organism moves from need or impulse to satisfaction and rest. The cycle comprises six stages: Sensation (the organism notices a physical or emotional cue); Awareness (the sensation becomes conscious, forming a ‘figure’ against the background); Mobilisation (energy builds toward action); Action (the organism moves toward meeting the need); Contact (full engagement with the environment or other); and Withdrawal (the need is satisfied, energy recedes, and the cycle closes).

Client Example: A client named David notices a tightness in his chest during a team meeting (Sensation). He becomes aware that he feels invisible and undervalued — his ideas are consistently overlooked (Awareness). He feels a surge of frustration and a desire to speak up (Mobilisation). He raises his hand and articulates his perspective clearly (Action). His manager acknowledges the contribution and thanks him (Contact). David feels the tension release and a sense of calm settles (Withdrawal). In therapy, interruptions to any stage — such as David habitually stopping himself at the Mobilisation stage — become the focus of exploration and intervention.

4. Gestalt Therapy and Diverse Client Populations

Strengths: Gestalt therapy’s emphasis on phenomenological exploration — attending to the client’s unique, lived experience without imposing a predetermined theoretical framework — makes it inherently respectful of cultural difference. Because Gestalt does not pathologise non-Western expressions of self or emotion, it can be adapted to clients whose cultural backgrounds emphasise collective identity, spiritual experience, or non-verbal communication. The experiential techniques — movement, imagery, and creative expression — offer non-verbal pathways into therapeutic work that may be more accessible for clients whose first language is not English or who are wary of purely verbal modalities.

Potential Pitfalls: Gestalt’s strong emphasis on individual responsibility and direct emotional expression may conflict with the values of clients from collectivist cultures, in which emotional restraint and deference to family or community are virtues rather than defences. The directive, confrontational style of some Gestalt practitioners — particularly the challenge of avoidance mechanisms — may feel culturally inappropriate or even shaming for clients from backgrounds where indirect communication is the norm. Therapists must exercise considerable cultural humility and adapt their style accordingly, avoiding the imposition of Western individualist assumptions onto diverse client populations.

5. Behavior Therapy and Diverse Client Populations

Strengths: Behaviour therapy’s structured, skills-based, and goal-oriented approach can be highly accessible to clients from diverse backgrounds, particularly those who are sceptical of insight-oriented or emotionally exploratory therapies. Its emphasis on observable, measurable outcomes aligns well with clients who prefer practical, problem-solving frameworks. Techniques such as modelling, role-play, and social skills training are adaptable across cultures and can be tailored to context-specific behaviours and norms. Research evidence for Behaviour therapy’s efficacy across a range of presenting problems is robust, and culturally adapted versions of CBT and behaviour-based interventions have been developed and validated for diverse populations.

Potential Pitfalls: Behaviour therapy’s focus on individual behaviour change risks overlooking the systemic, structural, and cultural factors — racism, poverty, discrimination — that shape client experience and that cannot be addressed through personal behaviour modification alone. Therapists must be careful not to inadvertently reinforce dominant cultural norms through the selection of target behaviours, or to frame culturally sanctioned coping styles as ‘maladaptive’ when they serve important adaptive functions within their context.

6. Using Modeling to Teach a Social Skill

Modelling, rooted in Bandura’s (1977) social learning theory, involves the therapist or a relevant peer demonstrating a target behaviour for the client to observe and subsequently imitate. To help a client develop the skill of initiating conversations — for example, a socially anxious young person who struggles to introduce themselves to new peers — the therapist would begin by explaining the components of the skill (eye contact, open body language, a warm greeting, asking an open question). The therapist then role-plays the scenario, demonstrating the behaviour while narrating the internal process: ‘I notice I feel slightly nervous, but I take a breath and approach.’ The client observes, then rehearses the behaviour in a safe, low-stakes environment with coaching and positive reinforcement from the therapist. Graduated real-world practice assignments consolidate the learning.

References

Bandura, A. (1977) Social Learning Theory. Englewood Cliffs, NJ: Prentice Hall.

Corey, G. (2021) Theory and Practice of Counseling and Psychotherapy (10th ed.). Cengage Learning.

Cormier, S. and Nurius, P. (2003) Interviewing and Change Strategies for Helpers. Pacific Grove, CA: Brooks/Cole.

Perls, F., Hefferline, R. and Goodman, P. (1951) Gestalt Therapy: Excitement and Growth in the Human Personality. New York: Julian Press.

Rogers, C.R. (1951) Client-Centered Therapy. Boston: Houghton Mifflin.

Wolpe, J. (1958) Psychotherapy by Reciprocal Inhibition. Stanford, CA: Stanford University Press.