Case study using CBT ON CLIENT WITH SEVERE ANXIETY

Recently, I completed a psychosocial assessment on a patient in the PHRM/ISS program. She was 21 years old, pregnant with her fifth child. When she initially walked in she seemed pleasant. Then, before we could get started she received a phone call. She politely asked could she step out and of course I said sure. Immediately, after she walked back in she seemed anxious and annoyed as evidence by her frowning and checking her phone every minute. Then, she would continue to say yes and not pay attention to the questions that I was asking. After a while, this began to bother me. This is because I would ask her a question and she would not answer or ask me to repeat myself. Then, she made a comment stating that “it does not matter and she was ready to go because she was upset.” At that moment, I knew that I needed to take an assertive stance.

CBT has a number of strengths; first beginning with its capacity to yield empirical results as to its effectiveness. Countless studies have shown CBT to be the most effective treatment for anxiety and depression (e.g., Oei & McAlinden, 2014; Tolin, 2010); this is likely the result of a number of factors. CBT is a collaborative, educational, time-limited model that demystifies the therapy process; changes are made with clients, not to clients, the strategies learned equip clients to better navigate current and future difficulties, and the setting of goals allows clients to clearly see their progress (Corey, 2013; Skinner & Wrycraft, 2014). An additional strength of CBT for anxiety and depression is its applicability to both individuals and groups; group CBT has a number of auxiliary benefits including, vicarious learning, a sense of cohesiveness that can increase motivation, social interaction and the opportunity to help others (Oei & McAlinden, 2014).

Cognitive Behavioral Therapy in contrast to many other therapeutic frameworks has both an explicit rationale and an empirically demonstrable success rate. In addition to the wealth of published case histories there are a plethora of controlled studies attesting to the efficacy of CBT interventions with an equally diverse range of psychological and behavioral conditions. (Emmelkamp et al 1992).

The purpose of this paper is analysing the contributing treatment approaches that resulted in the emergence of the Behavioural Cognitive Behavioural Therapy (CBT). The paper presents and analyses the contributions that previous psychological treatment methods made in culminating the CBT. To this end, the paper presents the main treatment methods that are assumed to be most important and analyse their main arguments in

This experience was educational and I was able to learn how to tailor questions that follow specific presentation complaints during the history intake process. Upon initial presentation, and discussion of her symptoms, it became evident that the questions needed to be more specifically related to the frequency of her disturbance, her diet, mood, social history, and activity level. At this same time, an evaluation of the severity needed to be explored with consideration the co-existence of anxiety and depression. Confirming the absence or presence of an acute life stressor was important to uncover during the history portion of the exam. This encounter was exciting to diagnosis because the diagnosis came from the clinical findings from the exam. The historical flow was intuitive and helped differentiate the diagnosis. Lab tests were not necessarily helpful to diagnose, although important to rule out other potential differentials. Both anxiety and depression were found to be present

This essay will review the literature on the effectiveness of cognitive behavioural therapy (CBT). Cognitive Behavioural Therapy was developed by Aaron Beck in the early 1960s and originally it was defined as cognitive therapy (CT). According to Beck (1967, 1976) cognitive therapy is a time restricted but structured approach, which is used effectively in treatment of many different mental illnesses. Despite the fact that the literature covers this therapy in a variety of contexts, this paper will mainly focus on applying CBT to depression. Depression can be described as a type of afflicted psychological well being, where the individual lacks confidence in their own worth (DH, 2004). Overall, this paper will review literature which is of

Firstly, she went right into the dialogue that you have, and build off of with a patient (especially substance abuse ones), and how difficult it can sometimes be

Following this step, in order to be sensitive to the client and ensure she understands confidentiality and consent, I would explore the reasons she is seeking help. Through this exploration process I would use the techniques of empathic responding and motivational interviewing to establish rapport with the client. Empathic responding and motivational interviewing will also help to ease any reservations Precious may

The brief treatment model that will be utilized will be Cognitive-behavior therapy (CBT). As such, the client’s treatment plan will reflect four CBT intervention techniques which are: identifying maladaptive thoughts, challenging those maladaptive thoughts and beliefs, behavioral activation, and problem solving. Brewin describes CTB as,

The main goal of CBT is to help individuals and families cope with their problems by changing their maladaptive thinking and behavior patterns and improve their moods (Blackburn et al, 1981). Intervention is driven by working hypotheses (formulations) developed jointly by patient, his/her family and therapist from the assessment information. Change is brought about by a variety of possible interventions, including the practice of new behaviors, analysis of faulty thinking patterns, and learning more adaptive and rational self-talk skills. (Hawton, Salkovskis, Kirk, and Clark, 1989).

“The goal of CBT is to teach clients how to separate the evaluation of their behaviour from the evaluation of themselves and how to accept themselves in spite of imperfections” (Corey, 2009, p. 279). In CBT the clients are expected to change their current behaviour (normally full of automatic thoughts) to a more rational way of thinking. The clinician will challenge the client’s behaviour in order for the client to understand his or her behaviour and get alternatives to change his/her behaviour. When using CBT, the client’s behaviour changes when they are aware of the abnormal behaviour. This approach allows the client to focus on improving his/her wellbeing. This enhances the client’s awareness of an existing issue and that changes are necessary. The client will develop new coping skills to deal with the situation and develop a new way of thinking from negative (automatic thoughts) to positive (more realistic thoughts). Initially the client may not recognise that a problem exists, but through this process will get

CBT is an integrated approach using various combinations of cognitive and behavioral modification interventions and techniques (Myers, 2005). The aim is to change maladaptive patterns of thinking and behaving that impact clients in the present (Weiten et al., 2009). From a cognitive behavioral perspective Jane would be diagnosed as having faulty thinking and dysfunctional behavioral issues suffering from depression, and anxiety in the form of Agoraphobia (Weiten et al., 2009).

Today Cognitive behavioral Therapy has been influenced by two major therapeutic approaches: firstly, Behaviorism as developed by Skinner, Pavlov and others in the 1950s and 1960s, where the main research was related to rewards and punishments, or stimuli’ and their response. Second is Cognitive therapy which was introduced or made popular by Beck and Ellis in the 1960s. CBT by definition is a form of treatment that focuses on examining the relationships between thoughts, feelings and behaviors. By exploring the patterns of thinking that lead to negative actions and the beliefs that dictate these thoughts, families can identify and change the patterns in order to

The other client name is Alan, who is a successful young man, married but was ganged raped at 13. He has kept this secret from his family for 21 years. It has caused him to have nightmares, suffers from physical and psychological issues. He has outbursts of anger and suicide ideations. However, one evening he reached out for help for rape victims using his computer. So, I will start off by discussing Sarah’s case and then follow it by Alan’s.