Cognitive Behavioral Therapy For Older Adults: A Case Study

Cognitive Behavioral Therapy is the inspired work of Albert Ellis and Aaron Beck which emphasizes the need for attitudinal change to promote and maintain a behavior modification (Nichols, 2010 p. 167). Ellis believed, people contribute to their own psychological problems, as well as specific symptoms, by the rigid and extreme beliefs they hold about events and situations (Cory 2012, p. 291). CBT is based on an educational model with a scientifically supported assumption that most emotional and behavioral responses are learned. Therefore, the goal of therapy is to assist clients unlearn their unwanted behaviors and to learn new ways of behaving and thinking when he/she is faced with an

Psychological factors are known to contribute to how people experience and cope with pain. However, as people age, they experience normative age-related changes in psychological functioning. Thus, much of what is known about psychology and pain may not necessarily apply to older adults, unless it has specifically been tested in older populations. This is a particularly important point, because pain remains a major problem for millions of older adults. Furthermore, it is expected that the populations of older adults in America will increase significantly in the coming years, as people are living longer now that at any other point in history. Given that psychology changes across the lifespan, and that pain is a problem in older populations, this

Current literature suggests that the practising of cognitive therapy techniques on oneself is a valuable and useful way to learn about cognitive therapy (Beck, 1995; Padesky & Greenberger, 1995; Padesky, 1996). Padesky (1996, p. 288), for instance has written: ‘‘To fully understand the process of the therapy, there is no substitute for using cognitive therapy methods on oneself “. Beck (1995, p. 312) advises readers ‘‘to gain experience with the basic techniques of cognitive therapy by practising them yourself before doing so with patients . . . trying the techniques yourself allows you to correct

Currently in my facility, we do not have a policy regarding geriatric and/or demented patients and pain control. I believe this needs to be changed because although we have an initial assessment protocol, we do not have any kind of protocol to control a geriatric or demented patients pain. Since demented patients are quite often left unable to communicate their feelings, I believe there would be, less adverse effects and better patient outcomes for this group of people and better satisfaction with their families.

Developed in the mid 1960s by Aaron Beck, the Cognitive Behavioral Therapy (CBT) model theorizes that the interpretation of both external and internal events is biased, and can tap unhealthy underlying beliefs that potentially lead to emotional distress (Beck, 2005). Over the years CBT has accumulated an impressive track record in the treatment of a variety of mood disorders. In 1985, a review of 220 studies using CBT in the treatment of depression concluded that 91% supported the model (Beck, 2005). Large-scale literature meta-analyses on CBT in the treatment of anxiety disorders have also shown CBT to be highly effective in this population, particularly with posttraumatic stress disorder (Beck, 2005). Additionally, since the late 1990s evidence has accumulated showing CBT to be an effective treatment approach in substance use disorders, including alcohol dependence, marijuana dependence, and cocaine dependence (Carroll, 2004). No wonder CBT has been characterized as “the fastest growing and most heavily researched orientation on the contemporary scene” (Prochaska & Norcross, 2003, p. 369).

I will be collaborating with The National Institute of Mental Health for the funding of the research project. The research will attempt to identify what factors determine whether someone with PTSD will respond well to Cognitive Behavioral Therapy (CBT) intervention, aiming to develop more personalized, effective and efficient treatments. The mission of this project is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure (National Institutes of Health, 2013).

Cognitive-behavioral therapy (CBT) is a short-term, empirically valid amalgamation of facets from cognitive and behavior therapies. Cognitive-behaviorists believe that psychological problems stem from maladaptivity in both thought and behavior patterns, whether self-taught or learned from others. Therefore, changes have to take place in both thoughts and actions. Cognitive-behavioral therapy is structured as collaboration between client and therapist, focusing on the present. A prominent aspect of CBT is the client’s duty to be an active participant in the therapeutic process (Corey, 2013).

The paper focuses on the ethics of pain. Regardless of who we are, it is safe to say that pain is our biggest fear. Because good pain control is indicative to one’s quality of life it is important that it is addresses, especially when dealing with such a vulnerable population as the elderly. To complete this quality indicator, we will assess a day in the life of the Evangelical Lutheran Good Samaritan Society Nursing Home in Inver Grove Heights and how they address pain in the elderly.

It is a challenge to manage pain in older adults. The course of action, effect and

Bulimia nervosa is an eating disorder characterized by binge eating as well as by self-induced vomiting and/or laxative abuse (Mitchell, 1986). Episodes of overeating typically alternate with attempts to diet, although the eating habits of bulimics and their methods of weight control vary (Fairburn et al., 1986). The majority of bulimics have a body weight within the normal range for their height, build, and age, and yet possess intense and prominent concerns about their shape and weight (Fairburn et al., 1986). Individuals with bulimia nervosa are aware that they have an eating problem, and therefore are often eager to receive help. The most common approach to

Although ACT emerged in the 1980s, it wasn’t till 2005 that awareness and its popularity grew (Bach, & Moran, 2008). ACT was initially constructed as a substitute to the more classical forms of psychotherapy (Flaxman, Blackledge, & Bond, 2011). Rather than focusing on the reduction of indifferent cognitions and emotions, which is a primary focus in psychotherapies such as cognitive behavioural therapy (CBT), ACT looks at the possibility of increasing effective and progressive behaviours (Flaxman, et al., 2011). The contrast however between ACT and a psychotherapy such as CBT is that the therapist doesn’t focus on the presence or altering the unlikable emotions and thoughts of individuals, however they do in fact decrease through the ACT process

A therapy program targeted to adults 21 years and older, the Sensory Program focuses on sensory integration, rehabilitation, and quality of life (Aptus Treatment Centre, 2016). Sensory integration is the process of absorbing sensory information followed by organizing and assigning meaning to said information, and thus, making it worthwhile (Aptus Treatment Centre, 2016). To respond appropriately and effectively to given sensory input and/or a situation, one experience appropriate sensory integration (Aptus Treatment Centre, 2016). The cliental of Aptus impairments in the way they integrate, process, and organize sensory information, resulting in feelings of confusion, stress and anxiety, frustration and fear (Aptus Treatment Centre, 2016). Thus, the goal of the sensory program is to reduce feels of anxiety, develop coping strategies, and offer opportunities in which to learn self-regulation and self-expression (Aptus Treatment Centre, 2016). As such clients participate in activities such as a period within the “Snoezelen Room,” “relaxation time” and “music” (Aptus Treatment Centre, 2016). The “Snoezelen Room” is an artificially designed space that offers a relaxing environment through soothing lighting, music, gentle vibrations, and tactile sensations (Aptus Treatment Centre, 2016).

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.

The Cognitive Behavioural and Person-Centred approaches to therapy have many theoretical and practical differences, however they are also similar in their view of the individuals they seek to help. This essay will look at a hypothetical case study, involving a client named Stan who has been ordered to attend therapy sessions by a judge in relation to a driving under the influence of alcohol charge. Stan presents a number of issues affecting his self-image, confidence, identity and motivation. For the purpose of this essay, Stan’s depression and anxiety will be examined in the context of both Cognitive Behavioural and Person-Centred approaches to therapy. Additionally, the integration of these two approaches and the limitations and ethical considerations of such an amalgam will also be addressed.