Cognitive Behavioural Approach

Like stated in “A Plague of Tics” by David Sedaris, “A person had to do these things because nothing was worse than the anguish of not doing them.” A “normal” individual might argue, “Why not just stop focusing on that and stay positive instead?” To a “normal” individual that might seem realistic but it’s not so for someone like me. We all experience an innumerable amount of thoughts throughout the day, but the issue arises when one thought becomes recurring and more and more prominent in your thoughts. In a combination of anxious thoughts and my OCD, I can find myself entertaining the same thought for hours on end. This fixation on my anxious worries is what often at times causes me to choose stressing over sleeping. I’ve found myself thinking about one thing at 10pm and have that thought carry over until 4am when I can finally convince myself it’s just an unrealistic worry. What was that thought? It was whether I had bubbled my ID number in correctly on my scantron. Looking back I know that it’s ridiculous because I always check my scantron multiple times before I hand it in just to make sure I didn't make a mistake. Even after checking my scantron five times I still feel the urge to check again so I have to force myself to hand it in and trust myself. In the moment these things don't seem irrational. The over-focusing on thoughts and the rechecking of things seem like logical conclusions just to make sure I didn’t mess up. I mean everyone makes mistakes right? It’s sometimes hard to draw the line where it becomes obsessive. Like in the essay, I too find myself succumbing to my OCD because ignoring it would cause even more distress than I already am

Cognitive behavioral therapy differs in several respects from more traditional forms of therapy. It focuses on two specific elements: cognitive restructuring and behavioral activation. The client and therapist work together in cognitive restructuring with the goal to restructure thinking patterns. In behavioral activation, the client overcomes barriers to participating in activities. The main focus is on the present and on specific problems. cognitive behavioral therapy is a goal oriented and educational therapy, because goals for both the short and longer term are identified and it teaches the client to modify mood en behavior. The client has therefore an active role in learning e.g. coping skills. Multiple strategies are used in cognitive behavioral therapy, like imagenary, role

Cognitive therapy is one of the few theories that have been extensively scientifically tested and found to be highly effective in over 300 clinical trials. It focuses on the immediate or automatic thoughts the client has and how these thoughts affect their feelings and behaviors. The goal of cognitive therapy is to identify these thoughts that are poorly affecting the client. Then teach the client how to identify these automatic thoughts and how they can effectively change them. Through the very structured sessions of cognitive therapy, a client should essentially learn the tools to be their own cognitive therapist for future problems they may encounter. The therapy session will not make them an expert but they will be better prepared to

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

Obsessive-Compulsive disorder is a type of severe anxiety disorder that impacts an individual’s entire life and way of functioning. Obsessions are considered intrusive and recurrent thoughts or impulses that cannot be removed through reasoning. Compulsions are the repetitive and ritualistic behaviors and actions that associate with the obsessions. These compulsions are to be performed according to specific rules or methods and are thought to prevent or reduce stress and feared situations. Both compulsions and obsessions cause disabling levels of anxiety. The individual affected is often able to recognize the behavior as excessive and irrational, but is unable to control or stop the behaviors without intervention.

Cognitive therapy, now called cognitive behavioral therapy was developed by Aaron Beck. Beck believed that dysfunctional thought processes and beliefs are responsible for an individual’s behaviors and feelings. He also believed that individuals’ have the ability identify these distorted thoughts and change them to more realistic thinking in order to relieve their psychological discomfort. This type of therapy is designed to be a short-term, straight-forward and structured approach to counseling in which counselors and clients work together. I strongly identify with cognitive behavioral therapy because I believe all behaviors are a result of incorrect thoughts and beliefs. Irrational and negative thinking can influence an individual’s ability to cope and deal with any difficulties they may be experiencing. I also like cognitive behavioral therapy because it briefly includes a client’s historical background in its approach to counseling. I feel that counselors should include a client’s past experiences when trying to understand at what point the client’s incorrect assumptions developed. I believe that everybody in this world always has a choice on how they handle and behave in their given situation and circumstances. In cognitive behavioral therapy, once the counselor and client have identified the irrational thoughts and evaluated whether there is any evidence to its validity, the client has the ability to choose whether or not they desire to change their distorted ways of

Instead of exposing someone to the OCD triggers, it is intended to delay the need to complete the compulsive ritual like. Try to reduce the amount of time spending on the ritual, the patient will realize that is acquiring more controlling thoughts.

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).

Nursing diagnosis for OCD include Severe Anxiety which may be related to Feelings of inadequacy and recurring thoughts. The goal is to help patient demonstrate ability to cope effectively with stressful situations without resorting to obsessive thoughts or compulsive behaviors. Intervention for accomplishing this goal is to demonstrate effective coping mechanisms for dealing with anxiety which include relaxation techniques and stress management. Also, demonstrate interest in client as a person and assist to reduce present level of anxiety. This is because whatever the client feels anxious of will increase the ritualistic behaviors.

OCD is a brain disorder that may be caused by incorrect information processing. The three areas in the brain that are looked at are the Orbitofrontal cortex ,which is located in the prefrontal cortex above the eye, the caudate nucleus located near the basal ganglia, and the anterior cingulate cortex located in the front of the corpus callosum. Kring et al., (2014 ) states, the activity in these three places increase when people with OCD are shown objects that provoke symptoms. Other factors such as genetic, behavioral, environmental, and cognitive factors can trigger the disorder in an individual . It is not known which specific gene is inherited, but if a family member has OCD, their is a chance a child can have it. "Children who have family members with OCD have a greater chance of developing OCD early in life". (psychguides.com) One might have been conditioned as a young child to fear or become obsess by learning from ones' parent, which is the behavioral factor . The environmental factor can be caused because of a traumatic experience such as getting an illness like the flu. This type of traumatic experience can trigger OCD in a person in order to prevent from getting the illness again. The cognitive factor can cause individuals not knowing when to stop their obsessive thoughts and behaviors. According to Kring et al., (2014), people with OCD suffer in having a deficit in knowing when to stop their thoughts and behavior. They fail to gain the internal sense of completion , which it is defined as

Because victims of OCD realize their obsessive thoughts and behaviors are senseless and unnecessary, they may try to hide their problem. They fear people will think they are "crazy" or silly, and they may feel that they're all alone. Of course, nothing could be further from the truth. OCD affects as many as 2 percent of all Americans. Research indicates that, like depression and bipolar disorder, OCD is caused by an imbalance of the neurotransmitter called serotonin. This brain chemical, one of many that

The philosophy of cognitive behavioral therapy is that “think and feeling are connected people are creative (Halbur & Halbur, 2015, p.47)”. The key aspects of theory are to challenge the irrational beliefs that we hold about ourselves. Aaron Beck the primary founder of cognitive behavior theory assumed that people can control how they feel and what they think. He believed that our inner thoughts and beliefs affected how we are affected on the outside. One of the key concepts is that the client’s dysfunctional thinking can be derived from an erroneous internal process or bias.

Worries, doubts, superstitious beliefs- all are common worries of everyday life. However, when they become excessive, or make no sense at all, then a diagnosis is made. In OCD, it is as though the brain gets stuck on a particular thought or urge and just can’t let go, no matter how hard they may try. OCD is a medical brain disorder that causes problems in information processing (Obsessive-Compulsive Disorder Foundation [OCD Foundation], 2000).

Darcy’s first recollection of having obsessions occurs when her grandmother died this was also shortly before her father relocated the family to a big city where the compulsions began. Her grandmother’s death is a very plausible cause to her OCD because it made her feel lonely and full of grief which carried over to her adjustment into a completely new and different environment. The emotions of grief and loneliness could’ve caused her obsessions to develop as a result of her new fears of experiencing more grief and loneliness. These new obsessions eventually led to compulsions to prevent her fears from ever coming true. This can be seen in the idea that her obsessions focus on not doing anything socially unacceptable. It is very common that a tragic event in one’s death can lead to the result of obsessions. In order to treat Darcy’s case of OCD, I would recommend addressing the issue of her grandmother’s death with Darcy in order to help her cope and come to acceptance. I would recommend this because it is clear that her grandmother’s death had a huge impact on her life and was something that she was never able to properly address which the relocation of her family can be partially blamed for. After Darcy had come to terms with grandmother’s death, I would then recommend exposure therapy paired with cognitive behavioral therapy. Many studies pertaining to OCD have shown that the pairing of exposure therapy with CBT is very effective with the treatment of obsessive compulsive disorder. I believe that the same results would be produced in this case if it was use. In this case, exposure therapy would be used to expose Darcy to death and to show her that it is inevitable rather than the result of something that Darcy did wrong. After being exposed to this concept, it is then crucial to use CBT to change Darcy’s misconceptions

OCD is now a distant friend, whom I see rarely. When necessary, meditating is able to quell any waves of anxiety. It allows me to gain back my sense of control, as my thoughts, mood, and breathing are in the palms of my hands. My means of recovery is now a daily tool. OCD defined me as a person. Without it, I am able to define