Cognitive Behavior Therapy

What is the theory you chose?

Cognitive behavior therapy is a form of treatment that is based on a cognitive theory psychopathology. This cognitive model describes how the perceptions of people or spontaneous thoughts about circumstances impact their behavioral, emotional, and psychological reactions (Gallagher & Varga, 2015). A person’s views are usually distorted and dysfunctional during distress. They learn to identify and assess their “automatic thoughts” and to rectify their thinking for it to closely look like reality (Gallagher & Varga, 2015). When one does that, their distress often decreases, they thus can act more functionally, and their physiological provocation decreases. People also learn to identify and change their distorted attitudes: their fundamental understanding of themselves, other people, and their words (Gallagher & Varga, 2015). The distorted beliefs impact their dispensation of information and result in distorted thoughts. Therefore, the cognitive theory explains people’s physiological, emotional, and behavioral reactions as arbitrated by their views of exposure, which are impacted by their convictions and characteristic ways of relating to the environment.

What about this theory do you connect with and why?

I connect with this theory because it can be used to assist patients t evaluate and respond to their beliefs and automatic thoughts. Therapists can also teach patients to engage in the evaluation process by themselves. Patients may also be assisted by their therapists to plan behavioral experiments to conduct between sessions to assess cognition that is in prediction form. When a client’s thoughts are convincing, therapists do problem resolving, assess the patients’ conclusion, and work in their conjunction to embrace their difficulties.

How did you choose your client?

The client was chosen based on their issue and the population. Cognitive behavior therapy was to be applied to a patient with anxiety. I also like dealing with teen clients. Consequently, I decided to work on a teen with an anxiety disorder. I felt equipped and interested in working with teenagers and specializing in anxiety disorder. That made me feel I could give my best.

Techniques used and how they worked

Cognitive behavioral therapy has been proven effective for the management of anxiety (Hofmann et al., 2014), among other mental illnesses. CBT is conceptualized as a brief, skill-centered treatment that targets changing the maladaptive emotional reactions by changing the client’s thoughts and actions. CBT assumes that altering thoughts and behaviors results in a change in emotions and cognitions like appraisals.

Cognitive restructuring

Cognitive restructuring is a technique used in CBT that helps patients to identify dysfunctional thought patterns and build more grounded, rational ways of making sense of challenging circumstances. Cognitive restructuring is not much of a single technique, but it entails a collection of techniques to help in improving the patient’s thinking. The technique worked by helping the patients to track thoughts that she had during difficult situations, identify cognitive lies, and taking part in behavioral experiments to test out whether the thoughts are correct.

Graded Exposure assignment technique

Exposure is a CBT technique that assists patients to systematically approach their fear. Fear makes people avoid situations. Avoidance of situations feared is what maintains the feelings of anxiety and fear (Kaczkurkin & Foa, 2015). The technique works when an environmental stimulus that is similar to the feared stimulus is encountered, and these associative systems stimulate the fear formation. The fear composition is pathological while the association among stimuli, reactions, and their implication do not look like realism, like when it is triggered for safe incentives or reactions that look like the dreaded one (Kaczkurkin & Foa, 2015). Moreover, the fear formation is sustained by evasion behaviors that do not permit learning to happen. Therefore, through systematic exposure, patients gradually learn to face feared situations and handle increasingly difficult exposure assignments. Exposure is among the most successful psychological therapy that has about a 90% rate of effectiveness with anxiety disorders.

Benefits of using CBT to the client

The patient benefits from the CBT by improving their self-esteem. For most people suffering from anxiety, low self-esteem is the cause of their disorder (Hofmann et al., 2014). Cognitive behavioral therapy helps patients to develop self-esteem by centering on their issues and working towards the solution. As the client finds answers, her belief in herself will increase and will conquer anxiety (Hofmann et al., 2014). Cognitive behavioral therapy will benefit the client by assisting her in changing her negative thought into realistic, positive ones.

The cause of anxiety is a person’s failure to cope with situations that trigger fear and cause trauma or stress. CBT will offer the client with anxiety disorder ways of dealing with such situations (Hofmann et al., 2014). By the end of her therapy, the client will learn to express herself rather than covering up things. Another benefit will be the prevention of relapse. Patients suffering from mental disorders usually relapse after recovering. CBT provides anxiety patients with the tools they require to prevent a relapse (Hofmann et al., 2014). Since the client will have learned to identify their problems and learned coping techniques, they will be better equipped to identify the thought patterns they should avoid.

Assumptions that emerged during the session

During the session as a therapist I assumed that correcting the distorted cognitions of a patient will generate an improvement in the client’s behavior and mood. The therapist assumes that there is more happening in the mind of the client and that it has to be considered (Gumport et al., 2015). That is one of the cognitive psychology assumptions. It is assumed that what a client is remembering, thinking, leaning, perceiving, and their attitude towards stimulus, all has an impact on their behavior and should thus be considered. The techniques applied in the session lead to the assumption that cognitive distortions can be cause by social, environmental, and biological aspects (Gumport et al., 2015). They assume that a person’s beliefs and process of thoughts begin to develop in childhood, and it is when distortions can begin to occur. For example, someone who is from an abusive home can begin to think he or she is not lovable. Such thoughts can develop into adulthood.

Lessons from the application of the theory

 I learned that cognitive behavioral theory is not about “curing” bad thoughts, but assisting the client to learn how to react when they experience them (Gumport et al., 2015). I should thus inform the client that it is normal to have negative thoughts. They only need to learn how to react to them. Cognitive behavioral therapy trains clients to reframe negative thoughts or perceive them from a neutral view, which allows people to avoid certain uncomfortable emotions like anxiety. I also learned that someone might have spent many years trying to train their mind to think in a certain manner. However, CBT demands that people should actively retrain rather than rely on old habits of thinking. Clients should know that the key to upsetting any negative thought is practice. They should be aware that it takes cognizant efforts to retrain an embedded habit, and no one expects them to master it immediately.

Lessons on the counseling process

The work of a therapist is to guide a client, and it should not be a monologue where the therapist just talks at them for long. The counseling session should be more of a discussion on why and how a client feels about specific things, most of which they may have never thought about before. Clients should be allowed to explain their thoughts and feelings as a therapist listens. As a therapist, one should show the client that they are attentive to whatever they are saying and they empathize with them. Making assumptions is not allowed since it may seem like judgment. Clients would not open up when they realize they are being judged.

What would be done differently?

If I chose to counsel a client with anxiety disorder using cognitive behavioral therapy, what I would do differently is to have a discussion with a client rather than a monologue. I would be more willing to listen to the client rather than offer a solution to their issue. I have learned it is important to guide a client rather than give recommendations on what they should do. I would focus more on helping the client to gradually overcome negative thoughts rather than aiming to heal their negative thinking. I would also be patient with the client since upsetting negative thoughts is a process rather than a one time action.

References

Gallagher, S., & Varga, S. (2015). Social cognition and psychopathology: a critical overview. World Psychiatry, 14, 1, 5-14.

Gumport, N. B., Williams, J. J., & Harvey, A. G. (2015). Learning cognitive behavior therapy. Journal of Behavior Therapy and Experimental Psychiatry, 48, 164-9.

Hofmann, S. G., Wu, J. Q., & Boettcher, H. (2014). Effect of cognitive-behavioral therapy for anxiety disorders on quality of life: A meta-analysis. Journal of Consulting and Clinical Psychology, 82, 3, 375-391.

Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in Clinical Neuroscience, 17, 3, 337-346.