Cognitive Behavioral Therapy (CBT)
You are required to conduct a cognitive behavioral therapy to “Maria”
1- Maria has symptoms of anxiety like:
– worried about other people’s criticism
-avoiding crowded places
– insomnia, disappointment, and fatigue
-fear of blushing
-considering herself nothing without marriage
2- How do you evaluate the patient ?
3- List the questions that will be asked
4- Create a scenario to answer the questions or (find a real patients answers from a clinic)
5- explain how will you deal with the patient and what will you tell her.
6- after you finish, what is your evaluation and how will you treat her and why. (explain the how, do not mention: meditation only, explain the steps fully like you are treating the patient).
– (you can use real life case studies from a clinic)
– the aim of this paper is to demonstrate your understanding of the concepts, tools of CBT and how you can successfully apply them practically from the time you meet the patient and the time he/she leaves the clinic.
your references must be only retrieved from credible sources or books.
Cognitive Behavioral Therapy (CBT)
Cognitive behaviors negatively affect social and general life; thus, there is a need for intervention through the interconnection of thoughts, emotions, behaviors, and how the different aspects can influence each other. Patients or victims of cognitive-behavioral patterns are affected and characterized by depression, alcohol and drug use problems, anxiety disorders, marital problems, severe mental illnesses, and eating disorders (Losada et al., 2015). In this regard, Behavioral cognitive therapy is adopted as an intervention or psychological treatment that ensures that the victim can manage their problems by changing their behaviors and ways of thinking in reaction to different stimuli in their environment. The CBT treats different physical and mental health problems such as depression and anxiety. Consequently, under CBT, the professionals identify and explore how emotions and thoughts affect one’s actions. Upon identifying the patterns, one begins the reframing of thoughts helpfully and positively. Furthermore, different techniques are used under the CBT, such as SMART goals, guided discovery and questioning, journaling, self-talk, cognitive restructuring, thought recording, positive activities, and situation exposure. Cognitive behaviors negatively affect the victims’ social and general lives; thus, there is a need to adopt cognitive behavioral therapy to address the different issues and ensure that the victims lead normal lives.
Patient cognitive behavioral therapy
Maria has shown different forms of cognitive behaviors that need interventions through cognitive-behavioral therapy. In this regard, Maria shows a wide range of symptoms such as being increasingly worried about the criticism from different people, avoidance of crowded places, insomnia, disappointment and fatigue, fear of blushing, and looking down on herself due to lack of a marriage. The different issues and conditions negatively impact Maria’s social and general life; thus, there is a need for intervention to ensure that she leads a normal life.
Evaluation of a cognitive behavior patient
The evaluation of a patient’s cognitive behavior takes the identification of their different characteristics and relates them to their conditions. The different conditions have established patterns that contribute to the patient’s conditions and disorders. The different conditions have different likelihood in contributing towards the cognitive behaviors; thus, there is a need to establish them.
In the evaluation, there is a need to establish the sex of the patient. One being a male or a female contributed differently to the cognitive behaviors, as shown by Maria, with the females having the highest percentage (Atwood and Friedman, 2020). Consequently, the psychologist needs to identify the patient’s age range and link it to its percentage in contributing towards the conditions of the patient. Furthermore, the psychologist needs to identify the nationality and origins of the patients. People from different nationalities suffer differently from the environment they are based on the conditions subjected to them. In this regard, immigrants face different challenges and have different capabilities to counter them; thus, there is a need to establish the nationality to adopt the relevant measures. Moreover, there is the need to establish the victim’s civil status to enable the establishment of the causes and the appropriate interventions to be adopted. Different civil statuses include married, single, widows, separated, and divorced, all with different cognitive behaviors. The information on the civil status determines the perspective and approaches to be adopted addressing the cognitive behaviors. More so, the patient’s living condition determines the extent and types of cognitive behaviors that one is faced with. The living condition can be divided into one living with others; living alone and living in a community all have different contributions to an individual’s cognitive behaviors. Equally important, an individual’s professional status determines the rate or the percentage of their cognitive behaviors (Stefan et al., 2019). The intensity of cognitive behavior changes depending on an individual’s professional status that includes the employed, retired, student, housekeeper, unemployed, in search of a job, and other professional status. The professional status enables the psychologist to understand the issues and factors facing the patients. Additionally, the psychologist needs to consider and evaluate the patient’s education levels as it contributes significantly to the cognitive behaviors. The different education levels include a second-grade secondary school, first-grade secondary school, university degrees, primary school, or no education. The education levels determine different cognitive behaviors and ways and means of handling them.
List of questions to be asked
The evaluation and assessment of the cognitive behavior patient need to be done through the interview between the patient, and the interviewer whose is a professional/therapist or a psychologist. The interview enables the professional to establish the source of the problem, the process of the problem, and the patients’ existing condition, thus enhancing the adoption of relevant countermeasures.
1. Tell me your working conditions and the challenges involved at work and with colleagues and if you are generally happy or unhappy with work issues. If there undesirable issues at work, please mention them with the order of their impact on your life and operations at work.
2. What are the common challenges experienced both at work and in social interactions? What measures and interventions do you take to counter or prevent the noted challenges?
3. What mistakes have you made in the course of working and interacting with society? How did you feel about realizing the mistakes? What actions did you take t
4. How do you set goals and the expectation both at work and in social places? Are your goals always achieved? If the goals are not achieved, how do you react, and which steps do you take to make up for the unmet goals?
5. Give an example of goals you did not achieve and how it makes you feel over time? Did you accept the failure? How do you think people in society viewed you on recording a failure?
6. Describe ad decisions or an action that you took but were not popular? Were there external or internal challenges involved in implementing the unpopular decision? How did you implement the unpopular decisions?
7. How do you find working in a team both at work and in social gatherings? Give an example of how you worked in a group? Would you like to work with a group again?
8. What are your reactions and feelings when you are involved in a conflict with people both at work and social gatherings? What do you do when conflicts arise in the course of your operations?
9. What motivates you to work and engage in people at work and in different social gatherings? What factors put you off in interacting and engaging with people?
10. Have you come across a difficult situation such as an embarrassment, and what were your reactions?
11. What do you believe are the best strategies or countermeasures to handle challenges, conflicts, and problems in your life both at work and in social gatherings?
The scenario for the CBT interview
The scenario provides Maria answers to the different questions in the interview. Maria answers the questions from the therapist’s office, where she feels comfortable. The questions are answered chronologically as stated.
1. Maria argues that she feels intimidated when interacting with a group of people, and she feels comfortable working from home. The issues that make Maria experience challenges at work is competition, failures in meeting targets, conflicts at work, and lack of desired freedom at work.
2. The common challenges for Maria at work includes competitions or the feeling of being unwanted or not fitting in social groups. Maria addresses the challenges through running away and letting others take their space or has their ways.
3. Maria argues that one of the mistakes she did was failing to work on difficult tasks, thus not submitting them. In this incident, Maria felt like a failure and contemplated suicide and quitting employment.
4. Maria argues that she sets goals based on social expectations both at work and in public spaces. Maria argues that her goals are often not met because they are beyond her capability. Maria handles the situation by setting lower goals.
5. Maria says that one of the goals that she did not achieve was completing assignments and reports in good time and before her colleagues. Maria failed to accept failure and consistently worked towards her goals. Maria argues that she feels like a failure before the eyes of her colleagues.
6. Maria argued that her unpopular decision avoided engaging in fraudulent activities in her workplace despite agreements between colleagues to be fraudulent. Maria argues that colleagues sidelined her as she was viewed as a traitor. Later on, she gave in to pressure and engaged in different fraudulent activities.
7. Maria argues that she does not like working in groups because she is overwhelmed with fear of the unknown, thus feeling intimidated before different parties at work and in social places.
8. Maria says she feels intimidated when she engages in a conflict or confrontation with colleagues or other public members. Maria argues that she gives up when confrontations and conflicts arise in the course of engagements.
9. Maria argues that encouragements, motivations, and the existence of excellent colleagues motivate her to work. Maria argues that factors that put her off from working include aggressiveness from colleagues and unattainable targets sets by the management.
10. Maria argues that he has come up with an embarrassing situation where she cannot meet her duties and obligations at work despite others experiencing success. The incident made Maria cry and not attend work by faking sicknesses.
11. Maria feels that the way to prevent challenges is avoiding challenging experiences and taking less demanding tasks to avoid disappointment and fear.
Interventions to the patient
The interaction with Maria through the interview indicates thus she suffers from a wide range of cognitive behaviors that need interventions to ensure that she can lead a normal life and counter challenges in her daily life. The intervention to the patient needs to be implemented to ensure that they recover consistently through their effort (David, Cristea, and Hofmann, 2018). In Maria’s case, the therapist needs to break down the identified problems in different parts, such as the physical feelings, thoughts, and actions of the patients when they are subjected to different issues. This approach ensures that the therapist sufficiently understands the cognitive behaviors and issues with the patients.
The conducts analysis and assessment of different parts while determining the helpful and realistic aspect based on their impact on the patient (David, Cristea, and Hofmann, 2018). This approach ensures that the therapist can prioritize the areas and sections to work on to help the patient change unhelpful behaviors and thoughts.
The therapist works out on issues that need to be changed to ensure that the parties involved adopt positive behavior changes. The patient is advised to consistently practice the relevant changes till they achieve the desired change (David, Cristea, and Hofmann, 2018). The therapist ensures that they provide the patient with the necessary skills and knowledge on countering the undesirable behaviors. Consistent practice of the therapists’ changes ensures that the victims can manage their problems and ensure that they adopt positive changes and behaviors.
The therapist can recommend different forms of treatments to counter the cognitive behaviors of the patient. In this regard, self-talk treatment will be vital to the patient. In self-talk, the therapists encourage the patient to tell themselves about the situations, experiences, and challenges in their lives and replace them negative elements with constructive self-talk and compassion (Friedl et al., 2020). Consequently, cognitive restructuring is adopted in treating cognitive behaviors among patients. Cognitive restructuring identifies cognitive distortions affecting once thoughts and beginning to unravel them, thus effectively eliminating them.
The patient with cognitive behaviors is treated through graded exposure assignments. Graded exposure assignments as an approach ensure that people can systematically approach things they fear such that they can effectively deal with them (Friedl et al., 2020). Systematic exposure to fear one able to master feared situations and tackle any difficulties associated with such experiences. The approach ensures that the patient consistently gains confidence and strength to effectively counter fear.
Activity scheduling needs to be adopted in treating Maria’s cognitive behaviors. The activity scheduling treatment enables patients to increase their behaviors so that they achieve different goals and objectives (Shonin, Van Gordon, and Griffiths, 2014). The helpful behaviors such as working on projects, mediating, interacting with people, and walking should be scheduled to ensure that they are often practices.
The successive approximation treatment will be effective for Maria to ensure that she can complete tasks with certainty. People fail to complete tasks due to being overwhelmed or lack of familiarity with tasks (Shonin, Van Gordon, and Griffiths, 2014). The treatment enables the patient to master easy tasks that are similar to extremely difficult tasks. This treatment ensures that one is able to consistently complete tasks and achieve different goals and objectives.
Additionally, skill training treatment ensures that the cognitive behavior patients have the appropriate skills to counter undesirable experiences and behaviors. The skills training treatment is used in remedying such skills deficits (Mohr et al., 2019). In this regard, the skill training can involve assertiveness training, communication training tor social skills training. Skill training is implemented through problem-solving therapy, role plays, modeling, or direct instruction.
There are different treatments and interventions to counter cognitive behaviors that negatively affect people’s lives, thus making life to be manageable. The elimination of cognitive behaviors is done as a process that begins with identifying the problems and issues than addressing them through interventions and treatments. The interventions and treatments ensure that patients unlearn former behaviors and adopt desirable behaviors.
Atwood, M. E., & Friedman, A. (2020). A systematic review of enhanced cognitive behavioral therapy (CBT‐E) for eating disorders. International Journal of Eating Disorders, 53(3), 311-330.
David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in psychiatry, 9, 4.
Friedl, N., Berger, T., Krieger, T., Caspar, F., & Grosse Holtforth, M. (2020). Using the Personalized Advantage Index for individual treatment allocation to cognitive behavioral therapy (CBT) or a CBT with integrated exposure and emotion-focused elements (CBT-EE). Psychotherapy research, 30(6), 763-775.
Losada, A., Márquez-González, M., Romero-Moreno, R., Mausbach, B. T., López, J., Fernández-Fernández, V., & Nogales-González, C. (2015). Cognitive–behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial. Journal of consulting and clinical psychology, 83(4), 760.
Mohr, D. C., Lattie, E. G., Tomasino, K. N., Kwasny, M. J., Kaiser, S. M., Gray, E. L., … & Schueller, S. M. (2019). A randomized noninferiority trial evaluating remotely-delivered stepped care for depression using internet cognitive behavioral therapy (CBT) and telephone CBT. Behaviour research and therapy, 123, 103485.
Shonin, E., Van Gordon, W., & Griffiths, M. D. (2014). Cognitive behavioral therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia and pathological gambling: A case study. International Journal of Mental Health and Addiction, 12(2), 181-196.
Stefan, S., Cristea, I. A., Szentagotai Tatar, A., & David, D. (2019). Cognitive‐behavioral therapy (CBT) for generalized anxiety disorder: Contrasting various CBT approaches in a randomized clinical trial. Journal of clinical psychology, 75(7), 1188-1202.