...The essay aims to critically review Cognitive Behavioural Therapy (CBT) as a chosen intervention for clients suffering from dual diagnosis. A definition will be offered and a rationale given for choosing the intervention. This will be followed by a critique on the available evidence base for using the intervention with those with dual diagnosis. Essay will critically appraise the pros and cons of the chosen treatment interventions including its benefits in meeting the needs of the identified client group. This essay will then explore the efficacy of CBT for this client group. A conclusion will be given to establish whether the chosen interventions appropriately meet the needs of the chosen client group. Diagnostic and Statistical Manual (DSM-V),...
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...The basic assumption of cognitive behavioural therapy is that people often have distorted beliefs which influence their behaviour in maladaptive ways. I symptom of schizophrenia is delusions, this is thought to result from faulty interpretations of events and cognitive therapy is used to help the patient identify and correct these. Cognitive behavioural therapy for schizophrenia tends to focus on the positive symptoms such as hallucinations and delusions rather than the negative symptoms such as alogia. The coping strategy enhancement works by encouraging patients to trace back to the origins of their symptoms in order to get a better idea of how the symptoms might have developed. Patients may also be set behavioural assignments with the aim of improving their general level of functioning. During Cognitive Behavioural Therapy the therapist lets the patient develop their own alternatives to these previous maladaptive beliefs, often by looking at alternative explanations and coping strategies that are already present in the patients mind. Together they work to improve the patient’s existing coping strategies. Outcome studies are used to measure how well a patient does after a particular treatment. Outcome studies of CBT suggest that patients who receiver cognitive therapy experience fewer hallucinations and delusions and recover their functioning to a greater extent that those who only receive antipsychotic medication. Drury et al. (1996) found benefits in terms of positive symptoms...
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...related psychosis. Over the past 10 years there's been a growing movement towards diverse treatments for schizophrenia other than the acknowledged role of medication as a treatment modality (Birchwood and Tarrier 1993). Developments in psychological theory have led to a number of innovative psychological treatments drawn from human experimental psychology such as behavioural and social psychology and cognitive science. Therapies based on cognitive behavioural theory have been rapidly developing, initially for the so called ‘neurotic disorders’ but in recent years evidence has accumulated to suggest that these cognitive behavioural approaches can be effective for those people suffering from psychosis ( Williams 1995). The aim of this assignment is to explore the basis of Cognitive Behavioural Therapy and review its’ therapeutic application to schizophrenia. Cognitive Behaviour Therapy (CBT) is an evolutionary paradigm that came about a from the merging of the established paradigm of behavioural therapy and contemporary cognitive therapy (Clarke and Fairburn 1997). Behavioural therapy historically focused on anxiety, phobic and obsessional disorders. Treatments were aligned to the learning theories of Pavlov and Skinner, anxieties and phobias were conceptualise to be conditioned fear responses, passively acquired and elicited by conditioned stimulii (Clarke and Fairburn 1997). A variety of techniques were employed to enable the client to ‘unlearn’...
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...Introduction Helping others is one of the most important aspects in life today. There are many different ways, and different forms of helping people. Helping others could make another person feel better either inside, or about them self. ‘Helping’ is one of those taken for granted words. It is a familiar part of our vocabulary. Traditionally, for example, social workers, youth workers and support workers, guidance counsellors and psychologist have been talked about as members of the helping professions. The question, do you need some help? Should be part of our daily business as informal and formal educators and guidance counsellors. Yet what we mean by ‘helping’ is not that obvious and the qualities we look for in ‘helping relationships’ need some thinking about. Here we try to clear away some of the confusion. What do we mean by helping? For many people within the social professions, such as social work, counsellors, community workers and psychologist. The notion of helping is tied up with counselling and guidance. Many students such as myself major in psychology and or guidance and counselling because I am fascinated by people. I want to learn more about why people behave as they do and are motivated to help people improve their lives. However, there are key ingredients of a helping relationship in helping anyone includes acceptance, this is the act of relating to another person without judging him or her. Respect which is also an attitude of giving dignity to each individual...
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...Compare and contrast person centered and cognitive behavioural approaches understanding and making use of the counseling relationship Introduction This assignment is an attempt to discuss two different types of therapy, cognitive behavioural therapy and person centered therapy and highlight some important similarities and differences between them. Cognitive behavioural therapy John Watson (1957) believed psychology should be concerned with the observable, as behaviour could be measured and influenced (McLeod, 2008). Skinner, (1953) cited in McLeod (2008), believed a person has a repitior of possible responses to a stimuli and they exhibits the response that is reinforces or rewarded (operant conditioning). The central theme of Cognitive-behavioural therapy (CBT) is that thoughts connect (mediate) an event (stimuli) with an emotion. In other words it’s not the stimuli itself that elicits an emotional response but the interpretation (belief) of the stimuli. Ellis’s (1962) ABC model can be used to monitor reactions to an event. (McLeod 2008), A = activating event (actual event, attitude or action of an individual), B = beliefs about the event, C = the emotion or behavioral consequences; Ellis suggests, that C is determined by B. i.e. one person not being successful at an interview may think the competition must have been strong, another may think they don’t deserve a good job, they are stupid etc (McLeod 2008). CBT suggests that distress is caused by...
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...Cognitive behavioural therapy (CBT) can be described as a goal-oriented psychotherapy treatment that typically takes a practical approach to problem-solving. Its short term nature and overarching goal is to adjust patterns of thinking or behaviour that may be contributing to an individual’s worries, and so change the way they feel. CBT is one of the major orientations of psychotherapy (Roth & Fonagy, 2005) and represents a unique category of psychological intervention because it derives from cognitive and behavioural psychological models of human behaviour. Just as some knowledge of a client’s background can be helpful in understanding their current state, an appreciation of how CBT developed can help us to understand its modern form. Cognitive Behaviour Therapy has its modern origins in the mid 1950’s with the work of Albert Ellis, a clinical psychologist who...
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...problem to the nature of the client itself. Some counsellor may apply behavioural approach while some may be oriented towards humanistic approach. Similarly, some may go with psychodynamics while others may find cognitive behavioral approach favorable. Hence, it is important to realize which approach or technique will best suit the client with anorexia. However, it should also be kept in mind that a particular technique may suit a particular anorexic while the same approach may not go well with another anorexic...
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...In this essay I will analyse in reference to the case study, how psychological theory informs our understanding of mental health disorders. I have chosen the following two theories to analyse, Psychodynamic and Cognitive. I will also evaluate how certain therapies such as Cognitive Behavioural Therapy (CBT) and Psychotherapy may help or change a depressed person’s behaviour. Depression is a potentially disabling illness that affects many, but is understood by few. Suffers often do not recognise the nature of this terrible illness until they are so devastated that they can no longer help themselves. (Ainsworth 2000). According to Houpt 2010, Jamie is clearly showing signs of depression. Jamie is exhausted and his schoolwork is falling behind. He has fallen asleep in class and states that he feels depressed and anxious. He also feels a great sense of loss and his eating behaviour has changed drastically. Houpt states that depression reduces, depresses and slows a person’s functional level. It slows mental and bodily activities. Therefore a slowed mind is unable to process and respond to all incoming data. Adolescent depression is a mental and emotional disorder affecting adolescents and teens. More commonly referred to as teenage depression, adolescent depression is not medically different from adult depression and can affect a teen’s personal, school, work, social and family life therefore leading to social isolation. Empfield and Bakalar, 2013). A psychodynamic...
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...1. Introduction This paper provides a brief overview of evidence based psychological treatments for anxiety disorders. It addresses the following questions: • How common are anxiety disorders? • What psychological treatments have empirical support? • What recovery rates can be achieved with these treatments? • How enduring are their effects? • Is there value in combining psychological treatments with medication? Psychological treatments can be delivered in a variety of formats. This paper restricts itself to the traditional, and most extensively researched, format of face-to-face contact with a fully qualified therapist. For most anxiety disorders the therapy sessions are once weekly for 60-90 minutes spread over a period of 8-20 weeks, with homework assignments in between. However, in specific phobias, the strongest outcomes have been obtained with a single, long (3-5 hour) session with a therapist, followed by a briefer follow-up session a week or so later. 2. How common are anxiety disorders? The most recent British Psychiatric Morbidity Survey1 estimates that 16.4% of the population have a diagnosable anxiety and/or depressive disorder. The diagnostic system that was used in the survey (ICD-10) is different from the diagnostic system (DSM-IV) that has been used in most trials of psychological treatments. For this reason, it is difficult to be precise about the number of individuals in the UK who have anxiety disorders for which there...
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...Discuss two or more psychological therapies for schizophrenia (24 marks) Psychological therapies in dealing with schizophrenia are Cognitive-behavioural therapy (CBT), Family intervention and Behavioural therapy; token economy. Cognitive- Behavioural therapy is used to treat distorted believes which influences schizophrenic behaviour in maladaptive ways. For example a schizophrenia person may believe that they are being controlled by someone or something else, cognitive therapy is used to treat faulty interpretations of these events. In CBT patients are told to trace the origins of the symptoms to get a better understanding of how it started. Then patients are told to evaluate the content of their symptoms so they are able to test the validity of their faulty believes. Patients are then set behavioural assignments to improve their general levels of functioning. During the therapy the therapists allows the patients to come to their alternatives for dealing with maladaptive behaviour by looking for other explanations and coping strategies that is already present in the patients mind. Research has found that patients that receive cognitive therapy receive CBT experience fewer hallucinations and delusions and have a better recovery than those who receive antipsychotic medication. However Gould et al that found that all seven studies in the meta-analysis reported a statistically significant decrease in the positive symptoms of schizophrenia after treatment. Although most studies...
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...determines emotion: there must be something else. CBT says that the ‘something else’ is cognition, i.e. the interpretations people make of the event. When two people react differently to an event it is because they are seeing it differently, and when one person reacts in what seems to be an unusual way, it is because he has unusual thoughts or beliefs about the event. CBT is to oppose rigid cognitions with the purpose of creating increased flexibility through conscious intention (Beck, 1975; Ellis, 1962). CBT is driven largely by real life experiments that provide structured opportunities to test new thoughts and behaviours (Hayes et al., 1999). It has allowed us to scientifically measure and track performance....
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...people knowingly do things that will cause them to fail or bring them trouble. It is defined as “any deliberate or intentional behaviour that has clear, definitely or probably negative effects on the self or on the self’s projects.” The concept of and theories behind why a person behaves in ways that are self-defeating is one that has been examined by many psychological approaches over time. In this essay I will define and explain self-defeating behaviours, their origins, causes and reasons for maintaining them, together with examples of such behaviours. Subsequently I will focus on two approaches to addressing self-defeating behaviours, incorporating similarities and differences. The two approaches I have chosen to look at are Cognitive Behavioural therapy and Person Centred I will then give my personal thoughts as a student counsellor. The origins of self-defeating behaviour can often be traced back to childhood. One trigger may be constant criticism whereby the child is told that he/she can never do anything right, is useless and so on. This can lead to the child engaging in self-defeating behaviour that reinforces their resultant poor self-image. If the parent(s) are seen as the most important people in the child’s life, fear of disappointing them, or of not being able to meet their standards or expectations can result in developing self-defeating behaviour. The child may not even try to attempt a task for fear of failure. Too much emphasis placed on competition with other...
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...Disorder Specific Cognitive Behaviour Therapy Interventions – WHM-M-030 Introduction The purpose of the paper is to discuss the current theory and empirical literature for using a transdiagnostic approach in cognitive behaviour therapy and it’s relevance in current practice. I will discuss the theory and evidence for using a transdiagnostic approach and highlight the main processes. A discussion on the strengths and limitations of the approach will conclude the first part of the paper. The second part will be a review of personal clinical work discussing the transdiagnostic process and its hypothesised effectiveness. To conclude the author will provide a personal reflection. There has been a long widely accepted claim for the effectiveness of CBT with prolific amount of evidence for it’s effectiveness for Depression, Anxiety and Mood disorders (Roth & Fongy, 1995) Models such as cognitive therapy for depression (Beck, Rush, Shaw, & Emery, 1979), panic disorder (Clark, 1986,), posttraumatic stress disorder (Clark & Ehlers, 2004); and obsessive-compulsive disorder (Salkovskis, 1989) have led to disorder-specific interventions for treating common mental health problems. The benefits of devising a model on specific disorders is the high degree of research and comparable data involved; from that the therapist will be highly trained in the use of the model to deliver the approach for each disorder (Salkovskis 2002). Disorder specific models are seen to be easily delivered...
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...This assignment will discuss the application of the Cognitive Behaviour Therapy (CBT) in mental health nursing with reference to its principles and those of the Recovery Model. A brief discussion of CBT’s historical and developmental background in the management of mental health problems relating to the principles of recovery model will first be outlined. Subsequently, the range of treatment modalities used for depression preceding the start of CBT will be discussed with reference to the recovery model. The principles of CBT will then be evaluated and two CBT approaches used with depression will be explored giving a rationale for choosing them. Within the context of mental health care provision, limitations of CBT will then be explored. The assignment will conclude with highlighting the importance of adapting and using CBT approaches and the future development of new models of nursing practice. Confidentiality will be maintained throughout, in line with the Nursing and Midwifery Council (NMC, 2008). A list of appropriate literature and references will be provided. CBT is a psychological and behavioural treatment therapy that seeks to identify, evaluate and restructure dysfunctional beliefs, thoughts and emotional disturbances focusing on the here-and-now principle for conditions such as anxiety and depression (Bennett, 2011). It is based on the idea that the way people think is affected by their thoughts, beliefs and behaviour, hence helping clients to acknowledge how this...
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...Introduction Davies and Bhugra (2004) noted that, the humanistic and cognitive-behaviour approaches to therapy share little more than a resounding belief in the need for a strong therapeutic alliance to affect positive and lasting change in behaviour, thoughts and attitude of clients seeking therapeutic intervention. The difference lies in the application of the techniques and the beliefs underlying the origins and treatment of psychological problems, which are associated with the physical illness and biological abnormalities of one sort or another. (Davies, and Bhugra2004). According to Barker (2003) a therapeutic alliance is a situation in which patient and psychotherapists are bound together in working towards mutual communication and understanding. This means that the professional hopes to engage with and effect change in a patient. In addition, Gabbard (1994) noted that the essence of therapy is a transaction between two collaborating human beings with the goal of helping the patients, and that there is no right treatment approach. Different theoretical models and treatments strategies may apply flexibly over the course of treatment. This essay will compare and contrast humanistic approach and cognitive behaviour approach, and discuss their relevance to psychiatric nursing practice. Both approaches will be applied to the management of anxiety. The humanistic approach According to Bugental (1967), the humanistic approach is concerned with the...
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