Crucial Rating of Cognitive-Behavioral Treatment Developments and Disjunctive - Essay Example

Critical Discussion on Cognitive Behavioural Therapy (CBT) Name of Student Student Number Institution Course Code Name of Instructor Date of Submission Cognitive Behavioural Therapy: A Critical Analysis Introduction Cognitive behavioural therapy (CBT) evolved from the aspect of behavioural theory to critically focus on the cognitive models including reappraisal of thinking and schema change strategies. It is mainly referred to as an evidence-based talking therapy trying on cognitive and behavioural change on the basis of individualised responses of a client’s individual past, difficulties and view on the world and social situations (Hofmann, 2011). Within the concept of CBT models, cognitive processes brought up as meanings, appraisals, judgments and assumptions associated with given life events are stated as primary determinants of the feelings in an individual, as well as actions resulting from the effects of life events (Brewin, 2006). Therefore, they either facilitate or hinder the adaptation process to the prevailing life situations. Generally, CBT is a conglomeration of approaches crucial and efficacious in overcoming the effects of posttraumatic stress disorder (PSTD) (Brisebois, 2012). CBT brought about time-limited relatively effective treatments for anxiety disorders. This essay critically looks into the aspect of cognitive behavioural therapy in respect to its theoretical basis and core principles. This will be affirmed by also describing the effectiveness of the therapeutic approaches, as well as its usefulness in treatment of anxiety disorders. Cognitive behavioural therapy is form of psychotherapy that aims at changing the unhealthy thoughts and actions of a client (Hendriks, Oude, Kejisers, et al., 2008). With its inclusion, the patient is able to embrace ways of identifying distorted patterns of thinking, as well as beliefs and consequently take up more effective ways of thinking and acting as replacement. In most cases, the treatment is normally brief, as well as highly structured, oriented and prescribed as per the problem with the individuals being active collaborators. Hofmann, et al. (2012) indicates that CBT has been documented by various studies as the most effective remedy for chronic depression, as well as other illnesses. In the United Kingdom, CBT has been recommended primarily as an adjunct treatment for schizophrenia and used more than in Canada and US (Rector and Beck, 2002). This therapy possess beneficial effects in the course of depressive phase of bipolar disorder, but the studies that have been prior documented have given varying data and are not conclusive (Miklowitz and Scott, 2009). The utilisation of cognitive therapy in depression treatment was initially described in a clear manual format in 1979 by Aaron T. Beck. The format made emphasis on the need of focussing on the conscious thinking as a direct challenge to behaviourism, therefore turning out as the cognitive revolution or second wave (Beck, 1976). Beck’s theory was based on behavioural principles on the fact they not only identified with behaviour as the result of leaned contingencies existing between stimuli and events, but also placed more efforts on the clear relationships between cognition, physiology and emotion (DiGiuseppe, 2010). This theory was based on the assumption that was fundamental to psychoanalytical thinking. This means that early life experiences and social environment have a great contribution towards the progress of adult of emotional problems. According to Hoffman, et al. (2012), Beck further stressed that the early life experiences are salience in creating beliefs or schemas on the individual, as well as others and the world at large. The said beliefs were believed to lead to given cognitive distortions, as well as negative styles of thinking. Further, Beck postulated that, by utilising thoughts process examination, coupled with accuracy evaluation, diverse negative emotional reactions pegged upon inaccurate or distorted perceptions could be diminished (Dobson and Dobson, 2009). Critical analysis of the key elements of CBT reveal that, Beck’s inclusion of patient engagement is effective, with corroborative development of a given problem list and deciding on a clear goal for therapy process (Granvold, 2011). Upon deciding on the goal to be targeted, a CBT technique is utilised in the identification of a distorted style of thinking. On the same note, Thyer and Myers (2011) add that an agreed task follows in the form of homework to enhance the future therapeutic processes. Hence, this presents a gradual process where the client performs tasks on whatever is learnt and the therapist guides and assesses any progress made. In consistence with the medical approach of psychiatry, the main target for treatment is suppressing the symptoms, enhancing functioning, and diminishing the disorder gradually (Friedman, et al., 2006). To realise this goal, the patient turns out to be the active participant in a collaborative process of problem solving in order to assess and challenge the rationality of maladaptive cognitions, as well as modify behavioural patterns. Therefore, modern CBT is based on a myriad of interventions which combine a variety of cognitive, behavioural and emotional focussed techniques (Hofmann, 2011). Albeit the fact that the stated strategic measures greatly emphasize on cognitive factors; recognition of psychological, emotional and behavioural components is also highlighted in respect to the role they have in the maintenance of the disorder (Pantalone, Iwamasa and Martell, 2010). CBT approaches are crucial in respect to the fact that, they consist of a structure that reduces the chance of therapeutic sessions from just being chat sessions and clearly defines goals and methods that can be evaluated via scientific approaches (Friedman and Thase, 2006). Further, it acts as an emphasis to improve issues in respect to getting better learning on recognising and rectifying problematic assumptions which cause of many problems related to emotional and mental aspect of life. Two components create a favourable process of making the therapeutic procedure a viable approach and incorporate functional analysis and skills training (Arch and Craske, 2009). Functional analysis is very crucial in respect to playing a critical role in helping the client and counsellor assess high risk circumstances that may lead to, trigger or stimulate substance use (Hendriks, et al., 2008). Later in treatment, functional analysis of substance utilise episodes which aid in identifying the situations that are still difficult to cope with for the individuals. On the other hand, skills training can be viewed as a highly individualised training program to aid the client do away with bad habits that are associated with substance use, as well as learn or relearn healthier skills (Hays and Iwamassa, 2006). The behavioural interventions available in CBT are aimed at decreasing maladaptive behaviours and enhance adaptive ones through modification of their antecedents and consequences, as well as by behavioural practices resulting into new learning. The cognitive interventions are aimed at modifying maladaptive cognitions, self-statements or beliefs (Hofmann, 2011). The trademark features of cognitive behavioural therapy are problem-focussed interventions strategies which are based on learning theory and cognitive theory values. Thus, in respect to cognitive and behavioural therapies crucial for anxiety disorders are aimed at helping patients lower their distress through cognitive and behavioural responses change (Thase, et al., 2007). The approaches based on CBT are very important in psychological counselling, thus helping liaison psych therapeutic nurses to address any prevailing mental conditions in the best way possible (Scott, et al., 2006). Looking at a number of advantages of cognitive behavioural therapies, it is evident to note that they are very instructive. Patients are made to understand their condition and undertake the initiative to counsel themselves rationally with confidence of faring well later (Reas and Grilo, 2004). This leads to cognitive behavioural therapists to train their clients the aspects entrenched in rational self-counselling skills. On the same note, CBT approaches take shorter with the therapist analysing the patient their capacity to embracing the problems and searching for solutions in their lives (Miklowitz and Scott, 2009). Nevertheless, it may take more time or sessions to complete the therapies regarding to specific patients, as per the extent of the disorder being tackled. Cognitive therapies are entrenched on the basis of emphasising on getting better, instead of feeling better (Rector and Beck, 2002). Through correction of underlying assumptions, cognitive behavioural therapies create long lasting results due to correction of the problem being on progress. Cognitive behavioural therapies are cross-cultural in the sense that they are based on universal laws of human behaviour (Dobson and Dobson, 2009). Consequently, they focus on the targets of the clients instead of trying to dictate the interest or goals of the therapist unto the patient. Another important feature of the approaches to cognitive behavioural therapies is that they are structured (DiGiuseppe, 2010) thus, making the sessions less of chat sessions and more of therapeutic processes where much is accomplished in respect to solving psychological problems therapeutically. Due to the definitive nature of these approaches entrenched in the defined goals aspect and clearly defined techniques, identified scientific research technique scan be utilised during examination (Friedman and Thase, 2006). Finally, the approaches to CBT are adaptive with the fundamental principle of CBT being that cognitions bring about feelings and behaviours in an individual. Literature documents that research indicates CBT as very effective remedy for depression and other mental health problems (Hendriks, et al., 2008Friedman and Thase, 2006; Hollon, et al., 2005). In comparison to other talking therapies, CBT takes relatively short time to complete. Nevertheless, in order to reap the benefits of CBT, a client is required to commit to the entire process (Arch and Craske, 2009). The work of a therapist is to help and advise the client, but the full dissolution of the problems relies majorly upon the full cooperation of the client. Granvold (2011) indicates that a client has the key power of determining the duration of time to be undertaken in the recovery process. There exists two highly effective kinds of psychotherapy entrenched in CBT and include cognitive therapy and behavioural therapy. One critical point to note about behaviour therapy is that it helps an individual weaken the connections between their stimuli and habitual, undesirable reactions in their surroundings (Thyer and Myers, 2011). Stimuli in this context refers to situations, people or events with undesirable reactions including sadness, fear, self-defeating or self-damaging traits, sadness, panic worry, among others. The aspect of behavioural therapy extends relaxation strategies to calm the mind and body helping an individual to feel better and think more clearly (DiGiuseppe, 2010). In respect to cognitive therapy, it emphasises on the role of thinking how individuals feel and act (Dobson and Dobson, 2009). The cognitive therapist initiates sessions where the clients are encouraged to establish any unhealthy thoughts in their life that may result to unwanted feelings and behaviour. Then, they are trained on how to replace the unhealthy thoughts with healthier one start may bring up desirable results in their emotional and psychological aspect of life. The integration of the two therapies to give CBT approach, provide highly powerful tools for mitigating on the symptoms of fear, worry, anger, anxiety, and depression among other mental and psychological problems (Hofmann, et al., 2012). Various approaches of CBT exist and are based upon a number of principles forming core aspects of cognitive behavioural therapy in the life of an individual (Dobson and Dobson, 2009). The first principle involves thoughts which bring about the feeling or behaviour in some given ways that are not external and may include examples like situations, individuals, as well as events (Hofmann, 2011). This forms a fundamental basis of CBT and with effective utilisation of this fact; healthier thinking brings better feelings coupled with better reaction even with unsuitable circumstances. Secondly, the therapeutic approaches undertaken are short-term in nature (Hofmann, et al., 2012). It is known for therapeutic sessions to go on for months or years; nevertheless, CBT can achieve results in short durations of times. This is attributed to the fact that cognitive behavioural therapy is based on direct teaching utilising extra assignment to encourage clients to practice what is taught at their free time (Thyer and Myers, 2011). Nevertheless, in the real life situation pertaining to therapeutic progress durations, a number of factors contribute towards affecting time of completing a therapeutic process. These include: clients’ condition at the commencement of therapy; symptoms number and their severity; degree of impairment caused by the symptoms; chronic levels of the condition; and expectations of the client (Granvold, 2011). The third principle to cognitive behavioural therapies involves its ability to work best whenever the therapist or coach introduces or teaches principles perceived to have a positive impression upon the client (Pantalone, Iwamasa and Martell, 2010). Through careful listening to the issues raised by the client, the coach brings up guidance that identifies unhealthy patterns in the thinking processes of clients, while at the same time encouraging them to try new thinking ways. This is in respect to trying their level best to bring up desirable results in respect to feelings and behaviour of their clients (Friedman, et al., 2006). The fourth principle establishes that CBT is basically pegged or founded on the educational model pillar (Arch and Craske, 2009). This is in respect to helping clients forget the unfavourable reactions in their life and embrace a new way of reacting to stimuli. The fifth principle involves the fact that home assignments are very crucial in this therapy. Therapists who utilise CBT model assign home assignments to clients with the sole aim of making practice in healthy ways at their free time (Thyer and Myers, 2011). The assignments utilise charting feelings or behaviour to reinforce healthy ways of thinking or practicing techniques to calm the individual and may incorporate relaxation, visual imagery and affirmations. The final principle is based on the fact that CBT perceives behaviour as adaptive or maladaptive; leaned vs. unlearned and rational vs. irrational (DiGiuseppe, 2010). Unlearned behaviour results from learning and is caused by the thoughts within an individual. Rational behaviour is based upon three criteria of being based on fact; helps realise set goals and helps individuals feel the way they want to feel (Miklowitz, and Scott, 2009). Therefore, any behaviour that fails to meet the three criteria is not termed as rational, but rather irrational behaviour. Conclusion In conclusion, it is worth stating that cognitive behavioural therapy (CBT) is an effective approach in the treatment of anxiety disorders. Through talking initiatives, the coach undertakes a client-based approach which gradually helps the patient discern their unhealthy thoughts and reactions to stimuli, and consequently replaces the same with favourable thoughts and reactions. Generally, this approach tries to positively change the perspective of a patient towards embracing the reality facing them by being optimistic. Through cognitive interventions based on focussed fundamental identification and modification of distorted thoughts and schemas, the wellbeing of a client is improved (Hoffman, et al., 2012). Further, with behavioural techniques; exposure enhancement is made a priority coupled with increased activity, improvement of social activities and improvement on strategies to manage anxiety in useful modalities which can complement or increase the positive effect of cognitive strategies (Granvold, 2011). Consequently, the perspective employed in respect to cognitive approach ensures extra strength in behavioural models for therapy through teaching clients recognition methods and how to modify any circumstance that makes their attitudes vulnerable to negative reaction. Therefore, it is prudent to state that cognitive and behavioural therapies amalgamated in CBT model are the best-studied psychological treatments of major depressive, generalised anxiety, panic, as well as obsessive-compulsive disorders. The interventions described have shown great effectiveness in the context of strengthening this conclusive fact. References Arch, J. J. and Craske, M. G. (2009). First-line treatment: A critical appraisal of cognitive behavioural therapy developments and alternatives. Psychiatr Clin N Am, 32: 525-547. Beck, A. T. (1976). Cognitive therapy and the emotional disorders, Madison, CT: International Universities Press. Brewin, C. R. (2006). Understanding cognitive behaviour therapy: A retrieval competition account. Behaviour Research and Therapy, 44: 765-784. Brisebois, K. (2012). Cognitive-behavioural therapy and social work values: A critical analysis. Journal of Social Work Values and Ethics. 9(2): 21-33. DiGiuseppe, R. A. (2010). Rational emotive behaviour therapy. In N. Kazantzis, M. A. Reinecke and A. Freeman (Eds.). Cognitive and behavioural theories in clinical practice, 115-147. Washington, DC: American Psychological Association. Dobson, D. and Dobson, K. S. (2009). Evidenced based practice of cognitive behavioural therapy. New York: Guildford. Friedman, E. S. and Thase, M. E. (2006). In cognitive behavioural therapy for depression and dysthymia, Textbook of Mood Disorders, Stein, D. J., Kupfer, D. J. and Schatzberg, A. F. (eds.). Washington, DC, USA: American Psychiatric Publishing, 353-371. Friedman, E. S., Wright, J., Jarrett, R. B., et al. (2006). Combining cognitive therapy and medication for mood disorders. Psychiatric Annals, 36: 320-328. Granvold, D. K. (2011). Cognitive behavioural therapy with adults. In J. R. Brandell (Ed.). Theory and practice in clinical social work, 2nd ed., 179-212. Thousand Oaks, CA: SAGE Publications. Hays, P. A. and Iwamassa, G. Y. (2006). Culturally responsive cognitive behavioural therapy: Assessment, practice and supervision. Washington DC: American Psychological Association. Hendriks, G. J., Oude, V. R. C., Kejisers, G. P., et al. (2008). Cognitive behavioural therapy for late-life anxiety disorders: A systematic review and meta-analysis. Acta Psychiatr Scand, 117: 403. Hofmann, S. G. (2011). An introduction to modern CBT: Psychological solutions to mental health problems. Oxford, UK: Wiley-Blackwell. Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T. and Fang, A. (2012). The efficacy of cognitive behavioural therapy: A review of meta-analyses. Cognit Ther Res. 36(5): 427-440. Hollon, S. D., DeRubeis, R. J., Shelton, R. C., et al. (2005). Prevention of relapse following cognitive therapy vs. medication in moderate to severe depression. Archives of General Psychiatry, 62: 417-422. Miklowitz, D. J. and Scott, J. (2009). Psychosocial treatments for bipolar disorder: Cost effectiveness, mediating mechanisms, and future directions. Bipolar Disord, 11(2): 110-122. Pantalone, D. W., Iwamasa, G Y. and Martell, C. R. (2010). Cognitive behavioural therapy with diverse populations. In K. Dobson (Ed.). Handbook of cognitive behavioural therapies, 445-462. New York: Guilford Press. Reas, D. L. and Grilo, C. M. (2004). Cognitive behavioural assessment of body image disturbances. Journal of Psychiatric Practices, 10(5): 314-322. Rector, N. A. and Beck, A. T. (2002). A clinical review of cognitive therapy for schizophrenia. Curr Psychiatry rep. 4: 284-292. Scott, J., Paykel, E., Morriss, R., et al. (2006). Cognitive behavioural therapy for severe and recurrent bipolar disorders: Randomised controlled trial. British Journal of Psychiatry. 188: 313-320. Thase, M. E., Friedman, E. S., Biggs, M. M., et al. (2007). Cognitive therapy as a second-step treatment: A STAR*D report. American Journal of Psychiatry, 164: 739-752. Thyer, B. A. and Myers, L. L. (2011). Behavioural and cognitive therapies. In J. R. Brandell (Ed.). Theory and practice in clinical social work, 2nd ed., 21-40. Thousand Oaks, CA: SAGE Publications. Read More

Critical analysis of the key elements of CBT reveal that, Beck’s inclusion of patient engagement is effective, with corroborative development of a given problem list and deciding on a clear goal for therapy process (Granvold, 2011). Upon deciding on the goal to be targeted, a CBT technique is utilised in the identification of a distorted style of thinking. On the same note, Thyer and Myers (2011) add that an agreed task follows in the form of homework to enhance the future therapeutic processes.

Hence, this presents a gradual process where the client performs tasks on whatever is learnt and the therapist guides and assesses any progress made. In consistence with the medical approach of psychiatry, the main target for treatment is suppressing the symptoms, enhancing functioning, and diminishing the disorder gradually (Friedman, et al., 2006). To realise this goal, the patient turns out to be the active participant in a collaborative process of problem solving in order to assess and challenge the rationality of maladaptive cognitions, as well as modify behavioural patterns.

Therefore, modern CBT is based on a myriad of interventions which combine a variety of cognitive, behavioural and emotional focussed techniques (Hofmann, 2011). Albeit the fact that the stated strategic measures greatly emphasize on cognitive factors; recognition of psychological, emotional and behavioural components is also highlighted in respect to the role they have in the maintenance of the disorder (Pantalone, Iwamasa and Martell, 2010). CBT approaches are crucial in respect to the fact that, they consist of a structure that reduces the chance of therapeutic sessions from just being chat sessions and clearly defines goals and methods that can be evaluated via scientific approaches (Friedman and Thase, 2006).

Further, it acts as an emphasis to improve issues in respect to getting better learning on recognising and rectifying problematic assumptions which cause of many problems related to emotional and mental aspect of life. Two components create a favourable process of making the therapeutic procedure a viable approach and incorporate functional analysis and skills training (Arch and Craske, 2009). Functional analysis is very crucial in respect to playing a critical role in helping the client and counsellor assess high risk circumstances that may lead to, trigger or stimulate substance use (Hendriks, et al., 2008). Later in treatment, functional analysis of substance utilise episodes which aid in identifying the situations that are still difficult to cope with for the individuals.

On the other hand, skills training can be viewed as a highly individualised training program to aid the client do away with bad habits that are associated with substance use, as well as learn or relearn healthier skills (Hays and Iwamassa, 2006). The behavioural interventions available in CBT are aimed at decreasing maladaptive behaviours and enhance adaptive ones through modification of their antecedents and consequences, as well as by behavioural practices resulting into new learning. The cognitive interventions are aimed at modifying maladaptive cognitions, self-statements or beliefs (Hofmann, 2011).

The trademark features of cognitive behavioural therapy are problem-focussed interventions strategies which are based on learning theory and cognitive theory values. Thus, in respect to cognitive and behavioural therapies crucial for anxiety disorders are aimed at helping patients lower their distress through cognitive and behavioural responses change (Thase, et al., 2007). The approaches based on CBT are very important in psychological counselling, thus helping liaison psych therapeutic nurses to address any prevailing mental conditions in the best way possible (Scott, et al., 2006). Looking at a number of advantages of cognitive behavioural therapies, it is evident to note that they are very instructive.

Patients are made to understand their condition and undertake the initiative to counsel themselves rationally with confidence of faring well later (Reas and Grilo, 2004).

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