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(Neenan & Dryden, 2006). In many cases patients that require cognitive behavior therapy exhibit traits like self-destructive and repulsive habits, shame, avoidance, harbor unproductive thoughts and entertain blame games. (Willson & Branch, 2006). Stan's case is not isolated as he depicts similar traits. For example, he avoids the people he used to associate with while he was still in employment, he is unwilling to take work he is over qualified for hence has been unemployed for six months. At the same time he feels ashamed of his unemployment status hence avoids going out of the house at all, he drinks during the day rather than look for another job, he feels entitled to provide financially as the firstborn in his family irrespective of his impossible situation.
His panic attacks are as a result of the anxiety he feels from the overwhelming responsibility of being a father, a first born and a husband and the fact that he is not able to get himself out of the situation. The source of Stan's problems is in his pattern of thoughts. The way he perceives his situation has led to the outward show of his frustration and depression. For example, he lost his job and hence he thinks that he has failed. Highly likely are thoughts like 'I am no good' or 'I am a failure' and in that case a self-prophecy has been written in his mind.
It is from this thought that he now behaves like a failure and has no time to look for a job but drink during the day or avoid going out of the house to hide his failure. Of course, his problem aggravates because he avoids doing the very things that might be helpful in bringing forth a solution. For example he avoids former colleagues and friends and turns down employment because he is 'over' qualified. Stan's panic attacks root from anxiety linked to distorted thoughts and idealistic expectations.
Intervention strategies As seen Stan's problems are birthed from own thoughts and this has affected his behavior. Therapy will focus on helping Stan change his way of thinking. His panic attacks will be dealt with by challenging Stan's thoughts and fears. This will entail encouraging Stan to confront his object or subject of fear in this case going out of the house, not providing financially towards his fathers funeral and the new baby, fear of failure and so on. The aim here will be to desensitize these fears by helping Stan realize that he needs to react to situation in reality rather than from his own distorted perception of the situation.
First, the therapist will guide Stan in exploring his thoughts and situation the identify thought patterns and link them to behavior. (Neenan & Dryden, 2006). He might be required to document his thoughts, habits, feelings, events in a journal for review during therapy session. This will help the client and the therapist identify unproductive thoughts in Stan and guide him in replacing each of them with productive and positive thoughts. For example, 'if am jobless, I should not go out' can be replaced with 'I need to go out and network with friends so that I get a job' or 'I am a failure because I did not provide financially to my father's funeral yet am the first born' can be replaced
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