Cognitive Behavior Therapy (CBT) in the treatment of phobias - why is it the most effective method - Research Paper Example

?Cognitive Behaviour Therapy Albert Ellis, the founder of cognitive behavioural therapies, once when asked about his depressing and traverse childhood said, he had learned to face his suffering by, “developing a growing indifference to that dereliction”. (Ellis, Abrams, & Abrams, 2009) It is with this belief that in 1957 he developed a new way of changing a client’s vanquished behaviours, one which challenged the clinical results of psychoanalysis. Cognitive reconstruction and rational perlustration, he believed were the base upon which fallacious, rigid and subjugated thoughts could be broken down through the use of emotive, behavioural and cognitive methods. This is how Cognitive Behaviour Therapy (CBT) was first born. Later in 1997 when Aaron T. Beck, considered the father of CBT, began his work among depressed patients he noted that dysfunctional disorders, psychiatric disorders and behavioural disorders were all characterized by dysfunctional thinking which rationalized the affective and behavioural symptoms. A lot of studies showed that irrespective of the intervention that is used, patients got better only when there was an improvement in the way they thought (Beck, 281). He noted that the same could be held true even in the case of social phobia. Aaron believed that CBT was the future, he considered it to be a safer and more effective alternative to phamacotherapy (Beck, 283). In his article in the ‘Journal of Psychotherapy Practice and Research’ he wrote, “One of the major areas for psychotherapy in the future is going to be treating very serious disorders, such as the rapid-cycling bipolar or the general bipolar disorders, schizophrenia and various other serious disorders that are not totally controlled by drugs. An interesting study in which patients with acute schizophrenia were assigned either to treatment as usual or to cognitive therapy was done in Britain recently. It turned out that the schizophrenic patients treated with cognitive therapy required only half as much time in the hospital as those who received conventional treatment.” (Beck, 283) Over the years, CBT has been used in many clinical experiments with positive results. Henning K. R. and Frueh B. C. with a group of psychologists and corrections officers started using cognitive procedures with prisoners in the Vermont Department of Corrections and found that the relapse rate among prisoners who had been adminstered a specific cognitive-behavioural programme was one half as high than those who had received standard prison treatment (Henning & Frueh, 101). David Veale in his clinical assessment of emetophobia, a phobia of vomitting, found CBT to be the best treatment for this disorder. Through a processs of psycho-education, engagement and therapy, he was able to alter the way people thought and acted, thus helping them discontinue their excessive safety behaviours and stand up to their fears (Veale, 272). Phobic Neurosis On October 4th, 2000, Discovery Health released the findings of is telephonic study conducted by Penn, Schoen & Berland Associates, Inc. among 1000 American adults and found that nearly 40% of Americans had an excessive fear about key objects or situations but would rather suffer from it than seek professional help. It established that the level of dread was very high in the American society with women being more susceptive to it than men. (Newswire, 2000) Disorders of behaviour got classified as ‘neuroses’ in DSM II. It was here that phobic neurosis was first defined as, “intese fear of an object or situation which the patient consicously recognizes as no real danger to him.” (American Psychiatric Association, 1968) Phobias were ascribed to agitations displaced to the phobic object or situation from some other object or situation of which the patient was oblivious. Issac Meyer Marks in his article, ‘The Classification of Phobic Disorders’ propounded that phobias could be further classified into, Class I - phobias of external stimuli and Class II - phobias of internal stimuli (Marks, 377). Class I phobias were further divided into four main categories – agoraphobia, social phobia, animal phobia and other specific phobias. While, Class II phobias were categorized as – illness phobias and obsessive phobias. (Marks, 377) Phobias incommode a normal person’s ability to socialize, work and go about his daily chores. It affects his relationships with friends, colleagues and family members and influences his performance. This can sometimes leave the client exposed to other psychiatric disorders like depression. While phobias can result from a variety of factors, genetic, social and environmental it is normally a combination of all or any two of the three that sets it off. When one looks into the possible treaments available to treat phobia, most available literature recommends the use of the CBT treatment method. However, physicians across the world have also experimented with hypnosis and pharmacotherapy, to varying results. CBT in the treatment of Class I & Class II Phobias In an effectiveness study conducted by Cartwright-Hatton, Roberts, Chitsabesan, Fothergill and Harrington, from the Department of Child and Adolescent Psychiatry, University of Manchester among young people, below the age of 19 years who had been diagnosed with anxiety disorder. They established that CBT was a useful treatment method for children over the age of 6 years. Using 10 randomized controlled trials and employing conservative criteria, the remission rate of the anxiety disorder among the CBT groups was found to be 56.5%, while those of the controlled groups were found to be 34.8%. The pooled odds ratio came to 3.3 (CI = 1.9-5.6), insinuating that CBT had a consequential effect on the young people (Cartwright-Hatton, Roberts, Chitsabesan, Fothergill, & Harrington, 421). Further more, in a study conducted in 2005 which analysed the perceptions of the parents on the CBT treaments and pharmocological traemens for childhood anxiety disorders, they assessed that parents of anixous children chose CBT over medication for the treatment of their child’s disorder (Brown et al, 819). When treating children with disorders, the study summarized, patients’ preferences included not only the likes and dislikes of the child but also the concern of the respective parents who made all the major decisions regarding the child’s healthcare. It was thus believed that a better understanding of how parents distinguish CBT from pharmacotherapy would help ameliorate the clinical management of these problems (Brown et al, 820). Using the Treatment Perceptions Questionnaire-Parent Version, Spence Children’s Anxiety Scale for Parents and Modified Sheehan Disability Scale, the study analysed, “Of those that responded, substantially more parents indicated a preference for CBT as their first choice (54.5%) compared to medication (7.3%) and a combination of medication and CBT (38.2%). This difference was statistically significant, x2(2) = 19.02, p Read More