The Cognitive-Behavioural Therapy Skills - Assignment Example

Heading: CBT Your name: Course name: Professors’ name: Date Introduction With various mental health problems that people experience every, various therapies exist that attempt to offer the required solutions to the issues. One of these models is the Cognitive-Behavioural Therapy (CBT). Many researchers argue that the model is effective in the treatment of psychoanalytic and psychological issues. However, others claim that it is ineffective and suggest other models. Thus, this paper intends to explore the concept of CBT, its historical foundations, strengths and weaknesses, and effectiveness. It also focuses on self-reflection of philosophical practice with consideration of its strengths and weaknesses. Part 1 and 2 History of Cognitive-Behavioural Therapy CBT entails a general categorisation of psychotherapy, and many CBT approaches are in the category. These include Cognitive Therapy, Rational Emotive Behaviour, Schema Focused Therapy, Rational Living Therapy, as well as Dialectical Behaviour Therapy. Notably, every approach has its own history of development. The Rational Emotive Therapy was the first distinct, deliberately therapeutic CBT approach to be developed by Albert Ellis in mid 1950s. He popularised the emotions ABC model, and later changed it to ABCD model. He also renamed the model as Rational Emotive Behavioural Therapy in 1990s. Aaron Beck, in 1960s developed the Cognitive Therapy approach, which became famous for the successful management of depression (Hall 2010). Maxie C. Maultsby also developed the Rational Behaviour Therapy in 1960s, which focused on rational therapeutic homework and self-counselling skills. Maultsby’s contributions entailed the thought shorthand concept which implies attitudes, Rational Self-Analysis, Rational Emotive Imagery, and Five Criteria for Rational Behaviour. Other scholars include Michael Mahoney of Stress Inoculation Therapy, and David Burns of CBT (1980). Lately, Aldo Pucci of Rational Living Therapy, as well as Marsha Linehan, and Michael Mahoney have influenced the CBT works (Herbert & Forman 2010). What is CBT? According to Mustafa (2009), this entails a type of psychotherapy, which is beneficial in the treatment of problems and boosting happiness through the modification of dysfunctional emotions, thoughts and behaviours. Whereas conventional Freudian psychoanalysis that searches childhood experiences to get the root cause of problems, CBT emphasises on solutions, and thus stimulating patients to confront bent cognitions and alter destructive behavioural patterns. CBT addresses ways of thinking about oneself, other people, as well as the world. It also determines the way in which one’s actions influence his or her feelings and thoughts. The model is also critical in helping individuals to change their way of thinking (cognitive) and their actions (behaviour). These changes may help one feel better. Unlike other verbal therapies, it emphasises on the now and here difficulties and problems. Rather than emphasises on the causes of individuals’ past symptoms and distress, it focus on ways of enhancing their present state of mind (Wilhelm, Phillips, Fama, Greenberg, & Steketee 2011). It is evident that CBT helps to solve various kinds of problems including depression, anxiety, phobias (social and agoraphobia), panic, bulimia, stress, bipolar disorder, obsessive compulsive disorder, psychosis, and post-traumatic stress disorder. CBT is also essential in handling anger problems, low self-esteem, and physical health issues including fatigue and pain. The model is also helps one understand great problems through dividing them into small sections. This enables one to see the interrelationship among the issues and their possible effect on them (Sudak 2006). Schwartz & Carney (2012) assert that some of these parts include the difficult situation, problem, or event referred to as a situation, followed by emotions, thoughts actions, and physical feelings. Every area has an ability to influence others. CBT is influential in the breaking of vicious of changed feelings, thinking, and behaviour. When one can handle perceive these sequence parts explicitly, he can alter them, and modify their way of thinking. CBT intends to enable one to state in which he can handle the situation by himself, and devise ways of handling the issues. Presuppositions of CBT According to Hall (2010), Cognitive Behavioural Theories have three man prepositions in common. These include the reality that cognitive activity influences behaviour; it is possible to monitor and alter cognitive activity; and that cognitive change can facilitate change in desired behaviour. One of the definitions of cognitive behaviour modification entails the treatments that try to alter overt behaviour through adjustment of interpretations, thoughts, prepositions, and approaches of responding. Thus, CBT and cognitive behaviour modification are somewhat identical in regard to their treatment techniques and assumptions. The only difference arises in relation to the concepts’ treatment results. Whereas CBT centres its treatment impacts on cognitions, cognitive-behaviour modification intends to achieve changes in overt behaviour as an objective. Therefore, CBT is wider than cognitive behaviour modification, and includes the latter in it (Kingdon &Turkington 2002). In the first fundamental assumption of CBT, cognitive activity may affect behaviour. This is an interpretation of the primary mediation model. Even though initial CBTs had to write keep empirical and theoretical legitimacy f the mediation assumption, there is a lot of evidence that cognitive appraisals of incidences may influence the events’ responses, and that the modification of appraisals content has clinical worth. Secondly, CBT proposes that it is possible to alter and monitor cognitive activity. This implies that individuals may access cognitive activity, and that cognitions are assessable and knowable. Nonetheless, there is a rationale for believing that accessibility to cognitions is imperfect, and that individuals can report cognitive activities based on their probability of occurrence instead of real occurrence. Most scholars in the cognitive assessment, nevertheless, still attempt to record valid and reliable cognitive assessment approaches, often with behaviour as a means of data validation. Still on the second preposition of CBT, cognitive activity assessment is a preface to the modification of cognitive action. However, even though it implies that upon measuring a construct, individual can start manipulating it; actions do not essentially follow each other. In the context of human behaviour, cognition measurement doe not essentially help change efforts. Most of the cognitive measurement strategies focus on cognitions content and measurement of cognitive outcomes instead of cognitive process. Therefore, analysing cognition process and interrelationship among behavioural, cognitive, and affective systems will enhance people’s comprehension of change (Hall 2010). Thirdly, Hall (2010) maintains that CBT presumes that cognitive change can influence desired behaviour alteration. Therefore, whereas CBTs acknowledge that explicit strengthening contingencies may change behaviour, they are probable to focus on the substitute strategies of behaviour modification including cognitive change. Characteristics of CBT To start with, Kinsella (2008) holds that CBT is founded on cognitive form of expressive reaction. This implies that the model is founded on the notion that people’s thoughts result in behaviours and feelings, rather than external things including situations, people, and events. The advantage of this fact is that individuals can modify the way they feel, act, or think. Secondly, CBT is time-limited and briefer. It is among the fastest in regard to outcomes obtained. Averagely, clients obtain only 16 sessions throughout approaches and problems to CBT. Other kinds of therapy including psychoanalysis may take several years. CBT is briefer because it has a highly instructive nature, and utilises homework assignments. CBT is time-limited as it enables clients to understand at the start of the therapy process that it will come to an end. Notably, the client and therapist are the appropriate people to make a decision regarding the end of the formal therapy. Hence, CBT is a never-ending and not open-ended process (Herbert & Forman 2010). Thirdly, CBT requires a sound therapeutic association instead of focus in order to achieve effective therapy. Some of the therapeutic kinds presume that the major reason people improve is the positive link existing between the client and therapist. Cognitive-behavioural therapists acknowledge the significance of a trusting, good relationship, though that is inadequate. CBT therapists also think that clients improve due to their learning of effective ways of thinking differently, and they utilise the lessons. Thus, CBT therapists emphasise on training clients on logical skills of self-counselling (Vivyan 2009). Fourthly, CBT entails a cooperative effort between the client and therapist. The therapists intend to learn what clients’ goals in life, and then enable their clients to realise these objectives. The role of a therapist involves listening, teaching, and encouraging, whereas the client’s responsibility involves expressing concerns, learning, and implementing the lessons acquired (Price & Anderson 2011). Fifthly, CBT bases its facts on the stoic philosophy aspects. However, it is worth noting that not all components of CBT focus on stoicism. Some of the aspects focusing on stoicism include Rational Behaviour Therapy, Rational Emotive Behaviour, and Rational Living Therapy. Cognitive Therapy by Beck does not focus on stoicism philosophy. CBT does not prescribe how people should feel. Nonetheless, majority of the individuals seeking therapy want to get rid of their feelings. The approaches emphasising stoicism instruct on the importance of feeling, at worst, calm whenever faced with undesirable circumstances. They also focus the notion that people have their undesirable events whether they like the or not. In fact, when people are upset by their problems, they face two issues including the situation, and being upset by it. It is apparent that many people do not want many challenges. Therefore, when they learn the art of remaining calm in accepting personal issues, they will feel better, and manage to use knowledge, intelligence, resources, and energy in resolving the issue (Herbert & Forman 2010). The sixth feature of CBT is that it employs the Socratic technique. This is because therapists want to achieve a deep understanding of their clients’ problems. This explains why they always ask questions. Therapists encourage clients to conduct self-interrogation including ascertaining whether their fears are true. CBT is directive and structured, as therapists have particular agenda for every session. Particular concepts and techniques are taught in every session. The model emphasises on clients objectives, but does not prescribe the clients’ goals or tolerance. The model is directive, as it shows the clients ways of thinking and behaving appropriately to achieve realise their objectives. Thus, CBT therapists train clients on how to do, instead of telling them what they ought to do (Kinsella 2008). Additionally, Nelson (2005) holds that CBT is founded on educational approach, which is supported systematically presupposition facilitate most of the behavioural and emotional responses learning. Thus, the therapeutic goal is to enable clients to unlearn their undesired responses and learn adopt new ways of responding. The advantage of the educational model of CBT is that it causes log term outcomes. When individuals comprehend why and how they are functioning well, they adopt ways of maintaining their new status. According to Herbert & Forman (2010), the ninth feature of CBT is that its techniques and theories depend on the inductive technique. It indicates that people upset themselves with things when the circumstance is not like it appears. If they know that, they would not waste their time upsetting themselves. Thus, the inductive process encourages them to reflect on their thoughts as being guesses or hypotheses that may be tested or questioned. If they find that the hypotheses are wrong due to new information, they can align their thoughts with the actual situation. In addition, CBT has homework as a central characteristic. Goal achievement may consume a long time if all people were to think about topics and techniques taught once a week. This rationalises the CBT therapists assigning of reading assignments and stimulating their clients to always practice the learned techniques (Kinsella 2008). Assessing the CBT model Studies indicate that CBT model is an effective, as medicine, tool of managing depression, as well as other issues of mental health. Nevertheless, for CBT to be effective, a dedicated approach is indispensable, and it can be unsuitable for every client (Whitten 2009). To determine this, it is appropriate to discuss the advantages and disadvantages of the model. Advantages of CBT To start with, Wrycraft (2009) asserts that CBT helps in the successful management of depression and others mental health cases. It also beneficial as it takes a relatively short duration in comparison with other talking therapy forms. Additionally, the highly structure nature enables it to be offered in various forms including sessions, self-help computer programs and books, as well as groups. Besides, the skills learned from CBT are beneficial and practical approaches that may be integrated in everyday life in order to enable clients to cope with future difficulties and stresses. Disadvantages of CBT In order to achieve the best results from CBT, Linden, Bär and Zubrägel (2004) maintain that it is imperative that the client commit himself to the whole process. A therapist may help and advice the client, buy cannot eradicate his problems without his collaboration. Because of CBT’s structured nature, it may be inappropriate for clients with learning disabilities or complex mental health issues (Loewenthal & House 2010). Moreover, some critics assert that since CBT handles present problems and emphasise on particular concerns, it fails to address the potential essential causes of mental health conditions, such an abusive or unhappy childhood. What is more, CBT focuses on a person’s ability to change themselves in terms of feelings, thoughts, and behaviours, and fails to handle broader problems in families or systems that always have vital effect on an individual’s wellbeing and health (Vincent, Walsh & Lewycky 2010). Is CBT effective? Grant (2008) says that CBT is effective in managing problems including depression and anxiety so that they become less probable to have an adverse effect on one’s life. Often, there is a risk that bad feelings that people link to their problem will recur, but the CBT skills enable individuals to control them. In addition, upon feeling better due to the sessions, it is imperative for clients to practise their CBT skills. Some studies argue that CBT may be more effective as compared to antidepressants in the prevention of depression recurrence (Arch, Eifert, Davies, Vilardaga, Rose, & Craske 2012). Self-reflection on philosophical practice and possible benefits and/or challenges of CBT model Without doubt, the ideas of CBT elicit a wide variety of feelings and thoughts among different individuals. Perhaps, for some of them, CBT ideas may symbolise a therapy of preference for several psychological issues. For other people, it can evoke annoyances or frustrations because it reminds them of the way other therapeutic models have been ignored in terms of accessible and free provision. Besides, other people might find it ineffective. For me, the CBT models are significant in the handling personal or clients’ day-to-day challenges (Wrycraft 2009). CBT is a famously known as talking therapy. The term cognitive entails mental processes occurring in our minds including images, thoughts, and memories. CBT specifies that cognitions are core to the strategies in which we face life events. The constituents of an individual’s thoughts shape they way he interprets an event, which in turn influences his physical and emotional feeling. For instance, if I am driving along the road and a pedestrian suddenly crosses right in front of me carelessly so that I am forced to apply emergency brakes, I will have such thoughts as why are people so careless? Or is the person normal? I might also respond to the situation aggressively by shouting at the pedestrian, and telling him to be careful while crossing the road. I could also interpret the situation as the pedestrian might be depressed and thus crossing the road without thinking. I might also think that the pedestrian is a thug disguised as a confused person, and speed past him to run away from danger. These thoughts concerning particular situation affect the way we think and react to the situation (Zayfert & Becker 2007). With this understanding, it is easy to explain CBT nature. Nonetheless, it may create an impression that what I need to do is to think positive in order to feel better and maintain a good relationship with others. However, the actual argument of CBT is differently from this. Practically, the way we already feel in a situation affects our responses to the situations. For instance, if i was already anxious or agitated about certain life issues, I would react violently to the pedestrian crossing the road carelessly. Feelings also influence the way we think and is critical to know that we are all human beings subjected to life effects and situations. Therefore, understanding and sympathising with others and ourselves is an important element of CBT compared to other models (Laidlaw 2003). It is also worth noting that methods and relationship is crucial in CBT. This model focuses on collaboration, interpersonal effectiveness and two-way feedback. This is founded on the central counselling requirements underpinning humanness and professionalism in all therapeutic connections. In fact, CBT training emphasises on approaches of managing feelings, thoughts, and behaviours more than it does therapeutic experiences. It focuses on goal setting, problem-solving, emotional expression, cognitive challenging, behavioural testing, as well as exposure to apprehension (Friedberg & McClure 2002). As Morrison (2002) says, one of the CBT’s strengths is its emphasis on strategy, as is the importance of homework to boost practice of the acquired skills during sessions. Proficient CBT therapist should realise that both models and therapeutic association are core to the effectiveness of the management. In relation to question on whether CBT focuses on here and now, my response is no. Instead, the model focuses on the fact that work starts in the here and now to minimise the frequency and severity of symptoms. This explains why CBT may be time-limited as individuals cannot get what they seek in particular number of sessions used (Ruddell & Palmer 2000). Nonetheless, it is impossible for everyone as earlier life experiences largely influence their symptoms. These past experiences might have made them develop rigid negative beliefs on themselves, others, as well as the environment. In such situations, CBT absolutely investigates the past. This is possible through the recognition that the approaches people use presently were developed in their growth. Thus, it is essential to understand the sources of the present problems. Moreover, a skilled therapist should understand and sympathise with the client who had to adjust to his surroundings (Westra 2011). The misinterpretation that CBT fails to emphasise on the past experiences may partly occur since upon establishing the causes of the current issues, the therapy opts to emphasise on the way individuals may change. The model also involves the assessment of both helpfulness and accuracy of present strategies and beliefs (Tarrier 2006). It intends to enhance flexibility in an individual’s coping mechanisms to learn to select how to respond to pedestrian at the road, instead of reacting in the similar ancient way. I find CBT helpful in enabling one to better understand himself to develop into an own therapist. Conclusion Clearly, CBT is effective in the management of mental health issues that people experience in life. Some of these issues include depression, bipolar disorder, bulimia, stress, obsessive compulsive disorder, anxiety, psychosis, panic, and post-traumatic stress disorder. The model has various features including highly structured nature, time-limited, founded on educational model, based on stoicism philosophy, directive, employs Socratic technique, and depend on inductive method. Nevertheless, it is unsuitable for people with complex issues, learning disabilities, requires confrontation, and fails to address underlying sources of present challenges. In my opinion, the model is effective in making people to understand others, themselves, and their surroundings to as to appropriately think and react to various challenges in life. References Arch, JJ, Eifert, GH, Davies, C, Vilardaga, JCP, Rose, RD, & Craske, MG 2012, ‘Randomized Clinical Trial of Cognitive Behavioural Therapy (CBT) Versus Acceptance and Commitment Therapy (ACT) for Mixed Anxiety Disorders’, Journal of Consulting and Clinical Psychology,vol.80, no.5, pp.750-765 Friedberg, RD & McClure, JM 2002, Clinical practice of cognitive therapy with children and adolescents: the nuts and bolts, Guilford Press, New York. Pp. 1-20. Grant, A 2008, Assessment and case formulation in CBT, SAGE, Los Angeles, Calif, London. Pp. 1-15. Hall, K 2010, The problem with cognitive behavioural therapy, Karnac, London. Pp.1-40. Herbert, JD & Forman, EM 2010, Acceptance and mindfulness in cognitive behaviour therapy: understanding and applying the new therapies, John Wiley distributor, Hoboken, Pp. 1-30. Kingdon, DG &Turkington, D 2002, The case study guide to cognitive behaviour therapy of psychosis, Wiley, Hoboken, N.J. Pp.10-22 Kinsella, P 2008, Cognitive behavioural therapy for mental health workers: a beginner's guide, Routledge, London New York. Pp. 30-60. Laidlaw, K 2003, Cognitive behaviour therapy with older people, Wiley, Hoboken, NJ: Pp. 2-23 Linden, M, Bär, T, & Zubrägel, D 2004, ‘Cognitive behaviour therapy in generalized anxiety disorders, Results of a controlled clinical trial’, Journal of Psychosomatic Research, vol. 56, no. 6, pp.615-615 Loewenthal, D & House, R 2010, Critically engaging CBT, Open University Press, Maidenhead New York: Pp. 10-20. Morrison, AP 2002, A casebook of cognitive therapy for psychosis, Brunner-Routledge, Philadelphia, Pa.; Hove. Pp 20-42 Mustafa, K 2009 ‘The effect of cognitive-behavioural therapy on stuttering Social Behaviour and Personality’, An International Journal, vol.38, no.3, pp.301-309. Nelson, H 2005, Cognitive-behavioural therapy with delusions and hallucinations: a practice manual, Nelson Thornes, Cheltenham. Pp. 5-30. Price, M & Anderson, PL 2011, ‘The impact of cognitive behavioural therapy on post event processing among those with social anxiety disorder’, Behaviour Research and Therapy, 2011, vol.49, no.2, pp.132-137 Ruddell, BCP & Palmer, S 2000, Brief cognitive behaviour therapy, SAGE, London. Pp. 10-30. Schwartz, DR, & Carney, CE, 2012, ‘Mediators of cognitive-behavioural therapy for insomnia: A review of randomized controlled trials and secondary analysis studies’, Clinical Psychology Review, 2012, vol.32, no.7, pp.664-675 Sudak, DM 2006, Cognitive behavioural therapy for clinicians, Lippincott Williams & Wilkins, Philadelphia, Pa.; London. Pp. 1-25 Tarrier, N 2006, Case formulation in cognitive behaviour therapy: the treatment of challenging and complex cases, Routledge, London. Pp. 1-20 Vincent, N, Walsh, K, Lewycky, S 2010, ‘Sleep locus of control and computerized cognitive-behavioural therapy (cCBT)’, Behaviour Research and Therapy, 2010, vol.48, no.8, pp.779-783 Vivyan, C 2009, Self-Help Course in Cognitive Behaviour Therapy. Pp. 1-54. http://www.dbtselfhelp.com/SelfHelpCourse.pdf Westra, HA 2011, ‘Comparing the predictive capacity of observed in session resistance to self-reported motivation in cognitive behavioural therapy’, Behaviour Research and Therapy, vol.49, no.2, pp.106-113 Whitten, H 2009, Cognitive behavioural coaching techniques for dummies, Chichester: John Wiley UK ed. Pp. 5-19. Wilhelm, S, Phillips, K A, Fama, JM, Greenberg, JL, & Steketee, G 2011, ‘Modular Cognitive–Behavioural Therapy for Body Dysmorphic Disorder’, Behaviour Therapy, 2011, vol.42, no. 4, pp.624-633 Wrycraft, N 2009, Introduction to mental health nursing, Open University Press McGraw-Hill Education, Maidenhead, Berkshire. Pp. 180-190. Zayfert, C & Becker, CB 2007, Cognitive-behavioural therapy for PTSD: a case formulation approach, Guilford, New York; London. Pp. 11-35. Read More

Whereas conventional Freudian psychoanalysis that searches childhood experiences to get the root cause of problems, CBT emphasises on solutions, and thus stimulating patients to confront bent cognitions and alter destructive behavioural patterns. CBT addresses ways of thinking about oneself, other people, as well as the world. It also determines the way in which one’s actions influence his or her feelings and thoughts. The model is also critical in helping individuals to change their way of thinking (cognitive) and their actions (behaviour).

These changes may help one feel better. Unlike other verbal therapies, it emphasises on the now and here difficulties and problems. Rather than emphasises on the causes of individuals’ past symptoms and distress, it focus on ways of enhancing their present state of mind (Wilhelm, Phillips, Fama, Greenberg, & Steketee 2011). It is evident that CBT helps to solve various kinds of problems including depression, anxiety, phobias (social and agoraphobia), panic, bulimia, stress, bipolar disorder, obsessive compulsive disorder, psychosis, and post-traumatic stress disorder.

CBT is also essential in handling anger problems, low self-esteem, and physical health issues including fatigue and pain. The model is also helps one understand great problems through dividing them into small sections. This enables one to see the interrelationship among the issues and their possible effect on them (Sudak 2006). Schwartz & Carney (2012) assert that some of these parts include the difficult situation, problem, or event referred to as a situation, followed by emotions, thoughts actions, and physical feelings.

Every area has an ability to influence others. CBT is influential in the breaking of vicious of changed feelings, thinking, and behaviour. When one can handle perceive these sequence parts explicitly, he can alter them, and modify their way of thinking. CBT intends to enable one to state in which he can handle the situation by himself, and devise ways of handling the issues. Presuppositions of CBT According to Hall (2010), Cognitive Behavioural Theories have three man prepositions in common.

These include the reality that cognitive activity influences behaviour; it is possible to monitor and alter cognitive activity; and that cognitive change can facilitate change in desired behaviour. One of the definitions of cognitive behaviour modification entails the treatments that try to alter overt behaviour through adjustment of interpretations, thoughts, prepositions, and approaches of responding. Thus, CBT and cognitive behaviour modification are somewhat identical in regard to their treatment techniques and assumptions.

The only difference arises in relation to the concepts’ treatment results. Whereas CBT centres its treatment impacts on cognitions, cognitive-behaviour modification intends to achieve changes in overt behaviour as an objective. Therefore, CBT is wider than cognitive behaviour modification, and includes the latter in it (Kingdon &Turkington 2002). In the first fundamental assumption of CBT, cognitive activity may affect behaviour. This is an interpretation of the primary mediation model.

Even though initial CBTs had to write keep empirical and theoretical legitimacy f the mediation assumption, there is a lot of evidence that cognitive appraisals of incidences may influence the events’ responses, and that the modification of appraisals content has clinical worth. Secondly, CBT proposes that it is possible to alter and monitor cognitive activity. This implies that individuals may access cognitive activity, and that cognitions are assessable and knowable. Nonetheless, there is a rationale for believing that accessibility to cognitions is imperfect, and that individuals can report cognitive activities based on their probability of occurrence instead of real occurrence.

Most scholars in the cognitive assessment, nevertheless, still attempt to record valid and reliable cognitive assessment approaches, often with behaviour as a means of data validation.

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