Cognitive-Behavioral Therapy - Case Study Example

COGNITIVE BEHAVIORAL THERAPY Name: Instructor: Date: Cognitive behavioral therapy (CBT) is a psychotherapeutic methodology that seeks to address maladaptive behaviors, abnormal emotions and cognitive processes and contents using a number of goal-oriented, explicit methodical techniques. It is a combination of behavior therapy and cognitive therapy, both separately and integrated to address the problems earlier mentioned. A variety of both cognitive and behavioral therapy is used by therapists to treat psychological disorders such as anxiety and depression (Connolly & Harms, 2009, p.45). Some behaviors cannot be brought to control through rational thought and as such Cognitive behavioral therapy renders itself to use of systematic methods that are problem-focused and action-oriented to solve the psychological problems. This technique lays emphasis on selected cognitive approaches that are meant to bring about changes in thinking of the psychotherapeutic patient and by so doing change their behavior or mood. It is also based on the tenet of continuous learning and the changing effect, on cognition and behavior, of a child’s external environment. It typically employs a host of behavior performance-based techniques and usually brings on board the family or school in the therapy. Individual work and group sessions are the primary strategies employed. The chief aim of this approach to provide an opportunity for the child to try things out and develop new skills (Payne, 2014). There are two types of CBT namely: Social Skills and Anger Coping Skills Training and Problem Solving Skills Training. On one hand, the former focuses on amending and escalating the child’s relational appraisal processes so that the child cultivates a more refined understanding of views and needs in others and also refining the child’s aptitude to control their own emotional response. The latter, on the other hand, renders itself to problem-solving approach through training to correct the insufficiencies in cognitive problem-solving dispensation capabilities usually found in aggressive children and adolescents. The eventual aim of this approach is to aid the child in dealing with external problems that may aggravate behaviors (Olatunji, 2010, p.121). CBT as a psychotherapeutic technique has over the years been widely used in social work. It has extensively been used in children psychotherapy as well as adolescent and adult psychotherapy. Notably, CBT has been used in the treatment of such psychological disorders like anxiety disorder, Schizophrenia, psychosis and mood disorders as well as disorders related to ageing. In children and adolescent psychotherapy, CBT forms a crucial integral part in treatment plans for anxiety disorders such as depression, body dysmorphic disorder, suicidality and other repetitive behavior disorders like obsessive-compulsive disorder. In this regard, CBT-SP, a modification of CBT to address youths who are severely depressed and who have made suicidal attempts within a period of 90 days has been developed and actually, feasibly and acceptably applied (Sheppard, 2006). CBT has much respect for social work values such as integrity, competence, respect for patients’ cultural diversity and independence among others. Particularly, the technique is person-based in practice as it is centered on helping the patient, usually a child, to develop capacity to become an all-round social being based on their unique characteristics such as their behavior. In addition, the skill of the therapist plays a very vital in determining the success of the CBT. How well the therapist attached to the patient can articulate the tenets of CBT in relation to the psychological problem at hand and the peculiar characteristics of the patient dictates the success of the psychotherapeutic process. As such, CBT is based on competence (Teater, 2010). Also, the mandatory values of a social worker namely ethics and accountability guide the practice of CBT. The two values call for decision making and interpretations based on guided practice as opposed to personal values and opinions. CBT as a psychotherapeutic theory has stood this test of evaluation. As well, respect for the patient’s integrity as a social work value is clearly eminent in the practice of CBT. Particularly, the therapist educates the client about the patterns used in CBT in order to ensure that the process is centered on the client’s view (Healy, 2005). CBT also brings to the fore the four major assumptions of postmodernism influence on psychology. As such, it is based on the principle that communication and language pattern of the client is a replica of the power structure within the family system. Also, it recognizes that the pathology is not limited to the identified patient but it is based on the interactional patterns of the family. In addition, it also postulates that the identified patient is simply a manifestation of the dysfunctional nature of the family communication patterns and that the symptoms displayed by the patient are a form of language. This approach buys into the modernist and postmodernist practice of psychology that assumes that the manner in which patients see themselves is not accurately true. As such, it believes that the patient will gradually recover trough the development of a more objective self-appraisal through the process of therapy. In addition, the approach also recognizes the postmodernist view that the therapist cannot claim to have a superior view than the patient because the therapist view is culture-bound. The theory has, therefore, rendered itself to disrupting the client’s personal narrative by swapping the frame-of-reference (McKay & Storch, 2009). APPLICATION OF CBT TO CHILD PROTECTION FIELD OF PRACTISE IN SOUTH AUSTRALIA Policies and practices used in child protection in South Australia are informed and controlled by the Australian Centre for Child Protection. Over the years, the center has defined and continues to develop guidelines and techniques to address the sensitive issue of child protection. Particularly, the enactment of the Children’s Protection Act in 1993, legislation that guides the theory and practice of child protection in South Australia, was a significant step towards the success of this thrift. The act outlines the powers and responsibilities of the different organs and bodies tasked with the mandate to oversee child protection in South Australia (Lamont & Holzer, 2009, p.61). At the top of the hierarchy is the Minister, who is the overall overseer of the protection of children from abuse and neglect. The Chief executive is tasked with the responsibility of ensuring that the child protection standards defined in the act are maintained in theory and practice. The law also defines the powers and obligations of the authority responsible of the child and describes the penalties resulting from neglect and abuse. In addition, it stipulates the custody agreements with reference to children and the procedures followed in notification and investigation of allegations and confirmed cases of child abuse or neglect. The predicament of children suffering from psychological disorders is a serious issue in South Australia. Sawyer et al. (2008) found out that the frequency of mental health problems among children and young people is alarmingly high. Among adolescents and children aged 4 to 17 years, the rate was found to be 14% that was very close to the18% prevalence rate for adults. Further, the main problem affecting children and adolescents in South Australia was considered to be depression. The researcher found that one out of four children in South Australia experiences an occurrence of major depression by the time they attain the age of 18 years. Also, Sawyer et al (2008) found out that the incidence of internalizing problems namely depression and anxiety was equally high at 16.5%, for adolescents between the age of 13 years to 17 years. Most internalizing problems like anxiety usually manifest during adolescence. However, they have their roots in the early childhood life of the adolescent (Virginia and Tully, 2009). Anxiety is often manifested in terms obsessive-compulsive disorder, post-traumatic stress, generalized anxiety, social anxiety and separation anxiety. Moreover, externalizing disorders such as attention deficit hyperactivity disorder (ADHD) and conduct disorder are seen mainly in adolescents although many cases of such disorders have been reported in children aged below 10 years (Virginia and Tully, 2009, p.6). According to Teater (2010, p. 54) conduct disorder can be described as an array of behavior that oversteps on the fundamental rights of others along with age-appropriate norms and rubrics and comprises deceitfulness, aggressive behavior, truancy, damage to property such as sabotage and fire setting, and theft. It is often manifested through delinquency and anti-social behavior. In South Australia, the incidence rate for adolescents and children is 1% in girls and 3.8% in boys (Sawyer et al, 2008). On the other hand ADHD is exhibited in the form of persistent impulsivity, overactivity and problems in sustaining attention. The prevalence of ADHD in South Australia is 10% in boys and 3.8% in girls (Sawyer et al., 2001, p. 7). Miller and Glinski (2005) raised a concern over the increasing incidents of self-harm among children and adolescents in South Australia. The act of suicide is commonly thought to be symptomatic of substantial mental health difficulties, like anxiety, depression or stress coupled with some fundamental maladaptive thought processes. According to Sawyer et al (2008), the Australian National Mental Health survey found out that 12% of South Australian adolescents and children had in the past year experienced suicidal thoughts and that a further 9% had devised a suicidal plan. These statistics underscore the urgency with which this psychological problem needs address. The Australian Centre for Child Protection has continually undertaken research surveys on the theory and practice of child psychotherapy in an attempt to curb this eminent problem facing the children and adolescents in South Australia. This research is mainly based on the four fundamental areas of child and family protection namely children, practitioners, system and aboriginal service providers. Through this research, the center has been able to identify and define the recommended theories to be adopted in the child protection practice in South Australia. In this regard, CBT has been found to be a successful technique in addressing psychological disorders among the youth, children and adolescents. CBT has been found to have actually solved more than 400 cases for numerous psychiatric disorders, such as anxiety disorders, depression, substance abuse and eating disorders, among others, and it is presently being verified for personality disorders. Strengths of CBT CBT has been relatively successful in addressing the problems arising from child protection in South Australia. This model has a great application to the clients because it emphasizes on human thought. Human cognitive abilities account for the many accomplishments of an individual and so may also be responsible their problems. Based on this advantage of CBT model, children’s perception of their environment is modified which results in a complete change of thinking and behavior. This strength informs the success with which this model has been applied in South Australia children protection practice (Walsh, 2010). In addition, lots of people with psychological disorders, predominantly anxiety, depressive, and sexual disorders have as well been found to manifest maladaptive assumptions and thoughts, the tenets on which CBT is built. As such, the model has been able to address the psychological problems of the children through integration of the two aforementioned psychopathological principles. Also, the instructive nature of CBT has contributed to its success through lucid self-counseling skills inculcation into clients by the therapists. Confidence that the patient will continue to recover (get well) is cultivated in them through understanding how they can rationally counsel themselves (McKay & Storch, 2009, p.76). Moreover, CBT is shorter-term compared to other approaches. On average a patient is supposed to attend 16 sessions though special cases require more sessions. This makes CBT a more desirable approach by most clients especially because most children do not have the aptitude to attend many long sessions of psychotherapy. Better still, CBT is cross-cultural. The techniques used in this approach are grounded on universal laws of human behavior. That is, the techniques lay their focus on the goals of the client as opposed to those of the therapist. Furthermore, the structured nature of CBT sessions decreases the likelihood that the sessions will be the much therapeutically non-productive chat sessions. Besides, CBT is adaptive. The fundamental principle of CBT is that an individual’s behaviors and feelings are caused by their thoughts (cognitions) (Bowers, 2013, p.52). Limitations CBT success in addressing the problem of child protection in South Australia has not been without limitations. This approach renders itself to just one part of human functioning, thinking. There is therefore, the need to address broader issues. Also, there have been ethical issues arising from the practice of CBT. Directive therapy that aims to change cognitions is sometimes forceful. This raises some ethical concerns in social practice in South Australia. Worse still, there exists a technical reservation concerning some of the principles on which CBT is based. For instance, clarity needs to be sought as to whether faulty cognitions are a consequence or a cause of the psychopathology (Bowers, 2013, p.44). Conclusion In conclusion, based on empirical studies done on Cognitive Behavioral Therapy, it is evident that this approach has successfully been used to solve a range of psychopathological dysfunctions. The psychological problems surrounding child protection in South Australia are no exception. Based on the assumptions and fundamental principles of this theory, it is worthwhile to conclude that the success it has manifested so far is bound to continue into the future. However, the theory needs continuous review to address current issues arising from the changes in social practice in South Australia.   REFERENCES Bowers, E 2013,The everything guide to cognitive behavioral therapy: learn positive and mindful techniques to change negative behaviors, McGraw Open Uni Press, England. Connolly, M & Harms, L 2009, Social work: contexts and practice, , Oxford University Press Australia & New Zealand, South Melbourne, Vic. Gilson, M 2009, Overcoming depression a cognitive therapy approach : therapist guide, Oxford University Press ,Oxford. Healy, K 2005, Social work theories in context: creating frameworks for practice. Houndmills, Palgrave Macmillan, Basingstoke, Hampshire. Lamont, A & Holzer, P J 2009, Australian child protection legislation, Australian Institute of Family Studies, Melbourne, Vic. Mcinnis-Dittrich, K & Mcinnis-Dittrich, K 2009, Social work with older adults: a biopsychosocial approach to assessment and intervention, Allyn & Bacon, Boston. Mckay D & Storch, EA 2009, Cognitive-behavior therapy for children: treating complex and refractory cases, Springer Pub, New York. Miller, AL & Glinski, J 2005, ‘Youth suicidal behavior: Assessment and intervention’, Clinical Psychology, vol.96, no7, pp. 1131-1152. Olatunji, BO 2010, Cognitive behavioral therapy, Pa Saunders, Philadelphia. Parton, N 2004, Social theory, social change and social work, Open University Press, Maidenhead, England Payne, M 2014, Modern social work theory, Palgrave Macmillan, London.  Sawyer, MG, Baghurst, PA, Arney, FM, Graetz, BW,Clark, JJ & Kosky, RJ 2008, ‘The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being’, Psychiatry, vol. 35, no.6, pp. 806-814. Sheppard, M 2006, Social work and social exclusion the idea of practice, Aldershot, England, Ashgate. Teater, B 2010, An introduction to applying social work theories and methods, McGraw-Hill/Open University Press, Maidenhead, England. Walsh J 2010, Theories for direct social work practice, 2nd ed, Wadsworth Cengage Learning, Belmont, CAL.  Read More

In this regard, CBT-SP, a modification of CBT to address youths who are severely depressed and who have made suicidal attempts within a period of 90 days has been developed and actually, feasibly and acceptably applied (Sheppard, 2006). CBT has much respect for social work values such as integrity, competence, respect for patients’ cultural diversity and independence among others. Particularly, the technique is person-based in practice as it is centered on helping the patient, usually a child, to develop capacity to become an all-round social being based on their unique characteristics such as their behavior.

In addition, the skill of the therapist plays a very vital in determining the success of the CBT. How well the therapist attached to the patient can articulate the tenets of CBT in relation to the psychological problem at hand and the peculiar characteristics of the patient dictates the success of the psychotherapeutic process. As such, CBT is based on competence (Teater, 2010). Also, the mandatory values of a social worker namely ethics and accountability guide the practice of CBT. The two values call for decision making and interpretations based on guided practice as opposed to personal values and opinions.

CBT as a psychotherapeutic theory has stood this test of evaluation. As well, respect for the patient’s integrity as a social work value is clearly eminent in the practice of CBT. Particularly, the therapist educates the client about the patterns used in CBT in order to ensure that the process is centered on the client’s view (Healy, 2005). CBT also brings to the fore the four major assumptions of postmodernism influence on psychology. As such, it is based on the principle that communication and language pattern of the client is a replica of the power structure within the family system.

Also, it recognizes that the pathology is not limited to the identified patient but it is based on the interactional patterns of the family. In addition, it also postulates that the identified patient is simply a manifestation of the dysfunctional nature of the family communication patterns and that the symptoms displayed by the patient are a form of language. This approach buys into the modernist and postmodernist practice of psychology that assumes that the manner in which patients see themselves is not accurately true.

As such, it believes that the patient will gradually recover trough the development of a more objective self-appraisal through the process of therapy. In addition, the approach also recognizes the postmodernist view that the therapist cannot claim to have a superior view than the patient because the therapist view is culture-bound. The theory has, therefore, rendered itself to disrupting the client’s personal narrative by swapping the frame-of-reference (McKay & Storch, 2009). APPLICATION OF CBT TO CHILD PROTECTION FIELD OF PRACTISE IN SOUTH AUSTRALIA Policies and practices used in child protection in South Australia are informed and controlled by the Australian Centre for Child Protection.

Over the years, the center has defined and continues to develop guidelines and techniques to address the sensitive issue of child protection. Particularly, the enactment of the Children’s Protection Act in 1993, legislation that guides the theory and practice of child protection in South Australia, was a significant step towards the success of this thrift. The act outlines the powers and responsibilities of the different organs and bodies tasked with the mandate to oversee child protection in South Australia (Lamont & Holzer, 2009, p.61). At the top of the hierarchy is the Minister, who is the overall overseer of the protection of children from abuse and neglect.

The Chief executive is tasked with the responsibility of ensuring that the child protection standards defined in the act are maintained in theory and practice. The law also defines the powers and obligations of the authority responsible of the child and describes the penalties resulting from neglect and abuse.

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