Behavioural Therapy and Apply the Theory to Field of Practice - Essay Example

Analysis of Cognitive-Behavioural Therapy Name Institution Analysis of Cognitive-Behavioural Therapy This essay will be divided into two parts. Part one will describe cognitive-behavioural therapy and will explore the development of the theory and its relationship to social work values and purpose. The second part will apply the cognitive-behavioural therapy to the field of practice which is depression experienced by young people. Part One: Reviewing Cognitive-Behavioural Therapy Cognitive-behavioural therapy (CBT) contributes to social life as it emphasize on the importance of creating individuals’ rational management of behaviour in order to figure out the source of problems (Payne, 2014). The theory is focussed on managing and changing people’s behaviour so as to resolve social problems. Cognitive-behavioural therapy was built up from two influences; cognitive therapy approach and behaviour therapy. The cognitive therapy part of cognitive-behavioural therapy is intended to address challenges on how individual’s thinking influence behaviour while the behaviour therapy part of the theory focuses on addressing behaviour problems like depression, anxiety and phobia among others (Payne, 2014). Behaviour therapy emerged in contrary to the psychodynamic approach that was used in psychotherapy from nineteenth century (Payne, 2014). Psychodynamic was criticised due to lack of empirical evidence supporting it. Behaviour therapy was influenced by behaviourist movement which highlighted that human mind was not amenable to scientific study. The behaviour theory used the learning theory in order to transform unwanted behaviour. On the other hand, cognitive therapy was developed in 1950s and grew to become influential. Cognitive therapy was used to treat depression (Payne, 2014). As years went by, behaviour theory and cognitive theory grew together to a level that the resulting combination is now called cognitive behaviour therapy. Cognitive-behavioural therapy identifies systems including cognition, emotion, behaviour and physiology (Osmond and O’Connor, 2006). These systems interrelate in complex feedback process. Interaction between these systems is used to describe challenges in detail. Cognitive-behavioural therapy is part of behaviour theory and its occurrence was made possible by the presence of social learning theory (Tredget, 2001). The theory was also created from rational therapeutic development devised by several scholars who were worried about psychiatric conditions affecting people. The focus of cognitive-behavioural therapy is to increase the desired behaviours and at the same time minimize the undesired ones in order to be able to respond appropriately to social situations (Tredget, 2001). This is able to increase an individual’s ability to live a full and happy life. Cognitive-behavioural therapy is founded upon how people think, how they think ad how they interact with each other. Consequently, negative thoughts can result to distress and mental problems. CBT is therefore purposed to assist people become wary of negative behavioural patterns that underpin the distorted thinking (Matthews, Harvey and Trevithick, 2003). CBT is surrounded by many controversies due to its association with evidence-based practice. Cognitive-behavioural therapy has the most developed evidence base but its critique relies on the fact that the theory has some limitations in relation to social work practice (Matthews, Harvey and Trevithick, 2003). The contention is a question of whether its focus on modifying particular problems in a person’s behaviour attains success. In addition, the theory is focussed on amplifying problems instead of looking at strengths and objectives. Due to the CBT focussing on problems, it runs contrary to the principles of looking for positive objectives as proposed by strength and solution-focused practice (Matthews, Harvey and Trevithick, 2003). Moreover, cognitive-behavioural therapy is not applicable to most social work services. CBT is only applicable to psychological conditions such as anxiety, post-traumatic stress disorders as well as depression. Although CBT is surrounded by broad range of critiques, one strong argument for the theory is its success in attaining results (Matthews, Harvey and Trevithick, 2003). However, the success of the theory depends on the specific situation and the way it is deployed. Feminist theory has criticised cognitive-behavioural therapy due to its individualist focus as it perceives that all problems come from an individual’s mind and ignores the influences of oppression (Nash, Donoghue and Munford, 2005). CBT is also considered antifeminists as it makes women think they are irrational and it attempts to change the social factors involved in challenges tackled by social work professions. A major strength of CBT is that it has great appeal due to its focus on human thought and it has been effective in treating anxiety problems and depression (Nash, Donoghue and Munford, 2005). As mentioned earlier, cognitive-behavioural therapy observe characteristic of cognition related to specific kind of problems. For instance, in an event of depression, the thoughts of a depressed individual contain characteristic contents (Nash, Donoghue and Munford, 2005). Depressed person is able to show characteristic biases due to his or her perception. Characteristic cognition in depressed people is negatively biased perception of the world and of oneself. For example, an individual depressed view is that the future is bad, the world is bad and I am bad (House and Loewenthal, 2008). Cognitive-behavioural therapy is used to change this perception of a person. CBT proposes that due to early life experience, people develop beliefs that are functional and dysfunctional and that allow them to make sense of the world. The current status of cognitive-behavioural therapy is that it is strongly acknowledged as a therapeutic solution for several psychological disorders. The United Kingdom National Institute for Clinical Excellence has been a useful source for highlighting the success of CBT (House and Loewenthal, 2008). This body is used to determine the effectiveness of different treatments and make the decision as to what treatment should be made available in the National Health Service. NICE has made cognitive behavioural therapy available as a treatment for people with mild depression, schizophrenia, and generalized anxiety and panic and post-traumatic stress disorder (House and Loewenthal, 2008). It is a misconception to perceive that validating the efficacy of a treatment highlights the truth of the treatment-based theory. Therefore, the efficacy of cognitive-behavioural therapy as a treatment does not prove that cognitive-behavioural therapy is true. However, the knowledge of cognitive-behavioural therapy is able to assist in the improvement of the quality of people’s lives (Nash, Donoghue and Munford, 2005). Values are the main concern that social workers have with cognitive-behavioural therapy. CBT is used to manipulate behaviour without the consent of the client which could result to the therapy enforcing social expectations on unwilling clients (Nash, Donoghue and Munford, 2005). Since the development of CBT in 70s and 80s, the theory has been influenced by modern and postmodernist thoughts (Abramovich, 2006). Cognitive behavioural therapy has been influenced by postmodern paradigm. Post-modernism highlights pluralism as well as diversity of culture. Initially, CBT was based on the use of scientific paradigm to solve social problems. However, due to post0modern influences, the theory understands that scientific analysis is inadequate to solve problems. CBT today is based on the participation from clients in order to construct an accurate picture of the problem and be able to solve it (Abramovich, 2006). Due to post-modern paradigm, CBT rejects ethical ambitions in order to be able to offer client responsive services. The participation of post-modern practice in CBT has led to the abandonment of blind knowledge following and has broken the boundary between a client and an expert (Abramovich, 2006). It has made CBT to be a community-based as well as a participative form of therapy. Part Two: Apply the Theory to Field of Practice CBT theory has a limited use. It is particularly used for childhood problems such as depression and eating disorder, mild anxiety and adolescent mental health problems. Cognitive-behavioural therapy is effective in treating depression experienced with young people (Jordon and Thompson, 2006). There is no exact answer as to why young people develop depression. A lot of different factors can affect the mental health leading to depression. Every family experiences difficulties but some experience more challenges that can cause mental health problems. The risk factors for depression among young people include, living in poverty, experiencing discrimination and destruction of attachment, lack of parental support and loss among others (Jordon and Thompson, 2006). It is not usual for young people to experience depression but adolescence is considered an unsettling time with different physical, emotional and psychological changes that take place. This may be a driver of depression among young people (Jordon and Thompson, 2006). In addition, unrealistic academic and family expectation may put pressure on youngsters who may feel a strong sense of rejection and confusion. In this period, children need adult guidance in order to overcome everything to avoid depression (Abramovich, 2006). In the recent years due to increase in the use of media such as the internet, television and magazines, depression among young people has increased at an alarming rate. Survey conducted in the United States in 2012 indicated that one in five adolescent and teens suffer from depression (Jordon and Thompson, 2006). The seriousness of this problem calls for quick, suitable treatment. Depression is very difficult to diagnose among young people as they do not express their feeling very well. However, some symptoms of depression in teens include poor performance in school, anger and rage, poor self-esteem, lack of concentration, lack of motivation, sadness and suicidal actions etc. (Jordon and Thompson, 2006). It is important to come up with ways of dealing with this issue. One effective treatment of depression among young people is cognitive behavioural therapy developed from CBT theory. Cognitive-behavioural therapy theory assumes that an individual’s mood is linked to his or her arrays of thought (Jordon and Thompson, 2006). When a person has dysfunction or negative thinking, his or her moods, behaviour as well as sense of self is affected. What cognitive-behavioural therapy does is to assist people learn to be aware of negative arrays of thoughts, assess their influence and replace them with other positive ways of thinking. CBT is aimed at assisting patients change their behaviours that result from negative, dysfunctional thinking (Matthews, Harvey and Trevithick, 2003). When a person has negative and dysfunctional thoughts may result to depression. When the patterns of thoughts are changed the mood is changed. Cognitive-behavioural therapy for treating depression among young people is founded upon specific task; cognitive restructuring whereby the professional and the client work in coordination to change the thinking pattern as well as behavioural activation (Matthews, Harvey and Trevithick, 2003). This enables the client to learn to overcome obstacle and ensure they participate in enjoyable activities. CBT is very educational. The professional utilizes organized learning experiences that teach a young person how to monitor their dysfunctional thoughts (Matthews, Harvey and Trevithick, 2003). This enable young people recognize how these thoughts affect their behaviour and moods. With such learning experiences, it is possible for a young person to have problem solving skills and minimizes depression. Cognitive behaviour therapy uses the knowledge of CBT theory to treat depression in children and adolescence. CBT is meant to change the thoughts and behaviours of a client through positive and problem-solving approach (Matthews, Harvey and Trevithick, 2003). Cognitive-behavioural therapy is aimed at solving both cognitive and behavioural problems. Depression is considered a cognitive and behaviour problem that can be resolved using cognitive-behavioural approaches (Wampold et al., 2002). Depression among young people involves loss of interest in things, feeling sad and inability to enjoy life. Depression can radically affect young people’s ability to function well at school, at home and socially. It generally has a functioning effect on the entire society. When a person has depression, he or she has negative thoughts that cause negative emotions. For instance, a depression teen may have a belief that “I am a loser” or “I am worthless” when something happens contrary to the expectation (Wampold et al., 2002). With these negative thoughts he starts feeling down which affects the day-to-day activities. When such a teen received cognitive behaviour therapy, he or she starts to develop balanced thought such as “I am not going well, but there is room for improvement”. Due to this reconsideration of the situation, the teen will feel better and depression level will go down. CBT is able to question where the belief of “I am a loser” came from and works at changing the source (Wampold et al., 2002). In order to overcome the negative thoughts, the therapist encourages the client to develop an action plan which involves list of activities to do to feel better and lessen depression. Depression comes from damaged cognitions about the world. This faulty thinking stem from cognitive deficiencies and cognitive distortions (Parker, Roy and Eyers, 2003). These faulty cognitions distort how people see things and result to irrational thinking. Young people just like anybody else interact with each other through their mental representation of the world. When their mental representations are incorrect or are inadequate due to depression, then their emotions and behaviours are affected as they become disordered. In order to solve this issue, young people are taught how to identify distorted cognitions and how they influence their feelings (Parker, Roy and Eyers, 2003). CBT enable young people change their distorted cognitions which eventually change their feelings and behaviours. Studies have showed that CBT is among the most effective treatment of depression and is useful for all ages such as children, adolescence and adults. CBT for treating depression has undergone more than 50 clinical trials since 1977 (Wampold et al., 2002). Clinical trials have indicated that cognitive behaviour therapy is not as effective as reported. However, compared to other treatments such as psychodynamic therapy and antidepressant medication, cognitive behaviour therapy is a better alternative. The use of cognitive behaviour therapy alone is not as effective in treating depression (Wampold et al., 2002). Its use alone is considered a short-term alternative. Therefore, in order to be effective, cognitive behaviour therapy should be used in combination with pharmacotherapy. There are a number of evidences that suggest that the combination of CBT and pharmacotherapy bring about better outcomes than either modality alone (Wampold et al., 2002). However, CBT is generally useful in treating depression in young people. It has success in social work as therapists can offer supervision and patient-centred setting for treatment. Just like any other treatment technique, cognitive behaviour therapy has both advantages and disadvantages. This does not mean that they are ineffective. Treatments based on cognitive-behavioural therapy are well defined and technicist. They are able to change the negative and dysfunctional thoughts of people which affect behaviours. It encourages people to pay attention to important things in life that makes them happy. In addition, it minimizes the effects of risk factors of depression. Compared to other techniques, CBT should be used as a treatment for depression among young people. References Abramovich, E. (2006). Application of CBT in an Inpatient Setting: Case Illustration of an adult male with anxiety, depression, and axis II symptoms, Clinical Case Studies, 5(4): 305-330. House, R. and Loewenthal, D. (2008). ‘Introduction: an exploration of the criticisms of CBT’, in House, R. and Loewenthal, D. (eds) Against and for CBT: Towards a Constructive Dialogue? (Ross-on-Wye: PCCS Books): 7–18. Jordon, C. & Thompson, S. (2006). The effect of cognitive behavioural therapy (CBT) on depression: the role of problem-solving appraisal. Research on Social Work Practice, 16(5): 500-510. Matthews, S., Harvey, A. & Trevithick, P. (2003). Surviving the Swamp: Using Cognitive Behavioural Therapy in a Social Work Setting, Journal of Social Work Practice, 17(2): 177-185. Nash, M., O’Donoghue, K. and Munford, R. (2005). ‘Introduction: integrating theory and practice’, in Nash, M., O’Donoghue, K. and Munford, R. (eds), Social Work Theories in Action, (London: Jessica Kingsley): 15–28. Osmond, J. & O’Connor, I. (2006). Use of Theory and Research in Social Work Practice: Implications for Knowledge-Based Practice, Australian Social Work, 59(1): 5-19. Parker, G., Roy, K., & Eyers, K. (2003). Cognitive behavior therapy for depression? Choose horses for courses. American Journal of Psychiatry, 160: 825–834. Payne M. (2014). Modern Social Work Theory, 4th Edition. Basingstoke: Palgrave Macmillan. Tredget, J. (2001). Introducing and explaining CBT, Mental Health Nursing, 21(6): 8-13. Wampold, B. E., Minami, T., Baskin, T. W. & Tierney, S. C. (2002). A meta-(re) analysis of the effects of cognitive therapy versus other therapies for depression. Journal of Affective Disorders, 68: 159–165. Read More