Cognitive Therapy and Cognitive Behavioral Approaches - Research Paper Example

The Mitchell Family: Jonathan 1. Background information Jonathan Mitchell is a 17-year-old young man who hails from California. He lives with his parents, Dan and Deborah Lindner Mitchell in their Californian home. The couple have daughter, 15-year-old Sarah Mitchell, who is the last-born in the family. The family hails from a middleclass part of California with Dan Mitchell working as a vet while his wife, Debbie, works part time as a paralegal. Jonathan has a history of juvenile delinquency and was kicked out of school in the tenth grade for selling and using methamphetamines. This is despite the fact that he had been an outstanding student prior to his drug habit. He currently undergoes his second rehabilitation program in a private institution. Debbie wants his son to get cleaned up and go back to school, hence the reason for the referral for my expertise. 2. Assessment The fact that Jonathan was a normal bright student up to the tenth grade depicts some cause of destabilization that led to his drug habit. His parents hold strong divergent views on religion, with his father being a staunch Baptist, while his mother is a Jew from Brooklyn. The couple’s marriage has been in quandary since the beginning with constant arguments and more so during the holidays. It is mentioned that the two parents sought to distance their small family from both their two respective families and moved to California. The family is the most basic unit in the society. It is where one natures his health values, beliefs and practices. Jonathan seems to lack these fundamentals and forms the basis for his drug use, either to run away from his problems or to gather some sense of belonging. According to Jonathan, the situation worsened when Dan contemplated quitting his stress-filled job and move the whole family back to his parents’ farm. This evidently did not go well with Debbie, who had never been fully accepted into Dan’s family. She in turn threatened to file for divorce. Jonathan’s demeanor and the way he answers questions indicates he is a bright young man who is just frustrated by the state of affairs in his house. His dressing in baggy and sagging clothes is meant to toughen his looks but his mannerisms betray him. He is a child in need of attention and a better environment. He constantly blames himself, stating that his parents would not fight if it was not for him and Sarah. His logic is that his parents accepted and loved each other despite their differences. This is a very clever analysis albeit in the negative way. Jonathan expressed enthusiasm towards quitting drugs and we set up some goals that would act as his guidelines in getting back on track. He promised to finish out his remaining time in rehab and work towards being drug. We also scheduled a few more visits to keep an eye on his progress. A detoxification program was also part of the process. 3. Theoretical Background The willingness of the client to divulge information made it easy to put up a cognitive behavioral therapy (CBT) that was tailor made for Jonathan’s specific case. I was able to identify and understand his problems in terms of the relationships between thoughts, feelings and behavior. With Jonathan’s help, we were able to develop personalized time-limited therapy strategies that were to be monitored and assessed from time to time. Formulation driven CBT was the best for this case scenario since the client was not able to control his errand and sometimes-erratic behavior on his own. 4. Formulations The main formulation method I used focused on identifying the predisposing factors that in Jonathan’s case were both social and early experiences. Cognitive therapy suggests that psychological distress is caused by distorted thought about stimuli giving rise to distressed emotions. (Mulhauser,2011). In this regard therefore, we found that Jonathan had a distorted negative perception and thoughts even towards stimuli that may be deemed positive. This was precipitated by the state of affairs at home, which acted as fodder to his met amphetamine addiction. My formulation therefore sought to make him aware of the thought distortions that caused the psychological distress and the behavioral patterns that perpetuate the thoughts. Knowing this will help one to desist from such behavior. I used the Belief Driven CBT Formulation method (Mulhauser, 2011).In this case; a certain negative situation causes development of certain core beliefs in the affected individual. These core beliefs form the basis of all judgment and act like a lens through which we view other situations. Hence the beliefs shape an individual’s thoughts and behavior. The combination of thoughts and behavior affect bodily sensations. This is true in Jonathan’s scenario. In conceptualization of Jonathan’s case, it was of great importance to decipher the perpetuating factors to come up with a counter measure strategy. Core beliefs on issues were the first culprit. Jonathan strongly beliefs he is responsible for the squabbles in the house and blames himself. In this regard he low opinion of himself which low self esteem and low confidence. Drugs therefore are a welcome escape from reality creating an illusion of well being in his life. The company of fellow delinquents he keeps is also to blame for his actions. The real perpetrators are his parents. The unhealthy environment created by the parent’s differences has a negative effect not only on Jonathan, but also on his sister Sarah. It is reported that she has spiraled to a mess of neglect with her grades tumbling while her weight issue becoming more dire. These core beliefs have an underling basis from which they emanated from. This stem from personal schema, schema about others and maladaptive assumptions which may leave the patient jaded for life. For instance Jonathan has an assumption that he will never amount to anything, hence he does not see the need of education in his life. He prefers the drug life and even attempts to sell drugs, not because he has to, but he thinks this is the only way for him. 5. Treatment Plan-Motivation Interviewing Intervention Through the formulation and hypothesis, we were able to determine target areas for intervention. We identified and prioritized a number of goals. We developed a schedule of repeat sessions of twice a month with outside session assignments given while not in session. To build his confidence, quick and easily attainable goals were given first priority. These were the objectives laid out to be accomplished: Social skill training Reducing psychiatric symptoms Anger management Social support Enroll back to high school Whole family to attend therapy 6. Review In conclusion, use of Cognitive behavioral therapy is an effective technique that takes the patient through a journey of self-discovery through insight in depth analysis of his or her life. The forms part of the solution of the problem by working together with the therapist. Research shows that relapse in patients who have undergone CBT is low as compared to other interventional methods. Reference Dr.Mulhauser (22nd April 2011) An Introduction to Cognitive Therapy and Cognitive Behavioral Approaches Retrieved from http://counsellingresource.com/lib/therapy/types/cognitive-therapy/ Read More