Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a popular psychotherapeutic intervention that helps patients modify their maladaptive thinking and alleviate their consequent symptoms. CBT is extensively used, especially in patients with depression, anxiety, phobias, and eating disorders, and occasionally in patients with psychotic features.

Cognitive Behavioral Therapy

Christine Padesksy, a renowned cognitive therapy inventor, developed the hot cross bun model of CBT to better understand how the therapy works. This model demonstrates how thoughts, emotions, behaviors, and physical states impact each other (Dobson & Dobson, 2018). For example, the mere prospect of something horrible occurring causes worries (emotion), which may result in the action or behavior of fleeing, with the resulting physical state of perspiration or trembling.

With the model’s ideas, CBT may be utilized in individual, group, or family settings, each with its framework and structure. The subsequent sections of this paper emphasize a comparison of CBT usage in groups and individual settings, followed by a discussion of the challenges a PMHNP may experience when providing a CBT intervention.

How CBT in Groups differs from CBT in Family or Individual Settings

CBT intervention in a group setting necessitates a highly structured and participatory session involving multiple people with comparable mental illnesses. The interaction among group members serves as a foundation for change. For example, group members discuss their problems and experiences, and the group setting helps them understand that their diagnoses are not unique to them and are shared by others, enhancing their feeling of belonging (Guo et al., 2021).

Another kind of treatment that is delivered in a group environment is family therapy. In the couple CBT treatment video, Norman Cotterell, a clinical coordinator, emphasizes that couples may display skills such as communication methods and empathy techniques that would be difficult to demonstrate in an individual CBT session (Beck Institute for Cognitive Behavior Therapy, 2018). Furthermore, the fact that a therapist conducts a session with many patients at the same time saves time and money, making group CBT a desirable option for individuals of all socioeconomic backgrounds.

Individual CBT, on the other hand, takes place only between the therapist and the patient. Individual CBT interventions, as opposed to group interventions, provide for more patient confidentiality and privacy (Nyman-Carlsson et al., 2020). Individual CBT treatment sessions also build a successful therapeutic relationship between the patient and the therapist, which improves patient results.

Dr. Judy, a clinical psychologist, is in session with Kyle, the host who also serves as the patient, in the personalized CBT therapy video, and they are able to identify the patient’s problem, which is difficulty finding love, and both work on an individualized behavioral experiment to fix the problem (MedCircle, 2019). The film highlights the power of an individual CBT environment, where patients can freely share information without fear of breaching confidentiality or privacy.

Challenges PMHNs face when using CBT in an Individualized Setting.

The difficulties encountered when proving CBT might be attributed to either the patients or the therapist. Some patients may struggle with adherence, failing to attend planned sessions and thereby jeopardizing their therapy. While poor adherence may be a problem, other patients may be too compliant with the sessions and eager to please, stifling progress (Davies et al., 2018).

Patients who are overly compliant to please the therapists may fail to criticize the intervention when appropriate, and the therapist may be unaware if therapeutic goals have been accomplished or not. Furthermore, some patients may be hostile and temperamental, making it difficult to guide them through CBT intervention.

On the therapist’s side, a PMHNP may fail to finish the whole course of CBT and experiment with different theoretical orientations, which may lead to confusion and reduced effectiveness (Davies et al., 2018). Avoiding some of the problems may be difficult; nonetheless, to ensure a smooth overall course of CBT, both the therapist and the patient should concentrate on mutually agreed-upon objectives and practical ways to attain them.

Supporting Sources and Evidence of their Relevance

Besides using CBT-related media this week, the discussion above is backed by a wealth of research. Davies et al. (2018), Guo et al. (2021), and Nyman-Carlsson et al. (2020) explore different features of CBT in the treatment of various mental diseases in a systematic review, meta-analyses of randomized controlled trials and a randomized controlled trial, respectively.

The papers’ currency (published within the previous five years), relevance in addressing the intervention of concern, accuracy due to a strong back-up of sources, and authorship by experts in medicine and psychiatry all contribute to their credibility and potential for use as scholarly sources.

Conclusion

Psychotherapeutic therapies, particularly CBT, which is considered the gold standard of psychotherapy, are very beneficial in the treatment of mental diseases. The method allows patients to collaborate with their therapists in recognizing and overcoming problematic thought patterns.

The intervention may be conducted in various contexts, such as individual, group, or family settings, each with its framework and structure. While delivering the CBT intervention to patients may present difficulties for the PMHNP, focusing on agreed-upon objectives between the therapist and the patient is critical in maintaining a smooth course of therapy.

References

  • Beck Institute for Cognitive Behavior Therapy [beckinstitute]. (2018, June 7). CBT for Couples. Youtube. https://www.youtube.com/watch?v=JZH196rOGsc
  • Davies, S. R., Caldwell, D. M., Lopez-Lopez, J. A., Dawson, S., Wiles, N., Kessler, D., Welton, N. J., & Churchill, R. (2018). The process and delivery of cognitive behavioural therapy (CBT) for depression in adults: a network meta-analysis. The Cochrane Library. https://doi.org/10.1002/14651858.cd013140
  • Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy, second edition (2nd ed.). Guilford Publications. https://books.google.at/books?id=yvBUDwAAQBAJ
  • Guo, T., Su, J., Hu, J., Aalberg, M., Zhu, Y., Teng, T., & Zhou, X. (2021). Individual vs. Group cognitive behavior therapy for anxiety disorder in children and adolescents: A meta-analysis of randomized controlled trials. Frontiers in Psychiatry12, 674267. https://doi.org/10.3389/fpsyt.2021.674267
  • MedCircle [MedCircle]. (2019, December 13). What a cognitive behavioral therapy (CBT) session looks like. Youtube. https://www.youtube.com/watch?v=8-2WQF3SWwo
  • Nyman-Carlsson, E., Norring, C., Engström, I., Gustafsson, S. A., Lindberg, K., Paulson-Karlsson, G., & Nevonen, L. (2020). Individual cognitive behavioral therapy and combined family/individual therapy for young adults with Anorexia nervosa: A randomized controlled trial. Psychotherapy Research: Journal of the Society for Psychotherapy Research30(8), 1011–1025. https://doi.org/10.1080/10503307.2019.1686190

Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings Instructions

There are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in individual, group, and family settings, consider challenges of using this approach with groups you may lead, as well as strategies for overcoming those challenges.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To prepare:

  • Review the videos in this week’s Learning Resources and consider the insights provided on CBT in various settings.

LEARNING RESOURCES

Required Readings

  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disordersLinks to an external site.(5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
    • “Culture and Psychiatric Diagnosis”
  • Nichols, M., & Davis, S. D. (2020).The essentials of family therapy (7th ed.). Pearson.
    • Chapter 9, “Cognitive Behavioral Family Therapy”
  • Wheeler, K. (Ed.). (2020).Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
    • Chapter 8, “Cognitive Behavioral Therapy”
    • Chapter 21, “Psychotherapeutic Approaches with Children and Adolescents”
      • 793–802 only
    • Chapter 22, “Psychotherapy with Older Adults”
      • 840–844 only

Required Media

 Post an explanation of how the use of CBT in groups compares to its use in family or individual settings. Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly and attach the PDFs of your sources.