All psychotherapy approaches work to address the underlying thought patterns that result in psychological distress. The different treatment methods that are mostly used include behavioral therapy, rational emotive behavioral therapy, cognitive behavioral therapy, and reality therapy. Every condition and situation calls for application of a specific type of strategy by the counselor after evaluation of the elemental concern. However, many patients tend to suggest that as much as they recognize that certain thoughts are irrational or healthy, becoming aware of the same cogitations does not become easy to change them. Therefore, before conceptualizing on which particular approach to use in a case, it is important to identify client’s presenting concerns, concepts of the treatment model, and techniques to be applied for the stratagem.
As a counselor I would use the cognitive behavioral therapy (CBT) to conceptualize Gina’s case of criticizing herself angrily for her family’s tension and disagreement. The suitability of CBT lies on the fact that the method focuses on redirecting patients’ thoughts and changing their behaviors so that they can generally alter how they feel about a certain situation (Carpenter et al., 2018). With CBT, Gina’s negative feelings of blaming herself on all family’s problems can be retrained in order for her to make changes on how she perceives herself with regard to the incidents on her family (Rialon, 2016). Accordingly, CBT will enable Gina to cope up with similar problems in future and provide solutions to them without having to condemn herself for everything.
From Gina’s case, I can identify various presenting concerns by analyzing her situation. Firstly, there are feelings of anger within her because she berates herself on the notion that she has disappointed her father as the man expects her to be the strongest of all his children in the family (Tolin, 2016). Secondly, there exists the concern of excess worry from Gina because she thinks a lot about her family ordeal (Rialon, 2016). Thirdly, the presenting concern is the confused thinking that she constantly engages in over every member of her family (Tolin, 2016). The problems pose a greater threat to Gina’s mental health if she does not seek a counselor’s assistance as appropriate.
Based on the three presenting concerns I have identified, there is one that I would firstly address. I would start by addressing the confused thinking that Gina is undergoing. The reason for choosing this particular concern over others is that it can be reoriented to help the patient change her overall feelings about her mental problem (Carpenter et al, 2018). Without doubt, if Gina rids herself of demented thoughts are averted, and then she would not be bitter with herself and consequently regain confidence to be able to handle the crisis the family has gotten itself.
Three Central Concepts
There are three key concepts to CBT which must be well understood by a therapist before assessing the client. These ideas are core beliefs, dysfunctional assumptions, and negative thoughts. Core beliefs or schemas are the strongly held convictions about self, others and the outside world in which an individual lives (Tolin, 2016). In essence, the beliefs are learnt at the early stages of life and influenced by childhood experiences. Ideally, the early life incidents are often viewed as the absolutes. Dysfunctional assumptions are inflexible, tentative rules for living that people usually adopt (Carpenter et al., 2018). In some cases, the rules are impractical and therefore flawed. The third concept in CBT is the negative thoughts, which are the unconditioned thoughts activated in specific situations (Tolin, 2016). The negative thoughts comprise of all issues of negativity, low self-esteem, and uselessness, among others. As evident, the three concepts of CBT show how every rational human being think about themselves and their immediate environment.
Most importantly, the three CBT concepts are important in understanding or working on Gina’s case. In using the core beliefs, it is of utmost relevance to understand the religious or secular beliefs that Gina may hold. The understanding of Gina’s religious doctrines will automatically help a therapist to know the client’s core beliefs. Additionally it is also important to delve into her childhood life to understand her upbringing as this is also important in understanding how the early life shapes her core beliefs. Next, Gina’s dysfunctional assumptions are analyzed to check which rules and goals she has set for herself that may be contributing to her self-criticism. Moreover, Gina’s role models and their favorite quotes should also be checked to ascertain whether she subscribes to their thoughts and their ways of life. With the two concepts having been applied, the therapist is able to ascertain the negative thoughts and group them accordingly, whether low self-esteem, uselessness, or other. Therefore, the use of the three concepts of CBT is crucial to understanding Gina’s case.
Strengths and Limitations
Analytically, CBT has its best strengths that make it to be an appropriate model for Gina’s case. Firstly, CBT enables a patient to develop more rational thought processes (Rialon, 2016). This is much help because cognitive distortions do occur and are bound to occur at any point in the life of a human being due to their spontaneous natures. After a period of time, the process of questioning and replacing negative thoughts from Gina’s mind will automatically transform her thought processes. Secondly, the strength of CBT lies in its ability to equip patients with new skills and strategies that enable them to tackle new and future psychological distress (Tolin, 2016). As the process entails training or conditioning of behaviors, the clients can train their conduct to a specific direction and be champions of CBT. Accordingly, Gina can apply the skills she has acquired to future problems. Inarguably, CBT is a model that acts as a training school for mental patients.
Nonetheless, CBT has a share of its weaknesses that should be noted before employing it. Firstly, CBT model is narrow in scope as it focuses mainly on cognitive thought processes and behavior of an individual (Carpenter et al., 2018). Sometimes, mental problems are caused by external factors that usually need to be addressed before the behavior and thought patterns are assessed. The treatment paradigm therefore works best with patients who have exclusively distorted thought patterns and may fail to perform on patients with other associated problems (Rialon, 2016). Another weakness with the CBT treatment strategy is that it may be prone to ethical criticism, because of its training nature to a patient (Tolin, 2016). As CBT advocates for the change in thought processes and behaviors, it may be criticized of ‘forceful’ change in a person’s conduct and dogmas. Consequently, this may not yield good results for a patient who has strong attachment to some set of beliefs and is not ready to change.
Any rational human being may apply cognitive restructuring to one’s life when hit by challenging situations that may generate stress. If, for instance, one of my best friends is hosting a graduation party and I am not invited, this is most likely to make think that he does not like me or he does not highly regard me. I would use cognitive restructuring in creating alternative or balanced thoughts for example telling myself that the friend likes me but he does not have to invite me for everything (Rialon, 2016). The probable outcome for this thought would be happiness and relaxation for me (Tolin, 2016). With the cognitive restructuring, I am able to learn my cognitive biases and errors that would otherwise make me be judgmental of my friend by jumping into conclusions without any analysis (Carpenter et al., 2018). Therefore, learning to overcome reasoning errors is important to situations that might be stressing.
When attempting to apply cognitive restructuring from CBT to my life, I encountered numerous challenges. Firstly, as an individual, I had the difficulty in identifying my emotions and thoughts that resulted from my worries (Tolin, 2016). From the failure of one of my friends to invite me for his graduation party, I was not sure whether to be sad, regretful, or hateful of the friend or myself. Secondly, I was able to agree with the postulations of the strategy but altering my thinking became difficult (Tolin, 2016). Illustratively, I was more thoughtful of the negative reasons as to why the friend could not invite me for his party, and as such replacing positive thoughts in my mind was difficult. The situation in the example has strengthened me to rely mostly on cognitive restructuring as the best strategy in CBT.
Certainly, in applying cognitive restructuring, I noticed cultural limitation to this approach. Since CBT stresses on cognition, rationality, and verbal skills, I realized that the cognitive emphasis was leading to undervaluing of my cultural values. All my focus was drawn to restructuring my behavior and thoughts towards my friend who did not invite me to his party but, at the same time, neglecting the influences that the traditional customs had on me (Tolin, 2016). As a matter of fact, the friendship value had been defaced, and with my traditions, the friendship could have ended without having to reconsider it through any cognitive strategy.
Carpenter, J., Andrews, L., Witcraft, S., Powers, M., Smits, J., & Hofmann, S. (2018). Cognitive behavioral therapy for anxiety and related disorders: A meta‐analysis of randomized placebo‐controlled trials. Depression and Anxiety Association of America, 35(6), 502-514.
Rialon, B. (2016). Advances in cognitive-behavioral therapy for youth with anxiety disorders: A brief summary. Current Psychiatry Reviews, 12(1), 29-36.
Tolin, D. (2016). Doing CBT: A comprehensive guide to working with behaviors, thoughts, and emotions. Guilford Press.