Section 1
There are various literature sources that discuss Cognitive Behavior Therapy (CBT). The immense interest in this type of therapy is derived from the fact that it forms a seminal method of handling mental health issues that cannot be treated by medical doctors. This literature review however will focus on the works by Katy Grazebrook and Anne Garland (2005), as well as Richard G. Heimberg (2002). These authors bring out the concept of CBT in the clearest manner possible helping their readers understand that what they think can affect their feelings. They also have almost similar view about how best CBT could be administered so as to provide the best remedy to the people seeking this help.
Theoretical approach
Cognitive Behavior Therapy (CBT) is a therapy has it foundation on concepts and principles affecting human psychology, emotion, and behavior. It uses such theories as theory of normal and abnormal development, as well as theory of emotion and psychopathology. Grazebrook and Garland (2005) assert that CBT help people to overcome mental health problems. People undergoing mental distress will often think different about themselves and what happens to them. The role of a CBT therapist is to ensure that their clients identify and change their extreme thinking. If the instructions are taken carefully and religiously, then the client will exhibit major improvement in how he or she feel and think and feel.
CBT consists of two components, that is, the cognitive component and behavioral component. Cognitive component relates to how people think about and understand situations occurring around them. It also deals with symptoms and events in people’s lives and how they respond to these symptoms by developing perceptions about themselves and other people around them (Richard, 2002). On the contrary, the behavioral component relates to peoples' response to distress. Therapists seek to help people feel safe enough to test their assumptions and overcome their fears o as to change their behaviors.
How CBT works
CBT use questioning model to analyze various situation. The process is called guided discovery where the people’s style of reasoning and thinking and their potential to think differently are explored (Richard, 2002). Behavioral experiments are then carried out to identify the efficiency and accuracy of these alternative thinking in a manner that help them to perceive things and act differently.
The therapist and the client meet to establish a trusting rapport that can help them in finding solutions to the problem before them. Once the rapport is established, it is the duty of the therapist to ensure that an equal partnership exist between them. Each party is, therefore, required to bring some utility to the program. Feske and Chambless (1995) state that the therapist comes with skills and knowledge of psychology, theories of emotion and experience of being able to help the client. The client comes with their experience and psychological situation that requires redress.
The two parties then enter into a dialogue process usually referred to as Socratic dialogue. This involves probing the client in a manner that helps them think differently and see to it that there is an alternative way of reasoning (Richard, 2002). The therapist will engage the client skillfully to help them realize for themselves that are the alternative way of reasoning and handling the situation at hand. Therapy goals are established which are supposed to be achieved within a specified time limit. These goals are continually monitored and evaluated by the therapist to ensure that they are helpful in their course. The client is given homework where he puts the things he has learned into practice. The process is supposed to help the client attribute any improvement in his problems to his efforts with the help of the therapist.
What I find interesting is how the therapist allows the client to be part of the solution rather than a person seeking for a solution. But above all, it is interesting that the client is made to feel as if he found the solution himself with the help of the therapist (Grazebrook and Garland, 2005). The whole process is useful as it helps people to adopt helpful and alternative ways for reasoning to resolve their emotional or mental problems. I think couples must always communicate to ensure they resolve any emerging problem before it ends up at the therapist. CBT is similar to this model as it encourages the couples to find the best way of resolving dispute by them through alternative reasoning. I would adopt this method to the present situation by encouraging the couples to discuss their problems rather than ignoring each other. They must be able to promote a collaborative partnership by emphatically questioning each other to explore possible situations to their problems.
Section 2
Problem:
Financial crisis
Signs and symptoms
The family is in a financial crisis after Walter's father's death. They hardly agree on what they should use the money from the insurance policy for. The symptoms include constant worrying, restlessness as they seek financial security. The sign includes the argument between Lena and Walter about the money Walter was supposed to pay for Beneatha's schooling.
Biopsychsocail assessment
The family consists of Mama Lena, who is thirty-five years old and her children Walter and Beneatha. Walter is married to Ruth while Beneatha is expected to join college of medicine to further her career. The family is just coming from the unexpected death of their father, and Walter is relied upon as the decision maker for the family. He works as a limousine driver to a rich man. He is unhappy with the job as he thinks his family should be as rich as his employer should. Walter’s wife Ruth at one point becomes pregnant, the financial difficulties the family faces tempts her to abort a decision, which Walter holds in abeyance. Lena is a devout Christian, who intends to provide her family using the money she received from the insurance policy taken by her husband. Although the family is in dire financial crisis, putting this money into good use will help them develop economically. Beneatha is assertive and finds various ways to express herself. She is kind and generous who wants to become a doctor so as to help people. She accepts a marriage proposal from Asagai from Nigeria at the expense of George the black American because she thinks he understands her more than George does. The family has also to fight racial discrimination they face from their neighbor Lindner, Lena says even if they have to buy a house from Lindner that should not make them lesser beings.
Mental Status
The family is in trouble and so is the mood of everyone. Ruth is disgusted at the idea of his son selling Liquor. Walter is nasty at every member of the family even to the extent of telling his wife she would better of being a nurse than a doctor. Ruth is depressed at the idea of giving birth and therefore contemplates abortion. The whole family is depressed when Walter loses the money to his friend Willy whom Beneatha had told him not to trust. Now Beneatha is unhappy she would not be attending medical school after all.
Intervention Plan
Impression: the family is in a financial crisis and faces massive racial discrimination. Virtually every member of the family is working so hard to protect himself or herself from getting hurt by people around them. The children depend on their mother for support=Lena depends on Walter for decision-making. However, there seems to be no way out of this situation. To fix this problem, there is a need for the family to stick together and support each other despite previous events.
Goal: To overcome family financial crisis
1 Objective: Changing Negative Behavior
1 Task: Contingency management: Walter must be given a punisher to decelerate his behavior of trusting people he considers friends to the extent of letting them handle his financial issues. Beneatha should be rewarded for working hard in academics so as to be able to help other people including her family.
2 Task: Token economies: the tokens given to the family should be able to help it think differently about innovative ways to boost its financial situation.2 Objective: Restructuring distorted beliefs.
1 Task: token economies: the therapist gives tokens to the Walter and Beneatha. For Beneatha, the token may be images of black Americans as well as white Americans who fought against racism in America. The token will help Walter to drop his notion on gender identity that black girls can only be nurses and not doctors.2 Task: contingency contracting: the therapist in collaboration with Walter and Beneatha should develop a positive intervention mechanism specifying the behavioral and social expectations that will help them restructure the belief that they are inferior to other people like Lindner in the society.3 Shaping: the therapist should reinforce this change slowly step by step to ensure that the distorted belief about racial superiority is changed.
References
Feske, U., & Chambless, D.L. (1995). Cognitive behavioral versus exposure only treatment for
social phobia: A meta-analysis. Behavioral Therapy 26:695–720.
Katy, G., & Garland, A. (2005). What is CBT? British Association for Behavioral and Cognitive
Psychotherapies. Retrieved from http://www.anapsys.co.uk/cbt.pdf.
Richard G. H. (2002). Cognitive-behavioral therapy for social anxiety disorder: current status
and future directions, Society of Biological Psychiatry2 (51), 101–108.
