Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

Week 8: Cognitive Behavioral Therapy for Groups

CBT is the most widely researched psychotherapeutic model with demonstrated effectiveness in the treatment of a wide range of emotional and behavioral problems. CBT is the first order of business and treatment of choice for most patients who need internal resources and coping skills enhanced.

—Dr. Sharon M. Freeman Clevenger, Psychotherapy for the Advanced Practice Psychiatric Nurse

Although designed for therapy with individuals, cognitive behavioral therapy (CBT) has also proven effective in group settings. With its many benefits, including cost-effectiveness and efficiency, this therapeutic approach allows the psychiatric mental health nurse practitioner to effectively treat a greater number of clients in a relatively short length of time. With the widespread use of CBT with groups, it is important for you to understand how to use this therapeutic approach in clinical settings. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays .

This week, as you explore CBT for groups, you compare CBT in group and family settings. You also develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients.

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Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

  • Chapter 11, “In the Beginning” (pp. 309–344)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

  • Chapter 12, “The Advanced Group” (pp. 345–390)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays .

Note: You will access this text from the Walden Library databases.

Bjornsson, A. S., Bidwell, L. C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz Seghete, K. L., … Craighead, W. E. (2011). Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: A randomized controlled trial. Depression and Anxiety, 28(11), 1034–1042. doi:10.1002/da.20877

Note: You will access this text from the Walden Library databases.

Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Türkçapar, M. H., Kuru, E., & Yücens, B. (2014). The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225–233. Retrieved from http://www.turkpsikiyatri.com/

Note: You will access this text from the Walden Library databases.

Document: Group Therapy Progress Note

 

Discussion: Cognitive Behavioral Therapy: Group Settings Versus Family Settings

As you might recall from Week 5, 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 group settings and family settings, consider challenges of using this approach with your own groups. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays .

Learning Objectives

Students will:

  • Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families
  • Analyze challenges of using cognitive behavioral therapy for groups
  • Recommend effective strategies in cognitive behavioral therapy for groups

To prepare:

  • Reflect on your practicum experiences with CBT in group and family settings.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit! Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays 

By Day 3

Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

 

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 8 Discussion

 

Assignment 1: Practicum – Week 8 Journal Entry

Learning Objectives

Students will:

  • Develop effective documentation skills for group therapy sessions *
  • Develop diagnoses for clients receiving group psychotherapy *
  • Evaluate the efficacy of cognitive behavioral therapy for groups *
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders *
  • Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.

Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session.

Then, in your Practicum Journal, address the following:

  • Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session.
  • Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for each client.
  • Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays
  • Explain any legal and/or ethical implications related to counseling each client.
  • Support your approach with evidence-based literature.

By Day 7 of Week 10

Submit your Assignment.

Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

 

By Day 7

Complete the Board Vitals questions.

Making Connections

Now that you have:

  • Explored cognitive behavioral therapy (CBT) for groups and compared CBT in group and family settings
  • Developed diagnoses for clients receiving group psychotherapy and considered legal and ethical implications of counseling these clients

Next week, you will:

  • Explore psychotherapeutic approaches to group therapy for addiction
  • Develop diagnoses for clients receiving psychotherapy for addiction and consider legal and ethical implications of counseling these clients Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

 

Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays Individual vs. Family CBT

Cognitive behavioral therapy is short-term psychotherapy that emphasizes the need for attitude change in order to maintain and promote behavior modification (Nichols, 2014). Cognitive behavior therapy (CBT) has been found to be effective in a broad range of disorders. CBT can be done as an individual treatment or in a family setting. Individual CBT has a broadly defined framework with an emphasis on harm-reduction, especially with clients that have anxiety and substance abuse (Wheeler, 2014).

Cognitive-behavioral therapy for families is also brief and is solution-focused. Family CBT is focused on supporting members to act and think in a more adaptive manner, along with learning to make better decisions to create a friendlier, calmer family environment (Nichols, 2014). An example from practicum is a male (T.M) that participates in individual CBT once a week and family CBT once a week. T.M is struggling with alcoholism.

He originally presented for individual CBT because he had been “told by his wife” that he had a problem with alcohol. He reported that he drank “a few vodka drinks” three times a week but none for six weeks. Individual CBT therapy is a collaborative process between the therapist and client that takes schemas and physiology into consideration when deciding the plan of care (Wheeler, 2014). We worked with him using open-ended questions to assist with obtaining cognitive and situational information.  He would become angry easily and it was a felt that he was not being truthful about his alcohol use. Each time he was questioned about it, the story would change. He attended two individual sessions and it was then recommended he begin family CBT with his significant other (S.M) because “things were not going well at home.”

With family CBT, cognitions, emotions, and behaviors are seen as having a mutual influence on one another (Nichols, 2014). The first session was stressful, to say the least. T.M began talking about his alcohol use. S.M interrupted and said, “what about that one-time last month at the hotel. You were seeing things.” He became defensive, raised his voice, and said, “I was drugged. It had nothing to do with drinking.” She then looked down and was tearful. When he left the room to use the bathroom, S.M questioned if he could be tested for alcohol. This led the therapist to believe that T.M’s last use was not six weeks ago.

T.M’s automatic thoughts were that his alcoholism was not a problem in the marriage or in life. One of the core principles in using CBT for SUDs is that the substance of abuse serves as a reinforcement of behavior (McHugh et al., 2010). Over time, the positive and negative reinforcing agents become associated with daily activities. CBT tries to decrease these effects by improving the events associated with abstinence or by developing skills to assist with reduction (McHugh et al., 2010).

It was noticed that when T.M was alone, his stories would change. But when his wife was in the room, he would look at her while he spoke to ensure what he was saying was accurate. The therapist informed the client that it would be appropriate to continue individual therapy and family CBT once a week with the recommendation of joining the ready for change group. The CBT model for substance use states that, when a person is trying to maintain sobriety or reduce substance use, they are likely to have a relapse (Morin et al., 2017). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

Ready for change meetings was recommended because like this week’s media showed, clients may relate to others that are going through similar situations. Getting T.M to realize that his alcohol use is a problem, is the primary goal currently. This example was shared because it shows the difficulties that may be encountered with psychotherapy and that both individual and family may be needed to ensure that goals are met. Some challenges that counselors face when using CBT in the family setting are wondering if the structure of the session and if the proper techniques were effective (Ringle et al., 2015). Evaluating and consulting with peers may also assist with meeting client and family goals.

References

McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America33(3), 511-25. doi:10.1016/j.psc.2010.04.012

Morin, J., Harris, M., & Conrod, P.  (2017, October 05). A Review of CBT Treatments for Substance Use Disorders. Oxford Handbooks Online. Ed.  Retrieved fromhttp://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199935291.001.0001/oxfordhb-9780199935291-e-57.

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

Patterson, T. (2014). A Cognitive-Behavioral Systems Approach to Family Therapy. Journal of Family Psychotherapy25(2), 132–144. https://doi-org.ezp.waldenulibrary.org/10.1080/08975353.2014.910023

Ringle, V. A., Read, K. L., Edmunds, J. M., Brodman, D. M., Kendall, P. C., Barg, F., & Beidas, R. S. (2015). Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community. Psychiatric services (Washington, D.C.)66(9), 938-45. doi:10.1176/appi.ps.201400134

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to

guide for evidence-based practice. New York, NY: Springer.

 

Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays POST 2

Cognitive Behavioral Therapy is one of the most effective psychotherapy approaches, whether it be used in group, family, or individual treatment. It is important to understand the purpose of it what its process consists off. It can be used to treat different mental health conditions, ranging from addiction to more severe illnesses. Its approach is to work with the patient into strategizing ways to change unhealthy thoughts and behaviors. Throughout the process, the patient not only learns solving skills, but also to re-evaluate and learn how to understand other’s perspectives, skill that helps build their confidence.

Some believe group therapy is more effective than individual therapy, as established by Kellett, Clarke, and Matthews (2007, p. 211). It has been established that CBT in general can be effective, but based on the Johnson Family Session video, it leads me to believe that either group/family or individual would be effective depending on the condition that is being treated. It is clear from the video that the girl who had been sexually assaulted at the fraternity does not believe talking or sharing her experience, even if it is with other girls who went through the same experience, will help in any way. She still has some internal issues that need to be addressed individually in order to make progress and get her to a place where she can participate in group/family therapy with an awareness that it will help her and purpose to it. Another important aspect of having a client be committed to the treatment is that research has showed “Poor compliance can adversely affect the remaining group members who may become worried or insecure” (Söchting, Lau, Ogrodniczuk, 2018, p. 185).

An example during practicum that supports my belief is the case of a terminally ill patient who had been recommended comfort care through hospice. She was ready to do so, understood and accepted her prognosis, but her daughters and husband were in denial. Every time they participated in a family session the patient held back on her wishes and verbalized whatever their wishes were as if they were her own. When treated as an individual client, she would express her concerns of not being able to “disappoint and abandon my family”. She had suffered all her life from anxiety, insecurities, severe depression, and low self-esteem. Those were issues that should have been addressed individually before she could fully engage in a family session in a healthy and productive way, if she would’ve had the time. CBT would have still been the choice of treatment for individual therapy for this client, as evidenced by Driessen et al. who stated it “is the psychotherapy method with the best evidence-base in the treatment of depression” (2017, p. 654). Not being fully engaged in the program, or believing the treatment will not help, or having other issues that need to be addressed on an individual basis, are all challenges presented in a family setting when relying on CBT.

References

Kellett, S., Clarke, S., & Matthews, L. (2007). Delivering Group Psychoeducational CBT in

Primary Care: Comparing Outcomes with Individual CBT and Individual

Psychodynamic-Interpersonal Psychotherapy. British Journal of Clinical Psychology,

           46(2).

Söchting, I., Lau, M., & Ogrodniczuk, J. (2018). Predicting Compliance in Group CBT Using the

Group Therapy Questionnaire. International Journal of Group Psychotherapy, 68(2).

Driessen,E., Van, H. L., Peen, J., Don, F. J., Twisk, J. W. R., Cuijpers, P., & Dekker, J. J. M.

(2017). Cognitive-Behavioral Versus Psychodynamic Therapy for Major Depression:

Secondary Outcomes of a Randomized Clinical Trial. Journal of Consulting Clinical

Psychology, 85)7).

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Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays POST 3

Week 8 discussion

Cognitive Behavioral Therapy: Group Settings Versus Family Settings

Cognitive behavioral therapy (CBT) is an effective treatment for a broad range of psychiatric disorders and problems (Naik et al. 2013). CBT can be offered as an individual treatment, in a family setting or used in a group setting. Group cognitive behavioral therapy (GCBT) may be a more efficient form of delivering CBT in areas of the mental health system where providing adequate amounts of treatment for patients is challenging (Naik et al. 2013). To be able to recommend the use of GCBT in mental health settings, more work needs to be undertaken to establish patients’ perceptions of such treatment and whether it is effective in reducing symptoms (e.g., anxiety, depression, distress) in actual practice settings. In a study done to show the effectiveness of group CBT, it was assumed that CBT efficacy varies widely depending on the disorder presented. CBT is highly effective in the treatment of adult unipolar depression, adolescent unipolar depression, bulimia nervosa, childhood depressive and anxiety disorders, generalized anxiety disorder, panic disorder with or without agoraphobia, post-traumatic stress disorder, schizophrenia, and social phobia (Naik et al. 2013). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

Group cognitive behavioral therapy has also been shown to be more cost-effective because Group treatment has been presented as a more cost-effective method of treating a large number of children and adolescents especially in children or adolescent with anxiety disorders, depression, bulimia nervosa to mention but a few. Group CBT result in reduced medical and nonmedical costs, thereby contributing to a societal cost offset, but in a family setting, there is the scarcity of properly trained therapists and high costs (Hedman et al.2010). However, CBT is not readily available in healthcare settings. Therefore, it is essential to develop and evaluate methods of therapy that are more time- and cost-efficient. Because health care resources are limited, there has been an increasing demand for cost-effective treatments that reduce the societal costs of sick leave and health care consumption (Hedman et al.2010). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

References:

Hedman, E., Ljótsson, B., Andersson, E., Rück, C., Andersson, G., & Lindefors, N. (2010).

Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a

psychiatric setting: an open trial. Cognitive Behaviour Therapy, 39(4), 239–250.

https://doi-org.ezp.waldenulibrary.org/10.1080/16506073.2010.496460

Naik, A., O’Brien, A., Gaskin, C., Munro, I., & Bloomer, M. (2013). The Acceptability and

Efficacy of a Group Cognitive Behavioural Therapy Programme in a Community Mental

Health Setting. Community Mental Health Journal, 49(3), 368–372. https://doi-

org.ezp.waldenulibrary.org/10.1007/s10597-012-9484-3

 

Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays POST 4

Week 8 Discussion

Cognitive behavioral therapy (CBT) is an evidence-based practice for therapy. CBT can be used in individual, group, or family therapy. The use of CBT in the family setting grew from the Thibaut and Kelley’s theory of social exchange (Nichols, 2014). The theory of social exchange states that people will endeavor to increase rewards and decrease sacrifice in a relationship. Thibaut and Kelly express that this behavior has the goal of maintaining homeostasis in the relationship which they call behavior exchange theory(Nichols, 2014). CBT postulates that one person’s behavior affects how another person will react to them. CBT use in group therapy has a similar premise the difference between group CBT and family CBT is schemas (Wheeler, 2014). Schemas are a persons core beliefs, and these underlying beliefs shape the way a person responds even if it is unconsciously done. One challenge in the group setting is group members may attempt to bring the family schemas they possess into the group(Wheeler, 2014). Another challenge in the group setting with CBT is keeping group members focused on the here and now; even if the factors leading to the behavior was in the past (Wheeler, 2014). I have seen this in my practicum experience in the group therapy the therapist has to work hard on keeping members in the here and now and reinforcing the goal of change. In the family therapy sessions, I have seen more struggles over how to blend two family schemas into one where everyone can be happy. Creating new schemas is generally especially difficult for the families I have seen because they have autistic children which changes how families must react to behaviors. Bjornsson, Bidwell, and Brosse at el report that CBT in the group may be less effective because the concentration on restructuring activities, prevents the formation of group dynamics that is crucial in group therapy (2011). Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

 

References

Bjornsson, A. S., Bidwell, C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz, K. L., … Craighead, W. E. (2011). Cognitive-Behavioral Group Therapy Versus Group Psychotherapy For Social Anxiety Disorder Among College Students: A Randomized Controlled Trial. Depression and Anxiety, 28(11), 1034-1042. http://dx.doi.org/10.1002/da.20877

Nichols, M. (2014). The essential of family therapy (6th ed.). Boston, MA: Pearson.

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse (2nd ed.). New York, NY: Springer Publishing Company. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

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