Ryan Singer

Week 5 Discussion Ryan SingerCOL LA PS E

Week 5 Discussion: Cognitive Behavioral TherapyCognitive behavioral therapy (CBT) trains people with mental disorders to be

aware of their maladaptive thinking behaviors, feelings and thoughts that induce

negative behaviors. According to American Psychiatric Association (2013), adverse

childhood experiences and events lead to maladaptive thinking patterns. The main

objective of CBT is to convert negative thoughts into positive and constructive ones

by restructuring cognitive behaviors.

CBT in group therapy implies more than one client treated by at least one

psychotherapist. The number of clients participating in the group therapy can vary

from 5-12 clients per session (Karaca et al., 2019). Group therapy has some merits

which make some clients prefer it. It is universal in that it assures participants they are

not alone with their problems (Karaca et al., 2019). Clients are motivated to

participate in such groups where they share their experiences with people with similar

disorders. Through group therapy, clients model positive behaviors by imitating the

actions of their colleagues (Karaca et al., 2019). In terms of cost, it is less expensive

than individual therapy. Group therapy has shortcomings as well. First, the level of

privacy and confidentiality is far less than individual therapy (Karaca et al., 2019).

The focus of attention is group not specific individual hence it cannot meet personal

needs like in individual therapy. Karaca et al (2019), is a scholarly article because it

has been reviewed and cited by more than 4 scholars.

On the other hand, CBT in individual therapy consists of one client involved in

the therapeutic process guided by one psychotherapist. In group therapy the attention

is on the whole group while in individual therapy one gets one-on-one attention. The

therapist can assess and understand the specific psychiatric problem facing the

individual. Another reason why individual therapy is preferred is the high level of

privacy and confidentiality (Hauksson et al., 2017). Individual therapy is between the

therapist and the client personally identifiable and sensitive information is protected.

The therapeutic relationship is stronger in individuals than in group therapy

(Hauksson et al., 2017). One of the main components of successful therapy is

therapeutic bonding. The more the client has a stronger bond with the therapist the

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more the therapeutic process works. A shortcoming of individual therapy is it is more

expensive than group therapy (Hauksson et al., 2017). This may be a barrier to the

patients wishing to have individual therapy. Some patients are shy to participate alone

in therapy hence they may not be willing to participate in individual therapy. For such

clients, group therapy would suit them better. Hauksson et al (2017) are scholarly

because it is a peer-reviewed journal and has been cited by more than 6 scholars.

During my practicum, I provided psychotherapeutic treatment to a 40-year-old

male named A.C. A.C took part in individual therapy twice per week and group

therapy twice per week. The patient had a substance use disorder. The client

presented to the healthcare facility after his employer complained about his substance

use disorder which had affected his performance. A.C admitted that he was taking 2 -3

bottles of alcohol daily. After participating in group therapy, it was found that he was

not willing to share his experiences during the sessions. He was anti-social during the

group therapy and was worried about his confidentiality. The co-facilitators of the

group therapy recommended he participate in individual therapy twice per week. I

was in charge of individual therapy. A.C opened up why he was not willing to share

his information during the group therapy. A.C would give false information during the

group therapy and lie to the co-facilitators and during the individual therapy; he would

admit he can not share his condition before other people. PMNHPs face such

challenges during group therapy and they are not able to impact the life of the client.

CBT views substance use disorder as clients use the substance to reinforce their

maladaptive behaviors.

From this week’s learning media, clients with substance use disorder

experience relapse when reducing their drug intake. Individuals are motivated to

change when they see other people with similar problems in group therapy (Ringle et

al., 2015). One of the challenges that PMNHPs face during group therapy is

restructuring the thinking pattern of different clients at the same time. PMNHPs are

not sure whether group therapy is effective for all their clients and whether the CBT

techniques they apply to capture the problem of every individual. Another challenge is

addressing privacy and confidentiality (Chen & Chen, 2020). It is challenging to

foster privacy and confidentiality in group therapy. Therapists also face language and

cultural barriers. Some clients who may be migrants from other countries may not

communicate fluently in English, Spanish or other recognized languages except their

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first language. In such cases, interpreters are called in, which may impact the efficacy

of delivering group therapy (Chen & Chen, 2020). PMNHPs should be culturally

competent to understand diverse clients. Cultural beliefs can be a barrier to group

therapy some cultures discourage therapeutic processes and believe in spiritual

divinations to treat their psychiatric disorders (Chen & Chen, 2020). Chen & Chen

(2020) is scholarly because it is a peer-reviewed journal and has been cited by more

than 2 scholars.

References American Psychiatric Association. (2013). Diagnostic and statistical manual of

mental disorders (5thed.). https://doi.org/10.1176/appi.books.9780890425596

Chen, H., & Chen, E. C. (2020). Working with interpreters in therapy groups forforced migrants: Challenges and opportunities. International Journal ofGroup Psychotherapy, 70(2), 244-269.

Hauksson, P., Ingibergsdóttir, S., Gunnarsdóttir, T., & Jónsdóttir, I. H. (2017).

Effectiveness of cognitive behaviour therapy for treatment-resistant depression

with psychiatric comorbidity: comparison of individual versus group CBT in aninterdisciplinary rehabilitation setting. Nordic journal of psychiatry, 71(6),465-472.

Karaca, A., Yavuzcan, A., Batmaz, S., Cangür, Ş., & Çalişkan, A. (2019). The effect of

cognitive behavioral group therapy on infertility stress, general health, andnegative cognitions: a randomized controlled trial. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 37(4), 375-394.

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.mah awoh

Week 5 Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings

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

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CBT in Different SettingsThe cognitive-behavioral therapy (CBT) assists patients to change their attitudes to promote and maintain behavior modification (Nichols & Davis, 2020). To date, CBT is the gold standard of psychotherapy. According to the National Institute for Health and Care Excellence's guidelines and American Psychological Association, CBT dominates the international guidelines for psychosocial treatments, making it the first-line treatment for many disorders (David et al., 2018). That is why therapists use different CBT techniques to manage individuals, couples, and groups in therapy sessions. Individual therapy focuses on the problem of the single patient. Therefore, the sessions only evolve in the patient's problem and how the patient is affected by their mental disorder. In individual CBT, the therapist helps the patient deal with their problems and guides them in learning techniques to face their issues. Additionally, the therapist encourages the patient to identify and change core dysfunctional beliefs. Thus, individual CBT is beneficial in obtaining the patient's dysfunctional negative core beliefs and enhancing positive and more realistic ones (Neufeld et al., 2020).On the other hand, group CBT technique helps group members to restructure negative and dysfunctional cognitions about a social situation. In this approach, group members talk about their experienced situations to create a shift in their dysfunctional beliefs, resulting in a continuous improvement (Neufeld et al., 2020). Moreover, in group therapy, the therapist encourages social behavior and social skills through interactions and feedback from members of the group. Group CBT also decreases the feeling and stigma of being alone because each patient can relate to each other (PsychExamReview,2019). Finally, in family CBT, the therapist also works with multiple clients concurrently who perceive themselves as a family. Family CBT focuses on training parents in behavioral interventions for their children's behavioral problems. Thus, the sessions involve addressing the core symptoms of children's behavioral problems (Dattilio, 2021). Challenges A therapist can face challenges when someone in the group or family does not want to participate in the planned CBT technique. One example is when one group member or a family member is not comfortable opening up about personal matters to be shared with the group or family members. So, the therapist should be knowledgeable on how to carefully execute sessions

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accordingly to establish rapport and gradually gain each member's trust (GoodTherapy, 2019). Another challenge is when a patient feels judged by the therapist. Thetherapist should provide a nonjudgmental environment as some patients couldsense a minor hit of judgment. Thus, the therapist must avoid giving advice that makes the patient feel condemned or proving insight not covered by the scope of practice (GoodTherapy, 2019).Scholarly Sources For this discussion, I utilized journal articles. This includes David & Hofmann, (2018), Dattilio, (2021), and Neufeld, et al., (2020). These journal articles are considered scholarly because they are published in peer-reviewed journals and have undergone rigorous evaluation by subject experts prior to publication.References:

David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standardof psychotherapy. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00004 Dattilio, F. M. (2021). Cognitive-behavioral techniques and family system therapy. Консультативная Психология и Психотерапия, 29(3), 58–68. https://doi.org/10.17759/cpp.2021290305 GoodTherapy. (2019). 10 ways therapists can strengthen the therapeutic relationship. https://www.goodtherapy.org/for-professionals/marketing/customer-experience/article/10-ways-therapists-can-strengthen-the-therapeutic-relationshipNeufeld, C. B., Palma, P. C., Caetano, K. A. S., Brust-Renck, P. G., Curtiss, J., & Hofmann, S. G. (2020). A randomized clinical trial of group and individual cognitive-behavioral therapy approaches for Social Anxiety Disorder. International Journal of Clinical and Health Psychology, 20(1), 29–37. https://doi.org/10.1016/j.ijchp.2019.11.004

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Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Pearson.PsychExamReview. (2019). Cognitive therapy, CBT, & group approaches (intro psych tutorial #241) [Video]. Youtube. https://www.youtube.com/watch?v=A2_NN1Q7Rfg

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