An Introduction to Cognitive Behavioural Therapy: A Case Study Focusing on a Patient with Generalised Anxiety Disorder.
This essay will provide an understanding of the principles of Cognitive Behaviour Therapy and its application to a case study of someone who has mild to moderate health problems. It aims to critically evaluate the principles and philosophy that underpin cognitive behaviour theory, whist demonstrating an understanding of fundamental cognitive behavioural strategies, and finally to critically appraise the evidence base of appropriate treatment methods. For the purpose of the assignment and in accordance to British Association for Behavioural and Cognitive Psychotherapies (BABCP, 2010:7) Standards of Conduct, Performance and Ethics, the clients name has been changed to the pseudonym George. All other identifiable information has also been altered.
Cognitive Behaviour Therapy (CBT), as its name suggests, blends the theoretical insights of both the behavioural and cognitive therapies. CBT’s origins can be dated back to Stoic, Taoist and Buddhist philosophies which link human emotions to thoughts and ideas (Beck et al, 1979). Modern CBT is psychologically based and historically can be linked to behavioural theories such as those developed by Pavlov (Classical conditioning, 1927) and Skinner (Operant conditioning, 1938). Learning theories also focused on how new learning occurs to provide associations between a ‘stimuli’ and a ‘response’ (Westbrook et al, 2011). Behavioural Therapy (BT) proved particularly effective in the treatment of anxiety disorders, particularly with specific phobias. However BT did not recognise the importance of the patient’s internal thoughts in relation the maintenance of the distress, and was proved to be ineffective in the treatment of depression (Fennell, 1999). It was in the 1960’s that treatment for depression was revised and ‘cognitive therapy’ was devised.
Initially, in the 1950’s Kelly (cited in, Stojnov & Pavlovic, 2010:130) devised Personal Construct Theory. This concept was based on how an individual can facilitate changes in their perceptions which will influence their behaviour in the future. This theory was one of the first to consider how individuals interpret events and predict various outcomes in relation to these interpretations. Kelly hypothesised that these beliefs could be experimented with, allowing the individual to reconsider their expected outcomes. This exploration would allow the individual to revise their predictions and improve their expectations of events. (Stojnov & Pavlovic, 2010; Kelly, 2005). Kelly also contemplated that individuals may not revise their beliefs due to fear of behavioural implications and the consequences of this for the individual. (Stojnov & Pavlovic, 2010). This theory had a great influence on recognising that a change in an individual’s interpretation could influence behaviour, thus leading the way to developments in cognitive theory and practice.
Cognitive Therapy (CT) was developed by theorists such as Albert Ellis (1962) who established the Rational Emotive Theory and Aaron Beck (1967) who is the most famous fore founder of cognitive therapy. Beck’s work specifically focused on how a person’s thinking style would have an influence on their emotions and this in turn would impact on how they behaved in any given situation. Cognitive Behavioural Therapy (CBT) further developed through Beck’s cognitive techniques utilising earlier behavioural techniques, thus dealing with both cognitions and the psychosomatic aspects of an illness.
Within CBT a core principle is that thoughts, known as cognitions, influence a person’s emotions and behaviour. Cognitions can be defined as the processes and mechanisms that support thinking including the content of these processes which are the actual thoughts. According to cognitive theories dysfunctional thinking style relates to the individuals negative interpretation of events....
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