Cbt Essay

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 &

Bibliography: American Psychiatric Association. (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th ed, text rev. Washington: American Psychiatric Association. Baldwin, S. A., Wampold, B. E. & Imel, Z. E. (2007) ‘Untangling the Alliance–Outcome Correlation: Exploring the Relative Importance of Therapist and Patient Variability in the Alliance’. Journal of Consulting and Clinical Psychology. 75 (6) pp. 842–852. Beck, A.T. (1967) Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press. Beck, A. T. (1976) Cognitive Therapy and Emotional Disorders. New York: International Universities Press. Beck, A.T. (1979) Cognitive Therapy of Depression. New York: Guilford Press. Beck, J.S. (1995) Cognitive Therapy: Basics and Beyond. New York: The Guilford Press. Beck, A. T., Brown, G. & Steer, R. A. (1996) Beck Depression Inventory Manual, 2nd ed. Texas: The Psychological Corporation. Beck, A. T., Rush. A. J., Shaw, B.F. & Emery, G (1979) Cognitive Therapy of Depression. New York: The Guilford Press. Beck, A. T. & Steer, R. A. (1990) Manual for the Beck Anxiety Inventory. Texas: The Psychological Corporation. Behar, E., Dobrow-DiMarco, I., Hekler, E.B., Mohlman, J., & Staples, A.M. (2009) ‘Current Theoretical Models of Generalized Anxiety Disorder (GAD): Conceptual Review and Treatment Implications’. Journal of Anxiety Disorders. 23 (8) pp. 1011–1023. Blackburn, I-M. & Twaddle, V. (1996) Cognitive Therapy in Action: A Practitioner’s Casebook. London: Souvenir Press. Borkovec, T. D., & Ruscio, A. M. (2001) ‘Psychotherapy for Generalized Anxiety Disorder’. Journal of Clinical Psychiatry. 62 (11) pp. 37–42. British Association for Behavioural and Cognitive Psychotherapies. (2010), ‘Standards of Conduct, Performance and Ethics’, pg 7, point 3. http://www.babcp.com/Membership/files/conduct-and-ethics.pdf [accessed 8 November 2011]. Clark, D. M. (1997) ‘Panic Disorder and Social Phobia.’ In: Clark, D. M. & Fairburn, C.G. (eds.). The Science and Practice of Cognitive Behaviour Therapy. Oxford: Oxford University Press. pp. 121–153. Clark, D. A., Beck, A. T. & Alford, B. F. (1999) Scientific Foundations of Cognitive Theory and Therapy of Depression. New York: Wiley and Sons Ltd. Dugas, M. J., Gagnon, F., Ladouceur, R. & Freeston, M. H. (1998) ‘Generalized Anxiety Disorder: A Preliminary Test of a Conceptual Model’. Behaviour Research and Therapy. 36 (2) pp. 215-226. Dugas, M. J. & Koerner, N. (2005) ‘Cognitive-Behavioural Treatment for Generalized Anxiety Disorder: Current Status and Future Directions’. Journal of Cognitive Psychotherapy. 19 (1) pp. 61–68. Ellis, A. (1962) Reason and Emotion in Psychotherapy. New York: Lyle Stuart. Fennell, M. (1999) Overcoming Low Self-Esteem: A Self Help Guide Using Cognitive Behavioural Techniques. London: Robinson .Publishing Ltd. Grant, A., Mills, J., Mulhern, R. & Short, N. (2004) Cognitive Behaviour Therapy in Mental Health Care. London: Sage Publications. Hayes, S. C., Strosahl, K. D. & Wilson, K. G. (1999) Acceptance and Commitment Therapy: An Experiential Approach to Behaviour Change. New York: Guilford Press. Helbig, S. & Fehm, L. (2004) ‘Problems with Homework in CBT: Rare Exception or Rather Frequent?’ Behavioural and Cognitive Psychotherapy. 32 (3) pp. 291-301. Hilsenroth, M. J. & Cromer, T. D. (2007) ‘Clinician Interventions Related to Alliance During the Initial Interview and Psychological Assessment’. Psychotherapy: Theory, Research, Practice, Training. 44 (2) pp. 205–218. Horvath, A. O. (2001) ‘The Alliance’. Psychotherapy: Theory, Research, Practice, Training. 38 (4) pp. 365–372. Josefowitz, N. & Myran, D. (2005) ‘Towards a Person-Centred Cognitive Behaviour Therapy’. Counselling Psychology Quarterly. 18 (4) pp. 329-336. Kelly, G. A. (2005) ‘A Brief Introduction to Personal Construct Theory’. In: Fransella, F. (ed) International Handbook of Personal Construct Psychology. Chichester: John Wiley & Sons. pp. 3-20. Kuyken, W., Fothergill, C. D., Musa, M. & Chadwick, P. (2005) ‘The Reliability and Quality of Cognitive Case Formulation’. Behaviour Research and Therapy. 43 (9) pp. 1187–1201. Kuyken, W., Padesky, C. A. & Dudley, R. (2008) Collaborative Case Conceptualization: Working Effectively With Clients in Cognitive-Behavioural Therapy. New York: Guilford Press. Leahy, R. L. (2003) Cognitive therapy techniques: a practitioner 's guide. New York: Guilford Press. Martin, D. J., Garske, J. P. & Davis, M. K. (2000) ‘Relation of the Therapeutic Alliance with Outcome and Other Variables: A Meta-Analytic Review’. Journal of Consulting and Clinical Psychology. 68 (3) pp. 438–45. Mennin, D. S. (2004) ‘Emotion Regulation Therapy for Generalized Anxiety Disorder’. Clinical Psychology and Psychotherapy. 11 (1) pp. 17–29. Meyer, T. J., Miller, M. L., Metzeger, R. L. & Borkovec, T. D. (1990) ‘Development and Validation of the Penn State Worry Questionnaire’. Behaviour Research and Therapy. 28 (6) pp. 487-496. Pavlov, I. P. (1927) Conditioned Reflexes: An Investigation of the Physiological Activity of the Cerebral Cortex. Translated and Edited by G. V. Anrep. London: Oxford University Press. Persons, J. B. (1989) Cognitive Therapy in Practice: A Case Formulation Approach. Canada: Penguin Books. Robertson, D. (2010) The Philosophy of Cognitive Behavioural Therapy (CBT): Stoic Philosophy as Rational and Cognitive Psychotherapy. London: Karnac Books. Skinner, B. F. (1938) The Behaviour of Organisms: An Experimental Analysis. Oxford: Appleton-Century-Crofts. Spitzer, R. L., Kroenke, K. & Williams, J. B. (2006) ‘A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7’ Archives of International Medicine. 166 (10) pp. 1092-1097. Stojnov, D. and Pavlovic, J. (2010) ‘An Invitation to Personal Construct Coaching: From Personal Construct Therapy to personal Construct Coaching’. International Coaching Psychology Review. 5 (2) pp. 129-139. Wells, A. (1997) Cognitive Therapy of Anxiety Disorders: A practice Manual and Conceptual Guide. London: Wiley and Sons. Wells, A. (2009) Metacognitive Therapy for Anxiety and Depression. New York: Guilford Press. Westbrook, D., Kennerley. H. & Kirk, J. (2011) An Introduction to Cognitive Behaviour Therapy: Skills and Application, 2nd ed. London: Sage Publications Ltd. Whitfield, G. & Davidson, A. (2007) Cognitive Behavioural Therapy Explained. Oxford: Radcliffe Publishing. Wilkinson, A., Meares, K., & Freeston, M. (2011) CBT for Generalised Anxiety Disorder. London: Sage Publications Ltd. Wright, J. H. (2006) ‘Cognitive Behaviour Therapy: Basic Principles and Recent Advances’. Focus. 4 (2) pp. 173-178. Wright, B., Williams, C., & Garland, A. (2002) ‘Using the Five Areas CBT Model with Psychiatric Patients’. Advances in Psychiatric Treatment. 8 (4) pp. 307-315.