A good CBT therapist applies CBT theory in therapy. Describe how you use CBT principles and techniques to achieve good therapeutic outcomes in practice. Reflect on your 30 minutes DVD practice session using CBT skills to inform your assignment.
Introduction
The purpose of the essay is to describe the results of an enacted CBT session as part of the Introduction to the CBT module, in which I played the role of a therapist and a fellow student took the part of the client. By taking part in this process I hoped to understand the challenges that a CBT therapist faces when dealing directly with patients. Also to understand, more clearly the specific skills a therapist may use in different situations in order to help others (Egan 2007).
Using a critical reflective approach, I reviewed the session, and identified some of the strengths and weaknesses that I identified within the session and related these back to the notion of how a good CBT therapist functions.
I have described below some of the specific principles and techniques that I used in the session, which included the continuum principle, the here and now principle and the Socratic question technique.
I used a structured model to help me to conduct the session and manage efficiently the time from the beginning to the end of the session (Nelson-Jones, 2002)
Body
To ensure that ethical considerations and issues of confidentiality are met, the name of the patient will remain anonymous. (Sand, 2010) check this reference and add to ref. list.
The Essay on Good Night and Good Luck
Good Night and Good Luck is a movie that tells the story of McCarthyism and the media campaign against it. Edward R. Murrow is described as the protagonist fighting against the evils of this man and his campaign. The greater message of the movie is the use of media. The ethical question posed is, what place does television have in society? At its conception, there was a debate. Was television ...
The physical make-up of any room used for a counseling session is very important. Issues such as: privacy, intimacy and the environment help to make the client relax and are crucial for conducting a worthwhile counseling session. So the first thing I did was ensure that a “do not disturb” sticker was on the door, then I checked that the room was welcoming and that the chairs were comfortable (Geldard & Geldard, 2005).
Cognitive cognitive behaviour Therapy">behaviour therapy is a modern form of therapy which consists of two main influences, which are behaviour therapy and cognitive therapy. Behaviour therapy consists of reproducible associations between stimuli and responses. Cognitive therapy consists of an examination of mental processes like thoughts, beliefs and interpretation. These approaches complement each other however over a number of years they have merged to become what we know today as CBT.
These interventions are used in the context of a good therapeutic relationship which is characterized by Clarkson (2003) as a working alliance.
The working alliance is the part that enables the client and the therapist to work together to make the relationship constructive (Clarkson, 2003).
To become a good CBT’s therapist it is necessary to use some evidence based principles and techniques that are associated with good therapeutic outcome. Also it is important to be empathic, congruent, specific, organised, to use appropriate interventions, and to be collaborative, (Rogers, 1961).
Also you need to have good listening skills, maintain eye contact, and to be structured because CBT is time limited therapy. To build a good working alliance I maintained eye contact all of the time, I listened attentively, and l summarized various comments from the patient (Inskipp, 2010).
The Coursework on Dance Therapy People Therapist Patients
Dance therapy is a type of psychotherapy that uses movement to further the social, cognitive, emotional, and physical development of the individual. Dance therapists work with people who have many kinds of emotional problems, intellectual deficits, and life-threatening illnesses. They are employed in psychiatric hospitals, day care centers, mental health centers, prisons, special schools, and ...
As a result these skills help to build a good therapeutic relationship and working alliance. (not sure about this sentence here, does it match? lol)
From the beginning to the end of the session I used the here and now principle which according to Westbrook, Kennerley and Kirk (2011) is effective for focusing on current processes rather than the past. This is in contrast to psychodynamic principle designed by Freud which focuses on past experiences like childhood. Freud believed that by delving back to past experiences we can appreciate and understand today’s problems. Whereas the here and now principle focuses purely on the issues which are being faced at this time and the circumstances causing them. I explored the client’s present issues instead of looking into his past experiences, and it improved his outlook from the first session.
The patient was very nervous about being around a large group of people, he found this particularly difficult when he had to take the train in the morning on his way to work. His main concern was that the train would crash and because of the crowd he would get stuck and find it impossible to get out of the train. As a result of this fear he stopped going to work for 5 weeks just to avoid getting the train.
At the outset I agreed with the patient the aim of therapy, the aim was to explore his issues and by using a number of techniques I hoped to get him get back to work. This technique is called goal setting, a simple end result that we want to achieve and can work towards (Boyes, 2008).
I used this technique to help me plan and keep on track the main point of the therapy, also to let the client know what was going on collaborative nature of the therapy process& the mutual expectations within this (just copy this sentence and add it, please could you change the words, otherwise will be plagiarism)
I used the ABC model to help me to organise the information from the patient. The ABC model stands for: activating event, beliefs about the activating event (rational or irrational) and consequences. That is to identify any irrational thinking, beliefs and self – talk. The aim is to reduce the patient’s self- defeating beliefs which can cause anxiety and hostility. According to Boyes (2008), each of these areas affects the others to set up an automatic and sometimes ongoing vicious circle that makes one feel bad and even may create new negative situations.
The Term Paper on Assisting Patient Client With Eating And Drinking
The purpose of this assignment is to discuss the knowledge that underpins assisting a client with eating and drinking. I will begin by introducing a service user, who in order to maintain confidentiality and anonymity will be referred to as Dot. An attempt will be made to look at different factors that can influence the nutritional requirements of the individual. I will then discuss the principles ...
To help me to gather information from my client and access his negative automatic thoughts I used the Socratic Method. The Socratic method is a CBT technique based on a way of asking questions that encourage the patient to consider new perspectives by reviewing the information we consider in therapy and drawing their own conclusion to help them find the solution themselves (Padesky, 1993).
To activate the problem I tried to identify the event by asking him where and when it first happened. He replied that it happened six months ago and it happens only on the train, in the rush hour, when the train get very busy.
By asking him “what crossed to your mind when that happened?” I intended to access his self-talk that determined the meaning that he attached to the achivating event. He was afraid of getting stuck in the train and of not being able to escape if the train crashed. Together we analysed his beliefs and we found evidence against his negative automatic thoughts. This evidence was the fact that in 20 years taking this public transport he was never involved in or he never heard about a train crash. This made him conscious (or aware) of his false belief.
Then I asked him “what he felt when this feeling came over him?” and he said that he panicked, his heart beat increased and he started to breath heavy.
Continuing with the Socratic questions, I asked him “what would be the worst outcome that could happen?” and he said that he could die.
From the question above I decide to use the Continuum principle, which suggests that psychological problems are a continuation of an exaggeration of normal situations, and I tried to normalize and show him how he was exaggerating this situation without any evidence for his fear (Westbrook, Kennerley & Kirk, 2011).
By doing that I developed a trust, and the use of this principle helped bring me and the patient closer together, and our working alliance got stronger. A strong working alliance is fundamental to achieve good outcomes (Clarkson, 2003).
The Term Paper on Biofeedback Therapy Feedback Client Relaxation
Biofeedback therapy is a treatment technique that enables people to use signals emitted from their own body to monitor and improve their health. It is the "use of instrumentation to mirror psychophysiological processes of which the individual is not normally aware and which may be brought under voluntary control (Biofeedback pamphlet).' These processes include heart rate, respiration, skin ...
I suggested that he takes a later train which wouldn’t be so crowded or to get someone that he trusts to travel with him, and checked with him to make sure that he felt comfortable doing this. I asked if this could work for him and help him to get back to work, and he replied positively and was willing to try this. By doing this I set up the agenda, which is a home work for him which will help me to structure the following session and help the patient to face and solve the problem (Westbrook, Kennerley & Kirk, 2011).
As the client said at the beginning, he was very anxious getting to the train, as a result his heart beat increase. Before the end of the session I suggested for him to try a breathing technique, which consists of taking 4 deep breath in trought the nose, in 4 seconds, then hold it for 2 seconds then release for 6 seconds. According to Clark et al (1985) this technique is efficience in reduce the level of anxiety, and I believe it would help the patient to calm down when he get the train. But I didn’t specied to him clearly how to release the breath ( I forget to say that he should release it in 6 seconds, I didn’t find words at the moment to express myself) .
Before the session I was very nervous, as this was my first time acting as a CBT therapist, and during the session I think my body language showed evidence of my nervousness and inexperience. Also I was feeling slightly uncomfortable about my ability to be understood in English. English is not my first language and I was afraid of using expressions that have a different meaning or a different intention to what I was trying to communicate. I was nervous that I would not find the right word to express what I wanted to say, and in some points during the session I clearly struggled to find the right word.
As I said above I was very nervous and I found it hard to control my feelings. I think my inexperience showed and I was very conscious that the session was being filmed. I think I never fully relaxed which showed in the way I communicated and in some of the errors I made early on. However as the session progressed I found myself thinking more about what I have learned and found myself consciously trying to put this knowledge to good use.
The Term Paper on Advanced Counselling Skills 3
For this part of the assignment I am using examples from a 50 minute session recorded within the learning environment. I play the role of the counsellor, and another student plays the role of the client. In order for me to answer the learning outcomes, I have watched the DVD recording. 2.1 – Open the session, explaining the working agreement including the following:- What is on offer? ...
I was also smiling at the beginning which is not appropriate therapist behaviour, and because of my nervousness I didn’t think how my facial expression could possibly affect my client.
Conclusion
I gained valuable experience from this session. I have learned that my behaviour particularly at the initial contact can set the tone for the whole session. I need to work on my fear of making a mistake and my fear of using the wrong terms in English. I need to develop my ability to listen more attentively to the client and to stay focused. Having said that, I did make use of some of the skills I have learned.
From the mistakes I made in this session, I have learned a lot. In the future, I will use the positive outcomes that I have learned and will do a number of things differently. I would be more conscious of the initial contact and putting the client at ease. I will focus more on getting the information from the client instead of giving him advice or trying to immediately solve his problems. I will also try to use the CBT’s principles and techniques I have learned more effectively and then, to obtain a better outcome as a good CBT therapist.
I also intend to use a structured model in a better way, to help me to conduct the session and manage the time more efficiently from the beginning to the end of the session (Nelson-Jones, 2002), because I found it difficult to manage the time and explore the session effectively.
I hope to improve my English, which will give me more confidence in becoming a good CBT therapist.
Therapy is a collaborative effort between the two parties to achieve certain goals (Westbrook, Kennerley & kirk, 2011).
The achievement of these goals ensures a positive therapeutic outcome.
I used CBT theory and principles because they are evidence based. At the end of the session, by measuring the outcomes I can see if it was successful and if the patient was feeling better and if his level of anxiety decreased. In this case he was quite positive and was willing to try the suggestions we explored in the session. He was hopeful that these ideas would help to get him back to his normal life. (this statement clarify what is a good outcome?)
It is important to try and form a relationship early within the therapy for a working alliance between the councilor and the client to be successful. Research shows that the quality of the early therapeutic relationship, particularly when it is positive, greatly enhances the chance of a successful outcome. (Horvath and Symonds, 1991).
The Essay on Client Paper 4
Abstract Human service workers help clients become more self-reliant. They may do this by identifying specific skills or by recommending resources that allow them to care for themselves or work to beat setbacks. This paper will also identify problems facing human service clients. This paper details the persons served by, and the jobs usually found in human services. There are different types of ...
Reference List
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Clarkson, P. (2003) The Therapeutic relationship. 2nd ed. London, Whurr.
Egan, G. (2007) The skilled helper: a problem management and opportunity development approach to helping. 8th ed. Brooks/Cole Cengage learning.
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Furnham, A. (2012) Psychology: 50 ideas you really need to know. London, Quercus.
Geldard, K. and Geldard, D. (2005) Practical counselling skills: an integrative approach. Basingstoke, Palgrave Macmillan.
Inskipp, F. ( 2010) Generic skills, part three? Therapeutic skills and Practice in the Sage Handbook of Counselling and Psychotherapy. Sage.
Nelson-Jones, R. (2002) Essential counselling and therapy skills: the skilled client model. London, Sage.
Padesky, C. (1993) Socratic questioning: changing minds or guiding discovery? Keynote address delivered at European Association for Behavioural & Cognitive Therapies Conference. London
Rogers, C. (1961) On becoming a person constable: A therpist’s view of psychotherapy. New York. Mariner Books.
Westbrook, D., Kennerley, H. & Kirk, J. (2011) An introduction to cognitive behaviour therapy: skills and applications. 2nd ed. London: Sage.
Wills, F. (2008) Skills in cognitive behaviour, counselling & psychotherapy. London. Sage.
