Cognitive Behavioral Therapy Essay Example

Cognitive Behavioral Therapy

A description of the client, identifying any pertinent history or medical information

Dorcas, a 38 years old complains of feeling exhausted and stressed all the time. Dorcas, who divorced with her husband four years ago and has three children and is a part time worker at a grocery store. She also takes care of her mother who is suffering from dementia. Dorcas does not have a substantial medical history, even though she frequently visits her general practitioner about the problems she experiences. The client was depressed after her divorce and was put on antidepressants but refused. She then attended counselling sessions, greatly improved her symptoms.

Dorcas states that she constantly feels stressed and worried about everything and anything, with her anxiety becoming worse in fourteen months when her mother was diagnosed with cancer and that that she is unable to regulate these thoughts. When anxious, Dorcas feels stiffness in the legs, shoulders and stomach, and her heart beats faster, and at times she cannot breathe easily. She has difficulty falling asleep and frequently awakens as a result of worrying.  The client feels irritable and tired.  She doesn’t use drugs.

An explanation and justification of my diagnosis for the client using the DSM-5

The client is suffering from generalized anxiety disorder (GAD). A patient with GAD is usually worried about usual, daily situations. The nervousness is invasive, causes functional impairment or distress, and normally covers numerous domains such as health, family and finances. Locke et al (2015) argue that the worry is usually connected with physical symptoms like gastrointestinal symptoms, restlessness, chronic headache, muscle tension and sleep disturbances. Some factors connected with GAD include unmarried status, female sex, presence of stressors and poor health.

According to Locke et al (2015), DSM-V criteria for diagnosing gad include extreme worry or anxiety occurring often for at least six months, with the patient finding it hard to regulate the anxiety.  The worry and anxiety is connected with at least three of the following symptoms; tiring easily, edginess or restlessness, irritability, difficulty sleeping, difficulty concentrating and muscle tension.  The physical symptoms, worry or anxiety lead to clinically considerable distress or weakening in occupational and social functioning and the disorder cannot be attributed to physiological impacts of substance such as a medication or drug or a medical condition such as hyperthyroidism.

Effectiveness of cognitive behavioral therapy with the client

Cognitive behavioral therapy(CBT) is an effective therapy for treating the client. Research has shown the effectiveness and efficacy of CBT in treatment f anxiety disorders including panic disorder, social anxiety disorder, obsessive compulsive disorder and generalized anxiety disorder. According to Kaczkurkin and Fao (2015), CBT is usually hypothesized as a short-term treatment that is focused on skills and is intended to change maladaptive emotive responses through altering behaviors and thoughts of the patient. Exposure- based methods are commonly utilized in treatment of anxiety disorders.

Exposure alters the compulsive fear structure through its activation then provision of a novel informational that causes disconfirmation of the compulsive, unrealistic connections within the structure. Through defying the feared responses or stimulus and incorporating remedial information within the brain’s fear memory, it is expected that fear decreases (Kaczkurkin & Fao, 2015).  When the patient exposes herself to her own emotions, she will be capable of learning ways of fighting permits the patent to stay maintaining factors along with avoidance behaviors that propagate GAD and the cognitive procedure sought after is habituation.   Borza (2017) asserts that exposure to anxiety to stay in the existence of imaginations connected to their probable concerns, so as to enhance emotional habituation. The patient can learn to endure fears, which will subsequently permit her to thinks less about her worries.

According to Kaczkurkin and Fao (2015), exposure might take numerous forms entailing interoceptive and imaginal in vivo. Imaginal exposure takes place when a person has vivid imaginations of the situation or outcomes that they are afraid of and doesn’t avoid their resultant nervousness.  Interoceptive exposure entails deliberate induction of physical sensations that the patient is afraid of. These exposure methods permit the permit to attain novel learning so as to alter the anxiety structure. Treatment of the patient can involve imaginal exposure (for instance, imagining the worst scenario connected with her fears) and less often in vivo exposures/. The patient participates in exposures where she repetitively recounts her anxieties   utilizing imaginal exposure with the aim of lessening the worry intensity

Legal and ethical implications related to counselling the client

Mental health counselors are legally and ethically mandated to be competent, obtain informed consent and maintain confidentiality. Competence implies that the counselor must have the prerequisite knowledge, skills and qualification Welfel (2015) notes that it is vital that therapist is aware of his or her competence with respect to the degree of his or her training, supervised experience and knowledge. Informed consent is very valuable in psychotherapy because it ensures that the decision of the client to participate in counselling is informed, rational and voluntary.

Wefel (2015) assert that even though it is assumed that seeking assistance of a counselor by a patient implies consent, it doesn’t equate to informed consent. Informed consent must be viewed as the basic scheme of safeguarding the self-governing and self-determining rights of patients as it offers the patient the chance to make a decision on participating in counselling. When a psychotherapists want to obtain informed consent, they must utilize a language that the patient understands, and understand patient’s competence to offer consent.

Maintenance of confidentiality is the basis of psychotherapy.  According to Pastorino and Doyle-Portillo (2018), psychotherapists are required to maintain confidentiality of their conversation with clients. A counselor can consult with other professionals only when the client permits. Using client experiences or stories in in print work isn’t allowed without client’s permission. Nevertheless, there are certain exceptions when confidentiality can be breached. For instance, when a client is at the risk causing harm to herself or others, the counselor is legally mandated to inform the person at the risk of being harmed.

References

Borza, L. (2017). Cognitive- behavioral therapy for generalized anxiety. Dialogues in Clinical Neuroscience, 19(2): 203-208.

Locke, A., Kirst, N., & Shultz, C. (2015). Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician, 91(9): 617-624.

Kaczkurkin, A., & Fao, E. (2015). Cognitive-behavioral therapy for anxiety disorder: an update on the empirical evidence. Dialogues in Clinical Neuroscience, 17(3): 337-346.

Pastorino, E., & Doyle-Portillo, S. (2018). What is Psychology? Foundations, Applications, and Integration. New York: Cengage Learning.

Welfel, E. (2015). Ethics in Counseling & Psychotherapy. New York: Cengage Learning.