Week #5 Discussion COLLAPSE
Cognitive behavior therapy is a short-term intervention which focuses on attitude modification to maintain and improve change in behavior. Modality of its behavior modification improve the identification of maladaptive thinking patterns and situation awareness, thought processes, and emotions such as negative automatic thought process. Efficacy of cognitive behavior therapy has demonstrated its effectiveness in the treatment of family/group, individuals suffering from all types of mental issues (Florensa, Keliat, Wardani & Sulistiowati, 2019).
Cognitive behavior therapy among other forms of therapy has proven success in treatment of children and adolescent on individual levels – when apply as an individual cognitive behavior therapy. Structural differences are in between group/family and an individual to function within a given session (Mychailyszyn, Carper & Gibby, 2018). Whereby one client or patient and a psychiatric mental health nurse practitioner is involved in an individual therapy session; on the other hand, group/family therapy includes in its context a client system and a psychiatric mental health nurse practitioner. Family therapy in its context refers to a system of family unit which includes each individual within the family dynamic as well as its function to influence each other (Shikimoto, Tamura, Irie, Iwashita, Mimura & Fujisawa, 2021).
Lundkvist-Houndoumadi and colleagues (2016), argued that effectiveness or efficacy of group/family therapy is more potent when compare to individual therapy. Although cognitive behavior therapy is effective; however, the Johnson Family Session video from this week’s media, demonstrates that either an individual, group/family can be effective, it all depends on the issues and the type of treatment provided. The video makes it clear, as seen with the girl who had been sexually assaulted previously in a fraternity, she didn’t believe in sharing her past experience, she doesn’t want to talk about it. She doesn’t believe that sharing her experience with her peers, including those with similar past experience will help her. There are some internal issues bothering her. These issues need to be address on the individual basis for her to move forward. At this time the girl is not prepared to participate in any of the group or family therapy session. Forcing her to do so will impaired the purpose of her self-awareness.
CM is a 41-year-old female accompanied by her husband to participate in a scheduled one day a week individual cognitive behavioral therapy session and a one day a week family cognitive behavior therapy session. The problem she presented with was alcohol abuse. Patient stated that her husband forced her into attending this session because he felt like she was unable to control her alcohol abused issue. Patient reported that each day she would drink 5 to 7 drinks of alcohol. Patient stated: “It made me lose multiple jobs throughout my career. Open-ended questions were asked during individual cognitive behavior therapy session to obtained situational and cognitive information from the patient. Any question inquiring about her alcohol use provoked her, she got very upset and defensive. This indicates that she was not being honest about her alcohol intake. Other times she wouldn’t provide answers to questions that were being asked of her. On the contrary, she responded appropriately to questions ask during family cognitive behavior therapy session. She opens up about her alcohol intake, and frequency. CM contradicted herself during the family cognitive behavior therapy session. Saying: “my alcohol intake didn’t interfere with my personal life, job, marriage, and health. however, her husband corrected her each time. Evidence from the literature supports cognitive behavior therapy – individual use alcohol or other substance for behavior reinforcement. This makes the patient to abstain from developing skills desired to reduce substance use or alcohol intake.
Challenges which the psychiatric mental health nurse practitioner might encounter include restructuring thought process or thinking pattern of individual in a family dynamic or different individuals in each session of family and/ individual cognitive behavior therapy session. Moreover, the practitioner needs to ensure that structural of the session is appropriate for family members from diverse cultural background. For example, eating disorder such as: bulimia nervosa is common among lesbian and gay individuals. However, this population do not seek treatment often because of stigma associated with disproportional sexual minorities group/family. Therefore, practitioners during cognitive behavioral therapy need to structural the session to adapt emotions so that internal family members suffering from bulimia nervosa will share their experiences to improve treatment and function of family dynamic within this sexual minorities’ population (Minaiy, Johnson, Ciochon & Perkins, 2017). Also, practitioner needs to ensure CBT techniques/strategies are applicable and effective for every individual group member.
Florensa, M. V. A., Keliat, B. A., Wardani, I. Y., & Sulistiowati, N. M. D. (2019). Promoting the
Mental Health of Adolescents through Cognitive Behavior Group Therapy and Family Psychoeducation. Comprehensive Child & Adolescent Nursing, 42, 267–276. https://doi.org/10.1080/24694193.2019.1594459
Lundkvist-Houndoumadi, I., Thastum, M., & Hougaard, E. (2016). Effectiveness of an
Individualized Case Formulation-Based CBT for Non-responding Youths with Anxiety Disorders. Journal of Child & Family Studies, 25(2), 503–517. https://doi.org/10.1007/s10826-015-0225-4
Minaiy, C., Johnson, N., Ciochon, T., & Perkins, D. (2017). Adaptability of Family Therapy
Modalities in the Treatment of Lesbian and Gay Clients with Bulimia
Nervosa. Contemporary Family Therapy: An International Journal, 39(2), 121–131. https://doi.org/10.1007/s10591-017-9410-5
Mychailyszyn, M. P., Carper, M. M., & Gibby, B. (2018). Exploring the occurrence of sudden
gains among anxious youth receiving evidence‐based cognitive‐behavioral therapy. Child
& Adolescent Mental Health, 23(3), 251–257. https://doi.org/10.1111/camh.12254
Shikimoto, R., Tamura, N., Irie, S., Iwashita, S., Mimura, M., & Fujisawa, D. (2021). Group
cognitive behavioural therapy for family caregivers of people with dementia: A single‐arm pilot study. Psychogeriatrics, 21(1), 134–136. https://doi.org/10.1111/psyg.12643