NRNP 6645 Week 5 Assignment
NRNP 6645 Week 5 Assignment
By Day 3
Post an explanation of how the use of CBT in groups compares to its use in family or individual settings. Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly and attach the PDFs of your sources. NRNP 6645 Week 5 Assignment
Read a selection of your colleagues’ responses.
By Day 3
Post an explanation of how the use of CBT in groups compares to its use in family or individual settings. Explain at least two challenges PMHNPs might encounter when using CBT in one of these settings. Support your response with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly and attach the PDFs of your sources.
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Read a selection of your colleagues’ responses.
Ryan Singer
Week 5 Discussion Ryan Singer
COLLAPSE
Week 5 Discussion: Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) trains people with mental disorders to be
aware of their maladaptive thinking behaviors, feelings and thoughts that induce
negative behaviors. According to American Psychiatric Association (2013), adverse
childhood experiences and events lead to maladaptive thinking patterns. The main
objective of CBT is to convert negative thoughts into positive and constructive ones
by restructuring cognitive behaviors.
CBT in group therapy implies more than one client treated by at least one
psychotherapist. The number of clients participating in the group therapy can vary
from 5-12 clients per session (Karaca et al., 2019). Group therapy has some merits
which make some clients prefer it. It is universal in that it assures participants they are
not alone with their problems (Karaca et al., 2019). Clients are motivated to
participate in such groups where they share their experiences with people with similar
disorders. Through group therapy, clients model positive behaviors by imitating the
actions of their colleagues (Karaca et al., 2019). In terms of cost, it is less expensive
than individual therapy. Group therapy has shortcomings as well. First, the level of
privacy and confidentiality is far less than individual therapy (Karaca et al., 2019).
The focus of attention is group not specific individual hence it cannot meet personal
needs like in individual therapy. Karaca et al (2019), is a scholarly article because it
has been reviewed and cited by more than 4 scholars. NRNP 6645 Week 5 Assignment
On the other hand, CBT in individual therapy consists of one client involved in
the therapeutic process guided by one psychotherapist. In group therapy the attention
is on the whole group while in individual therapy one gets one-on-one attention. The
therapist can assess and understand the specific psychiatric problem facing the
individual. Another reason why individual therapy is preferred is the high level of
privacy and confidentiality (Hauksson et al., 2017). Individual therapy is between the
therapist and the client personally identifiable and sensitive information is protected.
The therapeutic relationship is stronger in individuals than in group therapy
(Hauksson et al., 2017). One of the main components of successful therapy is
therapeutic bonding. The more the client has a stronger bond with the therapist the
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more the therapeutic process works. A shortcoming of individual therapy is it is more
expensive than group therapy (Hauksson et al., 2017). This may be a barrier to the
patients wishing to have individual therapy. Some patients are shy to participate alone
in therapy hence they may not be willing to participate in individual therapy. For such
clients, group therapy would suit them better. Hauksson et al (2017) are scholarly
because it is a peer-reviewed journal and has been cited by more than 6 scholars.
During my practicum, I provided psychotherapeutic treatment to a 40-year-old
male named A.C. A.C took part in individual therapy twice per week and group
therapy twice per week. The patient had a substance use disorder. The client
presented to the healthcare facility after his employer complained about his substance
use disorder which had affected his performance. A.C admitted that he was taking 2 -3
bottles of alcohol daily. After participating in group therapy, it was found that he was
not willing to share his experiences during the sessions. He was anti-social during the
group therapy and was worried about his confidentiality. The co-facilitators of the
group therapy recommended he participate in individual therapy twice per week. I
was in charge of individual therapy. A.C opened up why he was not willing to share
his information during the group therapy. A.C would give false information during the
group therapy and lie to the co-facilitators and during the individual therapy; he would
admit he can not share his condition before other people. PMNHPs face such
challenges during group therapy and they are not able to impact the life of the client.
CBT views substance use disorder as clients use the substance to reinforce their
maladaptive behaviors.
From this week’s learning media, clients with substance use disorder
experience relapse when reducing their drug intake. Individuals are motivated to
change when they see other people with similar problems in group therapy (Ringle et
al., 2015). One of the challenges that PMNHPs face during group therapy is
restructuring the thinking pattern of different clients at the same time. PMNHPs are
not sure whether group therapy is effective for all their clients and whether the CBT
techniques they apply to capture the problem of every individual. Another challenge is
addressing privacy and confidentiality (Chen & Chen, 2020). It is challenging to
foster privacy and confidentiality in group therapy. Therapists also face language and
cultural barriers. Some clients who may be migrants from other countries may not
communicate fluently in English, Spanish or other recognized languages except their
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first language. In such cases, interpreters are called in, which may impact the efficacy
of delivering group therapy (Chen & Chen, 2020). PMNHPs should be culturally
competent to understand diverse clients. Cultural beliefs can be a barrier to group
therapy some cultures discourage therapeutic processes and believe in spiritual
divinations to treat their psychiatric disorders (Chen & Chen, 2020). Chen & Chen
(2020) is scholarly because it is a peer-reviewed journal and has been cited by more
than 2 scholars. NRNP 6645 Week 5 Assignment
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of
mental disorders (5th
ed.). https://doi.org/10.1176/appi.books.9780890425596
Chen, H., & Chen, E. C. (2020). Working with interpreters in therapy groups for
forced migrants: Challenges and opportunities. International Journal of
Group Psychotherapy, 70(2), 244-269.
Hauksson, P., Ingibergsdóttir, S., Gunnarsdóttir, T., & Jónsdóttir, I. H. (2017).
Effectiveness of cognitive behaviour therapy for treatment-resistant depression
with psychiatric comorbidity: comparison of individual versus group CBT in an
interdisciplinary rehabilitation setting. Nordic journal of psychiatry, 71(6),
465-472.
Karaca, A., Yavuzcan, A., Batmaz, S., Cangür, Ş., & Çalişkan, A. (2019). The effect of
cognitive behavioral group therapy on infertility stress, general health, and
negative cognitions: a randomized controlled trial. Journal of RationalEmotive & Cognitive-Behavior Therapy, 37(4), 375-394.
Ringle, V. A., Read, K. L., Edmunds, J. M., Brodman, D. M., Kendall, P. C., Barg, F.,
& Beidas, R. S. (2015). Barriers to and Facilitators in the Implementation of
Cognitive-Behavioral Therapy for Youth Anxiety in the Community. Psychiatric
services (Washington, D.C.). 66(9), 938-45.
mah awoh
Week 5 Cognitive Behavioral Therapy: Comparing Group,
Family, and Individual Settings
COLLAPSE
Cognitive Behavioral Therapy: Comparing Group, Family, and
Individual Settings
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CBT in Different Settings
The cognitive-behavioral therapy (CBT) assists patients to change their
attitudes to promote and maintain behavior modification (Nichols & Davis,
2020). To date, CBT is the gold standard of psychotherapy. According to the
National Institute for Health and Care Excellence’s guidelines and American
Psychological Association, CBT dominates the international guidelines for
psychosocial treatments, making it the first-line treatment for many disorders
(David et al., 2018). That is why therapists use different CBT techniques to
manage individuals, couples, and groups in therapy sessions.
Individual therapy focuses on the problem of the single patient. Therefore,
the sessions only evolve in the patient’s problem and how the patient is
affected by their mental disorder. In individual CBT, the therapist helps the
patient deal with their problems and guides them in learning techniques to
face their issues. Additionally, the therapist encourages the patient to identify
and change core dysfunctional beliefs. Thus, individual CBT is beneficial in
obtaining the patient’s dysfunctional negative core beliefs and enhancing
positive and more realistic ones (Neufeld et al., 2020). NRNP 6645 Week 5 Assignment
On the other hand, group CBT technique helps group members to restructure
negative and dysfunctional cognitions about a social situation. In this
approach, group members talk about their experienced situations to create a
shift in their dysfunctional beliefs, resulting in a continuous improvement
(Neufeld et al., 2020). Moreover, in group therapy, the therapist encourages
social behavior and social skills through interactions and feedback from
members of the group. Group CBT also decreases the feeling and stigma of
being alone because each patient can relate to each other (PsychExamReview,
2019).
Finally, in family CBT, the therapist also works with multiple clients
concurrently who perceive themselves as a family. Family CBT focuses on
training parents in behavioral interventions for their children’s behavioral
problems. Thus, the sessions involve addressing the core symptoms of
children’s behavioral problems (Dattilio, 2021).
Challenges
A therapist can face challenges when someone in the group or family
does not want to participate in the planned CBT technique. One example is
when one group member or a family member is not comfortable opening up
about personal matters to be shared with the group or family members. So,
the therapist should be knowledgeable on how to carefully execute sessions
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accordingly to establish rapport and gradually gain each member’s trust
(GoodTherapy, 2019).
Another challenge is when a patient feels judged by the therapist. The
therapist should provide a nonjudgmental environment as some patients could
sense a minor hit of judgment. Thus, the therapist must avoid giving advice
that makes the patient feel condemned or proving insight not covered by the
scope of practice (GoodTherapy, 2019).
Scholarly Sources
For this discussion, I utilized journal articles. This includes David &
Hofmann, (2018), Dattilio, (2021), and Neufeld, et al., (2020). These journal
articles are considered scholarly because they are published in peer-reviewed
journals and have undergone rigorous evaluation by subject experts prior to
publication.
References:
David, D., Cristea, I., & Hofmann, S. G. (2018). Why
cognitive behavioral therapy is the current gold standard
of psychotherapy. Frontiers in Psychiatry, 9.
https://doi.org/10.3389/fpsyt.2018.00004
Dattilio, F. M. (2021). Cognitive-behavioral techniques
and family system therapy. Консультативная Психология
и Психотерапия, 29(3), 58–
68. https://doi.org/10.17759/cpp.2021290305
GoodTherapy. (2019). 10 ways therapists can strengthen the
therapeutic relationship. https://www.goodtherapy.org/forprofessionals/marketing/customer-experience/article/10-
ways-therapists-can-strengthen-the-therapeuticrelationship
Neufeld, C. B., Palma, P. C., Caetano, K. A. S., BrustRenck, P. G., Curtiss, J., & Hofmann, S. G. (2020). A
randomized clinical trial of group and individual
cognitive-behavioral therapy approaches for Social
Anxiety Disorder. International Journal of Clinical and Health
Psychology, 20(1), 29–37.
https://doi.org/10.1016/j.ijchp.2019.11.004
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Nichols, M., & Davis, S. D. (2020). The essentials of family
therapy (7th ed.). Pearson.
PsychExamReview. (2019). Cognitive therapy, CBT, & group
approaches (intro psych tutorial #241) [Video]. Youtube.
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