Discussion replies
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.
Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.
Post 1 from Mat Ola
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) is an effective treatment for a variety of mental health disorders, most especially anxiety and depression. CBT has been demonstrated to be more effective than other types of psychotherapy; this leads to significant improvements in functioning and quality of life (American Psychological Association, 2021). For this week’s discussion, I will explain how the use of CBT in groups compares to its use in the family or individual settings. In addition, I will expatiate on challenges that might be faced by the PMHNP and other mental health professionals in the course of utilizing CBT in one of these settings.
Individual CBT:
Individual CBT provides individuals with interpersonal strategies to help them overcome their difficulties. Patients have been shown to benefit from individual CBT when it comes to diet, exercise, sleep, pain, coping skills, anxiety, or depression. By using individual CBT, patients can re-think their behaviors, confront their fears, and feel a sense of accomplishment. For people with a borderline personality disorder or antisocial personality disorder, individual CBT might not be suitable. Moreover, patients with comorbid conditions may not benefit from this therapy, since the presence of a second problem may hinder progress (Cully, et al., 2021).
Group/Family CBT and Benefits:
Contrary to individual CBT, in a group setting a number of people get together with the therapist. Many groups address specific issues, such as depression, obesity, panic disorder, social anxiety, chronic pain, or substance abuse. Some groups focus on improving social skills, such as coping with anger, shyness, loneliness, and low self-esteem. In summary, group CBT positively impacts the thought processes of the participants.
The most important reason for using CBT within the family is to help family members recognize distortions in their thinking, restructure them, and modify their behavior to improve their relationship (Lan & Sher, 2019). Furthermore, family CBT focuses on the family’s interactive aspects rather than on individuals’ internal processes. For example, in the video, “Beck Institute for Cognitive Behavior Therapy” watched under this week’s media, the therapist speaks about how couples cannot control each other’s thoughts and behaviors. Through CBT, however, the couple can change their personal thoughts about one another, which may result in better communication and a peaceful relationship.
Among the benefits that could be derived from group/family therapy but not present in individual cognitive therapy include being able to learn from the therapists and the peers who are experiencing similar challenges. Those who participate in group CBT may also receive social support from the group members. Patients benefit from group cohesion and normalization effects and may also be able to use the group as an arena for engaging in behavioral experiments (Thimm & Antonsen, 2014). Moreover, studies reveal that group therapy is as effective as individual therapy, and may even be more cost-effective
Challenges of CBT
Cultural Challenge:
Acknowledging the patient’s culture provides an opportunity to fully understand the patient and encourages open discussion. In a case where the therapist does not have complete knowledge of some group members’ cultures, this could pose a problem. The concept of group CBT might feel “foreign” to a few of the underrepresented members. For example, some groups view expressing emotions as weak or unstable. Also, some may view discussing themselves with a complete stranger as being awkward. This kind of situation might limit some patients’ comfort and their involvement in group activities since they are not comfortable expressing themselves. Based on this fact, being culturally competent is highly essential for any PMHNP that might want to engage in group therapy (Cully, et al., 2020)
Public Speaking Phobia:
For those who have a severe social phobia, it might be difficult to speak in front of a group. Additionally, for members who have experienced traumatic events, it could be triggering or overwhelming to have to take part in discussions about abuse or trauma. And having to share intimate details of past experiences with relative strangers might be difficult for someone with social fears to do.
Post 2 from Ade Fa
Cognitive Behavioral Therapy: Comparing Group, Family, and Individual Settings
Cognitive behavioral therapy (CBT) is one of the psychotherapeutic approaches used in treating mental health conditions. It is considered a gold standard due to its extensive research and for being superior and effective compared to other approaches among other reasons (David et al., 2018). It focuses on the relationships between thoughts of an individual, emotions and his or her behavior. According to this approach, the emotions and behaviors of individuals ate affected or influenced by how the perceive things. For example, individuals who are depressed tend to be negative in how they perceive and interpret things and situations. CBT works by changing the core beliefs, thoughts, and perceptions of an individual to being more positive. This paper focuses on discussing CBT in different settings including individual, family and group setting.
Individual cognitive behavioral therapy focuses on providing one on one therapy sessions. This involves the therapist and an individual patient. Trials have found this kind of therapy to provide more chances and opportunities for treatment that individualized and thus, addressing specific patient’s needs (Guo et al., 2021). Individual cognitive behavioral therapy has been found to be effective in treating different conditions including anxiety. for anxiety, some of the techniques the therapist can use on the patient include role plays, affective education, and relaxation techniques among others (Edwards, 2015).
Cognitive behavioral therapy in a group setting is a bit different from individual setting. The therapists in a group setting work with patients that have similar challenges and diagnose in small groups (Edwards, 2015). For example, patients diagnosed with substance abuse are placed in one group and go through the therapy sessions together. In this setting the therapist will ai at not only developing a therapeutic relationship between the patient and him or herself like in individual setting. The relationship among the patients in the group should also be developed. group therapy provides more support to the patients unlike an individual setting where the support is from the therapist. The patients get to support one another and learn from each other how to cope with challenges and issues. This makes it easier for the patients to be more proactive compared to individual setting. Notably, the therapist has more time and a wider setting to observe the patient’s behaviors.
There is also CBT in a family setting. This is different from group and individual setting. It integrated the cognitive approaches in addition to behaviorism and applies the in a family system (Lan & Sher, 2019). According to CBT in a family setting, feelings, behaviors and the emotions of an individual influences and is influenced by the other members of the family. In other words, the perceptions of an individual are shaped and developed by underlying schema that is stable, which is learned during early life from the primary sources that affect the automatic thoughts of this individual and how he or she responds emotionally in relationships that are significant (Lan & Sher, 2019). Therefore, it aims at helping the family members change their ways of thinking to one that is more adaptive. This helps improve decision making and interaction in the family.
While using CBT in a group setting, a few challenges can be encountered. First, developing cohesion and relation within the group can be a big challenge. Every individual is different but positive relationship and cohesion in the group is needed for effective group therapy. Second, maintaining confidentiality is also challenging. Every member of the group is expected to protect the confidentiality of the group. What is discussed in the group should remain in the group. Ensuring that every group member respects this can be challenging.
In conclusion, CBT is one of the effective treatment approaches for mental health conditions. It can be practiced in different settings including individual, family or group settings. Each setting has its benefits and challenges. In group setting, challenges may be more since more individuals are involved. However, they can be managed.
