Intervention Assignment Part I
Intervention is the basis of therapy and is a major component of the therapeutic process. Choosing an intervention is essential to the outcome of client goals, and social workers must choose an intervention that best suits each client since not all interventions are suited for every individual and their situation. Cognitive Behavioral Therapy better known as CBT is an intervention rooted in a plethora of evidence-based practice and empirical research. Its focus is on the cognitive distortions that affect behavior and changing these distortions to change client behavior. CBT is also a short-term based intervention not intended for long-term therapy that treats a variety of mental health issues. Although literature lacks the proven applicability and effectiveness on diverse populations, Cognitive Behavioral Therapy is the leading intervention chosen by social workers because of its significant amount of empirical evidence and proven effectiveness through evidence-based practice.
Cognitive Behavioral Therapy was developed in the late 1950’s and early 1960’s by Dr. Aaron T. Beck. The theory was developed when Dr. Beck made the decision to test his theory of depression, that depression is a result of opposition only turned inward towards the self and depressed clients felt the desire to suffer (Beck, 2011). He studied the dreams of clients only to find that his assessment was incorrect since clients were not having dreams of hostility towards the self as expected and did not display a need to suffer. Rather, clients had dreams of loss, deprivation, and defectiveness in Beck’s study (Beck, 2011). Beck discovered that these dreams also reflected his clients not only while asleep but when they were awake as well. This later led Beck to develop Cognitive Behavioral Therapy after working with many clients and discovering that clients thinking affect their behavior. Cognitive Behavioral Therapy is based on the cognitive model which holds that distorted thinking is related to all psychological disturbances (Beck, 2011). The cognitive model states that the way individuals view their situations affects their behavior. Cognitive Behavioral Therapy also stems from behaviorism and psychodynamic models of therapy that focus on behavior change (Dobson, 2010). The theory developed further during the “cognitive revolution” in which theorists began to question the strict behaviorism form of thought. Thus, Cognitive Behavioral Therapy relates to the understanding and treating of an underlying problem by addressing the way individuals think and rationalize to change their behavior.
Additionally, Cognitive Behavioral Therapy or CBT consists of several intervention strategies that also embody different behavior techniques that are aimed at addressing the client’s constructions of reality against fact (Leahy, 2017). CBT involves several important concepts, principles, and value tenants that enable its evidence-based practice. A major concept of CBT is the focus on behavior modification, or changing individual behavior by altering the thought process. CBT holds that behavior is affected by covert and subconscious thought processes and behavior can be modified by changing these thought processes. CBT consists of three propositions being that cognitive activity affects behavior, a cognitive activity can be monitored or altered, and that desired behavior change is effected by cognitive change (Dobson, 2010). CBT also maintains many principles that guide its use in practice. CBT focuses on the patient and their problems stresses a good client-therapist relationship, emphasizes collaboration, goal oriented and problem-focused approach, an initial focus on the present, is time limited, education focused, structured, and focuses on identifying client thought to change behavior (Leahy, 2017).
Similarly, CBT involves a vast number of steps, strategies, and techniques that are associated with the intervention. Many therapists use different forms of open-ended questioning, homework, and self-monitoring as part of their methods. Thus, CBT can consist of a vast array of different strategies and steps aimed at modifying client behavior. Seven specific themes of a Cognitive Behavioral Approach in Therapy are assessing the risk behavior, educating the client on the need for change, motivating the client with personalized messages, evaluating and increase self-efficacy, modifying behavior, and maintaining the behavioral change (Saarmann, Daugherty, & Riegel, 2002). These seven strategies identify the central theme within each CBT intervention. Eliciting thoughts, evaluating and testing thoughts, evaluating assumptions and rules, examining information and processing illogical errors, modifying decision making, putting things into perspective, and examining and challenging cognitive distortions are among other important techniques used in CBT (Leahy, 2017). Other steps or strategies many therapists rely on are behavioral experiments and goal setting as part of their treatment plan with clients.
Equally important, Cognitive Behavioral Therapy is based on a research foundation and is one of the most widely used forms of interventions since it is backed by a considerable amount of evidence (Dobson & Dobson, 2009). CBT is also one of the most trusted forms of short-term interventions used by practitioners. Thus, it is considered evidence-based, based on the number of empirical evidence in its use in practice. CBT has a broad base of evidence because of many studies and empirical research as one of the most powerful interventions for mental health problems. Interest in CBT is also skyrocketing due to its amount of empirical evidence and trusted reliability (Dobson & Dobson, 2016). Its evidence base has shown to be even stronger when there is a strong alliance between the client and therapist and an active mutual strive towards goals (Dobson & Dobson, 2009). Thus, because of CBT's strong empirical base, it is considered evidence-based practice and is often used by practitioners as such.
Furthermore, Cognitive Behavioral Therapy is useful for addressing a variety of mental health problems and psychiatric disorders. CBT is used to treat anxiety, depression, post-traumatic stress disorder, addiction, eating and mood disorders, and many other mental health issues. Specific problems CBT is useful for addressing and is most often used for are anxiety and depression. A recent study showed CBT to be especially helpful for the treatment of major depression as well as anxiety (Watkins & MyiLibrary, 2016). CBT is shown to be useful in both group and individual therapy sessions for the treatment of anxiety and depression by changing individual thought patterns that in turn change overt behavior patterns that lead to anxiety and depression (Norton & MyiLibrary, 2012). Thus, CBT works best with clients experiencing mental health issues such as anxiety and depression. Since CBT is a short-term based intervention, it is not useful in treating many client groups suffering from mental health issues that require long-term forms of care. CBT is not useful for those needing long-term treatment and more ongoing intensive therapy. It is also not helpful and should not be used for more invasive mental health problems such as schizophrenia and bipolar disorder. Although CBT has been shown ineffective with these groups, it has been demonstrated to be useful for early detection and intervention of these groups (Addington et. al, 2011).
Although this may be true, CBT has not always been shown to be favorable among oppressed groups, and diverse populations and much of the literature and empirical evidence is regarding studies on white middle-class populations, leaving diverse groups including children out (Dobson, 2010). There is also conflicting research on the effectiveness of CBT on children. Some research shows CBT effective on children. However, there is a consensus that more research is needed regarding CBT and children based on their individual cognitive abilities (Manassis & MyiLibrary, 2016). Thus, there is much argument on CBT's effectiveness in treating these diverse groups and its applicability on managing these groups. However, there are ways that CBT can be tailored to make it more culturally sensitive and useful for different populations. Social workers must learn to work with people who are different than themselves and be honest about those differences when using any intervention or form of therapy. When considering behavior, social workers must also take into account the client's culture that affects their behavior and the learned thought processes of culture that influence behavior. Clients of different cultural backgrounds have different health beliefs, identities, communication styles, and collectivism vs. individualistic views (Dobson, 2010). Therefore, these differences must be taken into consideration when using CBT on diverse populations to make them more applicable and culturally sensitive.
Accordingly, Cognitive Behavioral Therapy has many strengths and limitations to its use. The intervention has been shown to treat many different mental health issues to include anxiety and depression but is not useful in treating more invasive mental health problems. CBT is a short-term based therapy and is valuable in treating those only needing short-term care but is not useful for long-term care. In researching this intervention, many professional gains were made. CBT is an intervention that is widely used and many times thought helpful for all mental health issues. As a professional, it is important to understand the strengths and limitations of each intervention and its usefulness to diverse populations. Thus, this research has enhanced the knowledge base of CBT, increasing and expanding professional gains in the long-term.
Ultimately, Cognitive Behavioral Therapy has many uses in practice with a vast number of strategies and techniques to aid therapists in its use with clients. The intervention can be adapted to several populations and has been shown to be effective in many client populations. There are many positives and negatives regarding CBT intervention and its use on a diverse amount of populations. However, CBT has been shown to be the top chosen intervention by practitioners due to its large amount of empirical evidence and its history as one of the leading evidence-based practices.