Introduction

Cognitive-behavioral therapy (CBT) is a subset of psychotherapy techniques whose popularity over the last few decades is premised on the fact that it is structured, time-limited, and outcome-oriented. The underlying principle of CBT is cognitive restructuring, in which case the therapist works together with the patient to disrupt thinking patterns and activate behaviors to help patients overcome obstacles. The following is a case analysis for Tim using the CBT technique.

The Presenting Problem

According to Fenn & Byrne (2013), the presenting problem is the initial symptom that prompts an individual to seek help from a psychologist or a mental health practitioner. In the case of Tim, there are several such symptoms. Social withdrawal is the first presenting problem. It is notable that Tim is not on talking terms with his mother, and only visits his sister once in a while. These are defining features of social withdrawal and could be the manifestation of a psychological or mental problem(Fenn & Byrne, 2013). Tim has demonstrated episodes of confused thinking; another type of a presenting problem. Despite holding several full-time and part-time jobs, Tim admits that he is not sure of the best career to pursue. Such behavior points to confused thinking and warrants medical attention(Fenn & Byrne, 2013). Lastly, Tim has negative thoughts as demonstrated by wondering about the meaning of his life. These factors qualify Tim for an appointment with a psychologist or mental health professional.

Core Beliefs

Core beliefs, also called schemas, are deeply held beliefs about the world, self, and other people. In most cases, core beliefs form at an early age and they solidify to become cognitive constructs as a person matures(Beck, 2016). In the case of Tim, it is not apparent whether his core beliefs were formed during childhood. However, Tim has specific adverse core beliefs. For example, Tim is not on speaking terms with his mother and rarely meets with his sister, implying a feeling of resentment towards family members. The situation has been worsened by the recent breakup with his longtime girlfriend, which might have fuelled a feeling of being unlovable.

Conditional Beliefs

One of the primary objectives of cognitive-behavioral therapy is to reframe conditional negative beliefs into positive rules and assumptions.  Conditional beliefs refer to negative assumptions about self(Beck, 2016).  Tim presents a classic example of conditional beliefs by questioning whether he can find another girlfriend like his former girlfriend. Ideally, conditional beliefs operate under a system of demand and consequences. In the case of Tim, the demand is that Tim feels he has to be different to find a similar girlfriend as the former girlfriend. The consequence is that Tim feels he will not find a good girlfriend in his state. These rules and assumptions influence behavior. For example, Tim could try to change some of his natural attributes and personality in the hope of getting a girlfriend.

Negative Automatic Thoughts

Negative automatic thoughts (NATs) are involuntary thoughts that incentivize people to overestimate risk and underestimate the prospect of success in certain situations. These thoughts handicap a person’s ability to make progressive decisions(Sedmak MA, 2015). One of Tim’s negative automatic thoughts is that he is not likely to get a fulfilling full-time job because of past disappointments. Further, Tim overestimates the risk of failure in getting a new girlfriend compared to the prospect of success in getting a girlfriend. These negative thoughts are symptoms of an underlying mental disorder, implying that Tim needs to seek medical help.

Event

The event in CBT refers to the activating event that triggers negative thoughts and beliefs and ultimately leads to feelings and dysfunctional behavior. It is important to note that the consequences of the activating event are not directly attributable to the event. Instead, the CBT model contends that the consequences stem from cognitive distortions and irrational beliefs(Sedmak MA, 2015). In the case of Tim, the breakup between him and the girlfriend is the activating event. However, in line with the CBT model, social withdrawal, confused thinking, and negative thoughts are a result of cognitive distortions and irrationals beliefs that might have persisted for a long time.

Feeling and Emotion

Feeling and emotions are natural to all individuals. In normal circumstances, feelings and emotions trigger people to change their environments without external interventions. However, due to the cognitive distortions and irrational beliefs for people with mental health conditions, feelings and emotions manifest differently(Fenn & Byrne, 2013). For example, after the breakup, Tim is emotionally anxious. This emotion could manifest in feeling exhausted.

Steps to Conduct Counseling based on CBT

Counseling through the CBT model involves the following four steps.

• Assessment stage
• This is the first session and allows the patient to determine whether the therapist meets their criteria.
• The therapist defines the problem, goals, and designs a treatment plan.
• Cognitive stage
• The therapist helps the patients to understand their thought processes and identify faults in that process.
• Working with behavior
• The therapist guides the patient on to change their behavior and how to overcome obstacles.
• At the end of the sessions in this stage, the patient should implement the lesion in real-life situations.
• The patients become their personal therapist
• The stage marks the end of the sessions between the patient and the therapist.
• The patient continues with the lessons, treat relapses, and overcome other challenges that arise in life.

Conclusion

Cognitive behavior therapy differs from the traditional therapy methods in that it isstructured, time focused, and begin by defining the desired outcomes. In light of the various elements of CBT, it is apparent that Tim has a mental health condition that can be solved using the CBT model. To that end, the therapist should employ the four stages of the CBT model, acknowledging that there is no limit in the sessions required for every step. The ultimate objective is to stimulate cognitive restructuring and disrupt distorted thinking patterns.

References

Beck, A. (2016). Cognitive Therapy: Nature and Relation to Behavior Therapy – Republished Article. Behavior Therapy, 47(6), 776-784. https://doi.org/10.1016/j.beth.2016.11.003

Fenn, K., & Byrne, M. (2013).The key principles of cognitive-behavioral therapy.Innovait: Education and Inspiration for General Practice, 6(9), 579-585. https://doi.org/10.1177/1755738012471029

Sedmak MA, M. (2015). Application of Cognitive Behavioral Techniques in the Treatment of Depression in the Context of School Counseling: A Case Study Example. Journal of Psychology & Clinical Psychiatry, 3(6). https://doi.org/10.15406/jpcpy.2015.03.00175