Description
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.
Unformatted Attachment Preview
Respond to peer’s discussion post. Week 5.
Read a selection of your colleagues’ responses.
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.
Discussion # 1
Cognitive Behavioral Therapy
A psychological treatment method called cognitive-behavioral therapy may be employed
with clients’ in group, family, and individual settings. Through daily practice and
education of coping mechanisms, this type of treatment aims to promote emotional and
psychological well-being by altering problematic habits, feelings, and ideas. Numerous
psychiatric conditions, including chemical dependence, personality disorders, psychotic
disorders, major depressive disorder, mood disorders, and anxiety, have shown
improvement in prognosis by utilizing cognitive behavior therapy. Particularly for
individuals who don’t comply with medication adherence, cognitive behavioral therapy
(CBT) as a treatment modality is just as successful as pharmaceutical treatment and is
even better utilized as and adjunct treatment option with medications. This discussion
board will contrast individual, family, and group cognitive behavioral treatment and their
associated problems PMHNP’s may endure.
Individual CBT
Unlike group or family therapy, individual CBT provides treatment customized to meet a
client’s particular needs and address numerous obstacles. In individual therapy, the
therapist collaborates with the patient one-on-one to pinpoint problems and provide
solutions that they can implement into their everyday lives to cope. Upholding the
ethical standards of autonomy, beneficence, justice, and non-maleficence in the patient
to provider relationship empowers the patient to have control in making health-carerelated decisions that reflect their true desires as well as enhance rapport and trust.
However, some challenges with individual CBT, includes clients might encounter
limitations or difficulty in expressing their thoughts and feelings and applying them
adequately. According to research findings, individual cognitive behavioral therapy (CBT)
was more beneficial than group treatment for clients with severe depressive disorder
when compared to group therapy (Hauksson et al., 2017). Compared to group therapy,
where clients could be embarrassed or fear criticism, individual treatment allows clients
to establish a therapeutic relationship with the therapist and feel more comfortable
expressing information. According to Lavik et al. (2022), in the early stages of
psychotherapy, therapists can actively detect and mend ruptures in relationships by
facilitating a healthy and positive therapeutic relationship.
Group CBT
For patients with mixed diagnoses and low socioeconomic level, group therapy may be a
cost-efficient method of treatment, as well as an effective means of normalizing settings
and providing more opportunity for positive peer modeling, social support, and exposure
to social situations. According to Ezhumalai et al. (2018), the goals of group therapy are
to reduce symptoms including low motivation and unpleasant symptoms while also
enhancing social functioning, adaptability, and interpersonal connection abilities.
Hauksson et al. (2017) highlights that each client in group therapy receives no
customized plan, and that factors such as client involvement, therapist training, and
length of treatment may influence the outcome. In group therapy, the therapist goes
over the schedule for the day and the tasks that each member of the group is required to
do. Despite the broad spectrum of patients, the therapy approach is applied universally
to the group. According to Hauksson et al. (2017), group dynamics including a sense of
connection, validation, support, and belonging might enhance group engagement. Time
management may be difficult in group therapy as each client only has so much time to
share information and get input from peers and the therapist. In contrast to individual
therapy, the client has an uninterrupted hour to talk about their feelings and thoughts.
The efficacy of treatment may also be hampered by issues with group cohesion and
interaction. Group dynamics may be impacted, for instance, by a client who provides
another member with harmful or cruel criticism. Furthermore, a patient who is not
understanding the lesson will not finish their assignment, and a patient who does not
provide feedback may cause the treatment to proceed more slowly. Furthermore, a fear
of expressing genuine emotions in a group context might impede the process of
treatment when there is a lack of confidence and openness.
Family CBT
Individual CBT sessions are available for adults with cognitive and behavioral disorders;
however, family treatment may be necessary for children and adolescents in order to
guarantee engagement and assignment completion. Families that struggle to
communicate with one another or are dysfunctional may benefit from cognitivebehavioral therapy. The main areas of focus for family CBT include communication,
relationships, behaviors, and family interaction. Family therapy presents a number of
difficulties, including unwillingness to communicate feelings and thoughts in front of
others, conflicts that do not get settled, and family members who are easily sidetracked
or off subject. Family members may be more understanding of an individual’s struggles in
family therapy, or they may lean the opposit way and agitate the distressed person,
which can occasionally result in punishment, animosity, and criticism (Stewart,
Summantry, and Malivoire, 2020). When dealing with the symptoms of mental disorders
such anxiety, depression, OCD, and autism in children, they may adopt maladaptive
behaviors; if family members do not provide assistance, the symptoms may increase.
According to Selles et al. (2018), family CBT can lessen the intensity of symptoms, lessen
functional impairment, lessen disruptive or coercive behaviors in the family, and enhance
family functioning.
CBT is a type of psychotherapy that helps treat a wide range of problems and enhances
the quality of life for its patients. In order to improve mental health and minimize stressrelated diseases, cognitive-behavioral therapy (CBT) assists people in overcoming
avoidant and safety-seeking tendencies that impede the self-correction of false beliefs
(Nakao et al., 2021). CBT can be used with groups, families, or individuals. When
undergoing CBT, clients may face obstacles such as time constraints, difficulty applying
techniques, ethical and legal concerns, and hurdles of communication. At the start of
each session, a therapist can establish professional boundaries, go over the schedule, and
make sure that each patient has ample time to communicate or express their feelings.
References
Darby, W. C., & Weinstock, R. (2018). The Limits of Confidentiality: Informed Consent
and Psychotherapy. Focus (American Psychiatric Publishing), 16(4), 395
401.https://doi.org/10.1176/appi.focus.20180020
Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group
interventions. Indian journal of psychiatry, 60(Suppl 4), S514–S521.
https://doi.org/10.4103/psychiatry.IndianJPsychiatry_42_18
Hauksson, P., Ingibergsdóttir, S., Gunnarsdóttir, T., & Jónsdóttir, I. H. (2017).
Effectiveness of cognitive behavior 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. https://doiorg.ezp.waldenulibrary.org/10.1080/08039488.2017.1331263Links to
an external site.
Lavik, K. O., McAleavey, A. A., Kvendseth, E. K., & Moltu, C. (2022). Relationship and
Alliance Formation Processes in Psychotherapy: A Dual-Perspective Qualitative
Study. Frontiers in psychology, 13,
915932. https://doi.org/10.3389/fpsyg.2022.915932Links to an external site.
Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive-behavioral therapy for
management of mental health and stress-related disorders: Recent advances in
techniques and technologies. BioPsychoSocial medicine, 15(1), 16.
https://doi.org/10.1186/s13030-021-00219-w
Selles, R. R., Belschner, L., Negreiros, J., Lin, S., Schuberth, D., McKenney, K.,
Gregorowski, N., Simpson, A., Bliss, A., & Stewart, S. E. (2018). Group family-based
cognitivebehavioral therapy for pediatric obsessive-compulsive disorder: Global
outcomes and predictors of improvement. Psychiatry Research, 260, 116–122.
https://doiorg.ezp.waldenulibrary.org/10.1016/j.psychres.2017.11.041
Stewart, K. E., Sumantry, D., & Malivoire, B. L. (2020). Family and couple integrated
cognitivebehavioral therapy for adults with OCD: A meta-analysis. Journal of Affective
Disorders, 277, 159–168. https://doiorg.ezp.waldenulibrary.org/10.1016/j.jad.2020.07.140
Discussion # 2
Initial Post.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a versatile approach used in different settings that
include individuals, families, and groups. The focus and dynamics in the application of
this therapeutic approach differ with the different settings and contexts. CBT is more
problem-focused and action-oriented and this comes with various forms of activities.
The therapist and the patient work together and narrow down engagements to focus on
specific areas that need improvement. When they engage in this manner, they structure
a program of behaviors that aid making more rapid progress in the specific areas.
Transparency is critical in the application of CBT since the therapist makes it clear to the
patient what they are doing, including reasons and the expected outcomes (Wheeler,
2020). The therapy is more interactive and the patient is made aware of every step and
objectives they are supposed to achieved. The patient has to be actively engaged in the
process with some exercises being assigned to them. The application of CBT for
individuals and group settings differs based on the differences in the approach given to
each.
In group settings, CBT encourages interpersonal learning and it is meant to allow
different people to share their experiences. This is meant to reduce isolation and
promote universality among members. The group members can learn from each other
and achieve mutual support (American Psychiatric Association, 2022). Different
perspectives and mindsets can be applied to develop better ways of handling issues and
achieving improvement in specific areas of mental health needs. However, challenges
may arise due to the diverse nature of groups, leading to the development of strategies
to ensure individual needs are addressed in a collective manner (PsychExamReview,
2019).
In the family settings, CBT involves identification and modification of dysfunctional
behaviors and patterns contributing to different family dynamics. Emphasis is on
problem-solving and managing issues that affect the family system (PsychExamReview,
2019). There are different factors that affect the family setting, and the therapist has to
be able to identify them and deliver on their needs (Goldenberg et al., 2017). There has
to be a balance between individual and collective well-being of the family because the
relationships have to be stabilized.
How the Use of CBT in Groups Compares to its Use in Family Settings
Foremost, the focus of CBT in a group setting emphasizes shared experiences among
group members whereas, it focuses on dynamics addressing relationships and
communication patterns in a family setting (Kameoka et al., 2020). Secondly, a group
setting has unique dynamics where individuals can learn from each other. In a family
setting, the therapist has to work with separate family members simultaneously. Finally,
there are differences in challenges experienced and how they are supposed to be
handled. In a group setting, balancing individual needs and managing group dynamics can
pose challenges. In a family setting, navigating complex family structures to avoid
resistance and creating conflicts poses a major challenge (Solish et al., 2020).
One of the challenges that PMNPs may face in group therapy is achieving a balance
between individualized attention with the collective goal of the group. This is a factor
that needs a high level of skill and understanding of all parties in a group to manage. The
challenge that may be faced in the family setting is addressing sensitive topic areas
without facing resistance or creating conflicts within the family. CBT entails using all
honest opinions and being truthful when solving a problem. This may expose some of
the issues that may easily lead to conflicts or lead to resisting the intervention
(PsychExamReview, 2019). The challenges require the application of adaptive CBT
techniques that suit the unique dynamics of different groups to achieve the desired
outcomes. Children can develop various forms of resistance if they are not handled
effectively during therapy (Franklin et al., 2023). The sensitive nature of issues affecting
group and family dynamics has to be addressed effectively to mitigate chances of failure
of interventions.
To conclude, CBT is an effective approach to therapy because it focuses on different
factors affecting individuals, families, and groups. There are different techniques under
CBT that can be used to address the issues that affect different settings more
effectively. Therefore, the therapist should understand the context and develop an
effective means of handling issues around such a setting to maximize effectiveness and
reduce the risk of resistance or conflict.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental
Disorders. https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatr
yonline.org/doi/book/10.1176/appi.books.9780890425787Links to an external site.
Franklin, M. E., Engelmann, J. M., Bulkes, N., Horvath, G., Piacsek, K., Österlund, E.,
Freeman, J. B., Schwartz, R. A., Himle, M. B., & Riemann, B. C. (2023). Intensive
Cognitive-Behavioral Therapy Telehealth for Pediatric Obsessive-Compulsive Disorder
during the COVID-19 Pandemic: Comparison with a matched sample treated in
person. JAACAP Open. https://doi.org/10.1016/j.jaacop.2023.09.007
Goldenberg, I., Stanton, M., & Goldenberg, H. (2017). Family therapy: An overview (9th ed.)
Cengage Learning.
Kameoka, S., Tanaka, E., Yamamoto, S., Saito, A., Narisawa, T., Arai, Y., Nosaka, S.,
Ichikawa, K., & Asukai, N. (2020). Effectiveness of trauma-focused cognitive behavioral
therapy for Japanese children and adolescents in community settings: a multisite
randomized controlled trial. European Journal of Psychotraumatology, 11(1).
https://doi.org/10.1080/20008198.2020.1767987
PsychExamReview. (2019). Cognitive Therapy, CBT, & Group Approaches (Intro Psych
Tutorial #241)https://www.youtube.com/watch?v=A2_NN1Q7RfgLinks to an external
site.
Solish, A., Klemencic, N., Ritzema, A., Nolan, V., Pilkington, M., Anagnostou, E., & Brian, J.
(2020). Effectiveness of a modified group cognitive behavioral therapy program for
anxiety in children with ASD delivered in a community context. Molecular Autism, 11(1).
https://doi.org/10.1186/s13229-020-00341-6
Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide
for evidence-based practice (3rd ed.). Springer publisher
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