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Here is my essay that i have to deliver. The title is about how CBT can help bipolar Disorder. I want someone to just change the therapeutic plan section I would like the treatment plan to be piloted towards the individual. The treatment contract and techniques (e.g. Socratic, cognitive questioning, etc.) should be mentioned. Separate sessions with material by session group. Possibly lengthening of sessions. Closure plan. The booster session.
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A comprehensive case study of bipolar disorder and an overview of cognitive behavioral
therapy
Student name
Institutional integration
Course number and name
Teacher
Date
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Contents
1. Summary presentation
2. Introduction
3. Historical overview of Cognitive Behavioral Therapy
4. Case study
5. Literature review
6. General stress theory
7. Effects and coping mechanisms
8. Case study and critical analysis
9. Psychoeducation
10. Recognition of stimuli and preliminary indicators
11. Cognitive restructuring
12. Prevention of relapse
13. Code of ethics and conduct
14. GST in Bipolar Disorder
15. Cognitive interventions
16. Conclusion
Bibliography
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A comprehensive case study of bipolar disorder and an overview of cognitive behavioral
therapy
Overview
Cognitive behavioral therapy ( CBT ) studies the relationships between thoughts,
feelings, and behavior. It can be characterized as a guiding, time-limited, structured strategy
that deals with different thematic mental health issues. Cognitive Behavioral Therapy (CBT)
is a highly recognized and effective treatment method for many mental health issues, such as
bipolar disorder. This research focuses on bipolar disorder, a chronic mental health illness
characterized by severe mood swings, including episodes of mania and depression. This text
provides a comprehensive review of the theoretical and research bases of Cognitive Behavioral
Therapy (CBT). as a therapeutic approach for bipolar disorder. The analysis is supported by a
case study in which Mrs. N.
Introduction
This particular case study examines the use of Cognitive Behavioral Therapy (CBT) in
the management of bipolar disorder. The aim is to demonstrate the effectiveness of Cognitive
Behavioral Therapy (CBT) as a complementary treatment for Bipolar Disorder and to offer
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ideas for the integration of this therapeutic method into integrated mental health care. Although
medication remains a fundamental aspect of Bipolar Disorder treatment , additional
psychosocial approaches, such as Cognitive Behavioral Therapy (CBT), have shown potential
to improve overall outcomes. This paper examines the longitudinal evolution of Cognitive
Behavioral Therapy (CBT) and its use in the treatment of bipolar disorder, as demonstrated by
an extensive case study .
.
Historical overview of Cognitive Behavioral Therapy _
GST originated from behaviorism and later incorporated cognitive elements . It has
become a widely used and scientifically supported method of treatment ( Link et et al ., 2015).
The theoretical background of Cognitive Behavioral Therapy (CBT), combined with the solid
evidence that highlights its effectiveness in the treatment of bipolar disorder and beyond , make
it a promising therapeutic intervention ( Link et et al ., 2015). By identifying and correcting
cognitive distortions, promoting behavioral activation, and providing psychoeducation,
cognitive behavioral therapy ( CBT ) can potentially empower people like N to effectively
manage their symptoms and improve overall quality of life their. Emphasis will be placed on
the definition of bipolar disorder , both when it occurs alone and when it occurs together with
anxiety disorders and, depression or other chronic problems.
The historical context will cover the evolution of GST from its origins to the present day as a
widely recognized and empirically supported therapeutic modality. Bipolar disorder, formerly
referred to as manic-depressive illness, has an extensive historical lineage that can be traced
back to ancient civilizations ( Thibaut , 2017). The understanding and treatment of bipolar
illness has progressed over the centuries. Historically, people who exhibited symptoms of
bipolar disorder were often socially stigmatized or attributed to supernatural influences. The
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modern understanding of bipolar disorder emerged throughout the 19th and early 20th
centuries, when scholars such as Emil Kraepelin differentiated manic-depressive illness from
other types of mood disorders ( Ruggiero et et al ., 2018). Cognitive Behavioral Therapy
(CBT), originally developed to treat depression, has been modified to treat a range of
illnesses, including bipolar disorder.
Case study
This module aims to enhance clinical competence in Cognitive Behavioral Therapy (CBT)
for bipolar disorder seeking secondary care. Based on the present case study, Mrs. N , who is
46 years old and unmarried and by profession a tax official in the public sector, had an
unexpected development in her family environment, which very soon suddenly turned into
deep melancholy . This development had to do with her younger brother, who announced his
marriage to her without considering her opinion. An important feature is that N felt like her
brother’s mother. He has an older sister as well, married with children. After a while N started
to lose interest in her activities, she didn’t want to go to work and stayed at home for hours,
mostly in her bed. After a week he had a sudden change in mood. She announced that she
was marrying a university professor. He took a loan from banks to go out to expensive
restaurants and thus exceeded the credit card limit. She wasn’t getting enough sleep because
she and her fiance were going out late. In addition, she tried to use all her wealth to buy a
building so that children without families could live there. When her brothers found out, they
tried to help her, but it was not possible. N herself called the police in her defense, but her
brothers informed her what was happening and so N was transferred to a Psychiatric Clinic.
It has been observed through research that people with sudden mood swings, emotional
stability as well as intense impulsivity, usually belong to the spectrum of Bipolar Disorder.
Review of the bibliography
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The study conducted by Link et al. (2015) attempts to understand the dynamics of
bipolar disorder through the lens of General Distortion Theory. The goal is to investigate the
possible influence of stressors on the induction of mood episodes and to gain insight into
effective coping strategies. Bipolar disorder is a psychiatric illness characterized by severe
mood swings, which include manic and depressive episodes. Research in this area typically
focuses on understanding the etiology, manifestations, and effective interventions for bipolar
disorder. The influence of bipolar disorder on a person’s behavior and decision-making is a
widely studied topic. Extensive studies have explored the complex relationship between quality
of life and depressive states. Uptake of life research on bipolar disorder has been somewhat
sluggish. However, there is now a growing number of studies focusing on quality of life in
bipolar populations ( Thibaut , 2017 ). This literature review aims to conduct a comprehensive
review of studies examining the assessment of both general and health-related quality of life in
individuals diagnosed with bipolar disorder.
Colizzi et al. (2020) argue that a high standard of living goes beyond physical well-being.
Specifically, it denotes the totality of a person’s physical, emotional, social, occupational and
spiritual well-being. However, understanding this concept is complicated by the lack of
unanimous agreement on the definition of a satisfactory quality of life. Bipolar disease results
from complex and multifaceted origins, including genetic, neurological, and environmental
variables. Studies involving twins, families, and adoption have highlighted a significant genetic
influence, with heritability estimates ranging from 60% to 80%. Bipolar disorder is categorized
into several subtypes, such as bipolar I, bipolar II, and cyclothymic disorder, depending on the
intensity and duration of mood episodes. However, according to Ye et al . (2016), a growing
body of research shows that a high standard of living is an important measure of overall wellbeing.
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General stress theory
Link et al . (2015) suggest that the General Theory of Strain, formulated by Robert Agnew ,
argues that individuals with bipolar disorder may resort to criminal activities as a reaction to
various strains or stressors. The present study extends previous research by investigating the
extent to which strains or stressors clarify the relationship between mental illness and
violence. This case study explicitly applies general strain theory ( GST ) to examine the
lagged effect of various stress measures on Ms. N’s aggression. These triggers may include
feelings such as hopelessness, worthlessness, and thoughts of self-harm. GST , or General
Strain Theory, posits that individuals resort to maladaptive behavior to adapt to or cope with
strain and stress. Serravalle et al . (2020) argue that strain can result from adverse
experiences, such as the inability to achieve goals, the absence of positive stimuli, or
exposure to negative stimuli. According to the hypothesis, individuals may resort to deviant
behavior to cope with adverse emotions associated with stress.
Effects and coping mechanisms
It is vital to recognize that, although General Strain Theory focuses heavily on criminal
behavior, not all individuals with bipolar disorder engage in illegal activity. Nevertheless,
individuals may use inappropriate coping strategies, such as engaging in risky behaviors, to
alleviate the stress associated with their condition ( Serravalle et et al ., 2020). Treatment and
support: Ms N’s case highlights the importance of a comprehensive approach to mental health
care, including medication, psychotherapy and support systems. Additionally, addressing the
cultural stigma associated with mental health could help provide relief for people with bipolar
illness. In conclusion , General Strain Theory offers a structured approach to understanding the
challenges experienced by people with bipolar illness and how these challenges may influence
their actions and coping methods ( Link et et al ., 2015).
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study and critical analysis
Bipolar disease presents difficulties both for individuals diagnosed and for mental health
professionals ( Fenn & Byrne , 2013). The present case study emphasized the unique
difficulties, symptoms and treatment background of the patient, providing a practical view of
the complexities associated with the management of bipolar disorder ( Colizzi et et al .,
2020). In this case study, we will evaluate how effective Cognitive Behavioral Therapy
(CBT) is in dealing with the complex aspects of bipolar disorder.
This section explores the relationship between bipolar disorder and Cognitive
Behavioral Therapy (CBT), presenting a detailed case study and historical background (
Ruggiero et et al ., 2018). By analyzing the actual application of Cognitive Behavioral Therapy
(CBT) to bipolar illness and exploring its historical underpinnings, the aim is to provide
important perspectives that can enhance both clinical understanding and treatment strategies
for individuals experiencing this complicated disorder . _ Over time, CBT has evolved to
include not only one specific treatment but also various psychotherapies based on cognitive
principles. Dialectical behavior therapy and acceptance and commitment therapy are the most
notable therapies ( Colizzi et et al ., 2020). Although the treatment approaches are becoming
more popular, a review of studies shows that there is no discernible difference in effectiveness
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Psychoeducation
Psychoeducation is an important starting point for bipolar disorder . This entails
providing information to the patient about the characteristics of bipolar disorder, its recurrent
pattern, and the importance of medication adherence ( Fenn & Byrne , 2013). Gaining an
understanding of the correlation between thoughts, feelings and behaviors is of utmost
importance. However, it is often a time- consuming process.
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It is important to emphasize that psychoeducation consists of two main components.
The initial component involves elucidating the symptoms and the bipolar nature of the
condition and providing broad information about its etiology ( Ruggiero et et al ., 2018). Based
on the principle of learning, when a reinforcing occasion follows a behavior, the probability of
that behavior occurring again tends to increase ( operant conditioning ) ( Ye et et al ., 2016).
Recognition of stimuli and precursors
Cognitive Behavioral Therapy (CBT) helps people identify the factors that can lead to
mood disorders and recognize the early warning indicators that indicate the onset of manic or
depressive episodes. The patient acquires the ability to recognize workplace pressures or
changes in sleep patterns that may precede mood swings ( Kimura et al ., 2019).CBT may not
be appropriate for implementation during acute manic or major depressive episodes ( Link et
et al ., 2015). Cognitive Behavioral Therapy (CBT) is usually used when there is a period of
relative stability.
Cognitive restructuring
Cognitive restructuring involves modifying faulty cognitive patterns . During manic
episodes, the client may have the illusion of invulnerability, which may lead to reckless
decision-making ( Ruggiero et et al ., 2018). Cognitive restructuring helps challenge and
change these beliefs , encouraging more balanced thinking. However, in the context of bipolar
disorder, cognitive distortions may show a stronger association with mood symptoms (
Serravalle et et al ., 2020). Distinguishing between true and distorted cognitions can be
challenging amid mood swings.
Relapse prevention
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Prevention provides individuals with the necessary tools and techniques to effectively
avoid relapse. This entails constantly monitoring the individual’s emotional state, recognizing
the initial signs of regression and applying the coping mechanisms acquired during treatment (
Serravalle et et al ., 2020). This section examines how CG addresses faulty cognitive processes,
maladaptive behaviors, and difficulties in emotional regulation. ( Thibaut , 2017). Through
elucidating these key features, the goal is to understand how CBT might be adapted to address
the particular obstacles posed by bipolar disorder.
Code of ethics and conduct
The Code of Ethics and Conduct involves assessing how ethical principles and rules
can ensure the well-being, respect and fair treatment of people with bipolar disorder ( Tan et et
al ., 2022). Mrs. N , a person suffering from bipolar disorder, is currently experiencing
challenges in maintaining a firm grasp of reality. At one particular juncture, she sought to
liquidate her assets to acquire a property in the city center that would serve as an exclusive
institution for orphaned children. The code prioritizes recognizing and preserving people’s
autonomy. Health care providers and family members should involve Ms. N in collaborative
decision making by presenting her with the relevant facts and options . In the context of the
case study, Ms. N’s support system, namely her siblings, is crucial in promoting her well-being.
The code motivates professionals to advocate for the welfare of individuals.
The code supports cultural competence by urging professionals to be aware of and show
respect for a wide range of cultural perspectives. To be more precise, the therapeutic process
of CST and the code of ethics emphasize the importance of the active participation of the treated
( Pope , 2018). In addition, the GSTH trains therapists to impart the knowledge and skills
necessary to effectively deal with the difficulties that arise . It is difficult to maintain an
apparent concentration and a single methodology in this situation, and occasionally, it appears
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that the skills and expertise of CBT are not suitable to achieve the desired outcome for the
client ( Pope , 2018).
Ensuring a client’s autonomy can be very complex. For example, Mrs. N cannot make
independent decisions about her goals or her treatment process without receiving accurate
information ( Pope , 2018). The clinician will consistently demonstrate respect and appreciation
for clients’ intrinsic value while promoting an unconditional self-acceptance and acceptance of
N . In this way, the clinician will always provide Mrs. N with true and understandable
information ( Pope , 2018).
C STH in bipolar disorder
Evaluation
During this stage, it is vital to establish the diagnosis and investigate any other
diagnoses . To achieve this goal, it may be preferable to use the semi-structured interview
known as the Diagnostic and Statistical Manual of Mental Disorders, Fourth or Fifth Edition (
DSM – IV or DSM -5) or the Short International Neuropsychiatric Interview ( Abreu , 2016).
The assessment interview provides a unique opportunity for individuals to gather information
about the contextual elements that cause bipolar disorder (DD) and how flare-ups affect their
relationship with the environment. It is important to understand the challenges patients face in
fulfilling their obligations during a depressive episode, as well as the effects on their intimate
relationships, work performance, and interpersonal relationships during a manic or hypomanic
episode. It is important to record the escalation of target behavior (such as new efforts,
increased spending, and engaging in sexual and risky activities) along with their outcomes and
associated challenges during periods of hypomania and mania. In addition, it is important to
consider patients’ feedback about their previous encounters and the explanations they provide
( Abreu , 2016). Recording any observations or information about the patient’s self-perception
and perception of the outside world during the medical history taking process is essential .
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Cognitive interventions
Cognitive therapies are not appropriate for conditions characterized by particularly
severe depressed or elevated mood. Caution should be exercised as it may intensify feelings of
inadequacy and ruminative thinking, especially when severe depression is present. Cognitive
therapy is based on the principles of schema theory. Schemas are cognitive frameworks that
govern perception and focus of attention, facilitate information processing, and influence
emotions and behavior ( Serravalle et et al ., 2020). Immediate thoughts and mental images
arise from these cognitive frames that are rooted in the memory system. Biological and
environmental factors activate patterns that influence cognitive, emotional, and behavioral
responses. The cognitive system regulates emotional and behavioral responses to the situation,
person, or internal stimulus in a particular environment. When dealing with thoughts,
interventions for cognitive systems at the reflective and contemplative levels vary. The
automatic thinking system responds faster while relying on fewer data sources. In contrast, the
reflective system works more slowly, but uses a larger amount of data and produces a more
thorough result. The fundamental principle of cognitive processes is identifying thoughts,
making associations with feelings and actions, and evaluating beliefs. The person could
manage their thoughts by evaluating them based on their alignment with reality, logic,
appropriateness and functionality ( Tan et et al ., 2022). It would then create more practical,
appropriate and effective alternatives.
Conclusion
This paper presents a retrospective of the historical development of Cognitive
Behavioral Therapy (CBT) and its use in the management of bipolar disorder, illustrated
through an extensive case study. The results confirm the effectiveness of Cognitive
Behavioral Therapy (CBT) as a beneficial adjunctive therapy, fostering a comprehensive and
patient-centered approach to the management of Bipolar Disorder. Examining the history of
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CSD provides a framework for understanding its development and significance in mental
health. The case study provides a comprehensive analysis of a patient diagnosed with Bipolar
Disorder, highlighting the treatment process, interventions and outcomes . It is worth noting
that Cognitive Behavioral Therapy (CBT) is often used as a component of a comprehensive
treatment strategy for bipolar disorder, which may include medication, psychoeducation, and
help from mental health professionals and support systems. In addition, the effectiveness of
GST can vary between individuals, which makes it necessary to adapt the intervention to
their particular requirements and preferences.
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Βιβλιογραφία
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