Dale and Cognitive Behavioral Theory
Respond:(shakir)
Conceptualization Week 6
Client and Theory:
Dale and Cognitive Behavioral Theory
Presenting Problem:
Dale, 52 years old, White male, prison guard, ex-police officer, former bouncer, divorced, remarried, estranged father of an adult son, currently married, exhibits racist views and actions. In mandated therapy by the employer. His beliefs and actions are causing extreme hardships for him in both his professional and personal life.
Hypothesis:
(CBT Constructs – Core Beliefs, Maladaptive Beliefs and Behaviors)
The client is facing professional and personal challenges as a result of his core beliefs and behaviors. These core beliefs were adopted due to the existential ideology during his childhood. People’s behaviors are greatly influenced by their environment (Shaw and Green, 2022). His role as the oldest child forced him to take on the family core beliefs, as well as their perceived social constructs, which has him living incongruently. One’s birth order affects their development and provides a blueprint for their beliefs, thoughts and behaviors (Dufrene and Clark, 2022). The client is experiencing tremendous hardships as a result of his instilled core beliefs.
The client’s core beliefs have allowed him to develop intermediate beliefs, which has caused him hardships in every aspect of his life. His maladaptive beliefs have and continues to sabotage his professional and personal relationships. Maladaptive beliefs generally result in negative emotional and behavioral outcomes (Shaw and Green, 2022). Dale was fired from his position as a police officer due to racial profiling and currently being reprimanded at his current employment for racist actions, all caused by his maladaptive beliefs.
Goal:
(Overarching Constructs – Change Client Thinking)
The goal for the client is to assist him with changing his thinking regarding other cultural and ethnic groups. In working with the client, it would be beneficial to outline the experienced hardships he has faced as a result of his maladaptive behaviors. By discussing a client’s maladaptive patterns, can assist the client with becoming more aware of them and provide a pathway towards treatment (Shaw and Green, 2022).
As the therapeutic relationship strengthens and progresses, I would work with the client in deeply addressing his core beliefs, by collectively developing a cognitive case conceptualization for his sessions. From a cognitive perspective, CBT counselors can collaborate with a client to develop a cognitive case conceptualization (Shaw and Green, 2022). This collective plan would allow the sessions to focus on his main problems, beliefs, relevant history, current situations, strengths and treatment plan.
Interventions/Techniques:
The intervention methods used in this case conceptualization will be aligned with the Cognitive Behavioral Theory.
Intervention 1: Cognitive Reframing
I have chosen an intervention strategy which focuses on cognitive reframing, through exploring cognitive defusion. Dale’s core belief framework was established as a child, both directly and indirectly, by his parents. The framework in which he inherited has created turbulence for him throughout most of personal and professional life. Since he possesses a negative cognitive framework, we have to address his oftentimes self-sabotaging, racist and biased behaviors, which would lead to cognitive reframing as part of his treatment plan. Through cognitive defusion, clients are able to view their thoughts more openly and are able to accept the existence of negative thoughts (Shaw and Green, 2022).
Intervention 2: Self-Monitoring Thought Record
The second CBT intervention strategy I would use is self-monitoring thought record. Self-monitoring thought record teaches clients a model for assessing and developing an awareness of their automatic thoughts and how these relate to their emotions and behaviors (Shaw and Green, 2022). This intervention strategy would work well, and even assist with the implementation of cognitive reframing. In working to reshape the client’s core beliefs and framework, this strategy would serve as a tool to assess and monitor his thoughts in his daily lifestyle and interactions.
This strategy will further assist the client with developing skills and awareness that would allow him to self-analyze his thoughts and behaviors in real time. Unlike, sharing feelings and thoughts within a session, the self-monitoring thought record strategy will allow him to confront his attitude, thoughts and behavior while his emotions are present.
Expected Outcome:
After implementing the above interventional steps, I believe the client will begin analyzing his thoughts, beliefs, emotions and actions without the immediate involvement of a counselor. He will begin to explore the root causes of the feelings and thoughts, and how they are affecting his life.
The client will begin to cognitively challenge the ideas he has closely held onto since his childhood. With him becoming more aware of his thoughts, the use of suggested social interactions with other cultural groups he opposes, would further assist him in the reframing. These cultural interactions would be geared towards the idea of behavioral activation. Behavioral activation involves counselors giving clients daily challenging activities that are designed to positively reinforce improved the client’s mood and well-being (Shaw and Green, 2022). These challenging processes and lessons will begin to assist him in leaning into new cognitive patterns and behavioral choices. And as changes begin to occur, he would find himself moving more towards a self-actualizing state.
References:
Dufrene, R. L. & Clark, L. B. (2022). Existential theory. In D. Capuzzi & M. D. Stauffer (Eds.), Counseling and psychotherapy: Theories and interventions (7th ed., pp. 95-112). American Counseling Association.
Shaw, S. L., & Green, J. W. (2022). Existential theory. In D. Capuzzi & M. D. Stauffer (Eds.), Counseling and psychotherapy: Theories and interventions (7th ed., pp. 193-213). American Counseling Association.
Respond Lindsay
Presenting Problem: The client Deidre is a single 16-year-old Latino female living in a nuclear family with 1 brother and 1 sister. The client is attending Tuckahoe High School. The client is showing signs of Anxiety, depression, and ADHD but has potential signs of Autism as well. Based on the client’s behavior, the mom referred the child to counseling services. The mother states that the client is having anger outbursts, shuts downs, and is having a delay in social skills. The mother also states that Deirdre is sad due to the loss of her friend and tends to dwell on the past as well as gets anxious about the future.
Hypothesis: The client is experiencing these problems mostly because they believe that they are having a hard time with their family. The client states that their mom has a very authoritarian parenting style and uses negative punishment to control Deirdre. According to Shawn & Green (2022), “mainstream concepts such as positive reinforcement, punishment, and negative reinforcement commonly used in parenting, training animals, and in schools stem directly from Skinner’s work”. An example of Deirdre and her family dealing with Operant Conditioning within the family structure is portrayed when the client throws anger outbursts due to them not getting their way such as trying to go on their ipad after screen time is up for the day or not cleaning up their toys. The client then acts out because they want their toy back due to mom taking them away. The client will also shut down as well as try several manipulation tactics to get mom to get her toy back by saying she won’t act out again which doesn’t work well. The client then feels as if her mom is too hard on her which then reinforces the behavior of the child and the parent dealing with the same occurrence again. The child is also experiencing Classical Conditioning in which the child also is nagged by mom at home which is considered an unconditional stimulus next the child feels fearful and anxious which is considered an unconditioned response. Then the child has to be around the mother constantly which is considered the conditioned stimulus. Lastly, mom provokes the stress which then the child tries to not be social around the family and therefore does not want to be around anyone in general which is considered the conditioned response. This “concept refers to a response that becomes generalized to other settings that are similar or have something in common with the original stimulus. Stimulus generalization occurs when the child begins to have a fear response to all social situations” (Shaw and Green, 2022).
Goals: The main goal for Deirdre is to change the anxiety and stress that comes with learning how to manage her emotions to change the client’s thinking patterns. What this goal means is “to change client thinking, behavior, and/or emotions to reduce symptoms and improve the client’s well-being” (Shaw and Green, 2022). For example, if the goal is to try to change how she thinks, behaves, and feels she must try to recognize first that she is at fault then try to unpack why she may be doing these behaviors and how to change them. By bringing this to her attention, she then can be more aware and try to manage it before tantrums by reinforcing herself to be more vocal about what emotion she is feeling, recognizing the specific feeling (using an emotion wheel) before she acts on it. The goal is for her to hopefully start to verbalize why she feels uncomfortable and then be able to put into words her discomfort before any negative action is done. Another goal is behavior and/or emotions to reduce symptoms and improve client’s health and welfare. The client could identify and stop responding to negative stimuli such and become more aware of potential toxic surroundings and then remove oneself or change the way one responds. Which “decreases [the] likelihood that a behavior will occur [again]”(Shaw and Green, 2022). Once the pattern of unwanted errors is broken, then the child can relearn and regain a sense of control and hopefully cope better.
Interventions:
Intervention 1: The intervention method that would be beneficial would be Reflective Journaling. Using this intervention can be helpful because the counselor “can assist the client with becoming more aware of them [the thoughts] and provide a pathway towards treatment” (Shaw and Green, 2022). A method of helping the client is by choosing and committing to a time in your day that is considered downtime. Everyone has a busy life, but making a time commitment just for jotting down events that occurred in the day such as positive and negative items can help with how one can deal with the emotional burden of life. By making her mental health as a priority by adding it to the calendar can help relieve stress, especially from her mother which then make her feel isolated. This would be useful to the client in meeting goals according to CBT because it can help with emotional recognition.
Intervention 2: The intervention method that would be beneficial would be behavioral activation. By using this method, it can decrease depression and increase productivity. It “involves counselors working with clients to identify and schedule daily activities for the client that are positively reinforcing to produce improved mood and well-being” (Shaw and green, 2022). One can not just wait around to be motivated or stimulated so one must simply act in order to feel increasingly better. If a person does the opposite of what they want to do and use little tasks to help them feel less overwhelmed it can be helpful. In the case of Deirdre, she would probably prefer to be lazy and not go to school in the morning but if she were to do the opposite of how she is feeling and got up and at least started brushing her teeth then at least she would feel accomplished with one task and same goes for putting her toys away. An example of how she would use this is by making a schedule full of simple achievable goals and positive activities so that once she can slowly excel at that then she can move on to more challenging goals. This would be useful to the client in meeting goals according to CBT because it can help with behavioral recognition and reinforce patterns.
Expected Outcome: The goal of CBT therapy is to help with the cycle is for the client to “recognize, challenge, and modify maladaptive thoughts and behaviors; improve emotion regulation; and learn to develop healthy coping skills” (Shaw and Green, 2022). The outcome that I hope to achieve for my client is that one can recognize their thoughts, feelings, and emotions using the interventions above. “CBT emphasizes the role of thinking and cognitive processes in human behavior and emotions” (Shaw and Green, 2022). I believe this can be beneficial to the client because then the client can recognize not only their own problems but also recognize others and their thought patterns and why they react in that way. The client will then be able to recognize negative processes and be able to ‘trash’ negative thoughts and feelings and not pay any mind to it. If it comes to the point where one has to confront the issue, the client will hopefully have the tools. The client will be given a worksheet on how to schedule her positive events and activities to help improve her mood and reinforcement. This can be helpful in the relationship with the mother such as doing a chore chart and then doing a fun activity after her toys are cleaned up making a healthy balance for both parties.
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