Research Abstract and Draft
RESEARCH PAPER DRAFT 1
The Effectiveness of Cognitive Behavioral Therapy (CBT) as an Intervention for Student diagnosed with Anxiety
Melissa Kelly
Albany State University
COUN5620 Research and Program Evaluation for Counselors
Dr. Claudia Calder
November 10, 2021
Abstract
Anxiety, a common disorder in children and adolescents, results in substantial and persistent fear of one or more social and performance positions. The purpose of the study is to examine the effectiveness of Cognitive-Behavioral Therapy as an intervention for students diagnosed with anxiety disorder. The aim of this study is to explore the effectiveness of Cognitive-Behavioral Therapy as an intervention for Middle/High/Elementary students diagnosed with anxiety. The study employs a qualitative research survey design and utilizes a purposeful Sampling technique which is a sampling technique used by qualitative researchers use to choose participants who can offer in-depth and comprehensive information about the application of Cognitive Behavioral Therapy (CBT) as an intervention for students diagnosed with Anxiety under investigation. The research participants will include 15 students selected from 1250 students aged between 9 and 13 years from 5 different learning institutions. Data will be collected through the use of online pretreatment questionnaires and recorded interviews. NVivo software will be used to analyze the data collected by the questionnaires. Therefore, this study will contribute to the scientific record by detailing the importance of cognitive-behavioral therapy on reducing stress among youths, especially students diagnosed with the condition. Based on the study results, cognitive-behavioral therapists will be able to help students identify how anxiety and depressing contemplations can be controlled and managed. This will aid in identifying, challenging, and adjusting depression and anxiety-related indicators.
Introduction
Anxiety, a common disorder in children and adolescents, results in substantial and persistent fear of one or more social and performance positions. The condition impairs one social functioning, reduces peer relationships, leading to social skills deficits and comorbid psychological illnesses (Stjerneklar et al., 2019). Individuals, particularly students with anxiety disorder, often have few and poor-quality relationships and impaired relationships. According to research, anxiety often impairs students’ emotional development and social functioning (Luo & McAloon, 2021). Surprisingly, most people suffering from this condition are rarely recognized as most do not seek treatment due to few psychotherapeutic involvements focused on the student anxiety disorder (Walter et al., 2020). Cognitive-behavioral therapy has proved an effective treatment for fluctuating involuntary thinking processes, self-criticism, and behavioral patterns that cause depression and anxiety. Various studies imply that CBT is leading to significant development in quality and working of life.
In many studies, CBT has been recognized to be as functioning as, or very effective as, other methods of mental therapy. According to AACAP, cognitive-behavioral therapy (CBT) is beneficial to patients aged 6 to 18 years old with social nervousness, widespread anxiety, parting anxiety, detailed phobia, or panic illness. CBT highlights cognitive, social, and physiologic procedures that lead to and maintain anxiety signs; these courses are well-educated and purpose in a social setting (Luo & McAloon, 2021). CBT encourages family-directed interventions that help improve parent-child relations, strengthen family problem-solving and communication skills, minimize parental worry, and foster anxiety-reducing childcare skills frequently add-on individual treatment. Additionally, young individuals exposed to the cognitive-behavioral method have a high quality of life about well-being and comfort and lower anxiety levels (Walter et al., 2020). The cognitive-behavioral intervention had an affirmative result supporting reduced anxiety levels. A previous study noted that the use of cognitive-behavioral intervention enhanced the mental health of individuals (Stjerneklar et al., 2019). On the same note, research more has designated that cognitive-behavioral involvement assisted in treating youths with anxiety symptoms (Walter et al., 2020).
Statement of the problem
Globally, anxiety is the most common disorder affecting approximately 10% of youths (Walter et al., 2020). If the condition is not treated, it leads to persistent challenges and permanent effects on general development, social functioning, and educational achievements. Cognitive-behavioral therapy has proved to be an effective treatment in reducing anxiety symptoms. According to research, only about 25% of the youth with an anxiety disorder receive treatment due to the limited accessibility of healthcare services (Luo & McAloon, 2021). Youths are particularly reluctant to seek treatment due to various healthcare barriers, including cost, confidentiality, and the fear of social stigma (Walter et al., 2020). Cognitive-behavioral intervention helps in restoring automatic thinking, behavior pattern, self-criticism, which causes depression and anxiety. The therapy has proved to be an effective technique as it improves people's mental health, especially those with depressive symptoms. A follow-up investigation has established that cognitive-behavioral interventions have long-term effectiveness and positive clinical impact in lessening the severity of anxiety symptoms. Nonetheless, there is limited research about the role of cognitive-behavioral therapy in improving anxiety indicators. Furthermore, medical providers' early identification, assessment, and treatment of anxiety illnesses significantly affect both an individual and public health problem of mental disease amongst children and youths.
Purpose of the Study
The study's purpose is to examine the effectiveness of Cognitive-Behavioral Therapy as an intervention for students diagnosed with anxiety disorder. The aim of this study is to explore the effectiveness of Cognitive-Behavioral Therapy as an intervention for Middle/High/Elementary students diagnosed with anxiety. The objective is to determine if Middle/High/Elementary students are more aware of triggers/coping skills after engaging in CBT intervention.
Significance of the research
The study will assess the effectiveness of cognitive-behavioral therapy in the treatment of anxiety disorders and in altering automatic thoughts, self-criticism, and behavior patterns that cause anxiety. According to research, the cognitive-behavioral intervention has been confirmed and revealed as an effective technique in improving the mental health of individuals with anxiety symptoms in different countries globally (Stjerneklar et al., 2019). Additional studies established that cognitive-behavioral intervention upholds its long-standing efficacy in lessening the severity of anxiety symptoms (Luo & McAloon, 2021). Scholars have also reported the permanent positive clinical significance of cognitive-behavioral intervention in treating depression and anxiety (Stjerneklar et al.,2019). Therefore, this study will contribute to the scientific record by detailing the importance of cognitive-behavioral therapy on reducing stress among youths, especially students diagnosed with the condition.
Based on the study results, cognitive-behavioral therapists will be able to help students identify how anxiety and depressing contemplations can be controlled and managed. This will aid in identifying, challenging, and adjusting depression and anxiety-related indicators. Due to the efficiency of cognitive-behavioral therapy, the government can use the study results to help students by financing school-based cognitive-behavioral involvement programs precisely intended to decrease anxiety symptoms. This can assist students in pacifying their rational and automatic thinking. Equally, the research will result in enhanced evidence-based treatment as effective treatment results are based partly upon the accuracy of the analysis, the medical formulation's complexity, and the treatment plan's extent. Further, CBT emphasizes assisting persons in learning to be their counselors, which entails helping individuals develop coping skills to learn how to change their personalized reasoning deals with problematic behaviors and emotions (Walter et al., 2020). Students exhibiting anxiety symptoms are susceptible to various disorders, health difficulties, drug and substance abuse, and poor academic accomplishment. Notwithstanding the commonness of anxiety disorders amongst students, very few receive treatment of anxiety symptoms; hence, the study is very impactful as it will increase the likelihood of students receiving treatment.
Literature Review
Cognitive-behavioral therapy is defined as psychotherapeutic treatment that helps people in learning how to manage and identify worrying or negative thought patterns that cause an undesirable influence on one's emotions and behaviors. It focuses on changing the negative thoughts automatically, which often contributes to and worsens emotional difficulties, anxiety, and depression. These spontaneous thoughts harm an individual mood (Luo & McAloon, 2021). Cognitive-behavioral therapy is a well-established treatment for anxiety disorder in adolescents and children. Research has shown that about 60% of youths recuperate from anxiety disorder and experience a significant reduction in the disease’s symptoms after treatment (Stjerneklar et al., 2019). According to various studies, cognitive behavior therapy has proven effective in treating anxiety disorders in children and adolescents. This form of therapy helps promote improved self-control, elude activates, and develop coping skills for day-to-day stressors.
Effectiveness of Cognitive-Behavioral Therapy as an intervention for students diagnosed with the disorder
Cognitive-based therapy is founded on a cognitive model of mental conditions and hypothesizes that individual perceptions influence people's emotions and behaviors. CBT teaches patients to be their therapists by assisting them to comprehend their current ways of behaving and thinking and equips them with gears to modify their maladaptive conduct and cognitive patterns. The therapy helps foster an environment of collaborative observation and those supporting problem-focused and structured focus of CBT (Jon & Krister, 2016). Collaborative empiricism is founded upon starting a collaborative relaxing association in which therapist and patient work together to develop maladaptive behavior and cognition test their validity, and make rectification when required. Unlike other forms of treatment methods and difficulties and problems, CBT focuses on the causes of the symptoms and distress and aims at finding ways of improving the patient thoughts processes (Jon & Krister, 2016). Further, CBT focuses on the current situation in a person's life contributing to anxiety; hence, the treatment focuses on a person's history for it to develop more effective ways of coping with life.
Stjerneklar et al. (2019) posit that anxiety disorder is the most common type of mental illness in youths. Research has highlighted the harmful impact of youth anxiety on cognitive and behavioral wellbeing in adulthood. Early intervention of the condition has helped to minimize these effects. The use of cognitive-behavioral therapy as an intervention measure helps in decreasing anxiety efficacy. The cognitive model asserts that anxiety dysfunction occurs mainly due to interpretive biases in one's belief system leading to thinking errors and enactment of behaviors in line with biased beliefs (Anna et al.,2018). Health providers employ a wide range of behavioral and cognitive strategies in the treatment to provide better outcomes (Stjerneklar et al., 2019). Behavior change possibly arbitrates treatment results. Research recommends that developing increased coping skills through attention allocation and problem rationalization may facilitate treatment outcomes. Walter et al (2020) noted that exposure tasks lessen avoidance actions and meaningfully improve reactions on measures of symptoms strictness. However, reduced behavior avoidance has a possible tool of change. However, it is difficult to assess whether lessons in avoidant behavior are agents of change or rather a product of evolution following other processes (Anna et al., 2018). In adult studies, acceptance of emotions is a potential mediator of symptom change following CBT for social anxiety disorders. Negative emotions, such as physiological indicators of fear, have the possibility of mediating treatment.
Cognitive-behavioral therapy is founded on the belief that maladaptive behaviors and thought distortion play a critical function in maintaining and developing various mental disorders. Thus the anxiety symptoms can effectively be reduced by teaching new information coping and processing mechanism. Anxiety illness is characterized by uncontrollable and excessive worry and is alleged to be maintained by cognitive biases towards threat-relevant stimuli and use of fear, related tension, and overly cautious behaviors means towards avoiding catastrophic images and linked autonomic situations (Walter et al., 2020). The benefits of CBT encompass cognitive therapy in addressing worry and cognitive biases, relaxation to discourse tension, and imaginably exposure to destructive ideas and direction to stressful circumstances while response preventing over-cautious behaviors.
CBT Intervention Equips Student with Anxiety Coping Skills
CBT focuses on providing youths with tools to help them in coping with their current problems. It is founded on the principle that thought patterns affect one emotion that consequently affects one's behavior. According to CBT, negative thoughts results in adverse feeling and actions hence therapist teaches students to reframe their thoughts more positively, leading to more positive emotions and supportive behaviors. The clinician teaches the youths on making changes one can implement and impact one with skills that one can continue to use generally CBT helps students identify specific problems in life and to become aware of unproductive thought patterns and their impact on their skills. Being in a position to identify the negative thinking and reshapes in the way of changing how one feels and learning new behaviors and them putting them into practice, Through the cognitive behavior model, a student is taught how to restructure their thoughts by taking a hard look o at the negative thought patterns. These enable students to stop overgeneralizing and, based on the assumption that the worst must happen, place much importance on the minor details. Once the students are of their thoughts, they can effectively certain situations; reframing one's thoughts helps one to be more positive and productive. Equally, CBT focuses on exposure therapy that teaches the youths how to confront phobias and fears (Walter et al., 2020). The therapist exposes students to things that provoke concerns and then guides coping with anxiety in that particular moment. Exposure to fears makes one feel more confident and less vulnerable in one coping abilities. In CBT, a person uses progressive relaxation methods, which include taking deep breaths and imagery to facilitate muscle relaxation. Those practical skills assist in lowering stress and increase one sense of control. This is particularly more supportive for one to deal with phobias, social anxieties, and other stressors.
Definition of Terms
Cognitive-behavioral theory - psychotherapeutic treatment that helps people in learning how to manage and identify worrying or negative thought patterns that cause an undesirable influence on one's emotions and behaviors
Anxiety disorder- a mental health condition that makes one respond to certain things and situations with fear and dismay.
Emotions- a complex state of feeling resulting in physical and psychological changes that affect one thought and behavior.
Psychotherapeutic treatment- A way of helping people deals with a variety of mental disorders and emotional difficulties.
Research Questions
What is the effectiveness of Cognitive-Behavioral Therapy as an intervention for students diagnosed with the disorder?
Does CBT Interventions equip Student with anxiety coping skills?
Hypotheses
1. Cognitive-Behavioral Therapy is an effective intervention for students diagnosed with anxiety disorder.
2. CBT Interventions equip students with anxiety coping skills.
Research Methods
A qualitative research survey design will be used for the study. The qualitative survey will encompass the use of open-ended questions for data collection with an aim of revealing the respondent’s experienced opinions and accounts. Qualitative surveys purpose to prompt a comprehensive response to an open-ended topic question in the participant’s personal words.
Data Sampling
The study will utilize the purposeful sampling technique which is a sampling technique used by qualitative researchers use to choose participants who can offer in-depth and comprehensive information about the application of Cognitive Behavioral Therapy (CBT) as an intervention for students diagnosed with Anxiety under investigation. Purposive sampling is a nonprobability sampling technique where the sample is determined based on specific characteristics intended to provide a various and valid understanding of the selected individual experiences (Anna et al., 2018). Participants for this study will include 15 students diagnosed with anxiety disorder and 5 parents whose children have a history of anxiety disorder. The number is recommended as qualitative research usually recommends a sample with a minimum number of 12 participants (Stjerneklar et al.,2018). Children with a history of being diagnosed with intellectual impairment, psychosis, or neurological disorder will be excluded from this study. The inclusion criteria for participants involved children with primary diagnoses of anxiety disorders based on parent or guardian reports about the child and those with a sample of DNA available for analysis.
Data Collection
Data will be collected through the use of online pretreatment questionnaires. However, participants' comfortability will be measured through a question aimed at assessing the participants' feelings about the use of computers and the internet. The questionnaire will be administered for two weeks to give participants ample time for responding. Each participant will take 5 to 10 minutes to respond to the questionnaires. The electronic data collection to be used for helping the questionnaire is the surveys (Stjerneklar et al.,2018). On the other hand, the interviews will be recorded electronically, and the audio recordings of the interviews will be listened to severally and then copied verbatim and anonymized. The thematic analysis procedure was used to study the data. Further, the incorporated line-by-line coding of all the interviews will take an inductive method, which involves using the NVivo software package for organizing the data proficiently. The study acquired ethical approval from the University Senate. Participants' informed consent was obtained from parents and guardians and permission from young people.
Data Analysis
Data analysis will encompass the recognition, investigation, and interpretation of themes and patterns in written data and assess how these patterns and themes are trying to answer the research questions involved. Data analyses will therefore involve reading many transcripts to determine the differences and similarities or differences and then finding subjects and developing groups. In order to minimize technical sophistication and reduce the laborious task, thus making the data analysis process moderately easier NVivo software will be used to analyze the data collected by the questionnaires (Stjerneklar et al.,2018). NVivo is a computer package developed to mechanize this 'coding' process and assist in searching and retrieving data (Stjerneklar et al.,2018). The most fundamental characteristic and the primary tool of NVivo help qualitative researchers analyze and manage the data described in open-ended questionnaires.
Discussion
Significance of the study
Cognitive Behavioral Therapy was found to moderately reduce symptoms associated with anxiety disorder. Subgroup analyses designated that persons who contributed to group CBT experienced better treatment effects t compared to those who participated in CBT individually. CBT produces more significant results than other psychotherapeutic involvements and has proved beneficial for affective and cognitive factors. Strengths of the present study comprise the use of a large sample of assessments for the tenacity of instituting psychometric possessions for the scale, allowing the use of factor examination to examine the structure of the scale.
Limitations of the study
Some of the recorded interviews were from personal treatment, and more assessments from group treatment may be required to evaluate psychometric treatments.
Future Research
Further studies should consider adding a more comprehensive range of measures evaluating anxiety difficulties, such as anger and impulsivity. There are some significant paths for future research. A key focus should also be taken on comparing the effectiveness of specific CBT with the extensively used one-session, CBT conducted for anxious youth (Krister et al., 2017). These educations should also measure critical biological and cognitive processes that could be dynamic replies to CBT treatment set-ups. Finally, a study to evaluate these inquiries amongst adolescents is desirable.
The implication of future research
Cognitive Behavioral Therapy is an effective and acceptable therapy for students with anxiety disorders, totaling research signifying that it may be a suitable first-line intervention. There is essential to recognize instruments of change in CBT (Jon & Krister, 2016). Though some processes are revealed to facilitate treatment results, widespread research is essential to dependably define mediators and instruments of change in treatment. Currently, there is research to support change in undesirable self-talk and handling as possible mechanisms (Luo & McAloon, 2021). Therefore, future studies should contemplate including a diversity of cognitive, behavioral, and emotional measures and should study the effects of treatment mechanisms as a step towards recognizing instruments that improve CBT for teenage anxiety. Explicitly, future research should evaluate changes in other cognitive factors that may mediate treatment, such as the bias of uncertainty or automatic negative opinions (Luo & McAloon, 2021). Studies may also benefit from distinguishing between mental process changes and avoidant behaviors when investigating behavioral interferences.
The significance of the research
The benefits of CBT encompass cognitive therapy in addressing worry and cognitive biases, moderation to manage tension, and possibly exposure to critical ideas and direction to stressful conditions whereas response averting over-cautious behaviors. The use of cognitive-behavioral therapy as an interference measure assist in decreasing anxiety efficacy. The cognitive model emphasizes that anxiety dysfunction occurs primarily due to explanatory prejudices in one's belief system resulting in thinking errors and behaviors in line with prejudiced opinions (Walter et al.,2018). Health providers use a wide range of cognitive and behavioral strategies in the treatment to offer improved outcomes. Since CBT is more focused on the causes of the symptoms of anxiety distress, it provides an effective way of improving the patient beliefs procedures. Additionally, CBT emphasizes the present state in an individual's life that contributes to anxiety; subsequently, the study asserts that an individual's history can develop more operational ways of managing and dealing with life worries. School counselors should apply Evidence-based practice (EBP) in psychotherapy when dealing with a student with anxiety disorders which encompasses the integration of the best available research with clinical expertise in the context of patient features, culture, and preferences'.
References
Anna, M., Robert, K. & Jonathan, R. C., 2018. The impact of treatment delivery format on response to cognitive behavior therapy for preadolescent children with anxiety disorders. Journal of Child Psychology and Psychiatry, 59(7), pp. 763-772.
Jon, F. B. & Krister, W. F., 2016. Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS-CBT) for anxiety disorders in youth: Psychometric properties. Psychological Assessment, 28(8), p. 908.
Krister, W. F., Wendy, N. & Tina, D. J., 2017. Mothers’ and fathers’ internalizing symptoms influence parental ratings of adolescent anxiety symptoms. Journal of Family Psychology, 31(7), p. 939.
Luo, A., & McAloon, J. (2021). Potential mechanisms of change in cognitive behavioral therapy for childhood anxiety: A meta‐analysis. Depression and Anxiety, 38(2), 220-232.
Stjerneklar, S., Hougaard, E., & Thastum, M. (2019). Guided internet-based cognitive behavioral therapy for adolescent anxiety: predictors of treatment response. Internet interventions, 15, 116-125.
Walter, H. J., Bukstein, O. G., Abright, A. R., Keable, H., Ramtekkar, U., Ripperger-Suhler, J., & Rockhill, C. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107-1124