Conceptualization and Treatment Plan 2.pdf

Running head: CONCEPTUALIZATION 1

Conceptualization and Treatment Plan 2

Dolly M. Beck

Liberty University

CONCEPTUALIZATION

Abstract

Cognitive Therapy is a therapeutic approach that focuses on the use of cognition to change

dysfunctional thoughts and behaviors. In this approach clients learn to identify and examine

dysfunctional thoughts and challenge them. This case conceptualization and treatment plan

addresses the background of the cognitive therapy approach and introduces selected intervention

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The Cognitive therapy approach is a model of therapy in which one’s thoughts influence their

feelings (Murdock, 2013). Founded by Dr. Aaron Beck, this approach was originally used to

treat depression however, it is now utilized to treat various additional conditions such as anxiety

and panic disorders (Sudak, 2006). While maintaining that this theory is original, Dr. Beck

recognizes the influence that previous philosophers and therapists have had on his work

often influenced by their thoughts about a particular situation or interaction (Sudak, 2006). This

approach utilizes various techniques to combat dysfunctional thinking by clients and replace

these dysfunctional thoughts with healthy thinking patterns. Dr. Beck posits that the human

reproduce (Murdock, 2013). He theorized that humans achieve these ultimate motivations to

survive by adapting to their environments, and that they do so by depending on their cognition to

adjust their behaviors in such a way to achieve positive outcomes. (Murdock, 2013). An

individual’s beliefs about different situations, events and interactions are grouped into schemas.

These schemas are developed internally to help humans organize all of the information they

encounter. The Cognitive approach holds that individuals can develop both adaptive and

maladaptive schemas based on their experiences and how these experiences are perceived by the

individual in light of their motivational goals (Murdock, 2013). Within these schemas lie a

person’s core beliefs that are basic beliefs they hold to be true often about themselves. These

core beliefs often affect a person’s behaviors as they respond to various situations. In addition to

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occur in conjunction with conscious thinking (Murdock, 2013). These thoughts are often tied to

emotions a person may be experiencing and more often than not negative or distorted.

The use and effectiveness of the Cognitive therapy approach is widely accepted by the

scientific community as is evidenced by a variety of studies. Once utilized to treat depression,

studies demonstrate the effectiveness of Cognitive therapy in reducing symptoms of myriad

in reaching a more productive state of wellness. She consistently has self-defeating thoughts

regarding her own abilities and values that may be rectified through the use of cognitive therapy

techniques.

Dianne is a 35-year old woman who previously worked as a nurse and held a career in the

military. She can no longer work in her previous careers due to a back injury sustained during

her military service. Dianne struggles with depression and anxiety related to her perceived lack

of meaning and usefulness. She has stated on numerous occasions that she has no sense of

purpose since she cannot work in the careers she enjoyed. She has also stated that she feels that

she has “faded away into obscurity”. She is interested in pursuing a career in writing however;

she expresses anxiety over the thought that she may not be successful and would not be able to

support herself with that as her sole career.

Dianne was given three goals for her treatment plan. Goal number one was to connect with

other veterans either locally, via social media, or both. Achieving this goal will help Dianne

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meet others who can support her through her transition. The second goal was to reduce her

anxiety regarding her professional life by finding healthy coping methods. Dianne’s third goal

was to write two more short stories and submit them to various literary magazines.

Questioning

Questioning is a basic technique used in Cognitive therapy to help the client identify and

only identify it as dysfunctional thinking but also help her learn how to challenge this self-

defeating statement. For example, I may ask Dianne what evidence does she see that she has

faded away into obscurity. I may also incorporate a downward arrow questioning technique to

unimportance (Murdock, 2013). I may ask her for example what it means to her that she has

faded away into obscurity. She may answer that she no longer feels useful or important. I may

then follow up with an additional question of what it means that she is not useful or important.

Dianne may then answer that she is not important because she is no longer helping people.

Through the use of questioning I can help Dianne identify dysfunctional thinking and

dysfunctional core beliefs and challenge them. When Dianne connects with other veterans and

practices challenging her dysfunctional thoughts about her purpose, she will be more open to

understanding how she can have a productive life that is full of purpose outside of her military

career.

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A second intervention I may employ for Dianne is assigning graded tasks. Dianne struggles

with fear that she is not a good enough writer to make writing a viable career. She is intimidated

by the idea of beginning a writing career. Assigning Dianne a graded task such as writing one

short story a week for one month will make the larger goal of achieving a writing career less

daunting. Dianne can focus on one small step at a time that will bring her closer to her ultimate

depression and anxiety over the loss of her careers and the beginning of a new one. She is

intimidated at the idea of failing in a new career and feels she has no purpose since she lost her

previous ones. As her therapist I can brainstorm with Dianne to develop a plan to halt

when she begins to think about her current career situation and her fear of pursuing writing, she

begins to have self-defeating thoughts that essentially paralyze her and cause to feel hopeless. A

problem solving intervention I may employ with Dianne is to have her utilize a turn-off

technique to disrupt the self-defeating thoughts (Murdock, 2013). After disrupting the thoughts I

would advise Dianne to clear her mind by practicing some deep breathing techniques. Finally, I

would advise Dianne to challenge her self-defeating thoughts with positive statements about her

abilities.

Spiritual Application

Incorporating a client’s faith into therapy may be helpful in reducing symptoms of depression

and anxiety (Pearce & Koening, 2016). Dianne is a Christian and regularly reads her bible,

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community and participates in many of their community outreaches. Because Dianne has a

strong faith base, there do not appear to be any conflicts or concerns with incorporating her

spirituality into her treatment plan. One way in which I may incorporate faith into Dianne’s

treatment plan is to encourage her to identify at least three dysfunctional thoughts she has, write

them down and then pray specifically about these thoughts seeking to gain God’s perspective on

purposes.

The Cognitive therapy approach has both compatibilities and incompatibilities with the

Christian faith. One way in which cognitive therapy is compatible with Christian beliefs is in the

saying that “as a man thinks in his heart, so is he…” (Prov. 23:7, New King James Version). In

the Cognitive approach, a central construct is that an individual’s thoughts about something can

determine their behaviors. A person’s thoughts and behaviors can be controlled according to

Jones and Butman’s critique of Cognitive theory and Christianity. Both systems believe that

one’s quality of life can be affected by their thoughts (Jones & Butman, 2011).

An additional similarity between Christian beliefs and Cognitive therapy is the concept of

change or growth. In the Christian worldview change must take place both in the mind,

sometimes referred to as the heart, as well as in the individual’s behavior. In the cognitive

approach, growth is measured in a similar fashion. As a person changes their thought patterns

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(Jones & Butman, 2011).

A third similarity is the view that humans are motivated to enhance their own welfare or

gains. From a Christian perspective this concept can be likened to selfishness or man’s tendency

to desire living in the flesh. Jones and Butman (2011) illustrate this point by saying of the

Christian, “seeing self-enhancement as a core motivation should not be a surprise for persons

perspective it is not always seen as a desirable trait.

One difference between Cognitive therapy and the Christian beliefs is in how human

motivation is viewed by each tradition. In cognitive therapy the human motivation to seek one’s

attached. In the Christian perspective seeking one’s own gain can at times be seen as selfish or

as living in the flesh depending on the behaviors associated with the motivation. For example,

earning money can be beneficial and provide positive gains for one’s welfare; however,

obsessively seeking to earn money to achieve status may be seen as living according to the flesh.

A final incompatibility between Christianity and Cognitive therapy is in the origins of truth.

The Christian faith holds that all truth comes from God. The words of Jesus assert this belief

when he stated, “I am the way, the truth and the life. No one comes to the Father except through

me” (John 14:6, New King James Version). In the Cognitive approach truth is subjective and

comes from the rational thoughts of the individual (Jones & Butman, 2011).

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Cognitive therapy is an approach that is helpful for clients that may suffer from patterns of

dysfunctional thinking. Dianne suffers from depression and anxiety brought on in part by her

dysfunctional patterns of thinking in which she believes she has no purpose and cannot

realistically pursue her writing career. By employing therapeutic techniques such as questioning,

graded tasks and problem solving Dianne will be able to achieve an improved sense of

Accomplishing various graded tasks related to her writing and career progression will instill

greater confidence in Dianne and will help her to view the larger goal of becoming a writer as

being attainable, realistic and less daunting. It is expected that by employing these therapeutic

symptoms and an increase in her confidence, self-esteem and value as a contributing member of

society.