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Shawna, a 24-year-old woman, is experiencing social phobia and psychomotor agitation. This is a psychiatric condition characterized by mental stress and anxiety (Josefowitz and Myran 185). It is evident in Shawna's case by her emotional tenacity, misery, and aimless movements. She explains that she is really scared when she is out in public and alone. This, she claims, happens even while her mother is around. Her issue does not appear to be a new occurrence, but rather stems from her youth; for example, during her first week in kindergarten, she frequently sobbed whenever she was left alone. The condition, however, changed after her father insisting to her to toughen up before reappearing after his death.
Cognitive and Cognitive Behavioral Therapy
To Explain and treat Shawna’s condition, I would use the cognitive and cognitive-behavioral therapies (CBT). From Shawna’s presentation of her issues and giving a special focus to the duration between kindergarten and 17 years of when her condition was not evidenced, there is a clear picture of a distorted thoughts leading to behavioral patterns. The Cognitive behavioral therapies are guided by the ideas that an individual’s thoughts and lead to the individual’s feelings or emotions which culminate in the individual’s behaviors (Albin and Bailey 219).
Negativity and unrealistic thinking can be a major cause of psychological distress which in turn leads to negative impacts and skewed actions. For instance, causing Shawna flee from any public places such as malls, public transport, supermarkets, movie theaters and any other platform that she is not in the company of someone close to her emotionally despite being a grown-up adolescent. She has vague feelings of anxiousness and being terrified that she can possibly pass out or wet herself without anyone to help her. This clearly depicts her thoughts towards such a situation leading to her feeling of insecurity and wanting to cling emotionally to someone close. The two then lead to her behaviors to run away from public arenas. By using CBT to analyze Shawna’s condition it proves that it is her negative interpretations that distort her thinking.
To start with I would try to understand Shawna’s reasons for the persistent fear of getting to the public or interacting with many people to identify the distorted cognitions. I would then assist her in setting recovery goals. The monitoring process will involve setting tasks for her to perform over a period of time and keeping a record of her thoughts while tackling those tasks. This technique will enable her to challenge her own irrational thoughts and beliefs and with time her beliefs will transform (Josefowitz and Myran 218). As a therapist, the process will help me monitor cognition hence teaching her to identify the distortions.
The therapeutic techniques I would put in place include having a social phobia inventory. This is a type of diary and self-evaluation questionnaires and tasks to understand the level of social anxiety disorder, her phobic avoidance of the public and the autonomic symptoms displayed by her. Major areas of focus of the treatment would involve cognitive restructure. These are the techniques that enable a quick modification of an individual’s catastrophic thoughts and negative beliefs (Hofmann and Asmundson 145). They include; organizing pleasurable activities, relaxation training, systematically exposing her thoughts to situations and places that she is avoiding. For instance, setting up a lunch date alongside a friend, acquittance or stranger or an outdoor interesting picnic with a mix of different people. The purposes of such an exposure to Shawna would be to make her realize that their beliefs are false and the feared outcomes of such situations are not true. Over time Shawna, should start to experience the reduction and ultimately the end of anxiety.
Cognitive behavioral therapies are made successful through the collaborative working of both the patient and the therapist towards challenging the thought patterns and behavior activation (Hofmann and Asmundson 187). In the case of Shawna, it will enable her to overcome the obstacles present in her mind and start participating enjoyably in public activities.
Factors to Consider During Clinical Treatment
Among the most important factors in therapy is Ethical considerations. It is inappropriate so subject to the treatment practices to a mentally impaired client without them having an authorized aid (Josefowitz and Myran 239). As the Therapist, I would also consider maintaining privacy between me and the client. This involves not sharing information about the patient to third parties or questioning about unnecessary private information from the patient. Seeking consent from the recommended person is also necessary when planning some of the pleasure activities. Other factors include the situations that initially led to Shawna’s conditions, the culture of her family and how it impacts on her thoughts and essentially her social life. Her social life includes; her closest friends, her interactions with those she trusts and how she interacts with other people. These factors are essential to understanding her background and what affects her most.
Benefits and Limitations of Cognitive-Behavioral Therapies
Cognitive Behavioral therapies are the most widely used modern practices in the clinical treatment of a variety of mental health disorders. The practice is evidence-based and is based on well-conducted empirical research. Unlike the psychoanalysis and the psycho-dynamic which approach issues from the unconscious explanation of behaviors, CBT focuses on the current problem and is action oriented (Hofmann and Asmundson 195). This means treatment is based on a specific diagnosis and the therapeutic actions are meant to assist the patient to address their specific disorder. CBT is also goal oriented. Patients set goals and work toward achieving them periodically. This also acts as a measure of the success of the process to the patients. There is prioritization of the cognitive problems and behaviors and focus is put into addressing the two (Albin and Bailey 210).
CBT puts in action an educational approach. Patients are taught how to monitor and record their own mental pictures and thoughts and hence recognizing how their thoughts affect their emotions and physical reactions. There are also educational experiences on skills to cope with their problems and getting engaged in pleasurable activities (Hofmann and Asmundson 198). Patients are also actively involved in the learning process through assignments which are reviewed for evaluation purposes. Another advantage of the practice is that it is time-limited and takes a short time to recognize a change in behavior as opposed to other therapeutic techniques. However, CBT has some limitations such as being considered as unsuitable to treat complex mental health problems and for people with difficulties in learning. Critics have termed it as having a narrow treatment focus and ignore many important factors such as the historical background, family problems and other emotional issues (Albin and Bailey 187). For instance, the death of Shawna’s father which seems to have brought back the problem cannot be featured in the therapy process.
In conclusion, Shawna’s disorder is best solved with the Cognitive-behavioral approach. This is because despite not considering the historical factors in her condition, it will solve the problem as a current issue which would be more successful and fast opposed to other approaches like the psychoanalysis and psychodynamic. CBT focuses greatly on the patient's motivation to therapy, preparation to deal with the avoided situations, anxiety reduction, increase the self-esteem and modifying the negative thoughts.
Albin, Jayme, and Eileen Bailey. Cognitive behavioral therapy. New York: Alpha, a member of Penguin Group, 2014. print.
Hofmann, Stefan G and Gordon J G Asmundson. The science of cognitive behavioral therapy. London: Academis Press, 2017. document.
Josefowitz, Nina and David Myran. CBT made simple : a clinician's guide to practicing cognitive
behavioral therapy. Oakland: New Harbinger Publications, 2017. document.
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